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EARLY HELP COLLABORATIVES CHILDHOOD OBESITY SUPPORT TOOLKIT
November 2017
Contents
Introduction……………………………………………………………………………….. 2
What does the literature say?........................................................................3
What services and activities are available?..............................................4
What can Early Help Collaboratives do?...................................................13
Commitments and Actions……………………………..……………………………14
Appendices 1……………………………………………………………………………….15
Appendices 2 ..…………………………………………………………………………….17
Appendices 3 ……………………………………………………………………..……….18
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Introduction
This document has been developed to help Collaborative members understand some of the practical ways in which we can work together to reduce childhood obesity and improve health outcomes in Doncaster. It provides Collaborative with background information and data in relation to obesity and highlights some of the free resources that are available to be utilised by partners as a precursor to funding interventions to support healthy weight for children.
The latest National Child Measurement Programme (NCMP) data highlights that approximately 1 in 5 Reception Year children in Doncaster has excess weight (either overweight or obese), increasing to 1 in 3 by the time of leaving school. In relation to obesity; 1in 10 children are obese at the start of primary school and this doubles to 1 in 5 by the time of leaving. See Appendix 1.
Doncaster data from 2015/16 highlights:
23.8 % of Children aged 4-5 years are overweight or obese. This is 869 Reception children with excess weight, 384 of whom are obese.
33.9% of Children aged 10-11 years are overweight or obese. This is 1085 Year 6 children with excess weight, 626 of whom are obese.
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74% of Adults are overweight or obese
What does the literature say?
Childhood obesity is higher in lower socioeconomic groups. Obesity inequality becomes most pronounced between the ages of 5 and 11. A five
year old from a low income background is twice as likely to be obese than a child from the most affluent background and this becomes three times more likely at age 11 years.
Children from more deprived homes are more likely to develop into obese adults. Parental leanness is a protective factor against childhood obesity regardless of
socioeconomic status whereas parental obesity is a greater risk factor for childhood obesity in lower socioeconomic groups
Being overweight in primary school increases the likelihood of being an overweight teenager by a factor of 20
Overweight children are less active and have poorer movement skills than those of normal weight
Physical activity and participating in organised sports and after school clubs is linked to improved academic performance
Being overweight or obese during childhood can: increase the risk of conditions including Type 2 diabetes, high blood pressure,
cardiovascular disease and bowel cancer. negatively impact educational attainment, lead to low self-esteem and negative body image, limit the ability to take part in physical activity increase visits to GP
Recognition is a problem – it is estimated that a third of parents in England are unable to recognise that their children are overweight.
There is no easy solution. Childhood obesity is complex and the causes multifaceted, with contributions from changing society, cultures and environments (leading to the so-called 'obesogenic' modern environment), together with genetic factors.
There is no single intervention or policy approach that can be implemented to deal with the issue. Therefore any strategies need to include a multitude of stakeholders (family, children, schools, government, and business) and consider the broader social and cultural factors.
The WHO strongly recommends actions in pregnancy and early life (early years settings).
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What services and activities are available to support families, schools and collaboratives?
1.1 Public Health Team
Doncaster’s Public Health team provide support and information to schools and collaboratives and regularly attend the collaborative meetings. Key Public Health led activities that schools and collaborates should get involved in include:
Healthy Learning, Healthy Lives
The new Healthy Learning, Healthy Lives programme launches in October 2017. It is FREE and aims to improve the health of local children by providing support to education providers. The programme is being coordinated by Public Health at Doncaster Council. In addition to schools, we will also support early years providers.
As part of the programme, education providers will soon have FREE access to:
A new website with resources, evidence and contacts designed specifically for education settings.
An accreditation scheme that ensures providers can meet national and local standards and priorities.
Online support to identify strengths and areas for improvement, with help to achieve this.
The programme will be launched in January 2018 but schools can sign up now by emailing: [email protected] to nominate a Healthy Learning, Healthy Lives lead for your setting. This could be a teaching or support member of staff and you may want to factor in some time for them to work towards the accreditation in the next academic year. Providing their name and contact details will ensure you do not miss out on key updates plus your exclusive invitation to the launch of the programme.
