A lifestyle modification program developed by the Macarthur Division of General Practice (now South Western Sydney Primary Health Network) has been so successful it is continuing to expand nationally.
Originally funded by the federal government in 2010, the Healthy Eating, Activity and Lifestyle (HEAL) program is an 8-week, group-based intervention for people with, or at risk of, developing chronic conditions such as obesity, diabetes and cardiovascular disease. Participants require a referral from a general practitioner (GP) or must complete pre-exercise risk screening, with medical clearance if risks are identified.
Once enrolled in the program, participants:
- Receive an initial assessment to discuss medical history, current eating behaviour, physical activity, and goals and expectations
- Attend a nutrition and healthy lifestyle education session weekly
- Undertake a one-hour, moderate-intensity, supervised group exercise session weekly, with home-based exercises between sessions
- Receive an individual assessment after 8 weeks − changes to body measurements, eating and physical activity are assessed, and goals reviewed. A summary report is sent to the referring GP
- Five months and 12 months after starting, participants are assessed against the same measures as the initial and post-program assessments. Outcomes are sent to the referring GP.
Evidence based
The Executive Director of the Centre for Primary Health Care and Equity at the University of New South Wales, Professor Mark Harris, said HEAL was one of the most widely adopted and successful of the preventive programs developed and delivered by Divisions/Medicare Locals.
“It provides a local, evidence-based group program option at low cost to patients referred from primary health care services,” he said. “It will be important that this is supported in the transition to Primary Health Networks.”
National HEAL coordinator Jerrad Borodzicz said HEAL had been successfully delivered in a variety of settings across Australia, including by 46 local councils who originally adopted the program, and 26 organisations that are continuing despite cessation of federal funding in 2013.
He said a recent qualitative study (unpublished) involving program coordinators and stakeholders had highlighted the importance of identifying underlying health, behavioural and psycho-social problems commonly experienced by program target populations.
“Despite the diversity of target population needs … a common theme arising [from the study] was the importance of program facilitators and stakeholders being able to identify and define these specific and sometimes complex underlying factors,” he said.
“This [study] highlighted the importance of having an excellent understanding of target group needs by those involved in designing program implementation strategies. By modifying their program delivery they were able to overcome the identified challenges unique for their target population and engage participants in HEAL.”
“Changing lives”
Jennifer Green, service support manager at South Western Sydney Primary Health Network, said it was exciting to see HEAL grow from a local program in south western Sydney to a national one “changing lives Australia-wide”.
“Its success is based on its adaptability to different communities and cultures, where the unique needs of each community can be catered for,” she said. “In a world of fad diets and quick fixes HEAL is successful in promoting long-term lifestyle changes by setting realistic short-term goals.”
Gillian Street, from City of Cockburn in Western Australia, said the city introduced HEAL via funding from the federal Healthy Communities Initiative. She said Department of Health WA data had shown 73.8% of Cockburn residents older than 16 were overweight or obese.
“The results from HEAL exceeded our expectations − the last 69 people who completed the program and were measured achieved an average waist reduction of 3.8cm in 8 weeks. I often attend final sessions and am amazed at how confident participants are that they will continue to make gradual changes.”
