Alex: 0:37

Hello and welcome to the Working it Out podcast. I'm here today with Move Consulting Director Elaine McNish. Welcome to the Working it Out community, Elaine.

Elaine: 0:47

Hello and thank you for having me on your podcast.

Alex: 0:51

No worries at all. This is a, an amazing thing for me and one I want to say, because it's a proud moment of your organization reaching out to have a conversation with us. So thank you very much as an organization for reaching out and wanting to get involved in the conversation.

Elaine: 1:03

No, you're welcome. It's, I've had a chance to take a look at some of your podcasts and it's really interesting the angle that you're taking and coming at it from a slightly different angle to some of the other podcasts out there. So thank you for inviting me again.

Alex: 1:18

That was really great to hear. So what we do with all of our members is we've got a Working it Out locker where previous guests will add one item into our Working it Out locker. It could be anything to do with your relationship with physical activity. So I'm really interested to hear what yours is. What would your one item be?

Elaine: 1:36

I had a lot of thought about this. It feels a bit like desert island discs, doesn't it? It's a little bit, and was a bit of me that wanted to go a bit traditional and put my dry robe in there, but I went no, be honest, I'm not letting my dry robe go anywhere. It's too precious. So that's not happening. So I thought a little bit left wing as it were, or left of field and I've gone for sea glass. a piece of sea glass.

Alex: 1:58

Seaglass?

Elaine: 1:59

There is a good reason for it. You probably have guessed from my original proposal for the locker, the sea in particular is my happy place. I am really lucky to be able to live. to be living not far from the beach at Portobello and up in Edinburgh, And to be able to get into that water all times through the year, believe it or not. Some people think I'm completely bonkers, but do love it. And also the other aspect of it is for me it conjures up a moment. My, my nephew and I, go walking along the beach every so often we get To. And we've had a number of occasions where he's better at collecting sea glass as I am because he's a bit shorter so he can see them easier. And I remember one occasion where he turned to me and he went, this is better than being on a computer. And I was like, Yes! I'm not sure he would say that. This was a year ago, so whether he would still feel the same way, I'm not sure. But it was just being out and about with him. And then we can take them, we've taken them back and made things out of them, pictures Other things. So for me, I've gone for sea glass. And if I was being a little bit metaphorical, if I want to take it to the nth degree,

Alex: 3:05

Please.

Elaine: 3:06

what I like about sea glass is it goes in all jagged edges and not looking particularly pretty. And it gets knocked around a bit and it comes out something different. And I suppose that's happened to me, I feel in my life. I've been knocked around a bit, but hopefully I've come out something bit different, bit better and a bit stronger from the, from it.

Alex: 3:27

Wow. What a start. I've made, I didn't think I'd be writing notes, like scribbling down this quite as fast as I have been. There's quite a lot to dig into there. So the first part is just the dry robe would have been a great shout as well. I know how popular they are, and it could, And I'm really interested to dig more into water being a happy place. And when we talk about the early memories, I can imagine that will be coming up. I think the interesting part is that last bit you said there around being knocked about a bit, be interested to understand more what you mean by that, please.

Elaine: 4:00

I think I was at the back of the queue when they were handing out body parts some times. I'm living with a number of health conditions. I've had cancer twice I've just had a diagnosis of arthritis. So I'm, for me, it's understanding particularly when it comes to physical activity, I've had to modify. Maybe my expectations, but also I'm still learning about what this new state of body needs and continue, will continue to need as I go on. So for me, there's a lot of learning that's come from that. Ironically, the first time I was diagnosed with cancer, I was working for Macmillan on their physical activity campaign programme. I remember going to my boss and said part of this role is. understanding the needs of people with cancer and when it comes to physical activity. I think I've gone a little bit too far this time. I mean that I've been at a diagnosis myself. And they was invaluable. That learning experience about learning and being stronger. I done my, training in cancer and physical activity. I've done the qualification was level four. that helped me a lot through while I went through the disease and the treatment, but what it didn't prepare me for was, you can talk about how Particularly chemo impacts on your fatigue but it isn't the same as going through it. And so as a result of that, I learned a lot about being active during that treatment phase and what it was like to try and continue to be active during that period of time, which can be very challenging, particularly the chemo phase, I have to say the rest wasn't so bad. So for me it was, there was a huge learning experience from that.

Alex: 5:46

Thank you for sharing that. That's that's incredible. So you say, I think that's definitely just dig into this more in terms of the learning experiences, because I feel like there's definitely things we can learn and share here. So what what did you learn? What did you take away? What was the your experience in terms of how to manage that fatigue, et cetera?

