J Trigwell

Ethnic differences in parental attitudes and beliefs about being overweight in childhood

Objective: This study examined the relationship between ethnic background and parental views of healthy body size, concerns surrounding overweight and attitudes to perceived causes of overweight in childhood. Method: A self-report questionnaire was designed to explore parental attitudes towards childhood weight. Sampling deliberately over-represented the views of parents from minority ethnic groups. Eight-hundred-and-eight parents of school-aged children completed the questionnaire. Parental data from Asian British, Black African, Black Somali, Chinese, South Asian, White British and Yemeni groups were included in the analysis. Results: Data showed that ethnic background was significantly associated with parental beliefs that overweight children will grow out of being overweight (X2[12, n = 773] = 59.25, p < 0.001) and that overweight children can still be healthy (X2[12, n = 780] = 25.17, p < 0.05). In both cases, agreement with the statements was highest among Black Somali parents. While the majority of parents believed that both dietary behaviours and physical activity played a role in the development of overweight in childhood, Yemeni parents were more likely to attribute overweight in childhood to dietary but not physical activity causes. Conclusion: Ethnic differences in parental perceptions of weight in childhood must be considered in the design of, and recruitment to, childhood obesity interventions aimed at minority ethnic groups.

Health trainers making a difference to mental health and wellbeing.

This short report explores the key findings from a review1 of information on health trainers in 2013/2014 which had a particular focus on mental health and wellbeing. After summarising the key findings of the review, it focuses on mental health, briefly exploring the links between mental and physical health before discussing what differences engagement with a health trainer made to people’s sense of self-efficacy and wellbeing. Health trainers are a non-clinical workforce introduced in 2004,2 who receive training in competencies to enable them to support people in disadvantaged communities to improve their health.3 The population groups or settings that health trainers focus on varies from service to service, but all work one-to-one, most spending at least an hour with a client at their first appointment, supporting and enabling them to decide what they want to do. The emphasis is on the client determining their own priorities and how to achieve them. Generally, health trainers see clients for a total of six sessions, where how to achieve goals and progress towards them is discussed. The Data Collection and Reporting System (DCRS) is used by approximately 60% of Health Trainer Services to record monitoring data. Around 90% of Health Trainer Services using DCRS record ethnographic data on health trainers and clients, plus the issues clients worked on and the progress they made. There is also a wide range of other data which can be recorded, including before and after mental health and wellbeing scores. We were given access to aggregate data in order to conduct an analysis. Descriptive statistics were generated to calculate percentage change pre- to post-intervention. A total of 1,377 (= 919 full time equivalents) health trainers were recorded in the DCRS system as working with 97,248 clients in England during 2013/2014. The health trainer model embodies the principle of lay support,4 and services aim to recruit a high proportion of their staff from similar backgrounds to their clients. They have been reasonably successful with 32% of health trainers coming from the most deprived areas (Quintile 1),i with a further 20% from Quintile 2. In all, 40% percent of health trainers lived in the same areas as their clients.

Influence of family and friend smoking on intentions to smoke and smoking-related attitudes and refusal self-efficacy among 9–10 year old children from deprived neighbourhoods: a cross-sectional study

BackgroundSmoking often starts in early adolescence and addiction can occur rapidly. For effective smoking prevention there is a need to identify at risk groups of preadolescent children and whether gender-specific intervention components are necessary. This study aimed to examine associations between mother, father, sibling and friend smoking and cognitive vulnerability to smoking among preadolescent children living in deprived neighbourhoods.MethodsCross-sectional data was collected from 9–10 year old children (n =1143; 50.7% girls; 85.6% White British) from 43 primary schools in Merseyside, England. Children completed a questionnaire that assessed their smoking-related behaviour, intentions, attitudes, and refusal self-efficacy, as well as parent, sibling and friend smoking. Data for boys and girls were analysed separately using multilevel linear and logistic regression models, adjusting for individual cognitions and school and deprivation level.ResultsCompared to girls, boys had lower non-smoking intentions (P = 0.02), refusal self-efficacy (P = 0.04) and were less likely to agree that smoking is ‘definitely’ bad for health (P < 0.01). Friend smoking was negatively associated with non-smoking intentions in girls (P < 0.01) and boys (P < 0.01), and with refusal self-efficacy in girls (P < 0.01). Sibling smoking was negatively associated with non-smoking intentions in girls (P < 0.01) but a positive association was found in boys (P = 0.02). Boys who had a smoking friend were less likely to ‘definitely’ believe that the smoke from other people’s cigarettes is harmful (OR 0.57, 95% CI: 0.35 to 0.91, P = 0.02). Further, boys with a smoking friend (OR 0.38, 95% CI: 0.21 to 0.69, P < 0.01) or a smoking sibling (OR 0.45, 95% CI: 0.21 to 0.98) were less likely to ‘definitely’ believe that smoking is bad for health.ConclusionThis study indicates that sibling and friend smoking may represent important influences on 9–10 year old children’s cognitive vulnerability toward smoking. Whilst some differential findings by gender were observed, these may not be sufficient to warrant separate prevention interventions. However, further research is needed.

