Promoting Healthy Lifestyles – Healthy Weight, Somerset NHS - Obesity

Themes this local practice example relates to:

  • General resources
  • Local area early intervention strategies

Basic details

Organisation submitting example

Somerset Health and Wellbeing in Learning Programme (formerly Somerset Healthy Schools)

Local authority/local area:

Somerset


The context and rationale

In Somerset healthy weight has been identified as a priority in the county’s Sustainable Communities Strategies and childhood obesity has been identified as a priority within the Somerset Children's Plan. Overweight and obesity rates for children in Somerset are in line with those of England as a whole but there are local wards where obesity rates are above the national average. At a local level, data and rates are collected through the National Child Measurement Programme (NCMP). On an annual basis children in reception and year 6 have their height and weight measured which in turn is converted into a BMI measure. When this project was established we had evidence of an increase in numbers of children overweight or obese in both age groups with 23.6% of reception aged children and 30.9% of year 6 children being overweight or obese. In addition, local health profiles identified certain areas of Somerset where children were significantly less active. 

The Healthy Schools Programmes across the South West were given the opportunity to pilot a new programme of health behaviour change beyond National Healthy Schools Status. The Healthy Schools Plus pilot required each county to target 50% of schools with the greatest health needs. Schools were required to undertake a piece of work which directly related to local priorities. Therefore, primary schools were asked to plan one intervention to tackle healthy weight. 

Local programmes were also given the opportunity to develop new interventions and projects to help tackle any health issues. A pilot of Learning to Lead was funded by Somerset Healthy Schools as a process of encouraging pupil participation and thus Emotional Health and Wellbeing – children and young people form common interest teams which they run by themselves for the benefit of their school. In this instance, the children created a team from an interest in being healthy.

Data

Healthy Schools Plus targeted the 50% of schools with the greatest health inequalities. A variety of measures was used to select these schools: Joint Strategic Needs Analysis (JSNA) data for each ward, National Child Measurement Programme (NCMP) data, Wealth Poverty Ranking, Free school meal entitlement, Transport, Rural setting/ urban setting, Teenage pregnancy rates, Children in Care, Traveller Children and EAL.
Data for West Pennard
• Number of children on roll – 213
• NCMP data – 2007/2008/2009 average – 15.8% of children were measured as overweight or obese. The Somerset average is 15.7%
• Wealth Poverty Ranking 175/280 with 16.8% children living in lowest 3 poverty deciles
• JSNA Ward level data – Glastonbury – High priority ward affecting health of children and young people
• Claiming Free School Meals – 8.5% (18 children)
• Children in Care – 2
• Traveller Children – 3
• Children who walk or cycle to school – 17.5% (38 out of 213 children)
• Distance from nearest children’s centre, supermarket, town centre facilities (swimming pool, play park, etc) – 3.8 miles on narrow country lane (no pavement or footpath).

In addition, West Pennard Primary School was selected as part of this group on the basis that it would promote healthy weight using the Learning to Lead model and it fell into a ward with above average rates of overweight children and was situated in a local area where children were significantly less active. (South West Public Health Observatory Local Area Health Profile - Mendip 2009).

The practice

Somerset Healthy Schools

Training and launch event for Healthy Schools Plus guiding schools through process: identify need, select priority area, set healthier behaviour outcome, plan intervention, take baseline, run intervention and take final measure using ‘Getting Started with Healthy Schools Plus’ 

Provide Healthylunch.org website training

Provide individual planning session using reporting information Grid (See West Pennard – Healthy Schools Plus – school reporting information

2 subsequent follow-up visits to monitor progress with school

http://www.c4eo.org.uk/localpractice/files/489_west_pennard_healthy_schools_plus_school_reporting_info.doc
Staff training – Learning to Lead (LtoL) (see school priority) – September 2009

Introduce LtoL process and establish Learning to Lead Food Team – October 2009

LtoL Food Team set up list of aims, designate roles within team, timeline through 3 terms and beyond and send letter home to parents notifying them of Food Team’s goals
Survey packed lunches and use this to form baseline for Healthy Schools Plus

Termly survey undertaken – Autumn/ Spring/ Summer
Issue questionnaire to children and parents on healthy lunch ideas

Use Food for Life guidance to Bronze Award level and healthylunch.org resources to promote healthier eating – tasting sessions, designing healthy sandwiches workshop, unusual fruits provided for children on ‘try something new days’, sandwiches, rewards system for children who make healthy choices, create poster and display around school ‘increase your 5 a day, decrease the junk!’ (November 2009 – March 2010)

Year 4 ‘BOB’ and the lunchbox campaign developed to promote more fruit and veg at lunchtime: What does a healthy lunch look like, what do we need to include, food types and portions – All information displayed throughout school and sent home to parents once a month in a ‘Did you know?’ leaflet April/ May 2010

Salad bar established in school canteen – Summer term 2010

Parent Health Education Evening introduced: How can you encourage your child to eat healthy food? – July 2010

Evidence and evaluation - making a difference to children, young people and families

32 children took part in running the Healthy Team for West Pennard School. As part of this they ran a survey of 65 children from across the school at the beginning of the project. 24 children out of 65 were already achieving the desired outcome which was to ‘Increase the number of children who have more fruit and vegetables in their lunchboxes.’ The children set a target of 45 to achieve in 3 terms. The final measure did not reach the target but was still a considerable 36 (an increase of 12 children).

Helping others to replicate your practice

Costs
The 50% of schools who took part in Healthy Schools Plus were given £2000 to run 3 projects over 1 academic year. This money could be used for training, to support teachers being released from school to attend training, for resources, etc.
West Pennard School used part of this money (£1000) to purchase whole-school training in Learning to Lead. We also ran Learning to Lead training days for groups of schools to attending. This would be a way of cutting costs. For details:www.learningtolead.org.uk

Learning from Experience
In Somerset we have now (2 years on) developed a more user friendly process for achieving Healthier Behaviour Outcomes. In principle it uses the same structure as Healthy Schools Plus – identify need, select priority area, set healthier behaviour outcome, plan intervention, take baseline, run intervention and take final measure – but schools select one priority to focus on and record their planning directly onto an online planning grid (seewww.somersethealthinschools.org). 

Challenges/ Barriers
1) West Pennard Primary School was part of the first cohort of Healthy Schools Plus schools and as such was a ‘guinea pig’ in what was eventually to be a national model for all schools in England. Whilst schools were confident in gathering data about attainment, they were new to using a baseline method for health interventions and tended to want to use percentages rather than actual numbers. We needed to have actual numbers.
2) Learning to Lead had only been used in a secondary school setting at the point when West Pennard began to use this approach. We were unsure as to whether a primary school setting would allow for enough pupil participation without staff wanting to ‘lead’ their ideas.
3) Learning to Lead was also used to help increase the children’s confidence and self-worth at West Pennard Primary and we were concerned that one intervention was being used to tackle a few priorities at the same time. This turned out to be a false concern and the children gained confidence whilst establishing healthy eating behaviours simultaneously.

Replication
The Learning to Lead process of setting up ‘teams’ in a school setting can be successfully reproduced. Children are very keen to have an active role in school and will encourage others to take part. Teams can be made up of any number of children and can be driven by any interest a child might have: reptiles, horses, school toilets, tuck shop, transport, gardening, etc.
The Food Team at West Pennard was very successful because it was a local area priority (most areas still have this as a priority), it was a school priority (ditto), it links to other areas of curriculum and other teams (cooking, gardening, waste, etc), it has quick wins yet needs re-visiting on a regular basis, and it encourages links to parents and the wider community.

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