Leeds Beckett University is leading a major national programme commissioned by Public Health England (PHE) and supported by the Local Government Association and the Association of Directors of Public Health on how adopting a whole systems approach can help local authorities make a step change in tackling obesity.
This conference aimed to share emerging outputs from the Programme as whole systems working continues to emerge globally as a more constructive approach to combatting complex, multi-dimensional challenges.
With local authorities’ responsibilities in health, planning, highways, transport, education, culture, housing, employment, social care and their relationships with businesses of all sizes, they are in a uniquely influential position to bring about transformational change in the way that obesity is tackled. As part of the programme, we are working with local authorities and a wider Community of Learning in UK and internationally to understand how a whole systems approach can make a difference. We introduced the draft route map and materials that we are co-producing with local authorities and shared the lessons to date on how systems working can be a game-changer.
The conference also ran a series of workshops on some of the major issues identified by LAs and stakeholders, to share suggestions and practical tools on how to address these issues. A short summary of each workshop and links to the materials presented are detailed below.
A full conference report, including details of the plenary sessions, can be found here.
Outline of the Day
|Welcome from the Chair
Jim McManus ADsPH and Chair of the Programme Advisory Group – Slides available here
Context: why PHE has launched this Programme
Alison Tedstone, National Lead Diet and Obesity, Public Health England – Slides available here
Whole Systems Approach and Systems Thinking: Direction, Challenges and Progress so far
Jim McManus, ADPH and Chair of Advisory Group – Slides available here
Systems Leadership and Tackling Obesity
Ian Fytche, CEO North Kesteven District Council – Slides available here
Update on route map: key findings, how we have used them to inform the work to date; key elements of the route map
Paul Gately, Leeds Beckett University – Slides available here
Panel Q&A Session
Positive Organisations – interactive demonstration
Jim McKenna, Leeds Beckett University – Slides available here
- Decision-making in a whole systems approach
- Talking about obesity
- The Food Environment
- Health and Planning
- Using community assets
- Data and Information
Closing session – feedback and next steps
Jim McManus, ADsPH and Chair of the Programme Advisory Group – More information on next steps can be found here
Chair: Jim McManus, Hertfordshire County Council
Carol Weir, Leeds Beckett University & MoreLife
Joanna Saunders, Leeds Beckett University
Duncan Radley, Leeds Beckett University
Run by the Leeds Beckett Whole Systems team, this workshop introduced one of the key elements of the draft route map – a process for supporting LAs and their stakeholders in assessing current actions and those under consideration. Colleagues had told us that support in working through these often complex issues would be helpful – we summarised our current thinking, explained the source of the material and shared this element of the draft process and sought colleagues’ feedback on how well this met their needs.
Colleagues found the structured approach helpful – we will be setting up a series of events to share the route map in more detail and seek further comments.
Workshop slides can be found here
Chair: Carlton Cooke, Leeds Trinity University
Sarah Le Brocq, HOOP
Stuart Flint and Ralph Tench, Leeds Beckett University
How we think about obesity – its causes and impact – can influence our decisions and partnership working, as well as affect how well we can engage with the general public and those most at risk. This workshop considered how different groups talk about and understand the term obesity, and we can raise the issues and frame the debate more constructively. The session heard three different perspectives about how organisations, communities and the public talk about obesity and what it means in practice including:
- Evidence for weight stigma including anti-fat attitudes and beliefs
- Examples from different settings and their impacts including home, schools, healthcare and workplaces
- Discussion about why stigma exists and how we form our views
- How the media portray obesity and its implications
- Findings of an obesity campaign in Sheffield
The workshop discussed a range of issues about recognising and intervening with weight stigma, and delegates were invited to complete the Beliefs About Obese Persons Scale, which self-assesses the extent to which each of us considers obesity is controllable.
Delegates welcomed the opportunity to hear about different perspectives and the research, and to understand and discuss the nature and significance of stigma. Leeds Beckett will be using the feedback to inform the supporting materials for the Route Map.
Workshop slides can be found here
BAOP test can be found here
Chair: Alison Tedstone (morning) and Pinki Sahota (afternoon)
Amanda Donnelly, Soil Association Food for Life
Jenny Morris, Chartered Institute of Environmental Health
Sue Bagwell, London Metropolitan University
Patricia Mucavele. Children’s Food Trust
Amanda Donnelly explained that Food for Life was a Soil Association initiative, which began life in 2003 and developed into an award-winning national programme to transform school food culture thanks to funding from the Big Lottery Fund. Independent evaluations show the impacts the programme is achieving. It works with public and private sector leaders to make good food the easy choice for everyone, whoever and wherever they are. It aims to change both the food environment and food culture within which people make choices. The team works with caterers to put good food on the menu in all the places where people live out their daily lives. We engage communities to get people of all ages cooking and growing food again and out onto local farms so they have a positive connection with real food. We work with nurseries, schools, universities, workplaces, hospitals, care homes and visitor attractions. We work in the high street, with local authorities, NHS Trusts and with entire cities. The team also shines a spotlight on poor quality food – especially food that is targeted at children or vulnerable groups. A report on the “Out to lunch” campaign that aims to work with providers to improve food on offer outside the home has just been published, including a league table.
