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PACO III Aruba 5 – 7 June 2013 What can we learn from the Belgian case?. Prof. em. Jan Vinck Hasselt University (Belgium) Expert Committee Viasano. What can we learn from the Belgian case?. Adaptations are necessary at regional and local level
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PACO IIIAruba 5 – 7 June 2013Whatcan we learnfrom the Belgian case? Prof. em. Jan Vinck Hasselt University (Belgium) Expert CommitteeViasano
Whatcan we learnfrom the Belgian case? • Adaptations are necessary at regional and local level • Is the program effective?
Viasano by EPODE in Belgium 16 cities, 655 275 inhabitants Aarschot Schilde Hasselt Huldenberg Jette Dilsen-Stokkem Woluwe St Pierre Liège Pepinster Comines-Warneton Mouscron Flobecq Mons Marche- en-Famenne Braine-le-Comte Rochefort
Belgium Complex country: at crossing of latin and nordicEuropea.o. • 3 regionswithowngoverment, politicaltraditions • 3 languages • different organization of health promotion
Viasano by EPODE in Belgium 16 cities, 655 275 inhabitants Aarschot Schilde Hasselt Huldenberg Jette Dilsen-Stokkem Woluwe St Pierre Liège Pepinster Comines-Warneton Mouscron Flobecq Mons Marche- en-Famenne Braine-le-Comte Rochefort
Viasanocharacteristics • 16cities in 3 regions • 100% private sponsoring • Overall Epode methodology • Dualapproach (social marketing & environmental)
Example of environmentalapproach: Esseghem
Bruxelles, Ville-Région en SantéLe diagnostic en marchant Jette Parc de logements sociaux Immeubles de grand gabarit (blocs) Forte densité de population
Bruxelles, Ville-Région en SantéLe déroulement: nouveau projet
Bruxelles, Ville-Région en SantéLe site d’Esseghem: une fête
Bruxelles, Ville-Région en Santé Le site d’Esseghem: les graffeurs
Bruxelles, Ville-Région en Santé Le site d’Esseghem: atelier wok
Whatcan we learnfrom the Belgian case? • Adaptations are necessary at regional and local level • Is the program effective?
Regionaladaptations • Politicaltradition: decisionregionalorcommunal? • Health promotion system: stronglyorganized? • Language: simpletranslation is notenough
Localadaptation: role of local program manager (LPM) Adaptation of interventions to localsituation and population • identify relevant populations/subgroups • identify relevant actors (control relevant aspects of environment) • mobilize these actors • inspirelocalaction • organizecollaboration
Is the program effective? • Evaluationstudy in 2 towns in FrenchCommunity (Mouscron and Marche) • BMI of all school goingchildrenages 3-4 and 5-6 • Measuredbytrained nurses • Measurementpoints 2007 and 2010 • N= 1300 and 1484 • Controlpopulation: all other school children of FrenchCommunity of sameage at sameperiods • N= 76864 and 79602
Results (1) evolutionoverweight: in pilottowns9.5% 7.4% change in pilottownssignificantlygreaterthan in controlpopulation (p=0.047)
Results (2) evolutionoverweightplusobesity: in pilottowns13.5% 11.2% change in pilottownssignificantlygreaterthan in controlpopulation (p=0.046)
Evolution in obesityalone: non-significant trend forgreaterdecrease in pilottowns
Conclusion • Implementationrequirescarefulladaptation of the program to the localsituation • Results of evaluationstudy are veryencouraging: effect even after 3 years