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Healthy Child Weight (CHW)

Healthy Child Weight (CHW). Heather Donald September 2011. The Scottish Health Survey (SHeS) -2009 1. 28.2 % of children classed overweight or obese (≥85 th Centile) Rates increase with age Rates in girls and boys appear similar (27% and 29.4% respectively) ≥ 85 th Centile

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Healthy Child Weight (CHW)

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  1. Healthy Child Weight (CHW) Heather Donald September 2011

  2. The Scottish Health Survey (SHeS) -2009 1 • 28.2 % of children classed overweight or obese (≥85th Centile) • Rates increase with age • Rates in girls and boys appear similar (27% and 29.4% respectively) ≥ 85th Centile • Significant associations between SIMD quintile and obesity

  3. National Policy Drivers for Tackling Child Overweight and Obesity in Scotland • Preventing Overweight and Obesity in Scotland: A Route Map towards Healthy Weight 2 • Early Years Framework 3 • Improving Maternal and Infant Nutrition: A Framework for Action4

  4. NHS Scotland Healthcare Quality Strategy 5 • Quality Ambition 1: • Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision making

  5. Quality Ambition 2: • There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times.

  6. Quality Ambition 3: • The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful of harmful variation will be eradicated

  7. Sources of evidence for guidance 2011-2014 • SIGN 115 (2010) 6 • NICE (2006) 7 • NHS Health Scotland Evaluation of the Implementation of HEAT 3 8 • Data from the impact of HEAT 3 Interventions from individual boards

  8. Integrated systems approach to child overweight and obesity prevention and management • Obesity prevention • Overweight and obesity management • Specialist assessment

  9. Qualifying interventions – key requirements • Intervention components • Behaviour change • Family-based • Decrease overall dietary energy intake • Increase the levels of physical activity • Decrease the amount of time spent in sedentary behaviours

  10. BMI Criteria • BMI at or greater than the 91st centile for BMI (based on the UK 1990 Reference Growth charts) • Participate at Tier 2 level programme • Complete at least 75% of the Programme

  11. Weight management/intervention goals • Key goal for child healthy weight interventions is to achieve a stabilisation or reduction in a child or young person’s BMI and BMI standard deviation score (SDS-BMI) (also known as BMI z-score)

  12. Duration of programmes (one-to-one/group) • Number of Sessions • Duration of Sessions • Timing of sessions

  13. Age range – 2-15 years • Inequalities – 40% of CHW completions should be achieved by children/families in the two most deprived SIMD quintiles, 1 and 2 by local SIMD datazone

  14. Integrated Care Pathway – Child Healthy Weight • Scottish Government require each board to have a care pathway that embeds CHW into practice • NHS Grampian ICP for CHW • Pilot initially to 3 areas

  15. Identified problems • Training for Staff 9 • Measurements • Equipment • Raising the Issue 10

  16. Tier 1 • Expectation of preventative work from all • Schools are delivering “Grow Well Choices” • Resources • Social Marketing

  17. Tier 2 • Intervention is “Eat Play and Grow Well” • For those with a BMI above the 91st Centile • How do you refer?

  18. Contact Details • Community Dietetics, Westholme, Woodend Hospital – 01224 556304 • Moray Dietetic Dept, Dr Gray’s Hospital – 01343 567350 • Email:- nhsg.communitydietitians@nhs.net

  19. Thank you

  20. References • 1Scottish Health Survey (SHeS) (2009). http://www.scotland.gov.uk/Publications/2010/09/23154223/0 • 2Scottish Government (2010) Preventing Overweight and obesity in Scotland: A route map towards healthy weight . http://www.scotland.gov.uk/Resource/Doc/302783/0094795.pdf • 3 The Scottish Government. (2008) http://www.scotland.gov.uk/Resource/Doc/257007/0076309.pdf • 4 Improving Maternal and Infant Nutrition: A Framework for Action (2011) http://scotland.gov.uk/Resource/Doc/337658/0110855.pdf • 5 The Health Care Quality Strategy for NHS Scotland (2010) http://www.scotland.gov.uk/Resource/Doc/311667/0098354.pdf • 6Scottish Intercollegiate Guidelines Network (SIGN) (2010). Management of Obesity: A National Clinical Guideline. NHS QIS: Edinburgh. www.sign.ac.uk/guidelines/fulltext/115/index.html • 7 National Institute for Health and Clinical Excellence (NICE) (2006). Obesity guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. Available: www.nice.org.uk/nicemedia/live/11000/30365/30365.pdf

  21. 8 NHS Health Scotland H3 evaluation (2010). www.healthscotland.com/documents/4836.aspx • 9 NHS Health Scotland. Healthy Weight National occupational Standards (2011) http://www.healthscotland.com/uploads/documents/15725-National%20OccupationStandards.pdf • 10 Health Scotland http://www.healthscotland.com/topics/child_healthy_weight.aspx

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