Embed Size (px)
Citation preview
Shared Intelligence
Evaluation of the HEY! ProgrammeSummary report
September 2015
HEY! Summary Report 1
2 31Shared Intelligence
1 Summary ReportBackgroundHealthy Eating for Young Children (HEY!) is an Early Years community health improvement project led by Danone Nutricia Early Life Nutrition (Danone). The ambition for HEY! is to improve the health outcomes and life chances of local children aged one to three years by engaging their parents in healthy eating and Skills for Life learning. This reflects Danone’s global mission and core purpose of ‘bringing health through food to as many people as possible … because nourishing early life today really matters for tomorrow’.
HEY! is based on a body of evidence that shows childhood obesity is linked to parents’ eating habits. Recent research by the University of Exeter, published in the International Journal of Obesity in April 2015, discovered that the rise in obesity among very young children has been largely restricted to the minority with obese parents. The research data suggests that ‘parenting is the fundamental influence on weight gain in the early years, whereas more general (peer-group) influences take over later on….and public health strategies may need to be tailored accordingly’.
Research demonstrates that families living in the most disadvantaged communities are often those who have the worst health outcomes because they face the most challenges in managing their health and wellbeing. A lack of language, literacy and numeracy skills is one of the major contributing factors to this. For this reason, HEY! took an embedded learning approach by delivering health messages through Skills for Life learning.
The project was initiated in 2011 and created in partnership with Danone, Wiltshire County Council, 4Children and the Community Health and Learning Foundation (CHLF). Following a successful pilot, 70 HEY! courses have been run at children’s centres across the UK.
This independent evaluation of HEY! by Shared Intelligence has assessed:
● Change in parents’ and children’s healthy eating behaviours as a result of HEY!;
● Whether and how this behavioural change is sustained after the end of a course:
● What works well in enabling behavioural change through HEY!; and
● The sustainability of the HEY! model to ensure quality and credibility.
Design and delivery of HEY!The HEY! programme is delivered over seven weeks and covers topics such as budgeting, food safety, portion sizes and cooking skills through interactive and practical learning, with LLN skills embedded in the resources. HEY! was endorsed by the RSPH in 2013 and course participants can earn a RSPH Level 1 Award in Health Improvement, equivalent to two learning credits at Level 1 on the Qualifications and Credit Framework (QCF).
The evaluation showed that:
● The partnership between Danone, Wiltshire County Council, 4Children and the CHLF was essential to design and develop HEY! as an evidence-based, accredited programme to address childhood obesity and promote healthy eating.
● The resources developed enabled HEY! to address its health improvement aims through an embedded learning approach to address parents’ Skills for Life needs and improve their knowledge about healthy eating.
● Most HEY! courses target vulnerable or socially deprived parents, which meets local authority priorities and needs that have been identified by the children’s centres.
● HEY! adds value to centres’ offer but finding the resources to staff the courses and crèche provision is becoming more of a challenge due to local authority budget cuts.
● Tutors are positive about the ‘Train the Trainers’ session and value the resources – particularly the HEY! Diary, which is attractive and easy to use.
● These have contributed to HEY! courses going well. The group working helps learning about healthy eating and parenting. The main challenge has been engaging parents in a way that promotes regular attendance and prevents drop-out.
HEY! Summary Report 2
Who is providing HEY!?As of July 2015, there are seven provider organisations running HEY! courses. They are:
● 4Children
● Spurgeons
● Action for Children
● Barnardo’s
● Independent Children’s Centre
● Buckinghamshire County Council
● Leicestershire County Council
Where has HEY! been delivered?
All figures are up to July 2015
HEY! Summary Report 3
Impact of HEY!Data was collected from 90 parents who had filled in ‘before course’ and ‘after course’ monitoring forms. The evaluation utilised a range of indicators – about increases in fruit and vegetable intake and increases in physical exercise which relate to the Public Health Outcomes Framework. Also measured were improvements in health literacy, budgeting and cooking skills, as well as confidence and self-esteem to capture the impact of the programme.
Analysis of the monitoring data up to April 2015 showed notable increases in parents’ knowledge and this greater awareness translated into positive behavioural change. The graphic below (‘Impact of HEY!’) sets out some of the evidence of the impacts the course had.
These impacts are related to parents’ enjoyment of HEY! – particularly the social aspects of being part of a group, and the cooking and practical exercises – with most parents saying that they would have liked more cooking and recipe ideas.
The only thing to which there was a more mixed response is ‘the paperwork’ – echoing tutors’ comments that some parents found the accreditation difficult. However, while it was a challenge for some parents, this was often outweighed by the boost to self-esteem from gaining a qualification from the course.
HEY! Summary Report 4
Sustaining behavioural changeThe real test of HEY! is whether healthy eating behavioural change is sustained after a course. We spoke to a sample of 22 parents from seven courses to explore this and found that behavioural change was continuing at 6-8 weeks after the HEY! course. We found that parents were all:
● Reducing portion sizes;
● Swapping to healthier foods;
● Cooking ‘from fresh’;
● Using a greater variety of foods for their children; and
● Most parents were sitting down with their children to eat at regular mealtimes.
