Page 1


Toolkit Contents:

2

Organisations and groups who took part.

3 4 4 5 6

Who we are. Aim of the Toolkit. What do we mean by "health"? Why promote healthy lifestyles? Why are community organisations well placed to promote healthy lifestyles?

7 9 11 14 16 19 21 22 23

Getting started‌key principles. The key facts about food. Types of projects - food. The key facts about physical activity. Types of project - physical activity. The key facts about smoking Types of project - smoking. The key facts about stress. Types of project - stress.

24

Overall good practice.

26 26 29

Help! Resources, training and help (Ceredigion). Resources, training and help (National).

32 34

Service Level Agreements Policy

35 37

Evaluation Self-assessment

38

Acknowledgements.


2

HEALTHY

COMMUNITIES

TOOLKIT

Organisations and groups who took part in the Healthy Heart programme in Ceredigion:

l l l l l l

l l l l l l l l l l l l l l

Ceredigion Local Health Board Ceredigion County Council Ceredigion Health Alliance Ceredigion Association of Voluntary Organisations (CAVO) Area 43 (Youth support and information centre) Primary Health Care Teams in Aberystwyth (Ystwyth Medical Practice, Church Surgery, Padarn Surgery) and in Cardigan (Ashleigh Surgery) Ceredigion Healthy Schools Scheme National Smoking Cessation Service University of Wales (Dept. of Sport and Exercise Science and Dept. of Leisure) Communities First, Aberystwyth Ceredigion Social Services Ceredigion Youth Offending Team Ceredigion Pupil Referral Unit Ceredigion Training Age Concern, Ceredigion Ceredigion WI Cantref Housing Association Ceredigion Local Agenda 21 Children and Young People's Partnership

Small World Theatre Riverside Festival, healthy food theme, Cardigan.

l l l l l l l l l l l l l l l l l l l l l l l

Surestart Homestart Flying Start Women's Aid, Aberystwyth Penparcau Family Centre Residents of Golwg y Castell and Ridgeway, Cardigan Cardigan Toy Library, Maesglas Penparcau Youth Club Jigso - Children's Centre, Cardigan Cardigan and Aberystwyth after schools Clubs Ceredigion Pupil Referral Unit Plascrug Leisure Centre Finch Square CafĂŠ, Cardigan Camau Bach (MYM) Canolfan Padarn (Day Centre) Cardi Cardiacs Crazy Fruit Club Crymych Leisure Centre Aqua Serena Country Club Aberystwyth Mind Small World Theatre Pfizer UK

l and the lead organisations -

Ceredigion Public Health Team (National Public Health Service) and Ymlaen Ceredigion (a not for profit organisation promoting sustainable community development).


WHO

Who We Are: Ceredigion Healthy Heart Programme

WE

ARE

3

The Ceredigion Healthy Heart programme was established in April 2002. Originally a three year programme funded by the Inequalities in Health fund of the Welsh Assembly Government, it was subsequently extended and is now due to finish in March 2008. It is one of 62 Inequalities in Health projects in Wales. The overall aim of the fund was to target areas of inequality and reduce the risk of developing coronary heart disease in ways that could be sustainable. The Ceredigion Healthy Heart programme worked in the communities of Aberystwyth and Cardigan. Our aim has been to reduce the risk of serious illness by promoting healthy lifestyles. This meant focusing on healthy eating, physical activity and issues relating to smoking and stress. The programme has worked with individual groups and organisations to identify ways which would make it easier for their members to either eat healthier food, increase physical activity or deal with stress and smoking issues Within the two towns, 52 projects emerged. Activities chosen by the participants included, fruit snacks, provision of healthy meals, recipe swaps, cooking skills, training on healthy eating, production of resources such as a Cardigan step and calorie map, production of an exercise video, community gardens, physical activity sessions, classes and equipment, awareness raising discussions and events, environmental improvement, personal mentoring, smoking cessation support and residential and other intensive programmes aimed at young people at risk. The best results came when community leaders were able to work with both their members and their staff to bring about positive changes in lifestyles.


4

HEALTHY

COMMUNITIES

TOOLKIT

It was important to do this in a way which could be sustained after the project had finished and into the long term future. The healthy heart programme showed conclusively that community organisations, given initial support and a modest level of investment from our fund, were pleased to promote healthy lifestyles. Community organisations felt that the introduction of the healthy lifestyles agenda, especially where related to food, produced a positive response from both staff and members. Social interaction and communication increased and raised confidence which in some cases led to other healthy lifestyle initiatives, such as group activities (e.g. walks) or smoking cessation. Some initiatives have had such a positive response that participants have agreed to contribute to the cost to make the initiative sustainable for the longterm.

The Aim of the Toolkit The aim of the toolkit is to encourage and support community organisations and groups to promote healthy lifestyles by: l

Clarifying the meaning of health

l

Identifying the potential of organisations to influence healthy lifestyles

l

Identifying the benefits of promoting healthy lifestyles to both organisations and members

l

Providing information on healthy lifestyle messages

l

Providing information about resources, training and support networks, both locally and nationally.

The Toolkit is based on the experience of the healthy heart programme's work with community organisations. We hope that it will inspire you to take up the promotion of healthy lifestyles.

What do we mean by health? The World Health Organisation defines health as: "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". In the light of this definition, many community organisations will recognise that they already make a significant contribution to the health and well-being of their members. For example: Many community organisations support vulnerable and hard-to-reach members of the community. They engage with them and listen, offering advice, reducing stress and providing a safe, positive social environment. Indeed, some of these organisations have health issues at the centre of their agenda, for example those supporting people experiencing mental health problems. It is important therefore for everyone to recognise that community organisations are already likely to be contributing to the health and well-being of their members in some way. Health is also about the individual staying healthy. This includes, having access to information, making informed choices about health and well- being and having the confidence and self esteem to make changes. Adopting a healthy lifestyle is one of the ways of improving your health by enjoying healthy food, taking enough exercise, stopping smoking and tackling stress issues. Community organisations have the opportunity to adopt an "holistic" approach to health which can be particularly effective, as it considers the whole person and the situation in which they find themselves. It is an approach which values rather than labels the individual and identifies root causes of problems, rather than just symptoms. "We will focus on health and wellbeing, not illness by using every avenue to promote healthy communities (and by) empowering individuals to take responsibility for their own health." "Designed for Life" - Health and Social Care in Wales in the 21st Century


WHO

WE

ARE

5

Why promote healthy lifestyles? Most people would benefit from increasing their physical activity, eating a healthy balanced diet, avoiding too much stress and of course, not smoking. There are immediate benefits to adopting a healthier lifestyle and being more active. Physical activity and a balanced diet help people feel better not only in themselves, but about themselves. Even for those people facing particularly difficult and challenging circumstances, changing to a healthier lifestyle is something positive which they can achieve for themselves and for their family.

We know that those members of the community suffering the most disadvantages have the greatest risk of ill health. Organisations that access this target group are particularly well placed to support changes in their lifestyle. Promoting healthy lifestyles fits well with many of the key policies and strategies which inform the development of our services and our communities here in Wales. This may be helpful when seeking funding.

Small changes can significantly increase our chances of avoiding illness, such as heart disease, some cancers, obesity or diabetes.

These include: The Assembly Government's consultation document Well Being in Wales which emphasises that everyone in Wales shares responsibility for health. Government's role is to help create the conditions necessary to help people to improve their health.

Teachers and parents consistently report better behaviour and better concentration levels from children who have eaten regular, balanced meals, especially breakfast and from children who have avoided some of the additives found in fizzy drinks and sweets.

'Health Challenge Wales' is the Welsh Assembly's challenge for the nation. It asks organisations in the voluntary sector to do as much as they can to help the people who use their services and their own employees, to improve their health.

Evidence shows that people feel better after taking some form of physical activity such as a walk in the open air. Even this modest level of activity promotes mental health and can help combat depression.

The Welsh Assembly Government has developed a nutrition strategy called "Food and Well-being" which outlines the actions required to improve the diet of people in Wales.

Plascrug Leisure Centre - cycling in the woods, near Aberystwyth.


6

HEALTHY

COMMUNITIES

TOOLKIT

The Review of Health and Social Care in Wales 2004 (known as the Wanless Report) states that the demands on health care services are unsustainable in the longer term and that greater emphasis on preventing ill health in the first place is essential. "Designed for Life" is the ten year strategy outlining how National Health Services should look by 2015. "Life Long Health" is one of the Three Design Aims. The aim is to focus on health and well being not illness by: l

Using every avenue to promote healthy communities

l

Empowering individuals to take responsibility for their own health.

