Shared Intelligence: Hey! Summary

Shared Intelligence

Evaluation of the HEY! Programme Summary report

September 2015

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Shared Intelligence

1 Summary Report Background

Design and delivery of HEY!

Healthy Eating for Young Children (HEY!) is an Early Years community health improvement project led by Danone Nutricia Early Life Nutrition (Danone). The ambition for HEY! is to improve the health outcomes and life chances of local children aged one to three years by engaging their parents in healthy eating and Skills for Life learning. This reflects Danone’s global mission and core purpose of ‘bringing health through food to as many people as possible … because nourishing early life today really matters for tomorrow’.

The HEY! programme is delivered over seven weeks and covers topics such as budgeting, food safety, portion sizes and cooking skills through interactive and practical learning, with LLN skills embedded in the resources. HEY! was endorsed by the RSPH in 2013 and course participants can earn a RSPH Level 1 Award in Health Improvement, equivalent to two learning credits at Level 1 on the Qualifications and Credit Framework (QCF).

The evaluation showed that:

●● The partnership between Danone, Wiltshire HEY! is based on a body of evidence that shows County Council, 4Children and the CHLF was childhood obesity is linked to parents’ eating habits. Recent research by the University of Exeter, essential to design and develop HEY! as an published in the International Journal of Obesity in evidence-based, accredited programme to April 2015, discovered that the rise in obesity among address childhood obesity and promote healthy very young children has been largely restricted eating. to the minority with obese parents. The research data suggests that ‘parenting is the fundamental ●● The resources developed enabled HEY! to influence on weight gain in the early years, whereas address its health improvement aims through an more general (peer-group) influences take over later embedded learning approach to address parents’ on….and public health strategies may need to be Skills for Life needs and improve their knowledge tailored accordingly’. about healthy eating.

Research demonstrates that families living in the ●● Most HEY! courses target vulnerable or socially most disadvantaged communities are often those deprived parents, which meets local authority who have the worst health outcomes because they priorities and needs that have been identified by face the most challenges in managing their health the children’s centres. and wellbeing. A lack of language, literacy and numeracy skills is one of the major contributing ●● HEY! adds value to centres’ offer but finding factors to this. For this reason, HEY! took an the resources to staff the courses and crèche embedded learning approach by delivering health provision is becoming more of a challenge due messages through Skills for Life learning. to local authority budget cuts.

The project was initiated in 2011 and created in partnership with Danone, Wiltshire County Council, ●● Tutors are positive about the ‘Train the Trainers’ 4Children and the Community Health and Learning session and value the resources – particularly the Foundation (CHLF). Following a successful pilot, HEY! Diary, which is attractive and easy to use.

70 HEY! courses have been run at children’s centres across the UK. ●● These have contributed to HEY! courses going well. The group working helps learning This independent evaluation of HEY! by Shared about healthy eating and parenting. The main Intelligence has assessed: challenge has been engaging parents in a way that promotes regular attendance and prevents ●● Change in parents’ and children’s healthy eating drop-out. behaviours as a result of HEY!; ●● Whether and how this behavioural change is sustained after the end of a course: ●● What works well in enabling behavioural change through HEY!; and ●● The sustainability of the HEY! model to ensure quality and credibility.

HEY! Summary Report

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All figures are up to July 2015

Who is providing HEY!?

Where has HEY! been delivered?

As of July 2015, there are seven provider organisations running HEY! courses. They are: ●● 4Children ●● Spurgeons ●● Action for Children ●● Barnardo’s ●● Independent Children’s Centre ●● Buckinghamshire County Council ●● Leicestershire County Council

HEY! Summary Report

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Impact of HEY! Data was collected from 90 parents who had filled in ‘before course’ and ‘after course’ monitoring forms. The evaluation utilised a range of indicators – about increases in fruit and vegetable intake and increases in physical exercise which relate to the Public Health Outcomes Framework. Also measured were improvements in health literacy, budgeting and cooking skills, as well as confidence and self-esteem to capture the impact of the programme.

Analysis of the monitoring data up to April 2015 showed notable increases in parents’ knowledge and this greater awareness translated into positive behavioural change. The graphic below (‘Impact of HEY!’) sets out some of the evidence of the impacts the course had.

These impacts are related to parents’ enjoyment of HEY! – particularly the social aspects of being part of a group, and the cooking and practical exercises – with most parents saying that they would have liked more cooking and recipe ideas.

The only thing to which there was a more mixed response is ‘the paperwork’ – echoing tutors’ comments that some parents found the accreditation difficult. However, while it was a challenge for some parents, this was often outweighed by the boost to self-esteem from gaining a qualification from the course.

HEY! Summary Report 3

Sustaining behavioural change

Conclusions and recommendations

The real test of HEY! is whether healthy eating behavioural change is sustained after a course. We spoke to a sample of 22 parents from seven courses to explore this and found that behavioural change was continuing at 6-8 weeks after the HEY! course.

We found that parents were all:

We conclude that the Danone HEY! course is having a substantial impact on healthy eating and healthy lifestyles for parents and their young children. This impact is largely due to the design of HEY! and the resources in place for the delivery of HEY! – which children’s centres, tutors and parents have greeted enthusiastically.

