1. 1 12 TH March 2009 NHS Calderdale Caroline Snell and Kath Rhodes HEALTHY HALIFAX – CONSUMER RESEARCH Date Prepared for: Prepared by:

2. 2 INTRODUCTION

3. 3 BACKGROUND AND OBJECTIVES NHS Calderdale want to illustrate and understand the lives of people in its most deprived communities in relation to weight and physical activity Research was needed to understand: –Current behaviour around diet and activity –Attitudes to losing weight –Needs/ preferences about initiatives to help weight loss in Halifax: what should Healthy Halifax be?

4. 4 METHOD AND SAMPLE 5 x 1.5 hour group discussions, 8 in home depth interviews and 4 follow up meal time interviews or accompanied shopping trips were conducted. All respondents were parents of children between 2 and 15 All were either overweight themselves and/or had overweight children Respondents lived in Illingworth and Mixenden, Ovenden, Town or Park wards between 25 th Feb to 5 th March 2009 Respondents were recruited from outside primary schools and crèches, outside local parades of shops (convenience stores and chip shops), in the street, in pubs, through friends of friends and via local community workers. The majority of respondents were White British, but interviews with British Asian Muslims were also conducted.

5. 5 SAMPLE 5 x 1.5 hour group discussions with parents of children 2 - 15 GroupGenderEthic GroupClusterArea 1FemaleWhite British1 Illingworth & Mixenden 2Female1Ovenden 3Female1 and 3Town 4FemaleAsian Muslims1Park 5MaleWhite British1All areas

6. 6 SAMPLE 8 x 1 hour depth interviews, plus 4 additional accompanied shopping trips and shared meal times IntGenderEthic GroupClusterArea 1FemaleWhite British1Illingworth 2Male1Mixenden 3Female3Ovenden 4Male1 5Female1Town 6Male1 7FemaleAsian Muslim3Park 8MaleAsian Muslim1

7. 7 MAIN FINDINGS

8. 8 KEY LEARNINGS

9. 9 LOCAL ISSUES GENERALLY POOR HEALTH: can act as a barrier to weight loss (can’t exercise), but also provides the opportunity for the GP to act as a gateway to health initiatives around food/ activity MULTIPLE DEPRIVATION: The perceived cost of healthy eating and participating in activities is seen as prohibitive. Weight loss can be a lower priority vs. other health or social concerns: depression; alcoholism; long-term disability. LOCAL ISSUES: Safety in the local community for children playing out in the neighbourhood and local parks is a strong concern. Also the weather and hilly surroundings can act as a disincentive to outdoor activity

10. 10 FAMILY ISSUES DON’T RECOGNISE CHILD ISSUES: parents can often be blind to the risk of their children being over-weight – because they are currently thin/ full of energy despite poor diet/exercise OBESITY IS SEEN AS AN AESTHETIC ISSUE FOR CHILDREN: parents are often unaware of the health risks associated with obesity in children INDIVIDUAL ISSUES: weight and health are often seen as issues for the individual in the family, e.g. mums on a diet, one of the children has ‘fat’ genes… OTHER CARERS: take easy, child-placating options – often unhealthy diet choices

11. 11 DIET AND NUTRITION: KNOWLEDGE/ INSIGHT ROLE MODELS: parents don’t know they are role models to their kids – and that kids pick up and re-play their attitudes to food (e.g. love treats, hate vegetables) PORTION SIZES: parents don’t know about child-size portions and how much they and their children should be eating in a day LACK SKILLS: parents don’t know the full picture on healthy eating and how to make quick, easy, healthy meals for all the family SNACKING: parents don’t know about appropriate levels of snacking for themselves and their kids FEAR RISK: parents choose ‘safe’ popular options

12. 12 DIET AND NUTRITION: ATTITUDE AND BEHAVIOUR FOOD IS LOVE: parents don’t want or know how to limit their kids’ food. They use food, particularly sugar treats, to reward and also value giving kids choice in food MISSED MEALS: lots of adults are eating erratically and missing meals, not eating until well into the afternoon and then over-eating afternoon and evening FOOD AND HAPPINESS: food and alcohol are used by adults to comfort, alleviate boredom, entertain and for habitual treats GENDER DIFFERENCES: women are generally more willing to regulate weight through changing diet, men are more willing to regulate weight through exercise. MULTIPLE MEALS: kids can be given multiple meals – at child-minders/ at home..

