Transcript Narrowing the gap

NARROWING THE GAP
What are we advising the July LSP Board
to do next on NTG
Narrowing the gap
• Changing context
• Approach
• Positive impacts / outcomes
• Challenges / Next steps
Changing Context
– Public sector resources ( money and staff)
reducing
– Slow growth or recession continues and
increases the Gap
– Does our focus on NTG need to change
Approach to date
•
•
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Assess need
Know population
High impact changes
Implement evidence base/ or ensure
evaluation undertaken
• Focus on target groups
• Lead organisation identified
APPROACH
• Determinants / Prevention (long term)
• Early detection ( Short / medium term)
• Services to Make it Better ( Short term)
Narrowing the Gap Themes
•Life Expectancy
•Adults basic literacy, numeracy and IT skills
•% Pupils achieving 5 GCSE A-C
•Young people not in education, employment
or training (NEET)
•Fuel poverty
•Residents’ satisfaction levels
•Super Output areas in 5% most deprived
nationally
•Feelings of safety
•Crime rates
•Unemployment rates
Causes of Death Accounting for Lower Life Expectancy in Deprived Areas
Source: Association of Public Health Observatories and Department of Health
Risk factors
• Smoking accounts for half of the difference
in life expectancy between best /worst
areas
Other major contributers
– Physical activity
– Alcohol
– Diet
2 case studies breastfeeding and
smoking
• Identify need
• Segment population
• Understand what approach works for
segments
Breast feeding – infant inequalities
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Our vision is to improve the health of the people of Calderdale, one step on this
journey is to encourage mothers to breastfeed
•
We want to increase and sustain the uptake of breastfeeding for new mums in North
Halifax, specifically in Ovenden, Illingworth & Mixenden
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Within six months, we hope to see:
- 10% increase in new mums having attempted to breastfeed at the time of discharge
from hospital
- 5% increase in new mums breastfeeding at 10 days
- 3% increase in new mums breastfeeding at 6-8 weeks
•
Insight research highlighted two main barriers to breastfeeding – attitude and lack of
belief that breast milk is superior to artificial milk
•
Developed a six month marketing campaign targeting 16-24 year old females in
North Halifax (January 09)
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The campaign and messages have been tested by the target audience at each step
Attitudes Towards Breastfeeding
Attitudes towards breastfeeding varied, however most do feel that it is not the ‘norm’ and is
frowned on by some in public, possibly the older generation? For some there are two hurdles
to get over; breastfeeding at all & breastfeeding wherever Mums need/want to. This supports
the need for the campaign to support Mums who do want to try breastfeeding and to reinforce
the benefits.
Positive
• Some Mums are positive
regarding breastfeeding
• The benefits are seen as:• Naturalness
• Closeness with baby
• Some health benefits
Mixed
Negative
• Some acknowledged
the benefits but also felt
embarrassment at
breastfeeding in public
and had experienced
physical difficulty with
breastfeeding
• Some feel that health
professionals try to
force breastfeeding on
Mums
• Formula was seen as
equal to or superior
than breastfeeding by
some
A need for information before birth and support during
breastfeeding clearly exists
Lifestyle Context – A Typical Day
Mums feel that they are constantly busy, with weekends being much like weekdays, as all were
on maternity leave and not working. Most try to get outside daily so a lot of small trips to the
shops/window shopping occurs.
Going To The
Shops
A Typical Day
Doing Chores
At Home
Looking After
Children
Attending Baby
Groups
Social Networking
Sites
Sometimes Seeing
Friends
Key Messages Communicated By Each Advert
• Mums can still have a social life & breast
feed
• You can breastfeed when you are
out & about
• Educating friends re: acceptability of
breastfeeding
• There are health benefits due to
breastfeeding
• There are health benefits due to
breastfeeding
• Some query whether breastfeeding
is the ‘norm’ currently
Campaign Delivery - Detail
Posters On/In Buses & At Bus Stops
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This is expected to be very
noticeable
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First is the bus company used
most in the area. It is also more
pushchair friendly in comparison
to TJ Walsh
Stickers In Local Businesses
•
This idea was welcomed as most
Mums are not sure where they will
be encouraged to breastfeed while
out of the house
•
A suggestion was made to swap
over the text so that the
welcoming breastfeeding is more
obvious than the campaign tag line
Campaign Delivery - Detail
Facebook
Website
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This was a popular idea
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¾ of the respondents currently
use Facebook, none were
using Bebo and only a minority
were using MySpace
This idea was liked as it is
there if Mums want it as a
resource for further
information
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www.onlynatural.org.uk
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A snowball effect expected as
many Mums felt that they
would pass invites on to friends
Ideally the Facebook group
would include blogs to share
experiences, an area to ask
questions - ideally from
professionals as well as other
Mums
Leaflets
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A number of locations
were suggested,
including; supermarkets,
waiting areas, train
stations & bus stations
The leaflets are expected
to be more noticeable
than current leaflets on
the subject as the colours
are more eye
catching/interesting
Impact of campaign
Breastfeeding rates 2009/2010
70
% breastfed
60
50
2008
40
Q1 2009
Q2 2009
30
Q3 2009
20
Q4 2009/10
10
0
Calderdale Calderdale Ovenden Ovenden 6 Illingworth illingworth
10 days
6 weeks
10 days
weeks
and
and
Mixenden Mixenden
10
6
selected area/time
Changing Context
– Public sector resources ( money and staff)
reducing
– Slow growth or recession continues and
increases the Gap
– Does our focus on NTG need to change
Challenges 1
• What works elsewhere
• What should our focus be
–
–
–
–
the 10 themes
topic Eg Smoking
population groups Eg young children or families
Geographical Eg ward
• Short term or long term interventions - here and
now or the next generation
Challenges 2
• People constraints (are people ready to change)
– better population segmentation to maximise
impact
• Scale – Large scale mainstream from small
scale projects
• Resource constraints
– money
– Workforce ( skills and capacity)
Narrowing the Gap Themes
•Life Expectancy
•Adults basic literacy, numeracy and IT skills
•% Pupils achieving 5 GCSE A-C
•Young people not in education, employment
or training (NEET)
•Fuel poverty
•Residents’ satisfaction levels
•Super Output areas in 5% most deprived
nationally
•Feelings of safety
•Crime rates
•Unemployment rates
DISCUSSION
• What do we focus on to have the most
impact in the next 3- 5 years ?
• What about the long term ?
• What are we are we advising the July LSP
Board to do next on NTG
NEXT STEPS
• WE HAVE REWARD MONEY BECOMING AVAILABLE
• WE HAVE MAINSTREAM INVESTMENT (subject to savings)
• ARE THE 3 AREAS THE LSP SHOULD FOCUS ON FOR THE
BIGGEST IMPACT
– SMOKING
– EMPLOYMENT
– YOUNG PEOPLE (0-5)
• CONTINUE WITH THE 10 NTG THEMES (EFFICIENCY AND
IMPACT)
• TEST WITH DELIVERY GROUP/ THEME GROUPS/LSP /
SCRUTINY