Back in 2016 in a hot and humid Bangkok at the end of an energetic and inspiring conference England agreed to host the 2018 International Congress on Physical Activity and Health. Two years later over 1,200 delegates from over 69 different countries have come together in London to share, learn and celebrate the journey so far and look to the challenges ahead.
Led by a partnership between Public Health England, ISPAH (International Society for Physical Activity and Health), Sport England and supported by WHO and HEPA Europe, the conference has really reflected the diversity and vibrancy of the global action to address inactivity.
So from a packed agenda of inspirational speakers, e-poster presentations and conversations in the corridors what stood out for me?
First the narrative has changed – in 2018 we are no longer begging for people to understand that physical activity is important to population health, that argument has been clearly set out by WHO in the Global Action Plan on Physical Activity and the call is clear – BE ACTIVE, Everybody, Everywhere, Everyday.
Two years on from Bangkok the discussion and the narrative is now firmly in the how to we accelerate pace and implement the existing evidence base.
In her keynote, the global power influencer, Prof. Fiona Bull set out the call to action for delegates to help us move from talking about the issue to implementing the evidence base at scale across every nation and every community around the world.
The second theme that stood out was healthcare integration.
We have known for over a decade that brief advice by healthcare professionals on physical activity creates a demonstrable impact on patient levels of physical activity.
At ISPAH2018 we saw a suite of excellent presentations, including one from England and one from Scotland, showing how this can be integrated at scale into healthcare systems and this definitely gave hope of more whole system approaches to embedding this into business as usual practice in the clinical world.
This was further strengthened by sessions highlighting the issues and opportunities of physical activity in different disease conditions. There were presentations on physical activity in the context of multiple sclerosis, diabetes, stroke and cancer among others and many more poster presentations in similar space.
The clear health connection was most powerfully made by the attendance of the English Secretary for State for Health, Rt. Hon Matt Hancock, who in a phenomenally busy parliamentary day dominated by Brexit kept his personal commitment to launch the Moving Medicine programme.
Moving Medicine is a fantastic example of how a small amount of funding can kick start a step change in approach. The free resources have been co-produced with front line healthcare professionals as well as their professional bodies and embedded within the reality of daily clinical practice. The tools provide clinicians with simple ways to integrate conversations of two minutes or five minutes into daily interactions with patients tailored to different conditions and common patient symptoms. What is truly inspiring about the approach is the way the Faculty for Sport & Exercise Medicine has worked across specialty boundaries with other medical and nursing colleges and specialisms and with a broad church of disease focused charity partners, realising the benefits of partnership and building on lived experience to make a tool that really works in real life.
These were great examples of translating evidence into practice for every day clinical business.
The third was that evaluation is getting smarter and more embedded into programmes of activity.
There was a strong thread through the conference of the role of technology both in monitoring and evaluating impact and as a vehicle/vector for behaviour change.
The poster sessions particularly demonstrated the growth of evaluation as a key part of programme development, including celebration of the PHE/UKActive partnership Promising Practice where there was demonstrated improvement in evaluation methodology and cultural shift in the physical activity sector linked to an investment in training and awareness raising as well as building better relationships between academics and practitioners.
The examples that really stuck with me were the dynamic ways in which mapping and GPS technology was being used to influence the urban planning and design sector to think differently and seeing the benefits of active design in terms and benefits that they understand.
Technology is not the silver bullet answer, but it’s a great enabler!
Evaluation is also evolving in that we are getting better at considering the needs and focus of commissioners and different federal and state departments who make the key policy decisions. Evaluations increasingly are broadening to reflect business productivity impact, air pollution and congestion outcomes as well as direct health benefits. The policy sessions reiterated that this is fundamental to embedding a whole system approach across policy.
There were also real conversations about the challenges of growing urban living and the reality of ever increasing housing density and the domination of the car as an aspirational brand, a point highlighted in Prof. Richard Wilkinson’s keynote on inequalities.
The final, and perhaps the most important personally, was the fantastic visibility of disability inclusion issues across the conference.
The launch of the new Chief Medical Officer infographic and evidence report on physical activity for disabled adults is groundbreaking and a potential game changer.
There are 11.5 million disabled people in England and nearly half (42%) of them are inactive per week compared to 21% of those with no disability, a two-fold difference.
However, 4 in 5 disabled people report they would like to do more physical activity, highlighting continued barriers that prevent them from being active. As a society we are fundamentally disabling people from taking part in physical activity – and this is more than just the physical barriers for wheelchair access, we are blocking their aspiration with paternalistic messages to rest and reframe from activity. So it is great to see this infographic as a first step in changing this conversation…
Throughout the conference in presentations and in questions from the floor the issue of disability inclusion was a consistent thread – including a question to the Secretary of State for Health on the inconsistency of launching a new resource to encourage activity in people with long term conditions through clinicians and a welfare system that potentially penalises them for getting engaged in physical activity – one he recognised and said he was actively responding to with his colleagues.
So as the conference comes to an end this afternoon and many people return to their normal days, I hope they return inspired, energised and recharged with hope that we can turn the tide of inactivity and create a more active future for everyone!
Dr. Justin Varney 