Dr Jenny Woodward

Background. This research aimed to explore how Friends Groups work with local authorities and other partners to ensure their local urban green spaces are a well maintained and utilised amenity for public health. Good quality green space, close to where people live, improves health and wellbeing yet, in deprived areas with worse health, there is less access to this health-promoting resource. Improving green space in these areas could help tackle health inequalities. Friends Groups, local people who act together to improve their local green space, are a growing phenomena. There is a lack of evidence however regarding how they develop and are sustained, especially in deprived areas, and whether relying on them contributes to or mitigates against inequality. Methods. This study utilised qualitative methodology, influenced by ethnography. Seven case studies, in disadvantaged neighbourhoods, participated: five established Friends Groups and two developing. Data collection included participant observation, interviews, focus groups, and ‘walk and talks’. Developing group data was collected longitudinally, over three years. Semi-structured interviews were conducted with local authority park staff. Analysis was initially by case to produce narrative accounts, and then cross-case to identify explanatory success factors. Results. A conceptual framework was developed that identifies four domains affecting the success, or otherwise, of Friends Groups: Place, People, Process and Power. Each domain identifies the most pertinent factors influencing group development and sustainability. Leaders play a key role. Commitment, perseverance and motivation are vital whilst being confident, capable, with authority and connections improves chances of success. Place also affected success. Groups operating in informal spaces found it harder to become established than those in traditional parks. Having formal structures, regular activities and in-built sociability helped groups succeed. The relationship between local authorities and Friends Groups was often challenging, with conflict and disagreement leading to frustration and stress. Different perceptions of participation and control contributed to tensions. Parks teams were often unaware of issues relating to inequality. Implications. This study raises concerns that, as the model currently operates, it could exacerbate green space inequalities. Deprived neighbourhoods are less likely to have leaders with the required qualities and connections for success, and parks teams show a preference for working with more capable groups, who are likely to be in more affluent areas. Recommendations centre on supporting Friends Groups in disadvantaged areas to strengthen capabilities and working with local authorities to encourage greater sharing of control.

This study was funded through a pump-priming grant from the Strategic Promotion of Ageing Research Capacity (SPARC) programme. The purpose of the project was to bring together transport and public health research in order to demonstrate how the involvement of older people can help improve tools for transport planning. The study was unique in that it brought together public health and transport planning and engineering with older people to consider how services can be more responsive to older people’s transport needs. The project had five research objectives: 1. To investigate how accessibility problems impact on older people’s independence 2. To determine the extent to which currently available data sources and modelling tools reflect older people’s stated accessibility needs 3. To understand how the gap between expected and perceived accessibility problems varies across different categories of older people 4. To pilot techniques that could be applied to provide a more robust measure of accessibility for older people. 5. To build new research capacity across disciplines to develop a national focus on the interactions between ageing and transport planning. The methods were determined on the basis of ‘appropriate tools with maximum output’. Focus group interviews were selected as a useful tool for reaching a large number of older people within a limited time span, for providing an arena for discussion and debate about a topical subject and for generating ideas for improving transport planning. Following the interviews accompanied walks were undertaken with older people in a range of road environments and traffic situations. The purpose of these walks was to observe and explore the way older people interact with their environment. Data from the focus group interviews and the observations were compared with the outputs from an accessibility planning tool used by local authorities to plan accessible and acceptable transport routes (Accession™). The purpose of this exercise was to investigate whether or not such tools are able to take into account the varying needs of older people. The study was undertaken over eight months. Eighty one older people living in the Leeds district took part in the focus groups. They covered a broad range of mobility levels and used a variety of transport types, as such a reasonably rounded perspective on the issues concerned was offered. In addition six walks were undertaken with older people in their community.

This article describes a series of small-scale investigations conducted with older people to understand the importance of independent transport to their daily lives and the key barriers that they face which constrain their travel patterns. The investigations used a blend of methods including literature review, focus groups, accompanied walks, geographical information system (GIS) mapping and interviews with older people and experts working in the field of transport planning. The findings were tested through a series of practitioner and user workshops. While other studies have also provided valuable evidence on the importance of transport to ell-being the article presents evidence as to important cultural aspects of the predominant approach to transport planning which lead to older people's needs not receiving the attention that they need or deserve. There is a lack of training of professionals in the specific needs of this group compounded by a lack of time devoted to understanding these. Efforts to automate the identification of problem areas using GIS mapping do not match well to the problems expressed by older people. This leads us to conclude that a more community-based, user-led approach is most likely to deliver the inclusive transport system that transport planners say they wish to develop and that older people would like to travel on. Copyright © Pier Professional Ltd.

Getting around would be difficult without roads, rail and pedestrian walkways. Despite what we take for granted, the older traveller is often left feeling frustrated by the current transport infrastructure. Based on their research, Dr Greg Marsden et al explore in this article why this is the case, they look at the barriers that prevent older people getting out and about and the considerations when planning transport for the older traveller.

This research aimed to find out how Voluntary and Community Organisations (VCOs) can help improve the mental health and wellbeing of Black women born outside of the UK. Factors that can help improve mental health and wellbeing and those that affect it negatively were explored. People were asked what barriers there were to accessing mental health services and what support VCOs can give. Key messages and recommendations are included in an executive summary.

