Richard Kimberlee

Food sustainability education as a route to healthier eating: evaluation of a multi-component school programme in English primary schools

Promising approaches to the promotion of healthier eating among children in primary school settings include the opportunity to practise practical cooking and growing, promoting the take up of healthier school meals and nutritional education. However, less is known about the potential for strategies that integrate approaches through a focus on food sustainability issues--such as the promotion of awareness about local, seasonal, organic, fair trade and higher animal welfare foods. This paper presents an evaluation of the Food for Life Partnership, a multi-component programme that sought to address both the health and sustainability aspects of food. The study consisted of a two-stage cross-sectional survey of Years 5 and 6 students (ages 9-11) in 30 primary schools at enrolment and after 18-24 months, combined with an analysis of programme delivery. Higher self-reported fruit and vegetable consumption in the second stage survey was associated with a range of indicators of school participation in the programme. These included the reform of school meal procurement and preparation; experiential food growing, cooking and farm-based education and improved opportunities for stakeholder engagement. The study therefore develops a case for multilevel programmes that incorporate sustainability issues alongside experiential food education in primary school settings.

Understanding high traffic injury risks for children in low socioeconomic areas: a qualitative study of parents' views.

Objective: To gain an in-depth qualitative understanding of parents’ views about their children’s exposure to road traffic injury risk in low socioeconomic areas. Design: Focus groups facilitated by a moderator with content analysis of data. Setting: Focus groups were conducted in 10 low socioeconomic English districts that also have high rates of child pedestrian injury. Research was conducted in community venues within each area. Subjects: Parents of children aged 9–14 years living in low socioeconomic areas. Results: Parents believe that children play in their local streets for the following reasons: they like playing out with friends near home; there are few safe, secure, and well-maintained public spaces for children; children are excluded from affordable leisure venues because of their costs; insufficient parental responsibility. For children that play in the street, the key sources of risk identified by parents were: illegal riding and driving around estates and on the pavements; the speed and volume of traffic; illegal parking; drivers being poorly informed about where children play; children’s risk-taking behavior. Conclusions: Intervention programs need to take into account multiple reasons why children in low socioeconomic areas become exposed to hazardous environments thereby increasing their risk of injury. Multi-agency partnerships involving the community are increasingly needed to implement traditional road safety approaches, such as education, engineering, and enforcement, and provide safe and accessible public space, affordable activities for children, and greater support for parents.

The Role of Community Centre-based Arts, Leisure and Social Activities in Promoting Adult Well-being and Healthy Lifestyles

Developed countries are experiencing high levels of mental and physical illness associated with long term health conditions, unhealthy lifestyles and an ageing population. Given the limited capacity of the formal health care sector to address these public health issues, attention is turning to the role of agencies active in civil society. This paper sought to evaluate the associations between participation in community centre activities, the psycho-social wellbeing and health related behaviours. This was based on an evaluation of the South West Well-being programme involving ten organisations delivering leisure, exercise, cooking, befriending, arts and crafts activities. The evaluation consisted of a before-and-after study with 687 adults. The results showed positive changes in self-reported general health, mental health, personal and social well-being. Positive changes were associated with diet and physical activity. Some activities were different in their outcomes—especially in cases where group activities were combined with one-to-one support. The results suggest that community centre activities of this nature offer benefits that are generically supportive of health behaviour changes. Such initiatives can perform an important role in supporting the health improvement objectives of formal health care services. For commissioners and partner agencies, accessibility and participation are attractive features that are particularly pertinent to the current public health context.

