Barwon Health Integrated Health Promotion Plan 2013-2017

Barwon Health Integrated Health Promotion Plan 2013-2017

Integrated Health Promotion Plan 2013/17 1.

PURPOSE

This document has been prepared reflect Barwon Health’s Integrated Health Promotion (IHP) priorities and objectives for the 2013/2017 planning period. This plan identifies the health promotion priority issues that Barwon Health Integrated Health Promotion funding will be allocated towards as part of the overall health promotion and prevention system across the catchment area. It has been developed according to requirements identified in the Department of Health Community Health Integrated Health Promotion Planning Guidelines 2013-2017 This planning process has presented opportunities to review health promotion services with consideration of a number of contextual issues:  Alignment with Municipal Health & Wellbeing and the G21 Alliance planning process  Implementation of the statewide Healthy Together Victoria initiative with particular consideration of the City of Greater Geelong initiative – Healthy Together Geelong  Ongoing consolidation of planning aligned to objectives of the Barwon Health Strategic Plan 2010/15

Barwon Health Integrated Health Promotion Plan 2013-2017

2.

SUMMARY

VISION

AUSTRALIA’S LEADING REGIONAL HEALTH SERVICE – BUILDING A HEALTHIER COMMUNITY

PRIORITIES

KEY OBJECTIVES

1. Increasing healthy eating and physical activity

Decrease the rates of people in the overweight and obesity measure categories.

2. Increasing Community Connectedness and Social Inclusion

Promote Mental Health and Wellbeing

Barwon Health Integrated Health Promotion Plan 2013-2017

3.

VISION SETTING

This plan reflects Barwon Health’s vision for 2010-2015: To be Australia’s leading regional health service – building a healthier community. This vision will be realised through our organisational priorities: YOUR HEALTH: We will work with the community to deliver significantly improved health outcomes OUR SERVICE: Our health care service will be well-connected to ensure a positive experience for those we serve OUR REGION: We will have strong partnerships with all providers who influence health in our region OUR PEOPLE: Our workforce will be thriving, collaborative and highly skilled 4.

PRIORITY SETTING & PROBLEM DEFINITION

The priority setting process has been informed by population health data and input from key stakeholders, including;  Department of Health, Community Health Integrated Health Promotion Program Planning Guidelines 2013-17  G21 Health & Wellbeing Pillar Planning Project  Local Government Area Municipal Public Health & Wellbeing Plans  Healthy Together Geelong  Local population health data. The priority health issues and the associated strategies reflect specific areas which complement the work of Healthy Together Geelong, G21 Health and Wellbeing Pillar and other health promotion agencies operating within the region. Barwon Health will focus on two priority health issues, these being: 1. Increasing healthy eating and physical activity Priority 1 aligns with the key objectives of Healthy Together Geelong. Activities will contribute to meeting the Healthy Together Objectives of Increasing physical activity undertaken by individuals from 30.7 to 36.4% Work towards an overall objective of decreased obesity in the COGG to 48.6% This priority also overlaps with the priority of G21 and the Municipal Health and Wellbeing plans in the region to increase physical activity. Please note these targets represent current HTG targets. These will be updated within the life of this plan. 2. Increasing Community Connectedness and Socials Inclusion This priority builds on previous work at Barwon Health, and aligns closely with the G21 Integrated Health and Wellbeing Plan priority of increasing community connectedness and social inclusion. This alignment will help support the objectives across the broader region. There are currently no targets associated with the G21 Objective. Barwon Health will adopt these targets as they are established.

Barwon Health Integrated Health Promotion Plan 2013-2017

Priority Area

Increasing healthy eating and physical activity

Goal

Decrease the rate of overweight and obesity experienced by people in the COGG. Objective 1: Women living in the Geelong region who have caring responsibilities for young children (0-4 years) Women (18-50 years) living in the Geelong region Geographical cluster areas: Corio/Norlane/North Shore Newcomb/Whittington/Moolap/St Albans/Breakwater Grovedale/Marshall Bell Post Hill/Bell Park/Herne Hill Portarlington/Indented Heads/St Leonards (Interventions delivered by Bellarine CHS)

Target population group/s per objective

Objective 2: Residents in the Greater Geelong region with priority given to those who are socio-economically disadvantaged, socially isolated and from diverse communities Objective 3: Children aged 5–12 years attending State and Catholic primary schools (N=44) in the Greater Geelong region, and their families. Objective 4: Children aged 0-5, their families, and early years settings throughout the G21 region - including Maternal and Child Health centres, Playgroups, Kindergartens, Child care services, and other paediatric services.

Budget and resources (include evaluation budget)

$673 500

Key evaluation question/s? 1. 2. 3. 4. 5.

Objective 1

Has there been a reduction in the rate of obesity and overweight in the Geelong region? Have the target populations been engaged in health related behaviour initiatives? Is there evidence of increased healthy behaviours in the community? Have effective partnerships been developed with relevant organisations? Are the initiatives sustainable?