The Chiles Webster Batson Commission asked questions about the relationship between disadvantaged neighbourhoods and recreational, informal sport of the type that young people warm to because it is designed to be fun. It aimed to shine a light on the importance of such sport for many low-income young people and show the positive role that neighbourhood organisations play in supporting low income areas to become happier, better networked, enriched, more active places to live. The Commission took as a starting point the interconnectivity between life in a low-income neighbourhood and low rates of participation in sport and physical activity. Limited access to sport and physical activity is a feature of growing up poor in 21st century Britain. 72% of the demographic cohort do not attain the CMO’s physical activity guidelines of one hour a day of enhanced physical activity. Only 16% are members of a sports club and just 14% visit leisure centres. This under-representation of low-income young people in the sports system is not best explained by reference to personal choice. Rather, there is a structural inadequacy in our sports system which results in the exclusion of low-income young people. Traditional sports provision, like a tennis or rugby club, is less accessible to low income families than to more affluent families for reasons of geography, and the tendency of such clubs to market themselves to people in their own image. It is the same with gym membership where the cost is frequently prohibitive. The problem of under-representation is made more chronic by young people’s tendency to prefer sociable sports to the solo sports and activities, like jogging or walking. Such sociable activities tend to require an organiser and often require kit, indoor space or marked-up outdoor space. In other words, sociable sports need organisation and resources which the sports system does not supply. The Commission recognised that missing out on an active lifestyle increases the deficits endured by children and young people living in disadvantaged neighbourhoods. It is likely that in comparison to the lives of their more affluent peers, young people growing up in low income areas connect with fewer positive role models; enjoy fewer opportunities to take a leadership and organising role and have fewer opportunities to exercise and develop their problem-solving skills. Appropriately organised sport offers these opportunities in abundance. Disadvantaged young people miss out on the positive properties of sport in the context of lives lived with higher rates of exposure to violence, poorer mental health, higher rates of food insecurity and a lack of safe spaces. It is ironic that those neighbourhoods most in need of the benefits of well organised sport, run by wise and relatable role-models, are those which struggle most to access it. To respect the importance of the neighbourhood organisations which do provide opportunities to take part in fun-sport, and reap the associated benefits, the Commission adopted an approach which amplified their voices and combined that with hard academic evidence. Such twin-tracking allowed Commissioners to comprehensively assess the strengths, challenges and opportunities for this specialised, and generally under-appreciated, corner of the sporting landscape. This approach also embraced Asset Based Community Development theory which privileges strategies that make the target community the actor in driving change and not the recipient of external, top-down impositions – no matter how benign. To hear of the ‘lived experience’ of the neighbourhood organisations enriched the Commissions understanding of what works and why. The Commission intended to visit about 10 neighbourhood organisations to see their work in-situ and talk with the leaders and the young participants. Covid restrictions all but prevented these visits. Zoom gatherings substituted for the planned programme in a ‘make-do’ spirit. Undoubtedly, this reduced the input of the organisations’ leaders and the young participants. However, there were advantages in the Commission operating during the pandemic. It did highlight the importance of the neighbourhood organisations to their community. Driven by commitment to their patch (and operating with their lean structures and decision making powers close to the ground) these organisations rapidly became important to pandemic relief interventions. The Commission saw at first hand their flexibility and importance to neighbourhood life on a scale that reached far beyond sport.

This briefing gives examples of health trainers and GPs working together, outlines the key benefits and sets out how to establish a good working relationship.

Following on from last year’s successful Warm Homes Healthy People Campaign, NHS Leeds (Public Health), Leeds City Council and partners in the voluntary sector decided to launch an expanded campaign in 2012 in order to support a more varied range of services over the winter period. The overall project amounted to £527,368 which comprised £171,000 set aside by NHS Leeds together with £199,067 of funding from the Department of Health’s Warm Homes Healthy People Fund which was jointly bid for by Leeds City Council, NHS Leeds and our voluntary sector partners, £130,393 from Leeds City Council’s bid to the DECC fuel poverty fund which was used to enable the Warm Homes Service to provide larger scale capital measures such as heating and boiler replacements and other funding from partners. As with the 2011-12 Warm Homes Healthy People Fund, projects were selected that addressed those needs that were known to arise and increase within the City during winter.

The Lincolnshire 2012 Joint Health and Well-being Strategy identified the need to ‘develop a Community Health Champion programme for Lincolnshire building on current good practice that will enable people to volunteer to offer help and support to other members of their community in leading healthier lives’. This was intended to be one of two interlinked schemes, designed to achieve the key outcome of supporting people to lead healthier lives.