13. 13 SNACK CUPBOARDS

14. 14 FURTHER BARRIERS TO WEIGHT LOSS: DIET Low motivation Pleasure deprivation/hunger associated with dieting Past ‘failures’/ yoyo dieting Trade off being overweight with being able eat what want Dislike spending time on cooking Hard for mums to prioritise their needs over others

15. 15 PHYSICAL ACTIVITY: KNOWELDGE/INSIGHT KIDS ARE ACTIVE: Only parents who acknowledge their kids are over-weight or at risk see physical activity as something that needs to be a planned part of family routines – most presume their kids are sufficiently active AN HOUR A DAY: Few are aware or even accept kids need one hour a day physical activity WHAT IS ACTIVE?: Most adults only have a general idea of what physical activity entails, and what level of activity is needed for them/ their children to lose weight

16. 16 PHYSICAL ACTIVITY: ATTITUDES AND BEHAVIOURS NO TIME: parents feel they are very limited in the time that they have to dedicate to physical activity: working patterns; child-care issues; child routines; tiredness are all barriers FUN: physical activity is rarely associated with having fun, but when it is – it is warmly welcomed SEPARATENESS: adults can provide activities for children, but often don’t join in – families rarely do activities together GENDER DIFFERENCES: women generally resist the idea of strenuous activity. Men are more attracted to competitive sports and getting fit

17. 17 FURTHER BARRIERS TO WEIGHT LOSS: EXERCISE Embarrassment Effort needed Cost Dislike the idea of physical discomfort – sweaty, heart racing Lack of child- care facilities/ concerns over child-care Needing to devote a lot of time/ effort to get results Past ‘failures’ Associate exercise with youth Fear of children playing out/ area younger children in tow Needing to cater for children of different ages/

18. 18 CASE STUDIES

19. 19 OVERVIEW Some individuals have greater motivation but less knowledge than others and vice versa. However everyone interviewed had limited knowledge of healthy eating or healthy levels of exercise. Also everyone’s motivation to change is limited

20. 20 MORE MOTIVATED

21. 21 ALL CHANGE ADAMS Dad working, mum not, boy 5, girl 4, girl 2 Both parents have weight related medical issues (but no advice on weight loss) Dad has recently given up smoking Strong desire that children do not become overweight like them Child freedom to choose food v. important 2 weeks into new healthy regime – lower fat, less take aways, more veg, more home cooking (little awareness of portion sizes) Want children to be active but afraid of local area Travel in car to go to park (infrequently) Disinclined to exercise themselves Mum v shy – rejects group activities

22. 22 ALL CHANGE ADAMS There’s nowt round here that you’ll really want to walk for… we go where we want to be and then walk from there…..I don’t even let the kids out to go and play on the park here…. The furthest we let the kids out of the house is in the back garden to play, they’ve got bikes and bits out there …. If we are going anywhere and they want to play out we go to a park where we know they are safe…. That (climbing frame) has been here for 6 years, its been damaged… you wouldn’t want to let the kids out because of the joy riders running about… you get a lot of that round here. 1 We will get in set foods and let them decide what they want themselves, unless it’s a rush job. When I was growing up it was set meals every night. I don’t want to give that sort of thing…..My mother used to pile my plate up sky high. I was getting an adult portion when I was 5…. 2

23. 23 ALL CHANGE ADAMS: INSIGHTS AND THEMES  Child safety a key concern  Lack of depth of knowledge e.g.  Parents and children joining in together to do activities  Ways to play/ stay active  How much diet needs to change: child-sized portions/ snacking behaviour/ nutritional information  Child choice and autonomy around food can get in the way of good diet  Personal psychology – options needed for individual support as well as groups

24. 24 TRYING TRACY Married, both working, daughter 11, son, 10 Wants to lose weight herself Has sent off for Change 4 Life pack Has been member of gym before Work and children fill her time Tries to be active with her kids, family walks, walking the dog, but infrequent Is aware son (10) is getting bigger, unsure how to address He will do rugby in summer (but worried as has asthma) He wants to eat like his father – same portions Grandma child minds after school, and likes to give them popular food i.e. pizza

25. 25 TRYING TRACY & FAMILY MealMumDadGirl 11Boy 10 Breakfastcoffee 1 crumpet4 crumpets Lunch (12.15) Snack attack + apple juice + frube + crisps Snack on way home Packet of crisps At Grans (3.15) Mini pizza snack X 1 Mini pizza snack X 4 6pm Fajitas – chicken in breadcrumbs, tortilla wrap, salad, pasta, salsa & coleslaw 2 or 3525 Pre bed snackChocolate/crisps