Impact indicators

Evaluation methods/tools

Timelines and responsibilities (include partners as relevant)

Participant survey

2013 -2017

Document Audit

Barwon Health

Key Informant Interviews: partners, stakeholders, community members

Project Steering Group

Healthy Lifestyles - change in health related behaviours: Proportion of women who report changes in (1)healthy eating and (2) increased participation social, leisure and physical activities. The type of change reported and described by women.

Personal skills: Healthy Eating and

To provide opportunities to increase the health and wellbeing of Geelong women during critical windows and transition times of their lifecycle

Mental Health & Wellbeing; - increased knowledge - improved skills - changed attitudes, motivation - enhanced social skills and self esteem

Community strengthening - social capital: Increased participation in community life, including social and physical activities. - social action and influence: Community women take collective action on local determinants of health

Supportive Environments -social, political and economic environment: enhanced access to community resources and opportunities.

Community Organisations Focus Groups Document audit against capacity building domains and Department of Health System Building Blocks

Healthy public policy and practice - organisational practice: modification of organisational practice to align with the aim to increase the wellbeing women living in Geelong.

Interventions/Strategies

To provide opportunities for women to participate in local area initiatives that increase healthy eating and physical activity

Process indicators

Evaluation methods/tools

Reach and partnership collaboration achieved Relevant stakeholders are represented on steering and advisory committees

Participant survey Document Audit

Formative, evidence based documentation is completed Content and reach of resources

Major Strategy for 2014-2015: Implementation of Healthy Lifestyle Program for Women (HeLP-her) 12 month pilot with potential to expand program beyond June 2015.

Sectors and workers involved in workforce development opportunities

Timelines and responsibilities (include partners as relevant)

Key Informant Interviews: partners, stakeholders, community members Focus Groups Document audit against capacity building domains and Department of Health System Building Blocks

2013 -2017 HeLP-her Pilot: 2014 – 2015 Barwon Health Project Steering Group

Reach of stakeholders participating regional forums Number of women & community organisations participating in evidence based solutions (120 women attend Help-her across 4 sites) The type and number of new opportunities that arise due to the shift of resources into women’s health and wellbeing.

Community Organisations

Objective 2

Impact indicators

Evaluation methods/tools

Timelines and responsibilities (include partners as relevant)

Supportive environments Organisations in the Greater Geelong area are involved in partnering in the Community Kitchen initiative to address healthy eating, social inclusion and community strengthening

Socio-economically disadvantaged, socially isolated and diverse communities in the Greater Geelong region have increased opportunities to develop self-efficacy in healthy food knowledge and skills.

Community Strengthening Community Kitchens facilitators and organisations are supported to implement the Community Kitchens model through ongoing skill and knowledge development

2014-2017

Document Audit Key informant interviews

Barwon Health HTG

Surveys Community Organisations

Healthy Lifestyles Community Kitchen participants and facilitators have an increased knowledge of healthy food options, budgeting and health related behaviours Healthy Public Policy and Practice Responded to local food security issues by leading Community Kitchens research in the Greater Geelong region focussing on independence and

Focus Groups

Food Security Network

sustainability of the model. To have Community Kitchens represented at the regional Food Security Network Interventions/Strategies

To coordinate the ongoing development of an evidence-based Community Kitchens model throughout the Greater Geelong region

Process indicators

Evaluation methods/tools

The number of Community Kitchens’ operating and new Community Kitchens established

Document Audit

The number of organisations involved in the Community Kitchens model The number of Facilitators who access resources and attend networking and training opportunities

Objective 3

Children between the ages of 5-12 in the Greater Geelong area report a decreased intake of sweet drinks.

Impact indicators Supportive Environments: State and Catholic primary schools in the Greater Geelong area (N=44) implement water-or-milk only policies, and actively promote water and milk, and supporting reduction in sweet drink consumption. Community Strengthening Parents informed and supportive of policies and practices Healthy Lifestyles Students do not consume sweetened drinks within state and catholic primary school primary schools

Key informant interviews Surveys

Timelines and responsibilities (include partners as relevant)

2014 – 2017 Barwon Health HTG

Focus Groups Community Organisations

Evaluation methods/tools

Timelines and responsibilities (include partners as relevant) 2014 – 2017 Project partners Educational organisations

Document Audit Key informant interviews Surveys HTG data

TARGETS: Yr 1: One or two schools become water only. All baseline measures complete. Greater understanding of consumption patterns obtained. Yr 2: Between 4 – 8 schools become water only. Marketing resources developed and disseminated Yr 3: Up to 12 schools become water only

throughout the Geelong region.

Yr 4: Up to 20 schools become water only. Community measures indicate reduction in sweet drink consumption.