The Pupil Lifestyle Survey
This free survey is delivered free in primary and secondary schools. The resulting detailed report of pupils’ health and wellbeing and enabling schools to plan their work. The latest survey results will be available in the Autumn term 2017 for those schools that agreed to be involved.
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Contact: [email protected]
Free Healthy Eating and Oral Health training
Public Health are introducing some new free training opportunities for colleagues working throughout the Doncaster borough, who would benefit from additional training around nutrition and oral health.
The training will be available for anyone who has a role; working with early years, primary and secondary school aged children.
The training will cover the key health messages and latest government guidance. The training is suitable for those who have not received nutrition/oral health training before, those who would benefit from refresher training, or anyone who would like to learn more.
The training will take place at Doncaster Councils Civic Office or where numbers permit training can take place externally.
For more information regarding upcoming training opportunities please contact
Laura Quinn
Public Health Improvement Co-ordinator
01302 737260.
1.2 - Modeshift stars
Modeshift STARS is the National school travel accreditation scheme. The scheme rewards schools that promote and encourage active travel. The aim is to get more families walking, scooting and cycling to school, improve parking and congestion problems at the school gate, and make it safer for your pupils.
Every school in Doncaster can register to take part in Modeshift STARS. Once you have registered you can access support from your Active Travel Officer who can deliver activities and lessons, give you resources and ideas for projects and help you with your accreditation all for free. Examples of activities include scooter skills sessions, map work, parking pledges, 5 minute zones, road safety lessons.
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The Modeshift STARS system creates a comprehensive School Travel Plan. It helps you monitor what work you have done around active travel and you can create an action plan for future work.
Alice Nelson
South Yorkshire Active Travel Officer
07506 822 531
www.modeshiftstars.org
@SY_STARSAwards
Usual days: Mon, Wed & Thurs
1.3 - Change4life
Change4Life’s school zone contains resources and ideas for promoting physical activity in schools. Campaigns take place each year and are free to take part in.
https://campaignresources.phe.gov.uk/schools/topics/our-healthy-year/overview
https://campaignresources.phe.gov.uk/schools
1.4 - Bikability
The Bikeability scheme is ‘cycling proficiency’ for the 21st century, designed to give the next generation the skills and confidence to ride their bikes on today’s roads.
Helping cyclists develop observation and manoeuvrability skills, it introduces the Highway Code for Young Road Users, teaches the importance of cycle maintenance and hazard awareness and provides information and advice on being conspicuous and wearing protective headgear.
For more information or to book Bikeability training in your school
email: [email protected]
1.5 - Healthy Start Vouchers
If you are pregnant or have a child under four years old you could get Healthy Start vouchers to help buy some basic foods. This important means-tested scheme provides vouchers to spend with local retailers.
In Doncaster all pregnant women and women with a child under 12 months can receive free Healthy Start vitamins through their midwife or health visitor.
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Women and children (under 4 years of age) getting Healthy Start food vouchers also get vitamin coupons to swap for free Healthy Start vitamins.
For more information go to https://www.healthystart.nhs.uk/
1.6 - Health Visiting
The Health Visiting Service works with families and local settings to lead the delivery of the Healthy Child Programme 0-5 (HCP), a prevention and early intervention public health programme that lies at the heart of the universal service for children and families. The HCP aims to support parents at this crucial stage of life, promote child development, improve child health outcomes and ensure that families at risk are identified at the earliest opportunity.
All families with a child aged 0-5 years and all pregnant women currently resident in the local authority area must be offered the HCP. Healthy eating and physical activity are key themes running throughout the HCP starting in pregnancy with promotion of breastfeeding, weaning advice and first foods.
