1. Family Health Initiative ‘Healthier Choices, Healthier Families’ Diane Boyd Community Health Co-ordinator

2. Our Vision Children are: Strong, competent & visible in their communities Physically & emotionally healthy Eager & able to learn Respectful of difference

3. Our Values We Believe in: Childhood - in its own right Listening to children – and those who care for them A strong voice for children Play, fun & creativity Parenting Participation Community Partnership Inclusion & diversity A professional, committed & recognised workforce Excellence & evidence based innovation Effective stewardship & governance Valuing staff, members & their commitment

4. Obesity – Statistics: 27% of children aged 2-15 years are obese/overweight in Northern Ireland (NI H&WS 2010/11) 1 in 5 (22%) of children under 5 are overweight/obese. 17% are overweight 5% are obese (CHS 2008/9) 1 in 4 (27%) of children aged 11-13 years are overweight. 20% of these children are overweight and 7% are obese (2008/9 BMI measurements) 61% of adults are either overweight or obese (2011/12 Health Survey NI)

5. Programmes Healthy lifestyle – Prevention programme for families with children under 5yrs (8wks) Making a Difference – Healthy lifestyle programme for families with children aged 8-11 yrs aimed at targeting obesity (12wks) 3 Key Areas: Healthy Eating Physical Activity Emotional Wellbeing Whole Family Focused Approach

6. Partnership Multi component community based partnership Design Team Steering Group Referrals Specialist – Dietetics, Active Communities Coaches, Wellbeing lead, Storyteller

7. Overall Aims Empower families to: Understand importance of balanced diet & make healthier food choices Understand importance of exercise & increase physical activity levels Understand physical & emotional consequences connected to obesity Build skills & confidence of parents to model healthy lifestyle choices for children

8. Healthy Lifestyle Programme 8 week Programme - Each session 1 ½ hrs Consists of: Parent Time (45 mins) – Discussion in group setting Food Time (15 mins) – Families try new foods Family Time (30 mins) – Families engage in activities together

9. Puppets BEN MEGAN ORLA STEFAN Meet the healthy living gang! Children identify well with puppets: Gain knowledge of healthy lifestyles Help express feelings & emotions

10. Storybooks & Puppets Each family taking part receives a copy of each book

11. FREE Incentives each week

12. Evaluations Prevention Programme: Dr Katrina Collins Methods: Pre & Post Surveys Goal Sheets Post it Feedback Facilitator Journal Tracking Interviews Attendance Sheet Community Map

13. Prevention Programme 124 families engaged: 81 completed (65% completion rate) 11 programmes: Day Care, Playgroup, Parent & Toddler, Childminders, Travellers AdultNumber Mothers97 Fathers0 Grandmothers12 Child-minders21 Other Family member1

14. Pre & Post Surveys Pre programme expectations: “I want to better myself and my kids” “I want to eat healthier so my family eat better” Post programme impact: “We now eat healthy and try lots of new foods” “I feel like a much better parent” “We now do a lot more exercise as a family”

15. Goal Setting - Eat more fruit & vegetables - Eat less fatty & sugary foods - Turn off TV for a certain amount of time - Do things together as a family - Go for walks together - Find out what on in local community - Cook healthy meals from scratch

16. ‘Trackers’ 2 participants from each group Every 6-8 weeks - semi structured interview Journey of change tracked across 1 year period Changes in family life were embedded in daily events - meal times, shopping trips, food purchases & physical activity. “I cannot believe how much I have learnt and the difference it has made in how we eat”

17. ‘Making a Difference’ 12 week Family Healthy Lifestyle Programme Target: 8-11yr olds with a BMI>91 st centile 8 week Programme - Each session 1 ½ hrs Consists of: Discussion Time (45 mins) – Discussion in group Food Time (15 mins) – Families try new foods Family Time (30 mins) – Family physical activity

18. Evaluations Making a difference: University of Ulster, Coleraine Methods: Pre & Post Surveys Measurements Goal Sheets Post it Feedback Facilitator Journal Case Studies Attendance Sheet Community Map

19. Change in children’s BMI z-score T1 to T7 P<0.001 Core completers - T1 64% children classified as obese, 56% at T3 Full completers – T1 58% children classified as obese, 46% at T7

20. Change in children’s waist circumference z-score T1 to T7 P<0.001 Core completers – T1 to T7  1cm decrease Full completers – T1 to T7  1 cm decrease

21. Self-esteem of child P<0.001 Significant improvement in self esteem in children

22. Child – feelings about how they look - Yes T1T3T7 I really like what I weigh33%49%63% My weight makes me unhappy47%39%12% I wish I were thinner73%64%42% I think I have a good body56%71%84% Other people make fun of the way I look 31%22%10% I'm as nice looking as I’d like to68%71%86% I worry about the way I look33%24%19%

23. Conclusion Combined evaluation evidence points to the impact of the Family Health Initiative on improving health outcomes. Specifically: Eating & exercise habits Family routines Attitudes to healthy lifestyles Impact can be traced to three factors: 1. Service Design Manual 2. Resources 3. Facilitation & Delivery style

24. Video

25. If you would like more information: Diane Boyd Community Health Co-ordinator dianeb@early-years.org www.early-years.org