26. 26 TRYING TRACY Depends on what mood he (partner) is in really. Whether he wants to do anything. Cos he does work, not long hours, but everyday, when he comes home all he wants to do is rest he doesn’t want to be going for walks and stuff 4 The rugby club is further up the road and X (son) was doing rugby when he was younger. But he was getting a lot of problems with his chest and I took him to the doctor who said he had asthma. So he hasn’t done it since, but he does want to go back into it, so we are looking at going back into that 3

27. 27 TRYING TRACY: INSIGHTS AND THEMES  Food issues:  portion size,  food knowledge,  mini me,  childminder feeding unhealthily  GP as gateway  Health barriers to exercise  Hard to fit exercise into everyday life

28. 28 SEPARATED SMITHS Divorced, mum (student), dad (working) takes daughters (6 and 2 ½ ) out every Sunday pm Mum overweight since 3 Mum wants to improve health (smoking weight, tackling weight first – dietician) Elder daughter bullied because of weight (post divorce), mum wants to help her change Trying to cut out snacks and monitor food (hard to control what childminder gives her and child ‘steals’ food) Enrolled her in more clubs – gymnastics and swimming Dad sees kids on Sunday pm – he always does something active, but feeds kids whatever they want

29. 29 SEPARATED SMITHS MealMUMGirl 6Girl 2.5 BreakfastHoney shreddies + milk Chocolate ready brek Lunch (12ish) 1 st chicken sandwich + salad 2 nd sausages + peas + sweet corn + banana Sausage casserole Snack/at childminder biscuitCroissant + custard Tea (6pm) chicken with cook in tikka masala sauce + rice + pitta Fish fingers + new potatoes + carrots + broccoli Petit filou Pre bed snack Muller rice + biscuit cereal

30. 30 SEPARATED SMITHS Dad, usually takes them swimming on a Sunday, I don’t tend to take them swimming. He only has them on a Sunday so not that much (involved in their physical activity)….It’s active, it gets us out. I take them swimming, to the park, a bit of both, or ice skating. I’m pretty active, or try to be. (eat?) Anything they want to…. She had an allergic reaction on Monday so I rang up to find out what they ate. He just said an abundance of sweets, millions of sweets…so no chance of finding out what caused the allergic reaction….Sunday they get what they want. 5 I don’t want her to know the word, I don’t want to say to her you are on a diet. There are times when I lose my patience when she steals from the cupboard – for God’s sake no wonder you are fat. Then I feel awful. Now I try to watch what I say, last year were hard. I’m a lot better in myself this year. Now I’ll say I’m trying to help you, and me, I want to get fitter. How can I help you when you are stealing out of the cupboard. I don’t want to take her there (the dietician) and make her feel like… I think I can go there and learn enough to pass it on. 6

31. 31 SEPARATED SMITHS: INSIGHTS AND THEMES  Gender focus (male exercise, female diet)  GP as gateway  Child bullying  Children as the focus of concern in the family  The psychological aspects of food and weight gain  Limited awareness of:  How much activity needed  How much diet needs to change: child-sized portions/ snacking behaviour  Parents as role models

32. 32 HELP ME HELEN Mum with husband and teen kids – teacher on her feet all day Seen GP several times and recognises needs to lose weight, no physical reasons for putting on weight In the past tried exercise with sister: –Jogging, Walking, Gym Some modifications to diet: –Cutting out drinking, Smaller portions No weight loss – has lost motivation to go to gym, classes are day-time, Husband insistent on traditional diet 2 fridges/2 freezers - overstocking on food Food issues part of family dynamic

33. 33 HELP ME HELEN: INSIGHTS AND THEMES  GPs failing to follow through on support and advice  Dieting an individual issue  Needs personal support to help her identify real barriers to weight loss  Needs motivation to get back to exercise

34. 34 MOTIVATED MAYA Born in Pakistan, husband born in the UK, 1 daughter (9) and 1 son (1) Motivated to exercise and lose weight Has already made an appointment to see a dietician (via the GP) Has already joined a cooking club Support from rest of family is short- lived Finds it very hard to say no to her husband or children, both also want to eat ‘British’ food Experience and repertoire of British food is mainly unhealthy Priority for children is religious and academic study