1.7 - Breast feeding support
The UNICEF Baby Friendly Initiative is a global programme which provides a practical and effective way for health services to protect, promote and support breastfeeding and to strengthen the mother-baby and family relationships. Both Health Visiting and Midwifery services have achieved Stage 3 UNICEF Baby Friendly accreditation. Family Hubs, in partnership with Public Health, have recently embarked on achieving Baby Friendly accreditation also.
1.8 - Breastfeeding Welcome scheme
Organisations across Doncaster can sign up to be ‘Breastfeeding Welcome’. A Breastfeeding Welcome business pledges that mothers who wish to breastfeed their infants in their premises can be assured they can do so in a safe environment and they will never be asked to stop or move on.
1.9 - Breast Start groups
Groups usually held in family hubs and co-delivered by health and family hub staff provide a forum for breastfeeding mothers to meet, socialise and discuss any issues with breastfeeding and provide advice and support for each other
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1.10 - Breastfeeding peer support
Mothers who have previously breastfed themselves are trained to offer information and support to new mums who wish to breastfeed. The peer supporters can work in numerous venues but are more often found in Family hub at Breast Start groups.
1.11 - Let’s eat together group (4 months)
Universal service to all parents, invited to group session at 12- 16 weeks. Content of session include:
Listening to baby fullness and hunger cues Responsive feeding Myths and truths of introducing solid food Healthy mealtime routines and habits Henry video Foods to try, healthy balance and portion sizes Impact of parental food preferences, role modelling and habits Progressive introduction to nutritious foods Foods and drinks to avoid Introducing activity Reducing screen time Introduction to Henry group programme and registration Dental health and advice Advice re Healthy Start Vitamins and vouchers
1.12 - Family Hubs
Family Hubs are a government led programme designed to give every child the best start in life. Each family hub provides different activities to meet the needs of the local community, including family support, social care services and childcare.
All contact information and timetable details can be found at:
http://www.doncaster.gov.uk/services/schools/children-s-centres-and-services
1.13 - School Nursing
What is it?
The Doncaster school nursing team is a group of experienced qualified nurses and support workers who support young people aged 5-19 years and their families to stay healthy.
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The school nursing team work in partnership with other health service and education providers, and other wider social care and voluntary services for children young people and families.
School nurses can provide support and advice around healthy eating and physical activity. School nurses weigh and measure children as part of the National Child Measurement Programme (NCMP) in Reception and Year 6 and can offer 1:1 intervention.
School nursing also deliver Active Kids sessions Key Stage 1 and 2 children during half term holidays across Doncaster to encourage participation in physical activity (dates to be confirmed). Sessions in school time may be available on request from the School Nursing service.
How to access it?
Families of children who meet the threshold for intervention following NCMP will be contacted by the service. Aside from this schools can refer children to the school nursing service for 1:1 weight management intervention, provided they have discussed it first with the child’s family and the child themselves wishes to be referred. Families can also self-refer.
Single point of contact email: cyp&[email protected]
SPOC telephone number: 01302 566776
1.14 - Adult Family & Community Learning
To access any adult learning class you must be aged 19+.
Family Learning
What is it?
Family learning refers to any learning activity which benefits both children and adults and has a positive impact on the whole family. It refers to learning that includes more than one generation of a family (including extended families and carers). Family Learning supports parents to help their children achieve, gives parents the confidence to go on learning for themselves and encourages progression to further learning, for both adults and children. Family Learning courses include Healthy Family Cookery, Family Gardening, Family English and Family maths.
How to access it?
To find out more about our courses please contact Ruth Precious, Curriculum Lead Family Learning.
Contact: 01302 862688
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1.15 - Functional Skills
What is it?
Functional Skills covers the English and Maths skills you need to get on in life and work. Qualifications are offered up to level 2.
How to access it?
To find out more about our English and maths provision please contact James Sandford, Curriculum Manager English & Maths.
Contact: 01302 862688
1.16 - Bentley Urban Farm
What is it?