This study was undertaken in response to a request by the Thomas Pocklington Trust to identify and explore the following issues: • The needs and concerns regarding immediate risks to health and safety related to sight loss; • Additional risks arising from sight loss for those who are also managing a long term disease; • The difficulties in maintaining and promoting health; • Whether or not health promotion activities and policies sufficiently address perceived needs. Findings pertaining to these objectives have been generated from data collected in Leeds, UK, a city where innovative programming for sight loss has either been planned or is being incorporated into health planning and a review of the literature. Findings related to the last two issues indicate that gaps exist in service provision for maintaining health and emphasise the need for more explicitly targeted health promotion initiatives that could address current weaknesses. - A review of the literature; - Focus group discussions with a range of people who had experienced sight loss; - Interviews with professional practitioners engaged in service provision to this population; - An expert hearing with four professional practitioners, one of whom had sight loss, and two service users with sight loss. Most participants were from the West Yorkshire region and the services described in the study are largely located in Leeds. Evidence from the literature review suggests that people with visual impairment have increased risk of accidents within the home and that ensuing consequences include injuries incurred and decreased confidence. Rates of depression among people who are blind or partially sighted are far higher than in the wider population and the likelihood of depression increases with age, although psycho-social interventions and technological assistance can be successfully implemented to improve quality of life. Sight loss together with other long term health conditions exacerbates the impact of other health conditions and has particularly severe impact on the wellbeing of older people insofar as it may affect their mobility, which in turn increases their risk of falls and depression. The nature and level of support available to people is variable but it is clear that access both to the right information at the right time and to appropriate services is a critical issue. Focus group discussions, interviews and the expert hearing corroborated and extended the themes noted in the literature and discuss the differential impact of different risks to health and the difficulties of coping with these at different times in a person’s life. A simple typology was defined using two dimensions of experience (‘stage of life’ and ‘early/late onset of sight loss’) as a means of organizing findings and providing a means of making further distinctions in interpreting the data. Potentially, this scheme can allow health promotion initiatives to be targeted more effectively to stages at which people with sight loss are more likely to encounter specific difficulties in managing and maintaining their health. There was a clear consensus throughout the study that interventions to meet the needs of people with sight loss must be tailored to meet the specific needs of individuals: people with sight loss are not a homogeneous group and the way in which each person experiences the challenges of sight loss and of managing their health will inevitably vary from person to person. Recommendations generated by this study include: • The scope for more pro-active services and need for closer collaboration between service providers; • The need for provision and promotion of targeted information; • The need for greater awareness of the needs of people with visual impairments among generic service providers; and • Further research that explores the usefulness of the typology with a larger sample more representative of population demographics such as BME communities that are more likely to slip through the cracks of service provision.

The literature review has been commissioned by NHS Health Scotland to review the health behaviour change models and approaches for families, children and young people to support the development and delivery of effective child healthy weight programmes. Despite the consistent recommendations from NICE and SIGN for the inclusion of behavioural components in child healthy weight programmes, there is little information on effectiveness of specific techniques and which to incorporate. The aim was therefore to provide information on which specific behavioural treatment components, behaviour change models and approaches should underpin clinical guidelines and childhood obesity treatment programmes. Secondly, in light of recommendations for programmes to be delivered by appropriately trained professionals, the review aimed to identify the skills and competencies required and resources and training available for effective delivery of the behavioural components. The outcomes of the literature review will be applied in enhancing the guidance for practitioners involved in the development and delivery of effective child healthy weight programmes; and thereby support achievement of the Scottish Government’s HEAT 3 target aimed at monitoring the attendance and completion of approved ’child healthy weight intervention programmes’. The report includes the background, aims, and objectives, sets out the scope of the review, presents a brief description of the methods and main findings. The methods and stakeholder views are then presented followed by a discussion of the implications for applying the evidence in practice and further research recommendations.

This briefing focuses on how health trainers engage with clients from deprived areas. It gives examples of the community engagement approaches Health Trainer Services (HTS) use and how they connect people to others, to activities and to services.

Free school meals aim to provide a “nutritional safety net” for the poorest UK children. Yet it is estimated that up to 30% of those entitled do not take up this entitlement. In Leeds approximately 6,000 children do not take the free school meals that they are entitled to. National and local targets are for 100% take up. Phase 2 of the Leeds Free School Meal Research Project aimed to develop, implement and evaluate a series of interventions to increase the uptake of free school meals. The interventions were tested in ten Leeds schools between December 2007 and October 2008. The research was undertaken by the Department of Nutrition & Dietetics within The Centre of Food Nutrition and Health at Leeds Metropolitan University on behalf of Education Leeds.

The winter of 2012/13 was longer and colder than usual; whilst temperatures were average in December, it was colder than usual from January through to May. March was the coldest it has been for 50 years (Met Office, 2013). This evaluation focuses on the organisations funded by the Winter Warmth campaign to deliver services to Leeds residents. The overriding aim of the evaluation was to inform the operation of possible future schemes, with good practices and any issues identified. The views of organisations on the need for the funds and how the campaign was organised were ascertained. How they delivered the services, reached clients and worked with other stakeholders is explored and their suggestions for improvements described. This report should be read alongside the overall campaign report, by Leeds City Council, and the beneficiary report.

The ‘Building Sustainability: Extended Support Package’ aimed to increase the capacity and sustainability of 94 local projects - all were Voluntary, Community and Social Enterprise (VCSE) organisations funded by the Health and Social Care Volunteering Fund (HSCVF). The bursary scheme, as it became known, was managed by Ecorys as the lead partner alongside Eastside Primetimers, CSV and Attend as the three delivery partners. Projects chose from a menu of over 50 offers including mentoring, coaching, on-site support, training and ‘other’. A Support Consultant, allocated to each project, helped them assess their needs, choose the most appropriate offers and submit the application. The scheme was introduced in 2012 with all offers utilised by May 2013. It was funded by the Department of Health. This report presents the findings from an evaluation undertaken by the Institute for Health & Wellbeing at Leeds Metropolitan University.

