CHANGE4LIFEan analysis and comparative study

• Current trends in Britain and the Department of

Health’s plans

• DefiningChange4Life

• Analysingit using determinants of behavioural

change and evaluating its

• Effectiveness

• Comparative study with Singapore’s programmes

OUTLINE OF PRESENTATION

• Studies

– Annual increase in obesity related deaths between

2000 and 2006. (University of Oxford)

– More than 190 people under 65 had direct obesity-

related deaths compared with 88 in 2000.

CURRENT TRENDS. defining . analysing . evaluating . comparing

• Change4Life

– A societal movement, the social marketing part of "Healthy

Weight, Healthy Lives", the cross-governmental strategy

for England. (broad based strategy, not top-down)

– Alifestyle revolution to change people's behaviour and

prevent obesity (preventative campaign, not remedial)

– Started in January 2009

– Mission: to encourage people to eat well, move more and

live longer

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• What Change4Life is based on

Change4Life Behavioural Change Model

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• Target Group

– Focused on families with children aged 5-11, greatest risk of becoming overweight or obese

• grouped into clusters (income) with 5 being high-risk

– Pregnant mums and families with babies aged 0-2 (Start4Life)

– Ethnic minority communities - Pakistani, Bangladeshi and West African (TV commercials and advertorials in key ethnic titles)

– Recently: middle-aged adults

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• Made up of

– Grassroots supporters

– NHS and local government staff

– Commercial sector partnerships

– Non-government organisations

• To spread messages with the help of

– Schools

– GP surgeons

– Community centres

– Supermarket

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• Support

– Health charities: Cancer Research UK, Diabetes UK,

British Heart Foundation

– NGO: Natural England and Sustrans

– Business: free gym access, money off fruit/vege, low

cost bikes

– National Partners: Kellogg's, Nisa, SPAR, TESCO

current t rends. def ining . ANALYSING . evaluat ing . comparing

• Provides practical tips, helpful information– E.g. 8 Healthy Behaviours

• Provides a coordinated campaign for health promotion nationwide– E.g. Facebook updates on events in the local community

• Subgroups– Let's Dance with Change4Life

– Bike4Life

– Walk4Life

– MuckIn4Life

– Play4LifeSwim4

– Lifeadvertisements:

• http://www.youtube.com/watch?v=dyvfSmB0YOQ

• http://www.youtube.com/watch?v=i3xXK1BcMB4&feature=relmfu

• http://www.youtube.com/watch?v=Nb0fLYdPEPM&feature=relmfu

current t rends. def ining . ANALYSING . evaluat ing . comparing

• Bike4Life– Promoting: Cycling, whether its a day to day activity, or an occasional

adventure, is a great way to help keep you and the rest of the

family healthy. Getting on our bikes more often can help us on

the way to making the small changes that can bring short and

long term benefits to your health, the environment and your

purse.

– Encouraging kids to cycle from an early age and getting them to

take their Bikeability test will equip them with a skill for life.

– Singapore context: do not think it will work, because not bike

friendly, many bikes accidents etc.

current t rends. def ining . ANALYSING . evaluat ing . comparing

• Swim4Life– Similar to UH: 4 swims with the 5th free!

– Similar to Singapore

• Compulsaryfor schools to have swimming lessons to make sure

students are equipped with fundamental survival skills

• By Primary 4, students must be able to tread water and swim 50m,

• Good life skills plus it encourages students to excercise more

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• Change4Life

– Creating an environment that better supports people

in developing and sustaining healthy eating and

activity habits

– On a social level - culture, people, lifestyle

– ie. through messages, posters, activities (see people

moving about), influences

– Interactions with family and friends

– Includes institutions in the local community

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• Effectiveness

– 85% of mothers agreed that the Change4Life

advertising made them think about their children’s

health in the long term

– 81% agreed it made them think about the link

between eating healthily and disease

– 83% agreed that is made them think about the link

between physical activity and disease

current t rends. def in ing . analys ing . EVALUATING . compar ing

• Key Determinants

– Life history / impact of life transitions --> starting from young,

good! (an age when behavior change is the easiest!)

– Awareness of role models --> parents , good! but... actual

effectiveness, questionable. beyond the reach of Change4Life,

it's personal... (correct target audience, effectiveness is

questionable because whether parents will implement it? when

children kick up a big fuss, will they give in?)

