L5 Early Professional Experience Exercise and green prescriptions

Overview

This lecture, given by Michael Jolly (Healthy Lifestyles Manager, Sport Otago), introduces Sport Otago’s strategic mission and its Healthy Lifestyles Team, which runs three programmes: Green Prescription, Active Families and Access and Choice. It sets out New Zealand physical activity, nutrition, sleep and screen-time statistics, explains what Green Prescription and Active Families offer and who can be referred, and presents the “Tinana Ora mō ngā Tamariki / Physical Wellbeing for Children” resource, an acrostic-based whānau checklist and goal tracker used with families.

Sport Otago and the Healthy Lifestyles Team

Sport Otago’s strategic plan (2024-28):

• Vision: “Otago: the world’s most active region.”
• Purpose: “Empowering Otago to be active.”
• Strategic priorities:
  • Participation - improving physical activity levels for tamariki, rangatahi and whānau; reducing physical inactivity among them; reducing barriers to participation; increasing programmes/projects/events targeted at priority communities.
  • Partnerships - driving community-led change through partnerships with key decision-makers; strengthening partnerships in priority communities; increasing partnerships with organisations that enable physical activity; building community capacity and capability.
  • Influence - ensuring Sport Otago’s role as regional champion for physical activity is understood and valued; increasing recognition of its role in promoting physical activity for health and wellbeing; developing a workforce equipped to influence physical activity.

What Sport Otago does:

• Sport - supporting communities to provide accessible, cost-effective, positive experiences in traditional sport across Otago.
• Active Recreation - less structured, non-competitive physical activities for wellbeing and enjoyment.
• Play - giving tamariki time, space and permission to actively follow their own ideas and interests for their own reasons.

The Healthy Lifestyles Team delivers three programmes: Green Prescription, Active Families, and Access and Choice.

Physical wellbeing in NZ

From the New Zealand Health Survey 2024/25:

• 53.8% of adults did not meet physical activity guidelines; one in eight adults did little or no physical activity.
• 8.6% of adults and 5.8% of children are meeting the vegetable intake guidelines.
• 27% of adults are sleeping less than recommended.
• 68.2% of children did not meet recreational screen time guidelines.

Green Prescription (GRx)

Free individualised healthy lifestyle support covering movement, exercise, physical activity, healthy eating, mindfulness, and Te Whare Tapa Whā. Support is delivered through goal setting, motivational interviewing, ongoing support, accountability and behaviour change, plus local connections, community groups and subsidised access to facilities.

Referral criteria:

• 17+ years of age and “medically stable.”
• Not currently meeting Ministry of Health physical activity and healthy eating guidelines.
• Wants to make a lifestyle change.

Referral routes: any health professional can refer via the Sport Otago website or via ERMS (Allied Health); people can also self-refer via the website.

A guest speaker described their experience with Green Prescription support after an initial consultation the previous November (case example, no further transcript detail given).

Active Families

Free individualised healthy lifestyle support for the whole whānau, covering the same domains as Green Prescription: movement, exercise, physical activity, healthy eating, mindfulness, and Te Whare Tapa Whā. Sessions can be based at the whānau’s home or in the community, wherever the whānau is comfortable. Support model is the same as GRx: goal setting, motivational interviewing, support, accountability, behaviour change, local connections, community groups and subsidised access to facilities.

Referral criteria:

• Between 4 and 17 years of age and “medically stable.”
• Not currently meeting Ministry of Health physical activity and healthy eating guidelines.
• Wants to make a lifestyle change.

Referral routes are the same as Green Prescription: any health professional via the Sport Otago website or ERMS (Allied Health), or self-referral via the website.

Tinana Ora mō ngā Tamariki (Physical Wellbeing for Children) resource

A whānau-facing checklist resource (sourced from Sport Waikato) rated Not Yet / Sometimes / Mostly / Always against the TINANA ORA acrostic:

• T - Togetherness - eat together as a whānau. Tips: sit together for meals; pick a time that works for everyone; turn off TV/phones; cook one meal for everyone rather than multiple meals; reduce bread on the table; add water and a raw vegetable platter.
• I - Inu - keep water as the main drink, reduce sugary drinks. Tips: remove cordial, fizzy drink, sugar sachets and flavoured milk from the shopping list; offer cold water often; flavour water with lemon, berries or mint; note powdered chocolate drinks usually contain sugar and are not recommended daily.
• N - Not too much kai - age-appropriate portion sizes. Tips: use the child’s hand as a guide - palm = protein, fist = carbohydrate, two cupped handfuls = vegetables; try the ¼ (carbohydrate), ¼ (protein), ½ (vegetables) plate rule for dinner; choose smaller bowls/plates.
• A - Activity at least 60 minutes daily (“huff ‘n puff” activity). Tips: family weekend activity; walks or playground; join a club (karate, squash, badminton, waka ama, kapa haka); park further away or walk if under 2 km; activity can be broken into 10-15 minute chunks.
• N - Not too much screen time, less than 2 hours daily (TV, computers, consoles, phones, tablets). Tips: replace screen time with active time; plan screen time in advance; for every 30 minutes of screen time take a 10-minute activity break; keep the bedroom screen-free.
• A - Always have a healthy breakfast/parakuihi. Tips: choose cereal with preferably less than 15 g sugar per 100 g (e.g. Weetbix, porridge); fruit with yoghurt; wholemeal/grainy toast; stop snacking after dinner so children wake up hungry for a healthy breakfast.
• O - Once a week or less for takeaways (including bakery items like pies/slices/savouries). Tips: plan a dinner menu and shopping list; share cooking duties; prepare home-made lunch combos with children; avoid upsizing.
• R - Rest - sleep 10-12 hours. Tips: set a suitable bedtime with a regular routine; keep the bedroom free of electronics; leave a roughly two-hour gap between eating and bedtime; daytime activity helps sleep.
• A - Always eat your veggies, 5+ a day. Tips: aim for at least three handfuls of colourful vegetables daily; fruit at breakfast and in the lunchbox; cut fruit/carrot sticks for after school; add spinach/greens to pizza, mince, pasta or soup.

