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Reducing cardiovascular disease risk requires many approaches including healthy ways of life and preventative interventions. Smoking, Diet, Alcohol, Physical activity and Obesity are all important but often difficult to manage. Scotland has lead the way in national tobacco control problems but much less action has happened in relation to diet and obesity. Our work is focussed on identifying effective ways to support behaviour change both through working at policy level with government and developing interventions across the life course from ways to support breast feeding in early life to diet and activity programmes in later years.
Our work has targeted “teachable moments” in life when people may have had a disease scare or when they have developed a greater awareness of cardiovascular disease (often due to family reasons). By using approaches which combine capability (e.g. education, food skills), opportunities (e.g. providing pedometer based walking programmes) and increasing motivation (e.g. through setting realistic goals for change) we have shown we can produce effective behavioural change in diet, activity and body size.
We have combined cardiovascular risk measurements and behaviour change in cardiovascular and cancer screening settings and thus creating opportunities for decreasing overall morbidity profiles. Working in large multi-disciplinary teams have also allowed us to develop effective lifestyle interventions in conjunction with football clubs offering football fans the opportunity to use club stadia to participate in weight loss programmes. We have also undertaken schools based programmes (focussing on fruit and vegetables) and clinic based programmes (focussed on increasing physical activity).
The TICR facilities have enabled us to develop and provide low cost, “hands on” interventions on food skills which we have also used in community based programmes as a positive route to demonstrating (and tasting) healthy diet options. We have also benefited from patient and public input in helping us understand the challenges of weight management and how we might develop more effective programmes for change.