A Qualitative Study to Understand the Potential Efficacy of an Information-Based Sugar Reduction Intervention among Low Socioeconomic Individuals in the UK.

Sugar consumption in the UK consistently exceeds recommendations, despite the association it has with poor health outcomes. Low socioeconomic groups are most likely to over-consume sugar, which could exacerbate existing health disparities. Various interventions attempt to reduce the amount of sugar consumed, but their effectiveness is still unclear. This study qualitatively explored the sugar consumption behaviours of individuals experiencing food poverty, and examined how an information-based sugar reduction intervention might influence these behaviours. Eight clients and six volunteers from a food bank in Bristol (UK) completed semi-structured, one-to-one interviews that were thematically analysed. Food bank clients appeared to heavily consume sugar, with little understanding of the associated health effects and limited awareness of the intervention. Consumption behaviours were particularly influenced by personal and psychological factors, such as mental health; in addition to social factors, like familial behaviours and food access issues. It emerged that food bank clients' often-challenging personal circumstances were likely to promote their sugar consumption. Making intervention materials visually appealing and easily comprehendible were found to be important for improving an intervention's reception. Recommendations were developed to improve the efficacy of similar information-based sugar reduction interventions among socioeconomically deprived groups.HF now works under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence which is funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trus

Measuring the social value of prevention and management of type 2 diabetes in a community setting

Background: Type 2 diabetes affects 1 in 20 people over the age of 65. Although there is growing evidence around the effectiveness of lifestyle interventions to prevent or delay the onset of this disease, there is limited evidence of the wider social outcomes and value of such programmes. Social Return on Investment (SROI) is a method of defining,measuring and valuing the wider social outcomes and describing the process of change through the eyes of those who benefit. This paper aims to evaluate the wider impact and social value of the Westbank Living Well, Taking Control (LWTC) community-based diabetes prevention and management education programme. Methods: The SROI methodology involves a mixed methods design. Qualitative methods were used to identify outcomes that were viewed as important by stakeholders in terms of the impact they create. A quantitative approach was used to define the numbers experiencing the outcomes, a monetary representation of the outcomes and their value.Results: SROI analysis found that for every £1 invested in LWTC, there is £5.80 of social return over a three-year period. The sensitivity analysis showed that the value of the social return for every £1 invested in the LWTC is likely to be between £1.30 and £6.57.Conclusions: The study demonstrates the potential social value of a community-based diabetes prevention and management education programme in terms of outcomes for participants, and also the wider outcomes for staff, volunteers, family and friends of the participants and the organisations involved. Better appreciation of such wideroutcomes could have an important role in building partnerships, community engagement and political mandate for public health interventions

The potential yield of active play in the prevention of cancer

Literature has shown that participation in physical activity is associated with a reduction in the incidence of certain cancers. Physical activity levels across the life course are low. Since cellular damage from an inactive lifestyle accumulates over time, promoting physical activity from childhood is fundamental for cancer prevention. To date, interventions to promote physical activity in children have been unsuccessful over the long term. Physical activity can be accrued through several domains including sport and active play. Research suggests that sport participation and not active play tracks from childhood to adulthood. Active play is easier to promote because it does not necessitate a certain level of skill or competency, and is enjoyable. The purpose of the present paper is to encourage more research into all areas of active play to increase population physical activity levels across the life course and thus aid in the prevention of specific cancers

Evaluation of living well, taking control: A community-based diabetes prevention and management programme

IntroductionType 2 diabetes is a serious, expensive and growing public health challenge. In England, national guidance recommends intensive lifestyle interventions promoting weight loss for people at risk of diabetes and programmes of individualised care, information and advice for those recently diagnosed with type 2 diabetes (NICE, 2012; NICE, 2015). There has been little formal evaluation of ‘real-world’ type 2 diabetes prevention and management programmes in the UK, particularly those delivered by community and voluntary agencies. To inform options for action on type 2 diabetes, there is an urgent need for evidence on the implementation and effectiveness of innovative service models.Living Well, Taking ControlLiving Well, Taking Control (LWTC) is a programme designed to prevent and manage type 2 diabetes in non-clinical, community settings. Between July 2013 and October 2015, LWTC was led by Westbank Community Health and Care, and funded as part of the Big Lottery Fund’s (BLF) Wellbeing Programme. LWTC was delivered through third-sector agencies Westbank based in Devon, and Health Exchange in the West Midlands. The programme is compliant with NICE guidance. Evaluation questionsThe evaluation sought to address the following research questions:1.What are the characteristics of the population that the programme attracts?2.What are the patterns of participation in the programme?3.How well does the programme perform in terms of the main outcomes of weight loss and change in glycated haemoglobin (HbA1c), and secondary outcomes (e.g. physical activity, diet, mental wellbeing)?4.What is the association between programme exposure and outcomes?5.What is the association between practice effects (changes in delivery over time) and outcomes?Evaluation methodsThe evaluation is based upon a pre-post assessment of the experiences of programme participants, with additional data derived from programme delivery records. All individuals taking part in LWTC were asked to complete questionnaires and provide biometric measures at the point of enrolment between November 2013 and April 2015. Participants provided follow-up data for a minimum of six months post-enrolment up to the end of October 2015. In addition, all participants who had reached the point of 12 months post-enrolment were asked to provide further follow-up data.Key FindingsParticipants enrolled in LWTC achieved statistically significant improvements in weight and most associated measures (BMI, waist circumference), for those with pre-diabetes and diabetes, at six-month and 12-month measurement points. Of those participants who provided data, 2kg weight loss was achieved by 41.9% (n=156/372) at Month 6 and 44.2% (n=73/165) at Month 12. The 2kg weight loss was achieved by more participants with pre-diabetes than those with diabetes, with 42.9% (n=115/268) and 39.4% (n=41/104), respectively at Month 6. Weight loss and HbA1c were, in the main, closely paralleled by changes in the secondary outcome measures. Overall, there were statistically significant positive changes in general health state, overall life satisfaction, mental wellbeing, anxiety and depression, and self-reported diet at both Months 6 and 12. However, changes in self-reported physical activity were not statistically significant at either measurement point.Further details on the findings are available in the main report.ConclusionsThe evaluation findings suggest potential positive effects of LWTC on diabetes risk and the early stage management of diabetes. The LWTC programme model offers a number of features that are important for scaling up and embedding action on type 2 diabetes. LWTC incorporates key elements of NICE guidance on both the prevention and management of type 2 diabetes. It has developed successful methods for recruitment in partnership with primary care agencies. The programme builds upon the local expertise and capacity of third sector providers, trained community facilitators and local partner agencies

Social Return on Investment Report (SROI) final report on a type 2 diabetes prevention and management programme delivered by Westbank CHC

Final SROI report on Living Well Taking Control, diabetes prevention and management programme delivered by Westbank CHC, Devon. This is part of a Big Lottery Funded evaluation of South west Wellbeing programme. This led to a total of nine SROI analyses with community health projects in the South west of England