LISA SPENCER

ASSESSING THE REAL WORLD EFFECTIVENESS OF HEALTM

A CHAT WITH COURTNEY SULLIVAN

MEETING OUR 2015 EXERCISE RIGHT WEEK SUPERHEROS

TOM PENROSE RESEARCH AND COMMUNITY SERVICES GRANT WINNER

CARLTON FOOTBALL CLUB’S SPORTS SCIENCE ANALYST

JUNE 2015

THE YEAR OF THESUPERHERO

www.essa.org.au

STATE % FOR ALL MEMBERS

SA4.5%

NT0.5%

TAS2%

QLD22%

VIC20%

NSW37%WA

12%

NATHAN REEVESPRESIDENT

DR. KADE DAVISONDIRECTOR

PROF STEVE SELIG DIRECTOR

CHRIS TZAR DIRECTOR

SEBASTIAN BUCCHERIDIRECTOR

DR. BELINDA PARMENTERDIRECTOR

ANDREW HAYNES DIRECTOR

LARINA TCHERKEZIANDIRECTOR

PROF. AARON COUTTSDIRECTOR

ANITA HOBSON-POWELLNATIONAL OFFICE EXECUTIVE OFFICER

RACHEL COLLINSP.A. TO THE EXECUTIVE OFFICER

BELINDA BURKE OFFICE MANAGER

RACHEL HOLMES NUCAP MANAGER

VANESSA BROOKE ACCREDITATION SUPPORT OFFICER

ZOE BICKERSTAFFE MARKETING AND COMMUNICATIONS MANAGER

KELLIE DUGGANMARKETING AND COMMUNICATIONS COORDINATOR

EMILY DONOHOEDESIGN AND COMMUNICATIONS OFFICER

SARAH HALL PROFESSIONAL DEVELOPMENT OFFICER

JANETTE FRAZER-ALLEN STANDARDS COMPLIANCE OFFICER

LOUISE CZOSNEKINDUSTRY DEVELOPMENT MANAGER

KATIE WILLIAMSINDUSTRY DEVELOPMENT OFFICER

ALEX LAWRENCEINDUSTRY DEVELOPMENT OFFICER

CARLY RYAN STANDARDS AND COMPLIANCE SUPPORT OFFICER

DR. SHARON HETHERINGTONPROJECT OFFICER HEAL AND INDUSTRY DEVELOPMENT OFFICER

RENEE FITZGERALD MEMBERSHIP SERVICES OFFICER

NARELLE O’LOUGHLINMEMBERSHIP OFFICER

NARDINE PRESLANASSESSOR

MELISSA CREEDASSESSOR

ASHLEE CANNON ADMINISTRATION OFFICER

KRISTY DOBBIEADMINISTRATION OFFICER

CAMELLA HOLLAND-BRIGHTMAN RECEPTIONIST

NAT

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AL B

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AL O

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POSTAL ADDRESS:

Locked Bag 102, Albion DC, Qld 4010Phone: 07 3862 4122 Fax: 07 3862 3588Email: info@essa.org.auWeb: essa.org.au

Disclaimer: Activate magazine has been compiled in goodfaith by ESSA. However, no representation is made as to thecompleteness or accuracy of the information it contains. Inparticular, you should be aware that this information maybe incomplete, may contain errors or may have become outof date. This publication and any references to products orservices are provided ‘as is’ without any warranty or impliedterm of any kind. Subject to any terms implied by law and whichcannot be excluded, ESSA accepts no responsibility for anyloss, damage, cost or expense incurred by you as a result of anyerror, omission or misrepresentation in this publication. ESSArecommends that you contact its staff before acting on anyinformation contained in this newsletter.

ESSA STATS

STUDENTS

AEPs

ASpsFELLOWS

FULL

ASSOCIATE

ACADEMICS

NUMBERS OF MEMBERS/TYPES:

6853,359

29 18

4,02816

40STATE % FOR ALL MEMBERS

ESSA MEDIA RESULTSFACEBOOK LIKES:

9,220

MEDIA RELEASES

35

20 BLOG POSTS

174 MEDIA MENTIONS

TOTAL MEDIA VALUE OF:

1,780TWITTER FOLLOWERS

WWW.ESSA.ORG.AU VISITORS :

120,292

WWW.EXERCISERIGHT.COM.AU VISITORS:

14,385

$662,791

APPLICATIONS

APPLICATIONS

APPLICATIONS

485 470AEP EXERCISE

SCIENCE

ESSA NATIONAL BOARD

22% 78%

MALE FEMALE

3ACTIVATE | JUNE 2015

A WORD FROMI have just returned from beautiful, tropical Cairns after yet another successful ESSA Business Forum. A touch over 200 members made their way north to hear from allied health industry leaders and business experts and I feel everyone left the event filled with information, advice, networking relationships and an abundance of inspiration and motivation to help their business succeed. Each time I attend our business events, I am excited at the level our industry is reaching.

The 2015 ESSA Business Forum also played host to the Annual General Meeting which saw a momentous event for the association. With a vote of 94%, a new constitution was agreed to by the membership. This change will strengthen the organisation and set us up for a resilient and prosperous future. The new constitution will see a number of changes, with a particular focus on the separation of membership and accreditation and the introduction of a ‘Qualification in Exercise Science.’ Of course these changes will take time to implement and the ESSA National Board will be seeking consultation with the membership before implementation.

The AGM also saw the support of two new ESSA National Board members, so I must pass on my congratulations to Dr Simon Rosenbaum and Professor Steve Selig – another exciting step for the association.

Of course the work of ESSA is never done and as we see the Business Forum move along, we will now be focussing on the next conference – Research to Practice 2016 – which will be

held in Melbourne. The event will be the largest exercise and sports science conference in the southern hemisphere and will be bigger and better than the already successful 2014 conference. Keep an eye on the ESSA website for more details as they come in.

By the time you read this our national awareness week, Exercise Right, will have been and gone. The awareness week will continue to grow, and with the support of our members I am sure we will be able to spread the important message of how essential it is to exercise right for who you are and what role an AEP can play in this journey. A huge ‘thank you’ to our 2015 superheroes – Zoe Cole, Marc Roetteler and Vicky Graham – three passionate accredited exercise physiologists who represent our members and the profession. Expert, lifesavers, caring and always available – these are all key traits of a superhero and all of these characteristics are shown by our members each day.

Never give up trying to help and never stop caring, together we will make a difference to the lives of all Australians.

I wish you all a happy exercise right week and appreciate all the super work you carry out each day.

Yours in health,

Anita Hobson-PowellEXECUTIVE OFFICER

THE EO

INDUSTRY DEVELOPMENT,EPAG

PRESIDENTSREPORT

GOVERNANCE, 2014 AWARDS,NATIONAL OFFICE08 GOVERNANCE

08 2014 AWARDS

09 NATIONAL OFFICE

12-13 INDUSTRY DEVELOPMENT

12-13 EPAG

10-11 PRESIDENTS REPORT

CONTENTS

5ACTIVATE | JUNE 2015

ESAG, NUCAP

MARKETING AND COMMUNICATIONS

EIM

HEAL, CONFERENCE, STANDARDS

MEMBERSHIP STATS, FINANCIAL STATMENTS

TREASURER’S REPORT ,PRE EXERCISE SCREENING

13 ESAG14 NUCAP

15 MARKETING AND COMMUNICATIONS

16 EIM

10-11 PRESIDENTS REPORT 17 HEAL

17 CONFERENCE

18 STANDARDS

20-21 MEMBERSHIP STATS

22-48 FINANCIAL STATEMENTS

19 TREASURER’S REPORT

19 PRE EXERCISE SCREENING

CONGRATULATIONS TO ESSA’S NEW FELLOWS IMAGE GALLERY

Adam ScottAwarded fellowship

Adam has a good academic track record but where he really shines is his contribution to firmly establishing the profession

of exercise physiology in being critical for supporting patients with cardiovascular disorders. He has provided excellent

professional service to ESSA and has contributed to the education of a large number of students, particularly in cardiac

testing and rehabilitation.

Andrew Williams Awarded fellowship

Adam has a good academic track record but where he really shines is his contribution to firmly establishing the profession

of exercise physiology in being critical for supporting patients with cardiovascular disorders. He has provided excellent

professional service to ESSA and has contributed to the education of a large number of students, particularly in cardiac

testing and rehabilitation.

Damien Johnston Awarded fellowship

Damien has worked tirelessly for our association and has contributed in major ways to key milestones that have been achieved particularly in terms of advancing our profession. His highly active involvement with numerous boards and committees within ESSA have amply demonstrated his commitment to furthering our profession for well over a decade.

Itamar Levinger Awarded fellowship

Itamar has an outstanding academic track record for an individual at his career stage. He is clearly contributing substantially to advancing knowledge and best practice in the field of exercise and sports science. His work advancing best practice in applications of exercise for cardiac rehab has been highly impactful and greatly increased the recognition of our field as a critical component of patient care. Itamar has also been a very active member of numerous ESSA expert panels and working committees which substantially raises the profile of ESSA as the pre-eminent professional organisation in our discipline nationally.

7ACTIVATE | JUNE 2015

CONGRATULATIONS BUSINESS FORUMIMAGE GALLERY

PROFESSIONAL DEVELOPMENT NEWS

UP C

OMIN

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ENTS

Each topic of this professional development will be supple-mented by case studies or case material, based on de-identi-fied real clients of the presenter, Steve Selig. Case studies will cover some or all of these: referrals [medical input], screening, initial assessments [both low-tech and high-tech approaches], guidelines for exercise testing and exercise prescription.

1. Laws of the Heart in apparently healthy individuals: Cardiac Cycle, Starling, La Place, Fick, Rate-Pressure Product, Coronary Perfusion

2. Acute and chronic exercise for individuals with CVDs encountered by AEPs

a. Major pathophysiological and diagnostic features of common CVDs

i. Conditions to be covered include CAD / IHD, CHF, HT, aortic valve disease, selected congenital heart disease, atrial fibrillation and other common arrhythmias

b. Using the Laws of the Heart to understand pressures, flows, volumes, cardiac dimensions, coronary perfusion and cardiac rate and rhythm (as appropriate to the client presentation) for common CVDs at rest

c. Using the Laws of the Heart to understand pressures, flows, volumes, cardiac dimensions, coronary perfusion and cardiac rate and rhythm (as appropriate to the client presentation) for common CVDs before, during and after acute exercise: guide to screening, monitoring and pre-program exercise assessments

d. Using the Laws of the Heart to predict chronic responses to exercise training for common CVDs: informing exercise prescription and training

3. Workshop de-identified case studies and case problems (in addition to case material in parts 1 & 2 above).

PRESENTED BY: Professor Steve Selig, ESSAM AEP

TRAVELLING TO: Gold Coast, Qld WHEN: 20 June 2015

TARGET AUDIENCE: Any Accredited Exercise Physiologist

PRE-REQUISITES: Pre-reading is required and will be provided to you upon registration

ESSA CONTINUINGPROFESSIONAL DEVELOPMENT POINTS: 9

CARDIOVASCULAR CLINICAL EXERCISE FOR AEPS: A CASE-BASED APPROACH

Focusing on clinical paediatric populations this workshop will focus on the theoretical, practical and key considerations for an exercise physiologist or movement therapist working with children and adolescents working across a range of clinical groups. Pathologies and impairments discussed include obesity and metabolic syndrome, cancer, neurological, musculo-skeletal and neurodevelopmental conditions (e.g. Autism, ADHD, DCD).

Practical case studies will incorporate knowledge and participation of paediatric assessments and exercise programming in a community setting. Participants will be required to demonstrate the selection of appropriate assessment techniques, interpretation of results and implementation of exercise rehabilitation program based on assessment results across a variety of cases and conditions.

PRESENTED BY: University of Western Australia Paediatric Exercise Health Research Group, including Dr Bonnie Furzer, Dr Ashleigh Thornton, A/Prof Siobhan Reid, Dr Melissa Licari, A/Prof Louise Naylor, Ms Kemi Wright & Ms Claire Willis

TRAVELLING TO: Perth, Sydney, Melbourne, Brisbane and Adelaide

WHEN: July – November 2015

TARGET AUDIENCE: Any Exercise Scientist, Exercise Physiologist, Sports Scientist, Sports coaches, Physical education teachers or other allied health professionals working in Paediatrics

PRE-REQUISITES: Completion a university degree in sports science or an allied health discipline with a motor control and/or exercise background, and completion of the ESSA Fundamental movement skills and motor proficiency and development in paediatrics and its impact across the lifespan

ESSA CONTINUINGPROFESSIONAL DEVELOPMENT POINTS: 7.5

EXERCISE REHABILITATION AND ASSESSMENT IN SPECIAL PAEDIATRIC POPULATIONS

9ACTIVATE | JUNE 2015

PODCAST LIBRARY

MONTHLY WEBINARS

OTHE

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ENTS

ESSA is growing a library of podcasts, ranging in topics – make sure you check out the latest podcasts! All podcasts will earn 1 CPD point upon successful completion of an assessment.

ESSA has released a number of podcasts of presentations held at the 6th Exercise & Sports Science Australia Conference and Sports Dietitians Australia Update: Research to Practice, held in Adelaide on 10 – 12 April 2014. If you attended the conference you will receive complimentary regis-tration* for these podcasts for the first 3 months of their release.

To register for any of our podcasts, please visit the ESSA Professional Development Centre > Podcasts.

*To receive complimentary registration for the conference pod-casts, you must have registered and attended the conference, and your podcast registration must be received by ESSA within the set 3 month period.

