The power of persuasion

… is not enough, according to The House of Lords Science and Technology Committee, which has published a report on its year-long investigation into behaviour change. The report focuses on two case studies of nudging: reducing CO2 emissions and obesity. In the context of the latter, the health trainers programme (because it aims to address inequalities) comes in for commendation, whilst the Public Health Responsibility Deal receives the opposite.

Back to school

As the new round of the National Child Measurement Programme (NCMP) starts up, DH publishes results of a review by the Thomas Coram Research Unit of the show so far. The review looks principally at delivery of the programme, although does also challenge the perception that most parents view the programme negatively. Areas for concern as regards local delivery included feedback letters, as well as lack of capacity in weight management services for effective referral. The report highlights the importance of effective engagement with schools, especially through the involvement of a Healthy Schools Co-ordinator, along with sharing results with schools. In the interests of spreading the word more effectively, the National Obesity Observatory has produced a set of slides explaining the NCMP and key data on child obesity. The latest survey on take up of school meals has been published by The School Food Trust and the Local Authority Caterers’ Association.

Planning for health

Some useful guidance on incorporating health issues into spatial planning from the Spatial Planning and Health Group and also The Town and Country Planning Association (the latter looks particularly at how this fits with Joint Strategic Needs Assessment - JSNA). Meanwhile HSJ reports on Liverpool's Green Infrastructure Strategy, a joint initiative between the PCT and te City Council, designed to enhance the contribution of the city's green space to reducing inequalities.

Food for thought

In the context of the Public Health Responsibility Deal, DH commissioned the National Heart Forum to survey the regulatory landscape for marketing of food and drink to children. The report will be considered by the snappily titled Food Network High Level Steering Group in the course of its work next year. Under the same banner, the Calorie Reduction Expert Group has proposed reducing levels of daily calorie recommended by 100kcal/day. Again, this recommendation will be examined by the Food Network High Level Steering Group.

Getting the message right

DH has published a strategy for social marketing for the public health arena. One of the key messages is "less is more:" while acknowledging the success of some campaigns, DH now suggests that it's time for a somewhat slimmed down approach, even going so far as to pilot payment by results. An article in Critical Public Health takes a cool look at the use of health trainers to help people in deprived areas self manage health behaviour. How people understand healthy living and how they use health information to make health choices is the subject of a study in Social Science and Medicine, based on interviews with people in the UK and Canada.

Children's Services

Guidance for commissioners for children's, young people's and maternal services from NHS North West takes a life course approach to the issue as well as looking at common themes across all age groups, such as child poverty, vulnerable children and young people and emotional health and wellbeing. The Government's response to the Munro Review of child protection offers the usual pieces of evidence for efforts towards reform (not just health visitors), with particular emphasis on the Supporting Families in the Foundation Years paper.

Personalizing healthcare

Personal health budgeting is likely to continue to expand in the UK, so this evaluation of individual budgets for families with disabled children is interesting. The pilots ran for two years from April 2009 in six sites in England and have reported varying levels of success in broadening how funding can be used by families: "work in progress" is the verdict from the Department for Education's evaluation. DH has also published an evaluation of personal health budgets programme, looking at the cost of implelementation.

Nanny state?

Liberal thinktank Centre Forum has stepped into the social mobility debate with a report on early years and parenting. The key message is the idea of a parenting "5-a-day": 5 positive actions that could be marketed in the same way as current healthy eating campaigns. The paper also recommends incentivising adherence by lower income families. There was a cautious welcome from Children's Minister Sarah Teather .

Prison health

The CQC has once again reviewed healthcare for young offenders and praises improvements in how healthcare is managed by Youth Offending Teams (YOTs). As is often the case, there is criticism of how transfer from child to adult services, along with transfer between custody and community and the usual pleas for better communication between YOT staff and healthcare workers. As the commissioning role for prison based substance abuse treatment is transferred from the Ministry of Justice to the Department of Health, some guidance about how the changeover will work from DH. Further details on service design will be offered in the forthcoming Building Recovery in Communities framework (BRiC), which has been the subject of recent consultation.

Mind the gap

How poor is poor? A new research report from the Department of Work and Pensions looks at how child poverty is measured in the UK, under the Child Poverty Act and the National Child Poverty Strategy and considers how to measure depth of poverty (the poverty gap). Meanwhile, according to the Joseph Rowntree Foundation's measure, the Minimum Income Standard, living costs have risen by 5% on last year, with the greatest burden on families with children, who would need to earn at least 20% more (before tax and benefits) to meet this Minimum Income Standard.

A good start in life

The critical importance of a child's early years in terms of life chances and health is now widely acknowledged, as is the association of the two issues. The Government sets out its stall in some new pages from the Department for Education (DfE) website. DfE has also published Supporting Families in the Foundation Years, in which it sets out policy for this area and responds to Frank Field's earlier report on child poverty, Graham Allen's first early intervention report and Dame Clare Tickell's report on early years. Highlighted offers include health visitor recruitment (again!), slimming down the Early Years Foundation Stage but including greater focus on parents, a reprieve for Sure Start centres, introducing greater flexibility for parental leave and extending free early education for the most disadvantaged 2 year olds. Some of these policy moves are familiar. Offering free pre-school education to disavantaged 2 year olds follows a recent pilot, although this plan was announced last year, too, and is not entirely dissimilar to the previous government's commitments. DfE has also published an evalution of Sure Start, with an economic focus.

Moving on up

Exercise for young children was the main story as the CMOs' physical acivity guidelines were published last month. However, the accompanying report, which surveys physical activity in the UK, provides evidence across all age groups for the risks associated with inactivity and the benefits of exercise. This is the first set of UK-wide physical activity guidelines and also the first time that under 5s have been included. The focus on sedentary behaviour is new, too. A study from a team in Bristol looks at the relationship between neighbourhood deprivation and physical activity amongst older adults. An evaluation of a physical activity care pathway in a primary care setting considers the cost recruitment via disease register screening and opportunistic screening. Although the opportunistic screening was inevitably cheaper, patients recruited via disease register screening had higher completion rates and generally better outcomes in terms of behavioural change.

Weight management

A selection of recently published research on obesity and weight management:
The NHS practice of offering Weight Watchers on prescription for obesity is examined by the MRC Human Nutrition Research Unit. As the abstract says "This is the largest audit of NHS referral to a commercial weight loss programme in the UK and results are comparable with other options for weight loss available through primary care."
A team from Sweden offers a cost comparison between standard ante-natal care and care with additional weight gain restriction for obese women who are pregnant. There's also a qualitative study of a UK community based prevention and management programme for maternal obesity.