Bentley Urban Farm is a fledgling project set up to encourage better food health and to provide affordable, healthy, locally grown food in an area which is something of a 'food desert' where it is easier to buy kebabs than kale. As well as creating an 'upcycled market garden' which uses waste materials to grow fresh produce, they are also developing a subsidised 'Fun Time Farm Box' scheme. General sales of organic farm boxes will be used to subsidise a number of very cheap boxes for families most affected by food poverty and poor nutrition and free boxes for those families who have previously accessed food banks. The Fun Time boxes will also include activities such as growing boxes and seed bombs to encourage children and their families to grow their own fresh produce at home. In conjunction with the neighbouring Manna Community Cafe, farm box collection days will also double as open days where children will be able to engage with more practical activities and parents, carers, grandparents and individuals can prepare and enjoy a range of healthy food in an inclusive, inter-generational environment.
How to access it?
To volunteer or arrange a visit to Bentley Urban Farm please contact Warren Draper for more information.
Contact: [email protected]
1.17 - Home-start
What is it?
Home-start South Yorkshire have been commissioned by DMBC to deliver a Volunteer Family Support Service to a minimum of 200 families per annum. It focuses particularly on the hard to reach children aged 0-5 years and one of the measured outcomes is “Children to be as fit and healthy as can be - Improved Children’s Health and Wellbeing”.
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The service includes but is not limited to the following;
Individual group work with families supported by a volunteer Group based family support supported by volunteers
It is the expectation that all families supported will be living in the 10% most deprived areas. Families referred would display two or more of the following criteria:
Families without a support network Families who do not engage with statutory services Families with a first baby Families with multiple children under 5 Families with a child(ren) with a disability
How to access it?
Referrals may come from health visiting service and family hubs but also from schools for any children under 5.
Contact: [email protected]
1.18 - Stronger Families
What is it?
The aim of Stronger Families programme is to change the way families are supported to improve their lives using a whole family approach coordinating services through a lead worker. Families are supported to tackle the issues they face and build their resilience; through this there will be a reduced demand on high cost services by identifying and supporting families earlier. Families may be included if:
children in families have problems attending school young people are not in education, employment or training adults are claiming out of work benefits, or there are issues getting into work or debt the family may be affected by domestic violence and abuse members of the family may be affected by a range of health problems family members may be involved in crime or anti-social behaviour
Families are identified by local information available from services, professionals may refer families who are experiencing difficulties, and families themselves contact the team.
They work with schools whereby a family has a child/children in a school setting.
How to access it:
If it is decided within the school environment that the issue raised and support required for a child or family is beyond the school remit, further support and help can be utilized via referral to the Children’s Early Help Hub and highlighting the need.
Contact: Tel: 01302 734110
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Email: [email protected]
1.19 - Communities Team – Wellbeing Officers
The Wellbeing team is to support adults to improve health and wellbeing from an early intervention approach. It is low level support and will work with adults to prevent / delay social care and health needs – including linking into community activities, winter warmth, falls prevention, minor adaptations, etc.
How to access it: Via Telephone or email. For internal users with access to Carefirst system, request support directly from the wellbeing team.
Contact: Wellbeing Triage Tel: 01302 735553
Email: [email protected]
1.20 - Sport England
The national organisation created to support and grow grass roots sport. Several grants are currently available to apply for and more are announced at regular intervals. Visit https://www.sportengland.org/ for more details.
1.21 - Yorkshire Sport Foundation
The Sport England funded County Sport Partnership covering West and South Yorkshire. Currently funded to help schools spend the PE and Sport Premium effectively (free resources, visits from PE consultants and training opportunities are currently available), develop school sports clubs through the Satellite Club programme, and link to local sports clubs. For further information visit www.yorkshiresport.org
2. What can Schools and other settings do to encourage healthy weight in children?
Obesity is complex and home and family environment is one of the main factors in determining childhood weight. However, given that there is a significant rise in obesity during the primary education years with prevalence doubling from entry to school to leaving school, it is recognised that primary school is an important period for obesity development see Appendix 2. With most children spending a significant amount of time in school it provides an infrastructure in which behaviour can be influenced.