The Advocacy in Action Study a cluster randomized controlled trial to reduce pedestrian injuries in deprived communities

Background Road trafficrelated injury is a major global public health problem. In most countries, pedestrian injuries occur predominantly to the poorest in society. A number of evaluated interventions are effective in reducing these injuries. Very little research has been carried out into the distribution and determinants of the uptake of these interventions. Previous research has shown an association between local political influence and the distribution of traffic calming after adjustment for historical crash patterns. This led to the hypothesis that advocacy could be used to increase local politicians knowledge of pedestrian injury risk and effective interventions, ultimately resulting in improved pedestrian safety. Objective To design an intervention to improve the uptake of pedestrian safety measures in deprived communities. Setting Electoral wards in deprived areas of England and Wales with a poor record of pedestrian safety for children and older adults. Methods Design mixedmethods study, incorporating a cluster randomized controlled trial. Data mixture of Geographical Information Systems data collision locations, road safety interventions, telephone interviews, and questionnaires. Randomization 239 electoral wards clustered within 57 local authorities. Participants 615 politicians representing intervention and control wards. Intervention a package of tailored information including maps of pedestrian injuries was designed for intervention politicians, and a general information pack for controls. Outcome measures Primary outcome number of road safety interventions 25months after randomization. Secondary outcomes politicians interest and involvement in injury prevention cost of interventions. Process evaluation use of advocacy pack, facilitators and barriers to involvement, and success.

Implementing the Rock Challenge: Young people's perspectives on a drug-prevention and performing-arts programme

This paper presents the qualitative process findings from an evaluation of a school-based performing arts programme, ‘Rock Challenge’. Rock Challenge aims to promote healthy life styles ‘by building resilience amongst young people involved’. The research aimed to capture the experiences and perceptions of young people’s involvement in the programme, particularly in relation to the concept of the ‘drug-free high’, support offered throughout the programme and participants’ response to Rock Challenge as a drug-prevention initiative. Findings from the study suggest young people felt very positive about their involvement and, in particular, valued the skills and experiences associated with organising a performance, team-working, developing confidence, friendship, fun and excitement. The excitement felt during dance rehearsals and the live performance was associated with the concept of a ‘drug-free high’, feeling good in the absence of drugs and alcohol, and was seen as a key benefit of the programme. While support from teachers and families was perceived as high, difficulties were identified in the recruitment of males and students vulnerable to substance misuse and recommendations are made for improvement. The health promotion opportunities for school nurses and other public health practitioners and personal, social and health education co-ordinators are highlighted.

A process evaluation of student participation in a whole school food programme

Purpose – Health promotion programmes are widely held to be more effective when the subjects of them actively participate in the process of change. The purpose of this paper is to report on an evaluation of the Food for Life Partnership programme, a multi‐level initiative in England promoting healthier nutrition and food sustainability awareness for students and their families through involvement in cooking, growing, farm visits and School Nutrition Action Groups (SNAGs).Design/methodology/approach – The study adopted a mixed methods approach, drawing upon quantitative and qualitative data sources. The data sources included quantitative data on school level programme related activities, qualitative data collected through focus groups with children and reports from teachers and other staff involved in the delivery of the programme.Findings – The paper concludes that the pivotal role of SNAGs in catalysing and embracing a whole school approach must be seen as an important mechanism for any health promotion ...

The Advocacy for Pedestrian Safety Study: Cluster Randomised Trial Evaluating a Political Advocacy Approach to Reduce Pedestrian Injuries in Deprived Communities