Personal skills Families display supportive attitudes to water-only school environments

Interventions/Strategies

Process indicators

All schools accessing and disseminating resources to reduce consumption of sweet drinks. Evaluation methods/tools

Timelines and responsibilities (include partners as relevant)

Relevant Partner agencies are represented on the working party and engage with the initiative. Provide support to State and Catholic primary schools throughout the Greater Geelong region (N = 44) to develop, implement and sustain policy and practice documentation which limits access to sweet drinks within schools

Objective 4

Increase physical activity through increasing opportunities for children to experience outdoor play

Document Audit All primary schools in the greater Geelong area engage with the initiative.

Key informant interviews

2014 – 2017

Surveys Community members engage, and express satisfaction, with the initiative. Impact indicators Supportive Environments Early years settings throughout the G21 region (including Maternal and Child Health centres, Playgroups, Kindergartens, Child care services, and other paediatric services) actively promote increased uptake of outdoor play opportunities for children aged 05. Community Strengthening Parents informed and actively supportive of increased outdoor play opportunities for young children.

Evaluation methods/tools

Document Audit Key informant interviews Surveys

Timelines and responsibilities (include partners as relevant) 2014 – 2017 Barwon Health Project Partners Community Organisations. TARGETS: Yr 1: Greater understanding of early childhood services, and communication pathways between those services, which promote outdoor play for young children, obtained. Gaps identified. Partnerships formed. Yr 2: Pathways developed as required. Resources developed. Community

information opportunities developed and implemented Yr 3 & 4: Pending above outcomes.

Healthy Lifestyles Children aged 0 - 5 years engage in increased physical activity. Interventions/Strategies

To provide resources, information and skill development opportunities to settings and the community that encourage increased uptake of outdoor play opportunities for children aged 0-5

Process indicators

Evaluation methods/tools

Early years settings and community members participate in initiative(s)

Document Audit

Early years settings and community members express satisfaction with initiative(s)

Key informant interviews Surveys

Timelines and responsibilities (include partners as relevant)

2014 – 2017 Barwon Health Project Partners Community Organisations.

Logic Model Objective 1: Provide opportunities to increase the health and wellbeing of Geelong women during critical windows and transition times of their lifecycle. Inputs

Budget to deliver strategies

Activities

Partnerships and network collaboration

HPU Staff Internal & External Partners Healthy Living Programs (HELP-Her): - Facilitators - Facilitator training - Program resources

Conduct evidence based literature review and needs analysis of the health and wellbeing experiences of Geelong women Develop local women’s health resources Workforce development

Regional community forums Support the provision of evidence based solutions for the health and wellbeing needs of Geelong women(HeLP-her 12month Pilot with potential to expand) Flexibility to respond to additional opportunities as they arise

Please refer to Appendix 1 for background information

Outputs

Impacts

Reach and partnership collaboration achieved Relevant stakeholders are represented on steering and advisory committees

Healthy Lifestyles - change in health related behaviours relating to healthy eating and mental health & wellbeing.

Formative, evidence based documentation is completed Content and reach of resources Sectors and workers involved in workforce development opportunities Reach of stakeholders participating regional forums Number of women & community organisations participating in evidence based solutions (120 women attend Help-her across 4 sites) The type and number of new opportunities that arise due to the shift of resources into women’s health and wellbeing.

Personal skills: Healthy Eating and Mental Health & Wellbeing; - increased knowledge - improved skills - changed attitudes, motivation - enhanced social skills and self esteem Community strengthening - social capital and social action and influence Supportive Environments - enhanced access to community resources and opportunities. Healthy public policy and practice - organisational practice: modification of organisational practice to align with the aim to increase the wellbeing women living in Geelong

Outcomes

Reduced risk of chronic health conditions

Increased physical activity

Reduced rates of overweight and obesity

Logic Model Objective 2: Increase the opportunities for people living in the Greater Geelong Region to develop self-efficacy in healthy food knowledge and skills. Inputs Staff time 3 - 4 days per week 2013 - 2017.

Allocation of funds for professional development and administrative resources

Allocation of funds for purchase of resources to support implementation of strategies

Community Kitchens Facilitators Networking committee

Develop internal and external partnerships

Activities

Outputs

Provide advice and support to organisation who are establishing/operating a Community Kitchens in their local area.

Number of Community Kitchens operating in the Greater Geelong region receiving input from BH from 11 in 2013

Organise professional development opportunities for Community Kitchens facilitators and organisations including raising awareness of healthy lifestyles

No. of community organisations engaged in networking and professional development opportunities

Lead the evolution of Community Kitchens Network for Community Kitchens facilitators Build on the evidence base completed previously by BH and other organisations, focussing on level of independence and sustainability of the CK model

Active participation in the regional Food Security Network

Please refer to Appendix 2 for background information

No. of partnerships formed with agencies in the Greater Geelong region increases from 10 in 2013 No. of CK facilitators seeking advice and participating in workforce development opportunities Ongoing contribution to Community Kitchen evidence base with focus on level of independence and sustainability of Community Kitchen model 2016/17 Contribution to regional Food Security Network activities

Impacts Supportive Environments To have 20 Community Kitchens operating in the Greater Geelong region by June 2017. To support organisations to address issues of food security, healthy eating, social inclusion and community strengthening through the Community Kitchens model. Community Strengthening 100% of Community Kitchens Facilitators are supported through ongoing skill and knowledge development Healthy Lifestyles To increase Community Kitchens participants knowledge of healthy food options, budgeting and health related behaviours Healthy Public Policy and Practice To provide a response to local food security issues by leading Community Kitchens research in the Greater Geelong region. To have Community Kitchens represented at the regional Food Security Network

Outcomes Community Kitchens to be operating in the Greater Geelong region beyond 2017.

