1. Co-producing change: community involvement in research and action to address low birth-weight in an East London borough
Susanna Rance [1], Angela Harden [1], Gail Findlay [1], Patrick Tobi [1], Dilisha Patel [2], Gulnar Ali [1] Asmat Syed [1], Jin Tong [1], Judith Stephenson [2]
[1] Institute for Health and Human Development, University of East London
[2] Institute for Women’s Health, University College London
Faculty of Public Health EXPO & Annual Conference 2017 – Telford, 20th -21st June

2. Low birth-weight: an issue of local concern
In , 9.7% of babies born to women living in the London borough of Newham had low birth-weight (<2.5 kg).
Nearly four in ten women living in the borough (37.4%) were at risk of having low birth-weight babies.
Preventing low birth-weight and its adverse consequences is a priority for Newham’s Clinical Commissioning Group.
The locally-funded project “Low Birth-Weight in Newham: Definitions, Antecedents and Consequences” aims to:
understand factors influencing low birth-weight
identify community assets that could help to address the issues
involve stakeholders in co-producing preventive action.

3. Using elements of the CEAD model for community and stakeholder engagement in co-production of a local programme
Findlay G, Tobi P (2017). Well Communities. Perspectives in Public Health; 137(1):17-20

4. Low Birth-Weight project stages and stakeholder involvement
ENGAGEMENT
Community consultation
PPI group
RESEARCH
Hospital data analysis
Community asset mapping
Interviews with parents & professionals
ACTION
Stakeholder consultations & feedback
Prioritisation Workshop
Intervention co-design
Pilot actions & evaluation
Patient and Public Involvement group
Stakeholder prioritisation workshop

5. Results of the co-design process
Appreciative Enquiry workshops, with discussion and voting on priority proposals, brought initially divergent stakeholder positions closer together:
Common interests
1-to-1 and group support for parents
Women’s pre-pregnancy care
Healthy infant feeding
Shared concerns
Professionals’ conflicting messages
Involving partners and family members
Addressing language barriers

6. Co-designed Action 1: Piloting and evaluation of pre-pregnancy service delivered by “health buddies” in primary care
Women planning a pregnancy, recruited via their GP practice, are offered “Healthy Conversations” with trained volunteer health buddies.
Tinati T, Lawrence W et al. Implementation of new Healthy Conversation Skills to support lifestyle changes – what helps and what hinders? Experiences of Sure Start Children’s Centre staff. Heath & Social Care in the Community 2012; 20(4):430–437

7. Co-designed Action 2: Case studies and video for public dissemination showcasing local healthy infant feeding initiatives
Antenatal, postnatal and community-based drop-in breastfeeding support sessions; and community baby & toddler group

8. Current step: co-designing an improvement model
Empowering relationships and Healthy Conversations
Dissemination of evidence-based “missing messages”
Partnership working and reflective practice
Evaluation of pre-pregnancy “health buddy” service delivered in two local GP practices
UEL Knowledge Exchange Internship: “Partnership work translating research into action: taking key messages from the Low Birth-Weight in Newham study into healthy infant feeding initiatives”

9. Topics in tension: challenges identified in the co-design process
Expectations of “health buddies” Involving women’s partners Gaps in breastfeeding support Not/talking about formula feeding Avoiding rapid “catch-up” growth of babies born small