We have a very exciting year of webinars planned for you this year. Make sure you watch for the webinar announcements in the monthly PD News and via the ESSA Professional Development Centre > Upcoming ESSA Professional Development

POST-OPERATIVE MANAGEMENT FOLLOWING ORTHOPAEDIC SURGERY, PART 1. COMMON KNEE SURGERIES:EVIDENCE-BASED, CLINICALLY DESIGNED REHABILITATION LEADS TO BETTER OUTCOMES

This workshop will form part of a series designed to provide participants with the tools needed to appro-priately rehabilitate patients following a wide array of common orthopaedic surgeries. Part 1, The Knee, will focus on isolated and combined ligamentous reconstruction, meniscal surgery, articular cartilage surgery, surgery for uni and tricompartmental osteoarthritis, and surgical options for tibio-femoral

or patella-femoral mal-alignment. Following workshop completion, patients will have a better understanding of pertinent knee anatomy, biomechanics and relevance to optimal knee function, injury mechanism, clinical assessment of knee injury and the wide array of orthopaedic knee surgeries employed to address these common pathological conditions. Post-op-erative management for these surgeries will be covered, including initial assessment measures and progressive exercise prescription, contrain-dications to exercise throughout the rehabilitative process, potential complications that can arise (and efforts that can be employed to minimise such complications), the use of other functional devices employed post-surgery specific to the different knee surgeries (ie, crutches, bracing etc.) and the post-operative clinical and radiologi-cal assessment of these surgeries.

PRESENTED BY: Dr Jay Ebert, ESSAM AEP

TRAVELLING TO: Sydney, NSW WHEN: 20 June 2015

TARGET AUDIENCE: Exercise Physiologists with 2+ years experience

ESSA CONTINUINGPROFESSIONAL DEVELOPMENT POINTS: 7

2015 ‘MUSCULOSKELETAL HEALTH’ WEBINAR SERIESManaging Back Pain in Primary Care: Incorporating New Research Findings into Clinical Practice17 June 2015, Onlinewww.arthritisvic.org.au 1 CPD point claimable

20TH ANNUAL CONGRESS OF THE EUROPEAN COLLEGE OF SPORT SCIENCE “SUSTAINABLE SPORT”24 – 27 June 2015, Malmo, Swedenwww.ecss-congress.eu/2015/15 1 CPD point per delivery hour; Maximum of 7.5 CPD points per day; Maximum of 15 CPD points claimable

2015 ‘MUSCULOSKELETAL HEALTH’ WEBINAR SERIESSleeping Better – Understanding Common Sleep Problems and Strategies to Assist People to Sleep Better20 July 2015, Onlinewww.arthritisvic.org.au 1 CPD point claimable

2ND ANNUAL PERIOPERATIVE CARDIOPULMONARY EXERCISE TESTING (CPET) AND PREHABILITATION WORKSHOP29 August 2015, Melbournewww.poshdownunder.com 1 CPD point per delivery hour; Maximum of 7 CPD points claimable

SPORTS & EXERCISE SCIENCE NEW ZEALAND CONFERENCELooking to Rio: The Science of Elite Performance31 August – 2 September 2015www.sesnz.org.nz/Conference 1 CPD point per delivery hour; Maximum of 7.5 CPD points per day; Maximum of 15 CPD points claimable

ICDAM91 – 3 September 2015, Brisbanewww.icdam9australia.com 1 CPD point per delivery hour; Maximum of 7.5 CPD points per day; Maximum of 15 CPD points claimable

11TH NATIONAL ALLIED HEALTH CONFERENCE9 – 11 November 2015, Melbournewww.nahc.com.au 1 CPD point per delivery hour; Maximum of 7.5 CPD points per day; Maximum of 15 CPD points claimable

WORLD CONGRESS ON ELITE SPORT POLICY23 – 24 November 2015, Melbournewww.elitesportconference.com 1 CPD point per delivery hour; Maximum of 7.5 CPD points per day; Maximum of 15 CPD points claimable

For a full and up to date listing, please visit the ESSA Professional Development Centre > Other Events & Conferences.

MORE INFORMATIONIf you have any direct queries on your professional development, please contact Sarah Hall, ESSA’s Professional Development Officer on education@essa.org.au.

EXER

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15

THE YEAR OF THE SUPERHERO

The theme of Exercise Right Week 2015 was the superhero. Not just any superhero, but exercise superheroes.

The week celebrated the work of Accredited Exercise Physiologists and the role they play in providing expert advice that could save the lives of Australians.

As part of the campaign we enlisted the help of three Brisbane based volunteer exercise superheroes, in this issue of Activate we wanted to introduce Zoe Cole, Vicky Graham and Marc Roetteler.

ZOE COLE, AEP – FEEL GREAT CHALLENGE

I have been an accredited exercise physiologist since 2010 and I especially love those who are extremely dubious at the beginning then before they know it, they are sleeping better, experiencing less pain and noticing a big improvement in their quality of life.

I love exercise and sport so initially that is what attracted me to start studying sport and exercise science. However, once I realised how much one could benefit from seeing an accredited exercise physiologist I returned to do further education. It is such a crucial component to the allied health world.

Our bodies are genetically designed to be active. Our gene expression changes depending on our levels of physical activity.

I believe that our current lack of physical activity will have a huge impact in the future. We pride ourselves on being a sporting/outdoors nation and doing well at the Olympics regardless of our population. Unfortunately, I think it’s turned into more spectating rather than being active. If Australians can’t reconnect with the great outdoors and increase the level of physical activity, not only will we have fewer

athletes but an increase in depression, stress and anxiety disorders as well as a higher prevalence in lifestyle diseases including diabetes, cardiovascular disease and some cancers.

My advice to people would be do what you enjoy. Keep experimenting with different activities until something clicks for you. It’s so much more than exercising and playing sports.

It’s how you interact with your friends, family and children. When you first become more active, it’s going to feel a little bit like a chore, but that’s because it’s not part of your routine. Practice makes permanence. Some habits you have been doing for most of your life, so be patient as you try to make some new ones.

Get comfortable with discomfort. In saying that, listen to your body. There is a distinct difference between training hard and over training. If your body is sending you alarm bells, take notice…however if it’s just whinging at you, tell it to shut it and keep going!

I wish more Australians would back themselves when they want to make change, not be so hard on themselves when things don’t go to plan and support and care for their family and friends’ health journey too.

11ACTIVATE | JUNE 2015

VICKY GRAHAM, AEP – TRUE NORTH WELLNESS

I have been in the industry for over 25 years but became an accredited exercise physiologist four years ago. I wanted to help people improve their health and quality of life and I believe moving more is one of the simplest strategies that people can use to do this.

My clients range in ages from children to the elderly with a variety of health conditions and injuries. These might be chronic conditions like cardiovascular disease, diabetes or recovery from cancer through to musculoskeletal rehabilitation. Many clients have never seen an AEP before and are not sure how we can help them. I use simple language and break down lifestyle changes into small sustainable steps. It’s important they feel confident they can make these health changes.

Many do see success over time. Often there are other issues that need to be addressed to allow them to make positive lifestyle changes. It’s important to look at the whole person and not just their physical health. I think we are only seeing the beginning of what our sedentary lifestyle is doing

to our health. We now have children leading sedentary lifestyles that will carry through into adult life. This is when we are going to see the real effects of a lifetime of sedentary behaviour. As I was previously a teacher I saw the changes that were taking place with our children and their activity levels. Many are not growing up with a history of active play and exercise which makes it harder in adult life to change these behaviours.

My advice to Australians would be to get the right support is important, particularly if there are medical conditions or injuries. Seek out advice from a qualified health professional, and an accredited exercise physiologist is the right person to provide that for them. We have the knowledge, skills and experience to help people improve their health through simple lifestyle changes. Every day I go into work hoping to inspire and empower people to discover their true health potential.

Have you checked out the Exercise Right website yet? Do it today at- www.exerciserightweek.com.au

MARC ROETTELER, AEP - FIRST STEP REHAB

I became an exercise physiologist by accident! When I graduated from high school all I knew was that I enjoyed being active, and that I wanted to help people. I was in my second year before I even knew what an exercise physiologist was! As soon as I read up about what you can do for people as an exercise physiologist, however, I haven’t looked back.

As an accredited exercise physiologist I am responsible for giving people any and all information they need to start a more healthy life. I am proud to be an accredited exercise physiologist because I feel we provide an important service that can change people’s lives. I try to make exercise a positive experience. Exercise isn’t a fun thing to talk about for people who have never even tried it before, so making the experience as positive as possible is the best course of action.

It’s been shown time and time again through research how important an active lifestyle is to health. With the rise of chronic disease throughout the general population, it’s more important than ever to have people wake up and

realise how many of their issues can be improved by simply going for a 30 minute walk each day.

The group that worries me most is the younger generations, especially with regards to their skeletal development. We all know loading the bones in the younger years is important down the track for maintaining bone density and preventing osteoporosis. I worry that the rise of exercise-free entertainment is putting these children at serious risk. Australians need to start moving more no matter what age they are. If you have any concerns on where to start, find your nearest exercise physiologist. They have both the tools and training to provide you with the guidance you require to put your mind at ease.

I wish more Australians would realise just how easy it is to be healthy.

TOM PENROSE RESEARCH AND COMMUNITY SERVICES GRANT WINNER

LISA SPENCERA CO

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WIT

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I am excited to have the opportunity to share with ESSA members the background for my PhD research and my gratitude at being the recipient of the Tom Penrose Research and Community Services Grant for 2014. I hope you will find this area of health research interesting and be able to see how it could benefit practitioners working with a range of clinical populations.

Firstly, about me. I am a dual qualified Accredited Exercise Physiologist and Accredited Practising Dietitian currently completing my PhD candidature at the University of Newcastle. I graduated from Griffith University (Gold Coast) with a Bachelor of Exercise Science in 2009 and a Master of Nutrition and Dietetics in 2011. Before commencing my PhD in April 2014, I worked in a dual-professional capacity across a variety of settings including aged care, chronic disease management, population health, paediatric obesity and telephone based health coaching.

I had always been passionate about obesity prevention and felt that I wanted to pursue a career researching nutrition and exercise strategies to reduce the burden of obesity and chronic disease, and particularly how to translate these strategies to practice. This led me to connect with the phenomenal research team at the Priority Research Centre for Physical Activity and Nutrition at the University of Newcastle. My supervisory team now includes Professor Clare Collins, Dr Megan Rollo and Dr Melinda Hutchesson. Broadly, the aim of my PhD research is to investigate effective and innovative approaches to weight management following childbirth.The prevention and treatment of overweight and obesity in Australia is a key health priority. Pregnancy has been identified as a risk factor for obesity and despite women being recommended to achieve a healthy weight prior to conceiving

a baby,1 up to half of women in Australia enter pregnancy overweight or obese.2 This is an issue as maternal obesity increases the risk of a number of adverse health outcomes for both mother and child including gestational diabetes, hypertensive disorders of pregnancy, non-elective caesarean delivery and large-for-gestational-age infants.3 In addition to this, around half of women exceed Institute of Medicine recommendations for weight gain during pregnancy which also increases their risk of adverse maternal and child health outcomes.4Of additional concern is that many women then go on to retain gestational weight following childbirth. Previous research has demonstrated that post-partum weight retention six and twelve months following childbirth is a predictor of long term obesity.5, 6 Further, an increase in maternal weight of ≥1 unit of BMI between first and second pregnancy has been shown to increase the odds of a number of adverse maternal and child health outcomes.7 With the fertility rate in Australia just over 1.9 births per woman (2012)8 it can be seen that for many women, the post-partum period can easily become the pre-conception period for their subsequent pregnancy, making weight management at this life-stage critically important.

Regular physical activity is recommended following childbirth for a range of health benefits including weight management. Additionally, the Australian Medical Association’s position statement on Women’s Health recommends

support for health to be provided to mothers throughout the postpartum period.9 This echoes the recommendation from the Institute of Medicine for women to be offered counselling on diet and physical activity following pregnancy to assist them to reduce postpartum weight.1We know that Accredited Exercise Physiologists are well placed to provide exercise prescription, education and counselling for women following childbirth based on their expertise working with high-risk and complex populations. However, despite this, the ability for health professionals to engage women during this life-stage is very difficult. Women are busy caring for their new infant as well as maintaining other household and work commitments. These competing commitments, in addition to potential geographic factors of women and service providers, create barriers to accessing traditional face to face healthcare.

Telehealth, utilising telecommunication and information technology as an alternative, or supplement, to face-to-face delivery provides a new approach to traditional healthcare.10 Telehealth provides the opportunity for postpartum women to access specific exercise support by an AEP, to assist in exercise prescription, education and counselling for weight management regardless of the previously identified barriers. Research broadly in to Allied Health Professionals using telehealth indicates patient and provider satisfaction, similar clinical outcomes to face-to-face and

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SMARTMOVEMENT

2015 SEMINARS

E: info@smartmovement.com.auW: www.smartmovement.com.au

Dr Robert CrowtherBSpExSc(Hons), PhD, ESSAM, AEP

Miss Jessica PohlmannBExPhys(Clinical), ESSAM, AEP

M: 0468 994 722

SM ONLINE CONSULT SEMINARS

Gait Rehabilitation & Retraining - 8 CEP

Ecological Dynamic Rehabilitation - 8 CEP*NEW

1. Perth - 13 Jun2. Melbourne - 8th Aug

4. Sydney - 10th Oct5. Brisbane - 12th Dec

1. Brisbane - 16th May2. Sydney - 4th Jul

4. Melbourne - 12th Sep5. Perth - 28th Nov

3. Adelaide - 5th Sep

3. Adelaide - 5th Sep

13ACTIVATE | JUNE 2015

some potential cost savings.10 However, evidence for the use of telehealth by many allied health practitioners including Exercise Physiologists is very limited, particularly in women following childbirth. Given the rapid evolution of technology and readily available access many Australians have to information technology and internet connectivity,11, 12 AEPs are presented with a unique opportunity to engage with postpartum women to achieve improved health outcomes.

