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Providing public health nutrition through integrated interventions in everyday life settings – insights from SoL-Bornholm project the 7th Nordic Health Promotion Research Conference in Vestfold, Norway, June 17-19 Mikkelsen, BE. AAU-MENU & the SoL team Professor, PhD, Research coordinator, [email protected] Researchgroup: Meal Science & Public Health Nutrition ( WWW.MENU.AAU.DK ) There is a growing interest and belief in the potentials of interventions in everyday life settings such as kindergarten, schools, institutions and workplaces. Such settings are increasingly taking on public health responsibilities to address the issue of education for health and life skills as part of their public or corporate social responsibility. This paper presents insights form Project SoL at the isle of Bornholm. It aims to develop healthy communities by focusing on families with children and their shopping, eating and exercise habits living on the Danish island of Bornholm. The project is a partnership between different organizations on Bornholm that includes representatives from civil society, community-based associations, businesses and the public administration. The SoL project is being implemented in the three neighborhoods of Allinge, Hasle and Nexø through an integrated approach where promotion of health eating and non-sedentary behavior is coordinated across supermarket, media, school and kindergarten setting. The primary target group is families with children aged 3-8 years-old. The families are the key to the development and execution of a range of specific health promotion activities. The project started in autumn 2011 and is running over four years. The activities of Project SoL is based on three areas that together form a super setting: child care centers/kindergarten, supermarkets and media. Each of the sites is engaged with a number of predetermined health promotion activities and participant-driven activities which will be modified and fine-tuned as the project progresses. Project SoL is expected to affect Bornholm families' knowledge, attitudes and behaviors around healthy lifestyles with an emphasis on food and exercise. The project aims to strengthen the families' actions and competencies towards practicing a ‘healthy lifestyle’ and increase social community involvement. All these factors are expected to pave the way for better well-being and quality of life for the families and children. Project activities will be monitored and evaluated on an on-going basis to provide evidence of how far these aims are being met. This includes recording sedentary, buying and eating behavior. This paper presents the formative research of the project. It lay out the protocol for the program evaluation and reflects on how the local community seems to be shaping a new form of local governance. It reports on perspectives and limitations in engaging citizens, media, front workers and politicians in participatory approaches. It finally discusses the type of interventions including new approaches to behavioral change such as choice architectures

Bent Mikkelsen NHPRC2013

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Providing public health nutrition through integrated interventions in everyday life settings – insights from SoL-Bornholm project

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Page 1: Bent Mikkelsen NHPRC2013

Providing public health nutrition through integrated interventions in

everyday life settings – insights from SoL-Bornholm project

the 7th Nordic Health Promotion Research Conference in Vestfold, Norway, June 17-19

Mikkelsen, BE. AAU-MENU & the SoL team

Professor, PhD, Research coordinator, [email protected]: Meal Science & Public Health Nutrition (WWW.MENU.AAU.DK)

There is a growing interest and belief in the potentials of interventions in everyday life settings such as kindergarten, schools, institutions and workplaces. Such settings are increasingly taking on public health responsibilities to address the issue of education for health and life skills as part of their public or corporate social responsibility. This paper presents insights form Project SoL at the isle of Bornholm. It aims to develop healthy communities by focusing on families with children and their shopping, eating and exercise habits living on the Danish island of Bornholm. The project is a partnership between different organizations on Bornholm that includes representatives from civil society, community-based associations, businesses and the public administration. The SoL project is being implemented in the three neighborhoods of Allinge, Hasle and Nexø through an integrated approach where promotion of health eating and non-sedentary behavior is coordinated across supermarket, media, school and kindergarten setting. The primary target group is families with children aged 3-8 years-old. The families are the key to the development and execution of a range of specific health promotion activities. The project started in autumn 2011 and is running over four years. The activities of Project SoL is based on three areas that together form a super setting: child care centers/kindergarten, supermarkets and media. Each of the sites is engaged with a number of predetermined health promotion activities and participant-driven activities which will be modified and fine-tuned as the project progresses. Project SoL is expected to affect Bornholm families' knowledge, attitudes and behaviors around healthy lifestyles with an emphasis on food and exercise. The project aims to strengthen the families' actions and competencies towards practicing a ‘healthy lifestyle’ and increase social community involvement. All these factors are expected to pave the way for better well-being and quality of life for the families and children. Project activities will be monitored and evaluated on an on-going basis to provide evidence of how far these aims are being met. This includes recording sedentary, buying and eating behavior. This paper presents the formative research of the project. It lay out the protocol for the program evaluation and reflects on how the local community seems to be shaping a new form of local governance. It reports on perspectives and limitations in engaging citizens, media, front workers and politicians in participatory approaches. It finally discusses the type of interventions including new approaches to behavioral change such as choice architectures