Members of the public are becoming increasingly important in the delivery of public health programmes. The work they do varies. They might give out information about a health issue or tell people about a local service. They might help someone who is going to a health improvement activity for the first time or organise a group that encourages healthy living. Some are paid, others are volunteers. The People in Public Health research study wanted to find out more about these lay health workers. It wanted to discover what type of things they do in public health programmes, how they are recruited, trained and supported and what is needed to make these approaches work well.

Purpose: The purpose of this paper is to design and implement interventions to increase free school meal (FSM) uptake in pilot schools. This paper describes the interventions, reports on acceptability (as perceived by school working parties) and explores the process of implementing change. Design/methodology/approach: The research consisted of two phases, an exploratory phase followed by an intervention phase. Findings from the latter are presented. Ten pilot schools (five primary and five secondary) in Leeds, England were recruited. Each established a working party, examined current claiming processes and implemented individualised action plans. This paper draws on the final action plans and interviews/focus groups with working parties. Findings: Interventions to improve FSM claiming process, minimise discrimination and maximise awareness were designed. The majority were implemented successfully, the exception being amending anti-bullying policies. Creative ways of delivering interventions were demonstrated. The process of change was effective, critical factors being having individualised action plans that allowed flexibility in implementation, reflecting on current claiming processes, and setting up working parties. Practical implications: Ways of working with schools to increase FSM uptake and more generally improve nutritional policies are suggested. Amending claiming systems in schools is recommended as is greater pupil and parent involvement in nutrition policies. Originality/value: An estimated 300,000 UK children do not take FSMs they are entitled to – with many schools unaware of the issue. This study worked with schools to discover how to address this issue and evaluated the perceived acceptability and feasibility of the approach.

Objectives England’s Health Trainer Service (HTS) aims to reduce inequalities by supporting people from disadvantaged areas to improve their health and wellbeing. As lay people, trained to offer personalised ‘support from next door,’ Health Trainers (HT) assist individuals in setting behaviour change goals and empowering them to improve their lifestyle. This presentation; • summarises evidence on the service’s effectiveness in terms of behaviour change and mental health and wellbeing improvements • identifies successful factors of various HTS models– including how HTs work within Primary Care and communities • explores pertinent issues in relation to how the service is changing in terms of its setting and its approach Methods A range of data gathered by the research team is drawn on; • a synthesis of eight HTS evaluations • a review of outcome data - from 97,248 clients and 1377 HTs • case studies and interviews collected whilst hosting the Yorkshire & Humber Regional HT Hub Results HTs are able to reach people living with disadvantage - 43% of clients come from highly deprived areas. They are successful at enabling clients to make changes - more than 59% develop a personal health plan and 49% of those fully achieve their goals. Self-efficacy, General Health and WHO-5 wellbeing scores also improve. Evaluations reveal that HTs ‘person centred and peer led’ approach, their ability to connect with people and their status as non-clinicians is important. HTS are becoming more closely integrated within Primary Care and an increased emphasis on meeting targets is evident - current debates include how this could impact on reach and affect the service’s holistic ethos. Conclusion The HTS’s holistic, person-centred approach is effective at reaching deprived communities, empowering behaviour change and improving wellbeing. Maintaining this approach within a more target driven culture is challenging but examples of HTS achieving this balance can be identified.

A summary of the evaluation of Wise Up To Cancer. A Community Health Initiative funded by Yorkshire Cancer Research, aiming to improve cancer outcomes.

Gypsies and Traveller community members belong to a community that has been described as the most excluded in the UK. Furthermore, the health status of this community is considerably poorer than other English speaking ethnic minority groups. Gypsy and Traveller communities in Britain experience wide-ranging inequalities, notably in relation to health. In recognition of this, one CCG within West Yorkshire has employed a specialist outreach nurse to work with the local Traveller and Gypsy community, with a remit to improve the health of this population, initially over a one-year period, subsequently extended to two years. This work is being evaluated by Leeds Beckett University, who will present the early qualitative findings from this on-going evaluation. So far the data shows that the community members face numerous barriers to accessing services, report complex health needs and will work with the outreach nurse, whose role is perceived as acceptable. Her work is also resulting in self-reported health improvements. A key lesson from the implementation of this model of care thus far is the importance of trust in successfully implementing such an intervention.