35. 35 I started dieting at the first of last month. I said to my husband, please, I need to diet, I feel unhealthy and lazy. I was crying and getting a bit emotional. He said ok and that he would eat the (healthy) food I made. He lasted 2 weeks, and then he said ‘who told you were overweight’. I said I feel it, nobody told me. But he doesn’t agree so I say he can buy any food he likes but should eat it outside or in the bedroom. 8 MOTIVATED MAYA (My kids say) Mum I want chocolate, I want crisps, mum I want this… The habits we’ve got go into children….But if you stop the children and say no.. I haven’t got that big a heart. I am a very soft person. You have to make yourself a very hard person to say no….for 2 weeks they make you very upset….Then they say why, why you stop chocolate ….If I say no my husband says alright. 7

36. 36 ADDITIONAL THEMES FROM ASIAN WOMEN  Many cultural foods high in fat  Culturally important to provide food for guests and family  Role of mother and wife important – to support and care for others, denying/restricting food difficult to sustain and receives little support from family  Hard to say no to children  Want to give children ‘British’ food, want to learn how to cook in British and modern Pakistani style food  Substantial snacking after school and again after religious study

37. 37 ADDITIONAL THEMES FROM ASIAN WOMEN  Range of motivation to exercise, some strongly in favour  Facilities must be segregated, culturally appropriate and sufficient.  Strong interest in all Asian women walking group  Activity clubs for children lower priority than academic and religious education.  Can see activity for boys as a man’s role

38. 38 OVERWEIGHT OLIVIA Father working, wife and grandmother, 2 girls (4 and 2 ½) son (1 ½) Worried about eldest daughter Thoughts prompted by Channel 5 show ‘Too fat to toddle’ Trying to introduce strategies to reduce her weight – limiting snacks, saying no to her requests Limited knowledge of what further measures to introduce Still rewarding with food Mother previously bulimic Food anxiety re one child’s constipation

39. 39 OVERWEIGHT OLIVIA: INSIGHTS AND THEMES  Role of TV in raising awareness of child obesity  Limited strategies to reduce child weight  Limited knowledge of the purpose of healthy eating  Unhealthy snacks as reward  Focus on individual rather than family change

40. 40 LOWER MOTIVATION

41. 41 BUSY BRENDA Single mum (not working) 4, 9 and 16 Losing weight is not high on her priorities and her children are slim Enjoys eating, drinking, deep frying and snacking frequent Little understanding or interest in nutrition Value for money very important Too tired to do anything after 7.30 Not particularly motivated to change

42. 42 BUSY BRENDA The sweets I keep in the cupboard next to the tins of food. So when I say to the kids what do you want for tea, they can see the sweets and they know they won’t get their sweets without eating their tea. So they pick what they want looking at the sweets. At least they’ll pick something, then they know they can go back in for the sweets. 9 A luxury thing for the weekend for me and my boyfriend is a curry. We like it on chips and that’s when we have our beer and that’s it. 10 When I make chocolate muffins, I do them triple size. To buy them ….would cost £4/5, but when I cook them for about 12 it costs no more than £1.50 11

43. 43 BUSY BRENDA : INSIGHTS AND THEMES  Represents a common attitude  Hard to reach audience  Enjoys food and her lifestyle  Lack of willingness to change  Lack of perceived need to change

44. 44 NO PROBLEM NEIL Dad, Mum, daughter (7) Dad’s first meal of day at 6pm Used to be in army, believes only way to lose weight is by exercise Arteriosclerosis prevents him exercising Resigned to own bad health and weight Believes overweight daughter (7) only has puppy fat Associates child weight with appearance /popularity more than health She ‘steals’ food from cupboards and often asks for sweets

45. 45 NO PROBLEM NEIL & FAMILY MealDadMumGirl 7 Breakfast5am - coffeecoffeecereal Lunch (12ish)2 biscuits Ham sandwiches, mini jaffas, muffins SnackSugar lollies Tea 6pm 6 slices of bread, 4 beef burgers, 4 fish fingers (4pm) Shepherds pie and chips Supper (7.30)cereal

