Embedding physical activity for health in student learning in practice

Aim
To design then evaluate a physical activity (PA) intervention within the UWS nursing curriculum in order to increase student awareness and skills in health behaviour promotion in themselves and in others.

Introduction
In 2009, it was estimated that 58% of NHS staff were overweight or obese with 40% partaking in PA on two or less days per week. Nurses’ own health behaviour could be improved; the fact
remains that many nurses engage in unhealthy lifestyle activities. Yet evidence has demonstrated that health professionals, such as nurses, can be effective in increasing PA with patients during consultations. Supporting nurses at an undergraduate level to deliver PA health behaviour change could further the preventative health agenda by embedding skills/competencies at an early stage.

Method
Action research using focus groups and photoelicitation techniques were used to obtain students' opinion and experiences about their engagement with the PACE initiative. Experiential learning is appropriate as it is thought to be insightful to the learner. It was
envisaged that student nurses would have a greater understanding of PA benefits both for themselves, and those involved in the initiative, as they had to source the evidence of the benefits of PA allowing them to promote this effectively to their selected community group. Prior to visiting the community group, students were required to review current evidence and policy including e-learning modules on PA and health behavioural change for each life course stage. Thereafter, in small groups, students delivered their evidence to a wide range of cross sector groups.

Results
Three themes emerged from the focus group data:" Graduateness", "Reflections", and “Making Connections". Students promoting PA to community groups reported an increased knowledge of PA and the benefits of activity to themselves and those in their care. Students
benefitted their “graduateness” in participating in the intervention reporting the need for adaptability, creativity and good communication skills. Importantly, the students were better
equipped in “making the connections” then applying them within practice. Some students struggled with promoting PA publically and were concerned that groups would not be supportive. Student “reflections” found the experience had helped with presentation
anxiety/confidence to discuss PA. One student stated that “some nurses do not know the recommended exercise. I now feel I could discuss this with my mentors and other nurses”

Discussion
The intervention reached organisations/groups where PA levels are often reported to be low. These included for example; breast feeding groups/after school clubs/mental health organisations/lesbian/gay/transgender/transsexual groups and nursing homes. The intervention therefore contributes to outcome 1 of the Active Scotland Outcomes Framework for PA to encourage and enable the inactive to remain active throughout life”

These findings support the “Health and Social Care” ambition within the Scottish PA Implementation Plan that all NHS and Care Services to be promoting PA recommendations.

Conclusion
Nursing students gained confidence and insight into the need to be physically active both in themselves and those in their care. Providing experiential learning opportunities should be
considered a key approach to empowering nurses to deliver health behaviour change in practice.