Mind Exercise Nutrition Do It! MEND

1. Mind Exercise Nutrition Do It!MEND Elaine Tabony School Health Team Leader (Hillingdon Community Health) Professional Lead Childhood Obesity Care Pathway (Public Health) MSc Health Promotion and Public Health BSc(Hons) Community Health Specialist Practitioner Community Health School Nursing RN RSCN CPT(Level M)

2. What is MEND? Lifestyle behaviour change programme Improving health & behaviour, and NOT a rapid weight loss programme • Designed: child obesity experts • Delivered: health, education & fitness professionals • Community-based • 1st line treatment: NICE Guidance, ADA • Report, Canadian Clinical Practice Guidelines

3. Why Lifestyle Behaviour Change ? Influences on Childhood Overweight and Obesity • National factors - eg. Transport, media, vending machines, manufactured imported goods, • Community/Local - eg. School buses, Safety, awareness/attitudes, parks, Community level education • School - eg. Teacher knowledge/attitudes, snack shop, activity time/ curriculum content • Home - eg. Family diet, family activity patterns, Child care, parental knowledge/attitudes • Individual - eg. TV in child’s room, child’s diet and activity outside school, • International factors - eg. Globalisation, marketing, convenience foods, children’s spending power (Doak et al. 2006)

4. M=Mind Based on behavioural models of change & social learning theory • Goal & reward system • Self-esteem & confidence • Role modeling • Triggers - hunger vs. craving • Problem solving • Positive parenting e.g. bullying, sleep etc • (5 / 8 sessions – parents only)

5. E=Exercise • Multi-skills • Group play • Non-competitive • Graded activities • Increased self-esteem: dance, voice & drama • Land & water based • FUN!!!

6. N=Nutrition • Not a diet – healthy eating customised • No foods are forbidden • 16 Nutrition Targets • Educating and empowering families • (All sessions - parents & children)

7. How is MEND delivered? • 20 x 2-hour group sessions over 10 weeks • Introduction and farewell • Holistic pre-assessment and post assessment (Opportunity for Hillingdon to become part of a research project including quality of life assessment) • 8 Mind sessions • 8 Nutrition sessions • 18 Exercise sessions

8. Who delivers MEND in Hillingdon? Multi-agency approach • School Nurses deliver ‘Nutrition’ and ‘Mind’ theory sessions • PE Teachers and Personal Trainers deliver exercise sessions Programme supported by Health Care Assistants Support services: Hillingdon Sport and Leisure Services • Hillingdon Sport and Leisure Complex • Highgrove Pool • Hayes Pool • Barnhill Community School, Harlington Community School, Harefield Academy, Ruislip High School, Stockley Academy

9. Why do we need this programme in Hillingdon? • The NCMP data for the last the years shows the following percentages:

11. Healthy Weight, Healthy Lives: A Cross Government Strategy for England. • Published in January 2008: this set out the first steps to meeting the challenge of excess weight in the population. • Nationally, success in meeting the ambition and the Child Health Public Service Agreement (PSA) will be measured using Health Survey for England data for prevalence of overweight and obesity in children. • Locally, PCTs and local authorities use NCMP data to set local goals, agree them with SHAs and Government Offices and monitor performance.

12. The future Further interventions in development: • MEND Graduates – Fit-Teens 13+ programme Different age groups • MEND 5-7 years responding to NCMP programme • Mini-MEND age 2-4 years • ‘Achieving Healthy Weight’ Group in Hillingdon • Special needs • GP-delivery platform • International adaptation & evaluation (e.g. Denmark, Finland, Greece, Australia & USA)

13. Parents views about MEND • I knew my child was overweight and I thought MEND was a great opportunity to help my child. I learnt a lot in terms of nutrition and how to take action and changed my child’s diet. My child found it very fun and encouraging and was not forced. My child’s diet has completely changed. My child’s confidence has grown • Before I came I thought it would be a waste of time but I was worried about my child’s weight. I found out it was not so much what he had to eat but that I was overfeeding him. He found confidence in his ability that he had never had. Before he came he was quiet and unconfident and did not much like what he looked like. He was bullied at school and did not stick up for himself. The most important thing was my child grew in confidence and as a bonus he lost weight - we both learned a lot • He needed an incentive to lose weight. I learnt lots of new ways to feed my whole family • My child did not like what they looked like or fit clothes. She made friends and looked forward to coming. Because the school knew about MEND, the school took the bullying issues seriously

14. Six Hillingdon MEND 7-13 sites How to contact MEND in Hillingdon Monday and Wednesday 4-6pm Land based exercise - Stockley Academy Water-based exercise- Yiewsley Pool Monday and Friday 5-7pm Water based exercise- Highgrove Pool Land based exercise- 5.15-7.15pm Ruislip High Monday 4-6pm and Saturday 9.30-11.30am Land based exercise- Hillingdon Sports and Leisure Complex Water-based exercise- Hillingdon Sports and Leisure Complex Tuesday 4-6pm and Saturday 10am-12pm Land based exercise- Harlington Community School Water-based exercise- Hayes Pool Wednesday 3-45pm and Saturday 9am-11am Land based exercise- Barnhill Community School Water-based exercise- Hayes Pool Thursday 4pm-6pm and Saturday 9.30am-11.30am Land based exercise- Harefield Academy Water-based exercise- Hillingdon Sports and Leisure Complex Hillingdon MEND Office 020 8573 1271 Minet Clinic, Avondale Drive, Hayes, Middlesex. UB3 3NR