Knowing this, we wanted to test a technology based intervention targeted at women following childbirth to see if remotely delivered exercise care was feasible, particularly in this population. So with the support of the Tom Penrose Research and Community Services Grant from ESSA we will be able to investigate the implementation, acceptability and preliminary efficacy of a postpartum exercise program delivered by an AEP via video conferencing. We envisage that findings from this research will be able to provide some much needed evidence regarding remote delivery of exercise care, which will also have direct applications to a variety of clinical populations. Obesity management is a significant challenge for Australia, and indeed the world, and innovative approaches to healthcare need to be explored to

help fight the growing problem. And whilst this research project is aimed at improving the health of women following childbirth, our hope is to see it applied across a range of clinical populations enabling AEPs to provide exercise care to even more Australians.

Finally, I want to extend a big thank-you to ESSA for the Tom Penrose Research and Community Services Grant for helping me pursue my passion for obesity prevention, and enable us to undertake this exciting research. I hope to be able to keep ESSA members updated on the progress of our research!

REFFERENCES

1. Institute of Medicine (US). Weight gain during pregnancy: reexamining the guidelines. Washington DC: National Academies Press; 2009.

2. Hilder L ZZ, Parker M, Jahan S, Chambers GM. Australia’s mothers and babies 2012. Cat. no. PER 69. ed. Canberra: AIHW; 2014.

3. Dodd JM, Grivell RM, Nguyen AM, Chan A, Robinson JS. Maternal and perinatal health outcomes by body mass index category. Australian & New Zealand Journal of Obstetrics & Gynaecology. 2011 Apr;51(2):136-40.

4. Al Mamun A, Mannan M, O’Callaghan MJ, Williams GM, Najman JM, Callaway LK. Association between gestational weight gain and postpartum diabetes:

evidence from a community based large cohort study. PLoS One. 2013;8(12):e75679.

5. Linne Y, Dye L, Barkeling B, Rossner S. Long-term weight development in women: A 15-year follow-up of the effects of pregnancy. Obesity Research. 2004 Jul;12(7):1166-78.

6. Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol. 2002 Aug;100(2):245-52.

7. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006 Sep-Oct;368(9542):1164-70.

8. Australian Institute of Family Studies. Family facts and figures: Births [Internet]. 2012. Available from: http://www.aifs.gov.au/institute/info/charts/births/.

9. Australian Medical Association. Women’s Health - 2014 [Internet]. 2014. Available from: https://ama.com.au/position-statement/womens-health-2014.

10. Raven M BP. Allied Health video consultation services. In: Review. PRPI, editor.: Adelaide: Primary Health Care Research & information Service; 2013.

11. Australian Bureau of Statistics. 8146.0 Household Use of Information Technology, Australia 2012-2013 [Internet]. 2014 [08/09/2014]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/8146.0Chapter32012-13.

12. ACMA. Australia’s mobile digital economy - ACMA confirms usage, choice, mobility and intensity on the rise [Internet]. 2013 [08/09/14]. Available from: http://www.acma.gov.au/theACMA/Library/Corporate-library/Corporate-publications/australia-mobile-digital-economy

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NEW_sh_booklet_8pp.indd 1 19/09/2014 10:31:15 AM

COURTNEY SULLIVAN

ACTIVATE | JUNE 2015 15

– CARLTON FOOTBALL CLUB’S SPORTS SCIENCE ANALYST

A CHAT WITH COURTNEY SULLIVAN

MEM

BER FOCUS

Courtney – so glad you could speak with us. Tell us a little about your current role.

I’ve been a Sports Science Analyst with Carlton for four years now, I was initially offered an As-sistant Sports Science role following graduation from my Human Movement undergraduate degree at RMIT University.

My role as a Sports Scientist is primarily con-cerned with monitoring individuals and the team and their ability to cope with the demands of our AFL high performance program. This is achieved by applying evidence based processes such as training load analysis, GPS, subjective wellness questionnaires, hydration analysis and testing of physical capacity. A large part of my role is also concerned with developing and evolving internal research projects.

How about challenges – what are the main ones you face in your position?

Educating players and staff around evidence based practice and the interpretation of the data that we collect. Another constant challenge is listening to the questions that coaches and performance staff have and developing tools or processes that can effectively answer those questions. The sophistication of program devel-opment now allows for the cross-collaboration of some of our data which means we can now solve some of these questions that have previously been impossible to answer –not to mention the research potential of such data. This kind of collaboration however often comes with many challenges such as software bugs and manual data entry.

How did you find university?

I really enjoyed university. I found that starting my degree at 23 meant that I had developed a certain level of independence and was focused and com-mitted to doing well. My class was quite small with only 40 or so students and therefore we bonded well and became close friends. While there were certainly fun times, I was committed to learn as much as possible about Sports Science and gain the most practical experience I could. I found the program itself challenging at times, particularly the biology and anatomy courses as I didn’t take any science electives in my HSC years, howev-er remaining focused and dedicating myself to understanding the course content while studying hard for exams contributed to graduating with First Class Honours.

Did you always have your heart set on a career in Sports Science?

No. I originally began studying Graphic Design through the TAFE system. I applied for a degree in visual communication however was not suc-cessful in gaining a place. I had no back-up plan but needed to shape a career for myself. I had always been interested in sport and health and therefore studied the certificate 3 and 4 in fitness and worked in a gym environment for a few years. While I enjoyed this work, I am an ambitious per-son and always knew that I would return to study someday. Sports Science was the obvious choice!

You made the decision to gain your accreditation, why was that?

I believe it will soon be mandatory for all Sports Scientists and therefore wanted to ensure I was ahead of the field.

The reputation of Sports Science within AFL is no doubt still recovering from the recent drugs in sport saga which may have been avoided if an appropriate accreditation framework was in place. I also believe that it should be simple for employ-ers to determine the qualifications and practical experience potential employees possess. The ESSA Sports Science accreditation framework allows for this.

What’s it like working in an industry traditionally dominated by men?

I don’t put too much thought into that to be honest. My colleagues have always been supportive and respectful and I often forget that I’m in the minority when I walk into work. The stigma of football being a man’s world needs to be broken down. My role requires expertise in Sports Science and the ability to communicate and relate to my colleagues – in my opinion gender should never come into the equation.

Quick fire question time?Do you have any favourite sports (outside of AFL?)?

I participate in a few sports socially however, AFL

tends to take up a lot of my time. My partner is an engineer for a V8 Supercar race team so I really enjoy following the V8s. We often draw parallels between our work. He was very helpful when I was studying biomechanics!

Favourite Carlton player past or present?

It is difficult to view sport as a fan when you have been involved at the elite level and important to remain professional at all times. As long as players are training and available for matches we are happy!

What are your thoughts on Carlton’s upcoming season?

It is really great after such a long pre-season training phase to finally be coming to the start of the home and away season and with the majority of our playing list available for matches. There is a real buzz around the club as we all anticipate what the season will bring.

You are obviously keen on exercise yourself! How do you keep fit?

I try to exercise for health and longevity and there-fore include regular weight training and walking in my weekly routine. I also keep active by playing netball and jogging and have recently taken up mountain biking which is a bit of a challenge but also a great way to get outdoors, reduce stress and see some beautiful parts of Victoria.

What are your plans for the future? Where do you see yourself in 10 years time?

Elite sport is volatile with large player and staff turnover. While I enjoy the organised chaos of Australian Football now, I would like to think that I would have a more secure position in 10 years time that incorporates teaching and research in a ter-tiary environment. I would expect to still be heavily involved in applied Sports Science research across a number of sports with talent development being a major focus. I would also like to be involved in mentoring some emerging graduates who are finding their feet early in their careers.

The stigma of football being a man’s world needs to be broken down...in my opinion gender should never come into the equation.

“ “

A Chat with Courtney Sullivan – Carlton Football Club’s Sports Science Analyst

As the footie season gets under way, we asked Courtney to spare a few minutes to have a chat with us about her role with Carlton FC. The

Accredited Sports Scientist has been working feverishly behind the scenes to help the boys in blue on the road to glory.

RESE

ARC

H A

RTIC

LE

ASSESSING THE REAL WORLD EFFECTIVENESS OF THE HEALTHY EATING ACTIVITY & LIFESTYLE (HEAL™) PROGRAM

Sharon A HetheringtonAD, Jerrad A BorodziczB, CeciliaM ShingC

ABSTRACTISSUE ADDRESSED: Community-based lifestyle modification programs can be a valuable strategy to reduce risk factors for chronic disease. However, few government-funded programs report their results in the peer-reviewed literature. Our aim was to report on the effectiveness of the Healthy Eating Activity & Lifestyle (HEAL™) program, a program funded under the Austra-lian government’s Healthy Communities Initiative.

METHODS: Participants (n = 2,827) were recruited to the program from a broad range of backgrounds and completed an hour of group based physical activity followed by an hour of lifestyle education weekly for 8 weeks. Physical activity, sitting time, fruit and vegetable consumption, anthropometric measures, blood pressure and functional capacity data were gathered at baseline and post-program.

RESULTS: HEAL™ participation resulted in significant acute improvements in frequency and volume of physical activity, re-ductions in daily sitting time and increases in fruit and vegetable consumption. HEAL™ participation led to reductions in total body mass, body mass index, waist circumference and blood pressure and to improvements in functional capacity (p < 0.001).

CONCLUSIONS: Based on these findings and the coordinated approach to program delivery, the HEAL™ program warrants consideration as a behaviour change strategy in primary health care networks, local government or community settings.

SO WHAT? These findings should inform future policy develop-ment around implementation of lifestyle modification programs; they strengthen the case for support and promotion of lifestyle modification programs to improve public health, lessening the financial and personal burden of chronic conditions.

INTRODUCTIONResearch evidence points to the efficacy of lifestyle modification programs in the prevention and treatment of conditions such as obesity, diabetes and cardiovas-cular disease. Key features of efficacious programs have been reported to include delivery by highly trained staff, inclusion of behaviour change education and goal setting techniques and targeting multiple physical activity and nutritional goals si-multaneously1-4. Baker et al.1 noted that the challenge was to translate efficacious pro-grams into effective programs implemented in a real world setting. Compared with other approaches, multi-component group-based interventions built on proven theoretical frameworks have been reported to be more effective in increasing physical activity3. However, it has been reported that few government-funded programs disseminate their results and experiences through the peer-reviewed literature limiting what might be learnt from these programs5.

In this paper we attempt, in part, to redress this by reporting results from the HEAL™ (Healthy Eating Activity & Lifestyle) pro-gram, a group-based, lifestyle modification program. HEAL™ was a National Program Grant (NPG) recipient under the Austra-lian government’s Healthy Communities Initiative (HCI) which supported local governments to deliver evidence-based community physical activity and healthy eating programs.6 Application to become one of the six NPG recipients was a competitive process requiring applicants to demonstrate significant evidential support for their programs. This was to ensure that local governments had a selection of evidence-based programs they could implement with confidence, helping to overcome reported difficulties in local gov-ernment accessing, and using, research

evidence in health promotion7. NPG funding was used to expand HEAL ™ resources, train & support facilitators Australia wide and to gather evaluation data. Data reported in this paper comes from HEAL™ programs completed during the HCI period (1 July 2010 to 31 May 2013) and shows the short term effects of program participation on participant behaviour change and on participant health indicators.

METHODOLOGYPARTICIPANTS

The aim of the HCI was to provide access to physical activity and healthy eating programs for disadvantaged Australians, particularly those out of the paid workforce. Target groups were identified within local government applications for HCI funding and councils recruited participants through a combination of media advertising, online advertising, brochures and posters placed in community venues and by canvassing local health services and general practi-tioners. A Health Communities Coordinator was employed in each council area that received HCI funding to oversee implemen-tation. HEAL™ programs were delivered to participants from a range of low socio-eco-nomic backgrounds including; retirees, Ab-original people, refugees, migrants, young mothers and people living with a mental or physical disability. Participants complet-ed an individual pre-program screening and assessment. Informed consent was obtained before proceeding with screening and assessment. The Adult Pre-Exercise Screening System (APSS)8 was used to risk stratify participants with those who answered yes to one or more questions in stage one of the APSS being asked to seek a referral from their doctor or an appro-priately qualified allied health practitioner prior to starting the program.

PROGRAM

The HEAL™ program is an eight-week, group-based lifestyle modification program designed for people with, or at risk of developing, chronic conditions such as obesity, diabetes and cardiovascular disease. HEAL™ was developed by a team of exercise physiologists, dietitians and chronic disease specialists at South Western Sydney Medicare Local (SWSML) and has been operating in their local health district for 12 years. In partnership with Ex-ercise & Sports Science Australia, SWSML were successful in securing HCI funding to expand the program nationwide; this fund-ing was used to administer the program, produce resources and to train and support facilitators in those local government areas that opted to run HEAL™ as one of their HCI interventions. Program implementation and achievement of project milestones were monitored by the Department of Health and Ageing. Quantitative and qualitative reports were submitted to the department every six months during the HCI period.

PROGRAM DEVELOPMENT

The development of the HEAL™ program education content was based on the ‘Transtheoretical Model and Stages of Change’ described by Prochaska et al.9.

