Implementing a settings
approach to health promotion:
Working together to promote
outcome focused programmes in
Childhood Obesity
Experiences from the UK
Aoife Prendergast
Lecturer, Institute of Technology,
Blanchardstown
Introduction: Obesity
•
“Global Epidemic”
•
Recognized internationally as a major public
health challenge.
•
Unfortunately, there are no exemplar populations
abroad to learn from as no country has been
successful in turning the tide on obesity.
Lessons Learned
•
My own UK Experience
•
NHS: Primary Care Trust
•
Public Health
•
Leeds Metropolitan University
•
Great Ormond Street
UK Interventions: Lessons
Learned
•
However there is an ever increasing and improving
body of evidence and some promising interventions
such as the Carnegie Weight Management (CWM)
Programme which is currently being delivered in
Peterborough in the UK.
CWM Peterborough
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Settings Approach
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Community
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Only targeted programme
•
CWM is a UK national programme led by Leeds
Metropolitan University
•
Delivered locally by health promotion specialist
staff at NHS Peterborough.
•
The programme aims to improve the health of
children between two and 17 years of age who are
overweight or obese.
•
It also provides families with the relevant support
and information to help them make healthy,
informed choices to maintain a healthy weight.
Type of Programme
Club programme
It runs as a 12 week programme
For 3 ½ hours each week
Young people are to attend with a parent or
carer. Parents are key to the programme
and they help to implement back in the
home what has been learnt on club.
After the 12 weeks there is 3 month follow
on support programme
NHS Peterborough:
Primary Care Trust
•
The commissioning process for the programme
started in October 2009 and delivery began in May
2010.
•
The city currently has one of the highest childhood
obesity rates for Year 6 children.
•
Results from the 2008/2009 school year show that
one in seven (13.8%) reception age children are
overweight and almost one in ten (9.2%) are obese.
•
Three age specific 12 week programmes were
delivered
•
2-4 years, the first of it’s kind in the UK
•
4-10 years
•
11-17 years
•
Delivered in settings across Peterborough for
children and their parents or carers.
•
There has been a high proportion of referrals for the
programme.
•
It is the first time that the pioneering programme has
been extended to include children between the age of
two and four.
Focus of Programme
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The programme focuses on a number of elements
that directly influence and affect a child’s weight.
•
These include diet and nutrition, physical activity,
anthropometric measurements, behavioural
change to the sustainability of change.
•
It is delivered as a 12-week intervention with a six
month and 12-month follow-up period.
Results and Conclusions
•
Continual evaluation concludes that there has
been:
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Reduction in body fat composition,
•
Reduction in waist circumference and weight
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As well as improved self image and self esteem for
children undertaking the programme.
Sustainability: Follow on
Support
•
To further support children undertaking the
programme, a post-Carnegie programme, Movers
and Shakers is currently being delivered by health
promotion specialist staff in partnership with
Vivacity.
•
The programme is delivered over a six week period
and introduces participants to locally available to
further encourage sustained behaviour change.
•
Two age groups are targeted throughout the
Movers and Shakers programme, 5-10 years and
11-17 years
Carnegie Club outcomes
Change
Children
Parents
Body mass
(kg)
0.7 + 2.3
-1.1 + 2.5
BMI (kg.m-2)
-0.19 + 1
-0.31 + 0.8
BMI SDS
-0.11 + 0.23
NA
Waist (cm)
-8.7 + 4.2
-5.9 + 4.2
% Body fat
-1.75 + 2.6
-1.2 + 5.3
0.2 + 0.4
0.3 + 0.3
Fitness (l.min-1)
Stakeholder Engagement
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Stakeholder engagement is a key success criterion
in order to reach those at risk who will benefit
most from the programme and ensure equality of
access.
•
More than 800 stakeholders have been informed of
the programmes including clinicians and nonclinical practitioners.
•
A successful outcome of the programme was the
number of referrals received through all the
potential routes and particularly those that are
able to access Peterborough’s six priority areas
Stakeholder Engagement Plan
STAKEHOLDERS
GP’s, SNT,
Public Health,
Healthy
Schools,
Sports Teams
, Dietitians,
Paediatricians,
Child Health
Teams, HVT,
Children
centre's
Key Partnership
Boards
Community
Media &
Communications
SELF REFERRALS
Businesses
To Replicate…..
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Using lessons learned
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Utilising the settings approach addressing the
contexts in which people live, work and play,
including:
•
–the needs and capacities of people in the setting
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–make the setting itself more healthy
Observations
•
Many challenges exist
•
Hardest part is that professionals are not equipped
with the right language and skills to talk
sensitively and helpfully with children and
families about overweight and obesity.
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Referral Procedures
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Sustainable behaviour change
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Multi – disciplinary approach – includes physical
activity, dietary and lifestyle education and a
cognitive behavioural approach
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Adheres to the NICE guidance for safe weight loss
What we need
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Behaviour Change and Motivation is key
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Urgent need to address this problem and come up
with realistic solutions
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Targeted programmes
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Social Media: Change 4 Life
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Key Stakeholders on board
Conclusions
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Overall, there has been a marked increase in the
efforts to prevent obesity over the past 5–10 years;
however, we are still virtually at the starting line.
•
Let us hope that the next 10 years will see a much
greater policy (and research) response to making
the food and physical activity environments less
obesogenic so that the health promotion efforts to
encourage healthier choices have some chance of
working.