nursing you: an app designed by nurses to …...nurses understand decisions around unhealthy...
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NURSING YOU: an app designed by nurses to improve nurses’ health and wellbeing
Michaela Nuttall, RGN MSc
C3’s vision
A world where there are no preventable deaths from non-communicable diseases (NCDs) because people find it easier to live healthy lives.
Why is prevention important?
3 risk factors
Tobacco use
Lack of physical activity
What we eat and drink
Four chronic diseases
cardiovascular diseases
type 2 diabetes
cancers
chronic lung disease
70% of the disease burden worldwide
Source: World Health Organization
Our mission & programme areas
C3 fosters multi-sector Collaboration to catalyse action in the global community, to promote 3 behaviour changes:
• Improving diet and avoiding harmful alcohol use
• Stopping smoking
• Increasing physical activity
C3 works globally with businesses, workplace health, communities and health professionals.
85 countries
3,000 professionals
C3’s NCD Nursing Model
1. Improve their own health
• patients • families • colleagues
2. Educate & promote health among their:
3. Disseminate knowledge &
promote skills development
with their colleagues
4. Advocate for NCD
prevention locally,
nationally & internationally
103
members
27 countries
Are nurses more obese than other groups?
18 25.1%
BMI of 30 or over
1st study to provide reliable estimates of prevalence of obesity among healthcare professionals (England)
Odds of a nurse being obese were:
• Higher than other healthcare professionals
• No higher than in non-health occupations
• Lower than in unregistered healthcare professionals
Why does it matter?
Expectation for nurses to be healthy role models Policy Delphi study of policymakers, curriculum shapers, practising nurses, student nurses, and service users
Impact on nurses’ health promotion practice Systematic review of the evidence base on the relationship between nurses’ personal health behaviours and their health promotion practice.
Impact on nurses’ health as individuals Survey of 200 nurses at RCN Congress 2016 to understand their attitudes to obesity, motivations to lose weight, and the availability and effectiveness of workplace health initiatives.
Evidence Review: What works to address obesity among nurses?
• Conducted to assess the strength of the evidence on workplace interventions to address obesity specific to nurses
• More effective interventions combine environmental and individual change strategies
• A participatory approach is important to understand employee needs and organisational culture
• Targeting those who are obese rather than the whole population is more effective
• Interventions need to fit with and support nurses’ working lives
• Lack of take up limits the effectiveness of interventions
• Current initiatives and interventions to address obesity in the NHS do not appear to be evidence-based
Kelly, M. and Wills, J. (2017) What works to address obesity in
nurses? An in-depth review. Occupational Medicine.
Wills, J. & Kelly, M (2017) What works to encourage student nurses to adopt healthier lifestyles? Findings from an
intervention study. Nurse Education Today, 48, 180-184
The Healthy Weight Initiative for Nurses (WIN.)
From 2015 to 2017, WIN. engaged
400 Interviews
Workshops
Focus groups
nurses who are obese to design interventions to help them achieve
and maintain a healthy weight.
WIN. timeline
Evidence review & prevalence study
Individual interviews & focus groups
Workshops and intervention design
NURSING YOU / Access to food / course
Evaluation and final report
Why do nurses think nurses are obese? Theme N
Work organisation “Lack of breaks or short breaks make it difficult to eat healthily” 46
“The work is more sedentary with the amount of paperwork” 9
“Shift work makes it harder to eat regularly and healthily” 59
Environmental factors “Chocolates, cake and biscuits are given as gifts, brought in for meetings and in the hospital
outlets and so are always available”
25
“The canteen makes it difficult (no healthy choices, too far away, too expensive) to eat healthily
and is not open at night or weekends for healthier food”
15
Nursing
Emotional labour: “Nursing is draining and stressful and self-care is not a priority and so nurses
resort to ‘comfort eating’
22
Social norms: “Most nurses are overweight so nurses think it’s “normal” 3
Individual responsibility “It’s not the job itself, it’s individuals’ own lifestyle choices” 18
What do nurses think should be done?
18
• NURSING YOU: An interactive tool to help nurses understand decisions around unhealthy behaviours, particularly at work.
• Living & Working with Obesity course: in partnership with the College of Contemporary Health.
• Access to healthy food at work: Restricted access to healthy food and drinking water was consistently described as a significant obstacle.
• This issue required further investigation through a survey to identify the barriers to nurses eating healthily.
‘The overwhelming response [to
WIN.] was “it’s about time someone
looked at this.”’
- WIN. participant and member of the advisory group of nurses
Benefits of NURSING YOU
NURSING YOU outcomes
• 66% active users
• 1,055 NURSING YOU users
• 1,747 goals set
• 498 badges awarded
Next steps
Why nurses?
If the millions of nurses in a thousand different places articulate the same ideas and convictions…and come together as one force, they could act as a powerhouse for change. Dr Haefden Mahler, WHO Director General (1985)