Jenny Morris, Sue Bagwell and Patricia Mucavele shared findings from their work with local authorities looking at what works well, and how LAs can make an impact. Much of their work was currently focusing on interventions with small local food businesses frequented by children and families, and was designed to help local authorities and their partners:
- Understand the links between the food and drink environment and consumption patterns
- Identify where interventions are required
- Develop a strategy
- Select suitable interventions
They illustrated their talk with examples of how LAs were using:
- The planning system, leases and licences
- Healthier catering schemes
- Initiatives aimed to make behaviour change Easy, Attractive, Social and Timely (EAST)
- Working with schools, local communities and suppliers
Delegates contributed to the development of a checklist to assess the Community Nutrition Environment (at premises level). More information about this work can be obtained from firstname.lastname@example.org. This toolkit and checklist are nearing completion and are due to be published early in the New Year.
Workshop slides can be found here
For more information please see:
Food for Life slides can be found here
About Food for Life: http://www.foodforlife.org.uk/
Food for Life evaluation: http://www.foodforlife.org.uk/about-us/our-impact/evaluation-reports
Sustainable Food Cities: http://sustainablefoodcities.org
‘Out to lunch’ campaign: transforming children’s food in high street restaurant chains – see the league table here
Chair: Andrew Marran, Leeds Beckett University
Tim Townshend, Newcastle University
Carl Petrokofsky, Public Health England
Tim Townshend explained some of the connections between health and planning and discussed some of the issues raised, He gave a brief overview of the impact of the built environment in supporting or inhibiting healthy lifestyle choices and discussed some of the ways in which planning might intervene. He highlighted some of the evidence about the impacts of green and blue environments – although the evidence base was far from perfect, he stressed that we do know much about some of the key pieces of the jigsaw (such as density) – and have good pointers about others (such as green space). He acknowledged that there is inertia in the built environment and currently there is little incentive for developers to do things differently, and it might be argued that post-2008 some developers seem to have retreated from more progressive design. However, planning policy can be developed to intervene (and has been around fast food proliferation). Whilst it is a huge challenge – there are many strong reasons why public health and planning should work together.
Tim and Carl then ran an interactive session on “planning dilemmas”. Each table opened a pack with a scenario and discussed it from different perspectives, with a view to trying to reach a consensus on whether a proposed development should or should not go ahead.
Workshop attendees were interested in the evidence base and examples. The team are considering how to reflect the importance of engaging with Planning, and case studies and opportunities to promote that engagement.
Workshop slides can be found here
Chair: Jamie Blackshaw, Public Health England
Jane South, Leeds Beckett University & Public Health England
Judy White, Leeds Beckett University
This workshop looked at applying asset-based approaches to support a whole system approach to health improvement and tackling obesity. This reflects an increasing interest in health assets and the factors that create and support positive health, in contrast to traditional approaches that focus solely on population needs. Using an Appreciative Inquiry structure, the workshop explored what the principles of asset-based and community-centred approaches are, how to map local assets and how to think differently about using those assets effectively. The workshop covered some practical methods to build capacity and support people to address health issues, including learning from health trainer programmes and similar approaches involving peer support.
Workshop participants were encouraged to discuss whether and how they can adapt asset-based approaches as part of obesity prevention in their areas. In any community, there are many different types of assets including local knowledge, skills, volunteers, social networks and community organisations. A key message was that making a list of assets is only a starting point; asset-based working has a strong relational element – strengthening social ties and empowering people.
Participants explored the potential for asset-based approaches in local practice and were keen to hear about practical examples where these had been applied to obesity prevention. The slides and accompanying handout contain a list of resources and frameworks for further information. The team will be exploring how the Whole Systems Programme can benefit further from learning and models of assessing and engaging community assets.
Workshop slides can be found here
Workshop handouts can be found here
Chair: Michelle Morris, University of Leeds
Claire Griffiths, Leeds Beckett University
Shireen Mathrani, Public Health England
Pablo Monsivais, University of Cambridge
Tom Burgoine, University of Cambridge
LAs hold or have access to a wide range of information, but it can be overwhelming to understand what information there is and how it can then be applied in practice to help Councils make better decisions.
Claire Griffiths from Leeds Beckett led a discussion about the types of information available and the value of Big Data, with colleagues giving illustrations of how it can be used through demonstrations of two new very practical tools:
Shireen Mathrani, PHE Obesity Risk Factors Intelligence, presented the new Fast food outlets by local authority: map and data. This is available on www.noo.org.uk. The map shows the density of fast food outlets by local authority along with a chart displaying the relationship between fast food outlet density and area deprivation. It is accompanied by fast food outlet data by local authority and ward across the country.
Pablo Monsivais and Tom Burgoine (Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge) introduced the Food Environment Assessment Tool (FEAT). FEAT is a comprehensive online resource for mapping and measuring English regional and neighbourhood food outlet access, including changes over time, facilitating the translation of research data into LA policy action. For questions about FEAT, which will be available summer 2017 (http://www.feat-tool.org.uk), please email the FEAT development team (email@example.com).
As part of the Whole Systems Programme, the team are working with LAs to identify what information LAs hold that could be relevant to strengthening their approaches to tackling obesity, particularly in the “pre-systems” phase, and tools will be included in the toolkit.
Claire Griffiths’ workshop slides can be found here