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Canadian Academy of

Sport and Exercise Medicine

Sports Medicine and the Prevention of Chronic Disease

An Emerging Role for Sport & Exercise Medicine and Primary Care Practitioners

Delta Grand Okanagan Resort Kelowna BC, Canada June 20-23, 2012

The Chronic Disease Epidemic Embarking on a Path for Change

Dr. Doug Owram, Principal and Deputy Vice Chancellor, UBC Okanagan

A Practitioner for All Seasons: Aligning Medical Education with Societal Expectations

Dr. Gavin Stuart, Dean of Medicine & Vice-Provost, University of British Columbia

CASEM & Prevention: An Emerging Role

Dr. Gordon Matheson, Professor & Director of Sports Medicine, Stanford University School of Medicine

What is "Prevention"? Where Do We Start? Tools for the Clinical Practitioner

Dr. Martin Schwellnus, Professor of Sport and Exercise Medicine, University of Cape Town, South Africa

What is the Scientific Evidence for Prevention?

Dr. Steve Blair, Professor, Departments of Exercise Science & Epidemiology, University of South Carolina

Three Types of Prevention 1? Prevention: Using an Exercise "Vital Sign" in Clinical Practice

Dr. Bob Sallis, Associate Clinical Professor of Family Medicine, UCR/UCLA & Exercise is Medicine

Exercise Training for Management of Disease and Prevention of 2? Co-Morbidities

Dr. Neil Eves, Professor of Health & Exercise Sciences, University of British Columbia Okanagan

3? Prevention: The View From the Family Doctor

Dr. Martin Dawes, Head, Department of Family Practice, University of British Columbia

How Do We Change Behaviour?

Dr. Kerry Courneya, Professor & Canada Research Chair in Physical Activity & Cancer, U of Alberta

International Experience with Prevention The National Health Service in the UK

Dr. Richard Weiler, Specialty Advisor in Sport & Exercise Medicine to National Health Service

The Swedish Physician Experience

Dr. Mats B?rjessen, Professor of Cardiology, Karolinska Institute, Stockholm Sweden

Promoting Change Through Research & Innovation

Dr. Jennifer Jakobi, Dr. Elizabeth Dean, Dr. Mary Jung, Dr. Joan Bottorff

Real Life Examples of Chronic Disease Prevention Change Through Sport: Breast Cancer and Canoeing

Dr. Don McKenzie, Professor of Human Kinetics and Sports Medicine, University of British Columbia

Change Through Rewards: The Cape Town Experience

Dr. Wayne Derman, Professor of Sport and Exercise Medicine, University of Cape Town, South Africa

Change Through Advocacy: Smoking Cessation in Canada

Dr. Andrew Pipe, Professor & Chief of Prevention & Rehabilitation, University of Ottawa Heart Institute

Preventable chronic disease is the greatest cause of morbidity and mortality in both developed and developing countries. It is the subject of formal meetings held by the United Nations and the World Economic Forum. The costs from preventable chronic disease are staggering with the potential to bankrupt entire economies. CASEM is hosting a special day on the Prevention and Management of Chronic Disease as part of its Annual Scientific Conference in Kelowna, BC.

Delta Grand Okanagan Conference Centre Kelowna, BC, Canada

Reservation Department Phone: 250-763-4500 or Reservation Office: 1-800-465-4651

To get the special conference room rate, identify yourself as being with the Canadian Academy of Sport and Exercise Medicine.

Panel Discussion: CASEM's Role in Chronic Disease Prevention

Speakers & Audience Discussion Moderated by Dr. Lars Engebretsen, Head of Scientific Activities, IOC Medical Commission

Preliminary Program and Registration casem-

1-877-585-2394 / 613-748-5851 email: admin@casem-

Preventing and Managing Chronic Disease ? An Emerging Role for Sport & Exercise Medicine Practitioners

Canadian Academy of Sport and Exercise Medicine Annual Scientific Meeting ? Thursday, June 21, 2012

The Chronic Disease Epidemic

Moderator: Gordon Matheson

8:00 ? 8:10 Embarking on a Path for Change

Dr. Doug Owram

8:10 ? 8:30

There is little doubt that health care needs to change in order to respond to the chronic disease burden. How does this type of change occur? The University of British Columbia, Okanagan is an excellent example of massive change, going from no campus to a flourishing academic environment with 7,000 students and 300+ faculty in just five years. As Deputy Vice Chancellor and Principal for UBCO during this time, Dr. Doug Owram provided the leadership for this remarkable change. Dr. Owram's remarks are an opportunity to reflect on years of leadership experience and identify the key elements involved in managing substantial change.