Socio-economically disadvantaged, socially isolated and diverse communities in the Greater Geelong region have increased opportunities to develop self-efficacy in healthy food knowledge and skills.

People living in the Greater Geelong region experience improved food security resulting from activities of the regional Food Security Network and Healthy Together Geelong

Logic Model Objective 3: Children between the ages of 5-12 in the Greater Geelong area report a decreased intake of sweet drinks. Inputs

Activities

Outputs Working party development.

Establish project coordination and HPO staff member

Primary schools in the Greater Geelong area Audit and evaluation

implement water-or-milk only policies.

implementation and sustainability

documentation.

Supportive Environments:

implement evaluation of sweet-

Outcomes

Reach:

strategic alliances that support the

Conduct literature review, and Budget for social

Impacts

Sample school policy and protocol documents.

School staff actively promote water and

Children between the ages

milk, and include class-based learning

of 5-12 in the Greater

experiences supporting reduction in sweet

Geelong area report a

marketing and

drink consumption at project

drink consumption.

decreased intake of sweet

community

commencement and conclusion

Community Strengthening:

drinks.

engagement events Build school capacity to implement

Information sessions for school staff.

Marketing materials for school

Students do not consume sweetened drinks

communities.

within state primary school throughout the Geelong region.

advocate for reduced sweet drink consumption.

Information materials for medical and ancillary professional services.

Please refer to Appendix 3 for background information

and practices Healthy Lifestyles:

water-or-milk-only practices

Work with school communities to

Parents informed and supportive of policies

Logic Model Objective 4: Increase physical activity through increasing opportunities for children to experience outdoor play

Inputs

Activities Establish project coordination and

HPO staff time 0.4

Outputs Working party development.

strategic alliances that support the

Impacts

Outcomes

Supportive Environments:

Early years physical activity opportunities in

implementation and sustainability Resource development.

the Greater Geelong area are re-aligned to support increased outdoor play for young

Staff professional development and skillbuilding

Social marketing resources

children.

Develop marketing resources and ensure broad dissemination.

Social marketing message dissemination

Provide skill-building opportunities to early childhood services

increased physical activity Early years services actively promote outdoor activity, providing ‘green referrals’ as incentives.

through greater

“Dirt Doesn’t Hurt’ resources are available

play.

Professional development

to early years services to promote family

opportunities

engagement and information provision Healthy Lifestyles:

Support information provision to the community through settingsbased initiatives.

Please refer to Appendix 4 for background information

Children experience

Families report increase in behaviours supporting physical activity and positive mental health in children

opportunities for outdoor

Priority Area

Promote Social Inclusion and Community Connectedness and wellbeing

Goal

Increase social inclusion and community connectedness, reported via an improved feeling of health and wellbeing within the G21 region between 2014 and 2017 Objective 1: Boys and men in the G21 region that experience poor health and wellbeing, specifically: Boys and men in the G21 region that experience poor health and wellbeing outcomes, specifically:

Target population group/s

-

Boys and men that are homeless or at risk of homelessness

-

Men that are unemployed or at risk of unemployment

-

Aboriginal men

Objective 2: Secondary school and workplace populations in the G21 region Budget and resources

$289 000

(include evaluation budget)

Do vulnerable males in the G21 region report increased feelings of connection with their local community? Has increased social inclusion and community connectedness improved male health and wellbeing? Key evaluation question/s

Have effective partnerships been developed with relevant organisations? Are the initiatives sustainable?

Timelines and responsibilities Objective 1

Impact indicators

Evaluation methods/tools (include partners as relevant)

Increase social inclusion and community connectedness of vulnerable males in the G21 region

Personal skills: - increased knowledge - changed attitudes, motivation - enhanced social skills, self-esteem and self-determination through life skills programs Community strengthening - Increased participation in community life, including social and physical activities. - social action and influence: collective action on local determinants of health Supportive Environments -social, political and economic environment: enhanced access to community resources and opportunities. - assessment and inventory of socially inclusive environments

AQOL survey

Participant survey Document Audit Key informant interviews: partners, stakeholders, community members Focus Groups

2014 and 2017 Community organisations and stakeholders Partners: SalvoConnect, St Laurence, Bethany, CoGG, Leisure Networks, Centrelink, Geelong LLEN, CatholicCare, Healthy Together Geelong

Healthy public policy and practice - organisational practice: modification of organisational practice to align with the aim to increase social connection for vulnerable boys and men. Timelines and responsibilities Interventions/Strategies

