Setting up a Targeted Healthy Lifestyle Pilot in Nottingham

Lynn McGuinness

Lynn McGuinness, Clinical Service Manager at Nottingham’s Children’s Public Health 0-19 Nursing Service, writes about their Targeted Healthy Lifestyle Pilot helping to support children and families to maintain healthier lifestyles through diet and physical exercise.

Obesity is highlighted in the NHS long-term plan and is a key priority for the Office of Health Improvement and Disparities (which replaced Public Health England). Nottingham is ranked as the 11th most deprived city in the UK, increasing the socio-economic deprivation and vulnerabilities of our population (Nottingham Insight - 2019)

In Nottingham, children aged under five from the poorest income groups are twice as likely to be obese compared to their more affluent counterparts, and by age 11, three times as likely (Public Health England, 2017). In addition, the National Child Measurement Programme (NCMP) results indicate that numbers of overweight or obese children are increasingly locally, with results from the school year 2022-2023 revealing that 23.6% of reception class children are either overweight or obese. Action is clearly needed to encourage healthier lifestyles from an early age.

We piloted a brief intervention aiming to improve the lifestyles of children and young people, led by the targeted Healthy Lifestyle Service within Nottingham CityCare Partnership. Following the success of this small-scale pilot, a new two-year pilot was funded by Small Steps Big Changes (SSBC) to deliver a targeted early intervention and prevention strategy to children aged 0-4 years. The intervention was initially aimed at children and families within the four SSBC wards of Aspley, Bulwell, Hyson Green and Arboretum, and St Ann’s, but was later opened up across the whole of Nottingham City.

Referral criteria for the programme are:

  • Under two years old - Rapid weight gain (2+ weight centiles crossed), OR weight above the 98th centile and 2+ centiles above length/height.
  • Over two years old - BMI above 91st centile.

We work with families to promote healthy lifestyle choices and prevent childhood obesity and poor health outcomes; this is about changing behaviours rather than a weight management service. It also involves assessing readiness for change and offering families a choice of home visits or group sessions.

Our sessions are designed to meet the needs of family life, which reflect the family’s diverse needs and their lived experience of diet, nutrition, and exercise. Up to six sessions are offered to families, and at each we set specific, measurable, and achievable goals with the family which are then reviewed at their next session. We work in partnership with Children’s Public Health 0-19 Nursing Service and SSBC Family Mentors, in particular their cook and play sessions, and we actively support the uptake of the Healthy Start Scheme. The pilot has now been running for 16 months and during that time we’ve supported 200 children.

In addition to a universal first foods group for families with babies aged four months, we have also developed a universal “Balancing Milk and Meals” group, to support the transition to three meals per day by the age of one year. The groups cover topics such as the eat well guide, nutritional recommendations for food and milk intake, healthy start vitamins, and how to deal with choking and gagging. They are a great opportunity for parents to ask lots of questions.

The service user engagement and feedback from the SSBC “Feed Your Way” campaign has supported the development of this group to ensure breast feeding parents are supported to continue breast feeding whilst balancing milk and meals. This group is due to be handed over to the universal Nutrition Peer Support Workers service to continue their work.

Feedback from families is very positive:

Researchers strongly advise measures to tackle childhood obesity aimed at pre-school children are a necessary intervention, and they are likely to be more effective than measures focused on older children.

The pilot was presented at the Institute of Health Visiting Evidence Based Practice conference 2023, and their feedback was very positive. You can view the poster for the conference by visiting the SSBC Website.

The work of the Healthy Lifestyle Pathway is supported by the recent publication:

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK.

Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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Visit the A Better Start website to find out more.