A Practitioner for All Seasons: Aligning Medical Education with Shifting Societal

Deputy Vice-Chancellor & Principal, University of British Columbia, Okanagan

Dr. Gavin Stuart

8:30 ? 8:50

Needs and Expectations

Modern health care systems already face huge challenges trying to provide ever expanding patient services. How then can our health care systems even think about the prevention and management of chronic disease? As Dean of the Faculty of Medicine and Deputy Provost at UBC, Dr. Stuart oversees the training of medical students and residents in a provincewide program that includes three medical schools. Dr. Stuart served as a physician in the Poly Clinic at the Vancouver Olympic Games. His depth of experience as a practicing physician and health care leader in a progressive university provide a unique perspective on the response required to manage chronic disease.

Why Did CASEM Change It's Name?

Dean of Medicine & Deputy Provost, University of British Columbia

Dr. Gordon Matheson

In 2010, CASM changed its name to CASEM. Why? This lecture discusses the potential role for sport and exercise medicine practitioners in the prevention and management of chronic disease. Why has "sports medicine" not been more involved up until now? Why is prevention so difficult to implement within our existing health care systems? How can sports medicine assume an increasing role? Dr. Matheson is a Professor at Stanford University in the Schools of Medicine and Humanities & Sciences and is the Director of Sports Medicine for Stanford Athletics.

Professor & Director of Sports Medicine, Stanford University School of Medicine

8:50 ? 9:10 9:10 ? 9:30

What is "Prevention"? Where Do We Start? Tools for the Clinical Practitioner

There are many possible entry points for bringing about change toward prevention. The choices can be overwhelming for the clinical practitioner. In this lecture, Dr. Schwellnus defines prevention and presents a framework for understanding the different entry points, target populations, and strategic plans for chronic disease prevention. This framework allows the clinical practitioner to choose, and thereby strategically focus their involvement in programs to reduce the morbidity and mortality of chronic disease. Dr. Schwellnus is an international expert in Sport and Exercise Medicine co-leads one of four IOC Centers of Excellence for research in injury prevention. He has substantial clinical experience in comprehensive lifestyle intervention.

What is the Scientific Evidence for Prevention?

Dr. Martin Schwellnus

Professor of Sport & Exercise Medicine University of Cape Town

Dr. Steve Blair

The morbidity and mortality associated with non-communicable diseases (NCDs) is felt world-wide in both developing and developed countries. The magnitude of the problem is expressed in human and economic terms. This lecture covers the evidence for the 1?, 2?, and 3? prevention of chronic disease over the past 20 years and chronicles the economic and human cost of NCDs. Dr. Blair is highly regarded around the world as a researcher and leader on exercise and lifestyle intervention for chronic disease.

Professor, Departments of Exercise Science and Epidemiology/Biostatistics, University of South Carolina

9:30 ? 9:45 Questions & Discussion

9:45 ? 10:00 Coffee Break

Three Types of Prevention ? the Role of Behavioral Change

Moderator: Martin Schwellnus

10:00 ? 10:20 10:20 ? 10:40 10:40 ? 11:00 11:00 ? 11:20

1? Prevention ? Using an Exercise "Vital Sign" in Clinical Practice

This lecture covers the experience with tracking exercise in patient populations using exercise as a vital sign as well as experience with Exercise is Medicine, a well known program that advocates changes in physician behavior. Dr. Sallis is Past President of the American College of Sports Medicine and Chair of Exercise is MedicineTM, a joint initiative of ACSM and the American Medical Association. He has served as the head team physician at Pomona College since 1988, and holds a Certificate of Added Qualifications in sports medicine. Dr. Sallis currently serves as editor-in-chief of ACSM's clinical journal, Current Sports Medicine Report.