And the ongoing impact of HEY! was over and above changes in healthy eating:
● Parents became interested in health more generally – and had taken up physical exercise;
● HEY! improved their confidence and relationships with their partners and children;
● With some parents signing up for other courses – including at the children’s centres.
Conclusions and recommendationsWe conclude that the Danone HEY! course is having a substantial impact on healthy eating and healthy lifestyles for parents and their young children. This impact is largely due to the design of HEY! and the resources in place for the delivery of HEY! – which children’s centres, tutors and parents have greeted enthusiastically.
We recommend that Danone and its partners build on the success of HEY! to maximise and sustain its impact by continuing to take actions to:
● Increase retention and reduce drop-out of course participants;
● Explore ways to increase engagement and sustain the positive impacts of the course beyond the seven week HEY! programme; and
● Sustain and increase capacity for centres to run HEY! courses.
HEY! Summary Report 5
2 31Shared Intelligence
2 HEY! Case study: Ashley“HEY! has changed my eating habits. My key worker got me on HEY! and it helped coming just before Christmas so I could make a fresh start, a new year’s resolution. We still have some treats but we feel much better in ourselves”
Ashley had recently moved to Leicestershire with her husband and two small children and felt isolated away from family and friends. She was introduced to the HEY! course – as well as a parenting group – at the children’s centre near where she lives.
Ashley says HEY! made her really look at what she ate and make a lot of changes such as reducing sugar and salt – not easy as she works in a fast food café with burgers and fizzy drinks freely available. “Before HEY! I used to have three or four coffees a day and three or four Red Bulls and full sugar Cokes. Now I have one coffee three times a week and water with sugar free squash. At work I have cup-a-soups and savoury crackers and bottled water – not burgers and chips. I’m not bloated now and have lost two stone”.
Ashley explains that she eats less and more slowly since HEY! and knows when she’s full. Her husband does most of the cooking and has changed to making healthier – and smaller – meals following HEY! Ashley has started to do more cooking and now buys less ready-made and processed food. “We make wraps now using 50/50 bread as we like Mexican food. We cook chicken breasts and haddock fillet and add vegetables and seasoning – then you know what’s in it”.
Not only has Ashley moved to healthier options for food and drinks and started cooking more, she and her family have changed their eating habits, which has brought them closer together. A big change was buying a dining table and chairs so they could eat together in the kitchen instead of on their laps in the living room, which means their toddler doesn’t play with his food or wander off any more. “We have breakfast with the kids now – and enjoy each other’s company”. This led to cooking for special occasions – like Christmas and the Chinese New Year, which their toddler was learning about at pre-school. “It’s better for our marriage – doing things together. We’ve done a Valentine’s Day meal and Pancake Day for the first time in three years”.
Ashley has learnt that healthy eating helps mental as well as physical health and sees eating as part of a healthy lifestyle.
She’s made other changes to her lifestyle including reducing her hours at work to shorter shifts and feels much better for it. “I’m sleeping much better now– there’s less stress but it’s the diet as well – less coffee and so on”.
“ The last 6 months of 2014 – with HEY! and the parenting course – have made a massive impact on me today”
HEY! Summary Report 6
2 31Shared Intelligence
3 HEY! Case study: Lyndsey“ I’ll never look back … [the HEY! course] has definitely changed my family’s life”
Lyndsey attended the HEY! course twice. Lyndsey completed the HEY! course in Gloucestershire and enjoyed it so much that she asked if she could be involved again so as to review the course content and to act as a helper in the sessions.
Lyndsey first heard about the course through participation in other adult education courses run by the children’s centre.
Attending the course for a second time, Lyndsey was enthusiastic about what can be achieved. She shared her learning with other participants, for instance advising other participants about the advantages of steaming vegetables instead of boiling and also revealing that she has begun using a slow cooker to prepare many of her meals.
The HEY! course helped Lyndsey to consider a wide range of changes she can make to help her and her family live more healthily. She is enthusiastic and determined about what she can achieve: “I’ve got loads of ideas of what I want to do. I’ve been keeping to it.” This includes eating more fruit and vegetables. For example, she said “we’re starting to eat quite a lot of fruit as a family... We’ve been sticking to our five a day.” She has also taken to “steaming vegetables regularly now.”
Another important change is around portion sizes. She found out from HEY! that she used to give her daughter an “adult’s size” portion. Lyndsey said they were also cutting down on salt and sugar significantly.
One of the biggest differences that Lyndsey has noticed as a result of these changes is that her daughter has lost weight and her children overall are less ‘hyper’. “My daughter has lost a stone and is feeling more confident now. She feels better in herself”. Lyndsey revealed that previously her daughter “lost a lot of self-confidence” and “She was bullied because of [her weight]”. Moreover her daughter “wants to exercise more now. She seems to have more energy.” Both her children are less ‘hyper’, which Lyndsey thinks is because she has cut down on things like sugar. According to Lyndsey this is “really helping” her as a parent.
Lyndsey has also started using a weekly food planner and “I know what food we are having all week, rather than wasting food.” She has involved her eldest child in the food planner. Doing this has really helped her financially, and she thinks she has “saved over £30, maybe £40 a week”.
“ Once I got into it, I found it quite easy – once I changed the habit.”