The constructs from this model that guided program development were:

1. consciousness raising: finding and learning new facts, ideas, and tips that support healthy behaviour change

2. environmental reevaluation: realising the negative impact of unhealthy behaviour or positive impact of healthy behaviour on one’s proximal social or physical environment

17ACTIVATE | JUNE 2015

3. self reevaluation: realising that behaviour change is an important part of one’s identity as a person

4. self-liberation: making a firm commitment to change

5. helping relationships: making use of social support for healthy behaviour change

6. counterconditioning: substitution of healthier alternative behaviours and cognitions for the unhealthy behaviours

7. contingency management: develop contracts, overt and covert reinforcements and incen-tives to maintain change

Table 1 shows the HEAL™ education session content and associated constructs. Combining exercise and education in every session was based on evidence for the effectiveness of combined lifestyle education and physical activity sessions in preventing chronic condition development or progression10, 11.

PROGRAM DELIVERY

Each week participants completed an hour of super-vised group exercise followed by an hour of lifestyle education. The exercise content was adapted to suit

the needs and interests of the participant group with the main stipulation being that activities not exceed a moderate intensity. Examples of activities undertaken include; aerobic circuit classes, weights sessions, supervised walks, traditional dance, outdoor gym sessions, aqua aerobics, modified boxing classes and line dancing. In some cases the exercise sessions were conducted by an exercise physiologist and the education sessions by a dietitian but in the majority of cases the education and exercise were conducted by the same facilitator due to workforce limitations or cost considerations.

SESSION TITLE SESSION TOPICS INTERVENTION COMPONENTS

LINK TO PROCESSES OF CHANGE

YOUR HEALTH AND YOUR CHOICES

Causes of weight gain, Health risks, Healthy choices

Identify modifiable and non-modifiable causes of weight gain and disease risk, ‘Choice & lifestyle game

Environmental re-evaluation

Self-reevaluation

PHYSICAL ACTIVITY

Impact of technologyWhy is it good for us?, Types of activity Australian guidelines

Discussion on modes of physical ac-tivity, guidelines and the benefits of being physically active, Participant makes a physical activity contract

Consciousness raisingEnvironmental reevaluation

Self-liberation

WHAT IS HEALTHY EATING?

The Australian guide to healthy eating, Energy balanceCarbohydrates & proteinAlcohol

Presentation on portion sizes, serves and the healthy plate modelGroup discussion on energy balancePresentation on nutrients in the diet

Consciousness raising

Self-reevaluation

FAT IN YOUR DIETTypes of fatAmount of fat in foodLow fat cooking methods

Identification of the types and amount of fat in a variety of foods, Discussion of alternate cooking methods

Consciousness raisingEnvironmental reevaluationCounterconditioning

EATING OUT AND MEAL PLANNING

Eating outHealthier meal choices

Presentation and discussion on healthier eating when away from home and modifying recipes to be lower in fat

Consciousness raisingEnvironmental reevaluationCounterconditioning

LABEL READINGPractical session in label readingSupermarket tour (if included)

Practical session on learning to read labels and interpreting the in-formation to make healthier choices

Consciousness raising

PLANNING FOR A HEALTHY LIFESTYLE

Making changesStaying on trackMaintaining changes

Discussion on goal setting and SMART goals, Identifying barriers to achieving goals, Making an action plan for staying on track

CounterconditioningHelping relationshipsAlso elements of contingency management

FOOD MYTHS AND NON-HUNGRY EATING

Exposing myths and misconceptionsNon-hungry eating

Identify common myths around food and eating, Identify triggers to eating and develop plans to combat those triggers, Learn about eating with awareness

Self-liberationCounterconditioning

TABLE 1: HEAL™ EDUCATION SESSION CONTENT

Barring illness the entire eight weeks was facilitat-ed by the same person or teaching combination. The program was delivered in a wide variety of lo-cations across 67 local government areas including; community halls, exercise studios, meeting rooms, Aboriginal health centres, refugee accommoda-tion centres and, in one instance, in the local pub. Location selection was the responsibility of the sup-porting council or local facilitator. Participants were deemed to have completed the program if they had attended at least six of the eight sessions.Each participant received a manual containing the education slides and support materials, group discussion points, home-based activities and a home exercise program. In response to suggestions from HEAL™ facilitators an abridged version of the participant manual was developed for people with low English literacy and for those from non-English speaking backgrounds. An Aboriginal and Torres Strait Islander version of the manual and promotion-

al resources were also produced, as was an A3 flip chart version for use during yarning sessions and cook-ups.

FACILITATORS

HEAL™ was facilitated by university-trained allied health professionals, predominantly exercise phys-iologists and dietitians. HEAL™ facilitator training included instruction in pre-exercise screening procedures and risk stratification; assessment procedures; understanding & delivering education session content; adapting & delivering the exercise session content; principles of self-managed change; active listening skills & an introduction to motivational interviewing; and program promotion, referral pathways, data entry and administrative functions. Facilitators participated in competen-cy-based assessments and had to pass a written theory assessment before receiving certification.

DATA COLLECTIONPhysical activity and sitting time data were gath-ered by survey at individual baseline and post-pro-gram assessments. Physical activity questions were based on the Active Australia Survey12 and included an estimation of the total weekly minutes spent; walking for more than 10 minutes for fun, fitness or transport; completing other physical activity (not walking) done for fun, fitness or sport; or in gardening or household chores that made participants breathe harder or “puff”.

Daily fruit & vegetable consumption were gathered from answers to questions one (fruit) and six (vegetables) on the Fat and Fibre Barometer questionnaire13 which asks participants to estimate their average daily serves of fruit and vegetables. Anthropometric data (height in metres, body mass (kg), body mass index (BMI) and waist circumfer-ence in cm); systolic and diastolic blood pressure;

DISCUSSIONThe HEAL™ program aims to assist people with, or at high risk of developing, chronic conditions to achieve positive lifestyle changes. Participants are encouraged to become more physically active, to decrease their sitting time, increase their fruit and vegetable consumption and to follow a low fat, high fibre diet. The program achieves this through group-based moderate intensity physical activity sessions combined with lifestyle education sessions.

BEHAVIOUR CHANGE

Improvements in post-program outcome vari-ables suggest that the program was successful in achieving its aims. HEAL™ participants were found to have significantly increased the quantity and frequency of their weekly physical activity and reduced their average daily sitting time. This is important because low levels of physical activity and prolonged sitting time have been shown to be independent risk factors for all-cause mortality14-16.

HEAL™ participants also achieved significant increases in fruit and vegetable consumption. Results from the 1995 Australian National Nutrition Survey and 2011-2012 Australian National Health Survey indicated that while 50% of people surveyed were eating two or more serves of fruit a day, only 20 - 30% were eating four or more serves of vegetables17, 18. By comparison, post-program 75% of HEAL™ participants reported eating two or more serves of fruit a day (an increase of 63% from baseline) and 31% reported eating four or more serves of vegetables a day (an increase of 17% from baseline). These increases in fruit and vegetable consumption by HEAL™ participants were noteworthy as education content on fruit and vegetable serving size and recommended intakes constituted just a small part of week 3 content and yet this information had been retained and acted upon. Additionally, in interviews conducted for the six-monthly qualitative evaluations, HEAL™ facilitators reported that, in general, participants began the program with low health and nutrition literacy levels. It appears then that what was new nutritional information to these participants about

fruit and vegetable consumption was understood and incorporated into participants’ lives.

Improvements in fruit and vegetable consumption also need to be viewed in the context of associated health benefits which include reductions in the risk of coronary heart disease (CHD)19, stroke20 and dia-betes21 and, because of their relatively low energy density and high fibre content, weight loss22.

ANTHROPOMETRY

Improvements in HEAL™ participants’ physical activity and eating behaviours led to reductions in waist circumference, body mass and BMI. Research has highlighted that decreases in these measures are associated with improved health outcomes. For example, greater waist circum-ference has been associated with an increased risk of cardiovascular disease and all-cause mortality risk23 highlighting the importance of the significant reductions achieved by HEAL™ participants. Uusitupa et al.24 reported that insulin sensitivity was markedly improved by weight loss,

RESULTS

PROGRAM DELIVERY

To May 31st 2013, 310 HEAL™ facilitators had been trained to deliver the program; these were predom-inantly exercise physiologists (47%) and dietitians (16%) but also included registered nurses (11%), physiotherapists (5%) and Aboriginal health work-ers (5%). Facilitators had been trained to deliver the program in 67 of the 92 HCI local government areas. To this date 297 HEAL™ programs had commenced.

PARTICIPANTS

To May 31st 2013, 2,827 participants had started in a HEAL™ program: of these 56% reported having a health care card. The government used the health care card as an indication of the participants’ so-cioeconomic status in order to monitor whether the HCI target group was being reached. To this date 61% of participants had completed the program and returned for post-program testing. Females consti-tuted 78% of HEAL™ attendees (n = 2,213) with an average age of 58 ± 14 years; males (n = 614) had an average age of 60 ± 15 years. There were significant improvements in all outcome variables (p < 0.001) for participants completing the program (see Table 2). These included increases in level and frequency of physical activity; reductions in daily sitting time; increases in daily serves of fruit and vegetables consumed; reductions in body mass, BMI, waist circumference, blood pressure; and improvements in measures of functional capacity. At baseline 60% of participants were not meeting recommended physical activity levels (210 minutes per week) while at post-program testing this had dropped to 45%.

For those who completed the participant satisfaction survey (n=568) 98% reported that: participa-tion had increased their awareness of the risks of physical inactivity and unhealthy eating choices; increased their knowledge of healthy physical activity and eating; and increased their skills with regard to setting goals and planning for a healthy lifestyle. Additionally 97% reported that they intended to change their lifestyle by maintaining healthy physical activity and eating practices.

OUTCOME MEASURE N BASELINE POST-

PROGRAMT-TEST P VALUE

PHYSICAL ACTIVITY (MIN/WEEK) 1728 248 ± 306 301 ± 313 <.001

PHYSICAL ACTIVITY (DAYS/WEEK) 1256 3.9 ± 2.3 4.8 ± 1.9 <.001

SITTING TIME (HOURS/DAY) 1220 5.2 ± 3.4 4.5 ± 3.2 <.001

VEGETABLES (SERVES/DAY)

1304 2.4 ± 1.4 3.0 ± 1.4 <.001

FRUIT (SERVES/DAY) 1307 1.7 ± 0.9 1.9 ± 0.8 <.001

BODY MASS (KG 1492 87.5 ± 20.7 86.5 ± 20.5 <.001

BMI (KG / M2) 1463 32.5 ± 6.9 32.0 ± 6.8 <.001

FEMALE WAIST (CM) 1155 101.8 99.2 <.001

MALE WAIST (CM) 350 112.8 ± 15.3 110.8 ± 16.6 <.001

SYSTOLIC BP (MMHG) 1406 134 ± 18 131 ± 17 <.001

DIASTOLIC BP (MMHG) 1406 80 ± 12 77 ± 11 <.001

6 MINUTE WALK (M) 1357 444 ± 148 493 ± 160 .001

30 S CHAIR RISE (N) 1371 12.9 ± 3.9 15.2 ± 4.8 .001

TABLE 2: BASELINE AND POST-PROGRAM OUTCOME MEASURE AVERAGES WITH T-TEST P VALUES

and functional capacity measures (6 minute walk test & 30-second chair rise) were also gathered by facilitators at these time points. Participants were invited to complete a satisfaction survey at the conclusion of the program. All assessment items were voluntary.

Facilitators entered quantitative participant data into individually coded spreadsheets and sent the most up to date copy of their spreadsheet to the HEAL™ project team staff every six months. A cus-

tom written database application was used to im-port spreadsheet data, produce reports and export the complete dataset for analysis. Qualitative data were gathered via telephone interviews conducted by the national HEAL™ project team with 12 healthy communities coordinators, 21 HEAL™ facilitators and 39 HEAL™ participants. Interviewees were a purposive sample from 12 local government areas that had opted to implement the HEAL™ program. Interview questions included success of engage-ment with HCI target groups, program reach and

effectiveness and participant characteristics.

DATA ANALYSIS

SPSS (version 11.5) was used for data analysis, baseline to post-program differences were assessed using paired sample t-tests. Data are presented as mean ± standard deviation. The study was approved by the Tasmanian Human Research Ethics Committee (H0013949).

OUTCOME MEASURE N BASELINE POST-

PROGRAMT-TEST P VALUE

PHYSICAL ACTIVITY (MIN/WEEK) 1728 248 ± 306 301 ± 313 <.001

PHYSICAL ACTIVITY (DAYS/WEEK) 1256 3.9 ± 2.3 4.8 ± 1.9 <.001

SITTING TIME (HOURS/DAY) 1220 5.2 ± 3.4 4.5 ± 3.2 <.001

VEGETABLES (SERVES/DAY)

1304 2.4 ± 1.4 3.0 ± 1.4 <.001

FRUIT (SERVES/DAY) 1307 1.7 ± 0.9 1.9 ± 0.8 <.001

BODY MASS (KG 1492 87.5 ± 20.7 86.5 ± 20.5 <.001

BMI (KG / M2) 1463 32.5 ± 6.9 32.0 ± 6.8 <.001

FEMALE WAIST (CM) 1155 101.8 99.2 <.001

MALE WAIST (CM) 350 112.8 ± 15.3 110.8 ± 16.6 <.001

SYSTOLIC BP (MMHG) 1406 134 ± 18 131 ± 17 <.001

DIASTOLIC BP (MMHG) 1406 80 ± 12 77 ± 11 <.001

6 MINUTE WALK (M) 1357 444 ± 148 493 ± 160 .001

30 S CHAIR RISE (N) 1371 12.9 ± 3.9 15.2 ± 4.8 .001

ACTIVATE | JUNE 2015 19

while Anderson and Knoz25 reported that for every kilogram of weight loss in their study participants there were associated favourable changes in blood biochemistry, blood pressure and blood glucose levels. Mertens and Van Gaal26 suggested that even modest weight loss had the potential to normalise blood pressure.