The Ceredigion Health, Social Care and Well-being Strategy is part of "Ceredigion 2020" which is the Community Strategy for the county. This is the basis for developing services and is the key vehicle for taking forward the Health Challenge Wales agenda in Ceredigion.

Why are community organisations well placed to promote healthy lifestyles? Community Organisations offer: A safe and trusted environment that accesses some of the most vulnerable members of the community. Such an environment is favourable to influencing change. A relationship with the client group that allows for open discussion which is non-judgemental. This environment and relationship provide a unique platform that can significantly influence changes in lifestyle issues.

A wealth of local knowledge and insight about their members and their community which can help the depth of engagement necessary to bring about longterm change. The opportunity to bring about change, not simply by telling and informing but by allowing the client group to experience change, through seeing, doing, or tasting something new. Again, such experiences can significantly influence change in the long term. A unique position outside the health service with its current emphasis on treating ill-health, where members of the community can access advice and support on healthy lifestyle issues.

The Benefits to your organisation: Healthy Lifestyle issues provide a focus for discussion and activities that is beneficial to both staff and clients. Discussions provide an opportunity to share thoughts and experiences, making clients feel included and valued. Healthy lifestyle initiatives prompt greater participation and the opportunity for greater engagement with the client group. Learning new skills increases the confidence and self esteem that is so essential for long term change. Staff may also appreciate being supported to live a healthier lifestyle and they in turn can subsequently become role models for members.


GETTING

Getting started...

STARTED

7

Promoting healthy lifestyles is about an organisation looking at the factors that influence health and taking up those that best suit the organisation and its members. This may be healthy eating or physical activity, stress or smoking. In our experience healthy eating has been a popular issue with which to start. It has helped organisations and their members develop their confidence and subsequently go on to introduce other aspects of healthy lifestyles. Reflect on your own organisation‌ what health messages does your organisation give? For example: Do you offer fruit as a snack option? Do you provide healthy meals? Does a health initiative have a place in the future aims of your organisation? How do you see a health initiative possibly benefiting your organisation, its staff and its members? Look at different types of projects either from the experience of the"Helthy Heart Project" (See "Projects") or use the websites and their links to other networks for further ideas (See "Resources"). Support of staff Assess the level of interest and commitment from your staff for a health initiative. Their support is crucial for its success. Assess the resources available amongst your staff; their level of knowledge, skills and confidence. Identify what you need to take the initiative forward e.g. training, resources, information, support, guidance etc .See "Resources" re what is available.


8

HEALTHY

COMMUNITIES

TOOLKIT

Support of Members It is important for the success of an initiative that you talk with the people who could benefit from taking action on healthy lifestyles Your project is more likely to succeed if your members are involved from the start in deciding what to do and how to do it. Everyone will bring with them some knowledge and experience. This needs to be respected and used as a baseline and a resource from which to move forward. It's important to start from where people are and offer the information and support in a way that is acceptable and promotes confidence and self esteem. All this can seem daunting, but remember the incentive for change is there - no-one is likely to regret feeling and looking better. Furthermore, improving their lifestyle is often something which is within their control, even when they are facing a range of serious problems and challenges elsewhere in their lives. Taking the Time Some initiatives take time to 'bed in'. Even positive changes can face pockets of resistance. This is why the support of staff and members for the initiative is crucial. Holding firm is important, giving people the time to adjust to the change Working with Others...Partnership and Networking It may be worth considering whether it would be beneficial to work in partnership or simply linking with another local group or organisation to share resources, support and experience. The Resource section lists various network web sites where ideas and experience can be shared. How to keep it Going‌ "Sustainability" Whatever initiative you choose you need to consider ways of making it sustainable. Training a member of staff rather than depending on outside skills, resources such as books, kitchen or sports equipment are all good investments with a long term effect. Organisations often found that following initial funding, members felt so positive about the initiative they were prepared to pay towards keeping it going. Where sustainability is not possible, it will help to collect evidence of success (see "Evaluation"). This can then be used to back up any future funding application.

Is it Working?... Evaluation This will involve identifying the changes your initiative has made on the organisation and the members. How you evaluate needs to be considered at the beginning. There is a section in this tool kit on the process of evaluation. This process is particularly important where you need to seek future funding. Making it a part of your organisation‌ Policy A policy can help identify to your staff and trustees what you are doing and why. It shows that good practice is embedded within your organisation. This tool kit contains an example of what you may wish to include in a policy. Funding Funding is not always needed to start an initiative.You may wish to relocate existing funding or come to an agreement with the members to introduce payment eg. 10p for a piece of fruit The healthy heart programme had an operational fund that gave financial support to the various projects. This fund ends in March 2008. Organisations needing to access sources of funding should contact Ceredigion Association of Voluntary Organisations (CAVO) who have up to date information on sources of funding. Details of CAVO and other sources can be found in the Resource section. Organisations should also be mindful of the latest government initiatives on healthy lifestyles. These are promoted via the media and in policy documents. If your work supports government objectives, it is more likely to attract funding. Writing Down the Detail for Funders‌ Service Level Agreements (SLA) If you are receiving or giving funding to improve lifestyles, you may find that a Service Level Agreement helps clarify in detail what the funder and the deliverer are trying to achieve. An example of the outline SLA we used appears at the end of this toolkit (page 54).


FOOD

9

Key facts about‌ Food l l

l

l

A third of the nation's children are now overweight or obese. Compared to those with a healthy diet, malnourished children are 51% more likely to exhibit antisocial behaviour at 17. Two in every three Britons who are overweight have a potentially life-threatening health problem as a result. Poor diets cost the NHS ÂŁ6 billion a year in ill-health.

Fruit & vegetables

Bread, other cereals and potatoes

The eight guidelines for a healthy diet are: l enjoy your food; l eat a variety of different foods; l eat the right amount to be a healthy weight; l eat foods rich in starch and fibre; l eat plenty of fruit and vegetables; l don't eat too many foods that contain a lot of fat; l don't have sugary foods and drinks too often; l if you drink alcohol, drink sensibly and limit the amount. There are no bad foods, only bad diets, say most experts. That means it is important to eat a wide variety of foods and include a good amount of fruit and vegetables. When it comes to healthy eating, little things can make a big difference. Here are a few tips on healthy eating l

l l l

Meat, fish & alterantives

Milk & dairy foods

Foods containing fat. Foods and drinks containing sugar

The Balance of Good Health aims to give people a practical message about healthy eating and is based on the 8 guidelines for a healthy diet. It shows the types and amounts of different foods that should be eaten to achieve a well balanced, healthy diet. The Balance of Good Health applies to most people. It applies to vegetarians, people of all ethnic origins and people who are a healthy weight for their height, as well as those who are overweight. However, it does not apply to children under two years of age because they need full fat milk and dairy products

l l

Try low-fat alternatives to dairy products, such as low-fat spreads instead of butter, and skimmed or semi-skimmed milk. (Skimmed or semi-skimmed milk contains a bit more calcium - good for healthy bones - than the full-fat variety). Trim the visible fat from meat. Grill or oven cook rather than fry. Get out of the habit of adding salt to your food taste it first. Add salad to sandwiches, and choose fruit for snacks. Check the labels. You would be surprised what some foods contain - and many 'convenience' meals are loaded with fat and salt. Use this handy guide

Sugars Total fat Saturated fat Fibre Salt Sodium

A lot 10g 20g 5g 3g 1.5g 0.6g

A little 2g 3g 1g 0.5g 0.3g 0.1g

Look at the fat, sugar and calorie content per 100g. How do they compare to the guidelines in the table above?


10

HEALTHY

COMMUNITIES

TOOLKIT

You should be aiming for more products that fall into the 'little' category, only eating products that fall into the 'lot' category sparingly. A small amount of fat helps keep you healthy but you need to be careful about how much you eat. This is especially true of saturates, which are found in butter and lard as well as cakes, biscuits and pastries. As the balance of good health chart shows, a healthy diet is based on starchy foods such as bread, pasta (particularly whole grain varieties) and potatoes, and at least five portions a day of fruit and vegetables. Add to this, small amounts of milk and dairy products, meat (or vegetarian alternatives) and fish, and a little of foods containing fat and sugar. A healthy diet also contains about two litres (3.5 pints or 6-8 glasses) of fluids a day. Everything counts water, milk, and hot drinks - but not alcohol. Getting your 5 a day Eating at least five portions of fruit and vegetables a day is an essential part of a healthy, balanced diet. By following the 5-a-day guidelines, you could reduce the risk of cancer, heart disease and other conditions.