Encourage schools to adopt the practices highlighted below: Engage with the local public health team to undertake the ‘Healthy Learning, Healthy
Lives’ accreditation. Nutrition: Evidence shows that only 1% of packed lunches meet the nutritional
requirements with apply to school meals. Therefore:
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Encourage healthy lunch boxes Encourage uptake of school meals
Physical Activity: Evidence shows that physical activity promotes a healthy weight and is linked to improved academic performance. Therefore:
Endeavour to ensure children undertake at least 30 minutes of activity at school each day.
Maximise funds from PE and Sports Premium to increase physical activity e.g. through provision of after school clubs. Local physical activity providers can provide support and expertise.
Consider undertaking the mile a day initiative: http://thedailymile.co.uk/
Engage with families and the local community – as parental leanness is a protective factor against childhood obesity
Engage with Parent Teacher Associations (PTAs) to encourage fundraising activities around physical activity or healthy eating and avoiding high fat sugary snacks at events.
Use local intelligence such as collaborative and school health profiles and Pupil Lifestyle Survey results to plan action
Be aware of all the services available for children and families locally and make best use of these (see below)
Consider how to work with the local authority, health partners and the local community sector to promote healthy eating and physical activity and to capitalise on local and national campaigns.
What can Early Help Collaboratives do?Obesity is the biggest human-generated burden on the economy after smoking and a number of Early Help Collaboratives are rightly focusing attention on this issue. Cross-sector working is key to implementing a range of effective interventions and to support this commitment – a working party convened made-up of collaborative members from across Doncaster. Through discussions and the completion of various tasks the group identified multiple factors influencing the weight of Doncaster children and formulated 2 commitments which for Collaboratives to use as a focus for early intervention.
They are:
We commit to reducing sedentary behaviour and increasing physical activity through early intervention and practical support for parents and families
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We commit to improving the food knowledge and skills of local parents and children by implementing and supporting local training and interventions
The full report can be found in Appendix 3
Commitments and Actions
Children and young people's participation in physical activity is important for their healthy growth and development. It can reduce the risk of chronic conditions (for example, obesity) and improve their general health and wellbeing. Emerging evidence suggests an association between being physically active and academic attainment and attention. Children and young people who are physically active are more likely to continue the habit into adult life.
Local data (27 schools) shows the correlation between children’s self-reported physical activity levels and obesity – with those undertaking physical activity less likely to be obese.
The recommendation for collaboratives who have identified obesity as a key theme is in the first instance to consider sources of support as detailed in the first section of this report. Thereafter, we request that partner’s utilise and adapt the information in the table below to demonstrate how the area as whole is subscribing to a range of low cost and free options before seeking to commission additional area support.
Actions for schools to be supported by non-school collaborative members
Details Milestones?
Sign up to Healthy Learning, Healthy Lives
Email [email protected]
to nominate a HLHL coordinator. The coordinator will receive updates regarding the scheme and will be invited to the programme launch in January.
Send a rep to the Launch event in January (date TBC)
Submit application to HLHL and receive award (by end 2018)
Sign up to the Daily Mile
Sign up to the daily mile here:
https://thedailymile.co.uk/
Sign up to daily mile and inform Emma Wilson by email
Participate in yearly audit of daily mile and feedback on success and
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Contact Emma Wilson for local support materials and inform her that you have signed up. [email protected]
challenges
Take part in at least two local physical activity campaigns that involve children and their families
Examples: Mode shift stars and Change4life are free but your chosen campaigns should fit in with school’s needs and priorities and may be done in partnership with local organisations that you currently work with
Sign up to at least two campaigns per year
Participate in free Public Healthy Nutrition training and promote with all early years settings
Contact [email protected] regarding the free nutrition training for professionals who work with children
Number and type of staff booked onto training and completing it
Feedback on dissemination of/use of knowledge and skills
Appendix 1
Local data (27 schools) shows the correlation between children’s self-reported physical activity levels and obesity – with those undertaking physical activity less likely to be obese.
