Child Nutrition In the WestChild Nutrition In the West2001-20032001-2003

Western Region Health CentreWestern Region Health Centre

Child Nutrition in the WestChild Nutrition in the West

Key program areasKey program areas::

1. Bilingual Peer Education 1. Bilingual Peer Education

2. 2. ‘Fresh Kids’‘Fresh Kids’ - - ccreating healthy eating reating healthy eating environments in six Maribyrnong primary environments in six Maribyrnong primary schoolsschools

3. 3. Development of the Vietnamese child nutrition Development of the Vietnamese child nutrition resourceresource

Fresh KidsFresh KidsPromoting daily Promoting daily

fresh fruit, fresh fruit, vegetables & vegetables &

water in schoolswater in schools

Fruit break everyday in classFruit break everyday in class

Partnerships with wholesalersPartnerships with wholesalers

Water bottles Water bottles (Moonee Valley Child (Moonee Valley Child

Nutrition PartnershipNutrition Partnership))Nutrition curriculumNutrition curriculum

Bilingual nutrition education for Bilingual nutrition education for parentsparents

Fruit & water policiesFruit & water policies

Bilingual Peer EducationBilingual Peer Education

The essence of The essence of Peer Peer EducationEducation is to share is to share ownership of ownership of information and the information and the ability to ability to communicate that communicate that information to peersinformation to peers

Program contextProgram context

Forty nine percent of Maribyrnong Forty nine percent of Maribyrnong population born overseaspopulation born overseas

Traditionally dietary education has an Traditionally dietary education has an illness focusillness focus

Facilitated by Dietitians with interpreters Facilitated by Dietitians with interpreters during health centre business hoursduring health centre business hours

Bilingual Peer EducationBilingual Peer Education Recruited 12 local women Recruited 12 local women

from 6 language groupsfrom 6 language groups Nine training days over five Nine training days over five

weeks.weeks. Five days ‘Child Nutrition’ Five days ‘Child Nutrition’

developed by Dietitian.developed by Dietitian. Four days training skills Four days training skills

facilitated by CAE: facilitated by CAE: Nationally Accredited Nationally Accredited Certificate IV Assessment Certificate IV Assessment and Workplace Training and Workplace Training CourseCourse

Employed by WRHC to Employed by WRHC to facilitate formal nutrition facilitate formal nutrition educationeducation

Ongoing individual & group Ongoing individual & group support by WRHC Dietitiansupport by WRHC Dietitian

Nutrition education themesNutrition education themes

General healthy eating General healthy eating Promoting breast feeding & Promoting breast feeding &

safe bottle feedingsafe bottle feeding Introducing solids for infantsIntroducing solids for infants Managing fussy eating for Managing fussy eating for

toddlerstoddlers Why no sweet drinks for Why no sweet drinks for

infants & toddlersinfants & toddlers Nutrition for pregnant and Nutrition for pregnant and

breastfeeding mothersbreastfeeding mothers Preventing Vitamin D Preventing Vitamin D

deficiencydeficiency Preparing school lunchesPreparing school lunches

ImpactImpact Over eighteen months 12 BNE have Over eighteen months 12 BNE have

delivered 78 nutrition education delivered 78 nutrition education sessions to over 850 people from sessions to over 850 people from linguistically diverse communities. linguistically diverse communities.

Increasing access to education Increasing access to education through existing community through existing community networks: schools, mosques, networks: schools, mosques, churches, housing estates, migrant churches, housing estates, migrant resource centres & SBS radioresource centres & SBS radio

Increased confidence, knowledge Increased confidence, knowledge and skills for BNE.’.. our families are and skills for BNE.’.. our families are eating better now’eating better now’

Successful trial of a new model in Successful trial of a new model in community health nutritioncommunity health nutrition

Contextual factors that made a Contextual factors that made a differencedifference

Commitment & enthusiasm Commitment & enthusiasm of individual educatorsof individual educators

Providing employment Providing employment opportunitiesopportunities

WRHC management WRHC management support to reorientate support to reorientate traditional dietetic services traditional dietetic services

Dietitians breaking down Dietitians breaking down professional boundaries professional boundaries

Collaboration & partnership Collaboration & partnership between agenciesbetween agencies

Community engagementCommunity engagementBNE successfully engaged BNE successfully engaged

their communities by:their communities by:

Dual employment of educatorsDual employment of educators Power of word of mouth Power of word of mouth Knowing how to get the message Knowing how to get the message

acrossacross Sharing culture, language & Sharing culture, language &

experienceexperience Understanding the diet & lifestyle Understanding the diet & lifestyle

transition upon re-settlement transition upon re-settlement Understanding traditional beliefs Understanding traditional beliefs

around food & health around food & health Peers as positive role modelsPeers as positive role models

Promoting better access to Promoting better access to nutrition educationnutrition education

Shared Shared language language powerfully powerfully integrates integrates mutual mutual understanding understanding of gender, of gender, race, history race, history and and experienceexperience

‘…‘…Peer education is a Peer education is a sharing of experience sharing of experience so they don’t expect so they don’t expect me to have me to have qualifications. My qualifications. My community would community would respect any respect any professional person professional person trying to help, but they trying to help, but they would just listen and would just listen and not ask questions and not ask questions and they would probably they would probably just go away and not just go away and not do anything about it ..’do anything about it ..’ . .