What counts as fruit and vegetables? l Fresh, frozen, chilled, canned, 100% juice and smoothies all count, as do dried fruit and vegetables. l Fruit and vegetables don't have to be eaten on their own to count. You can also include any vegetables found in soups, stews, sandwiches and other dishes. l Fruit and vegetables contained in convenience foods like ready meals, pasta sauces, soups and puddings, also contribute to your 5 A DAY. l However, these ready-made foods can be high in salt, sugar and fat, which should only ever be eaten in moderation, so it's important to check the nutrition information on the labels and packaging. l Dietary supplements like vitamins and minerals do not count towards 5 A DAY. This is because many dietary supplements don't have the same nutritional benefits as fruit and vegetables. l Potatoes do not count. This is because they are classified as a starchy food. They contribute to your healthy balanced diet, but not to your daily portions of vegetables.

What is a portion? A general rule, easy to remember, is that one handful is a portion, so this means smaller portions for children who will have smaller hands. A portion is about 80g of fruit or vegetables. This is roughly equal to: l an apple, orange, banana, or similarly-sized fruit l two plums, nectarines or similarly-sized fruit l a handful of grapes or berries l a slice of melon, pineapple or large fruit l one tablespoon of raisins or other dried fruit l two serving spoons of cooked vegetables, e.g. broccoli or carrots l a dessert bowl of salad l two serving spoons of beans and pulses l a 150ml glass of fresh fruit juice or smoothie

Penparcau Family Centre - healthy snacks, Aberystwyth.


FOOD

11

Types of Projects: Food 1. Fruit Snacks

2. Healthy Meals

Fruit offered at break time, instead of biscuits.

A healthy meal (e.g. breakfast or lunch) provided on a regular basis at low cost.

Key Features l Simple and effective way of introducing healthy lifestyles. l Low cost funding . l Both parents and children respond well. Benefits l Encourages children to try fruit they may not eat at home. l Introduces fruit as a snack option. l Children ask parents to buy fruit. l Raises awareness and discussion about healthy eating l Parents proud to see their children eating fruit. l Parents prepared to pay to keep the fruit snacks. l Easy to keep going---sustainable l Organisations encouraged by the positive response have gone on to start other health initiatives. l Staff have gone on to request training on healthy eating. l Supports the "5 a day" initiative and the Health Challenge Wales directive. Remember l Change takes time. Keep offering, as some children may initially be reluctant to accept fruit as an alternative to crisps and biscuits. l The initiative needs firm but supportive leadership from the organisation from the start.

"The fruit tuckshop has been a great success from the very beginning." (Cardigan Family Centre Annual Report.) "I'm proud that my child eats fruit. I never thought about giving it before." (Parent, Penparcau Family Centre.)

Key Features l Provides a healthy meal once a week or every day. l Can be run by volunteers or paid staff. l Members should be encouraged to participate and learn about preparing and eating healthier foods. l Participation leads to the sharing of cooking ideas, recipes, shopping and budgeting issues. l Requires commitment from designated members of the organisation to prepare and plan meals l Staff will have to go through the correct food and hygiene training. l May need funding to cover the cost of food initially. l Charges for meals to fund cost of food, may vary between asking for a minimum donation to one based on a waged and unwaged price. l Change of existing meals to healthy options, with no significant cost to the organisation. Benefits l Provides opportunity to taste a variety of healthy food. l Increases skills and knowledge about healthy cooking. l Increases confidence to try and to buy different food. l The sharing of recipes encourages clients to cook at home. l Prompts discussion about shopping on a budget and where to buy. l Provides a basis to engage with the client group and helps identify other client needs. l Provides the opportunity to engage positively with the client group - through sitting with members to enjoy the food clients often become more relaxed to talk about other issues. l Increases social interaction/ fun. l Leads to the organisation wishing to take up further health initiatives, such as yoga classes, group walks, swimming sessions and the provision of a smoking cessation service.


12

HEALTHY

COMMUNITIES

TOOLKIT

Remember l Success depends on the skills, attitude and approach of the session leader. l Staff will need to be given the time, support and training to undertake the initiative. l Meals need to be available on a regular basis e.g. every Wednesday, to gain the support of members. This requires commitment from the staff. "Provision of healthier food options on a regular, consistent basis proved a springboard for engaging clients in other matters relating to healthy living." Healthy Heart Project report to Welsh Assembly Govt. "Coming here and having a good breakfast is the best thing that's happened to me. I've stopped drinking and just got my own flat. Thanks." (MIND client).

3. Training and Cooking Skills Developing basic skills in food preparation and cooking. Key Features l Participation builds confidence and develops skills. l Opportunity to educate about budgeting and the preparation of low-cost meals. l Delivery needs to be appropriate and sensitive to your group. l A member of staff or external person may be used to deliver programme. Benefits l Practical experience in a supportive environment gives the confidence to try new cooking skills at home. l Raises self esteem. l Training a member of staff provides a resource for the long-term. Remember l You may need to recruit or train a suitable instructor. l For training on cooking skills and healthy eating, you can contact Ceredigion Public Health Team in Lampeter. "The cooking course gave me confidence to try out new ideas and made me aware of healthy options." (Family Centre parent).

4. Food Co- Ops A food co-operative is a group of people organising to buy fruit and vegetables in bulk direct from wholesalers or farmers. Key Features l Increases access to fruit and vegetables. l Reduces cost l Run mainly by volunteers l Funding needed to buy equipment e.g. weighing scales, knife and initial float. l Continuing costs include transportation, hire of premises and payment of volunteers' expenses. l Legally, co-operatives must be a membership organisation usually run on a modest annual fee of between 50p and ÂŁ2 Benefits l Increases consumption of fruit and vegetables. l Cheaper fruit and veg. l Can provide a setting for exchanging recipes and information about healthy eating. l Social benefit. People working together for their own community. l Volunteers can gain new skills e.g. book keeping and improve their chances of employment. Remember l The food co-op will need consistent support and commitment from volunteers. l It may require quite a lot of work and possibly financial skills. l To find a reliable supply of good quality produce and suitable storage. l It helps to have access to a supportive co-op network.

5. Using Arts and Crafts Relaying health messages to your group, using art and craft activities as an attractive way of getting people involved. Key Features l Popular activity can be themed around the health message. l Everyone can be involved in these activities l Many organisations will already have the necessary materials.


FOOD

Benefits l Stimulates discussion about healthy eating. l Children influence parents' choices. l Participation allows for greater social interaction and feeling of involvement. l Most organisations are able to supply materials without significant cost. Remember l You may wish to talk to or involve your local community theatre or a "Theatre in Education" company. l Funding may be needed to work with other community/theatre groups. Small World Theatre (Cardigan) worked with residents of Golwg y Castell and Ridgeway, using giant puppets and models of food options, engaging the participants and the general public in identifying healthier food choices.

13

6. Buying of resources The buying of equipment and materials to support health initiatives. Key Features l Organisations often need support to promote healthy eating by purchasing equipment or materials e.g. ovens, fridge freezers, basic cookery books etc. (See "Resources" for funding) Benefits l Food bought in bulk saves both on cost and staff time. l Ovens allow for participation / demonstration in food preparation. l Books stimulate discussion about cooking and exchange of recipes. l Books may be provided on a loan scheme to encourage cooking at home. l Such initiatives are sustainable. Remember l Staff will need the correct food and hygiene training before cooking with client group. l There are rules about health and safety relating to equipment and food handling-but don't be put off - these are not difficult to comply with. See Resources - Environmental Health.

Small World Theatre Arts and crafts with residents of Golwg y Castell and Ridgeway, Cardigan.