Process indicators

Evaluation methods/tools (include partners as relevant)

Facilitate / support local initiatives to support social connectedness for

-

Local community agencies consider the value of social connection for

Document Audit

2014 – 2017

vulnerable males

vulnerable males -

Increased percentage of vulnerable males who feel ‘part of a community’

-

Number of community agencies providing opportunities for social connection for vulnerable males

-

Number of vulnerable males participating in local initiatives (eg. Life skills programs)

Key informant interviews Surveys Program evaluation (program numbers, impact on health and wellbeing)

Community organisations and stakeholders Partners: SalvoConnect, St Laurence, Bethany, CoGG, Leisure Networks, Centrelink, CatholicCare, Healthy Together Geelong

Timelines and responsibilities Objective 2

Impact indicators

Evaluation methods/tools (include partners as relevant)

Personal skills: - increased knowledge - changed attitudes, motivation (Schools / workplaces)

Community strengthening

Partner in primary prevention initiatives aimed at reducing family and intimate partner violence in the G21 region.

- Better access to supportive relationships, including family relationships, peer support and social networks - Improved community capacity to take collective action - Increase number of secondary school students in the G21 region that have participated in healthy relationship programs - Decrease in the number of incidents of

family violence within the G21 region Supportive Environments - Safe and harmonious households

Document Audit Key informant interviews Surveys

Partners: CoGG, Zena Women’s Services, Barwon CASA, Victoria Police, Deakin University, Geelong Multicultural Family Violence Network, Together Against Family Violence Network

2014 - 2017

Healthy public policy and practice - organisational practice: modification of organisational practice to align with the aim of increasing capacity to promote healthy

relationships Timelines and responsibilities Interventions/Strategies

Process indicators

Evaluation methods/tools (include partners as relevant)

-

Engage with schools, workplaces and CALD communities to support healthy relationship and gender equity initiatives as well as other strategies to reduce family and intimate partner violence in the G21 region

Number of secondary schools engaged in the primary prevention of family violence programs and initiatives

Document Audit Key informant interviews Surveys

-

Number of secondary school students participating in healthy relationship programs

Partners: CoGG, Zena Women’s Services, Barwon CASA, Victoria Police, Deakin University, Geelong Multicultural Family Violence Network

-

Partnerships with other agencies to support primary prevention activity

2014 - 2017

Regional Family Violence Strategy developed with Barwon Health as a key partner.

Evaluation design

Mixed method evaluation: Qualitative and Quantitative Data Data Collection methods: Document Audit Key Informant Interview Survey Focus Groups Physical risk factors Field survey Validated tools and measures eg. AQOL

Utilising external data and measures collected through Healthy Together Geelong Data analysis and interpretation

Evaluation dissemination

Barwon Health, Health Promotion Unit. External agencies as required Barwon Health Department of Health Project partners Project Stakeholders Healthy Together Geelong Community participants

Logic Model: Objective 1 - Increase social inclusion and community connectedness of vulnerable males in the G21 region

INPUTS

Health Promotion Officer (F/T 2013 – 2017) Partnership with G21 Regional Alliance Partnership with Healthy Together Geelong Allocation of funds for professional development and administrative resources Barwon Male Health Network Male Health Victoria

ACTIVITIES Support the development of the health service provided at Christ Church (vulnerable males) Facilitate / support local initiatives to support vulnerable males around homelessness and unemployment On-going facilitation of the Barwon Male Health Network Support workplace forums in partnership with HTG Develop information and resources and ensure its dissemination to vulnerable males. Assist in the provision of skill-building opportunities for vulnerable males Eg. Development of a Life Skills program to address males’ anger management issues / Health and Wellbeing support for unemployed males Support information provision to the community through settings-based initiatives.

Please refer to Appendix 5 for background information

OUTPUTS Increased membership of Barwon Male Health Network which will further foster partnerships and collaboration opportunities Workplaces have access to information, services and programs related to male health and social connection. Increase in males’ knowledge of social connection opportunities and how to access them Vulnerable males acquire skills and capability. Local research and evaluation around male social connectedness.

IMPACTS

OUTCOMES

Personal skills: - increased knowledge - changed attitudes, motivation - enhanced social skills and self esteem

Community strengthening -

Increased participation in community life Increased empowerment

Supportive Environments -social, political and economic environment: enhanced access to community resources and opportunities.

Healthy public policy and practice - organisational practice: modification of organisational practice to align with the aim to increase social connection for vulnerable boys and men.

Vulnerable males in the G21 region report increased social connectedness and improved health and wellbeing.

Logic Model: Objective 2 - Partner in primary prevention initiatives aimed at reducing family and intimate partner violence in the G21 region.