Elaine: 6:05

Yeah. For me it was you can do the theory and they can learn the theory till the cows come home, but you have to work out what works for you as well. And so the theory was that. I knew that I needed to remain active. It was going to help with a number of outcomes for me in terms of supporting, my treatment supporting my energy levels. The obvious, the evidence is suggesting that it reduces the likelihood of it coming back. So there's lots of, I knew the benefits are there and in abundance. But when you have. Particularly the last round of chemo when you're, you achieve something when you just get out of bed and put a washing on, then you go, Oh, this is what fatigue feels like. It feels like somebody has essentially taken a syringe and sucked every energy, ounce of energy out of your cells. It's a really weird type of fatigue. And I'm sure, people who've been through it will know what I'm saying. And so for me, it was things like, okay, I'm going to go up and I'm going to go for a walk. Now, I don't know if I'll feel better or not, because I might be feeling sluggish because of the treatment. I might be feeling sluggish because I've sat around a lot because of. felt so bad. it might be that I'm losing some fitness as well. And I don't want that to happen. So I came up with my own. I'll go for a walk. If I felt better, I would walk a little bit further. If I felt rubbish, I would come home and go, it's not for me today. it's little things like that. The bit I struggled with is sometimes trying to cram much into the days that you feel really good. And that happens with other conditions as well. We hear it a lot from, with people who've got other health conditions. You try and do everything and then you're absolutely floored for two days afterwards. And that's a difficult one to get the balance right on. Because all these little things that you learn as you go through and They don't always teach you, sometimes they do, but as experienced instructors, we'll have listened to their clients and we'll know about this. But experience, it obviously helps when you're looking to support other people as well.

Alex: 8:13

In the first eight minutes of this podcast, we've spoken about everything from experiencing proper fatigue to happy places. So there's some real highs and lows in terms of emotions for you. This, which I'm interested with this next part around when there's, when it comes to physical activity, what one emotion would you describe your relationship with it?

Elaine: 8:35

for me, it represents freedom. Freedom is freedom of movement when I can make it terms of when it feels free, because some days it doesn't. It doesn't I'm struggling with the arthritic knee so there are days when you go out and it just feels amazing and there are days when you go out in it and it's painful and you have to moderate what you're doing but at least I'm getting out so that's the main thing and being in the water is definitely a different sensation and I've been helping out recently. There's a research project going on of the feasibility study looking at people who have had a fall in the water and providing them with an exercise programme. So I volunteered to go along to help out, get in the water with them and help them with the exercises. And In they said to me that I've heard over and over again when I was working for Swim England and we were doing the water being project, people feel different in the water. My group I go swimming with the Blue Tits. They

Alex: 9:35

Great name.

Elaine: 9:36

They are a real mixed bag of people, lots of people with arthritis in that group, who come down and swear that it helps them. It helps them either manage the pain, it helps them psychologically. There is something about being in that water and that floating action and that freedom that comes with that is really valuable. And we know from some of the research that was done. Off the back of implementing the good boost component of water wellbeing, that we were attracting people who couldn't walk 100 meters, couldn't walk, because that they could do things in the water that they couldn't on dry land. So for me, that movement and that freedom of movement that comes with being in the water is such a valuable thing.

Alex: 10:22

That's amazing. I think I've gone through a process which is the flip opposite where I'm currently learning to swim. So the water is quite a scary place, was a scary place for me, but where I've gone from, I speak about it all the time. I've just done the London Marathon, but then I hurt my knee. My, my wife recommended that I do some swimming to, for rehab. I go swimming and I try to do a length. I was like, I can't actually swim. I'm not actually that good at swimming. So then I've gone and started doing lessons. And yeah the difference that I'm feeling compared to exercising, especially the pressure that was on my knee all the way through training Being in the water, even though I'm tired Lung capacity wise from being like not being able to breathe properly underwater But like the pressure that's off my knee is just fantastic. So it feels like you can definitely do a lot of work

Elaine: 11:09

yeah, and you'll reach a point where that confidence comes. The interesting thing about we're coming back to Edinburgh and supporting that project I was in is I went back to the swimming pool that I really learned to swim in, and boy did it bring back some memories. It's also the swimming pool that David Wilkie was club was based at. So there was quite a lot of stuff going on around, obviously his unfortunate death. Death and memories of, from people who had swum with them and so forth. And they're all, in Edinburgh, we've got these beautiful Victorian baths. as a child, I remember having conversations with my grandfather and I was convinced that they, you had your own individual bath. That's what I thought it was like. I think originally some of them were, they were like, like that. But yeah, so they're beautiful environments to swim in.

