A new health and wellbeing service for children and families living in Kensington and Chelsea and Westminster will embed the insights learnt from a three-year pilot aimed at tackling childhood obesity in one of the most deprived wards.
Concerns about rising childhood obesity rates across central and west London, and an appreciation of the complexity of the problem, led to the development of the joint-approach; the Tackling Child Obesity Together programme.
The programme was based on a Whole Systems Approach and involved; collaborative and whole-council working across different departments, embedding “health in all policies” and a matrix approach to commissioned services which pooled resources across three councils (including Hammersmith & Fulham, who were part of the Tri-borough at the time of development).
A key element in the WSA was a three-year pilot of health promotion activities and campaigns focused in the Golborne ward of North Kensington, which has particularly high childhood obesity rates.
Rather than being a top-down initiative, the Go Golborne pilot leveraged the engagement and diversity of the area’s community groups, schools, families and businesses in its design and operation.
This allowed the same message to be shared and reinforced everywhere children and their parents went across the ward; at school, in the playground, at GPs and dentists and even at corner shops.
Initiatives such as Sugar Smart, which encouraged reduced sugar consumption, was amplified by on-the-ground action such as community centres banning sugar from playgrounds and shops sharing news about drops in sales of sugary snacks.
Harnessing the power of social media, the Go Golborne message was spread across the ward. Key activities, such as summer play days, were linked with key campaign messaging around eating well, keeping active and maintaining a healthy weight. To provide more detailed insights, the National Child Measurement Programme (NCMP) in the six schools in the ward was extended to every year group, not just Reception and Year 6.
A University of Kent evaluation of Go Golborne concluded that it helped to create a local environment that would make it easier for children and families to eat well and keep active. For example, schools and venues/services in the local community were starting to make noticeable, positive changes to support healthier diets and physical activity.
Go Golborne events were attended by more than 3,360 local children and families (900 children live in the ward and 1,700 attend nearby schools). Questionnaire findings showed increased knowledge about what constitutes healthy lifestyles and more positive attitudes to fruit and vegetables amongst children. The majority of parents said they had improved their children’s diet. Children also reported more physical activity.
NCMP data suggests that Go Golborne helped to prevent levels of unhealthy weight gain from rising, and there are indications of a declining trend amongst younger children. The percentage of overweight children aged between four and 11 fell from 27.7 per cent to 26.3 per cent.
The findings from Go Golborne have provided the evidence base for the new Bi-borough, which will be launched in April 2020.
It has three strands:
- organisational capacity building: workforce training, nutritional outreach service, Change4Life (C4L) award scheme and small grants scheme
- health promotion services: universal changes for life clubs, tier 2 C4L coaching scheme for children and young people who are very overweight, education outreach service
- neighbourhood projects: community engagement projects in targeted wards
One of the vital elements in Go Golborne’s success was momentum and mobilisation. The pilot had the benefit of a full-time officer with local knowledge who was skilled at building up rapport with communities and working closely with other council departments which supported the work. Mirroring this in the new service will be a challenge, hence the decision to appoint an officer to take forward community motivation work.
“Working with community groups will be their bread and butter,” said Houda Al-Sharifi, Bi-borough Interim Director of Public Health: “Community activation and building capacity across diverse groups, existing community providers, key local businesses, corner shops and markets is all part of that.”
The commissioned part of the new service will include weight management offerings that are wider-ranging and more flexible and more inclusive than the traditional 10-12 week programme that was previously in place.
How will the approach be sustained?
The Go Golborne evaluation indicated that shifts in knowledge, awareness and motivation have built a foundation for sustained positive change and created an environment that will help families to be more receptive to future public health initiatives.
In the new Bi-borough service, the various strands, including the appointment of a member of staff to work with communities, are aimed at up-scaling the encouraging findings from the pilot to create a “movement for change” with a range of collaborators across the boroughs. The Bi-borough will continue to share best practice amongst the sector.
Debbie Arrigon, Public Health Consultant at Westminster and Kensington and Chelsea