INPUTS

Health Promotion Officer (F/T 2013 – 2017) Partnership with G21 Regional Alliance Allocation of funds for professional development and administrative resources Barwon Male Health Network Male Health Victoria Geelong Multicultural Family Violence Network

ACTIVITIES

Support prevention initiatives and resources to reduce the prevalence of family violence and intimate partner violence in the G21 region including: -

White Ribbon Day

-

Month of Action

-

School–based healthy relationship programs

-

Geelong Multicultural Family Violence Network

-

Together Against Family Violence Network

-

CALD project – (auspiced by Zena Women’s Services)

Represent Barwon Health as a key player in regional effort to reduce family violence Flexibility to respond to additional opportunities as they arise

OUTPUTS

Increased community awareness among boys and men of family violence and strategies to reduce the incidence Regional Family Violence Strategy developed between Geelong and region agencies with Barwon Health a key partner

IMPACTS

Personal skills: - increased knowledge - changed attitudes, motivation Community strengthening - Better access to supportive relationships, including family relationships, peer support and social networks - Improved community capacity to take collective action - Increased number of secondary school students in the G21 region that have participated in healthy relationship programs - Decrease in the number of incidents of family violence within the G21 region Supportive Environments - Safe and harmonious environments Healthy public policy and practice - modification of organisational practice the aim of increasing capacity to promote healthy relationships

OUTCOMES

Reduction in the number of family violence and intimate partner incidents in the G21 region by 2017

TOTAL IHP REVENUE 2013/14: $ 990,356

Overall IHP budget breakdown 1. IHP staffing costs 1a) IHP staffing budget

$ 632,500

1b) Total IHP equivalent full time (EFT)

7.8

2. Other program costs 2a) internal (e.g. development of program materials)

$ 180,000

2b) external (e.g. providing grants to other organisations/community groups)

$150,000

Corporate costs

$27 856

TOTAL

$990,356

Summary of IHP budget by objective Priority 1

Estimated $ expenditure

Objective 1

$212 500

Evaluation

$60 000

Objective 2

$105 000

Evaluation

$36 000

Objective 3

$112 000

Evaluation

$24 000

Objective 4

$100 000

Evaluation

$24 000

Priority 2

Estimated $ expenditure

Objective 1

$141 000

Evaluation

$24 000

Objective 2

$100 000

Evaluation

$24 000

TOTAL

$ 962,500

Appendix 1: Background: Objective 1: Provide opportunities to increase the health and wellbeing of Geelong women during critical windows and transition times of their lifecycle.

WOMEN OBESITY AND OVERWEIGHT PROBLEM DEFINITION AND PRIORITY SETTING PROBLEM DEFINITION WOMEN’S HEALTH Obesity is a growing epidemic that affects many Australians. The promotion of healthy food behaviours and increase in physical activity is seen as one way in which individuals and whole communities can reduce their risk of becoming obese and developing chronic disease. However, the relationship between obesity, body image and mental health, and its impact on physical activity and eating behaviours for women is complex and not well understood. (Women’s Health Victoria, Gender Food and Physical Activity: Risks in Health Promotion Messages, 2014). Women today are gaining, on average, 7-10 kilos a decade more than their parents did at the same age. Rapid social changes have resulted in high energy foods becoming easily available as daily physical demands have decreased (Jean Hailes for Women’s Health, 2014). Women are an important target group as they are at high risk of ongoing weight gain. Longitudinal population studies report that adult women are increasing weight at a mean rate of 600g/year. Small increases in body mass index (BMI) even within the normal weight range have been associated with increased risk of chronic disease such as diabetes. Women with young children are particularly at risk. Starting a family is associated with changes in women’s diets that are mainly unhealthy (Australian Longitudinal Study on Women’s Health). Women also make many of the daily food and activity decisions for families, influencing their partner’s and children’s eating and physical activity levels. Targeting women with children to prevent weight gain has the potential to achieve significant health benefits for themselves and their families. Most Victorians are familiar with the health messages encouraging them to eat less, choose healthier foods and be more active. Yet despite the prevalence of such advice, Victorians and Australians generally are becoming heavier and sicker (VicHealth Letter Issue 39). Obesity and other weight-related paradigms are complex. They are shaped by an obesogenic environment and the broader social, cultural, economic, political and environmental contexts in which we live learn, work and play – that is the sum of influences that living conditions have on promoting obesity in populations and individuals . These influences include for example, sedentary work, transport, food production, food marketing, opportunities for physical activity and recreation.

THE SITUATION AT AN INTERNATIONAL AND NATIONAL LEVEL Overweight and obesity are the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity. In 2008, more than 1.4 billion adults, 20 and older, were overweight. Of these over 200 million men and nearly 300 million women were obese (WHO, 2013). 55.7% of Australian women are obese/overweight. Between 1995 and 2011-12, there were significant increases in the rate of overweight/obesity for a number of female age groups. This included 18-24 year olds (up 9%), 35-44 year olds (up 10%) and 45-54 year olds (up 7%) (ABS, 2013). The VicHealth report Past Trends and Future Projections of Overweight and Obesity has found that by 2025 around 75% of females living in Australia aged 20 years and above will be overweight or obese. THE SITUATION AT A VICTORIAN AND LOCAL LEVEL The total proportion of adults who are overweight/obese in Victoria is 49.8%. The proportion of adults in the Greater Geelong Local Government area is 56.0% which is above the Victorian state average (Victorian Population Health Survey, 2011-2012). The combined proportion of overweight/obese females in Greater Geelong (48.4%) is also above the Victorian state average (41.8%). Refer Table 1. Table 1. Percentage of Overweight/Obese Adult Females in Greater Geelong with Victorian comparison 2008* and 2011-12** Overweight