FUNCTIONAL CAPACITY

Increases in physical activity also led to improved functional capacity, as measured by the six-minute walk test and 30 second chair rise test. Improved functional capacity bestows a multitude of benefits including increased ability to participate in activities of daily living and a lower fall risk for older adults27. It has been suggested that lower functional capacity is more strongly associated with all-cause mortality than low levels of physical activity28.

STRENGTHS

A feature of this project was program delivery to a broad range of participant groups by allied health professionals rather than clinical researchers. This strengthens the case for the generalisibilty of the results to a wider community context, as opposed to an intervention delivered in a clinical research context. Based on the Transtheoretical Model the HEAL™ program provided participants with knowledge and skills to support behaviour change; used group support and group discussion to nor-malise healthy behaviours; and incorporated goal setting and elements of motivational interviewing to support participants on their journey of change. Participant feedback indicated that they felt they had increased their awareness of the benefits of behaviour change and had improved their knowl-edge and skills to implement changes in behaviour. Participants also reported that they felt confident to maintain these changes in the longer term. The positive improvements in participant health vari-ables, observed after a relatively short time period (8 weeks) argues for the program’s effectiveness. HEAL™ participants increased their

physical activity levels and functional capacity post-program and simultaneously increased their fruit and vegetable consumption, a finding which has been less clear from other multi-component group based interventions1, 10.

LIMITATIONS

Limitations to consider when interpreting the results of the current study include the lack of a control group which would have allowed comparison of the effectiveness of HEAL™ with another intervention or usual care. However, the authors note that other government funded, community-based, prevention programs have also lacked provision of a control group29, 30 and no control group was budgeted for under the terms of the HCI funding agreement for HEAL™. Nonetheless, studies which have incorporated control groups receiving either no intervention or usual care have found that a lifestyle modification intervention results in significantly better outcomes in terms of physical activity, weight loss and progression of type II diabetes1, 31, 32. As an example and point of comparison, participants in a 24 week intensive lifestyle modification program achieved 5.6 kg in weight loss as opposed to 0.1 kg weight loss observed in the placebo control group32.

Retention to post-program testing was 61% which while lower than rates considered robust for clinical trials (85%)33 is favourable when compared to re-ported retention in health related exercise programs (50%)34 and other lifestyle modification programs such as the Lighten Up program (53%)30. Nonethe-less, the significant improvements in participant health outcomes were meaningful especially in light of the fact that the majority of participants were drawn from traditionally hard to reach, socially and economically disadvantaged groups.

An additional limitation is that 78% of HEAL™ partic-ipants were female, meaning that men were under represented in the sample group. Similar bias has been reported in other community based interven-tions such as the Lighten Up program where 85% of

participants were female30. This reflects what we know from the literature: that “men are less likely to engage in behaviours that are linked with health and longevity”35 [pp. 1385]. However we also know from interviews with HEAL™ participants that the knowledge and skills gained in healthy eating, low fat cooking and engaging in physical activity were put into action in a family context. There is also liter-ature to support the observation that females mon-itor and attempt to control the health behaviours of their spouses36. The ability to quantify the effect this may have had on male partners of HEAL™ partici-pants is beyond the scope of this paper but would be an interesting area of future study.

CONCLUSION

In summary, the HEAL™ program, a group-based, lifestyle modification program incorporating be-haviour change strategies, and combining educa-tion and exercise, has been shown to improve the health behaviours and health outcome measures of participants who completed the program. The strengths of the HEAL™ program are the systemat-ic, coordinated manner of delivery and evaluation.

Based on these strengths, and where funding is available, the HEAL™ program warrants close consideration as a behaviour change strategy in primary health care networks, local government or community settings. Achieving sustainability would be highly beneficial in improving public health and lessening the financial and personal burden of chronic conditions.

ACKNOWLEDGEMENTS

This program was funded by the Australian gov-ernment.

This article will appear in the Health Promotion Journal of Australia Volume 26, No. 2 (In Press) and is reproduced here with permission.

Online Early version available at http://www.publish.csiro.au/?paper=HE14031

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3. Cleland C, Tully M, Kee F, Cupples M. The effectiveness of physical activity interventions in socio-economically disadvantaged com-munities: A systematic review. Prev Med. 2012;54(6): 371-80.

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5. Nichols M, Reynolds R, Waters E, Gill T, King L, Swinburn B, et al. Community-based efforts to prevent obesity: Australia-wide survey of projects. Health Promot J Austr. 2013;24(2): 111-7.

6. Department of Health and Ageing. A healthy and active Australia: Healthy Communities Initiative. Canberra: Australian Government; 2012 [cited 2012 31 July]. Available from: http://www.healthy-active.gov.au/internet/healthyactive/publishing.nsf/content/healthy-communities.

7. Pettman T, Armstrong R, Pollard B, Evans R, Stirrat A, Scott I, et al. Using evidence in health promotion in local government: Contextual realities and opportunities. Health Promot J Austr. 2013;24: 72-5.

8. Norton K, Coombes J, Hobson-Powell A, Johnson R, Knox C, Marino N, et al. Adult Pre-Exercise Screening System (APSS). Queensland: Exercise & Sports Science Australia 2011.

9. Prochaska J, Redding C, Evers K. The transtheoretical model and stages of change. In: Glanz K, Rimer B, Viswanath K, editors. Health behavior and health education: Theory, research, and practice. San Francisco, CA: John Wiley & Sons; 2013.

10. Lindstrom J, Peltonen M, Eriksson J, Aunola S, Hamalainen H, Ilanne-Parikka P, et al. Determinants for the effectiveness of lifestyle intervention in the Finnish diabetes prevention study. Diabetes Care. 2008;31: 857-62.

11. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vlie-gen E, et al. Management of obesity in adults: European clinical practice guidelines. Obes Facts. 2008;2008(1): 106-16.

12. Australian Institute of Health and Welfare. The Active Australia Survey: A guide and manual for implementation, analysis and re-porting. Canberra: Australian Institute of Health and Welfare 2003.

13. Wright J, Scott J. The fat and fibre barometer, a short food behaviour questionnaire: Reliability, relative validity and utility. Australian Journal of Nutrition & Dietetics. 2000;57(1): 33-9.

14. van der Ploeg H, Chey T, Korda R, Banks E, Bauman A. Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med. 2012;172(6): 494-500.

15. Owen N, Healy G, Matthews C, Dunstan D. Too much sitting: The population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38(3): 105-13.

16. Brown W, McLaughlin D, Leung J, McCaul K, Flicker L, Almeida O, et al. Physical activity and all-cause mortality in older women and men. Br J Sports Med. 2012.

17. AIHW. Towards national indicators for food and nutrition: An AIHW view. Reporting against the dietary guidelines for Austra-lian adults. Canberra: Australian Institute for Health and Welfare 2005. Report No.: PHE 70.

18. Australian Bureau of Statistics. Australian health survey: First results, 2011-12. ABS; 2012 [updated 29/10/2012; cited 2014 20 Jan-uary]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/D4F2A67B76B06C12CA257AA30014BC65?opendocument.

19. Dauchet L, Amouyel P, Hercberg S, Dallongeville J. Fruit and vegetable consumption and risk of coronary heart disease: A meta-analysis of cohort studies. J Nutr. 2006;136(10): 2588-93.

20. He F, Nowson C, MacGregor G. Fruit and vegetable consumption and stroke: Meta-analysis of cohort studies. Lancet. 2006;367: 320-6.

21. Harding A, Wareham N, Bingham S, Khaw K, Luben R, Welch A, et al. Plasma vitamin C level, fruit and vegetable consumption, and the risk of new-onset type 2 diabetes mellitus. Arch Intern Med. 2008;168(14): 1493-9.

22. Rolls B, Ello-Martin J, Carlton Tohill B. What can intevention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev. 2004;62(1): 1-17.

23. Czernichow S, Kengne A, Stamatakis E, Hamer E, Batty G. Body mass index, waist circumference and waist–hip ratio: Which is the better discriminator of cardiovascular disease mortality risk? Evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies. Obes Rev. 2011;12: 680-7.

24. Uusitupa M, Lindi V, Louheranta A, Salopuro T, Lindstrom J,

Tuomilehto J. Long-term improvement in insulin sensitivity by changing lifestyles of people with impaired glucose tolerance. Diabetes. 2003;52: 2532-8.

25. Anderson J, Konz E. Obesity and disease management: Effects of weight loss on comorbid conditions. Obes Res. 2001;9(S4): 326S-34S.

26. Mertens I, Van Gaal L. Overweight, obesity and blood pressure: The effects of modest weight reduction. Obes Res. 2000;8(3): 270-8.

27. Campbell A, Reinken J, Allan B, Martinez G. Falls in old age: A study of frequency and related clinical factors. Age Ageing. 1981;10: 264-70.

28. Lee D, Sui X, Ortega F, Kim Y, Church T, Winett R, et al. Compari-sons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med. 2011;45(6): 504-10.

29. Diabetes Australia. “Let’s prevent diabetes” – the case for a national diabetes prevention program for the high risk. 2012 [cited 2014 18 August]. Available from: https://www.diabetesaustralia.com.au/Documents/DA/NDW%202012/NDW%202012%20Media%20Report.pdf.

30. Stubbs C, Foley W, Kirkwood J, Ware R, Marks G, Lee A. State-wide evaluation of the Queensland Health Lighten Up to a Healthy Lifestyle Program. Brisbane: University of Queensland 2012.

31. Wadden T, Webb V, Moran C, Bailer B. Lifestyle modification for obesity: New developments in diet, physical activity, and behavior therapy. Circulation. 2012;125: 1157-70.

32. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervnetion or metformin. N Engl J Med. 2002;346(6): 393-403.

33. de Morton N. The PEDro scale is a valid measure of the meth-odological quality of clinical trails: A demographic study. Aust J Physiother. 2009;55(2): 129-33.

34. Dishman R. Exercise adherence. Champaign, IL: Human Kinetics; 1988.

35. Courtenay W. Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Soc Sci Med. 2000;50(10): 1385-401.

36. Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med. 1992;34(8): 907-17.

BISCUIT MAKERS TAKING ON THE BULGE!

“We all know and love Arnotts, with products such as Tim Tams, Mint Slice, Scotch Finger, Vita-Weat, Tiny Teddy’s, they are a true household brand,” says Ray. “Not only are they a strong Aussie brand but they also have a supportive and ground breaking workplace – it was great to hear that the average worker has been employed for over 20 years.”

“I began discussions with Arnotts who were keen to undertake a program as part of their overall employee engagement strategy and to tackle some key issues their employees were facing. Being shift workers, the staff had to deal with abnormal work hours combined with access to delicious products!”

“In June 2014 we commenced a 10 Week Health Program that saw 53 employees from four groups (day, afternoon and night shift workers and administration staff) participate in a coaching program that had them receiving one 15 minute consultation each week.”

“Within these consultations the staff were provided with an exercise program and meal plan which was adjusted each week to suit their lifestyle and individual circumstances. The meal plan consisted primarily of fresh, unprocessed

foods and the exercise program had most of the participants engage in daily walks at a low to moderate intensity.”

“The results we had over the 10 week program were fantastic, over that period the total amount of weight lost by the group was 643kg - an aver-age of 12kg per participant,” explains Ray.

HIGH BLOOD PRESSUREIn the initial screening, 36 of the 53 participants were found to have had high blood pressure (Sys-tolic >140, and/or Diastolic >95). At the completion of the program only 5 of the 53 participants still had blood pressure readings exceeding this level. This shows that 31 employees had their blood pressure improved. Most of these employees were not aware of their blood pressure problem, and out of those that did many saw a reduction or elimination of medications.

GOAL WEIGHTAt Week 1 the participants were asked what their goal weight would be, not just during the program but their actual ‘dream weight’. By the end of Week 10, 13 had not only achieved this

goal but had lost even more weight. A further 14 were within 5kg of their ‘dream weight’.

BODY MASS INDEXOver the course of the 10 week program the average BMI for all participants was reduced from 34.5 (Obese), to 29.8 (Overweight), showing a significant weight loss and improvement in health. In Week 1, 76% of participants were categorised as ‘Obese’ but this was reduced to 29.8% by Week 10.

ESSA member Ray Kelly recently worked with iconic Australian brand, Arnotts, in a fantastic new initiative implemented by the company.

<0kg 13

0.1-4.9kg 14

5-9.9kg 15

10-14.9kg 8

15-20kg 0

>20kg 4

WEIGHT TO LOSE

FOLLOW UPFor six months these employees received a monthly follow up consultation to assist them in maintaining their weight loss. Education on maintaining goal weight began from the first con-sultation and was of primary focus in weeks 7-10.We returned six months after the completion of the program and the average weight had only increased by 600g. 79% of participants had maintained or lost more weight. Of those that had increased weight, they had still managed to maintain an average weight loss of 8.8kg for the six months.

“I think the program was a success due to a number of factors. Firstly, the support from Arnotts - from the Site Manager down to the catering staff - was phenomenal. Consultations were done in work time, and the employees re-ally supported each other. The strategies were easy to comprehend and put in to action too, and that is essential especially when dealing with many people who use English as a second language.”

“I always enjoy the transformations! I love how life-changing the program is and how appre-ciative the participants are. They all smile when they see you in the corridor and come up and fill

you in on how their weight is, or how much fitter they are.”