Alex: 11:55

Yeah In terms of you've spoken about your childhood there and in learning to swim What is your earliest memory of being physically active? Is it linked to swimming or is it something else?

Elaine: 12:06

It probably isn't so much because I didn't get confident at swimming until I moved from primary to secondary. And actually, I was quite scared of the water as a child. And it was that swimming lessons in the summer between. Leaving primary school and going to secondary and having this amazing swimming instructor, David. Don't know whatever happened to David, but he changed my life in terms of swimming. He was so supportive and I gained confidence that summer. So for me, swimming wasn't initially my thing. I think my early memories, there's twofold, the more relaxed or free, freed one was that where we lived, we had a back lane and every, all the children just emptied out into that back lane. So summer holidays, that's where we were up and down that lane, cycling, running, whatever, just. games and things like that. it's really sad because mum still lives in the house and you look down the back lane and there are no children out there any longer. And it's so sad because that was, we made friends back there that's the whole street, you know the two backing streets played there so that was great. And I suppose the other memory for me was really around my dad was a very good coach, very good rugby player and so it, we used to spend a lot of time running around the outskirts of rugby pitches while he either played, coached, or whatever, then went into the bar afterwards and we'd run around the rugby pitches there while we waited on them. So I suppose those were the two memories. One was more, more related to a structured thing, and the other one was more out there and free and play.

Alex: 13:44

so really interesting examples and a common theme throughout most of these podcasts so far have been linked to school and their relationship with school but yours seems to be very much around everything outside of school. So your opportunity to swim, your opportunity to play at home, your opportunity to do activities with your father. What was your relationship with physical activity in school like?

Elaine: 14:10

Yeah, I think I unfortunately particularly hit secondary school when we had massive teacher strikes over a period of time. And we had very limited facilities at our school. I played hockey because that, to be honest, was the only extracurricular offer available to us. So I did play hockey.

Alex: 14:29

Okay.

Elaine: 14:30

But we had quite a, were limited in that extracurricular when the teacher strikes hit and they seem to be, I don't know, my memory of it was that they were a long But they probably weren't. We obviously did things within the curriculum. And I think in Scotland, it was a slightly different scenario because we had a lot more mixed sessions. So mixed gender sessions which. To a degree, it worked, but didn't work I think in my experience when I've spoken to people who were come from, In England was everything was far more segregated. The only thing they segregated for was for rugby and hockey. That was it. And everything else was mixed sessions, so I think there was a bit of a challenge there for me in terms of I'd lacked confidence, maybe in being active, and I also was growing up in a world and particularly my dad's world where my dad's golf club didn't have lady visitors, my grandfather's, they didn't, they were allowed in one part of the clubhouse, and when I think back, there was a subliminal message that yeah. certain sports weren't really meant me As a young girl or a woman. Now, I'd I'm glad things have moved on a lot, that was always there in the background and I think when I really came into my own was in our final year of school, Miss Scobie, our PE teacher, introduced a session at lunchtime, which was basically she put on Jane Fonda workout tape. That's how old And we did a session and I loved it. Absolutely loved it. I can still. There are certain songs when they come on, I can still remember the exercises that go with it. It's so ingrained and and from that really, it was like, Oh, actually, there is something that feels right for me here. That exercise sort of movement that was going on in the 80s. I had the leg warmers. Yes. And all of that. And

Alex: 16:25

amazing.

Elaine: 16:25

That was where I was introduced to that. So it was through school I was introduced into that.

Alex: 16:31

Wow, there's a lot there. But so yeah, thinking about, Your parents and family in general, so you say it seems like your dad had a slight influence on the activity because he was involved in it himself and then earlier on you spoke around about your nephew and now you're taking your nephew to do some activities. Is it, is that a common thing in your life? Are you and your family quite connected when it comes to health and well-being, leisure, physical activity?

Elaine: 16:59

Yeah, unfortunately my dad died quite young but we, I suppose as growing up we were following his career and he was offering support as well around being, as being active. So although he lived in this quite, I suppose macho world of sport as it was at the time and he was, got on the bench for Scotland at rugby. He coached scotland,

Alex: 17:22

he

Elaine: 17:23

got, he was a very high level coach and then he was a scratch golfer as well. Very annoying.