The resource also includes a “Today you were seen by” field, a Name/Date/Goal entry box, and a “Whānau Goals” weekly tracker table (Weeks 1-4, Monday-Sunday / Rāhina-Rātapu) for ticking off goals.

The TINANA ORA acrostic is the organising framework for all whānau lifestyle advice in this resource: Togetherness, Inu, Not too much kai, Activity, Not too much screen time, Always breakfast, Once a week takeaways, Rest, Always veggies.

Self-test

1. What is Sport Otago’s stated vision and purpose in its 2024-28 strategic plan?
2. List Sport Otago’s three strategic priorities, with one goal under each.
3. Distinguish Sport, Active Recreation and Play as defined by Sport Otago.
4. List the three programmes delivered by the Healthy Lifestyles Team.
5. According to the NZ Health Survey 2024/25, what proportion of adults did not meet physical activity guidelines, and what proportion did little or no physical activity?
6. Define Green Prescription and list the domains of support it provides.
7. State the referral criteria and referral routes for Green Prescription.
8. Distinguish Active Families from Green Prescription in terms of who it supports, the referral age range, and where sessions take place.
9. List the nine components of the TINANA ORA acrostic.
10. Describe the hand-based portion guide and the plate rule given for age-appropriate portion sizes.
11. What screen time and sleep recommendations does the Tinana Ora resource give for children?
12. A health professional wants to refer a 15-year-old and their whānau, who are not meeting the Ministry of Health physical activity and healthy eating guidelines and want to make a change. Which programme(s) could this family access, and why?

Answers

Reveal answers

1. Vision: “Otago: the world’s most active region.” Purpose: “Empowering Otago to be active.”
2. Participation - e.g. reducing physical inactivity among tamariki, rangatahi and whānau. Partnerships - e.g. driving community-led change through partnerships with key decision-makers. Influence - e.g. increasing recognition of Sport Otago’s role in promoting physical activity for health and wellbeing.
3. Sport is support for accessible, cost-effective, positive participation in traditional sport. Active Recreation is less structured, non-competitive physical activity for wellbeing and enjoyment. Play is giving tamariki time, space and permission to follow their own ideas and interests for their own reasons.
4. Green Prescription, Active Families, and Access and Choice.
5. 53.8% of adults did not meet physical activity guidelines; one in eight adults did little or no physical activity.
6. Green Prescription is free individualised healthy lifestyle support covering movement/exercise/physical activity, healthy eating, mindfulness and Te Whare Tapa Whā, delivered through goal setting, motivational interviewing, support, accountability and behaviour change, plus local connections and subsidised facility access.
7. Criteria: 17+ years old, medically stable, not meeting MoH physical activity and healthy eating guidelines, and wanting to make a lifestyle change. Routes: referral by any health professional via the Sport Otago website or ERMS (Allied Health), or self-referral via the website.
8. Active Families supports the whole whānau rather than an individual, referral age is 4-17 years (vs 17+ for Green Prescription), and sessions can be based at the whānau’s home or in the community rather than only through the standard programme setting.
9. Togetherness, Inu (water as main drink), Not too much kai (portions), Activity (60 min daily), Not too much screen time (<2 hrs), Always a healthy breakfast, Once a week or less for takeaways, Rest (10-12 hours sleep), Always eat your veggies (5+ a day).
10. Hand-based guide: palm = protein portion, fist = carbohydrate portion, two cupped handfuls = vegetables. Plate rule for dinner: ¼ plate carbohydrate (potato/rice/pasta), ¼ plate protein, ½ plate colourful vegetables.
11. Screen time should be less than 2 hours daily, with a 10-minute activity break for every 30 minutes of screen time and a screen-free bedroom. Sleep should be 10-12 hours, with a regular bedtime routine and roughly a two-hour gap between eating and bedtime.
12. The family could access Active Families, since its referral criteria (4-17 years, medically stable, not meeting MoH guidelines, wanting a lifestyle change) match a 15-year-old and their whānau, and it supports the whole whānau rather than an individual; the 15-year-old alone would not yet qualify for Green Prescription, which requires 17+ years of age.