46. 46 NO PROBLEM NEIL Little lass, she’s slightly chubbier than she should be..according to the school ….she is slightly overweight…they say you’ll have to watch what you are giving her and cut down on her sweets…. it comes down to stuff we can afford to get… I try to put as much fruit in her as I can and she’s not overly keen on her veg either She is fairly active.. personally I call it puppy fat, once she is older she’ll soon have it off…. Schools are all the same, if she is not underweight she is overweight…. We tried a chart system, she can have a sweet but not a handful, she behaves she can have a sweet and if she were bad, the following day she didn’t get it. 12 She doesn’t like much on the healthy side, like I don’t….. Sunday dinners (when he was a child) were a nightmare…. Turnip, brussels and cauliflower…uggh… but they were on your plate so you had to eat 13

47. 47 NO PROBLEM NEIL : INSIGHTS AND THEMES  Hard for parent to see child obesity  Child obesity seen as an aesthetics not a health issue  Illness prevents exercise  Associates health and weight loss with army style extreme exercise  GP as potential gateway

48. 48 MULTIPLE PROBLEMS MARY Single mum with 2 teenage girls, not working Multiple health and social problems caused by or added to by heavy drinking Visited regularly by health professionals, done exercise classes for people with health problems Children provided for but not guided or encouraged to eat/nutrition Mum unsupportive of child’s attempts to eat healthily Meat seen as most important element of a healthy diet Bored, will join exercise groups only if free

49. 49 MULTIPLE PROBLEMS MARY & FAMILY MealMumGirl 16Girl 13 Breakfast 4 Fish fingers + 3 slices of bread + 1 sausage roll Tea and toast Nesquik cereal + chocolate mousse Lunch (12ish) Chinese takeaway – prawn curry and chips + eggs fried rice ? Chip butty + curry sauce (£1) + fizzy drink Snack5 – 10 pints of beer?Packet of crisps 7pm2 slices of toast ½ boil in the bag rice + left over curry + chapatti 11.30pm Crisp sandwich + chocolate raisins ?? Pre bed snackChocolate/crisps

50. 50 MULTIPLE PROBLEMS MARY : INSIGHTS AND THEMES  GP/healthcare professional as gateway  Hard to motivate audience  Lack of willingness to change  Other deprivation factors get in the way

51. 51 RESPONSE TO IDEAS FOR HEALTHY HALIFAX

52. 52 ACTIVITIES

53. 53 FUN TOGETHER Ideas which centre around having fun as a group of adults and children have appeal HAVE FUN IN THE PARK – WEEKEND, HALF TERM AND SUMMER ACTIVITIES COOKING CLUB – NEEDS TO BE CENTRED AROUND HEALTHY EATING COMPUTER GAMES AT THE SPORT CENTRE (E.G. Wii FIT) INTERESTING FOR SOME IF IT IS PRACTICAL TO DELIVER (LIKE BOWLING ALLEYS) TRANSPORT TO SAFE PLAY AREAS WITH ADULT/ CHILD ACTIVITIES TRANSPORT TO BEAUTY SPOTS WITH WALKING TRAILS CHILD FOCUSED WALKS IN TOWN/ COUNTRY

54. 54 WHY FUN TOGETHER? Parents more readily focus on leisure time: –They have time to do this –They see the merit of doing things with kids –Anything that is fun is more positive, less arduous than ‘working out’ –Adults and children benefit – adults access their childish side Halifax has beautiful countryside: –So opportunities to get out there/ be taken there are welcome Safety is a major concern: –So being ‘transported’ to safe places feels positive for parents A way to get the family starting to feel positive about getting moving, but the message about frequent activity can be lost…

55. 55 SCHOOL-CENTRED ACTIVITY Popular ideas centre around activities and information with school at the heart of the community… AFTER SCHOOL ACTIVE CLUB FOR ADULTS AND KIDS FIT CLUB – CHOOSE FROM DIFFERENT TYPES OF FUN ACTIVITES E.G. DANCE CLUB/ FIGHT CLUB/ CIRCUITS/ PERFORM WHAT’S ON IN HALIFAX FOR YOU AND THE KIDS – INFORMATION ABOUT WHAT’S ON FED THROUGH THE SCHOOL/ OR YOUR DOOR.. COOKING CLUB – COULD ALSO BE ELSWHERE

56. 56 WHY SCHOOL-CENTRED ACTIVITY? Fits into the routine of life, mums already having to go to school anyway Real appeal with the idea of mums and kids doing stuff together And.. Key is HAVING FUN Schools potentially have the facilities needed (space for clubs) Could provide child-care for kids under school age Might be able to offer rolling programme (up to 5 nights a week)

