Wakefield Council’s Wellbeing team have been delivering the Junior Aspire Health Referral service for numerous years now - a referral service which supports families with children who are overweight to improve their overall health and wellbeing. We help families to make dietary and lifestyle changes, set goals that are realistic and achievable and focus on long-term changes.
The challenge
Historically, there have been high levels of childhood and adult obesity in Wakefield. Although some great work has been done over the last few decades it is evident there is an ongoing need for health and wellbeing support for families across the district. Recent NCMP data shows the rates of children living with overweight (including obesity) are higher than the national average in both YR and Y6 aged children in Wakefield.
On top of this, 33% (1 in 3) of all adults in Wakefield are living with obesity, which again is higher than the national level of 26%. In Wakefield, the level of obesity is significantly higher in the most deprived areas (41%), compared to the least deprived areas (27%).
In previous services there were high levels of dropouts and non-completers due to the requirement to attend appointments at leisure centers at set times. Feedback showed that time constraints, costs relating to travel and other commitments were reasons as to why families did not attend appointments.
The solution
The solution was to introduce an accessible, inclusive and engaging platform for all referrals to be able to utilize as and when they needed but still receive support from dedicated case workers.
The new approach enables families to complete an initial assessment to discuss their needs and areas of focus. Then they work through modules on a range of topics, whilst receiving tips, advice and motivation along the way before a mid-way point check in phone call.
To improve physical activity levels, families have access to appointments with a physical activity specialist and can receive a free 12-week leisure membership also.
A 12-week review appointment takes place once all modules are completed to ensure the family has a solid exit pathway.
The modules, which have been co-produced with previous referrals, cover topics such as energy balance, physical activity, goal setting, screen time, reducing sedentary behaviours, sleep and many more! The involvement of parents/guardians and siblings in the programme reinforces a supportive environment, ensuring all the family are on board and can benefit from the service.
The impact
Results and feedback from the pilots and subsequent roll out have been very promising, with families reporting an improvement in nutritional intake and physical activity levels alongside other healthy habits. There have been positive behavioural changes in relation to increased play, physical activity and movement, sleep, intake of fruits and vegetables, improved well-being scores and perhaps most significantly completing families are reporting to be confident to carry on with the lifestyle changes made.
The cost savings for all parties are significant also. With a reduction of missed appointments, remote support leads to significant environmental and patient cost savings along with less council money wasted. Reduction in travel time for staff also means we can support more referrals at any one time too.
We are confident that this approach will continue to reduce the burden and demand on wider council and Public Health service areas.
How is the new approach being sustained?
The Junior Aspire Health Referral service sits within the wider referral services element of Wakefield Council’s Wellbeing Team and therefore it will continue to be visible and accessible to existing health referrers to refer children and their families in to.
The platform’s design enables amendments and modifications to be made with ease, at a relatively low cost, ensuring continuous improvement and ensuring content is up to date and relevant. The strong link with Council Leisure facilities enables us to promote and provide physical activity opportunities for children and young people and their families.
6 month and 12 month follow up appointments after completing the programme are made with families to review long term behaviour changes and biometric measurements are taken at these to gather data to show improvements towards a healthier weight through continued positive lifestyle changes. Early results show many families are in a much healthier position at 12 months compared to previous services’ outcomes.
Lessons learned
Implementing the eLearning platform highlighted the importance of flexibility and accessibility when it came to the time/location of appointments. Switching to a predominantly remote support approach ensured those who needed the service could access it at times suitable for them with significantly reduced costs too. It was clear that to ensure engagement from families (perhaps especially those from deprived areas) we needed to remove as many barriers as possible.