Alex: 17:27

that is

Elaine: 17:29

That influence and that abilities and those things were happening. Sport was part of our world. My mum worked at the sports club at the rugby club and in, in the as a secretary in the club. And all of those connections have remained throughout my mum's life and they, that network of support is still there. That's another aspect of that sporting Comes together. So I think for me, it was I then went on to College to Liverpool when it was a polytechnic before it became John Moore's University. And I wanted to have a go at this rugby sport. And it was very early days of rugby. It was, I think, the first Women's World Cup was just happening. It was that kind of era. And so I did have a go at it. I wasn't particularly good at it. But I was, I enjoyed it. Because it'd been like, the sport that had always been around me but had felt out of reach for me to be able to have a go at To do that. So yeah, it's interesting how those opportunities arise and, when you can grab them you do.

Alex: 18:28

Yeah.

Elaine: 18:29

that was that one. And then, my mum's probably It makes me laugh sometimes because my mum's not sporty, I would say. She was more into, when she grew up, she liked singing and things like that. But my mum's now in her 80s and she's probably one of the fittest 80 year olds I know. Not from doing any, she'll, not from doing anything sporty or exercise classes or that. Hers is all the informal stuff. Going up and down the stairs, cleaning the house, doing the shopping, all of that sort of stuff. She is still doing. She hasn't got a cleaner. I keep thinking at some point she's going to need some help there. She has retained that level of activity throughout her life. And it's interesting when she talks to her peers. Many of them are becoming quite disabled and mum is still ploughing out there, going to getting on with it and doing these things. So it's activity by stealth in her case.

Alex: 19:25

Oh yeah. I can definitely see it and understand because on one side I've got my wife. Grandparents who passed away just well grandfathers just passed away recently at 98 and up until he was 94 and his grandma was 91. They were incredibly active but exactly like you said they were just doing the gardening just doing everything just normal day to day stuff go physically going out they shouldn't have been driving we thought but they were still driving to the shops and doing their own shopping. And then on the flip side, there's my grandmother, and she's pretty much bed bound. And just the movement part of it, I've always said to her, and that's been the biggest frustration for me. I don't think I'll ever achieve in my job until I get my grandma to be able to walk just to the shops and back. But it's a real mental barrier for her. And she's, like I say, if you don't move it, you lose it. And you see it in front of your eyes. So yeah it's a real mental barrier. When you get to see grandparents who are just, like Beccas, who are just darting about, it is still really good to see.

Elaine: 20:31

Yeah, definitely.

Alex: 20:33

So we've gone through a lot here, and so this is where we could transition into the second half of the podcast. So for those who haven't haven't heard of you before, or haven't heard of your organization before, I'll do a little intro on the social medias, but if you could give everyone a good idea, a good understanding of your role, organization, and just linked to physical activity, that'd be great, please.

Elaine: 20:56

so just to give you a little bit of background, as you can probably have guessed, all of my life has been working around the physical activity sector and I've been lucky enough to approach it from lots of different angles. I've worked in governing bodies of sport, I've worked in. in charity sector. I've worked in local government. I've had a period of time in, in the Welsh government. I was based in there leading on, I've written two Welsh sports strategies over the years. So if they do well at sport, I take some credit. I

Alex: 21:26

That's good.

Elaine: 21:27

Then And then laterally I was working for Swim England where we were developing whole systems approach to supporting people with health conditions into the pool. And so that theme of health and well-being has also been a thread that's run through my career. And We set up Move, myself and Craig Blaine, who had been working for UK coaching, similar background interest in health and being in particular. We set it up about, it was coming up to four years, which is amazing. how's the time passed so quickly? And we were really interested in, supporting organizations, because we recognize that we see a lot of wheels being reinvented in the industry. And we're really interested in supporting organizations to design programmes, particularly for those who are inactive. So that's our area and mainly adults, although we have done some work with kids. And I've, in my past, I've done a lot of work looking particularly at children's health and well-being, but a lot of the work we've done has been adult focused. So we were really interested in how do we support organisations to essentially design and develop interventions, if you want to call them that, or programmemes or projects that will support the least active into physical activity to help them gain the confidence and skills to move in a way that works for them. And one route is pathways. So we've been looking a lot at physical activity pathways. That's one of the big pieces of work that we're doing at the moment. And this was that's really stemmed from, I think when we set up the business, as I said to Craig I'm really keen, having set up Exercise Referral in Wales as one of the projects that I led when I was in the Welsh Government. I think there's so much more than just Exercise Referral. I think there are approaches that we need to take a look at about how do you support people in the right way, the right level of support, the right opportunities to get them into activity and get them to fall in love with activity. But also to, I've always said that I think for me, we know we've got, we've done our job if we can create. people who are able to be active in a way that works for them and they can access the menu of activities out there. They can become more free range for want of a better way because we don't want them to be totally reliant on those structured opportunities that are out there. for me it's about, we know we've done our job right when people can do that, pick and mix, do that, be active in a way that they enjoy and love and fall in love with basically if they haven't already.

