Disclosure Potential conflict of interest None/see below Relationships with commercial companies

Company names:

•  None

© HCWH Europe 2018

As a requirement of accreditation, The Royal Dutch Medical Association (KNMG) requires speakers to begin their presentations with a disclosure slide to make any financial relationships between speakers and

commercial companies transparent.

Green, Healthy and On the move: A initiative of the Radboudumc, the city of Nijmegen and the GGD

�  Dr. Gerard Molleman, Manager Healthy Living - GGD Gelderland Zuid

�  Marja Jillissen CMC, Senior Advisor Person-Centred Care – Radboudumc

�  Moderator: Paola Hernández Olivan, Food Project and Policy Officer - HCWH Europe

© HCWH Europe 2018

Green, Healthy and On the move An initiative of

�  CEO of Radboudumc,

�  CEO of the Municipal Health Service (GGD)

�  Three of the aldermen of the city of Nijmegen (health, welfare, education, sport, neighborhood, environment)

to improve health of the citizens of Nijmegen

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Mission statement “ We want to create a movement in Nijmegen that contributes to the realization of a green, healthy city in 'movement'. A social and physical environment that stimulates, supports and facilitates healthy behaviour.

We start with our own activities and invite others to shape and realize that movement together with us.

As a result, Nijmegen citizens will be fitter and healthier in ten years' time. "

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Commitment of core partners

�  Contribution to society

�  Influencing policy

�  Practise what you preach: as employer for own staff

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Why this initiative

•  At population level health can improve a lot

•  Health is responsibility of many stakeholders

Focus chosen on themes: healthy weight, smoking, alcohol use, mental health

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Healthy weight

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overweight exercise weekly

eat daily vegetables and /or fruit

daily vegetables daily fruit

age age

Effective health policy Ottawa-charter WHO (1986)

•  Health equity!!

•  Health responsibility all social

sectors

How do you promote health?

Prevention & care

Social environment

Physical environment

Behaviour

Participation

8 pillars for our approach �  With citizens

�  Administrative involvement

�  Public & private

�  Multi-sectoral, synergy circuits

�  Social marketing on all levels

�  Differentiation is essential

�  Process-oriented approach

�  Monitoring progress and results

You have to organize this approach

Main goals �  Sustainable improvement of the health of citizens

�  Create healthy environments

�  Make the healthy choice for everyone possible

�  Realize collective impact

�  Organise and bundle for 10 years effort, energy and strength

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Challenge : realize collective impact Connect: �  initiatives

�  strategic, tactical & operational level

�  different stakeholders

�  social & fysical

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Core activities ofGreen, healthy and on the move:

1.  Provide a platform for initiatives;

2.  Organize meeting and cooperation;

3.  Inspire;

4.  Actively encourage partners to contribute and make use of the

opportunities offered by the movement;

5.  Making visible the movement and the achieved results;

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Organisation �  Steering group �  Independent project Manager �  Project group

�  Communication staff �  Researcher

�  Website: https://www.wijzijngroengezondeninbewegingnijmegen.nl �  Budget : € 180.000,- a year

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Our logo

& = Nijmegen

& = working together

& = used for all kind of initiatives

movement

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Some initiatives �  4 inspiring conferences �  Vitality week �  Water challence

�  Alliance “quit smoking” �  Kids marketing & healthy kids meals in restaurants

�  Special conferences for schools & business (in 2019) �  Lifestyle in the doctor's office

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Our own experience

�  Have you ever been approached by a healthcare provider about your lifestyle?

�  How did that make you feel?

�  What worked?

�  What not?

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Change

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Practice what you preach

We start with our own activities.

Some examples, we: �  encourage a healthy lifestyle for all staff; �  realize a healthy and sustainable properties in our

restaurant facilities and receptions; �  encourage our employees to go more move; �  combine research themes.

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From the perspective of patients

Some examples, we: �  have attention to lifestyle in each patient contact �  have attention to the social context in addition to the

medical point of view �  optimize food for patients (Food for care) �  stimulate the move to inpatients (Better out of bed)

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Attention to lifestyle in patient contact

At first:

What happens in the Radboudumc to make lifestyle part of the discussion in the doctor's office?

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An inventory

Setting up a questionnaire

With questions such as: �  what is the vision related to lifestyle and prevention in our

Hospital; �  how is it now brought to the attention in the doctor's office; �  are there ongoing projects; �  what are the barriers and success factors.

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Interviews

Started with people who we knew were active.

We asked: who should we talk with, about this subject.

The list grew from 10 people to over 80.

40 people were interviewed.

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What did we learn?(1)

�  Far more people actively engaged

�  Much more projects than expected

�  People want to connect and learn

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What did we learn? (2)

�  Conversation techniques are very important

�  Difficult topic: there is a lack of evidence-based programs

�  Lifestyle change = behavioral change: very difficult for all!

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What are the next steps? �  Connect:

�  Inside Radboudumc; �  from hospital to primary care and public health.

�  Create vision and make a plan for this subject.

�  Visible support from the Board of directors is essential!

�  Involve as much professionals as possible.

�  Listen to patients.

2

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Discussion

�  To what extend are in your neighborhood healthcare, public health and municipality connected?

�  Are laws and taxing more important than lifestyle counseling in reaching lasting results regarding smoking, overweight and too much alcohol?

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Gerard Molleman gmolleman@ggdgelderlandzuid.nl

Marja Jillissen

marja.jillissen@radboudumc.nl

© HCWH Europe 2018

© HCWH Europe 2018