“It’s not only about them either. We did a survey with participants and for every person going through the program, 2 others in their household also made improvements to their lifestyle. I get to hear all about how their sons, daughters, or partners are going too!”

Our thanks to Ray for sharing this story, it’s great to hear of ESSA members taking on new exercise adventures – if you have a story to share, email us at media@essa.org.au

BEGINS

21ACTIVATE | JUNE 2015

A NEW ERA FOR STANDARDS AND ACCREDITATION BEGINS

STANDARDS AN

D

ACCREDITATION

These two areas have now been restructured to operate independently of each other. Consequently, in February 2015, the long standing NUCAP Executive Group and ESSA Accreditation and Curriculum Committee (EACC) were dissolved and have been superseded by a new Accreditation Advisory Council (AAC), and a Professional Standards Advisory Council (PSAC) respectively. These two councils will provide strategic advice to the ESSA Board. This will ensure that graduates to our professions continue to meet industry needs and that our professionals continue to maintain high standards of professional practice. The AAC also provides governance over accreditation requirements (university and individual, domestic and international), and the PSAC provides governance over professional practice.

ESSA thanks the members of the NUCAP Executive and EACC for their valued contributions over many years and welcomes the AAC and PSAC and the contributions they will make to the organisation moving into the future.

ESSA’s ongoing review of governance processes in line with ‘best practice’ recommendations, has recently extended to the areas of Standards and Accreditation.

medfitdonna mccook

Donna McCookPhysiotherapist & Exercise PhysiologistPhD Candidate, MHScience (Physio), PGD Manip PhysioPGD Clinically Applied Exercise Science(ESSA Accredited Exercise Physiologist)

Lower Limb Rehab Sydney August 1Perth August 14 (ICS)Melbourne October 11Darwin Sept (ICS - TBC) - email for info

Cervico-Thoracic Spine Sydney Sept 5/6 LUMBAR REHAB 1 WEBINAR - July (TBC) Melbourne Oct 31/Nov 1 Email for details Adelaide Aug / Sept (ICS - TBC)

Making Sense of the Shoulder Obesity Biomechanics Melbourne October 10 Sydney August 2Sydney October 17 WEBINAR August 2 Perth August 14 (ICS)Darwin Sept (ICS - TBC) - email for info

Courses for Exercise Professionals focused on

Exercise, Injury Mechanics, Rehabilitation & Clinical Reasoning

Lumbar Spine Rehab 1 and 2Sydney May 22/23Brisbane July 18/19Perth August 15/16 (ICS)Adelaide August / Sept (ICS - TBC)Darwin Sept (ICS -TBC)

ACCREDITATION ADVISORY COUNCIL MEMBERSHIP

PROFESSIONAL STANDARDS ADVISORY COUNCIL MEMBERSHIP

Dr Herbert Groeller (chair) Associate Professor Chris Askew (chair)

Associate Professor Annette Raynor Ms Angela Douglas

Associate Professor Margaret Torode Dr Prue Cormie

Associate Professor Leonie Otago Professor Jeff Coombes

Dr Robert Crowther Mr Nathan Harten

Dr Michael Baker Ms Kate Faber

Mr David Nunn Mr Ryan Timmins

Mrs Rachel Holmes, Accreditation Manager (ex officio)

Ms Janette Frazer-Allen, Standards Officer (ex officio)

PRA

CTIC

E SM

ART

S 10

1

EXERCISE SCIENTISTS, ACCREDITED EXERCISE PHYSIOLOGISTS AND ACCREDITED SPORTS SCIENTISTS WHERE TO START AND WHERE TO FINISH?

The Industry Development and Professional Standards units within ESSA have joined forces to launch a new initiative called ‘Practice Smarts 101’. Through this initiative we are aiming to build a suite of resources to:

• Help members better understand their professional environment• Support their development as skilled professionals• Support a culture of life-long learning and self-evaluation amongst our members.

WHO IS THE CLIENT?

Exercise and sports science professionals engage with clients who fall somewhere along the continuum of the exercising public (see Figure one). Most people will often start in the middle of spectrum as “apparently healthy” exercisers. Over time, some grav-itate towards the elite level of the scale before transitioning back towards the middle. Others, due to a combination of factors (i.e. lifestyle, injury and ageing) drift towards a diagnosed pathology. The most appropriate healthcare professional to work with a person may vary depending upon where they fall within this continuum

THE MOST APPROPRIATE HEALTHCARE PROFESSIONAL FOR THE EXERCISING PUBLIC Exercise Scientists (ES), Accredited Exercise Physiologists (AEP) and Accredited Sports Scientists (ASp) are three distinct professions and subsequently have varying skill sets that make them best suited to working with the exercising public at different points along the continuum outlined in Figure one. The approach to professional practice will need to alter depending upon whether you are working as an ES, AEP or ASp. The term working as is emphasised because what you are working as could be different to your professional title. For example, your professional title might be an AEP however on analysis of your services and the exercising public you are working with, you may actually be working as an ES.

ESSA suggests the approach under-pinning each profession is inherently different (see Figure two) and members can ask themselves some simple questions to help determine which model of care is under-pinning your practice.

• Where does my client sit on the exercising continuum?

• What is the clinical need of the client?

• What quality frameworks apply (e.g. best practice guidelines)

• What are my client’s goals?

• What (if any) regulatory frameworks apply (e.g. Medicare, private health funds)

DIAGNOSED PATHOLOGY OR

INJURY

APPARENTLY HEALTHY

EXERCISER

EXERCISE SCIENTIST

ACCREDITED EXERCISE PHYSIOLOGIST

ACCREDITED SPORTS SCIENTIST

AT HIGH RISK OF PATHOLOGY OR

INJURY

APPARENTLY HEALTHY: ENGAGED

IN AMATEUR SPORTS

TRANSITIONING ATHLETE:

SEMI-PROFESSIONAL OR RETIRING

ELITE SPORT PROFESSIONAL

LOW RISK OF PATHOLOGY OR

INJURY

FIGURE ONE: THE EXERCISING PUBLIC

“Exercise Scientists, Accredited Exercise Physiologists and Accredited Sports Scientists – Where to start and where to finish?” – is the first in a series of articles that will be published in Activate to support the Practice Smarts 101 initiative. This article gives an overview of the continuum of the exercise client, where our professions fit within this continuum and the underlying frameworks that support quality services, compliance and sustainable business practice.

23ACTIVATE | JUNE 2015

*Research falls across each category, it is also underpinned by the scientific model

TRANSLATING THIS MODEL INTO PRACTICE - CASE STUDIES Scenario one: Are you an AEP who has set-up a business model that is driven by financial gain rather than client needs?

An AEP intervention should always be working towards discharge and self-management for clients, however an exercise science intervention does have capacity to engage a client in a regular exercise program that is of the client’s choosing (i.e. a client chooses to attend weekly exercise sessions as part of their physical activity routine). Encouraging clients to return regularly to your business is acceptable, provided you understand where AEP services cease and client choice about ongoing exercise for their own well-being begins. One of the main implications of getting this wrong is inappropriately billing third parties (such as regulatory bodies or insurers), who are underpinned by legislation, for services which are

in effect fitness services not healthcare services. Third parties are not allowed (as enforced by law in many cases) to fund a person’s independent choice about what physical activity they wish to engage in long-term.

Scenario two: Are you an ASp who has estab-lished a business relationship with an innovative sports technology company and are now actively selling these product to your clients when the evidence does not support their application?

It is not illegal to sell products that complement your business, however your responsibilities and duty of care as a professional supersede any business partnerships (i.e. selling supplements that have no evidence to support their effective-ness). “Professionals have an ethical obligation to act in the best interest of their clients and patients. Ethical duties prohibit professionals from acting to promote their own self-interest.” (Australian Competition and Consumer Commis-

sion, accessed online 8 April 2015).

Scenario three: Are you an exercise scientist that is actually working outside your scope of practice and developing exercise programs for high-risk clinical populations?

ESSA’s accreditation guidelines recognise the specialisation of AEP and ASp and ESSA’s Code of Professional Conduct and Ethical Practice specifically refers to a practitioner’s competency and accountability. “An Exercise and Sports Science Professional must: work within the limits of their education, training, supervised experi-ences and appropriate professional experience; provide only those Services to their Clients for which they are trained and qualified based on the established knowledge of the profession of exercise and sports science; where appropriate, refer the client to another appropriate qualified healthcare or medical professional…” (ESSA Code of Conduct and Ethical Practice P10)

WHERE TO START AND WHERE TO FINISHSo, where does one profession start and the other end? The three professions sit upon a continuum with overlapping skills and therefore client-base (see Figure one). A useful question to ask yourself that may help guide professional responsibilities is: What is the purpose of my intervention? And, do I explain to my client the purpose of the intervention during our initial assessment?

The answer to this question can be used to help guide your practice as a professional and deter-mine when and if you are transitioning from working as one professional to another. For example, if an AEP is referred a client for treatment of acute exacerbation of non-specific lower back pain. The purpose of the treatment may be to provide an exercise and education intervention to address the acute exacerbation. You may also include self-management techniques to assist the person to independently manage future exacerbations and set them up on a home-exercise program that they can complete after discharge.

If, at discharge, the client makes an informed decision that they would like to continue seeing you to help with their compliance, improve their fitness and work on their overall strength to reduce the chance of further back injuries this signals a transi-tion in the purpose of care and should also trigger a review of whether it is acceptable to continue to bill third parties for care. The client is making an informed decision about the type of exercise or in-tervention they would like to continue with after the immediate treatment needs have ceased in order to facilitate long-term management of their health and condition. A client’s unwillingness to self-manage is not a justification to continue treatment.

A further scenario, an exercise scientist is running a small business providing strength and fitness programs to young tennis players. One player, whom you have been training for about 12 months, is showing particular promise and has recently received support from Tennis Australia to help them transition to elite level sport. While the client is very keen to remain with the exercise scientist, with whom he has built a relationship, the exercise scientist must consider whether they continue to be the most appropriately qualified person to train this individual. The client’s goals and focus

have changed – the purpose of the intervention has transitioned to development of an elite level professional tennis player. A referral to an ASp to take over care may be warranted.

CONCLUSION In essence this article is encouraging members to think about the scope of practice of each profes-sion. ASp and AEP are also qualified ES, thus it is acceptable that they may work in ES roles. Howev-er, being aware that you are actually working as an ES and the implications of this are fundamental. Exercise and sports science professionals have an obligation as trusted healthcare practitioners to understand the boundaries and responsibilities that accompanies your training. It may also be timely for members to think critically about how they practice, the services they offer and ask themselves: What profession am I really working as?

The Industry Development and Standards teams within ESSA welcome member comments and feedback on ‘Practice Smarts 101’. You can email your questions/comments to ID@essa.org.au – we will aim to address some of these questions in the next edition of ACTIVATE.

FIGURE TWO: MODELS OF CARE UNDERPINNING PRACTICE

ACCREDITED EXERCISE PHYSIOLOGY

• Healthcare/Medical model

• Services are driven by clinical need (i.e. client centred care, clinically required care)

• Service delivery considered as “treatment” moving towards self-management

ACCREDITED SPORTS SCIENCE

• Scientific model

• Services are driven by scientific principles (i.e. evidence based practice and ethical principles)

• Services are driven to maximise performance while considering the health and wellbeing of the athlete

EXERCISE SCIENCE

• Public Health Model

• Services are driven by health/wellbeing at a population level (i.e. health promotion)

• Service delivery considered as enabling people to increase control over and improve health

COMPLYING WITH PRIVATE HEALTH FUND LEGISLATION

HEAL

TH FU

ND

In order to protect your business and hip pocket, if you are an Accredited Exercise Physiologist (AEP) providing services to a member of a Private Health Fund (PHF), it is imperative you apply due diligence and ensure all business practises comply with the legislation outlined in the Private Health Insurance Act 2007 (31st ed.). PHFs regularly audit services providers, if you or your business is found to be non-compliant with the legislation you may have to return rebates paid to you by the PHF and/or potentially have your ability to provide services to the customers of the fund cancelled.

A number of PHFs will pay a benefit to their cus-tomers for clinical exercise physiology services and whilst the extent of cover is determined by the individual PHF and the patient’s policy type, there are a number of conditions that apply to all providers of privately insured services. Exercise Physiology services come under the classifica-tion “general treatment”. By virtue of s. 121-10 (10) of the Private Health Insurance Act 2007 (31st ed.), general treatment is defined as:

“General treatment is treatment (including the provision of goods and services) that:

(a) is intended to manage or prevent a disease, injury or condition; and

(b) is not *hospital treatment.”

General treatment is not, as specified in s. 11 of the Private Health Insurance (Health Insurance Business) Rules (2013):

“Treatment which primarily takes the form of sport, recreation or entertainment, other than such treatment which is part of a chronic disease management program or a health management program if the programs have been approved by the private health insurer”

In order for a patient to receive a rebate from their PHF, the patient’s cover must include exer-cise physiology treatment, or (and this depends on the individual PHF) a treatment intervention

that is part of a chronic disease management program (CDMP) or a health management pro-gram. Insurers do not pay a benefit for general fitness programs.