Alex: 24:06

I'm really interested in digging into the physical activity pathways. But I love the term free range participants. I just, in terms of being free range, that's something which I've never heard before, but It just makes sense in my head. It just the concept of it is something which is really fun. So I don't know if, I feel like that'll be a shorter bit. Is that just something which you coined or is that an actual, is that something that actually exists? I love that saying.

Elaine: 24:36

echoes back in my mind to, I think there was a children's report about, I think it was Couch, something about Couch kids. They were talking, particularly I was working with a lot of the play organizations, at the time when it was in the Welsh government and they were saying, actually, this idea that I mentioned at the beginning is why are there not children playing in the lane behind where my mum lives? Why are we. Why is that not happening? It should be happening. That's a fairly safe place. I would, there's no cars go up and down it. There's that, but it hasn't and doesn't happen, unfortunately. They were talking about The idea of children being, I think they described it, it was in relation to childhood obesity. If my memory serves me right, it was something like, I like to being in aviery car, can't say the word. So essentially being fed lots of food and not being allowed out, which was causing some of the challenges. So the idea of creating more free range children, I think it applies equally to adults. So

Alex: 25:36

Yeah. Oh, a hundred percent. That applies to adults. Cause even thinking myself. When I try to explain my role to even family and friends who, none of them work in the sports sector at all. They go, Oh, so you're a PE teacher. You must be like on your feet quite a lot. And I'm like, I'm sitting at my desk eight hours a day and in meetings for seven of that, looking at a screen, which is really unhealthy. So I have to really force myself before or after. So sometimes I do feel like a cage 10 in this spare room. So that's why I think I like the concept really well. So yeah, that sounds I'm going to use that. And the next part is around physical activity pathways. You say you're currently working in that area.

Elaine: 26:19

Yeah.

Alex: 26:19

Could you give some more information about what you're currently working on?

Elaine: 26:21

Sport England have funded active partnerships and we were part of the bidding process for this piece of work. So we obviously were successful in that, which was great because it's our passion. To be honest, it's what I've been doing most of my career. And where it. where we were starting from was there's been quite a lot of discussion about exercise referral over the years. I've sat on nice committees that have helped develop some of the guidance around that in the past as well, but we recognize that the world was changing. That model of purely looking at exercise referral was perhaps too constraining for people. And we were seeing people wanting to broaden out the offer essentially, in England, I would say because of the different types of funding pots, the different models that are out there and so forth. In Wales, we were able to create a fairly uniform service which is still going. keep losing track of dates, but 10, 15, 12 years on from when it started. So that's great. But even there, they're looking as well at how do you broaden out the offer? Because at the moment, that's their main offer for supporting people into activity with health conditions. And, At the time we were having these, the time that we were thinking about this and before this project even started, we'd seen the consensus statement come out which was basically saying that physical activity was pretty much safe for most people with health conditions and that Should have had the effect of maybe from our perspective. We were thinking this is great. That's going to open up opportunities to more people, but it started a debate and a discussion and people were finding that actually the whole area of risk was coming under the spotlight yet again about what does this mean and so forth. And the project that we are looking at, it was really to try and understand how do we create integrated pathways, because we have numbers of offers of pathways operating in one area, which makes it very confusing for health professionals referring in, but also for individuals who may be able to self refer into these pathways, or there are other routes in through, sometimes through employment services, through various other ways. So there's lots of different routes into these, but it can be a bit confusing because of different pathways. On the whole, there have been quite a few. focused on a traditional exercise referral offer, which is leisure center based, not always, but can be. That's not to say that it's only gym based, which is good. They're often broader than gym based, but quite a lot of them are very focused on gym based activity. So how do we broaden that out? Because there's a whole host of opportunities out there and I've always said, you can design the best exercise programme in the world. And, but if they don't come back on day two, because it's boring, or they don't like the gym, or they don't like whatever, then you failed. And the risk is not necessarily around the disease and the risk of adverse conditions. The risk is a behavioral one. Where that they don't get the support that they need and they're not able to keep coming back and enjoying it or feel don't have the confidence to do that. So what we want to do is we're looking at these pathways to try and understand what are the core characteristics of it. And we've done a bit of work and some previous work with some areas looking at. What are the key characteristics of pathways? What things we need to get right? What are our ambitions for these? And then this phase of the project, this part of the project is really trying to look for tools and ideas and trying problem solve the challenges that people are facing, getting them up and running. So we're doing it in a number of ways. And we have some lovely people who have agreed to be part of our communities of practice and those communities of practice are currently looking at a tool. And we'll be looking at subsequent other tools as well to see if they might help address some of the challenges that we've identified. So we've done more work around the challenges and the questions, and now we're looking for solutions. So the first part is the communities of practice are going out with a tool that's actually come from Scotland, which is looking at proportionate support and the right level of support for different they've tiered it, which is interesting That came out yesterday also has a tier approach to it, which is the one that the Faculty of Sport and Exercise Medicine have just produced their roadmap looking at pre exercise screening. So that we will be working with them to look at how we bring that in. So yeah, we're working with them to do that. We're also putting out surveys and If people can keep their eye out for a survey, so anybody that's been involved in the delivery of pathways have and thoughts and solutions to some of the challenges we've got, we're going to put out a sort of call for answers to those challenges so that we can collate in best practice across the field. Because I think. We wouldn't have operating people hadn't found solutions around the problems. So we believe the solutions are out there, somewhere. They may just be different solutions in different places, but we want to bring them together to essentially create a kind of, not a how to guide, but with flexibility. We're not going to, I don't think because people need to be able to adapt this to their own circumstances and environment, but to at least help people along the way too. To understanding what works, what might work for them, what ideas have they got and how can they make it happen?

