HENRY: Health, Exercise, Nutrition for the Really Young Mary Dawson Regional Manager (North)
Getting the message across Practitioners • Lack of confidence: 74% not comfortable discussing obesity • 86.5% did not consider themselves effective • Inability to identify obesity Parents reported • Concerns were dismissed • Feeling judged or criticised Edmunds L Arch Dis Child 2007 Perrin E Obesity Research 2005 Redsell SA Mat Child Nut 2012
Effective practice 2 day training Knowledge: Skills: Risk factors Relationship Whole family Qualities: healthy Empathy lifestyle Non- judgemental Raising the Healthy start issue Partnership Strengths Modelling Solution- focused
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 effect behaviour 70% (251) Eating patterns and habits 67% (240) Physical activity 65% (238) Brown et al, Community Practitioner 2013
Confidence in working with families e-survey up to 4 years later; n=354 50% 45% 40% 35% 30% < 12 months 25% > 12 months 85% < 12 months 20% 91% > 12 months 15% 10% 5% 0% 1 2 3 4 5 Very little impact Significantly improved
Practice and policy in children’s centres • Positive changes in practitioners’ lifestyles I think they’re more confident in tackling & • Enhanced confidence to bringing up things … I’ve approach and discuss lifestyle noticed that people are issues with families talking about lifestyle more, and are concerned about it • Healthier meals, snacks and portion sizes • Persistent change and impact Willis et al, on the culture and practice of J Hum Nutr Diet 2012 the wider team
Research into practice: the HENRY approach • 8 week programme • Delivered in children’s centres • Group or 1-to-1 • Over 8,000 parents • 37 local authorities I’ve realised I need to • Experiential and interactive eat with him and eat • Average retention rate of 81% healthier foods – who else is he • RCT based on implementation going to copy? optimisation underway
Research into practice: activity • Parent Champions setting up activities for parents including – Zumba classes – Buggy walks – Parachute balls – Music & movement – Picnics in the park – Indoor Olympics – Flying a kite ‘Being a new mum and having all the flabby bits and meeting new people at this group you feel a bit like everyone is going to be looking at you, but the instructor and everyone were very nice, I got on really well with them.’
Impact & outcomes of the HENRY programme A statistically significant and sustained impact on: • parenting efficacy and confidence to make changes • family activity levels • family mealtimes and feeding behaviour • what the whole family eats: – increased consumption of fruit and vegetables – decreased consumption of energy dense foods -Willis et al, Pediatric Obesity, 2014 -Willis et al, Public Health, 2016
5 a day • 44% children in families completing HENRY programme eat 5 a day
Parental self-agency Dumka 1996 Pre-course Post-course Follow-up 18 *P<0.001 *P<0.001 *P<0.001 *P<0.001 16 14 12 Mean score 10 8 6 4 2 0 Parental self-agency Setting limits Willis et al, Sure of self Mealtimes Pediatric Obesity Doing a good job TV/computer Perseverance Active play July 2013 Problem solving Bedtime General
Eating behaviour Golan 1998 Pre-course Post-course Follow-up 16 *P<0.001 *P<0.001 14 *P<0.001 *P<0.001 12 Mean score 10 *P<0.005 *P<0.005 *P<0.001 *P<0.001 8 6 4 2 0 Family eating Children eating with Structured mealtimes Parental eating behaviour adults behaviour Willis et al, Eating together Pediatric Obesity TV off for meals Home cooked food Lower scores indicate desired behaviours July 2013 Take away food
Effective local partnership: Redcar and Cleveland • Commissioned group of HENRY Training for delivery across area including – Core training x 6 – Group Facilitation Training x 1 – Advanced Training x 1 • Group programme delivery starting in Autumn term
Effective local partnership: a local case study • 7-year partnership with Public Health Department (originally PCT) • City Council working in partnership with CCGs • All health visitors and children’s staff HENRY trained – over 1,200 staff • Local staff trained to deliver practitioner training, family group programme and 1-to- 1 intervention • Now training childcare workforce • Volunteer Parent Champions supporting healthy local communities
Embedding prevention in local obesity strategy 10.5 10 Obesity Prevalence in reception (%) 9.5 9 Leeds England 8.5 HENRY implemented as part of city-wide 8 obesity strategy 7.5 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 Year
Reducing health inequalities 16 14 12 10 8 Least deprived Most deprived 6 4 2 0 2009/10 2010/11 2011/12 2012/13 2013/14 Leeds City Council NCMP data
Research and evidence • The Impact of HENRY on Parenting and Family Lifestyle: a national service evaluation of a pre-school obesity prevention programme. Willis TA, Roberts KPJ, Berry TM, Bryant M, and Rudolf MCJ Published Public Health 2016 • Combating child obesity: impact of HENRY on parenting and family lifestyle. Willis TA, George J, Hunt C, Roberts KPJ, Evans CEL, Brown RE and Rudolf MCJ Published Pediatric Obesity 2014 http://www.henry.org.uk/homepage/why-henry/evidence- base/clinical-studies/
Contact us mary.dawson@henry.org.uk www.henry.org.uk @HENRYhealthy
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