0 5 10 15 20 25 30 35 4005
1015202530354045
Correlation between Physical activity and Obesityfor Year 6 Children 2014/15
% Physical Activity 5 times per week
Obe
sity
Prev
alen
ce %
r = -0.3212
15
0 5 10 15 20 25 30 35 40 45 5005
1015202530354045
Correlation between No Physical activity and Obesityfor Year 6 Children 2014/15 by linear regression line
% No Physical Activty in previous week
Obe
sity
Prev
alen
ce %
r = 0.3107
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Appendix 2
Figure 2: Reception Children, prevalence of Obesity in three-year periods from 2006/07 to 20014/15 in Schools in the most and least deprived Quintiles.
2006/07 - 2008/09 2009/10 - 2011/12 2012/13 - 2014/150
5
10
15
20
25
30
Prevalence of Obesity over time in Reception Children in the most (Q1) and least (Q5) deprived quintiles
Quintile 1Quintile 5
Year
Obe
sity
Prev
alen
ce %
Figure 3: Year 6 Children, prevalence of obesity in three-year periods from 2006/07 to 20014/15 in Schools in the most and least deprived Quintiles.
2006/07 - 2008/09 2009/10 - 2011/12 2012/13 - 2014/150
5
10
15
20
25
30
35
40
Prevalence of Obesity over time in Year 6 Children in the most (Q1) and least (Q5) deprived quintiles
Quintile 1Quintile 5
Year
Obe
sity
Prev
alen
ce %
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Karen Horrocks Reka Sundhar Public Health, Doncaster Council 27th June 2017
EARLY HELP COLLABORATIVES CHILDHOOD OBESITY SUPPORT
TOOLKIT
A short report on our first childhood obesity workshop
Appendix 3
Contents
Background………………………………………………………………………………………………………………………………... 20
Aims of the workshop:…………………………………………………………………………………………………………………. 21
Method………………………………………………………………………………………………………………………………………… 21
Analysis ……………………………………………………………………………………………………………………………………….. 21
Results ………………………………………………………………………………………………………………………………………… 22
Figure 1: Local Childhood Obesity Model ………………………………………………………………………………….…. 22
Figure 2: Group 1 Action Plan ……………………………………………………………………………………………………… 23
Figure 2: Group 2 Action Plan ……………………………………………………………………………………………………… 23
Conclusion and Next Steps ………………………………………………………………………………………………………….. 24
Learning for future work ……………………………………………………………………………………………………………… 24
Recommendations ………………………………………………………………………………………………………………………. 24
Tools and resources …………………………………………………………………………………………………………………….. 25
Appendix 1 ………………………………………………………………………………………………………………………………….. 25
Appendix 2 ………………………………………………………………………………………………………………………………….. 26
Appendix 3 ………………………………………………………………………………………………………………………………..… 27
Appendix 4 ………………………………………………………………………………………………………………………………….. 28
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SummaryOn 26th June 2017 a small group of professionals took part in a Childhood Obesity Workshop. They had been asked by the Early Help Collaboratives to explore the causes of childhood obesity in Doncaster and suggest a way forward for each locality. This report outlines the findings of the group and provides two recommendations for action that should be considered by all Collaboratives that have prioritised obesity.
Background Collaborative groups are a key element of Doncaster’s Early Help Strategy; they are local strategic partnership groups. They aim to enhance local service provision through partnership working, which includes the pooling of knowledge and resources in a pursuit of improved outcomes for children and young people aged 0-19 years.
A number of Doncaster’s Early Help Collaboratives have identified Childhood Obesity as a priority. They requested the help of the Public Health at Doncaster Council to facilitate a piece of work exploring the causes of childhood obesity in Doncaster with the aim to creating action locally, led by each collaborative group. The workshop took place 26th June 2017 and was delivered by Karen Horrocks and Reka Sundhar.
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Aims of the workshop Examine the influences upon the weight of children and families in Collaborative
areas. Identify assets and barriers within communities and decide how to utilise/mitigate
them. Identify specific areas for action and start action planning for change.