14

HEALTHY

COMMUNITIES

TOOLKIT

Key facts about‌Physical Activity

Modern life is making us increasingly inactive and this is proving hazardous to our health. Physical Inactivity l Is a serious health problem. 7 in every 10 women and 6 in 10 men in the UK are not active enough to benefit their health. l Is a major cause of some of the UK's biggest killers - heart disease, stroke, diabetes and bowel cancer l Contributes to overweight and obesity in adults and increasingly in children l Increases frailty, dependence, falls and fractures in the elderly Estimated cost of physical inactivity (through disease and disability) in England & Wales is more than ÂŁ8.2 billion Recommendations Any increase in activity will benefit your health but experts agree that: l

l

l

l

Adults need to do at least 30 minutes of physical activity that makes you slightly out of breath on at least five days a week. Children and young people should aim for 60 minutes. You can add together separate periods of activity to get the total. If you use a pedometer to measure how far you walk, 10,000 steps a day would qualify as "active". Try to do at least 5,000. The aim is to make physical activity part of your everyday life. You can build up slowly and do it in 10 minute "bursts".

Why be more active? Physical activity improves your physical and mental health. It is one of the most important factors in maintaining a good quality of life. The heart is simply a muscle, but it's the most important muscle we've got, and it needs exercise to keep fit so that it can pump blood efficiently with each heart beat. Your health risks will decrease as soon as you start to do more. You don't have to be fit to start with - build up your level of activity

gradually, you'll soon feel the difference. Being active will make a difference to your quality of life. Once you start, the benefits will become obvious. You'll experience: l Improved health l More energy - you'll be able to cope with your daily routine and have energy to spare l Reduced stress - you'll relax more easily and feel better about yourself l Stronger bones and muscles l Better balance, strength, suppleness and mobility l More independence in later life - you'll be able to cope with daily tasks more easily l Improved sleep l Better maintenance of a healthy weight l More social opportunities - you'll meet other people who enjoy being active l A sense of achievement l Increased enjoyment - activity can be fun and it's something you could do as a family. TAKE CARE! If you have had heart trouble, high blood pressure, a bone or joint problem that could be made worse by exercise, or have any worries about becoming more active, talk to your family doctor. Don't suddenly take up very vigorous or competitive exercise like badminton or squash without medical advice.

Health or Fitness Some people are put off becoming more active because they think they have to work out at a high intensity, compete with others or wear a designer tracksuit. None of these things are necessary. If you want to feel better and reduce the risk of ill health you should be physically active. To achieve the health benefits it doesn't require the same intensity of training as becoming fit. You can simply build physical activity into your daily routine, either as a form of 'active commuting' (walking or cycling, perhaps) or in the comfort of your home or a health club. The main message is... 'it doesn't have to be hell to be healthy.'


PHYSICAL

ACTIVITY

15

Tips for becoming more active l It can be free...doing enough physical activity doesn't have to cost money. l You don't have to join a gym or buy any special equipment. l You don't need to be thin or fit to make a start. l Moderate activity includes brisk walking, gardening, housework and playing with children. l There are lots of small changes you can make to your lifestyle: l l l l l

Take the stairs instead of the lift Walk part (or all!) of your journey to work or school Go for a walk in your lunch break Walk to the shops Don't use the remote control to change TV channels

Tips on overcoming the barriers to activity. People may say that they would like to increase their activity levels but there's a barrier to doing so‌

Barrier

Solution

Lack of Knowledge and information

Provide leaflets/education

Lack of exercise partner/social support

Check community schemes or organise group activity

Not the 'sporty type'

Emphasise the activity, not "sport" or "exercise"

Financial constraints

Walking is the best activity and it's free

Lack of available facilities

Facilities are not always necessary

Lack of motivation and willpower

Think about developing a buddy system where you encourage each other to be active together

Fear of injury, fear of embarrassment

Walking is the safest and simplest activity

Don't enjoy it

Try from a variety of activities and find what you like

Fear of doing too much activity

Start very slowly and gradually build on current levels of activity


16

HEALTHY

COMMUNITIES

TOOLKIT

Types of Projects: Physical Activity 1.Group Walks

2. Taster Sessions

Walks led by organisational member.

May include, yoga sessions, swimming/ gym sessions at local leisure centre, use of exercise videos eg. salsa dancing.

Key features l No funding required. l Walks can be varied according to age and ability of group. l Pedometers can be used where available. l If required, training for walk leaders is available free of charge through the "Walking the Way to Health" scheme. Benefits l Feel Good factor-lifts mood. l Pedometers increase awareness of the amount of walking needed to reach the recommended daily target. l A varied programme of walks can be developed where the number of steps per walk can be counted to create a group step-map. l Participation--improves social interaction within the group. l Identifies walks to share with friends and family. l Increases awareness of environment, local features, nature. Remember l Be aware of safety issues relating to suitability of walk for your group including identification of any hazards.

Key features l Type of activity may be chosen by the participants according to the interest and skills of the group and local facilities available. l Encourages participation. l Women, in particular, may value group support to undertake physical activity. l Funding may be required for tuition and equipment. l Leisure facilities may operate reduced fees for certain groups.. Benefit l Group members value the time to focus on themselves. l Increases sense of well being l Improves group cohesion l Increases awareness that physical activity can make you feel better l Can lead to other initiatives such as making your own exercise DVD. Remember l Choose a suitable activity, bearing in mind, for example, that people may be sensitive about their physical appearance. l Government policy supports the funding of physical activity initiatives in the community. ( See Resources ) l On going costs means that an evaluation process needs to be in place if you want to support future funding proposals (see "Evaluation".) "The physical activity project had the greatest influence because it helped establish routines." (Head of Pupil Referral Unit.)


Medwyn Williams helping with plans for the Toy library garden, Maesglas, Cardigan

3. Grow Your Own! Creating or adapting gardens to produce fruit and vegetables.

l l l

Key features l Involves local people in decision making and planning. l Brings together individual gardeners to provide advice and guidance. l Area may be a plot of land, raised beds in a yard or a few containers/grow bags. l Tools provided may be shared with other such initiatives. l Organiser needs to have a good knowledge of growing and be able to relate well to people of all backgrounds. l Funding may be needed for tools if donations are not available from local gardening enthusiasts. Benefit l Encourages people to try different vegetables l Involves people of all ages and abilities. l Produce can be shared, given away or sold.

l l l

Sense of achievement Raises self esteem Working together Growing herbs can encourage people to try new flavourings and use less salt. May complement school curriculum. Combines participation in growing food with physical activity.

Remember l Insurance may be necessary if setting up a new garden (See Resources, 14.) l A local garden centre or gardening club may know where to buy reasonably priced equipment / plants etc. and may also know of an enthusiastic gardener to act as a volunteer adviser. The Healthy Heart programme worked with the Toy Library in Cardigan, Ysgol Ceredigion in Aberaeron and Felinfach and with residents of the Ridgeway, Cardigan to establish gardens to grow fruit and vegetables.


18

HEALTHY

COMMUNITIES

TOOLKIT

4. Buying of resources The buying of equipment and materials to support physical activity. Key Features l Organisations and individuals often need encouragement and support to take up physical activity. It may help to purchase materials such as pedometers, exercise mats, sports equipment, exercise videos, etc. and to pay for some tuition, (e.g. Yoga) at least to start up an activity (See "Resources" for funding). Benefits Activity in a group setting helps give mutual support and motivation and spreads the message. l Offers a variety of resources to allow the group to choose their starting point. l Is a good tool for increasing social interaction within the group. l

Remember l You can work with others... The Cardigan step map pictured here was produced by the Healthy Heart project in partnership with the University of Wales, Aberystwyth and local residents.

Ridgeway residents help make a local map showing steps taken and calories burned

Cardigan Step Map


SMOKING

19

Key facts about‌Smoking

l

Smoking is the single greatest cause of preventable illness and premature death in the UK.

l

Just over a quarter - 26 per cent - of adults in Wales are smokers. But 27 per cent of adults in Wales are ex-smokers.

Reasons to quit There are lots of good reasons to quit. Everyone's motivations to stop will be different. Here are some health benefits to quitting. The sooner you give up smoking the better.

l

Nicotine is very addictive. But it is the tar and other chemicals in cigarettes that cause cancer. Other harmful chemicals found in cigarettes include: l l l l l

After: l 20 minutes - your blood pressure and pulse return to normal l 8 hours - nicotine, carbon monoxide and oxygen levels in your blood begin to return to normal l 2 days - your lungs start to clear and your sense of taste and smell begin to return l 3 days - breathing is easier and your energy levels increase. l 2-12 weeks - circulation improves and exercise gets easier l 3-9 months - breathing problems, coughing, shortness of breath and wheezing improve l 5 years - risk of having a heart attack falls to about half that of a smoker l 10 years - risk of lung cancer falls to about half that of a smoker. You have the same risk of a heart attack as someone who has never smoked. Improve your health, whatever your age. Giving up smoking at any age will increase life expectancy.