Exercise Training for Management of Disease and Prevention of 2? Co-Morbidities

This lecture discusses the effects of exercise training on indicators of health and functionality in patients with already existing chronic disease. The physiological adaptations that occur in response to physical exercise provide a background for an explanation as to how they improve functional capacity even in the presence of chronic disease. Particular attention is paid to the adaptations that occur with aging and the significance of these for vitality and health. Dr. Eves, recently recruited to the University of British Columbia, Okanagan, won the "best teacher" award in the Faculty of Kinesiology at the University of Calgary.

3? Prevention ? The View From the Family Doctor

This is the 20th patient I have seen in my family practice today with a chronic disease and almost none of them do the 10/150. Nearly half my practice has a chronic disease and 70% of those have more than one. It is the scale of the problem that is challenging. We need to change society and I am sorry to say it is us that has to do this. Every practice needs an activity plan and each practice is likely to be slightly different. Exercise prescription, with follow-up, is just one part. How do I assess what patients can and can't do? Dr. Dawes will describe the evidence from Family Practice research and identify some of the knowledge nuggets as well as some of the gaps.

How Do We Change Behavior?

Dr. Bob Sallis

Associate Clinical Professor of Family Medicine, UCR/UCLA Biomedical Sciences Program and Family Medicine Residency Program, Kaiser Permanente Medical Center, Fontana, CA

Dr. Neil Eves

Professor of Human Kinetics, University of British Columbia, Okanagan

Dr. Martin Dawes

Head, Department of Family Practice, University of British Columbia

Dr. Kerry Courneya

11:20 ? 11:45

We often speak of the change required in patient behavior to improve compliance with exercise and comprehensive lifestyle intervention. How does that change occur? What determines compliance? What are the psychological barriers to exercise and the predictors of success with change? Is it just patients that need to change or do providers of health care also need to change their behaviors? Dr. Courneya is a professor and highly respected expert in behavioral change related to lifestyle intervention.

Questions & Discussion

Professor and Canada Research Chair in Physical Activity and Cancer, Physical Education and Recreation, University of Alberta

11:45 ? 1:00 Lunch

Experience with National Programs for Chronic Disease Prevention

Moderator: Andrew Pipe

1:00 ? 1:20 1:20 ? 1:40

The National Health Service in the UK

A great deal of effort has been put into the problem of chronic disease prevention at educational, legislative, advocacy, governmental policy and other levels. This lecture focuses on what has worked, what hasn't, and the role the National Health Service in Britain has assumed for chronic disease prevention. Dr. Weiler is a leader within the UK for changes in the health care system that promote prevention and he has been instrumental in organizing major new initiatives for prevention within the National Health Services.

The Swedish Physician Experience

The Swedish book entitled "Physical Activity in the Prevention and Treatment of Disease" (FYSS) is 623 pages of information related to the prescription of physical activity for health. It is published by the Professional Associations for Physical Activity in Sweden. Dr. B?rjesson was one of the main authors. In this lecture, Dr. B?rjesson discusses the impact this book has made on chronic disease prevention in Sweden.

Dr. Richard Weiler

Honorary Consultant in Sport & Exercise Medicine, University College London Hospitals NHS Foundation Trust and Speciality advisor in Sport & Exercise Medicine to National Health Service

Dr. Mats B?rjesson

Professor of Cardiology, Karolinska Institutet, Stockholm

Research & Innovation in the Prevention of Chronic Disease

Moderator: Steve Blair

1:40 ? 2:45 Promoting Change Through Research & Innovation

Dr. Jennifer Jakobi

Research and innovation help drive change within society and health care toward an increased emphasis on prevention. In this session, researchers and clinical scholars from the University of British Columbia (Vancouver and Okanagan campuses) provide short overviews of their original work. Presentations are 10 minutes with 5 minutes for questions. The moderator will ask thought provoking questions and invite the audience to participate in discussion.