Background Good quality green space, close to where people live, improves health and wellbeing. In deprived areas, where health is worse, there is less access to this health-promoting resource. Improving green space in these areas could help tackle health inequalities. Friends Groups consist of volunteers who act together to improve their local green space. Approximately 6000 such groups exist in the UK. This study aimed to explore how Friends Groups in deprived areas operate and whether relying on them to maintain green spaces, contributes to or mitigates against inequality. Methods This study utilised qualitative methodology, influenced by ethnography. Seven case-studies in disadvantaged neighbourhoods in England participated: five ‘established’ Friends Groups and two ‘developing’. Data collection took place over three years and included participant observation, interviews, focus groups and ‘walk and talks’. Semi-structured interviews were conducted with local authority park staff. Interviews / discussions were audio-recorded and transcribed verbatim, reflective field-notes were kept throughout. Data analysis was initially by case to produce narrative accounts and then cross-case to identify explanatory success factors. Results Successful Friends Groups were able to transform neglected, under-used green spaces into thriving community places, much used and appreciated by local people. A conceptual framework was developed that identified four domains affecting the success of groups: Place, People, Process and Power. Group leaders played a key role. Commitment, perseverance and motivation were vital, whilst being confident, capable, with authority and connections improved chances of success. The relationship between local authorities and Friends Groups was often challenging, with conflict and disagreement leading to frustration and stress. Different perceptions of participation and control contributed to tensions. Park teams were often unaware of issues relating to inequality. Conclusions The findings raise concerns that, as the model currently operates, it could exacerbate green space inequalities. Some of the identified success domains pattern with deprivation. Deprived neighbourhoods, for example, are less likely to have leaders with the required qualities, capacity and connections for success, and park teams show a preference to working with more capable groups, who are likely to be in more affluent areas. Recommendations include supporting Friend Groups in disadvantaged areas to strengthen their capabilities and capacity, and working with local authorities to encourage greater sharing of control with these potentially transformative community-based groups.

Introduction: Despite clinical guidance recommending the inclusion of behavioural components in child weight management programmes, there is little evidence on the effectiveness of specific techniques and strategies. Methods: A literature review was undertaken using a series of stages based on systematic review methodology and included evidence from studies undertaken in all settings, involving children 5–18 years, parents and family. Primary outcomes of studies included weight/bmirelated measures and diet, physical activity and psychological wellbeing as secondary outcomes. The evidence summarises the results from 74 papers consisting of 12 reviews, 7 qualitative studies and 55 interventions. Results: The application of behavioural components was hindered due to a lack of standardisation in the definition of behavioural therapy (self-monitoring, stimulus control, goal-setting, use of rewards and problem-solving) and cognitive behavioural therapy (addressing faulty cognitive restructuring, self-instructional training techniques) within programmes. Behavioural components were often poorly described and not evaluated. For interventions aimed at children under 12 years it is more effective to teach behavioural techniques such as monitoring of diet and physical activity, identification of problem behaviours, goal-setting, use of praise, contracting and rewards, role modelling, positive social reinforcement and coping strategies to parents. Adolescents benefited from coping skills training and structured programmes including parental behavioural components such as coping strategies, role modelling, stimulus control and use of rewards. Conclusion: Behavioural Therapy techniques are commonly used as a ‘package’ in effective programmes however specific techniques are poorly evaluated. Few studies utilise CBT and the lack of description and evaluation prevents conclusions on effectiveness to be drawn. Conflict of interest: None. Funding: The review was funded by NHS Health Scotland.

AIMS: The role that members of the public (non-professional lay people) can play in improving health is being increasingly recognised in research and policy. This paper explores what contribution lay people employed as health trainers are making to addressing health inequalities in England. METHODS: Data from eight local evaluations of health trainer services were synthesised using a data-extraction framework to find out about client populations, any lifestyle changes made, health trainers' background and community engagement activities. These data were compared with national data to assess how findings relating to addressing inequalities compared with the national picture. RESULTS: Local data largely matched national data and showed that health trainers are reaching people living with disadvantage and enabling them to make lifestyle changes. The data suggest that they do this by engaging with communities and taking a person-centred approach. Being non-clinical peers is also important. However, no evidence was found that health trainers were impacting on health inequalities at a population level. CONCLUSION:Health trainers are contributing to addressing health inequalities but the services evaluated were small and had been operating for a limited time, so to expect reductions in inequalities at a population level within districts would be unrealistic. The findings of this synthesis present a challenge to primary care and public health to employ health trainers in order to engage marginalised communities as one element of plans to address health inequalities.

OBJECTIVE: The present study sought to explore the factors that influence registration for free school meals and the subsequent take-up following registration in England. DESIGN: The research design consisted of two phases, a qualitative research phase followed by an intervention phase. Findings are presented from the qualitative research phase, which comprised interviews with head teachers, school administrators, parents and focus groups with pupils. SETTING: The study took place in four primary schools and four secondary schools in Leeds, UK. SUBJECTS: Participants included head teachers, school administrators, parents and pupils. RESULTS: Findings suggested that parents felt the registration process to be relatively straightforward although many secondary schools were not proactive in promoting free school meals. Quality and choice of food were regarded by both pupils and parents as significant in determining school meal choices, with stigma being less of an issue than originally anticipated. CONCLUSIONS: Schools should develop proactive approaches to promoting free school meals and attention should be given not only to the quality and availability of food, but also to the social, cultural and environmental aspects of dining. Processes to maintain pupils' anonymity should be considered to allay parents' fear of stigma.

Hive, a Shipley based charity, run a variety of creative courses. Three of their programmes - Thrive, Flourish and Make@Hive – are run for people with low to moderate mental health problems by project workers and volunteers, with the aim of improving wellbeing. The Centre for Health Promotion Research (CHPR) at Leeds Beckett University (LBU) were asked to evaluate the impact of these programmes on service users.