Obese

Combined

2008

2011-12

2008

2011-12

2008

2011-12

Geelong

31.4

26.4

17.1

22.0

48.5

48.4

Victoria

24.3

24.6

16.1

17.2

40.4

41.8

* Victorian Health Information Surveillance System (VHISS) 2008 (Revised and updated 2012) **Department of Health Victoria (DH) 2013 The Geelong Osteoporosis Study demonstrated that there has been a measurable increase in the prevalence of obesity over one decade amongst women in the Geelong region. The body mass index (BMI) was measured for 1494 women in 1993-7 and for 1076 women in 2004-7. The prevalence of Obesity (BMI>30.0 kg/m2) was 23.2% in 1993-7 and 29.1% for 2004-7. Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum.

PRIORITY SETTING TARGET POPULATION Women 18-50 years of age

Women with children 0-4 years of age RECOMMENDED HEALTHY LIVING PROGRAM FOR THE GEELONG REGION The Healthy Lifestyle Program for Women (HeLP-her) is one of the Department of Health Victoria recommended Healthy Lifestyle Programs and has been developed by women’s health experts at Monash University. The program is designed to support a healthy lifestyle, promote health and wellness and prevent excess weight gain in women. The HeLP-her program is deliberately designed to be low cost and easily delivered. Women attend a training and education session delivered by trained health professionals. In many cases the program will be delivered at a local primary school, a social group, kindergarten, sporting club, workplace or similar supportive environment. The program teaches women core skills in changing behaviour, self-monitoring and has a number of high quality resources including a self-management manual and website which is regularly updated. Ongoing support is provided throughout the program by mobile phone, website and mail. GEOGRAPHICAL APPROACH TO ADDRESSING PHYSICAL ACTIVITY, HEALTHY EATING RECOMMENDATION Healthy eating, physical activity addressed in the following suburb clusters: Corio/Norlane/North Shore Bell Post Hill/Bell Park/Herne Hill Newcomb/Moolap/Thompson/Whittington/St Albans Park/Breakwater Grovedale/Marshall Portarlington/Indented Head/St Leonards

RATIONALE Suburbs below the 2011 Greater Geelong SEIFA averages were compared against obesity. There was a clear correlation between suburbs of higher disadvantage and obesity prevalence. There was not as clear a correlation between areas of disadvantage and smoking and alcohol use. The following suburb clusters have been recommended based on low SEIFA averages and above state average obesity levels: Corio/Norlane/North Shore Bell Post Hill/Bell Park/Herne Hill Newcomb/Moolap/Thompson/Whittington/St Albans Park/Breakwater Portarlington/Indented Head/St Leonards Grovedale/Marshall has also been recommended as an additional suburb cluster. It also is the only postcode that has a specific community action plan allocated to its improvement and ‘The Grovedale 3216 Community Plan’ and was adopted by council earlier this year. The impetus for this project came from the recommendations of a comprehensive Bethany Project Report in 2009, which identified Grovedale as an area of geographical expansion which would benefit from community strengthening initiatives.

BIBLIOGRAPHY Healthy Together Geelong. (2013) Healthy Living Programs Recommendations October. Needs Assessment Project Group Lombard et.al (2009). Weight, physical activity and dietary behaviour change in young mothers: short term results of the HeLP-her cluster randomised controlled trail. Nutrition Journal 8:17 Pascoe, J. Brennan, S & Kotowicz. (2013). Morbid Obesity on the Rise: an observational population-based study. Public Health. 13:290 Provincial Health Services Authority (PHSA) 2013. Summary: from weight to wellbeing: Time for a shift in Paradigms VicHealth Letter Issue 39 VicHealth (2014) Past Trends and future projections of overweight and obesity Australian Longitudinal Study on Women’s Health Victorian Health Information Surveillance System (VHISS) 2008 (Revised and updated 2012) Department of Health Victoria (DH) 2013 WHO Overweight and Obesity Fact Sheet No 311 http://www.who.int/mediacentre/factsheets/fs311/en/ Women’s Health Victoria (2010) Women and Physical Activity. Gender Impact Assessment No.12 Women’s Health Victoria (2012) Women and Food. Gender Impact Assessment No.8