Maintaining employment and improving health: a qualitative exploration of a job retention programme for employees with mental health conditions

Purpose A proportion of the working age population in the UK experience mental health conditions, with this group often facing significant challenges to retain their employment. As part of a broader political commitment to health and well-being at work, the use of job retention services have become part of a suite of interventions designed to support both employers and employees. While rigorous assessment of job retention programmes are lacking, the purpose of this paper is to examine the success of, and distils learning from, a job retention service in England. Design/methodology/approach A qualitative methodology was adopted for this research with semi-structured interviews considered an appropriate method to illuminate key issues. In total, 28 individuals were interviewed, including current and former service users, referrers, employers and job retention staff. Findings Without the support of the job retention service, employees with mental health conditions were reported unlikely to have been maintained their employment status. Additional benefits were also reported, including improved mental health outcomes and impacts on individuals’ personal life. Employers also reported positive benefits in engaging with the job retention service, including feeling better while being able to offer appropriate solutions that were mutually acceptable to the employee and the organisation. Originality/value Job retention programmes are under researched and little is known about their effectiveness and the mechanisms that support individuals at work with mental health conditions. This study adds to the existing evidence and suggests that such interventions are promising in supporting employees and employers.

Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis

BackgroundEvidence of the effectiveness of social prescribing is inconclusive causing commissioning challenges. This research focusses on a social prescribing scheme in Northern England which deploys ‘Wellbeing Coordinators’ who offer support to individuals, providing advice on local groups and services in their community. The research sought to understand the outcomes of the service and, in addition, the processes which supported delivery.MethodsQuantitative data was gathered from service users at the point they entered the service and also at the point they exited. Qualitative interviews were also undertaken with service users to gather further understanding of the service and any positive or negative outcomes achieved. In addition, a focus group discussion was also conducted with members of social prescribing staff to ascertain their perspectives of the service both from an operational and strategic perspective.ResultsIn total, 342 participants provided complete wellbeing data at baseline and post stage and 26 semi-structured qualitative interviews were carried out. Improvements in participants’ well-being, and perceived levels of health and social connectedness as well as reductions in anxiety was demonstrated. In many cases, the social prescribing service had enabled individuals to have a more positive and optimistic view of their life often through offering opportunities to engage in a range of hobbies and activities in the local community. The data on reductions in future access to primary care was inconclusive. Some evidence was found to show that men may have greater benefit from social prescribing than women. Some of the processes which increased the likelihood of success on the social prescribing scheme included the sustained and flexible relationship between the service user and the Wellbeing Coordinator and a strong and vibrant voluntary and community sector.ConclusionsSocial prescribing has the potential to address the health and social needs of individuals and communities. This research has shown a range of positive outcomes as a result of service users engaging with the service. Social prescribing should be conceptualised as one way to support primary care and tackle unmet needs.

Impact and acceptability of the coach and teacher training within a school-based sport-for-health smoking prevention intervention: SmokeFree Sports

ABSTRACT This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by teachers. Interviews were also conducted with coaches (N = 7) and teachers (N = 12). Both groups displayed a significant increase in intervention knowledge and delivery self-efficacy from pre- to post-training, which was maintained at post-intervention for teachers. Data suggest that a brief training workshop is acceptable to practitioners and fosters confidence to implement a sport-for-health smoking prevention program.