Introduction The rise of Type 2 Diabetes is a major public health issue. Bradford, a city with high rates of deprivation and a large South Asian community (both factors being associated with a higher risk of developing diabetes), has piloted a programme that aims to tackle this issue. This paper reports on an evaluation of this Intensive Lifestyle Change Programme (ILCP). Targeted at high-risk individuals, the year-long, group-based ILCP is facilitated by health champions, from local communities. Beneficiaries receive advice on lifestyle changes, information and support and are encouraged to set behaviour change goals. 587 people have started the ILCP since it started in 2014. Methods The evaluation comprised of; pre and post clinical tests and questionnaires to measure changes in behaviour and health and wellbeing plus focus groups to ascertain participants’ views of the ILCP. The Results 57 people completed pre and post data. Statistically significant decreases in blood sugar levels were found plus statistically significant increases in; knowledge about diabetes, moderate physical activity, fruit and vegetable consumption and self-rated health. The programme was very positively appraised in eight focus groups. Key success factors include; the referral process, non-clinical people facilitating, group support, language diversity and culturally appropriate advice. Conclusion This evaluation demonstrates the effectiveness of a programme to prevent Type 2 diabetes in a disadvantaged community and its acceptability to beneficiaries. Learnings can be utilised elsewhere provided programmes are adapted to suit communities’ specific needs.

This document reports the findings of 'Wise Up To Cancer' a Community Health Initiative, funded by Yorkshire Cancer Research. The aims of Wise Up To Cancer were to; decrease behaviours associated with cancer risk, increase awareness of cancer signs and symptoms,, increase cancer screening rates and increase signposting to other services.

Aims: First proposed in the 2004 White Paper Choosing Health, health trainers are a new addition to the public health workforce. Health trainers are recruited from local communities and provide support to enable individuals to adopt healthy lifestyles. The aim of this paper is to examine the emerging role of the health trainer in the context of one of the twelve early adopter programmes. The paper describes the support and signposting model developed in Bradford.

Methods: An evaluation of the pilot scheme was undertaken using both quantitative and qualitative methods. The paper draws on two pieces of qualitative data from the evaluation. Two focus groups were held with 15 health trainers in their first months of practice. Telephone interviews were held with a sample of 16 key informants from community based placement organizations. Thematic analysis of the data was undertaken.

Results: The new health trainers were very clear about their role in listening and giving support. Clients presented with a diverse range of needs and often had complex problems. The health trainers perceived that a client-centred approach was of value but there were some issues about the boundaries of appropriate advice. Outreach and networking were considered important skills. In the telephone interviews, interviewees understood the health trainer role and identified potential benefits for service users. The significance of health trainers having local knowledge was highlighted, although some organizations were able to assist with networking. The health trainer programme was seen as an additional and distinct resource complementing existing provision.

Conclusion: The new role of health trainer is a significant development for the public health workforce. Health trainers can offer something quite distinctive and separate from professional advice, and there is potential to help individuals to access support and services in local communities. More research is needed on the relative value of different models of health trainer.

This study contributes to ongoing reflections and debate on the legacy of the Ottawa Charter by illustrating how contemporary forms of intersectoral collaboration can be mobilised to address persistent health inequalities. Collaborations involving organisations from diverse sectors are often viewed as well-positioned to tackle complex health challenges, yet they frequently encounter political, organisational and cultural barriers that hinder their effectiveness. This paper uses a longitudinal approach to explore issues in relation to the formation and sustainability of a multi-sector collaboration in one geographic area in the UK, working under the banner of the Health Determinants Research Collaboration (HDRC) – a programme which seeks to further understand health determinants and to improve health outcomes in communities. Through qualitative interviews at two time points – 12 months apart – with constituents of the collaboration, the data demonstrated a clear and shared vision for the collaboration and a neat ‘dovetailing’ of skill-sets related to community brokerage; academic rigour; and statutory legitimacy. While the collaboration under focus here was in its infancy, cultural and practical tensions in ways of working; trust issues; pace of working; and philosophy were predicted to, and indeed did, emerge and required careful monitoring to ensure intended outcomes were not derailed.

Purpose: This paper assesses the effectiveness of a toothbrushing intervention delivered in primary schools in Yorkshire and the Humber, a Northern district of England. The toothbrushing intervention was designed with the intention of improving the oral health of young children. The paper reports the effectiveness of the intervention and explores process issues related to its co-ordination and delivery. Design/methodology/approach: The evaluation had three data gathering approaches. These were: in-depth case studies of three selected schools participating in the toothbrushing programme; interviews with oral health programme leads; and a small scale questionnaire based survey which was sent to the 18 schools participating in the intervention. Findings: The intervention was accepted by children and they enjoyed participating in the toothbrushing scheme. Moreover, children had often become more knowledgeable about toothbrusing and the consequences of not regularly cleaning their teeth. The scheme was contingent on key staff in the school and the programme was more successful where school’s embraced, rather than rejected the notion of improving children’s health alongside educational attainment. Whether the intervention made differences to brushing in the home requires further investigation, but there is a possibility that children can act as positive ‘change agents’ with siblings and other family members. Practical implications: This paper suggests that schools can be an effective setting for implementing toothbrushing interventions. Originality/value: Toothbrushing in schools programmes are a relatively new initiative that have not been fully explored, especially using qualitative approaches or focussing on the views of children. This paper makes a particular contribution to understanding the process and delivery of toothbrushing interventions delivered in primary schools. The implications for programmes outside of the UK context are discussed.