What is in a cigarette? The three main components of cigarette smoke are: l Nicotine - a fast-acting drug that makes smokers crave cigarettes l Carbon monoxide - a poisonous gas that reduces oxygen in the blood stream causing breathing problems

Tar - a sticky black residue made up of thousands of chemicals that stays in the smoker's lungs and causes cancer.

l

Acetone - used in nail varnish remover Ammonia - used in dry cleaning fluids Arsenic - used in pest control and insecticides Benzene - used in chemical manufacture Cadmium - used in batteries Formaldehyde - used to preserve dead bodies.

Low Tar Cigarettes 'Low tar' cigarettes are just as harmful for you as regular brands. When people smoke 'low tar' cigarettes they breathe in much harder, to get the amount of nicotine their body craves. These cigarettes may be carefully designed to taste weaker but they are probably doing your body just as much damage as the 'stronger' brands. Giving up Giving up is the best thing a smoker can do to improve their health. Most smokers say that they would like to give up if they could. But for some, stopping isn't simple. Questions to ask before setting a quit date. l Why do I smoke? l Why do I want to stop smoking? l Is this the right time to stop smoking? l When am I most likely to give in to cravings? l What can I do to overcome these cravings? l Who can support me whilst I'm giving up? l How can I reward myself for giving up? l When would be a good quit date? Once you've thought about all these issues you may need some support with quitting for good.


20

HEALTHY

COMMUNITIES

TOOLKIT

Professional help There are professionals available to help you give up. The NHS has a range of services on offer. These include: l

l

The national Smoking Cessation Service in Wales offers various options for support, including individual or group sessions contact 0800 085 2219 The national Smokers Helpline is also there to offer friendly advice and support contact 0800 169 0 169

Withdrawal symptoms There are several products on the market to help control withdrawal symptoms. Many are free on prescription from your GP. Nicotine Replacement Therapy (NRT) NRT helps by reducing your nicotine cravings. It has been shown to double the chances of successfully quitting. It is also less addictive than smoking and doesn't cause cancer. NRT is available on prescription or over the counter as gum, patches, tablets, lozenges, nasal spray or inhalers. You usually take a 10-12 week course.


SMOKING

21

Types of Projects: Smoking Supporting the no smoking policy within organisations and the training of a member of your staff as a smoking cessation counsellor.

1. Support Key Features l Organisation supports clients with information about: l The national smoking cessation service. l The effects of passive smoking. l The cycle of quitting Benefits l Supports the national health message and legislation. l Staff and clients work in an improved atmosphere l Instigates discussion and information about quitting. Remember l Staff attitudes need to be supportive. l Smoking cessation represents a significant challenge. l May stimulate a demand for staff training on 'brief intervention' work (see Resource section).

2. Smoking Counsellor Support over a period of time, 1:1 or in a group, to give up smoking. Key Features l Needs specialist training input. l Uses either existing staff or the Smoking Cessation service. l An "advanced" intervention. Benefits l Major reduction of risk of serious illness. l Timely intervention as new law impacts on social activities. l Responds to the wish of the majority of smokers to give up. l Sets smoking cessation in a context where clients feel safe, supported and comfortable. l Produces measurable results which can be used for evidence for future funding. Remember l Consider the availability either of a suitable member of staff for training or of the Smoking Cessation Service. l Cost of training and staff time. l Funding would be needed for the specialist training and salary of a smoking cessation counsellor. l The cost could be taken up by the national smoking cessation service where evidence shows its effectiveness. l Might follow on from other simpler healthy lifestyle interventions which have engaged clients with, for example food.


22

HEALTHY

COMMUNITIES

TOOLKIT

Key facts about‌ Stress

l

l

Half a million people in the UK experience workrelated stress at a level they believe is making them ill. Twelve million adults see their GP with mental health problems each year.

Stress means different things to different people. A situation that is intolerable to one person may be stimulating to another. What you feel is determined not just by what is going on around you, but how you react to it. The important point is that you learn to recognize how you respond to stress and if necessary that you develop skills to deal with it. Are you under too much stress? How you may feel: l Tired l Breathless l Sweating l Difficulty in sleeping l Depressed l Irritable l Neglected l Fearing you are ill l Dreading the future l Dreading failure l Taking no interest in life l Believing you are bad or ugly l Lacking interest in others l Losing your sense of humour l Having no-one to confide in.

Ten tips to tackle stress l

l

l l

l

l

l

l

l l

How you may behave: l Difficulty making decisions l Inability to show true feelings l Problems concentrating l Avoiding difficult situations l Denying there's a problem l Frequently crying.

l l l l l

Make the connection. Could the fact that you're feeling under-the-weather be a response to too much pressure? Take a regular break. Give yourself a brief break whenever you feel things are getting on top of you - get a soft drink or take a brief stroll. Learn to relax. Follow a simple routine to relax your muscles and slow your breathing Get better organised. Make a list of jobs; tackle one task at a time; alternate dull tasks with interesting ones Sort out your worries. Divide them into those that you can do something about (either now or soon) and those that you can't. There's no point in worrying about things that you can't change. Change what you can. Look at the problems that can be resolved, and get whatever help is necessary to sort them out. Learn to say 'no'. Look at your long-term priorities. Step back and examine what it is about your life that's giving you too much stress. What can you off-load, or change? How can you introduce a better balance between work, social life and home life? Is it time to reassess your priorities? Improve your lifestyle. Find time to eat properly, get plenty of exercise and enough sleep. Avoid drinking and smoking too much. However much you believe they can help you to relax, they'll have the opposite effect. Confide in someone. Don't keep emotions bottled up. Focus on the positive aspects of your life. Learn to relax Close your eyes and breath slowly and deeply. Locate any areas of tension and try to relax those muscles; imagine the tension disappearing. Relax each part of the body, in turn, from your feet to the top of your head. As you focus on each part of your body, think of warmth, heaviness and relaxation. After 20 minutes, take some deep breaths and stretch your body.


STRESS

23

Types of projects‌Stress

Unlike the food and physical activity projects, stress by its very nature was not taken up as a specific project by the organisations. However the food and physical activity projects, with their emphasis on participation did much to raise self esteem and improve social isolation which in turn helped to alleviate stress. The following aspects of stress have therefore been identified by analysing the take up of projects by participants. Key Features l Recognising that stress means different things to different people. l Providing time to listen to peoples' concerns and worries is an important factor in alleviating stress. l Talking about healthy lifestyles made people more comfortable to discuss other personal issues with members. l A healthy lifestyle - physical activity and a balanced diet - helped greatly in dealing with stress. l Participation improved skills, self esteem and social isolation.

Young people biking in the hills above Aberystwyth

Benefits l The involvement of clients who found communication difficult was helped by their joining in with activities. l Health initiatives helped the group focus away from difficult issues and enabled them to see that a healthy lifestyle is something that can not only make them feel better but is also within their control. l Discussion with the group members about a health initiative showed not only that the group valued their health but also their views and ideas, thereby increasing feelings of self worth l Provision of a healthy meal was one initiative that was found to give clients a reason for attending the group. Without the provision some clients would not have had the courage to attend and ultimately receive the support they needed. Remember l Professional help is always available through the GP.


24

HEALTHY

COMMUNITIES

TOOLKIT

Overall Good Practice‌

This is a community organisation's own description of how, with modest financial support and advice, they were able to promote healthy lifestyles right across the organisation in a positive and effective way. "Jig-So Children's Centre initially started with a small grant from the Healthy Heart Project in 2003.This money helped start up a Fruit Tuck Shop. In consultation with users, a very important part of any project that we do within the centre, we tried to sell the fruit at a nominal cost to encourage children and adults to increase their daily intake of fruit. However, we quickly realised that our grant money was disappearing fast and the provision of fruit would not therefore be self sustaining. During a user group meeting all users agreed that it was currently too cheap and it was suggested that the price be increased in order to keep the project running indefinitely. As a result, the fruit now retails at 15p per item and the project is self sustaining. In consultation with the Health Team, we felt that we would like to encourage further healthy lifestyle options and set up healthy cooking and food sessions, one day per week. This involved training for staff, a grant for equipment and extensive consultation with the users, management and all involved. We recognize that learning by trial and error is fine. We recognize we are not perfect and it encourages others to try. Many things have changed. We operate an equal opportunities policy and therefore wanted to make sure people were not excluded on cost grounds. We ask for a donation of ÂŁ1 per family for meals and most donate. Again it is now self sustaining and we have requests to increase the number of days something to think about for the future.