Appendix 2: Background: Objective 2: Increase the opportunities for people living in the Greater Geelong Region to develop self-efficacy in healthy food knowledge and skills. Community Kitchens provide regular opportunities for groups of people to participate in planning, budgeting, cooking and sharing nutritious meals together in communitybased settings. The 2008 Frankston Pilot Project evaluation of the Australian Community Kitchen model demonstrated the effectiveness of Community Kitchens in creating opportunities for people to eat healthier, more affordable meals. Improvements were seen in the specific areas of cooking skills, motivation to cook, number of meals prepared at home, perceptions of healthy eating, frequency of fast-food consumption, consumption of fruit and vegetables and use of a shopping list. It was also demonstrated that the method of informal practical learning that occurs through participation in Community Kitchens has great potential to foster improved healthy eating behaviours. (Frankston Community Kitchens Pilot Project Final Project Report, Peninsula Health, January 2008) In 2008 Victoria University Wellness Promotion Unit was engaged to undertake further project evaluation. In summary, evaluation concluded that: “Overall the Community Kitchens Project has demonstrated that the model is flexible enough to operate in many different settings and to meet the needs of a broad range of population sub-groups, including those who are most at risk of chronic disease and poor mental health, people on low incomes, emergency food relief recipients, as well as healthy well resourced people who are socially isolated.” (Victoria University Wellness Promotion Unit Community Kitchens Evaluation Report, 2008). In 2012 ethics approved research of the Barwon Health Community Kitchens experience indicated increased opportunities for people living in the Barwon Region to develop self-efficacy in healthy food knowledge and skills by supporting organisations to establish Community Kitchens in their local area. The main findings included that: 1. Barwon Health has provided regional leadership, training, skill development, resources, and support to organisations who establish Community Kitchens in their local area. Underpinning the success of the work has been the strong partnerships which have been developed in the local Region. 2. There has been demonstration of organisational development and resource shift in community partners to sustain Community Kitchens in local areas. 3. Community Kitchen Facilitators have reported significant changes in personal skills, self-esteem and social capital. 4. Community Kitchen participants have reported; (1) Increased social capital: (2) Changes in health related behaviours; (3) Increased knowledge and skills; and (4) Enhanced social skills, self-esteem and self-efficacy. The positive outcomes achieved to this point together with further potential to grow the concept form an important part of the health promotion unit activity over the next four year period.

Appendix 3: Background: Objective 3: Children between the ages of 5-12 in the Greater Geelong area report a decreased intake of sweet drinks. The ‘State of Victoria’s Children 2011’ identifies a significant concern around sweet drink consumption in the Barwon South West Region. High rates of dental caries and obesity in the presence of reasonable rates of physical activity, implies a relationship between sweet drink consumption and these two health issues. Local schools report that their efforts to reduce consumption through education alone are not having a strong impact. They report that, where rules exist against carbonated drinks, students are less likely to bring these to school. They also report that the majority of parents are supportive of these rules. We know that similar interventions have been successful (‘Smiles4Miles’ 2005-0ngoing & ‘Romp & Chomp’ 2005–9. Both projects coordinated by Barwon Health). Individual behaviour change needs to be supported by creating an environment which makes healthier choices easier choices. Extending current initiatives within preschools into primary schools to ensure these environments, at least, are free from pressures and abilities to consume sweet drinks, would be a substantial step forward. It is our vision that children in the greater Geelong region will have better nutritional outcomes through reducing consumption of sweet drinks in educational settings. We intend to do this by supporting schools to become ‘H2Only Schools’.

Appendix 4: Background: Objective 4: Increase physical activity through increasing opportunities for children to experience outdoor play In Australia illness related to lack of physical activity (obesity and heart disease) is rising (VicHealth 2007). There is strong evidence that early opportunities to play in natural settings enhance physical health outcomes. In 2012 VicHealth announced a three-year study into parental fear as a barrier to children’s’ physical activity, to pinpoint causes and find solutions. “We still don’t have the answers about why fewer children are walking around their neighbourhoods than ever before, or why our society has become so hung up about risk. What we do know is that this is a real, and ultimately unhealthy, phenomenon”, stated VicHealth’s physical activity manager, Cameron McLeod. Currently there are a few independent strategies occurring across Geelong that support families to consider outdoor play (eg. Sandy hands muddy boots, Active in Parks). A cohesive approach to these would enable identification of barriers and gaps, and increase facility to respond to these. A community campaign will be implemented across the five municipalities in the G-21 region and target parents of pre-school aged children. (0–5 years). The campaign will be multifaceted: including elements of social marketing, professional development, and parent skill-building. A core aim of the project would be to implement and facilitate a ‘green referral’ system managed and implemented by medical services (paediatric, GP, allied health ….) that connects families with outdoor play opportunities It is our vision that by 2017 children across the G21 region will have improved opportunities to experience outdoor play in natural settings.

Appendix 5: Background: Priority 2/Objective 1 - Increase social inclusion and community connectedness of vulnerable males in the G21 region Social connectedness is a fundamental building block in determining people’s health and wellbeing outcomes. There are certain groups of vulnerable males in our region that face considerable barriers to their health and wellbeing, these including homeless men, unemployed men and Aboriginal men. These groups of men will be the target populations for the Unit’s work in the social connection area.