The Private Health Insurance Act passed in 2007 allowed PHFs to pay benefits for CDMPs to help play a greater part in keeping people healthy. A CDMP has a specific meaning for PHF. They must either “reduce complications in a person with a di-agnosed chronic disease” or “prevent or delay the onset of chronic disease for a person with identi-fied multiple risk factors for chronic disease”. The legislation classifies a chronic disease as being a disease that has been, or is likely to be, present for at least 6 months, and a risk factor includes but is not limited to: physical inactivity, and biomedical risk factors, such as high cholesterol, high blood pressure, impaired glucose metabolism or excess weight, and/or family history of a chronic disease. In addition to patient eligibility, s. 12 (1)(b) of the Private Health Insurance (Health Insurance Busi-ness) Rules (2013), stipulates that the prerequisites for a recognised chronic disease management program, must include the development of a written plan that:

Specifies the allied health service or services, and any other goods and services to be provided; and

Specifies the frequency and duration of the provision of those goods and services; and

Specifies the date for review of the plan; and

Has been provided to the patient for consent, and consent is given to the program, before any services under the program are provided; and

Is coordinated by a person who has accepted responsibility for ensuring the services are pro-vided according to the plan; and monitoring the patient’s compliance with the agreed goals and activities specified in the plan.When determining a patient’s eligibility to claim from a PHF, aside from their policy type, the AEP must establish the purpose of the intervention.

Each PHF will have their own confirmation process, however, in the event of an audit, the insurer will require evidence that the purpose of the intervention is to treat a specific health condition. It is imperative that ESSA members maintain a high level or accuracy when keeping records about PHF customer visits, including clinical notes about the treating conditions. PHFs have the legal ability to randomly or selectively audit any provider they have a concern about, for example, using the wrong item code when billing.

Whilst an AEP can draw upon complementary skills in a treatment intervention, it is compulsory that those skills are applied clinically. For example, if an AEP has additional qualifications in yoga, they are free to incorporate yoga exercises in an AEP led exercise prescription, as long as it can be clearly demonstrated that those techniques are being used in a manner that is applicable to: i) an AEP’s scope of practice, and ii) how those techniques will help achieve the treatment goal. The “Childs Pose”, “Bird Dog” and “Cobra Pose” are all commonly associated with yoga but are also sometimes used clinically in the treatment of some sub-categories of lower back pain. Having an additional qualifica-tion does not qualify a member to provide a yoga program in the guise of an AEP intervention. In order to provide a complementary therapy service, one would need to do this completely independent from the AEP role and in compliance with the ad-ditional requirements set out by the insurer and the legislation detailed in the Private Health Insurance Act 2007 (31st ed.). Any professional accessing PHF rebates must only provide services in keeping with their professional scope of practice (this can be found on the ESSA website).

Not only does the delineation between AEP and complementary therapeutic services need to be discernible in practice and in provider notes, but also in billing. Whether you are billing a patient at the point of service using HICAPS or providing your patient with a paper invoice/receipt, you will need to apply the following codes developed by ESSA, in conjunction with HICAPS and Private Health Care Australia:

Further information about HICAPS is available on the member’s only section of the ESSA website, under “AEP Important Information” and “HI-CAPS”. A number of complementary therapeutic services do not have specified item codes. You must not bill the aforementioned services under any of the AEP item codes.

The Industry Development and Standards teams within ESSA are actively working to develop resources to help members understand their pro-fessional obligations, however, as our profession gains recognition in the primary healthcare sec-tor, so too do we become increasingly scrutinised. ESSA advises all members to critically reflect on their professional practices.

For further information please contact Alex Lawrence alex.lawrence@essa.org.au.

ITEM NUMBER FULL DESCRIPTION ABBREVIATED DESCRIPTION

102 Initial Session – once only per course of treatment Initial consultation

202 Standard Consultation 30 – 60 minutes Standard consultation

302 Extended Consultation > 60 minutes Extended consultation

402 Standard consultation requiring travel Travel consultation

502 Group Session 60 minutes (maximum of 8 people)

REFERENCEPrivate Health Insurance Act 2007 (31st ed.). Retrieved from http://www.comlaw.gov.au/Details/C2014C00791Private Health Insurance (Health Insurance Business) Rules 2013. Retrieved from http://www.comlaw.gov.au/Details/F2013L02159/Html/Text#_Toc372124281

FEATURE ARTICLE

25ACTIVATE | JUNE 2015

PRIVATE HEALTH FUND LEGISLATION DEPARTMENT OF VETERANS’ AFFAIRS

FEATURE ARTICLEFEATURE ARTICLE

What every allied health provider must know before treating a Department of Veterans’ Affairs client living in a Residential Aged Care Facility.

THE BEGINNING .A doctor’s referral is not an approval for an allied health provider to treat an entitled Department of Veterans’ Affairs (DVA) client living in a Residential Aged Care Facility (RACF). It is the allied health provider’s responsibility to check the client’s Aged Care Funding Instrument (ACFI) classification (lev-el of care) before commencing treatment. It is important to obtain this information from the appropriate person at the RACF who manages the ACFI assessments. It is advisable to view the current documentation and remember that the client’s ACFI classi-

fication may change in time, as their care needs change. This is essential whether the provider is visiting the RACF or the client is seeking treatment in the provider’s rooms

THE ACFI LEVEL OF CARE IS IMPORTANTThe level of care a DVA entitled client receives in a RACF refers to the classifi-cation of the person as determined under the Classification Principles 2014. It is not determined by the name of the facility in which they reside or by the position of the room within the RACF.

The ACFI classification is a three letter code with one letter representing the score of the following categories: Activities of Daily Living, Behaviour and Complex Health Care. The score for each domain category is High, Medium, Low or Nil (H, M, L, N). If the three-letter code for a resident’s ACFI classification includes at least one ‘H’ or two ‘M’ scores then the client is receiving a greater level of care and the RACF is responsible to provide this level of care and services, including the provision of clinically necessary allied health services and most aids and appliances.

PRIOR APPROVAL IS NECESSARYIF YOU RECEIVE A REFERRAL TO TREAT A DVA ENTITLED CLIENT WHO IS RECEIVING A HIGHER LEVEL OF CARE prior financial authorisation is necessary for allied health treatment. DVA may consider prior approval in exceptional circum-stances for short-term clinically necessary acute allied health treatment. An example would be of a client who has an acute fracture of their neck or femur and because of their dementia, it is not appropriate to remain in the acute hospital set-ting. DVA may approve a limited number of allied health treatment sessions to optimise the client’s immediate post-operative care.

You must send a written request for prior approval to DVA (See: Prior Approval Contact Details section below). DVA cannot consider prior approval for general care such as strengthening exercises, a walking program, reconditioning, balance training, improving fitness, improving flexibility or improving quality of life as the responsibility for such treat-ment lies with the RACF.If you are a visiting provider to a RACF, your request should include information that details your collab-oration with the onsite allied health provider/s. A letter stating that the onsite providers do not have time to treat the DVA entitled client does not equate to justification for clinically necessary treatment.

THE CORRECT ITEM NUMBER IS ESSENTIALWhen claiming for payment for allied health treatment, it is important to use the correct item number as per the relevant allied health schedule of fees. Treating a DVA entitled client who resides in a RACF requires use of the item num-bers under the heading Residential Aged Care Facilities. The use of home visit or room’s code is incorrect. When conducting post payment

monitoring DVA has systems in place to ensure the item number reflects the client’s level of care. DVA reserves the right to recover monies paid to allied health providers for services where financial authorisation was required from DVA but not obtained and/or when the incorrect item number is used.

DVA MONITORS SERVICESPrior approval is not necessary for allied health treatment of DVA entitled clients classified as receiving a lower level of care. However, DVA monitors servicing patterns of allied health care providers and expects treatment to reflect best practice and have a basis on clear, appropriate and realistic functional goals.

The allied health provider must maintain appro-priate clinical records for the episode of care, which demonstrate the clinical justification for all treatment sessions and the progress towards the set functional goals. The records should reflect collaboration with the care staff and any allied health providers working at the RACF. DVA does not fund ongoing general exercise programs or general group exercise classes. Finally, where the RACF contracts the allied health provider to perform a service such as a Falls and Balance Program or a group exercise class/circuit, the allied health provider cannot also invoice DVA.

DVA may request repayment when the clinical records do not reflect justification for the volume and frequency of services or the types of ser-vices provided or when the RACF has also paid for the services.

MORE INFORMATION MyAgedCare Website - http://www.myagedcare.gov.au Quality of Care Principles 2014 -

http://www.comlaw.gov.au Classification Principles 2014 - http://www.comlaw.gov.au

Department of Social Services – Ageing and Aged Care page - http://www.dss.gov.au/our-responsibilities/ ageing-and-aged-care

DVA Notes for Allied Health Professionals, Section One: General – http://www.dva.gov.au/providers/al-lied-health-professionals#notes_allied_health_providers

DVA Notes for Exercise Physiologists Schedule of Fees Effective 1 November 2013

PRIOR APPROVAL CONTACT DETAILS

FORM:

Request for Prior Financial Approval Form / D1328 – http://www.dva.gov.au/sites/default/files/dva-forms/D1328.pdf

TELEPHONE - PROVIDER HOTLINE:

For Metropolitan callers: 1300 550 457 – select Option 3 then Option 1 For Regional/Rural callers: 1800 550 457 – select Option 3 then Option 1

FAX NUMBER:

(08) 8290 0422

POSTAL ADDRESS:

Medical & Allied Health SectionDepartment of Veterans’ AffairsGPO Box 9998ADELAIDE SA 5001

ESSA GETS ON BOARD WITH SENIORS’ WEEK NSW ACTIVITIES

ESSA members and staff were very active at NSW Seniors’ Week events across the state this March. With support from NSW Family and Community Services (FACS), ESSA participated in six Health and Wellbeing expos and also took part in activities at the Telstra and NSW FACS Seniors’ Hub at the Royal Easter Show at Olympic Park in Sydney. These community events have provided great exposure for the work ESSA members do in the ageing and aged care space. A summary of these activities is included below and plans are already being made for even more ESSA involvement in 2016 events. If you are working in the ageing or aged care space in NSW and want to register your interest in assisting with future events please contact sharon.hetherington@essa.org.au.

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AEPs Leah Burton, Rychelle Lang and Shannon Jobson helped out ESSA staff member Sharon Hetherington at the expo stand. They handed out flyers and factsheets detailing how an exercise physiologist can help people to age well and maintain their independence. One hundred exercise bands and instructions for using them were also given out. The most popular item by far was the A5 size fridge magnet that ESSA developed with funding assistance from

NSW FACS. The magnet depicts three simple exercises older people can do every day to maintain their leg strength and balance – heel raises, walking sideways and sit to stands. People who took them felt that they would be a good prompt to do the exercises each time they went to the fridge.

The local AEPs also promoted their group classes and individual services. Several people were keen to find out about

hydrotherapy and were encouraged to attend an introductory session at the hospital pool. People also expressed an interest in signing up for the ‘Lungs in Action’ and ‘Stepping On’ programs run by local AEPs. While paying a visit to the other stalls Alzheimer’s Australia asked for a local exercise physiologist to come and address their carers group about looking after themselves and the care recipient. This is currently being progressed.

A Tuesday was a busy day for AEP Michael Russo, attending the Sutherland event in the morning and the Bankstown expo in the afternoon. “The atmosphere at the Bankstown event was really relaxed. I delivered part of the Agents for Change training and then spent time talking with attendees about their health and wellness goals. We also did some gentle exercises together. I think the sessions really helped people to connect with the importance of doing something every day to maintain their health,” said Michael.

The Agents for Change training is primarily designed to educate community workers, volunteers, friends, family and care givers about the specific benefits of physical activity for older people and provides tools and ideas for beginning the conversation about being regularly active. It also outlines the roles of an AEP in the ageing and aged care space, presents several case studies and discusses referral pathways.

COFFS HARBOUR – 18TH MARCH – HEALTH AND WELLBEING SYMPOSIUM

ESSA staff members Alex Lawrence and Sharon Hetherington were assisted by local AEP Ella-Rose Kosick at this event where ESSA had a trade table giving away exercise bands, fridge magnets, flyers and fact sheets. Sharon also presented the Agents for Change training to audience members. This presentation fitted well with the day’s other speakers who touched on staying physically active as a component of successful ageing along with healthy eating, social connectedness, good financial management and community involvement. The training content was well received at the Coffs Harbour event, many of those in attendance appeared to be quite active but readily agreed that they knew of friends and family who might benefit from being more active.

The Northern Beaches area event was run at the Sydney Academy of Sport in Narrabeen. NSW FACS coordinated the expo with a variety of stalls, presentations and demonstrations from organisations providing services for mature aged people. Local AEP Leigh Sherry represented ESSA and delivered

an interactive presentation that engaged the attendees and got them all up and moving. The colour-graded exercise bands were a massive hit, with many people taking the time to ask questions about how they could use them at home.

“The feedback I got was that the event was a motivating and enjoyable experience for all involved,” said Leigh

Local AEP Michael Russo, in collaboration with 3 Bridges Community Centre and South Eastern Sydney Medicare Local, coordinated and delivered a community event to celebrate seniors’ week. More than 50 participants attended the morning event at the Menai Community Centre with the aim of increasing their knowledge about healthy ageing and having better awareness of local programs and services. Michael commented that, “The day was designed to be very interactive and people enjoyed the opportunity to share their stories, while listening to presentations from health professionals reinforcing the physical, mental and social benefits of regular physical activity.” Every participant received information packs with a resistance band and were encouraged to attempt the home exercise program. A participant appropriately summed up the day by saying to the group, “If you don’t use it you lose it.”

LOCAL COMMUNITY IN COFFS HARBOUR

PORT MACQUARIE - 16TH MARCH – SENSATIONAL SENIORS’ EXPO

BANKSTOWN – 17TH MARCH – HEALTH AND WELLBEING EXPO SUTHERLAND SHIRE – 17TH MARCH - GET ACTIVE! STAY WELL!