OVERALL

These sessions have prompted many comments: "but I always cook my Sunday chicken from frozen!" to: "you don't have to use fatty ingredients to have a tasty meal". We use simple achievable recipes such as soups, pasta etc. "I used all the recipes at home, followed your advice and the kids really enjoy themselves." We photocopy recipes, use questionnaire sheets and constantly talk to all involved in the process. If something isn't working we ask for suggestions and talk our way around the problem. Staff and users are enthusiastic and requested further healthy lifestyle initiatives: Yoga, Swimming, Gym sessions, and Walking (pedometers and refreshments encourage participation!). A "Health Fun Day" was organised, which included the launch of the Cardigan Steps map and fun aerobics and late last year we organised a Health, Safety and Wellbeing Day for the general public. This incorporated all aspects of health, including Diabetes, Stroke, Language, Dental and Diet and attracted all ages .

Jigso Children's Centre family walk, Cardigan

GOOD

PRACTICE

25

Grants were applied for and received (our service is free.) and though we've encountered a variety of hurdles: poor attendance (at first), pools closed etc. with perseverance, communication and a willingness to change and respond to the need, we have just finished a complete year of physical exercise combined with our healthy food programme. Users are already requesting more and we look forward to the next few years of promoting and supporting healthy lifestyles! Thank you to everyone who enabled us to take these first steps.

Debra Davies-Russell, Jigso Family Centre, 2 Pont y Cleifion, Cardigan debra@davies-russell.wanadoo.co.uk


26

HEALTHY

COMMUNITIES

TOOLKIT

Help! Resources: Including information, funding & training‌

Support within Ceredigion 1. Ceredigion Public Health Team (CPHT). (Funding, support, training, resources) CPHT is part of the National Public Health Service (NPHS) for Wales. The aim of the team is to deliver health improvement locally. The team work in partnership with and in support of other organisations both locally and nationally to co ordinate action within Ceredigion. They can therefore provide information on, local initiatives, resources and sources of funding. The team are responsible for the following areas of work: Community development, physical activity, healthy food, healthy schools, accident and injury prevention, workplace health, diabetes and cancer prevention, sexual health, substance misuse and tobacco control. They also co ordinates the following project funded work: Community Healthy Food Programme, Inequalities in Health and Mind your Heart Programmes. The Food Programme has developed a healthy eating training course for community group leaders called ' Train the Trainer'- this is a free one day course. They are currently developing a 'Cooking Skills' training programme. Contact: Ceredigion Public Health Team, First Floor, 9 Bridge St, Lampeter, SA48 7HG Tel. 01570 424105 helen.jones@nphs.wales.nhs.uk 2. Ceredigion Council for Voluntary Action. CAVO (Funding, training.) Funding: Provides information on sources of funding both at a local and national level and holds the latest major funding directories. It also has the two computer programmes 'FUNDER FINDER' and 'GRANT FINDER' for up-to-date searches. Administers the GOOD HEALTH GRANT SCHEME which aims to provide one off grants up to a maximum of ÂŁ5,000 to voluntary organisations operating in Ceredigion.


HELP!

Training: CAVO provide a variety of training courses throughout the year. A list of courses is available to all members and on request. Contact: 'Bryndulais', 67 Bridge St., Lampeter,SA48 7AB. Tel. 01570 423232 www.cavo.org.uk 3. Ceredigion County Council (a) Environmental Health Department ( Food and Safety) (Support and training) Aim to educate, advise and assist individuals and organisations. It is a legal requirement that you contact the department and register if you are setting up an initiative handling food. They provide up to date advice on current food and hygiene regulations and provide information on the availability of Food and Hygiene Training course in the county. The department organise the CURIAD CALON food awards presented to qualifying organisations providing healthy food. Contact: Environmental Health (Food and Safety) Penmorfa, Aberaeron SA46 0AP Tel 01545 572151 www.ceredigion.gov.uk (b)Leisure Services (Includes: Ceredigion Sports Development Team). (Advice and funding) Work with other agencies to provide additional resources and opportunity for sport and recreation. Contact: Education and Community Services, Department of Tourism and Leisure, County Offices, Marine Terrace Aberystwyth SY23 2DE. Tel.01970 633600 The Ceredigion Sports Development Team is employed by Ceredigion County Council to actively improve participation in sport and health related exercise within the county. It works closely with the Sports Council for Wales, National Governing

27

Bodies of Sport and organisations such as the Urdd. Administers sport grant applications. Contact: Leisure Services, County Offices, Marine Terrace, Aberystwyth SY23 2DE Tel. 01970 633588 www.ceredigion.gov.uk (c) Department of Education Dragon Sport (Resources) This is a Sports Council for Wales initiative designed to offer 7-11 year olds fun and enjoyable sporting opportunities. It supports the development of After School and Community Sports Clubs. The web site has downloadable information on activities, game rules and more. To find out more, please contact: Bryn Evans, Ceredigion's Dragon Sport Co-ordinator on 01970 633695. Or: Dept of Education and Community Services, County Office, Marine Terrace, Aberystwyth,SY23 2DE Tel.01970 633600 www.dragonsport.co.uk 4. Walking the Way 2 Health (WW2H) (Training and resources) This is a national initiative that aims to improve people's health and well being by promoting regular walks. They lead regular walks in Aberystwyth, Cardigan, Aberaeron, Treagaron, Lampeter and Llandysul. Maps of the walks are available through Age Concern offices. One day training for walk leaders is available for volunteers or anyone wishing to lead their own group Contact. Aberystwyth Tel.01970 615151 Cardigan. Tel. 01239 615777 www.ww2h.org.uk/


28

HEALTHY

COMMUNITIES

TOOLKIT

5. Smoking Cessation Service (Support) Ceredigion has two smoking cessation counsellors for north and south Ceredigion. They provide support on an individual or group basis. Some GP surgeries offer smoking cessation clinics. Brief intervention training day can be arranged. For further information Contact: Mid and West Wales Smoking Cessation Service Tel. 01267 225039 6. MIND Aberystwyth (Support) Provides a smoking cessation counsellor specifically trained to support those experiencing mental health problems. A drop in centre offering low cost healthy meals is available twice a week. Support is provided through group activities which include: - Art and crafts, yoga, swimming and organised walks Contact: The Mill, Mill St. Aberystwyth. Tel 01970 626225 7. Area 43 (Support and training) The Cardigan Youth Project, Drop-In and Information Shop, is a registered charity set up to give help and support to all young people in the Cardigan and surrounding area. Area 43 is also a recognised Open College Network training centre. Contact: 1 Pont Y Cleifion, Cardigan, Ceredigion, SA43 1DW. Tel. 01239 614566 www.area43.co.uk 8. Health Visitors (Advice and support) Health visitors are based with GP practices and can help with advice and support on lifestyle issues for people of all ages. Contact: Local GP surgery 9. Coed Lleol (Advice and Support) Aims to help more people enjoy and care for Welsh woodlands. If you would like to know about the health benefits of spending time in the woods Coed Lleol will give you relevant information and contacts.

It is hosted by the Small Woods Association in partnership with the Forestry Ccommission and the country Side Council for Wales. www.coedlleol.org.uk 10.Rural Regeneration (Support, training) The Community Food Co-operative Programme in Wales enables people to access fresh fruit and vegetables on a weekly basis at wholesale prices. The average ÂŁ2 bag of vegetables and ÂŁ2 bag of fruit can help a family achieve the recommended 5 a day. If you think that your community would benefit from having its own food co-op, or would like further information, then contact the rural regeneration unit: West Wales Maria Davies 01269 823888 maria.davies@rru.org.uk Mid Wales Jenni Moorhouse jenni.moorhouse@rru.org.uk Wales Mark Jones 01492 660263 or 07717 734406 mark.jones@rru.org.uk. To find your nearest fruit and vegetable food co-op, visit the Community Food Initiatives Database. 11. SUBSTANCE AND ALCOHOL MISUSE (The Healthy Heart Project did not undertake projects related directly to substance and alcohol misuse. However, community leaders may find the following contacts useful if their members' physical or mental health is affected by these issues:) Prism is a local charity working to promote safer or non use of alcohol. Workers are available across West Wales and the service is free and confidential. They also have a service for under 18's called SUDDS. Ceredigion contact: 01570 422555 www.prism-online.info DAN 24/7 is a national, confidential service providing 24 hour advice to drug and alcohol users and anyone wanting information on substance misuse. The helpline number is: 08006 33 55 88


HELP!

