Evidence based practice

What will the Government’s Obesity Strategy do for children?

By | Evidence based practice | No Comments

So, have the government finally realised the obesity epidemic is at crisis point after publishing their very first statistics relating to ‘severe’ levels of obesity in children and young people?

Let’s start with the good news. It was hugely heartening, following SHINE’s visit to London to give evidence to Diana Johnson (member of the Health Select Committee) and Sharon Hodgson (Shadow Health Minister) to get a promise that provision for Tier 3 services for severely obese children would be included in chapter two of the Government’s obesity plan.This is important because it’s a pathway to funding treatment. Clinical Commissioning Groups (CCGs) fund at a local level based on money allocated from central government. There is currently no ring- fenced money for Tier 3 services for children. We desperately need the government to set clear performance indicators and targets for multidisciplinary services so that CCGs have to fund these services. SHINE’s track record of delivery means we’re perfectly placed to deliver these services.

Anyway, just before the report came was published last summer, we found out it wouldn’t actually include provision for Tier 3 services. It did include the following passage –

“Signposting to appropriate advice, and where necessary, timely referrals for treatment was inconsistent for children living with childhood obesity. The Government must ensure there are robust systems in place not only to identify children who are overweight or obese, but to ensure that these children are offered effective help through a multidisciplinary, family-centric approach….’”

But there were no further details of how this would be managed.

The release of the report coincided with reports of the tragic death of an obese 13-year old boy from a blood clot whose weight was identified in post mortem as a “significant associated condition” – link.

The need for Tier 3 services is self-evident. We don’t just see it in the news, we see it every day at SHINE. When we started in 2003 we provided 12-week courses for 30 young people a year with ‘mild to moderate’ levels of obesity (BMI lower than 98th centile). We had rapid results and helped young people achieve their goal weight within six months. Today, we’re seeing around 200 families every year and children and young people weighing over 20 stone (BMI’s > 99.6 & 3.5 SDS known as clinical or morbid obesity) with extremely complex needs requiring intense interventions and long term support for up to two years.

So, going back to the question we started with – have the government finally realised the obesity epidemic is at crisis point for ‘severe’ levels of obesity in children and young people? Unfortunately it would appear not. How many more children need to die needlessly before we address this problem?

What’s the one thing parents really hate?

By | Evidence based practice, Research | No Comments

We’re coming to the end of our first year of research at Wybourn and Manor Lodge Primary Schools in collaboration with researchers at Leeds Beckett University.

So what are the key things we’ve learnt? Building trust with families takes a lot of TIME and parents really do seem to value honest feedback. It also turns out nutrition sessions are NOT a parent favourite. Having your knowledge tested is often useful but its also rarely the most comforting experience and the parents taking part in our research highlighted the worry that their eating behaviours will be judged. So we’ve looked for opportunities to adjust our approaches. That’s meant providing monthly physical activity sessions for families to enjoy spending active time together (which they love!) and using the mobile, friendly space of the SHINE Health Bus to discuss health assessment results.

Our parents have also prompted the development of new feedback tools too. Last year’s assessments coincided with the NHS’s National Child Measurement Programme in Reception and a very clear message from parents was that they did not like the feedback letter they received from them. So we’ve designed a simple sheet outlining age specific norm ranges of Body Mass Index (BMI), body fat percentage and waist circumference. Parents can then use these simple grids to compare the results of their child’s assessments. The great thing about this is that it enables parents to make their own judgements based on their own comparisons, rather than some well meaning professional who thinks they know best. We’ve had a great response to this in schools.

More results are coming in September and we’ll have further updates in our next newsletter so watch this space!

How to change a parent’s mind

By | Evidence based practice, Parents | No Comments

It might be shocking to discover that one in five children enter school obese when measured in Reception Year and that one in three children are obese when they leave in Year six but the really shocking thing is how little anyone knows about the factors contributing to these significant gains…

We’re partnering with Leeds Beckett University and two Sheffield schools on a seven year study to find out more. But six months in, one of our biggest challenges is getting parents involved in education around health and well being. Our first attempt to provide monthly nutritional sessions was not a success – just four out of 100 sets of parents attended. Time to try a different tack!

Although the sessions were designed to be interactive and fun it seemed like nutrition wasn’t an attractive theme. Wybourn School had another idea: switch from telling people what to do to helping them make a difference themselves. So our nutritional sessions become ‘activity mornings’ where parents could attend with their child and experience activities such as dance, play, aerobics and circuits.

The result was startling – from four in 100 we went to a quarter of our parents attending our first activity session. We hope these sessions will build up trust and confidence so that in July we can spend some time with parents to help understand what makes a difference and if there are any themes or patterns emerging.

We’re really excited and intrigued to find out more about this. Look out for a report in the next newsletter.