– Complex issues of perception of sport ability and self-confidence

--> more can be done on this front. talks etc.

current t rends. def in ing . analys ing . EVALUATING . compar ing

• Key Determinants– awareness of opportunities is also a key determinant and that

Change4Life did well with its widespread publicity. (but need to

think better where their posters are placed! - ie at the bus stop?

after the counter in the cafeteria?)

– social networks - friends and family involvement will aid the

effectiveness of the campaign. the approach of Change4Life, not

top down but with the authority spread to others such as

community volunteers enabled it to gain a better outreach. -->

good!

– economic reasons - such as financial incentives from asda and

tesco is helpful, good! more can be done on this front but it

requires the commitment of more corporate partners who are

profit-oriented.

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• Empowerment– In control of the behaviour change and that it is not forced from

‘outside’

– Lawson (2005) focuses on the issue of power, who holds it and how it can be used

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• Comparison with

Singapore’s health

promotion efforts

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• Demography

– Population of 5.18 million

– Land area of 778 km²

– Second most densely populated country in the world

• Health Department

– Health Promotion Board (HPB)

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• Life expectancy at birth (as of 2011)

– Males: 79.5

– Females: 84.9

– Average: 82.14

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Source: CIA World Factbooks 18 December 2003 to 28 March 2011

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• Causes of Death

Source: Ministry of Health Singapore, 28 Oct 2011

• Eating habits

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• Physical Activity

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• Smoking

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• Barriers to eating healthily

– Easy access to a large variety of food

– Preference for unhealthy food

– Low cost of food

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• Easy access to food– It is quite hard not to see food around you…

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• Preference for unhealthy food– Unhealthy food = Good food

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• Low cost of food– Cheap food = Buy more food

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• Low cost of food– Cheap food = Buy more food

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• Barriers to physical activity

– Consumed with family and work commitments, hence there

is little time set aside to exercise

– The misconception that “I am not obese so I am healthy” – a

link between obesity and health

– Urban setting which discourages preferred forms of

exercise prevalent in other countries e.g running and

cycling

current t rends. def in ing . analys ing . evaluat ing . COMPARING

• Barriers to physical activity

– Consumed with family and work commitments, hence there

is little time set aside to exercise

– The misconception that “I am not obese so I am healthy” – a

link between obesity and health

– Urban setting which discourages preferred forms of

exercise prevalent in other countries e.g running and

cycling

– Highly efficient and dense network of transport systems

including public transport and traffic network

• Eliminates the need to walk long distances

• “Why walk when I have a car?”

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• Singapore has a relatively low obesity rate at

10.8% as of 2011

• Thus, despite all the barriers to ensuring a

healthy lifestyle, something is going right…

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• National Service

– All males have to enlist in the conscripted armed forces at

the age of 18

– Serve a national service liability which runs for 2 years

– After service, the individual is still liable up to the age of 40

and is required to undergo an annual physical proficiency

test up till that age

– Individual Physical Proficiency Test (IPPT)

• Incentives and Disincentives

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• Health Promotion Board– Two-pronged approach

1. Healthcare system

2.Health promotion programmes

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• Healthcare System

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Source: AARP International

• Taking responsibility for your own health

– Absence of socialised models of social security

• Compulsory pension system

– Employees typically pay 20 percent of their wages

into the Central Provident Fund (CPF), while

employers pay 13 percent

– The money in these fund is then used for future

healthcare costs

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• Health promotion programmes

– The “Healthier Choice” programme

The Healthier Choice Symbol (HCS) on packaged food products indicates that they are healthier options, and this helps consumers to make informed food choices when grocery shopping.

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• Health promotion programmes

– Healthy Eating in Schools Programme (HESP)

• Enhance the availability of healthier food and beverage choices in schools through an integrated programmeinvolving teachers, canteen vendors and students

• 10 guidelines e.g– sale of drinks and desserts with less sugar

– sale of deep-fried food and preserved food on only one specified day a week

• As of 2009, 87% of schools in Singapore have achieved the Healthy Eating in Schools award

current t rends. def in ing . analys ing . evaluat ing . COMPARING

• Health promotion programmes

– Healthy Eating in Schools Programme (HESP)

• Enhance the availability of healthier food and beverage choices in schools through an integrated programmeinvolving teachers, canteen vendors and students

• 10 guidelines e.g– sale of drinks and desserts with less sugar

– sale of deep-fried food and preserved food on only one specified day a week

• As of 2009, 87% of schools in Singapore have achieved the Healthy Eating in Schools award

current t rends. def in ing . analys ing . evaluat ing . COMPARING

presented by

Grace Chua . Rachel Shong . Darren Nin