12. SEXUAL HEALTH (The Healthy Heart Project did not undertake projects related directly to sexual health. However, community leaders may find the following contacts useful if their members' physical or mental health is affected by this issue:) Ceredigion Family Planning Clinics give free contraception, pregnancy testing and advice on sex and relationships. They are based in Aberystwyth, Aberaeron, Cardigan and Lampeter. GUM clinics offer emergency contraception, treatments and testing of sexually transmitted infections (STI's) and HIV testing. They are based in Aberystwyth and Cardigan. All can be contacted on 01545 571224

Support Nationally 1. Food Standards Agency: FSA (Information, training and sources of funding) The FSA carries out a varied programme of work on nutrition including practical initiatives. Their web site is informative. Under 'Nutrition' find 'Community'. This section is for people working in the' Community,' containing details of how you can help people learn more about food and gain cooking skills through local nutrition initiatives The agency produces a wide range of publications for the public and food industry many are available free of charge. Some titles can be downloaded. l

l

A ' Get Cooking' training pack, provides trainers with a tool kit to teach young people broadly between the ages of 14-25 some basic cooking skills in a community setting. Also available is a pack on 'Funding for Initiatives on Nutrition and Diet'. Contact: 11th Floor, South Gate House, Wood St. Cardiff. CF10 1EW Tel. 02920 678999 www.food.gov.uk EAT WELL The FSA has a link web site 'eatwell', for consumer advice and information. The site is packed with practical healthy eating and food safety tips. www.eatwell.gov.uk

29

Publications include:l Eat Well-8 tips on healthy eating l Salt--Facts for a Healthy Heart l The balance of Good Health 2. British Heart Foundation. BHF (Information, advice and resources) BHF is a registered charity that funds research, education, care and more in its fight against heart disease. The foundation provides pamphlets on healthy eating, physical activity and smoking. These are available free of charge or for a small donation. Some can be downloaded and all can be ordered online. The website offers a smoking micro site, providing information, advice and online support to those wishing to stop smoking. Publications (see websites) include: l So You Want To Lose Weight‌‌For Good. l Healthy Eating l Staying Active www.bhfactive.org.uk l Get Kids on the Go l Smoking and How to Give Up www.bhf.org.uk/smoking/ Contact: 14 Fitzhardinge St. London.W1H 6DH. Tel. 020 7935 0185 www.bhf.org.uk 3. Big Fat Problem (Information, advice.) Information, news and advice about healthy eating and exercise from the BBC. www.bbc.co.uk/bigfatproblem * FOOD DIARY (your record of what you eat and how you exercise) and other practical advice from: bbc.co.uk/health/healthy_living/your_weight/ reaching_diary.shtml 4. British Nutrition Foundation (Information, resources) This site provides healthy eating information, resources for schools, news items, recipes and healthier packed lunches, plus details of the work undertaken around the UK/EU. Contact: High Holborn House, 52-54 High Holborn, London. WC1V 6RQ. Tel.020 7404 6504 www.nutrition.org.uk Publications l Healthier Packed lunches


30

HEALTHY

COMMUNITIES

TOOLKIT

5. Nutrition Network For Wales (information, successful initiatives) Provides a 'one stop shop' where a range of healthy eating information can be found. Also holds a database of community initiatives. Contact: Wales Centre for Health, 14 Cathedral Rd. Cardiff CF11 9LJ. Tel 029 2022 7744 www.nutritionnetworkwales.org.uk 6. 5 A Day (resources and information) Packed with information, downloadable resources, recipes, fun and games. Contact: The Department of Health, Richmond House, 79 Whitehall,London,SW1A 2NL. Tel 0207 210 4850 www.5aday.nhs.uk 7. The Physical Activity Network for Wales.(PANW) (Networking) The Network links with individuals and organisations in Wales providing support and the sharing of information with the aim of increasing the physical activity levels of the people of Wales. Contact: Wales Centre for Health,14 Cathedral Rd. Cardiff. CF11 9LJ. Tel 029 2022 7744 www.panw.org.uk 8. Sports Council for Wales (Information and resources) The Sports Council for Wales is the national organisation responsible for developing and promoting sport and physical activity: in particular it is concerned with creating sporting opportunities for children in schools and in the community and to increase participation in sport. Contact: Sophia Gardens ,Cardiff CF119SW Tel. 0845 045 0904 www.sports-council-wales.co.uk

10. Mind (National Association for Mental Health) (Information, advice, resources) The leading mental health charity, works to create a better life for everyone with experience of mental distress. Mind info line-offers confidential help on a range of mental health issues. Call 08457660163 from anywhere in the UK for the cost of a local call. Rural minds---aims to improve the mental health of people in isolated rural areas.

l l l

Publications include: 'Understanding---' series of, booklets covering, depression, anxiety etc. 'How To" series promotes ways of coping with, family life, loneliness, etc. 'Mind Guide to Managing Stress.' Contact: Mind, 15 - 19 Broadway, London E15 4BQ Tel: 020 8519 2122 Website: www.mind.org.uk Food And Mood Project, funded by Mind. Provides information, advice and support on how foods affect our mental and emotional health.

l l

Publications include: Mind Guide to Food and Mood Food and Mood Workshop Pack Contact: The Food and Mood Community Interest Company. PO Box 2737, Lewes, Sussex.BN7 2GN. info@foodandmood.org www.food and mood.org When you're preparing a bid for funding what about including funding for healthier food options?

11. National Smoking Cessation Service in Wales (Support and resources) Free phone number 0800 085 2219 .The service offers an appointment with a local counsellor and six week support following a quit date. Information relating to smoking, the facts and techniques of quitting are available free of charge.


HELP!

12. The National Smokers Helpline (Support and resources ) Free phone number 0800 169 0169. Offers individual advice from a counsellor, packs for adults or youths wishing to quit and access to the smoking cessation service. 13. Cancer Research UK (Resources and information) Easy to access information, good links with downloadable resources, recipes and healthy lifestyle tips. Contact: PO. Box 123, London WC2A 3PX. Tel. 020 7121 6699 www.cancerresearchuk.org.uk

16.British Trust for Conservation Volunteers. BCTV (Information, resources ) Supports groups that take practical action in their local community.eg garden projects. Provides a good information pack, ideas, insurance and more‌ for garden projects. Contact: BTCV. Sedum House, Mallard Way, Potteric Carr, Doncaster,DN4 8DB. Tel. 01302 388 888 www.bctv.org.uk

Publicity poster

14. Big Lottery Fund (Funding) Lottery grants available from ÂŁ500 upwards to support local projects. Provides advice on how to apply. Contact: 2nd Floor. Ladywell House, Newtown Powys.SY16.1JB Tel. 01686611700 www.biglotteryfund.org.uk 15. Health Challenge Wales (Ideas, overall view) Health Challenge Wales is the national focus of efforts to improve health and well-being. It recognises that a wide range of factors economic, social and environmental - have an impact on health, so that action in all these areas can help create a healthier nation. The Key Themes are: smoking, food and fitness, accidents and injuries, alcohol and other substance misuse, infections and mental health and well-being. A free Action Pack provides ideas on how you can respond to the Challenge by taking some simple steps to improve your health. www.healthchallengewales.gov.uk

31

for the project.


32

HEALTHY

COMMUNITIES

TOOLKIT

SERVICE LEVEL AGREEMENTS‌

Where a funder is arranging for an organisation to undertake some work on the healthy lifestyle agenda, it can be useful for both parties to have a Service Level Agreement to help clarify the details and purpose of the work. What a Service Level Agreement (SLA) might look like:


SERVICE

SERVICE LEVEL AGREEMENT INEQUALITIES IN HEALTH The Healthy Heart Programme- CEREDIGION 1. Memorandum of Agreement: This agreement is made between: (Funder) and (Organisation). 2. Conditions of Agreement: The purpose of the Inequalities in Health programme is to work with the people of Ceredigion to reduce their risk of developing Coronary Heart Disease by promoting physical activity and healthier food and reducing smoking and stress levels. To this end your Organisation will use the funding to: l Positively engage with the target group on the issue of healthy lifestyles, using… l Train and support XXX to cook healthy lunches for participants. l Explore existing knowledge and perceptions of healthy lifestyles amongst the target group and support participants to make positive choices about their own lives. l Produce evidence that the intervention is effective and contributes to the process needed for positive change relating to lifestyles. 3. Evaluation Evaluation is an important part of this programme. We need to know: l What happened and what changed as a result of this project? l Was it worth the money and the effort? l If you did it again, what would you do differently? l Were there any "spin offs" - i.e. unintended benefits? So the sort of information you may need to record is: l How many people took part? l Do you have feedback from them? For example from one or more of the following: questionnaires, individual or group discussion, a detailed account of one or two experiences (case study), quotations etc.