Alex: 32:07

You've just answered the part which I was thinking in my head whilst listening because earlier on you spoke around a whole systems approach and Especially within Sport England also having a sort of place-based approach to the way we're currently working. I was thinking how to say. What was your thinking around a solution for England? And, but you very much spoke around it there in terms of proportionate support has to be flexible and look different in different places. That makes the task extremely challenging.

Elaine: 32:37

it does, yeah. And you can throw into that when you talk about place based, making best use of those amazing community assets we have out there. Because up until now, we've probably not made that connection, fully, I think, between health and being and maybe using our sports clubs networks. It's happened in some places, don't get me wrong, and we have got examples of community football clubs leading exercise referral, older people's projects and things like that. So there are examples out there, but I don't think we've really maximized that. So yes, it is a complex system. We have no doubt about it. How do we go about it? Ask me in six months time, because

Alex: 33:21

Yeah.

Elaine: 33:22

we're still looking. What's reassuring is. When we've looked at the challenges and the things that are coming up, is nothing that we probably weren't aware of. But, so it's good that we know roughly what those challenges are. What does make it difficult is one challenge can, by solving it, you then have an impact on another area. So it's a bit like your web that you are growing. It's not dissimilar in terms of how interconnected different things are. And I

Alex: 33:54

the ripple effect it has.

Elaine: 33:56

and I think, but I think if we can collate all of these and bring them together, that's going to help people because I think that's the other challenge there. And I don't know if it's happened because of COVID or whatever, but we have been working in silos And so people have gone away and there's some amazing stuff going on, but they're not always connected. I used to work at a centre called the British Heart Foundation National Centre for Physical Activity and Health. You may have heard of it. It's gone, unfortunately. But it's got subsumed into the National Center for Sport and Exercise Medicine, some of the work that it was doing, which was great. It was good to see that being absorbed. But the one thing that probably was missing was what we did was try and join people up. And we'd have an annual conference each year that would have a theme and we would bring the best speakers, the best people who understood that subject area and really interrogated. And I don't think we're doing that in the same way as we used to then, which is a real shame. I think, and also what we would try and do is bring the academics and the delivery system together. And I think there's, with some exceptions in Scotland, we've got a centre which is really focused on trying to bring academics and practitioners together. But on the whole, it's not. It's not happening the way it used to and through that center. Yeah, it's a shame because we need to really look at what's happening on the ground, learn from it, and really try and then make sure that's spread across. So people aren't reinventing wheels all the time.

Alex: 35:28

So we've gone over quite a bit of just talking about your current work and I can see exactly where you're passionate about it and your, and the areas that you're wanting to intervene. The next part is all around. If you wanted to tackle the causes of inactivity and you were going to start building a map. I've been building this map with CEOs and it was started to really flesh it out now. So I'm interested to hear. Where your thought press would start, if you're going to start mapping out the cause of inactivity, and then let's start digging into some specific causes. If I can narrow you down.

Elaine: 36:05

Okay. Yeah. Narrowing down. That's an interesting one.

Alex: 36:08

That's a hard part. Yeah.