57. 57 WHY SCHOOL CENTRED ACTIVITY? Watch-outs: –Lots of after school activities already –Would interest wane?/ same crowd always join in –Cost/ need to charge something to gain commitment

58. 58 WORK INITIATIVES Ideas which centre around the workplace are supported by working men/ women COMPETITIVE ACTIVITIES – PARTICULARLY FOR MEN TIME AVAILABLE TO RUN/ WORK OUT WEIGHT LOSS CHALLENGES/ RAISE MONEY FOR CHARITY NUTRITIONAL SUPPORT AND IDEAS

59. 59 WHY WORK INITIATIVES? Time is a major factor in fitting in activities, so support in the work-place can make this a possibility Men respond particularly well to competitions/ tournaments Women are interested in the support of a group.. A way to overcome the key ‘time’ barrier/ meet the needs of an individual

60. 60 ACTIVITIES WITH MORE LIMITED APPEAL High frequency/ high commitment activities can be hard to accept for all but the most motivated… Free/ Subsidised gym membership/ Swimming Some are keen to attend the gym/swim but facilities act as an obstacle: –Ltd child care facilities –Limited number of machines/ limited opportunities to swim how you want –Changing rooms not suitable for Muslim women –Classes on in the day-time, not early evening –No time to fit this in At the gym, many feel overwhelmed by the idea of: –Thin, judgemental gym regulars (women) –Big pumped up regulars (men)

61. 61 ACTIVITIES WITH MORE LIMITED APPEAL High frequency/ high commitment activities can be hard to accept for all but the most motivated… Free/ Subsidised gym membership/ Swimming Muslim women (Park) are keen to an improved facility dedicated to them/ their cultural needs

62. 62 ACTIVITIES WITH MORE LIMITED APPEAL For the more motivated… Focus needs to be on making current facilities more accessible: times; changing facilities; price

63. 63 ACTIVITIES WITH MORE LIMITED APPEAL High frequency/ high commitment activities can be hard to accept… 1 hour a day of child activity Hard to accept that children need to do an hour a day: –Already do lots at school Hard to see how can fit in an hour a day for children: –Already busy routines (after school clubs/ religious education) –Need time to play –‘Adult-time’ in the evening – don’t want to focus on doing things with the kids

64. 64 ACTIVITIES WITH MORE LIMITED APPEAL Focus needs to be on giving the message about an hour a day time to cut through, and to provide lots of strategies for quick fun 10 minute slots – following lead of change4 life..

65. 65 ACTIVITIES WITH MORE LIMITED APPEAL Walking club –Asian women respond very positively –Can get together as a group –Opportunity to do gentle exercise –And.. Experience Halifax’s countryside –Perhaps a chance to learn more on exercise and nutrition –Could be schools based –Other are less keen.. Pedometers –The most motivated may use pedometers to encourage more walking Bike initiatives: –Less interesting: hills/ weather related –Although.. Disused railway lines could make good tracks

66. 66 MISSING INITIATIVES Men have a particular focus on being active – are there initiatives which can focus on: Traditional sports Tournaments and competitions Army-style training Appealing to the male psyche: goal oriented approaches?

67. 67 DIET/ ADVICE

68. 68 BUILDING UP KNOWLEDGE Knowledge-base on diet and nutrition is low and interest is there if delivered in the right way.. CHANGE 4 LIFE EASY HINTS AND TIPS E.G. ME SIZE MEALS CONSULT A NUTRITIONIST/ FOOD AND LIFESTYLE ADVISOR: ONE TO ONE/ IN A FREE ‘DIETING’ GROUP COOKERY SCHOOL – LEARN ABOUT EASY, QUICK AND CHEAP HEALTHY MEALS RECIPE CARDS FROM THE SUPERMARKET

69. 69 ABOUT BUILDING UP KNOWLEDGE Delivery of information and support needs to be done in various different ways in order to appeal to the widest ‘audience’: –For some one-to-one consultation is needed: uncomfortable in the group, need attention and support –For some information needs to be easily on-hand – door drops/ through the school / at a central location (One stop shop) –For some the group environment would be positive, feel safer supportive The overall appeal of knowledge initiatives lies in the emerging (for some) sense of what they don’t know/ they need to know more

70. 70 MOTIVATION Linked to knowledge, initiatives which try to support and motivate (in particular women) are needed for some PERSONAL SUPPORT/ TRAINER/ DIETICIAN ONE STOP SHOP