LEVEL

AGREEMENT

33

4. Length of Agreement: The programme will be funded from (start date) to (end date). 5. Funding and Payment: The total allocation is £XXX , This is broken down as follows: l Facilitators and trainers fees (planning with participants, 3 days, design and preparation of activity, 8 days, 22 sessions x half a day, 2 staff), £XXX. l Catering Costs, £XX. l Materials and equipment, £XX. l Travel (40p per mile), £XX l Expenses, subsistence and childcare, £XX. l Admin. and office overheads, £XX. Amount payable by invoice; Made out to: Name, address and contact number of funder. 6. Variation of Agreement: Any variation of this Agreement must be agreed in writing by both parties. 7. Organisational Responsibilities: Your Organisation must at all times follow all legal requirements and accepted good practice within your field of work, for example with regard to Health and Safety, child and vulnerable adult protection, insurance, financial matters, equality of opportunity, confidentiality.

8. Signatures: Organisation: Funder: Signed: Name: Position: Date:


34

HEALTHY

COMMUNITIES

TOOLKIT

Policy.

Some community organisations may wish to consider having a written policy on promoting healthy lifestyles. This does not need to be a long document and is simply intended to help reach agreement and clarity on what you are doing, how and why. Why have a policy? l It informs everyone connected with your organisation and other agencies that you consider healthy lifestyles to be important. l It makes sure everyone shares the same understanding. l It makes it clear how everyone is involved. It's important to make sure your policy actually leads to good practice. l An "action plan", listing aims, objectives, responsibilities, timescale and outcome, helps turn good intentions into definite action. l In order to know whether you're succeeding or not, it may help to set targets and monitor your progress and achievements against those targets. What might a policy include? A statement for clients / service users, explaining: l Why promoting and supporting healthy lifestyles is important. l How you will inform, consult with and involve service users and other stakeholders (people who have an interest in your work). l The details of what will be done, how and by whom. l How the results will be measured. A statement for staff: l A mission statement - an explanation of what you are trying to achieve, expressed in one statement. l How policy will be implemented. l Whose responsibility is it? l How results will be measured. l How staff will be supported to live healthier lifestyles and act as role models. (This doesn't mean being perfect!)


E VA L U AT I O N

EVALUATION So how do we know if its working? Some basic principles of evaluation:

35

Do you have clearly defined outcomes for the work and proper systems in place for measuring the success (or not) of these? What is an outcome? An outcome relates to the aim of what you're doing. Generally, it's something that happens in the longer term. e.g. Your aim is to help people choose healthier food options. To help achieve this, you organise a series of cooking demonstrations for cheap, healthy food. Lots of people turn up and clearly enjoyed the sessions. That may be a positive and helpful response, but it's not an outcome. Your aim was to change their choice of food, so that in the future they will regularly buy and cook healthier options. So to measure the outcome, you need to know whether they did (you may also wish to know to what extent they changed and why some didn't change). The key questions are therefore: l What are the changes or difference you want to make? (changes in the community, in people, in services, in policies‌) l How will you know if you have achieved these changes? l What information will you need (e.g. Did you reach your target group?) and how will you collect and analyse it? You may also wish to know‌ l Would anyone else benefit from knowing what was and wasn't successful? l Were there any unintended benefits (spin-offs) from the work? If you want more detail about how to evaluate these sorts of activities, we recommend "Evaluating Your Community Development Activities", available free from: Community Development Cymru, Plas Dolerw, Milford Road, Newtown, Powys SY16 2EH (01686 627377) admin@cdc.cymru.org


36

HEALTHY

COMMUNITIES

TOOLKIT

Some of the advice given in this document is reproduced here:

KEY EVALUATION QUESTIONS… 1. Is your activity successful? (i) Are you achieving what you set out to achieve? (ii) How do you know the intervention is working? (iii) What new things / change has occurred? (iv) Did it make things better, the same or worse? 2. What is the value of your work? (i) Is it worth the time? (ii) Is it worth the effort? (iii) Is it worth the money? 3. What will you do differently if you do it again? (i) What worked well? (ii) What didn't work well and why not? (iii) What have you learned? HOW MIGHT YOU COLLECT EVIDENCE? l l l l l l l l l

Your own or others' monitoring records and reports Observation Case studies Meetings, workshops and events Mapping Interviews Focus groups / group discussions Oral histories / tapes, photos or films Questionnaires, surveys, feedback forms

PLANNING YOUR EVALUATION (KEY QUESTIONS): l l l l l l l l l l

Why are we evaluating - who is it for? What resources do we need / what resources do we have? Who will be involved in the evaluation? What are we evaluating? What is our starting point? What information will we need and how will we get it? When are we going to do the evaluation? What does the information show? How will we use the results? How will we reflect on (evaluate) the evaluation?

AND FINALLY… just two words of evaluation jargon explained… QUALITATIVE: Concerned with measuring quality, expressed in words rather than numbers, for example: how people feel. QUANTITATIVE: Concerned with amount or quantity, expressed in numbers, for example the number of people attending an event or the percentage increase in people using a service.

Spinbikes Aberystwyth Day Centre.


SELF

ASSESMENT

37

Self-Assesment: HOW WELL DOES YOUR ORGANISATION PROMOTE HEALTHY LIFESTYLES? l

Do you offer fresh fruit as a snack? o Yes? o No? Comment:

l

Do you provide buffets? o Yes? o No? Comment:

l

Do you offer water and juice options instead of tea and coffee? o Yes? o No? Comment:

l

Do you provide healthy options? o Yes? o No? Comment:

l

Do you provide opportunities for physical activity in your programme? (e.g. group walks, swimming, yoga etc.) o Yes? o No? Comment:

l

Are there barriers to you providing opportunities for physical activity in your programme? o Yes? o No? Comment: (e.g. what are the barriers to you providing these opportunities?):

l

Do you help those members who want to give up smoking? o Yes? o No? Comment: (e.g. what would you want and need to do so?)

l

Do you have ways of supporting members who feel under stress and want help? o Yes? o No? Comment: (are there any barriers to you providing this support?)

l

l

Do your members have access to information on healthy lifestyles? (Healthy eating, physical activity, avoiding stress, not smoking, alcohol and substance misuse, healthy sexuality‌) o Yes? o No? Comment: Do you provide meals? o Yes? o No? Comment:

l

Do you provide healthy options? o Yes? o No? Comment:

l

Do you provide snacks? o Yes? o No? Comment:

l

Do you provide healthy options? o Yes? o No? Comment:


38

HEALTHY

COMMUNITIES

TOOLKIT

AND IF YOU WANT TO MAKE THINGS MORE FORMAL‌ l

Do you have a policy, strategy and/or an action plan to promote health and well-being? o Yes? o No? Comment:

l

Is promoting health and well-being referred to in your mission statement, in your promotional literature and/or on your website? o Yes? o No? Comment:

l

Is health and well-being mentioned in staff job descriptions? o Yes? o No? Comment:

l

Is health and well-being regularly discussed and reviewed? o Yes? o No? Comment:

l

Do staff understand how promoting health and well-being fits with major strategies and policies? o Yes? o No? Comment:

ACKNOWLEDGEMENTS: The work of the healthy heart programme and its findings would not have been possible without the support and commitment of: l l l l l

Welsh Assembly Government National Public Health Service / Ceredigion Local Health Board Ymlaen Ceredigion Community groups in Aberystwyth and Cardigan Ceredigion Association of Voluntary Organisations

l l l l l l

Communities First, Aberystwyth Ceredigion County Council Ceredigion Health Alliance Opinion Research Services, Swansea Welsh Institute for Health and Social Care University of Wales, Aberystwyth


Healthy Communities Toolkit 2008  
Healthy Communities Toolkit 2008  

A toolkit to help community organisations and groups in Ceredigion promote healthier lifestyles. Prepared in partnership with Ymlaen Ceredig...

Advertisement