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Increasing healthy eating among children in Portsmouth

Increasing the levels of physical activity and healthy eating amongst children aged 2-11 in Portsmouth

In 2009, Brilliant Futures was commissioned by Portsmouth City Council and NHS Portsmouth’s Healthy Pompey programme to undertake an in-depth social marketing scoping exercise to inform the commissioning of interventions to increase the levels of physical activity and healthy eating amongst families with children aged 2-11 within three target wards: Baffins, Fratton and Paulsgrove. Background to the project Portsmouth has higher childhood obesity rates than the average for England. The Portsmouth Healthy Pompey programme aims to make activity and healthy food choices easier for people in Portsmouth The overall aim of the programme is: To become a city where all people are healthier, feel well, and are empowered to take responsibility for their health.

Aim of the project

To gain insight into the health behaviours of families with children aged 2-11 living in the target wards and use this understanding to recommend interventions and services that will support positive behavioural change.

Objectives of the project

To understand the motivations behind the target families’ behaviour with regard to healthy eating and physical activity and the barriers to behaviour change 

To test the Change4Life behavioural goals with the target audience

To segment the target audience and develop targeted behavioural goals by segment

To determine the influence of key stakeholders on target behaviours

To provide insight-driven recommendations for policy, service design and behaviour change interventions

Methodology

A review of national and international research and previous similar social marketing interventions was undertaken and used to develop hypotheses to test in the primary research. Existing ACORN demographic data, Change4Life cluster data and other previous research was used, along with visits, to build a picture of the target wards. Stakeholder insight was gathered through an on-line survey, telephone and face-to-face interviews and an interactive Stakeholder event.

An analysis of current services and interventions provided by the public and voluntary sectors to support local people eat healthily and do more physical activity was undertaken to ensure the project drew on the experience of current activities.

In order to learn from companies that promote sedentary lifestyles and unhealthy eating, an analysis was undertaken to understand the sales and promotional activity of retailers – both nationally and by visiting the target wards.

To gain an understanding of the lifestyles and behaviours of the target families, in-depth interviews were undertaken that included participants completing a weeklong food and activity diary and being accompanied on a usual weekly shop. A face-to-face survey was conducted door to door with a representative sample of 511 residents in the target wards.

Key insights:

Family structure is a key driver of behaviour.

There is a major disparity between claimed and actual behaviour and many parents believe they are already doing many of the desired behaviours and don’t see the need to do more of them.

Many of the behaviours identified in the Change4Life programme (portion size, snacking, fat content) were prevalent in the target wards. Some issues are more readily recognised as problems by parents (e.g. fat content).

In terms of physical activity, there is a need to allay perceptions around safety in public spaces. Providing toys and games, along with Community Cafes, in local open spaces was well received by parents.

There is a lot of importance placed on cost and convenience – reliance on the freezer came through as a strong theme in the research.

The competition, and services that are working well, recognised the need to look after/provide benefits for the parent as well as the child.

‘Cooking’ for most parents means heating up frozen food or ready meals – it doesn’t necessarily mean preparing meals from fresh ingredients.

Segmentation

From our research we were able to identify four distinct segments by family structure.
1) Single, stay at home parents – this segment is struggling but open to support. The priority is developing skills in parenting and preparing healthy meals.

2) Single, working parents – this segment is coping, thanks to a set routine that is hard to change. The emphasis with this segment is convenience and making change easy.

3) ‘Traditional’ Stay at home parents – this segment are at home with young children while their partner is out at work. They can feel trapped and defensive. The priority is in positioning support in a way that they will want to use and recognise as being for them.

4) Couples, both working – this segment displays many positive healthy eating and physical activity behaviours, however there are issues with portion size and snacking.

Recommendations

We selected to focus behavioural goal setting and intervention development on the first three segments in Paulsgrove and Fratton wards as that is where the need was greatest and the biggest health gains could be made. The following concepts for interventions, founded on the insight gathered from the scoping exercise, were suggested across the range of the National Social Marketing Centre’s ‘intervention mix’.

INFORM – “The happy freezer campaign” - An initiative to encourage the purchase of quick, easy, tasty and healthy food for the freezer. Delivered through information provision and promotions on healthier alternatives, incentives and sales promotion material with retail partners.

INFORM – “Happiness on your doorstep”’ – building on insight gathered during a parallel project to increase the use of open and green spaces, communications to raise awareness of local outdoor spaces within 5 minutes from home and how easy it is to create happy family memories whilst using them

SUPPORT – “Parenting support groups” - peer-led groups addressing key issues with children’s behaviour – such as fussy eating or temper tantrums at mealtimes. Parents who have experience in how to cope/deal with these situations would provide advice and ideas to others.

SUPPORT – “Snacking sales promotion” - A commercial approach to encourage Snack Swaps. This would feature a ‘taste test’ event to provide parents with information on what healthy snack options their children may eat, and promoting snack swaps through local outlets. 

SUPPORT – ‘”Skills development” content for existing or new cooking skills courses encouraging parents to ‘make your own ready meals’ by cooking one batch of food and freezing it.

SUPPORT – “Happiness on your doorstep” –activity packs for free or subsidised hire at local open spaces and through local retail partners to provide easily available equipment for parents to use to play with their children.  DESIGN – “Community Café and Kitchen”- A commercially run Community Café running activities for both mothers and children. It would include working kitchens to deliver courses, toys and games for kids, the opportunity for peer-to-peer learning, socialising and respite. 

CONTROL - Limit new takeaways opening in the target wards and subsidise cafes and takeaways selling healthier food with lower rates or grants for starting up and promotion. Results As a result of our detailed scoping exercise and recommendations, the client has commissioned Brilliant Futures to further progess this project and support the development and implementation of a number of the above intervention concepts.

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