The work was done to support the Yorkshire Dales National Park (YDNP) Authority’s Access & Engagement team in developing and refining their Theory of Change (ToC) and to produce an evaluation framework. This should enable the Authority to better understand and articulate the impact of their work and assist with the planning of their future delivery.

This paper responds to challenges around how to generate robust evidence in keeping with the principles of an asset-based approach based on mobilization of community strengths. The design of a collaborative evaluation of a multi-site Asset Based Community Development program is described and emergent learning discussed. A qualitative mixed method design was used to capture changes at community and program level drawing on diverse sources of evidence. Shared principles on the conduct of the evaluation were developed with program leads and community practitioners and opportunities for shared learning were built in. The paper distils learning on evaluation into six design features including the asset-based model as a framework, understandings of evidence and outcomes, ethical conduct, and the centrality of a collaborative and developmental approach. The paper concludes that these features form a coherent approach to asset-based evaluation which can link the theory and practice of Asset Based Community Development.

The RNIB Eye Health Champion project, funded by the Department for Health’s Health & Social Care Volunteering Fund (HSCVF), aimed to reduce the rates of sight loss caused by diabetic eye disease. The Centre for Health Promotion Research (CHPR) at Leeds Beckett University (LBU) was commissioned to evaluate the project, starting in January 2015. This is the final report, covering the context of the project, the intervention, the evaluation methodology and findings reported thematically. The project ended in November 2017.

An evaluation of the Outreach activity conducted by YDNPA in Inner East Leeds.

A mixed methods evaluation of a Leeds youth organisation. Methods included; qualitative interviews, a survey of young people attending plus an SROI.

A summary of the evidence on neighbourhood-based Asset Based Community Development (ABCD). It includes information from scientific journals and evaluation reports. The evidence review was done for Leeds City Council as part of Leeds Beckett University’s evaluation of the ABCD programme in the city.

A summary presenting findings from Leeds Beckett University’s evaluation of an Asset Based Community Development programme in Leeds.

This report presents findings from the Leeds Asset Based Community Development (ABCD) programme evaluation. ABCD is a neighbourhood-based community building approach that uses community organising methods to identify, mobilise and strengthen the capacities or asset of individuals, families and communities (Kretzmann and McKnight, 1993). At the time of the evaluation. 12 ABCD pathfinder sites operated in Leeds neighbourhoods, the majority established in 2019. The model consists of: • Community Builders - paid workers hosted by Neighbourhood Organisations • Community Connectors - individuals living locally who may organise and support local activities • ‘Small Sparks’ grants - funds for groups and individuals to support local activity. Using mainly qualitative and participatory methods, this collaborative evaluation involved working with Leeds City Council and the Community Builders to gather evidence of what works and how. The findings show that the pioneering Leeds ABCD pathfinder model is still relatively new in its development and shifting to citizen-led activity takes time. Nonetheless the evaluation presents strong evidence on how ABCD works and the mechanisms of change thus demonstrating how a city-wide approach can be implemented. There is strong evidence for better social connections and the pathway to community change. Promising evidence for increased friendships, the social value of the pathfinder model, change in communities and other additional outcomes also exists. A series of recommendations and issues for consideration are presented to inform programme development.

Background A community empowerment programme in the UK aims to enable people to have greater collective control over area-based decision making, improved health and wellbeing and reduce health inequalities, by providing small grants to support residents of deprived neighbourhoods and communities of interest to come together to take action on issues of importance to them. Methods A survey was conducted at 4 6-month intervals as part of a mixed methods evaluation, to collect data about participant demographics, level of involvement, opinions of the project, and impacts. The survey was self-completed online or on paper, and distributed by local project leads. Outcome questions were adapted from the UK Government Community Life Survey to facilitate comparison with national statistics. Data were analysed using SPSS to produce descriptive statistics, supported by inferential statistical tests where appropriate. Regression analysis using multi-level modelling was used to estimate the conditional correlation between health outcome and Local People project participation. Results 1053 people from 29 local areas responded to the survey over the 4 time points; only 93 responded more than once. 43% took part in project activities, 36% were local project committee members and 19% were volunteers. The analysis found positive impacts on confidence, control, friendships, skills, happiness, life satisfaction, feelings of worth (p < 0.05), and that greater length and degree of involvement in the projects were associated with greater positive impacts on all of these outcomes. Conclusions The survey provides tentative evidence that participation in a community empowerment initiative may result in improved wellbeing, feelings of power and control, sense of belonging and trust. People who are involved for longer or more deeply involved are more likely to see these impacts. More community-based survey research is needed to gather people's views on neighbourhood initiatives. Key messages An evaluation of a community empowerment programme found positive impacts on control, wellbeing, belonging and trust. Greater length or degree of involvement were associated with greater impact.

This summary focuses on information from the Leeds Beckett ABCD evaluation about the effect of Covid-19 on the Leeds ABCD programme and how ABCD sites responded to the crisis.

