Stating the *** obvious

The government's new obesity call to action has been (almost) universally reviled. It's quite an achievement to elicit the scorn of the media (Daily Mail to New Statesman), experts from the medical profession (as told to the BMJ) and Jamie Oliver. Possibly the most arresting headlines were derived from the elegant summary by Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, who suggested that the government's proposed calorie cut was "equivalent to 16 dry roasted peanuts, containing six calories each." Behind the infamous call to action is a change in the advice from the Scientific Advisory Committee on Nutrition (SACN) on energy requirements, cutting advised maximum intake for women to 2079 and for men 2605 calories per day. Alongside the obesity strategy, Change4life is given a makeover, with an extended scope (including alcohol harm and physical activity).
An article in the Journal of Public Health Policy offers some insight into what the UK public thinks causes obesity, while a piece in the European Journal of Public Health casts a sceptical eye over partnerships between the food industry and public health.

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.

Power of persuasion

Some interesting pieces of research about behaviour change and technology: firstly a meta-analysis of online social marketing behaviour change interventions, which concludes that the web works for this kind of thing: "Given the high reach and low cost of online technologies, the stage may be set for increased public health campaigns that blend interpersonal online systems with mass-media outreach." Another study by some of the same researchers looked at the potential for smartphones to deliver alcohol use behaviour change and the availability (or otherwise) of apps for that.
A more recent trial of smoking cessation help delivered by text message also gained positive results. This large UK trial, text2stop, found "significantly improved" smoking cessation levels amongst the recipients of texts.

But is it worth it?

More to help the hard-pressed commissioner work out what works. The National Social Marketing Centre (NSMC), in collaboration with NICE, has developed a set of tools to help commissioners work out whether their social marketing and behaviour change interventions are cost effective. Currently there are 5 of the Excel-based Value for Money toolkits, covering: tobacco control, breastfeeding, obesity, bowel cancer, harmful and hazardous drinking and brief alcohol interventions. NSMC is also running a series of training events to support the tools.

Healthy eating round-up

You are what your friends eat, a systematic review of social network analyses of adolescent eating habits and bodyweight, underlines the importance of school friendships in shaping young people's eating behaviours. It also suggests that social network-based health promotion interventions may play well amongst this group. Well, you don't say ...
Another systematic review considers children's attitudes to obesity, body size, shape and weight, finding that children tend to focus on size, rather than health and also that researchers had rarely engaged effectively with their subjects.
Meanwhile DH has published some new material allied with the eatwell plate, a resource designed to show what a healthy, balanced diet should look like.

Is nudging good for you?

It's an idea that features strongly amongst policymakers in the UK and the US at the moment ... but can it really work for population health? Theresa Marteau and others, in a review and analysis of the literature in the BMJ, suggests that the evidence isn't great. While welcoming the debate that Nudge and other books have stimulated, the article observes that nudging towards healthier options fails to compete with the level of nudging in the opposite direction. Nudging works, but regulation works better. The Government thinks differently, as the report from its Behavioural Insights Team shows.
Elsewhere, a report from Ipsos Social Research Institute suggests that most people are willing to accept a level of nudging towards healthy living from government. And a review of Nudge by Thaler and Sunstein in the HSJ suggests it is an approach that can work for commissioning management. If the book has captured your imagination, you may also be interested in its accompanying blog. Also worth checking are presentations from the King's Fund event, Nudging Improvements in Public Health, the last in its Big Society series.

All change

More annual reporting, this time from Change4Life, which is also a year old. But have the delightful plasticine figures made a difference? Targeting families with children aged 5-11, the strategy has made a definite hit on the brand recognition front and (according to their own tracking group) mothers have made changes to their children’s diet or activity levels. Change4Life analysis also looked at food buying behaviour. In a pilot study using Tesco Clubcard data, researchers found that the Change4Life households did “contain a large proportion of lower income families” and that there had already been some changes in purchasing, such as choosing low-sugar drinks.
Recent articles from BMC Public Health take a slightly more sober view of lifestyle change interventions: Is there a demand for physical activity interventions provided by the healthcare sector? and The influence of a high intensity physical activity intervention on a selection of health related outcomes both provide interesting reading.

Health promotion commissioning guidance

The Royal Society for Public Health has published a guide for commissioners considering health promotion and looking in particular at the role of social marketing. Produced in association with the National Social Marketing Centre, the guide offers examples of good practice and self-assessment tools.

Social marketing

The National Obesity Obersvatory offers guidance on geographical mapping. This briefing paper stems from market research relating to Healthy Weight, Healthy Lives. It explains the development of a more detailed geodemographic segmentation approach.