dr michelle jones implemented by southern primary health of southern adelaide health service and...
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Dr Michelle Jones
Implemented by Southern Primary Health of Southern Adelaide Health Service and Murray Mallee Community Health Service
Program Evaluation for Program Evaluation for Healthier CommunitiesHealthier Communities
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EWBA Organisational ChartEWBA Organisational ChartEWBA Project Management
Committee
EWBA Evaluation Academic Team
Dr Jim Dollman
Dr Anthea Magarey
Dr Fiona Verity
EWBA Manager (1.0FTE)
EWBA Morphett Vale SPH:
Project Coordinator (1.0FTE)
& Admin support
Evaluation Coordinator(0.6FTE)
EWBA Murray Bridge, MMCHS:
Project Coordinator (1.0FTE)
& Admin support
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Guiding Principles and Values of Guiding Principles and Values of ewba Interventions and ewba Interventions and
EvaluationEvaluation
• Community Development Approach
• Capacity building
• Equitable
• Sustainability
• Cultural sensitivity
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• Aim: To contribute to the healthy weight of children, young people (0-18yo) through increasing healthy eating & physical activity
• Funded $1.5million over 3 years, by SA Dept Health
• 2 demonstration communities: • Metro: Morphett Vale (pop 24,000)
– Southern Primary Health
• Rural: Rural City of Murray Bridge (pop 18,000)– By Murray Mallee Community Health Service
Implemented by Southern Primary Health of Southern Adelaide Health Service and Murray Mallee Community Health Service
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Community Community consultationconsultation
1. What does the community look like?
– Mapping existing infrastructure, programs, policies & capacity
2. What does the community say?– Barriers to healthy eating & physical
activity
– Potential strategies to address barriers
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Consultations with:Consultations with:• Agencies
– eg local gov., welfare, housing, police, health
• Education sector – ie FDC & child care; pre, primary & high school
• Community members– eg school & kindy parent committees, new mother’s
groups, physical activity providers, F&V providers
• Aboriginal workers & community members• Children including
• Young peopleAboriginal students
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• Consulted with almost 500 people, in 36 sessions over 3 months
• Detailed data to inform development of locally relevant Action Plans
• Built awareness, support & ownership
• Early capacity building of stakeholders
• Identified key members for Advisory Groups & project ‘champions’
Outcomes of Outcomes of community community
consultationconsultation
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Community-Community-identified barriers identified barriers
to…to… HEALTHY EATINGHEALTHY EATING• Poor knowledge &
skills• High availability of
unhealthy foods• Poor access to water• Lack of policies• Commercial
advertising of foods• Cost of healthy foods• Facilities not
supportive of breastfeeding
PHYSICAL ACTIVITYPHYSICAL ACTIVITY• Lack of affordable
organised opportunities• Poor facilities/space/
equipment• Lack of parental time• High cost of involvement• Poor access to
facilities/spaces• Lack of/high cost of
transport• Parental safety concern• Public liability insurance
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Multiple sources to Multiple sources to inform Action Plansinform Action Plans
Community data ranked
Ranked barriers prioritised
Ranked strategies prioritised
Community refinement & endorsement
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Action PlanAction PlanPortfolioPortfolio
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InterventionsInterventionsMeaningful & diverse community
input+
Best available evidence framework+
Project guiding principles=
Well supported, feasible & locally relevant interventions
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Examples of InterventionsExamples of Interventions
• Development of physical activity and nutrition policies
• Infrastructure• Peer education and workforce
development• Community development• Promotion and marketing
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Peer education/leadershipPeer education/leadership
• ‘Active Foodies’
• ‘Eat Well’ peer leadership program
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Healthy School CanteensHealthy School Canteens
• ‘Canteen calendar’
• ‘Kids eat fresh in the canteen’ program
• Canteen support network meeting
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Drinking waterDrinking water
• Installation of Pura taps or classroom drinking water facilities installed
• Further drinking water facilities will be installed in coming months
• ‘Crunch & Sip’ fruit, veg & water break program launched
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Day Care & OSHC programsDay Care & OSHC programs
• “Playing for Life” physical activity workshop
• Start Right Eat Right training
• 2 Active Play train-the-trainer workshops