Page 3: Bent Mikkelsen NHPRC2013

Expected outcomes

• Increase• 15 % retail sale of F&V and whole grain compared to control • 25 % intake of F&V and whole grain among 220 intervention

families compared to control• Significant difference in knowledge (cultural capital) and

attitude among intervention families compared to control

• Decrease• 15 % of intake of candy and soft drinks compared to control• TV viewing of ½ hour among children in intervention

families

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SoL participation professional Kick Off

7 marts 2012

Page 5: Bent Mikkelsen NHPRC2013

Research consortium & project ownership

Local community, municipality & partnership ownership

Time

ActionModel for transfer of ownership

sustainability of intervention*

* O’Loughlin, 1989

Page 6: Bent Mikkelsen NHPRC2013

SoL high-impact intervention sites

Page 7: Bent Mikkelsen NHPRC2013

201320122011 2014CASE

CONTROL

Baseline Follow Up

Page 9: Bent Mikkelsen NHPRC2013

RQ

How can healthier local community be created and

sustained based on a participatory action research approach in a local community and integration accross settings with emphasis on food &

eating

Page 10: Bent Mikkelsen NHPRC2013

Example of intervention:Hands on Food Activity, HOFA

• Taste education• Farm2School

links• Roof gardens

• Edible school gardens• Cooking classes• School gardens

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Taste education atParadisbakken

, Supertaster Day 3

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Results

• First baseline results captured• A sustainable alliance built• A brand created and reinforced• Methodology/protocol ready, tested &

validated• Local action groups (LAGs) created

201320122011 2014CASE

CONTROL

Baseline Follow Up

Page 14: Bent Mikkelsen NHPRC2013

Evaluation

• Develop a program theory • Based on realistic evaluation• Combine with srummative

evaluation• Baseline/follow up & case control

Page 15: Bent Mikkelsen NHPRC2013

Outline of a SoL programme theory

Page 16: Bent Mikkelsen NHPRC2013

Realistic evaluation• Roots in implementation science • Acknowledges positivism as well as relativism (Dahler-Larsen,

2001). • Assumptions– Intervention takes place in open social systems– Interventions are volatile – External validity and transferability depends on context.– Complex relationships between • enviromental factors • individuals that interventions are targetting• mediators/intermediaries facilitating the interventions

Page 17: Bent Mikkelsen NHPRC2013

Conclusions

• Health has become a media darling• Health has become a CSR topic• Health needs to be dealt with in new non public

driven ways (meta public governance)• Parnerships are selfcontained• Partnerships take time• Participation too • Intervention intensity is key• Agency has been embedded in LAG’s

Page 18: Bent Mikkelsen NHPRC2013

Thank you/see you

• Meet us may 2014 at

• The SoL team• Charlotte Glümer• Ulla Toft• Lise L Johansen• Bjarne Bruun Jensen• Paul Bloch

• Laura T Clausen• Kjeld Poulsen • Helene C Reinbach• Tine B Andersen• Lise• Susanne Carlsen

Read more or subscribe to newsletter at www.sol-bornholm.dk