Objective To determine whether advocacy targeted at local politicians leads to action to reduce the risk of pedestrian injury in deprived areas. Design Cluster randomised controlled trial. Setting 239 electoral wards in 57 local authorities in England and Wales. Participants 617 elected local politicians. Interventions Intervention group politicians were provided with tailored information packs, including maps of casualty sites, numbers injured and a synopsis of effective interventions. Main outcome measures 25–30 months post intervention, primary outcomes included: electoral ward level: percentage of road traffic calmed; proportion with new interventions; school level: percentage with 20 mph zones, Safe Routes to School, pedestrian training or road safety education; politician level: percentage lobbying for safety measures. Secondary outcomes included politicians’ interest and involvement in injury prevention, and facilitators and barriers to implementation. Results Primary outcomes did not significantly differ: % difference in traffic calming (0.07, 95%CI: −0.07 to 0.20); proportion of schools with 20 mph zones (RR 1.47, 95%CI: 0.93 to 2.32), Safe Routes to School (RR 1.34, 95%CI: 0.83 to 2.17), pedestrian training (RR 1.23, 95%CI: 0.95 to 1.61) or other safety education (RR 1.16, 95%CI: 0.97 to 1.39). Intervention group politicians reported greater interest in child injury prevention (RR 1.09, 95%CI 1.03 to 1.16), belief in potential to help prevent injuries (RR 1.36, 95%CI 1.16 to 1.61), particularly pedestrian safety (RR 1.55, 95%CI 1.19 to 2.03). 63% of intervention politicians reported supporting new pedestrian safety schemes. The majority found the advocacy information surprising, interesting, effectively presented, and could identify suitable local interventions. Conclusions This study demonstrates the feasibility of an innovative approach to translational public health by targeting local politicians in a randomised controlled trial. The intervention package was positively viewed and raised interest but changes in interventions were not statistically significance. Longer term supported advocacy may be needed. Trial Registration Current Controlled Trials ISRCTN91381117

Commissioning Drug Services for Vulnerable Young People

This paper examines commissioning processes for drug services in the case of vulnerable young people. In the context of governments modernization agenda it characterizes drug service commissioning as an activity that should occur across professional boundaries in health, social care, local authority and crime agencies. A case-study approach draws attention to a number of difficulties including the lack of evidence base on which to form policy and policy change and the over-riding attention of agencies upon process rather than outcome. It recommends a multi-agency approach to discharge joint commissioning more effectively and begin incremental change to services. Development of a knowledge base with monitoring and performance evaluation systems must become priorities to inform future commissioning and decommissioning of drug services for vulnerable young people.

Ethnicity, deprivation and road traffic injury risk: a survey of risk and road safety and implications for injury prevention

Abstract Objective: To gain an insight into the relationship between ethnicity and road safety among adults living in low socioeconomic areas. Design: Questionnaire based face-to-face interview survey among residents from low socioeconomic areas. Setting: The survey was conducted in five districts which represent the poorest 15% of districts in England and Wales which also have high road traffic collision rates. Subjects: Community residents aged 16 or over living in low socioeconomic areas Results: Black, Asian and Minority Ethnic (BAME) participants in low socioeconomic areas are significantly more likely to report being injured in a collision as a car occupant, have access to a car in their household and less likely to report that they “always” wear a seat belt in the back of a car compared to the majority population. The data suggest that particular groups, notably Asian British, report relatively high casualty rates, are more likely to have access to a car in there household and are least likely to report “always” wearing a seat belt. Conclusions: More needs to be done to understand the reasons that underpin these observed differences between ethnic groups. The data suggests that the dichotomy between majority and BAME groups obscures important differences in risk between BAME groups. A segmented approach is required to targeting interventions at those most at risk. In order to do this we need to understand more about the types of car occupant collisions involving BAME groups and more about the factors that influence their safety behaviour.

Whole school food programmes and the kitchen environment

Purpose – The purpose of this paper is to describe the impact of the Food For Life Partnership (FFLP) whole school food programme on kitchen staff employment and professional development.Design/methodology/approach – This exploratory research involved baseline and follow‐up interviews with 74 kitchen staff (51 primary and 23 secondary English schools) enrolled onto the FFLP programme. Empirical data were collected using a semi‐structured questionnaire between 2007‐2010 with an average of 20 months between baseline and follow‐up. Data were collected on the perceived programme impact on school cook professional experience and employment and their role in health promotion.Findings – Numbers of kitchen staff and mean job satisfaction grew. Kitchen staff reported significant investment in their kitchen environment. They felt a greater degree of involvement and broader integration with the rest of the schools educational mission. However, towards the end of their involvement, kitchen staff became increasingly ...