h3 heat target and max in the middle dr graham foster consultant in public health medicine
TRANSCRIPT
![Page 1: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/1.jpg)
H3 HEAT Targetand
Max in the Middle
Dr Graham FosterConsultant in Public Health Medicine
![Page 2: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/2.jpg)
Evidence Review• Primary and secondary approaches
• Individual needs and community development
• Not stigmatising
• Whole school approaches
• Change physical activity, diet and behaviour
• Long term view not one off projects or short term support
![Page 3: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/3.jpg)
Examples of best practice
No single programme is model, but key elements can be identified
![Page 4: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/4.jpg)
Multi-agency planning day
![Page 5: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/5.jpg)
Existing Services and Programmes• Fit for Girls• Physical Activity Co-ordinators• Breakfast Clubs• Healthy Tuck shops• Leisure Centres and Sports Clubs• Hungry for Success
![Page 6: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/6.jpg)
Existing Specialist Services
• Primary Care• Community Dieticians• Specialist Obesity Clinic• YUFF Programme
![Page 7: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/7.jpg)
Primary 7 (aged 11-12)Source : Child Health Surveillance Programme - School
10%
15%
20%
25%
30%
35%
1999/00 2000/01 2001/02
Male -Overweight
Female -Overweight
Male -Obese
Female -Obese
Childhood Obesity in Scotland
![Page 8: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/8.jpg)
And it just gets worse
• By age 40 almost 60% of females in Central Scotland are overweight or obese
• For males 50%
![Page 9: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/9.jpg)
Conclusions
• Build on what we already have• Community / Family approach• Introduce a universal Level 1 -
Max• Join up the existing Level 2 • Expand the specialist Level 3 -
YUFF
![Page 10: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/10.jpg)
Max in the Middle
• Why are we doing it?• What is it?
![Page 11: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/11.jpg)
Max in the Middle
• School Based Programme• Whole class approach• Drama• Dance• Empowerment• Parental Involvement
![Page 12: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/12.jpg)
What is - Max in the Middle• History –
– behavioural intervention whole class approach
– substance misuse– pilots on healthy behaviours
• An 18 hour, intensive school based, whole class intervention promoting healthy behaviours and engaging parents and families
![Page 13: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/13.jpg)
Benefits - Max in the Middle• Universal–
– No Exclusions / withdrawals– Highly innovative– Exciting– Memorable– Not work– Links to Curriculum for excellence– Links to Community– Local Focus and relevance– Kids love it and want to participate– Families get enthused and engaged
![Page 14: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/14.jpg)
Meeting Monday
![Page 15: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/15.jpg)
Meeting Monday
• Meet the Team• Size up the class / school• Break the ice• Build confidence• Play games• Do some dance
![Page 16: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/16.jpg)
![Page 17: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/17.jpg)
Tasty Tuesday
![Page 18: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/18.jpg)
Tasty Tuesday
• All about Food• Parental volunteers• Food is not dangerous• Handle food, taste food, enjoy
food• Memorable Messages• Healthy eating plate etc
![Page 19: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/19.jpg)
Workout Wednesday
![Page 20: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/20.jpg)
Workout Wednesday
• Elements of fitness• Physical Activity as ADL• Local Opportunities• Clubs and Groups• Walks, games, transport• More dancing
![Page 21: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/21.jpg)
Thursday is Rehearsal Day
![Page 22: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/22.jpg)
Friday - Performance
![Page 23: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/23.jpg)
Friday - Performance
• Children do invites• All welcome• Big attendances even in most
deprived/least engaged schools• Opportunity to meet the parents• Interaction• NOT in front of school
![Page 24: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/24.jpg)
Review of 2008/9• Max in 21 primary schools, 600 children
• 200 obese children completed a Max week
• Positive internal evaluation
• Only NHS Board to deliver agreed number of interventions
![Page 25: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/25.jpg)
2009 to 2011• 42 schools per year, Approx 1200
children
• All introduced to level 2 (engagement)
• 40 referrals - YUFF/Specialist service
• NHS Health Scotland evaluation
![Page 26: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/26.jpg)
2012 so far• 84 schools per year, Approx 2100 children
• 42 Full Max Experience (18 Hours) Primary 6• 42 Max Lite (1 in Service day of teacher training
and 6 1 hour school visits) Primary 5
• Heights and Weights on all children (our greatest challenge)
• Planning for Sustainability
![Page 27: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/27.jpg)
Small changes count• 150 kcal xs per day = 7kg per year
• 150 kcal = 1 sandwichor
»1 can of cokeor
»1/2 Mars bar
![Page 28: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/28.jpg)
• Thank you
![Page 29: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/29.jpg)
Primary prevention – avoiding development of unhealthy weight
Secondary prevention – early detection of unhealthy weight to avoid development of health problems
Individual needs addressed within a community development approach
Evidence Base for Max Programme
![Page 30: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/30.jpg)
• Ideally multi-level: individual, school & community
• Whole-school approaches should be used in schools, ideally
• Schools-based approaches need support from families & communities
•Multi-component with behaviour change strategies to: Increase physical activity Improve eating behaviour
Promote behaviour Change
•All components tailored to the setting
![Page 31: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/31.jpg)
•Parental/carer obesity major risk factor for child obesity
• Parents should be actively involved
• Parents encouraged to have main responsibility for lifestyle changes
• Change can be hampered by complex living and working
• Participant engagement is fundamental to effectiveness
• Stakeholders (families, schools, others) need to be included
•Short term interventions and one-off events are insufficient
![Page 32: H3 HEAT Target and Max in the Middle Dr Graham Foster Consultant in Public Health Medicine](https://reader033.vdocuments.us/reader033/viewer/2022051401/5697bfd21a28abf838cab6de/html5/thumbnails/32.jpg)
•Need to tailor advice and address potential barriers
• Consider groups such as ethnic minorities, low incomes etc
•Overweight and obese children with significant co-morbidities or complex needs should be referred to specialists