PACO III
Aruba 5 – 7 June 2013
What can we learn from the Belgian
case?
Prof. em. Jan Vinck
Hasselt University (Belgium)
Expert Committee Viasano
What can we learn from the Belgian
case?
• Adaptations are necessary at regional and
local level
• Is the program effective?
Viasano by EPODE in Belgium
16 cities, 655 275 inhabitants
Aarschot
Schilde
Hasselt
Huldenberg
Jette
Dilsen-Stokkem
Woluwe
St Pierre
Comines-Warneton
Mouscron
Flobecq
Liège
Pepinster
Mons
Marche- en-Famenne
Braine-leComte
Rochefort
Belgium
Complex country: at crossing of latin and nordic
Europe a.o.
– 3 regions with own goverment, political traditions
– 3 languages
– different organization of health promotion
Een gezonde levensstijl voor de
inwoners van
jouw gemeente
Viasano by EPODE in Belgium
16 cities, 655 275 inhabitants
Aarschot
Schilde
Hasselt
Huldenberg
Jette
Dilsen-Stokkem
Woluwe
St Pierre
Comines-Warneton
Mouscron
Flobecq
Liège
Pepinster
Mons
Marche- en-Famenne
Braine-leComte
Rochefort
Viasano characteristics
•
•
•
•
16 cities in 3 regions
100% private sponsoring
Overall Epode methodology
Dual approach (social marketing &
environmental)
Example of environmental approach:
Esseghem
Bruxelles, Ville-Région en Santé
Le diagnostic en marchant
•
•
•
•
Jette
Parc de logements sociaux
Immeubles de grand gabarit (blocs)
Forte densité de population
9
Bruxelles, Ville-Région en Santé
Le déroulement
10
Bruxelles, Ville-Région en Santé
Le déroulement: nouveau projet
11
Bruxelles, Ville-Région en Santé
Le site d’Esseghem: une fête
12
Bruxelles, Ville-Région en Santé
Le déroulement: tonnelles
13
Bruxelles, Ville-Région en Santé
Le site d’Esseghem: les graffeurs
14
Bruxelles, Ville-Région en Santé
Le site d’Esseghem: atelier wok
15
What can we learn from the Belgian
case?
• Adaptations are necessary at regional and
local level
• Is the program effective?
Regional adaptations
• Political tradition: decision regional or
communal?
• Health promotion system: strongly organized?
• Language: simple translation is not enough
Local adaptation: role of local program
manager (LPM)
Adaptation of interventions to local situation
and population
- identify relevant populations/subgroups
- identify relevant actors (control relevant aspects of
environment)
- mobilize these actors
- inspire local action
- organize collaboration
Is the program effective?
• Evaluation study in 2 towns in French Community
(Mouscron and Marche)
• BMI of all school going children ages 3-4 and 5-6
– Measured by trained nurses
– Measurement points 2007 and 2010
– N= 1300 and 1484
• Control population: all other school children of
French Community of same age at same periods
– N= 76864 and 79602
Results (1)
evolution overweight: in pilot towns
9.5%  7.4%
change in pilot towns significantly greater than in
control population (p=0.047)
Results (2)
evolution overweight plus obesity: in pilot towns
13.5%  11.2%
change in pilot towns significantly greater than in
control population (p=0.046)
Evolution in obesity alone: non-significant trend
for greater decrease in pilot towns
Conclusion
• Implementation requires carefull adaptation
of the program to the local situation
• Results of evaluation study are very
encouraging: effect even after 3 years
Thank you