The workshop was attended by ten local workers including school staff, Doncaster Council employees, school nursing, family hub workers and community practice educators (health visitors). (See Appendix 1 for a list of attendees.)
Method
The workshop took place at the Doncaster Central Family Hub, it lasted for 1hr 30 minutes. (See Appendix 2 for the work plan.) Although intended to be an area specific work, the views and concerns raised by the professionals from other areas were found to be similar. This led to the discussion of developing a council wide approach.
1. A pre-questionnaire (see Appendix 4) was sent out to the group members before the workshop and was returned by approximately 50% of attendees. The questionnaires were used to populate the first version of the Childhood Obesity Model in Appendix 1.
2. A presentation (see Appendix 2) for group members introduced the topic of childhood obesity and some of the challenges in addressing it.
3. The group members were given a number of tasks, including identifying positive factors and local assets, which led to the creation of the Local Childhood Obesity Model and two Group Action Plans (Figures 1-3).
4. This report was then reviewed and refined by group members and shared with the collaboratives for action.
5. The role of the collaboratives is now to put the group’s recommendations into action by including the actions in their priorities and monitoring the progress towards them.
The Nesta (2013) Causes Diagram (see Appendix 3) was used to help the group members break down this complex issue by identifying the “causes of the causes”. This enabled them to start action planning. The resulting recommendations were sent to collaboratives to be assimilated into future priorities and actioned by collaborative members.
AnalysisDue to the time constraints of the workshop, the group were unable to finish the Local Childhood Obesity Model. The Public Health team spent further time sorting, checking and connecting some causes on the Childhood Obesity Model. They also “tidied up” the action plans. The Local Childhood Obesity Model was created using Insight Maker, a free web-based systems modelling programme. No additional causes were added to the model, except an overarching, connecting cause that emerged during the analysis phase-
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Pressures on Mental Health. Because of these refinements, this report and the model/action plans have been reviewed and amended and approved by the group members.
ResultsA list of the causes/influences on childhood obesity was used to create a Childhood Obesity Model (See Figure 1). This helped in identifying key areas for intervention and developing action plans for tackling them.
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Figure 1: Local Childhood Obesity Model
Figure 2: Group 1 Action Plan
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Figure 3: Group 2 Action Plan
DiscussionThe workshop achieved its intended aims: it explored the issues, generated ideas and provided a way forward. This model could be used additionally to identify areas for social/environmental change in the future and has potential as a tool for planning, communication or needs assessment. However, it needs consideration that the tool was developed using a small task group and requires larger input to make it robust.
Conclusion and Steps Forward The workshop identified multiple factors influencing the weight of Doncaster children. Those factors are interlinked in a complex manner, as illustrated by the Local Childhood Obesity model. The causative factors mapping and the assets identification enabled us to identify areas for intervention and for develop action plans locally
After refinement by group members, this report has been sent to all Early Help Collaboratives. Those Collaboratives that prioritised childhood obesity (and any others that wish to) will be committed to work towards the identified actions in Figures 2 and 3. This will be revisited by each collaborative meeting (quarterly). The next steps are not the responsibility of the Public Health, although they will involve partners from this area. It is now the role of the Collaboratives to drive the actions forward.
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Learning for future workWe believe that workshop model and related tools could be used to explore other Public Health (and perhaps wider) areas and we are keen to support the dissemination of the methods.
The workshop should have been at least 2hrs 30 minutes long, in order for the group members to complete and check the model. The first draft of this report was sent to the group members for approval as an alternative to this further work.
The pre-questionnaire was very useful for gathering information to get the obesity model started.
The venue was a little cramped; a larger hall with room for group work would have been preferable.
We believe that Insight Maker has uses far beyond the systems maps created for this project and should be explored further by our colleagues.
Recommendations
We recommend that every collaborative that has prioritised childhood obesity commit to and develop both action plans above, and that they monitor work towards them on a quarterly basis. This should be agreed at the next collaborative meeting.