Elaine: 36:10

I know that one of your previous guests has talked about the COM-B Model. Number of different ways when trying to really identify some of the challenges, particularly around designing programmes. And so we used it when we worked with the Chartered Society of Physios looking at their what became their stronger my way campaign. So we were trying to understand what were the capability motivation opportunities of physios themselves in terms of the advice and support they could give patients. So we look at that. We've also used it and looked at it through the lens of creating a wider strategy. In Buckinghamshire, we were looking at strategy development and trying to understand of activities that were coming towards that strategy, where was their focus? Did it cover the range of things that we were looking at? Of course, when we start to look at it in a systems approach, I suppose that the opportunity is there's loads of evidence out there around the design of the environment. And is a critical part of it. So it's interesting to see how when I worked in the Welsh government, I work very closely with the transport division. For example, we created walking and cycling strategies and looked at those component parts of it. So for me, that environment is really vital. It drives behaviours. Activity by stealth, which I find interesting because if you enable those behaviours, or you make places lovely for people to go walking around, then they will go. It is possible to create those environments to create walkable neighborhoods and all of those sorts of things. So that is an important part of it. The opportunities as I said to you, they partially they the other element of it is the opportunities to be able to utilize those. And that allied to the capability component. Come in for me. I do go back to using that free range concept. We are about trying to give people the confidence to be more active. and for some, it's, it is a difficult thing, if you have got a health condition. The first thing is you don't know and you're afraid that you might exasperate it. Now, we're slowly, the evidence is there to say that's not the case, but we've got to win the hearts and minds of both health professionals and and patients and participants to really understand what that means for them in a meaningful way. As I say, it was really interesting working with those falls patients recently because they, that confidence was the big thing for them. There were people who couldn't swim who had chosen to join us and get in the water. Is amazingly brave, but it shows the motivation they had to want to be active and to try something. But yeah, they were quite nervous, but we worked around it and over the, period of time the instructor worked with them and their confidence grew. So it's important that we're able to do that to provide them with that capability component of it. And hopefully the motivation will then follow with that. We used to use the term teachable moment in, in the cancer world. So a diagnosis might be a teachable moment for someone. And can we capitalize on that? And another project I volunteer at is 5K Your Way, which we've just started up in Edinburgh. And that's just providing people to come down who have been touched by cancer in some way, whether it's they've had a diagnosis themselves, whether they're going through treatment, whether it's one of their loved ones or people they know just to come down and join us for parkrun. Now they can volunteer, they can walk, they can run, they can do whatever, but our job is to make it enjoyable experience, not forgetting the coffee and the cake afterwards, very important, and to make sure that they in love with activity again at a time when it might be a challenging period to be able to do that and to get out and do that because we know from lots of research we've heard, that people really want to be active. There is a new report that came out recently that says that the there's an empathy gap as they classed it between what professionals think, that people with health conditions need or want or their motivations are and what those individuals are themselves. People want to be active, they are challenged with pain, fatigue and they need some support to understand what that's like for them and how best to be able to be active through those lenses. So for us it's about if you only want to walk to the first bench, have a seat, that's not a problem. You're out here, you've got here, that's good enough. We just want people to move in a way that works for them. Sorry, I think I've gone off piste from your question

Alex: 41:05

no, you haven't gone off piste. What you've done is a great job of showing the COM-B model in practice cause you've spoken around a lot there around opportunity and how that then links to the importance of focusing on also capability. Interventions that need to go in, be in place and to motivate people like 5K Your Way sounds like a fantastic programme to motivate people with cancer to join a community.

Elaine: 41:31

Yeah.

Alex: 41:32

So to start this mapping you've done the right thing, but also provided some great examples of what that looks and feels like. The job for me now is to go. And it's a very unfair question in terms of when you did say COM-B model, and I did this with Tim as well. So I said, if there was an area that you were most passionate around, around the capability, opportunity, or motivation that you were going to spend time looking into what area would it be?

Elaine: 41:58

If I take the water well-being model, which was developed in, with Swim England, that takes that whole systems approach, but it really tries to remove any of the obstacles that would get in the way of somebody to be active. So it looked at we had a a model which had three levels to it which was looking at what happens before somebody even gets into the pool. So what do they hear about About being active in the water, and it wasn't just swimming. We were looking at whole because I think pools are very underutilized resources as well, so it was really about how do we make create opportunities for people? But the first step is, how do you market to those people? How to get messaging out? So how do you create those nudges? Probably not using the terminology in the way that the behavioural scientists would, but that concept of. It's out there, there's an offer for me, it's right for me, I know it's right for me. Then how do you, then when somebody enters your facility, that they have been they are being looked after? Because the big thing that people want is they want Somebody to understand their condition feel that what they're doing is tailored to their needs and is supportive. So it's things like even just the car parking scenario that can be a barrier to people because some car parking is a nightmare. We did lots of work around dementia friendly swimming before this. So things like. How does somebody with dementia navigate your building and how can you make it more friendly for people? I don't know about you lockers and me, I can't remember where the locker number is. So we created a little thing, a saddle that used to go over the top of someone's locker so they could put their picture in, to help them remember a bit

Alex: 43:50

wow.

