1. Sarah Waddington Health Improvement Co-ordinator, Children & Young People Tel: 01905 733613 sarah.waddington@worcestershire.nhs.uk

2. What is ? ? A series of Worcestershire bespoke programmes based on Change4Life - “eat well, move more, live longer” County-wide initiative to address the LAA / NI56 reducing childhood obesity ‘Preventive’; ‘Health Education’ – Fresh Schools Programme ‘Targeted’; ‘first line intervention’ – Fresh Family Weight Management Programme Developed and delivered by Healthy Weight Trainers employed by Public Health and line managed by Health Improvement Co-ordinator, Children & Young People (backgrounds of staff - personal trainer /teaching assistant; health trainer, graduates in psychology and nutrition / healthcare assistant with School Health; community public health nutrition & dietetics) Commenced with families in the community in July 2010, and in schools in September 2010 =

4. Healthy Weight Trainers Ayn Coley - (Redditch & Bromsgrove) ayn.coley@worcestershire.nhs.uk Amanda Clifton - (Worcester & Droitwich) amanda.clifton@worcestershire.nhs.uk amanda.clifton@worcestershire.nhs.uk Edward Whitehead - ( Wyre Forest) edward.whitehead@worcestershire.nhs.uk edward.whitehead@worcestershire.nhs.uk Claire Moran - (Evesham, Malvern & Pershore) claire.moran@worcestershire.nhs.uk Tel: 01905 733813

5. Change4Life – 8 Lifestyle Changes Sugar swaps 5 a day Meal time Snack check Me size meals Cut back fat 60 active minutes Up & about

6. Sugar Swaps Behaviour: ‘Sugar swaps’ – simple ways to help kids eat less sugar 1. Drink swap4. Breakfast swap 2. Snack swap5. Dessert swap 3. Food label swap 5 a day Behaviour: ‘5 a day’ – smart ways to get even the pickiest kids to eat fruit & veg Drink one, Defrost one, Open one, Chop one, Pack one, Sprinkle one, Dip one, Add one, Snack on one, Pulse one

7. Meal Time Behaviour: ‘Meal time’ – making time for 3 regular meals: breakfast, lunch and dinner Meal times; Start at breakfast; Have a School dinner; Eat together when you can; 2 snax max Snack Check Behaviour: ‘Snack check’ - simple ways to reduce unhealthy snacking Keep count; 3 regular meals; ‘2 snax max’; It’s not you it’s the rule!; It’s kinder to say no; One of your five

8. Change4Life Snack Swapper

9. Me size meals Behaviour: ‘Me size meals’ – making sure that kids eat the right size portions for their age Make a fist; Clean plates; Don’t nag them to eat up; Watch packaging sizes Cut back fat Behaviour: ‘Cut back fat’ – easy ways to lower the fat in your family’s diet Cut down; Look for lower; Change your cooking; Make a swap

10. 60 minutes active Behaviour: ’60 active minutes’ – keeping your kids active, healthy and happy Play; Walk; Dance; Swim; bike Up & About Behaviour: ‘Up & about’ – how to limit ‘vegging out’ and make sure that your kids are active 2 hours max; Feet first; After school; Get up after eating; Family time

11. Change4 Life - Activity planner

12. Background

13. Family Weight Management Programmes Targeted first line intervention programme for children aged 7-13 years who are above a healthy weight Programme made up of Fresh 1; Fresh 2; and Fresh4Ever Fresh 1 – 2 hour group session for 6 weeks, 5-7pm Nutritional content based on Change4Life top tips; Activity sessions for family - ZigZag multi-player dance mats Fresh 2 – 2 hour group session for further 6 weeks Builds on advice given in Fresh 1 alongside practical supermarket tour and store cupboard makeover; Supports goal achievement; Continued family activity sessions Fresh4Ever – long term group and personalised support Pilot began at KGV in Worcester –Summer holidays 2010 with 10 children (8 girls, 2 boys – average age 9.8 years)

14. Evaluation – SEF criteria Baseline: Fresh 1 session 1 Weight, height, BMI, child and family member Waist circumference of child and family member Three questionnaires: Food frequency Validated physical activity ( PAQ-C) Rosenberg self esteem Mid–programme: Fresh 2 session 1 Weight, height, BMI, child and family member Waist circumference of child and family member End- programme: Fresh 2 session 6 Three questionnaires: (Food frequency ; Validated physical Activity ( PAQ-C); Rosenberg self esteem) Review ‘personal goals’ Satisfaction of programme

15. Family Weight Management Programme Pilot evaluation (n=7) Re Quantitative OutcomesQualitative Outcomes 70% completionAlways eat breakfast now 75% attendance recordDrink more water Range of BMI change (6 reduced/ 1 increased) -2.5 - +0.6kg.m2 Eat less unhealthy snacks – less fat and sugar Average BMI changes – 1.05kg/m2Eat smaller portion sizes 3 Mums also reduced BMI (average 0.9kg/m2) Choose to snack on fruit & veg PAQ-C noted seasonal activity changes and school settings Walk more Self esteem increasedEat eating meal as a family now

16. Family Weight Management Programme Quotes from parents after KGV pilot: “Really good, thoroughly enjoyed sessions, good to meet other families battling same issues” “Joining Fresh has given us the kick start we needed as a family to change the way we were living. It has given my daughter confidence and a lot of information and changes that hopefully she will use for the future. Thank you to the team”

17. Family Weight Management Programme Pilot at KGV moved into the Fresh4Ever phase Two Fresh 1 programmes started in September at the University of Worcester and Westland Community Hall in Droitwich and Fresh 2 will finish before Christmas. Groups will join KGV Fresh4Ever sessions A Fresh 1 programme started in November at Windmill Community Centre in Redditch Fresh 2 which will run until Feb 2011 Two new programmes planned for January 2011: – Fresh 1 at Y Centre in Kidderminster and Amphlett Hall in Bromsgrove By March 2011 6 full programmes will have been completed

18. Schools Programme Prevention / health education programme working with years 4,5,6 in schools – Change4life workshops and dance mat activities “taster sessions” in schools have been offered this academic year as part of the National Child Measurement Programme (NCMP) To date the Healthy Weight Trainers have visited jointly with the School Health Nursing teams 31 schools 2028 year 6 students (aged 10-11) have taken part in a “taster session” 13 schools received both dance mat and Change4life workshops; 16 received classroom Change4life workshops; and 2 schools received dance mat sessions only

19. Schools Programme Pilot ran in a Primary school in Worcester in September 2010 66 children attended the programme – 30 minute lesson as part of PSHE or PE curriculum time 100% Positive feedback from staff 95% of children enjoyed the programme with the most popular topics being ‘sugar swaps’, ‘up & about’ and ‘me size meals’ 77% reported making healthy changes as a result of the programme Learning outcomes have informed improvements for January programmes where 4 Middle schools and 1 Primary school will receive the programme

20. Please visit our display and view the Life Channel clip For further information please call 01905 733813 or email sarah.waddington@worcestershire.nhs.uk Thank you