71. 71 ABOUT MOTIVATION For some one-to-one support to kick start a change for life is important: –Lots of issues to contend with (health, family weight, lack of opportunities) –Low motivation –Trainers/ coaches sometimes wanted to give unequivocal advice on what is needed in a personal situation One-stop-shop for advice and information: –Is supported by those who travel into town centre (Illingworth less likely to use, maybe Park too?) –BUT key is to create a fun and positive environment that doesn’t feel too institutionalised

72. 72 MAKING HEALTHY EATING AFFORDABLE Some appeal with helping financially.. Free slimming clubs –Some have tried WW/ Slimming World and find them expensive, but value the weekly commitment to weigh-ins –A free club is therefore highly motivating for those who have tried with clubs in the past –Expectations are that the club would really focus on success (WW/ SW needs you to fail to some degree) –AND the club would be more holistic providing nutrition advice, activity advice –Needs to run for more than a limited time frame Money off vouchers for Weight Watchers/ Slimming World: –Only those already doing WW/ SW find this motivating –For others – put off by the fact they’d have to pay at some point/ don’t find slimming clubs appealing

73. 73 MAKING HEALTHY EATING AFFORDABLE Some appeal with helping financially.. Financial incentives to lose weight: –Those with lowest incomes/ on full benefits can be really motivated at first – a good way to boost income –BUT even here some doubt that they’ll succeed and feel this might reinforce a sense of failure long-term –Others can feel this is wrong – motivation should be internal –HOWEVER do support rewarding success e.g. if you reach target weight i.e. get free gym membership for x amount of time Money off on Fruit and Veg at Borough Market –Users of the market think this has appeal –Supports the market/ sends out positive nutrition messages –Non users can perceive the market as expensive – need to indicate prices to reassure

74. 74 ACTIVITIES WITH MORE LIMITED APPEAL Gardening Club: –Parents believe children will really enjoy this experience, but it might not help with good nutrition Community Garden –Muted appeal for some, some not sure they would participate

75. 75 CONCLUSIONS AND RECOMMENDATIONS

76. 76 CONCLUSIONS AND RECOMMENDATIONS There is a range of motivations, levels of knowledge and specific needs found amongst people within the key areas in relation to weight loss and exercise. Those with the greatest motivation to lose weight, and therefore the greatest openness to outside initiatives, tend to be people with overweight or genetically ‘at risk’ children 2 – 10. Children, in fact, often provide a route into tackling weight issues within the whole family context, and indeed parents are most motivated with they become aware of the need to give their children the best start in life through diet and exercise

77. 77 CONCLUSIONS AND RECOMMENDATIONS Barriers to weight loss can be complex and deep rooted and specific to different personal circumstances. Services and initiatives within the Healthy Halifax programme will need to cater for different personal psychologies and will need to include individual as well as group support/activity. There is a strong educational need for further information and strategies towards healthy living, knowledge on nutrition and cooking skills in particular are very limited, but interest in learning more is there

78. 78 CONCLUSIONS AND RECOMMENDATIONS When developing the Healthy Halifax initiative, it is worth taking into account : –Most are aware of the Change for Life campaign, but not all have realised that there is something in it for them. When seen the Change for Life packs are very well received. These packs could play a stronger role for parents in Halifax, i.e. if sent home from school in kids bags/picked up from school/handed out at after school clubs or even door dropped. –Due to high levels of chronic illness in the key areas, GPs are a key gateway for parents getting assistance with change. They could potentially play a strong role in directing patients towards advice and support. –Perception of child safety is another key theme, there is a strong desire to travel to safer areas for children to play / walk outside. However, for clubs there is greatest motivation when the activity / event is close to home. –The idea of activity which involves having fun with the children can be very motivating. Although parents often have limited motivation to be more active this can change when the activity involves having fun with their children.

79. 79 CONCLUSIONS AND RECOMMENDATIONS Specific and different needs also emerge: –Women can be more open to weight loss programmes and can respond well to ideas which focus around group support –Men often respond better to ideas which reflect masculine interests in competition and achieving goals –Facilities and activities for the Asian Muslim women within our sample need to be gender segregated. Women can be deterred from activity not because of lack of motivation but because of overcrowded or in appropriate facilities.

80. 80 CONTACT DETAILS 71a Walmgate York YO1 9TZ 01904 673114 Email:-info@claro-research.com www.claro-research.com