Main contact: Gail Barrow-Guevara
Project team: Professor Angela Harden (Principal Investigator), Dr Patrick Tobi, Professor Adrian Renton (Co-Investigators), Dr Emee Vida Estacio (Co-ordinator), Faye Adams-Eaton, Dr Marcello Bertotti, Shahana Lais, Gail Barrow-Guevara
Start date: January 2009
End date: June 2009
Project funder: NHS City and Hackney
Background
Combatting rising levels of overweight and obesity and their subsequent negative impact on health and well-being is an international, national and local priority. Strategies for promoting healthy weight need to encompass efforts to tackle the obesogenic environment as well as individual lifestyles. Before launching new strategies and projects there is a need to take stock of what is already happening. What is required is a clear picture of the kinds of healthy weight related projects that are currently in operation and an assessment of whether these projects demonstrate the characteristics known to be associated with effectiveness, acceptability, accessibility and good practice.
Aims
This research project aimed to: identify and map healthy weight-related projects at a local level in the London boroughs of City and Hackney, review project strengths and weaknesses, and develop a set of assessment metrics (including cost where possible) to review and monitor projects in the future. The project was part of a larger programme of work commissioned by NHS City and Hackney, Hackney Council, the Corporation of London and their partners who are seeking to effect a step change in their strategy to tackle obesity and promote healthy weight.
Methods
As many as possible of all the healthy weight-related projects in City and Hackney funded by NHS City and Hackney or their partners were identified and then surveyed. Data were collected on location, organisational set-up, processes and activities, costs, and monitoring and evaluation. In-depth case studies of five projects were undertaken, chosen in consultation with NHS City and Hackney. Background documentary material on the projects was reviewed and semi-structured interviews were conducted with project managers, front-line project staff and a small number of services users. A set of assessment metrics was developed which combined a) information from research evidence, national and local strategy on the efftiveness of healthy weight-related interventions with b) the perspectives of project providers and commissioners on effectiveness, coherence and integration and value for money. The assessment metrics were applied to each identified project to assess potential impact and value for money.
Main findings:
A total of 47 projects were identified and 38 (81%) of these repsonded to the survey. There was a balance between primary prevention projects that aimed to facilitate healthy weight in the population as a whole and secondary prevention projects that aimed to facilitate healthy weight amongst individuals referred to projects on the basis of weight, disease or clinical risk factors. Although the majority of projects worked directly with individuals there were a significant number of projects that targeted settings such as schools and nurseries to promote healthy environments. Projects targeted all ages across the life course although the greatest concentration of projects was upon primary aged children and adults. Case studies revealed several barriers and facilitators to success. Key barriers included limited resources for long-term follow-up; personal circumstances of service users; inappropriate or insufficient referrals; lack of support from schools (where applicable); insufficient publicity; availability of venues and facilities; and the weather. Key facilitators included no or minimal cost to service users; inclusivity of projects; safe environments and friendly atmosphere; family bonding; highly-qualified and experienced staff; effective teams; good management and operating systems; and availability of project review and feedback. The Value for Money (VfM) metric we developed helped to assess, in an explicit and transparent way, the potential impact of projects. The VfM metric was made up of the following 10 criteria: acceptability, multi-component, ongoing, intergenerational, equity promoting, not facility dependent, monitoring and evaluation, coverage, retention, and cost.
For further information please contact: Angela Harden
© 2010
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