1. A joined-up approach to a best start in life
Kim Roberts, Chief Executive

2. Creating the conditions for a healthy start
Supportive environment – practitioner effectiveness
Emotional readiness and energy for change – confidence and motivation
The space and opportunity to reflect, gain knowledge and understanding – and decide how to put this into practice in own life and family

3. Readiness for change
I sit there giving her advice and I know she’s not going to follow any of it …
Health visitor describing her work with the mother of an obese 3-year old

4. Catalysts for change The message: a healthy start in life
The message: a healthy start in life
The messenger: creating the conditions for change
Early nurture and feeding
Parenting skills
Healthy family routines
A balanced healthy diet for the whole family
Active play, physical activity and sleep
Emotional well-being
Building relationships based on trust and respect
Working in partnership
Empathy
Strengths-based
Solution-focused support to decide on goals and how to achieve them

5. Building confidence and motivation for change
Effective practice
Qualities:
Non-judgemental
Partnership
Modelling
Skills:
Relationship
Empathy
Strengths
Raising the issue
Solution-focused
Knowledge:
Risk factors
Whole family healthy lifestyle
Healthy start
2 day
training
Building confidence and motivation for change

6. Confidence in working with families
e-survey up to 4 years later; n=354
85% < 12 months
91% > 12 months
Very little impact
Significantly
improved

7. Changes to practice up to 4 years later
Aspects of Course
Regularly, Often, All the Time
Value of empathy
76% (276)
Key parenting skills
72% (261)
Healthy nutrition
71% (256)
Working in partnership
70% (250)
Solution-focused support
70% (251)
How emotions affect behaviour
Eating patterns and habits
67% (240)
Physical activity
65% (238)
Brown et al,
Community Practitioner
2013

8. Working with families
Parenting Early feeding Influences, attitudes and habits Healthy nutrition for the whole family Play, activity and sleep Social and emotional wellbeing

9. Parenting Desire, knowledge and confidence to provide a best start
Responsive and emotionally literate parenting
Skills and strategies
to hold boundaries
Now she’s a toddler there are lots of times when I just feel out of my depth and don’t k now what to do when she says no and takes no notice

10. Parenting styles and feeding styles
DICTATORIAL/ AUTHORITARIAN
AUTHORITATIVE
UNINVOLVED/
NEGLECTFUL
INDULGENT
in charge
responsive

11. Guided choices DICTATORIAL AUTHORITATIVE INDULGENT
Here’s some carrot for your snack, eat up
Here’s some carrot and tomato for your snack …. you choose
What would you like for your snack?
“Eat up your carrot.”
“Here’s some carrot and some apple for you – help yourself.”
“What would you like for your snack?” 11

12. Early feeding P8-year pare Support for breastfeeding
he takes such time and gives really good practical advice and we are still breast feeding four months on and it's
Support for breastfeeding
Optimal bottle feeding 
Starting solids to her great help.
I don't know what I would have done without such easy access to breast feeding support.
P8-year pare
We are still breast feeding four months on and it's very much due to the great help I got.

13. Taking babies on a taste journey
Window of opportunity to develop a baby’s palate
Babies have an inbuilt preference for familiar tastes – as well as sweet and salty
Start with vegetables
Don’t be put off by some of the expressions!
Repeated exposure
- start to accept a new food more readily by the 4th or 5th time they try it.

14. Influences, attitudes and habits
Responsive feeding
Family mealtimes and eating habits
Parental modelling
Using food for non-nutritional reasons
I’ve realised I need to
eat with him and eat
healthier foods – who else is he going to copy?

15. Responsive feeding

16. You provide, they decide

17. Mealtime atmosphere Sitting together with no distractions such as TV
Sociable – chatting and encouraging
Age-appropriate limits for behaviour
Not rushing – going at their pace
Parents eating and enjoying healthy food with their children

18. Emotional dimension of food
Bribes, rewards and comfort
What messages do we communicate about food?
Moderation in all things including moderation
Don’t stop it, swap it – non-food praise, encouragement and comfort
Carrot after supermarket
Naughty but nice
Forbidden fruits
Collective family rewards
Say it with words and hugs 18

19. Healthy nutrition Healthy balance Child-sized portions
Reducing energy dense foods and sweet drinks
Increasing fruit and vegetable consumption
Carrot after supermarket
Naughty but nice
Forbidden fruits
Collective family rewards
Say it with words and hugs
That’s why we all came on the HENRY programme. Knowing what’s healthy and how much we should be giving them is worrying, especially when they can’t talk. 19

20. Healthy Families group programme
8 week programme
Group or 1-to-1
Delivered by children’s centre staff
37 local authorities
Experiential and interactive
Popular with parents: average retention rate of 80%

21. Practice and policy in children’s centres
Positive changes in practitioners’ lifestyles
Enhanced confidence to approach and discuss lifestyle issues with families
Healthier meals, snacks and portion sizes
Persistent change and impact on the culture and practice of the wider team
I think they’re more confident in tackling & bringing up things … I’ve noticed that people are talking about lifestyle more, and are concerned about it
Willis et al,
J Hum Nutr Diet 2012

22. Parental self-agency Dumka 1996
Willis et al,
Pediatric Obesity
July 2013
Willis et al,
Pediatric Obesity
2014
Sure of self
Doing a good job
Perseverance
Problem solving
Mealtimes
TV/computer
Active play
Bedtime
General

23. Eating behaviour Golan 1998
*P<0.001
*P<0.001
*P<0.001
*P<0.001
*P<0.005
*P<0.005
*P<0.001
*P<0.001
Willis et al,
Pediatric Obesity
July 2013
Eating together
TV off for meals
Home cooked food
Take away food
Lower scores indicate desired behaviours

24. Food Frequency Questionnaire – Adults Hammond 1993
*P=0.003
*P<0.02
*P<0.02
*P=0.003
*P<0.001
*P<0.001
*P=0.005
*P=0.005
*P<0.001
*P<0.001
*P=0.007
*P=0.007
*P<0.001
*P<0.001
Willis et al,
Pediatric Obesity
July 2013

25. Changes in children’s food consumption
Willis et al,
Pediatric Obesity
July 2013

26. 5 a day 21% children in families starting HENRY groups eat 5 a day
44% children of parents completing HENRY programme eat 5 a day 26

27. HENRY in action: Bradford Better Start
Multi-layered package:
practitioner training
Healthy Start in Childcare
group programme for parents
targeted 1-to-1 support
peer support
HENRY-employed coordinator based within Better Start and public health teams 27

28. Effective partnership
Co-delivery with BBS and public health staff
Venues and recruiting families to group and 1-to-1 programmes in first year
Embedding HENRY approach across wider team – 70 practitioners trained in first year
Shared learning and supervision across city 28

29. Parent Champions 14 trained parent volunteers
Community activities to engage parents and promote healthy eating 29

30. Bringing it all together
What children need to flourish – from pregnancy to starting school
How we can work in partnership with parents so that they have the skills, knowledge and confidence – and motivation – to get babies and young children off to a great start 30

31. Contact us
@HENRYhealthy 31