Project sustainabilityProject sustainability

FacilitatorsFacilitators

Integration within WRHC Health Promotion Integration within WRHC Health Promotion Strategic plan, Neighbourhood Renewal, Best Strategic plan, Neighbourhood Renewal, Best StartStart

Dual employment of five educatorsDual employment of five educators Accredited training componentAccredited training component Transference of the peer education model to Transference of the peer education model to

other health areasother health areas Ongoing relationship of BNE within existing Ongoing relationship of BNE within existing

community networks community networks

Informal learningInformal learning

‘‘When they see me in the When they see me in the supermarket they come supermarket they come and look in my trolley and and look in my trolley and ask questions about the ask questions about the things that I buythings that I buy’’

‘‘I go to my friends houses I go to my friends houses and I know longer see and I know longer see soft drinks in their fridges, soft drinks in their fridges, just juice and water’just juice and water’

Project sustainabilityProject sustainability

BarriersBarriers Funding required to continue employment Funding required to continue employment Need for Victorian public health nutrition Need for Victorian public health nutrition

policy to sustain local projectspolicy to sustain local projects Insufficient public health nutrition Insufficient public health nutrition

workforce workforce Increasing access & intense promotion of Increasing access & intense promotion of

food/drinks of poor nutritional value food/drinks of poor nutritional value targeting childrentargeting children

‘‘In our country many In our country many generations have grown up generations have grown up healthy eating the same healthy eating the same wayway.’ Once arriving in .’ Once arriving in Australia the educators Australia the educators reported that often the reported that often the participants of their sessions participants of their sessions would not understand the would not understand the language spoken in language spoken in advertisements…advertisements… ‘‘they just see kids having they just see kids having fun at McDonalds in the fun at McDonalds in the advertisements and advertisements and sometimes they think that sometimes they think that their kids will be happier if their kids will be happier if they feed them from there.’they feed them from there.’

Evaluation Evaluation

External EvaluationExternal Evaluation: Deakin University facilitated two focus : Deakin University facilitated two focus groups with Bilingual Nutrition Educators to identifygroups with Bilingual Nutrition Educators to identify community nutritional beliefs and concernscommunity nutritional beliefs and concerns quality of training and support quality of training and support administration of the programadministration of the program impact of nutrition education sessionsimpact of nutrition education sessions value of peer education verses health professional educationvalue of peer education verses health professional education

Internal evaluation: Internal evaluation: participant evaluation via telephone surveys participant evaluation via telephone surveys

& written surveys& written surveys

Example of internal evaluationExample of internal evaluation Results of eight telephone interviews using Vietnamese Results of eight telephone interviews using Vietnamese

Interpreter after completion of five sessions with Linh NguyenInterpreter after completion of five sessions with Linh Nguyen

50-70% new information for all attendants50-70% new information for all attendants

‘‘After the sessions I change to feed my son meat & fish moderately. After the sessions I change to feed my son meat & fish moderately. Before I listened to my friends I fed him plenty of meat. I also increase Before I listened to my friends I fed him plenty of meat. I also increase meals and give him less bottles’meals and give him less bottles’

‘‘Before I eat everything I like but now I choose and balance my food Before I eat everything I like but now I choose and balance my food intake which has the five food groups’intake which has the five food groups’

‘‘I give her cheese now and I do not give her soft drink and chips as I give her cheese now and I do not give her soft drink and chips as much as I can’much as I can’

I advise them not to drink much soft drink. Drink more waterI advise them not to drink much soft drink. Drink more water

I have more knowledge about what food to give my child and how much I have more knowledge about what food to give my child and how much he needs instead of forcing him to eat the meat beforehe needs instead of forcing him to eat the meat before

Next timeNext time Maximise the value of Maximise the value of

peer education through peer education through linkages with broader linkages with broader public health nutrition public health nutrition programs, eg Fresh Kids. programs, eg Fresh Kids.

Encourage nutrition Encourage nutrition education in a series of education in a series of sessionssessions

Greater promotion of BNE Greater promotion of BNE Greater focus on food Greater focus on food

preparation utilising preparation utilising community kitchenscommunity kitchens

Engage school aged Engage school aged children with parents in children with parents in nutrition educationnutrition education