Obesity soc health-29june2010

Setting the Scene for the School Health Nursing Contribution Catherine Gleeson Independent Consultant Nurse in School Health and part-time Practice NurseEvery Person A Well Fed Person -Socialist Health Association29 June 2010Manchester

Tackling Childhood Obesity  3 aspects – Identification and monitoring – Treatment – Prevention  Where can school nursing fit?2

Foresight Report, 2007  Strategic view of obesity  Complex causes of obesity epidemic  Obesity can’t be prevented by individual action alone  Population level measures required  Partnership required between government, science, business , civil society3

Foresight Report - messages  Environment that supports healthy choices  Synergies with other goals – social inclusion, reduce health inequalities  NHS staff training – identification and initial treatment  Leadership - higher priority for prevention  Acknowledgement - school choice may reduce opportunities for walking, cycling i.e.  – an ‘unintended consequence’4

School Health Nursing – Govt policies  SN identified as key role in reducing health inequalities  National Healthy Schools Programme  School Nurse Development Resource Pack, DH/DfES, 2006 – Nutrition, childhood obesity and physical activity5

Obesity – School nurse role  Scarce resource – how to prioritise?  Effectiveness and efficiency  Individual versus population – is there room for both?  Inclusion and obesity – disabilities catered for?6

Programmes and Interventions  Fit for Sport  Jamie Oliver –role models  Eat small  MEND, Fit 4 life, Barnsley  Drop-in advice in schools and towns  Synergies – babies into books, oral health7

Scenarios linked with nutrition and exercise in schools  Parents of Ayisha, 5 yrs, ask for her to stay indoors during playtime as running around makes her asthma worse. Attendance - odd days off most weeks.  Tracey, 15 yrs is asthmatic, rarely misses school. Not particularly keen on sports. On a warm summers day she asks if she can miss the cross country run – no-one else likes it, pupils are resentful if anyone gets out of it  Craig, 12 years seems unenthusiastic about football. Attendance check - often absent on PE days. Teacher enquires and Craig says his legs ache13

Young People’s views – nutrition and exercise Balding, 2005: decline with age in most activities  except 5-a-side football, basketball, soccer, weight training, walking Balding, 2007: >50% girls would like to lose weight  But only 12% overweight using weight and height data  25% of girls age 10-11 think they have been bullied because of the way they look PHC study of adolescents, RCT  approx one quarter want to discuss body shape / diet (Walker et al 2002)14

Pupils with disability in mainstream schools  Study of 33 pupils in mainstream secondary schools, Lightfoot et al (1999)  Only 3 (of 33) felt their condition made no difference to PE participation  Pupils valued written information to improve communication  Valued PE teachers who: allowed child to decide if able to take part; made special arrangements ‘without making a fuss of child’; were understanding  But – teachers in same school react differently  SN’s unavailable so not seen as source of support15

School nurse workforce  Much smaller group – 10% of whole DN and HV service (McDonald et al 1997)  Variable provision (Cotton et al 2000)  2008 – Two national studies of community nursing workforce – Storey et al, 2008 ‘older nurses’ study 1188 SNs – Drennan and Davis, 2008 Trends over 10 years approx 2000 working in school nursing16

National Child Measurement Programme (NCMP)  One element of Government’s work progamme on childhood obesity  Introduced 2005  Operated jointly by DH and DCFS  Non-statutory Guidance to PCTs – performance managed on coverage  Envisaged that school nurse teams would deliver programme17

Purpose of NCMP  inform local planning and delivery of services for children  gather population-level surveillance data to allow analysis of trends in growth patterns and obesity  helps to increase public and professional understanding of weight issues in children  useful vehicle for engaging with children and families about healthy lifestyles and weight issues18

How is NCMP delivered  Includes children aged 4 and 11 in state schools (excludes Independent and Special schools)  Measure weight and height using DH standard equipment  DH Guidance (29 pages) - training  No results given to children or anyone else at school19

Logistics of measurement Equipment to be provided by PCTs – transportation to schools Planning with schools: room availability, fit around curriculum Paperwork – parent’s information (15 non-English languages), can opt out Parent can request result within 1 month20

Can aims of NCMP be met?  monitor population trends – data available from other sources – Evidence (Wake, 2009) could involve representative samples  inform local service planning – expert advice that multi-faceted interventions needed  increase public and professional understanding – unclear how?  useful vehicle for engaging with children – measurement process offers no opportunity for real engagement – Disclosure to parents – NZ ref pre school to GP21

Potential contribution of school nurses to reducing obesity  DH/DFES, 2006 School Nurse Development Pack  support Healthy Schools  Food in Schools Toolkit  increase overall daily exercise and healthy eating  individual health plans for pupils with long term condition, disability, obesity  drop-in clinics  identify and target groups of CYP with significant health needs, reduce inequalities  e.g. 60,000 CYP looked-after (TSA, 2005, Key data on adolescence)22

Obesity soc health-29june2010

by Socialist Health Association

Accessibility

Categories

Upload Details

Usage Rights

1 Embed 27

Statistics