NORTHERN BEACHES – 19TH MARCH – SENIORS EXPO

27ACTIVATE | JUNE 2015

ESSA GETS ON BOARD WITH

Local AEP Mark Roberts assisted Sharon Hetherington at this event, conducting on the spot blood pressure and grip strength tests – these were very popular with attendees. Exercise bands and the strength and balance magnets were also a hit at this event.

Sharon and Mark conducted a 30 minute presentation which was in part the Agents for Change training and in part a gentle exercise session. Again, when asked, those who attended felt themselves to be quite active but they knew of people who needed a little more support to be more active. Everyone in the audience participated in the exercise session and many came up to the presenters afterwards to thank them for re-invigorating them to do something every day. One of the other exhibitors, St Carthage’s Community Care, approached ESSA about running the Agents for Change training for their community workers and again Alzheimer’s Australia were interested in a local AEP presenting to their carers groups.

Tuesday and Wednesday of the show in 2015 were designated Seniors Days, with Seniors Card holders receiving half price entry on those days. The Telstra and NSW FACS Seniors Hub, which operates on the Seniors Days, is a focal point; offering seniors assistance with using new technology, a digital photograph competition, information on joining Seniors

Computing Clubs, road safety advice and access to the Get Healthy Coaching Service. ESSA was invited to contribute to the Seniors Hub and across the two days offered blood pressure checks, exercise demonstrations,

general exercise advice, and information about the role of an AEP and how to access

AEP services. Exercise bands, fact sheets and fridge magnets were also on offer and again these proved to be extremely popular. It is estimated that more than 3500 people stopped in at the hub and Sydney based AEPs Michael Russo and Leigh Sherry and ESSA staff member Sharon Hetherington were kept very busy talking to people about exercise and their health.

CONNECTING WITH THE LOCAL COMMUNITY IN COFFS HARBOUR

Coffs Harbour Women’s Health Centre (CHWHC) is collaborating with other service providers to offer the HEAL™ program in their community.

HEALTM

Since February 2013, CHWHC has delivered five HEAL™ programs to men and women at the centre, with intake via self-referral or GP referral. Two new programs started in April and these were offered specifically for adults with Type 2 diabetes. The CHWHC team met with local medical centres (stressing the availability of Medicare access), published articles in the paper, used social media, and posted flyers in community areas to raise community awareness of the program and maximise referrals to HEAL™. The team felt it important to stress collaboration rather than competition and marketed the program so that it would be seen as a useful tool when treating patients or clients. Building relationships with other community services by identifying mutual benefits for working together was key to their approach.Health Promotion Officer and Dietitian Becky Vaschak, one of the CHWHC team delivering HEAL™, says that, “The small, supportive environment of HEAL™ has been a huge draw for participants as many feel lonely and isolated and need the support of others to start or continue on their healthy journey. It has been

hugely rewarding seeing the successes of our participants along the way. It has also been great to see them make connections with each other and forming their own support networks.”At the end of each HEAL™ program, the CHWHC team provides each participant with a “show bag” filled with free passes to local gym facilities, an exercise band and “Market Dollars” generously donated by the Coffs Harbour City Council. These can be used to purchase up to $10 worth of fresh fruit and vegetables at the Coffs Harbour weekly farmers’ market. The council also donates a book that has information on seasonal produce as well as delicious recipes. “The participants love the show bags and, importantly, it gets them connected to the community and additional avenues so they can continue their healthy lifestyles”, said Ms Vaschak.

Adaptations to CHWHC’s HEAL™ classes have included conducting hydrotherapy sessions at the local pool and including as many “hands on” demonstrations as possible to facilitate the learning process. “We like to change up the

sessions to keep them fun and exciting which could be anything from doing the ‘Nutbush’ for a warm up to some sessions in the pool,” said Ms Vaschak. CHWHC has a range of plans for their future HEAL™ programs. Many former HEAL™ participants have expressed interest in a continued exercise program and so the team is looking at the option of starting maintenance exercise classes and a HEAL™ walking group to give former participants opportunities to exercise and socialise. The team is also interested in delivering HEAL™ to teenagers in partnership with headspace Coffs Harbour, with modifications to the exercises and education delivery style to offer teenage participants more interactive opportunities to explore and learn from the materials.

If you would like more information on the HEAL™ program or about training as a HEAL™ facilitator, please contact Sharon.Hetherington@essa.org.au.

Planning has already begun for next year’s event and we would love to hear from you if you would like to be involved. Please contact sharon.hetherington@essa.org.au.

Planning has already begun for next year’s event and we would love to hear from you if you would like to be involved. Please contact sharon.hetherington@essa.org.au.

NORTHERN BEACHES – 19TH MARCH – SENIORS EXPOLISMORE – 21ST MARCH – SENIORS EXPO

ROYAL SYDNEY EASTER SHOW – 31ST MARCH - 1ST APRIL – TELSTRA SENIORS HUB

Insurance issued by Guild Insurance Ltd, ABN 55 004 538 863, AFSL 233791 and subject to terms conditions and exclusions. Guild Insurance supports your association through the payment of referral fees. This information is of a general nature only, please refer to the policy for details. For more information call 1800 810 213. GLD2964 ESSA A4 Press Ad 10/2014.

It’s not a pleasant situation for anyone involved and many people think that it is unlikely to happen to them. At least you’re covered against such a risk by your employer’s insurance. Or are you?

Many people mistakenly believe they are adequately covered against claims by their employer’s insurance. In reality, there can often be gaps in this cover and, your employer’s lawyers will often act in your employers best interest, leaving you exposed and vulnerable to claims against you personally.

No matter where you work, it’s important to realise that claims can be made against you as an individual. And even when you’re found not to be at fault, the cost of defending a claim can be financially and emotionally crippling.

Your own policy is also portable, so you’ll be covered regardless of your place of occupation or your employer’s insurance status. What’s more you’ll be covered outside normal working hours, 24/7. This includes cover for work outside of your usual working environment, such as assisting at weekend sporting events.

Guild Insurance - we’ve got you covered

Receiving a complaint from a patient or notification of an inquiry can be a stressful experience. When your professional ability is brought into question and your reputation is at stake, you need the best support and advice available.

By working with ESSA, Guild Insurance has developed a deep understanding of the risks that are unique to Exercise Scientists and Physiologists and provides a comprehensive product for your needs.

With Guild Insurance you get a single policy that includes your choice of $5 million or $10 million in cover for Professional Indemnity, Public Liability & Products Liability.

But it’s those little extras in your policy that can make all the difference such as:

• Retired Insureds Cover - which means you are covered for claims made against you after you retire or cease to practice, but relate to the period when you held your policy.

• No standard excess or ‘deductibles’ on liability claims

• Pay your premium by the month at no extra cost.

You spend your career taking care of other people – isn’t it time you took care of yourself. Applying for cover is quick and easy!

1800 810 213 guildinsurance.com.au

Claims do happen.

So are you really protected?

What if you follow all the right procedures but a client accuses you of doing something wrong?

29ACTIVATE | JUNE 2015

WORKING WITH AN ACCREDITED SPORTS DIETITIAN

Your client has recently made the decision to compete in their first endurance event. They have come to you to better understand their physiological capabilities so they can train within their limits and still manage a full day at work. You’ve done all the relevant testing to provide suitable training zones, and

then they ask you ‘How do I lose 5kg while maintaining my energy levels for training?’.

Partnering with an Accredited Sports Dietitian (AccSD) can help your clients feel better, be healthier and perform at their very best in a safe way. AccSD participate in SDA’s rigorous assessment process to attain that recognition including regular audit and re-accreditation every three years, setting the benchmark for knowledge and practical experience in sports nutrition. Here are five reasons why you should refer your client onto an AccSD:

1. They take the thinking out of the equation AccSDs have the knowledge on what nutri-tional products are suitable and when the right time is to consume them. By removing the effort out of meal planning, AccSDs will prepare individualised meal plans, showing what should be eaten and when to optimise performance and recovery. They are Accredited Practicing Dietitians who have completed further study and gained addi-tional field experience in sports nutrition.

2. They transfer the theory into a practice AccSDs aren’t just about weight loss (or race weight). They can do sweat testing and hydration plans for athletes, to help reduce cramping and dehydration during training and racing; management of body composition, to help athletes achieve and sustain individualised targets to enhance

performance and minimise injury risk; and food manipulation for athletes with GI issues and food intolerances.

3. Save you time & money Training for endurance events takes up a lot of time. While there is loads of free advice on the internet, not all of it is accurate and could be a detriment to performance. AccSDs are up to speed with the latest industry trends and can help translate this from the lab to the table to optimise athletic performance. They know all the latest products (sports bars, gels, drinks), and can offer the pros and cons for each. They help educate how to fill the supermarket trolley with foods that tick your clients sports nu-tritional goals while not blowing the budget. The knowledge and expertise of an AccSD will remove the ‘whys or what-ifs’ as they do all the investigation work.

4. For confidence Clients attempting first-time goals may not understand the value or importance of a sports nutrition plan, es-pecially in the final stages of an endurance event. Everyone has individual needs and what’s right for one client might not be suit-able another client. An AccSD will provide an individualised nutrition plan for your client to implement during their training, to ensure they get the perfect mix for race day

success while also promoting long lasting change for health and performance in to the future.

5. They’re not the food police AccSDs aren’t there to make life less fun. Your client may even be pleasantly surprised at some of the foods encouraged to eat. Depending on the race, an AccSD will identify the dietary changes needed to achieve goals; they will be realistic, achievable and, most impor-tantly, sustainable. Athletes will still be able to have fun, and enjoy food and wine with friends, rather than be the ‘special’ person who makes extra unusual requests.

AccSDs and ESSA members working togetherWorking alongside ESSA members has a number of positive outcomes for AccSDs. Not only does it help to maintain client satisfaction and protect all parties from operating beyond of scope of practice, it also builds profession-al networks and facilitates mutual learning opportunities. So next time you have a client with committed exercise or body composition goals, put them in touch with an AccSD to help them achieve (or exceed) their performance expectations.

To find an AccSD near you follow this link: http://www.sportsdietitians.com.au/findas-portsdietitian

Keen to learn more yourself about sports nutrition principles in an active sport setting? SDA’s Active Nutrition Course is a one-day professional development event that covers healthy eating advice for different activity levels; how to provide dietary advice within your scope of practice; and pre, during and post exercise nutrition timing. Check out website http://www.sportsdietitians.com.au/NEScourses/ for course dates in your capital city.

bond.edu.au/hsmCRICOS Provider Code 00017B

DS

275

1

Leading the Way in Sports Science

At Bond, I’ve learnt that if you work hard, it is noticed and rewarded. Being able to work closely with the industry professionals who teach at Bond has opened up internship and employment opportunities which have ultimately allowed me to pursue my career with one of the largest university sports athletics programs in the world.

To find out more about our Bachelor of Exercise and Sports Science program and Master of Sports Science program, visit bond.edu.au/hsm.

Sam Coad

Bachelor of Sports Science (Honours) Alumnus, current PhD student and Assistant Strength and Conditioning Coach - Wolverines Football Team, University of Michigan Athletic Department

EXER

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WORKING TOGETHER

FOR BETTER HEALTHA successful program of four regional workshops for staff working in Aboriginal Community Controlled Health Services, and others working in Aboriginal health has been rolled out in New South Wales.

The Aboriginal Health and Medical Research Council of NSW partnered with Exercise is Medicine Australia and the Australian College of Nursing to develop an in-depth professional development opportunity. Four workshops were facilitated in Narooma, Forbes, Forster and Bourke to a combined audience of 55 employees from Aboriginal Community Controlled Health Services, Medicare Locals, and NSW Health staff. The workshops ran over two days and were delivered in two sections. Part one (Exercise is Medicine) was delivered by an Accredited Exercise Physiologist and covered the prevention and management of chronic disease. Part two, focussed on diabetes management and was delivered by a Credentialled Diabetes Educator. The Exercise is Medicine portion of the workshop in conjunction with existing EIM Australia resources supports health

professionals in their assessment and management of patients with and at risk of chronic disease.

Increased knowledge and understanding of the benefits of exercise is clear in evaluations, with numerous attendees identifying that they are now more confident to engage in a conversation about physical activity, and that they have access to resources to support long term behaviour change in their patients. Participants also note that they have more knowledge and understanding of the role of Accredited Exercise Physiologists (AEPs) in chronic disease prevention and management. The benefits of a multidisciplinary audience were also noted throughout the evaluations.

With 84% showing that the content was excellent or good, and 94% showing that

the content is relevant to practice, it is obvious that the workshop hit the mark. Respondents to this evaluation highlighted further resources may be used to address low activity levels, including culturally appropriate resources and the inclusion of statistics from Aboriginal populations. There is a need to up-skill healthcare practitioners in health coaching and assessment techniques and to introduce a range of strategies for the self-management of physical activity for this patient group. Targeted research, projects and programs, and ongoing education and networking opportunities are required to support these strategies and embed these processes into every day practice.

For more information contact us at info@exerciseismedicine.org.au

31ACTIVATE | JUNE 2015

bond.edu.au/hsmCRICOS Provider Code 00017B

DS

275

1

Leading the Way in Sports Science

At Bond, I’ve learnt that if you work hard, it is noticed and rewarded. Being able to work closely with the industry professionals who teach at Bond has opened up internship and employment opportunities which have ultimately allowed me to pursue my career with one of the largest university sports athletics programs in the world.

To find out more about our Bachelor of Exercise and Sports Science program and Master of Sports Science program, visit bond.edu.au/hsm.

Sam Coad

Bachelor of Sports Science (Honours) Alumnus, current PhD student and Assistant Strength and Conditioning Coach - Wolverines Football Team, University of Michigan Athletic Department

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