Professor, UBC Okanagan

Dr. Elizabeth Dean

Professor. University of British Columbia

Dr. Mary Jung

Dr. Jennifer Jakobi ? Preventable Chronic Disease and the Aging Process Dr. Elizabeth Dean ? The International Movement Toward Prevention in Physical Therapy Dr. Mary Jung ? Debunking Myths About Barriers to Behaviour Change Dr. Joan Bottorff ? Once Size Doesn't Fit All: Gender-Sensitive Health Promotion Interventions

Professor, UBC Okanagan

Dr. Joan Bottorff

Professor & Chair in Health Promotion & Cancer Prevention; Director, Institute for Healthy Living & Chronic Disease Prevention, UBC Okanagan

Real Life Examples of Chronic Disease Prevention

Moderator: Bob Sallis

2:45 ? 3:00 Example No. 1 ? Change Through Sport: Breast Cancer and Canoeing

Dr. Don McKenzie

Fifteen years ago, Dr. McKenzie embarked on a program using dragon boat paddling to regain muscular strength, endurance and prevent lymphedema in breast cancer survivors. Who could have known how wildly successful this program would become? It is now used in hundreds of centers throughout the world and involves thousands of cancer survivors.

Professor of Human Kinetics and Sports Medicine, University of British Columbia

3:00 ? 3:15 Example No. 2 ? Change Through Rewards: The Cape Town Experience

Dr. Wayne Derman

3:15 ? 3:30

Dr. Derman has been intimately involved in the creation of a program to change the health behaviors of patients insured by Health Care Funders in South Africa. Dr. Derman discusses the clinical aspects of lifestyle intervention for healthy people and for those with already diagnosed chronic disease. Practical examples of effective, sustainable, community-based preventive programs are discussed.

Example No. 3 ? Change Through Advocacy: Smoking Cessation in Canada

Professor of Sport and Exercise Medicine, University of Cape Town

Dr. Andrew Pipe

Dr. Pipe has been instrumental in advocacy for a smoke free Canada. He has more than 20 years experience in change at all levels ? government, industry, health care and personal.

Professor, University of Ottawa: Chief, Division of Prevention & Rehabilitation, University of Ottawa Heart Institute

Panel Discussion on CASEM's Role in Chronic Disease Prevention

Moderators: Don McKenzie & Lars Engebretsen

3:30 ? 5:00

CASEM's Role in the Implementation of Community-Based Programs for the

Prevention & Management of Chronic Disease

Strategies, target populations, intervention approaches, and financial models are different for 1?, 2? and 3? prevention. The prevention of chronic disease is complex and clinical leaders in this field require a set of skills that have yet to be defined. Current approaches need to be augmented by new, different strategies. It may be that chronic disease prevention requires the development of a unique health care professional who can deliver a package of programs that are community based. In this session, three evocative questions will be addressed by panelists in a 2-minute statement. The audience will then be asked to participate in two ways. One will be through questions and discussion with the panel. The second will be to write their best answer to the question and paste it on the wall. Wine is limited to one glass per question!

Q1 Panelists: Martin Schwellnus, Neil Eves, Martin Dawes, Richard Weiler

Bruce Davidson, Andrew Pipe, Steve Blair, Martin Schwellnus, Richard Weiler, Wayne Derman, Mats B?rjesson, Gordon Matheson, Martin Dawes, Bob Sallis

Q2 Panelists: Wayne Derman, Steven Blair, Mats B?rjesson, Gordon Matheson

Q1: What do you think the best strategy is for SEM (CASEM) & primary care physicians to be directly involved in managing chronic disease and preventing secondary co-morbidities (3? prevention)? Why? Q2: What is the best strategy for preventing chronic disease in middle-aged baby boomers who have risk factors for chronic disease (2? prevention)? Why? Q3: For the prevention of chronic disease in otherwise healthy people (1? prevention), what are the most important factors that must be present to create a community that promotes health? Quality food? Urban planning?

Q3 Panelists: Kerry Courneya, Andrew Pipe, Bob Sallis, Bruce Davidson

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