Elaine: 43:52

where their, which was their locker and help them with that. then the offer, getting the offer right as well. That offer has to support behaviour change. It's not just about turning up and not having that supported offer. Behaviour change has to be woven into everything we do. Be it the design of it, be it one to one, more traditional, route that we see, in terms of that exercise counselling for want of a better way of putting it we use old style language. But it needs to be woven in throughout to help with that, drive the capability, keep the motivation going.

Alex: 44:29

So There's a lot there which sounded very familiar to my previous role at the YMCA where in East Surrey we were called the Inclusive Sport Facility and we were funded by Sport England to build that. And part of me was absolutely buzzing that this place existed because People with long term health conditions disabilities knew they were going to get the experience they needed they knew the toilets were the right type of doors they knew that The changing rooms had exact types of things you were talking about and that they were catered for. There was a lot of staff there to help, car parking. There was more disability bays and normal bays to encourage Normal bays what bad terminology that is and just your average parking to To encourage other people to walk or cycle to the gym as well. It was a perfect place for then on the flip side, I said, why are we the only inclusive facility in East Surrey? Like not saying others weren't fully inclusive, but that was our USP when really that should be, we should be competing with every other site because they should have these things anyway, but they don't cater for the many.

Elaine: 45:35

Of it. I always think of the field of dreams, build it and they will come. We know in our industry, that's not always the case. So you can have, there are some amazing facilities out there, but without. It being designed and developed in consultation with the local community. You can have a brilliant facility in a certain part, and we've seen it, we've all seen them. Fantastic new facility opens a part of town. It's never used by people who live there. People drive into it. People who live their own estate and maybe use a kickabout area because it feels like it belongs to them. There's a whole thing around how you engage people in that way and bring them into those facilities, or ideally, create your facilities, design with them, in consultation with them in the first place to understand what that means. And it can mean, it can be quite interesting. I, when I worked in Sport Wales, we were doing a lot of work in Merthyr, which is a town at the top of the valley. Now there's an area in Merthyr called the Gurnos, and it is infamous and which is a real sad because I met some amazing people up there and there was some amazing initiatives going on. But it had very distinct communities and never the three, there were three communities. that saw themselves as separate communities, even within this small area. So if you put something on in one area, you are not going to get the people from other area comings. So you have to really understand and get under the skin of the communities that you're working with, because these little cultural norms drive behaviours very strongly in these areas, and it's trying to understand what those are, whether they can be broken down or whether you work with them, but you have to be aware of them.

Alex: 47:25

That was my biggest learning working there because I started during COVID and tried putting in a lot of measures to make it safer for the members because the site was known as the place where the older members could go as well as those with longer, long term health conditions, et cetera. But I whereas we're trying to make it safe, we introduced an app and web based booking and booking in advance and where I hadn't fully at the time appreciated how much that affects behaviours from going from a, before COVID where they would just sign up and fill it in on paper and just join in. And they were more than happy to be turned away if more than 20 people were in that class. That was the culture they have experienced for 50 years, some of them. And then for me, a 30 year old guy who they've never met before coming in and introducing an app, they're like, no, this is. This is a too big a change for me. This is why I didn't want this place, the other places. So that was a huge learning curve for me to say even if you're trying to better the environment, knowing the people and understanding how even if we were going to do that, how I could have transitioned it better and worked with them to implement something. That was a real lightning, that's when I first learnt about the whole systems approach there as well. It was a real interesting phase and I definitely learnt a lot bringing it to the new role.

Elaine: 48:44

We obviously do a podcast as well and one of the ones that I was really interested in, we had William Bird on and he was saying that when you're designing these things never going to get it perfect, but all you can do is listen and then adapt, listen and adapt. And I think that's it. It's the listening that's key to this, understanding going on in communities and understanding their needs is really critical.

Alex: 49:09

I think that's an amazing place to finish. Thank you very much for today and just a shout out to those listening and thank you for getting it this far. If anything you've heard today excites you, angers you or encourages you, please do head over to LinkedIn where I will be posting this podcast and also discussing it. But for now, thank you very much for joining and hopefully speak to you soon.