●● Reducing portion sizes; ●● Swapping to healthier foods; ●● Cooking ‘from fresh’; ●● Using a greater variety of foods for their children; and ●● Most parents were sitting down with their children to eat at regular mealtimes.

We recommend that Danone and its partners build on the success of HEY! to maximise and sustain its impact by continuing to take actions to: ●● Increase retention and reduce drop-out of course participants; ●● Explore ways to increase engagement and sustain the positive impacts of the course beyond the seven week HEY! programme; and

And the ongoing impact of HEY! was over and above ●● Sustain and increase capacity for centres to run changes in healthy eating: HEY! courses. ●● Parents became interested in health more generally – and had taken up physical exercise; ●● HEY! improved their confidence and relationships with their partners and children; ●● With some parents signing up for other courses – including at the children’s centres.

HEY! Summary Report 4

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Shared Intelligence

2 HEY! Case study: Ashley Not only has Ashley moved to healthier options for food and drinks and started cooking more, she and her family have changed their eating habits, which has brought them closer together. A big change was buying a dining table and chairs so they could eat together in the kitchen instead of on their laps in the living room, which means their toddler doesn’t Ashley had recently moved to Leicestershire with play with his food or wander off any more. “We have her husband and two small children and felt isolated breakfast with the kids now – and enjoy each other’s away from family and friends. She was introduced to company”. This led to cooking for special occasions – the HEY! course – as well as a parenting group – at like Christmas and the Chinese New Year, which their the children’s centre near where she lives. toddler was learning about at pre-school. “It’s better for our marriage – doing things together. We’ve done Ashley says HEY! made her really look at what she a Valentine’s Day meal and Pancake Day for the first ate and make a lot of changes such as reducing sugar time in three years”. and salt – not easy as she works in a fast food café with burgers and fizzy drinks freely available. “Before Ashley has learnt that healthy eating helps mental as HEY! I used to have three or four coffees a day and well as physical health and sees eating as part of a three or four Red Bulls and full sugar Cokes. Now I healthy lifestyle. have one coffee three times a week and water with She’s made other changes to her lifestyle including sugar free squash. At work I have cup-a-soups and reducing her hours at work to shorter shifts and feels savoury crackers and bottled water – not burgers much better for it. “I’m sleeping much better now– and chips. I’m not bloated now and have lost two there’s less stress but it’s the diet as well – less coffee stone”. and so on”.

Ashley explains that she eats less and more slowly since HEY! and knows when she’s full. Her husband does most of the cooking and has changed to making “ The last 6 months of 2014 – with HEY! and the parenting course – have made a massive healthier – and smaller – meals following HEY! impact on me today” Ashley has started to do more cooking and now buys less ready-made and processed food. “We make wraps now using 50/50 bread as we like Mexican food. We cook chicken breasts and haddock fillet and add vegetables and seasoning – then you know what’s in it”.

“HEY! has changed my eating habits. My key worker got me on HEY! and it helped coming just before Christmas so I could make a fresh start, a new year’s resolution. We still have some treats but we feel much better in ourselves”

HEY! Summary Report

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Shared Intelligence

3 HEY! Case study: Lyndsey “ I’ll never look back … [the HEY! course] has definitely changed my family’s life” Lyndsey attended the HEY! course twice. Lyndsey completed the HEY! course in Gloucestershire and enjoyed it so much that she asked if she could be involved again so as to review the course content and to act as a helper in the sessions.

Another important change is around portion sizes.

She found out from HEY! that she used to give her daughter an “adult’s size” portion. Lyndsey said they were also cutting down on salt and sugar significantly.

One of the biggest differences that Lyndsey has noticed as a result of these changes is that her daughter has lost weight and her children overall are less ‘hyper’. “My daughter has lost a stone Lyndsey first heard about the course through and is feeling more confident now. She feels better participation in other adult education courses run in herself”. Lyndsey revealed that previously her by the children’s centre. daughter “lost a lot of self-confidence” and “She Attending the course for a second time, Lyndsey was was bullied because of [her weight]”. Moreover her enthusiastic about what can be achieved. She shared daughter “wants to exercise more now. She seems to have more energy.” Both her children are less her learning with other participants, for instance ‘hyper’, which Lyndsey thinks is because she has cut advising other participants about the advantages down on things like sugar. According to Lyndsey this of steaming vegetables instead of boiling and also is “really helping” her as a parent. revealing that she has begun using a slow cooker to prepare many of her meals.

Lyndsey has also started using a weekly food planner The HEY! course helped Lyndsey to consider a wide range of changes she can make to help her and her family live more healthily. She is enthusiastic and determined about what she can achieve: “I’ve got loads of ideas of what I want to do. I’ve been keeping to it.” This includes eating more fruit and vegetables.

For example, she said “we’re starting to eat quite a lot of fruit as a family... We’ve been sticking to our five a day.” She has also taken to “steaming vegetables regularly now.”

HEY! Summary Report

and “I know what food we are having all week, rather than wasting food.” She has involved her eldest child in the food planner. Doing this has really helped her financially, and she thinks she has “saved over £30, maybe £40 a week”. “ Once I got into it, I found it quite easy – once I changed the habit.”

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