Suggested commitment statements:
We commit to reducing sedentary behaviour and increasing physical activity through early intervention and practical support for parents and families
We commit to improving the food knowledge and skills of local parents and children by implementing and supporting local training and interventions
Further work upon the Local Childhood Obesity Model could identify further areas for intervention, including key areas of influence that only became apparent post-workshop through analysis with Insight Maker. “Lack of Time” seems to be one of these areas.
Tools and resources
Insight Maker (2017) https://insightmaker.com/
Nesta (2013) Causes Diagram. http://www.nesta.org.uk/publications/causes-diagram
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Appendices
Appendix 1
Obesity Workshop Attendee ListName Role or OrganisationLaura Lambert West Road PrimaryTracy Fry Central Family HubTracy Long Community Practice Educator RDASHLynn Fitzwater Community Practice Educator RDASHVicky Ward Sandringham PrimaryEmma Hill Kirkby Ave PrimaryTracey Outram DMBCNaomie Knightly DMBC
Appendix 2
Obesity Working Group Plan 26.6.17
Karen Horrocks 13.30-15.00 Central family hub approx. 10-20 people from a range of areas and professions
The aim of the working party will be to help Collaborative members to:
Examine the influences upon the weight of children and families in their Collaborative area
Identify assets and barriers within their communities and decide how to utilise/mitigate them
Identify a small number of areas for action Start action planning for change
Segment Method Attendee interaction ResourcesIcebreaker Group members to
discuss in small groups and then share what one
Discuss the question and feedback
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thing they would do, given unlimited time and resources, to improve the health and wellbeing of their community
Obesity and children presentationA whole systems approach and key healthy behaviours
Short PowerPoint presentation and activitiesFurther slides used to guide exercises below
Understand the impact of and levels of Childhood ObesityUnderstand the influences upon weight
PowerpointProjector
Identifying community assets
Group exerciseEach group to discuss and fill out the assets flipcharts
Identify the assets available in each community and similarities
Flip chart and a different coloured pen/post-it for each area
Discuss the key drivers/causes of childhood obesity
Group exercise: Causes Diagram
Identify causes in a circle and connect them up
Causes flip chart
Understanding complex causes diagram
Looking at the priority (s) and identifying the causes
List the causes and underlying causes of the issues identifies
Nesta causes DiagramsPowerpoint slideFlip chart
Solutions focussed activity looking at solutions
Answer the questions on the slide.
Start action planning and create a statement/plan
Paper
Appendix 3
Nesta (2013) Causes Diagram
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Appendix 4
Obesity Working Group Pre-questionnaire
The following questions are designed to gather your local knowledge in advance of our Obesity Working group on 30th June. The working group will focus upon children, however, it will take an approach that considers the whole community, including their families and other adults.
Please answer the following questions and email to [email protected] by 10am 26th June 2017. Your answers will be collated but you won’t be identified (so speak your mind and be creative if you can).
Name and contact email:……………………………………………
1. What collaborative area do you work in?2. What is your role?
Intro
We know that the factors that affect obesity are complex and wide reaching. It’s not just about changing individual behaviour; we know that an individual’s choices are restricted, and supported, by their environment. For example, a family’s access to healthy food could be influenced by transport, market forces, availability, income, peer influences, skills and knowledge.
The following questions are designed to help us identify the factors might be having an effect on obesity in your community.
1. What do you think are the main reasons that children and families in your area struggle with their weight? This is just your opinion and could include any aspects of what they are eating and drinking or issues around physical activity, travel or lifestyle aspects. Try to give as much detail as possible and say why you have come to this conclusion e.g. have families told you this or you have seen the behaviour?
2. What are the assets (facilitators, resources or positive factors) in your community and/or your organisation that may already be helping people maintain a healthy weight?
3. If you were “all powerful” and could pick one or two things to change in your community, that would help children and families be a healthy weight, what would they be? Don’t worry too much about how we would do it.
4. What other comments or suggestions do you want us to consider at the working group.
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