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Schools InitiativeSchools Initiative• Continued support for schools to join Active
After Schools Program. • Customised, individual school-based staff
healthy eating training workshops planned for various primary schools
• ewba School Support service continuing individual site support visits to help schools identify & address their priority areas
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High Schools InitiativeHigh Schools Initiative
• ‘In the Mood for Food’
• Nutrition Education Resource Expo
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Epistemological influences on Epistemological influences on evaluationevaluation
• Nutrition Sciences
• Physical Exercise Sciences
• Community Development
• Lived and experiential knowledge
• Evaluation knowledges
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EvaluationEvaluation FrameworkFramework
Media Analysis
– Content
& Discours
e
Qualitative
Interpretive
Quantitative Positivist
Schools Surveys Breastfeedin
g Friendly Sites
Student Survey – Nut & PA
Parent Survey
LDC Survey
FDC Survey
Anthropometrics – 4-5 & 10-12
yrs
Post box
Stakeholder
Interviews
Focus Groups
On the Spot interviews
Case Study Analysis Snapshot
Action - Reflections
Intervention Outputs
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Health outcome (weight)Health behaviours (PA & HE)Attitudes, knowledge, skills
1800 Yr5-7 (2 intervention + 2 comparison sites)
Direct measure & self report
Evaluation:Evaluation:
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Attitudes, knowledge, skillsEnvironment eg policy, physical,
sociocultural, economic
1000 Yr5-7 Parents, 4 sitesSelf report
Evaluation:
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Evaluation:
4 sites, self report:40 Primary schools
+ OSHC + Canteens10 High schools16 Pre schools
9 Long day Care38 FDC Providers
Attitudes, knowledge, skillsEnvironment eg policy, physical,
sociocultural, economic
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Evaluation:
Community capacityEnvironment eg policy, physical,
sociocultural, economic
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Evaluation:
Monitor project’s ‘context’ including
media
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Evaluation ChallengesEvaluation Challenges
• Quantitative measurement of health promotion project
• Matching ‘comparison’ communities• Statistically significant sample sizes• Comparison to National guidelines
and existing data• Short funding timeframe
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Evaluation Challenges con’tEvaluation Challenges con’t
• Multiple layers of evaluation data• Evaluation approach and methods
consistent with intervention values• Respect for competing
epistemologies• Ability to bring all of the components
and layers of evaluation into coherent whole
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What does this look like in What does this look like in practice?practice?
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In Murray BridgeIn Murray Bridge
• MMCHS – changes to morning tea• One R-12 school – significant rubbish
reduction since wrapper free lunch intro
• One Primary school reports difficulty in keeping up with demand for fresh fruit
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In Murray BridgeIn Murray Bridge
• Since introduction of fruit and water breaks - reports that the children least likely to bring fresh fruit are prioritising fruit purchase at canteen to participate
• Shoplifting issue at one school has seen preference for fruit over previously preferred junk food thefts.
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In Morphett ValeIn Morphett Vale• One primary school – no chips sold at all in
Term 1. Due to lack of demand chips have been taken off the menu.
• This same school has seen sales of spring water increase, sausage rolls sales have halved, sandwich roll sales have increased and they are now selling plain milk and have sold 100 in 5 weeks
• One HS commenced staff fruit club
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In Morphett ValeIn Morphett Vale
• Most schools have changed staff meeting catering from chips and chocolate to fruit, vegies and dips
• One PS has all teachers now providing daily morning fitness sessions prior to their fruit/veg/water break
• One R-12 school have prioritised healthy fundraising
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In Morphett ValeIn Morphett Vale
• 2 Kindies and one preschool have made definite changes to their fundraising – healthy food at events, no chocolate fundraisers and structure PA into existing fundraisers – one has developed an obstacle-a-thon for non-stop PA
• One PS has phased out all soft drink and lollies and introduced healthy options
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In Morphett ValeIn Morphett Vale
• Mission Australia Youth agencies have switched to healthier catering for their events and are developing a healthy eating policy to firmly establish the changes
• R-7 school with no canteen have replaced their once a week hamburgers and sausage offer with Subway. Also provides a fundraising aspect back to school
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