This report reviews recent research on Asset Based Community Development (ABCD). ABCD is part of a broader group of asset-based approaches which have been applied in different types of community and settings. This report focuses on evidence about neighbourhood-based ABCD practice, which is the approach being taken in Leeds. Recent research studies are reviewed, building on previous reviews on asset-based approaches. The report summarises the evidence on key topics around ABCD theory, how the approaches work, implementation, evaluation and outcomes.

Background Despite growing interest in understanding complex systems and public health interventions, research methodologies that take account of system-wide action are relatively underdeveloped. Community-based participatory research (CBPR) is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of CBPR in complex public health intervention evaluations. The ‘Local People’ and ‘Local Conversations’ programmes use a community empowerment approach in 50 communities across the UK experiencing social disadvantage to increase social connections and collective control, improve health and wellbeing, and reduce inequalities (linked to SDG 3 and 11). Methods Evaluation of the programmes followed a mixed-methods design, including qualitative case studies, longitudinal survey, process appraisal, and CBPR. Residents from 10 communities across the programmes each undertook 2 rounds of CBPR. These projects resulted in written reports, which were analysed thematically alongside other data sources. Results There was some variation in the scope and design of the 20 completed CBPR projects. Whilst projects did not generally extend beyond the scope of the overall evaluation, peer research provided information from residents that were inaccessible to other data collection streams. Gathering community (lay) knowledge improved understanding of local priorities and actions within the programmes. However, the utility of CBPR was less consistent for community-researchers and local communities, often failing to support project development. Some community-researchers felt unprepared for the activity despite support from the academic team. Conclusions Conducted appropriately, CBPR can elicit data that would be less accessible through externally led research. This study highlights the value of CBPR in complex programme evaluations, enabling a deeper understanding of social context in which interventions occur.

Background Peer-research is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of peer-research in two complex public health intervention evaluations in the UK. Methods Reports from 18 peer research projects, completed by residents from 12 communities in the UK taking part in two community empowerment interventions, were analysed using cross-case analysis. Results Undertaking peer research helped to build the evaluation and research skills within individual projects as well as providing data on other outcomes related to the programmes Theory of Change. Some peer researchers, however, felt unprepared for the activity despite support from the academic team and were unsatisfied with project outcomes. While peer research projects provided more opportunities for local residents to engage with the overall evaluations, there was an overreliance on people closely connected to the programmes to be peer researchers. The peer research projects explored topics that were broader than the aims and objectives of the overall programme evaluations. All provided insight into the context in which projects occurred, while some also informed understanding of programme change mechanisms. Conclusions Including peer research as part of complex public health intervention evaluations can help uncover important contextual and ecological details beyond the reach of more traditional evaluation data collection. Peer research can also empower and build research/evaluation capacity within communities, which is particularly pertinent for community empowerment interventions.

Background The ‘Local People’ programme operates in 29 UK communities experiencing disadvantage and economic stressors that impact on population wellbeing. The programme uses a community empowerment approach to increase social connections, and collective control, improve health, and reduce inequalities. This links to SDGs 3 and 11. Mechanisms include a decision-making group led by residents, a project lead, funding, and support from a national charity. Methods A mixed method evaluation was conducted (2017-19) to identify processes and assess outcomes and impacts. This presentation outlines the findings from five in-depth qualitative case studies (c140 interviews) with emphasis on one post-industrial UK town suffering from the effects of industrial decline. A within case and cross case qualitative analysis was undertaken using a thematic framework. Results Priorities set by local areas focused on increasing community involvement and connections between people. A wide range of activities took place including regular classes and community events. The five case studies found strong qualitative evidence of increased social connectedness, community spirit and a sense of purpose, along with the area becoming a better place to live. People involved in project delivery gained confidence and skills, improved their wellbeing and gained a sense of control. There is, as yet, limited evidence that increased involvement has influenced the wider determinants of health. In the post-industrial town, people’s social networks expanded, enriching their lives and providing missed companionship. Participants in the programme reported improved mental and physical health, as well as increased confidence and skills. Involvement gave a voice to marginalised older people in the area. Conclusion Empowering communities and putting residents in control can lead to improvements in connectedness and some aspects of health and wellbeing, even in post-industrial towns facing considerable and complex challenges.

Community empowerment interventions, which aim to build greater individual and community control over health, are shaped by the community systems in which they are implemented. Drawing on complex systems thinking in public health research, this paper discusses the evaluation approach used for a UK community empowerment programme focused on disadvantaged neighbourhoods. It explores design choices and the tension between the overall enquiry questions, which were based on a programme theory of change, and the varied dynamic socio-cultural contexts in intervention communities. The paper concludes that the complexity of community systems needs to be accounted for through in-depth case studies that incorporate community perspectives.

Issues presented by COVID-19 to community resilience are located at individual, community and system level. In this paper, we reflect on WHO Europe propositions on what makes resilient communities, and explore how communities and systems with varying capacity have responded to the pandemic by absorbing and adapting to challenges. In our research we are seeing local responses at all three levels, which challenge current assumptions about the respective roles of citizen, local voluntary sector and state. This paper presents opportunities and challenges to translating this reactive social movement into proactive resilience-transforming change in how local systems work in the future.

This summary presents the results of a trial study to estimate the social value for one site taking part in Leeds City Council’s Asset Based Community Development programme.