Mind Exercise Nutrition Do It!

MEND

Elaine TabonySchool Health Team Leader (Hillingdon Community Health)Professional Lead Childhood Obesity Care Pathway (Public Health)MSc Health Promotion and Public HealthBSc(Hons) Community Health Specialist Practitioner Community Health School Nursing RN RSCN CPT(Level M)

What is MEND?Lifestyle behaviour change programme

Improving health & behaviour,

and NOT a rapid weight loss programme Designed: child obesity experts Delivered: health, education & fitness

professionals Community-based 1st line treatment: NICE Guidance, ADA Report, Canadian Clinical Practice Guidelines

Why Lifestyle Behaviour Change ? Influences on Childhood Overweight and Obesity National factors - eg. Transport, media, vending

machines, manufactured imported goods, Community/Local - eg. School buses, Safety,

awareness/attitudes, parks, Community level education School - eg. Teacher knowledge/attitudes, snack shop,

activity time/ curriculum content Home - eg. Family diet, family activity patterns, Child

care, parental knowledge/attitudes Individual - eg. TV in child’s room, child’s diet and

activity outside school,

International factors - eg. Globalisation, marketing, convenience foods, children’s spending power

(Doak et al. 2006)

M=Mind

Based on behavioural models of change & social learning theory

Goal & reward system Self-esteem & confidence Role modeling Triggers - hunger vs. craving Problem solving Positive parenting e.g. bullying, sleep etc (5 / 8 sessions – parents only)

E=Exercise

Multi-skills Group play Non-competitive Graded activities Increased self-esteem: dance, voice &

drama Land & water based FUN!!!

N=Nutrition

Not a diet – healthy eating customised No foods are forbidden 16 Nutrition Targets Educating and empowering families (All sessions - parents & children)

How is MEND delivered?

20 x 2-hour group sessions over 10 weeks Introduction and farewell Holistic pre-assessment and post assessment

(Opportunity for Hillingdon to become part of a research project including quality of life assessment)

8 Mind sessions 8 Nutrition sessions 18 Exercise sessions

Who delivers MEND in Hillingdon?Multi-agency approach School Nurses deliver ‘Nutrition’ and ‘Mind’ theory

sessions PE Teachers and Personal Trainers deliver exercise

sessions Programme supported by Health Care Assistants

Support services: Hillingdon Sport and Leisure Services Hillingdon Sport and Leisure Complex Highgrove Pool Hayes Pool Barnhill Community School, Harlington Community

School, Harefield Academy, Ruislip High School, Stockley Academy

Why do we need this programme in Hillingdon?

The NCMP data for the last the years shows the following percentages:

2005-2006 2006-2007 2007-2008Year R Overweight 10.7 11.2 9.8Year R Obese 9.2 8.6 8.4Year 6 Overweight 13.2 14.1 12.7Year 6 Obese 17.8 19.5 19.3

Figure 18C: BMI distribution by ethncity in primary school children 2006-7

66.5%61.2%

58.0%64.3%

55.3%63.0% 63.9%

13.2%

9.4% 14.3%

15.0%

13.0%

13.0% 12.6%

13.4%

15.0%18.5%

12.6%

14.2%

11.4%14.0%

7.0%14.4%

9.2% 8.2%

17.4%12.5% 9.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

White Asian Black Mixed Chinese and other Refused +missing

Hilingdon average

Underweight

Obese

Overweight

Normal

Healthy Weight, Healthy Lives: A Cross Government Strategy for England. Published in January 2008: this set out the first

steps to meeting the challenge of excess weight in the population.

Nationally, success in meeting the ambition and the Child Health Public Service Agreement (PSA) will be measured using Health Survey for England data for prevalence of overweight and obesity in children.

Locally, PCTs and local authorities use NCMP data to set local goals, agree them with SHAs and Government Offices and monitor performance.

The future Further interventions in development:

MEND Graduates – Fit-Teens 13+ programme

Different age groups MEND 5-7 years responding to NCMP programme Mini-MEND age 2-4 years ‘Achieving Healthy Weight’ Group in Hillingdon Special needs GP-delivery platform International adaptation & evaluation (e.g. Denmark, Finland, Greece, Australia & USA)

Parents views about MEND I knew my child was overweight and I thought MEND was a great

opportunity to help my child. I learnt a lot in terms of nutrition and how to take action and changed my child’s diet. My child found it very fun and encouraging and was not forced. My child’s diet has completely changed. My child’s confidence has grown

Before I came I thought it would be a waste of time but I was worried about my child’s weight. I found out it was not so much what he had to eat but that I was overfeeding him. He found confidence in his ability that he had never had. Before he came he was quiet and unconfident and did not much like what he looked like. He was bullied at school and did not stick up for himself. The most important thing was my child grew in confidence and as a bonus he lost weight - we both learned a lot

He needed an incentive to lose weight. I learnt lots of new ways to feed my whole family

My child did not like what they looked like or fit clothes. She made friends and looked forward to coming. Because the school knew about MEND, the school took the bullying issues seriously

Six Hillingdon MEND 7-13 sites How to contact MEND in Hillingdon

Monday and Wednesday 4-6pm Land based exercise - Stockley Academy Water-based exercise- Yiewsley PoolMonday and Friday 5-7pm Water based exercise- Highgrove Pool Land based exercise- 5.15-7.15pm Ruislip HighMonday 4-6pm and Saturday 9.30-11.30amLand based exercise- Hillingdon Sports and Leisure ComplexWater-based exercise- Hillingdon Sports and Leisure ComplexTuesday 4-6pm and Saturday 10am-12pmLand based exercise- Harlington Community SchoolWater-based exercise- Hayes PoolWednesday 3-45pm and Saturday 9am-11amLand based exercise- Barnhill Community SchoolWater-based exercise- Hayes PoolThursday 4pm-6pm and Saturday 9.30am-11.30amLand based exercise- Harefield AcademyWater-based exercise- Hillingdon Sports and Leisure Complex

Hillingdon MEND Office 020 8573 1271Minet Clinic, Avondale Drive, Hayes, Middlesex. UB3 3NR