by Beth Bradshaw | 26 November, 2021 11:32 am
In March 2020 the pandemic brought an abrupt halt to our family group programmes. This enforced hiatus gifted us the opportunity that we had been looking for. A deep dive into CPD told us that our well-intentioned approaches to the health of children and young people in bigger bodies, had the potential to cause harm. This realisation triggered the inevitable decision to let go of the traditional practices we had been faithful to for over a decade. It was with some courage, inspiration and skills-development that we started to create our current approaches.
Why are we promoting a Health Gains Approach?
We chose the descriptor of Health Gains Approach for our new range of resources. It captures our purpose, and focuses our attention on encouraging enjoyable, sustainable, health-promoting habits. Our focus is now away from weight, and the potential for stigmatisation, and towards sustainable health behaviours.
Who do we serve?
Our work is with the families of children and young people in bigger bodies, from the ages of 2-19 years.
What are our outcomes?
Our new resources stem from evidenced practices that support physical, mental and social wellbeing. Our outcomes promote:
What does a Health Gains Approach look like?
During the last 12 months we developed resources in 3 key areas:
We wanted to ensure that our new approach is robust, and communicated well, within the community services and beyond. So far we have trained 250 staff in the rationale and communication model, and in the use of Level 1, Brief Intervention resources.
Our Level 2 programme is an intensive, 10-week programme delivered to parents by the Healthy Families team. Each week we release short, carefully structured, motion graphic videos, each with a key parenting message. We chose Ellyn Satter’s Division of Responsibility (sDOR) as our core-feeding model. Through this, we encourage structured, responsive feeding and enjoyable mealtimes. Each family has an assigned coach to guide the parent through the programme and to personalise content to the strengths and idiosyncrasies of each family.
This short professional overview[1] video captures our approach.
What motivated us to change our approach?
In truth, we were ready for change. For some time we had been uncomfortable with the practice of weighing kids, and using these metrics to measure the outcomes of our programmes. Our ‘measurement nights’, with the look of upset or delight on young faces, we now realise could sow the seeds for a lifetime of shame and an unhealthy relationship with food, eating and bodies.
Our prescriptive nutrition messages were in line with good practice, our sessions were fun and interactive, and family feedback told us we were non-judgemental. Yet we were still, implicitly, stigmatising young bodies.
What did we learn during the last 12 months?
Where to start? Our learning continues on so many levels, as the resources we have recommended will start to indicate.
The approach we created is still in its infancy. As we transitioned our approach, we experienced ambivalence within ourselves. We debated, wrestled and challenged information that jarred against our long held, stubborn beliefs.
Once we were ready to take our approach out to our peers and families, we braced ourselves for resistance. We soon learned, though, that others are ready for change, too. In the main, we experience acceptance, relief, interest and enthusiasm for fresh ways of thinking and working.
Paediatrician feedback following an update presentation:
‘It’s likely the audience will change their clinical practice around use of language and weight, and how to discuss changes in weight with families and young people.’
Enhancing Families Team Leader feedback about new Level 1 resources:
‘I think in terms of weight stigma etc. that parents can be resistant, and the ‘what you need to do is…..’ approach generates more resistance. I love how the (resource) is focused on positives and I think it is a tool that will really stimulate a parent’s awareness.’
Family Feedback Highlights – Level 2 pilot programme:
“This Has Transformed our Mealtimes”
Three things we would recommend to others taking a similar approach:
If you would like to get in touch with Gemma and Jill to find out more, please use the following contact details: gemma.holdsworth@boltonft.nhs.uk / [2]jill.harrison@boltonft.nhs.uk[3]
Professional Training
| Title | Details | Link |
|
Unpacking Weight Science
|
Fiona Willer, Advanced Accredited Practicing Dietitian and lecturer at Queensland University. A range of training for health professionals and dietitians.
|
Unpacking Weight Science[4] |
|
Harvard Implicit Association Test
|
Self-test to measure weight bias. | Harvard Implicit Association Test[5] |
| Today’s Dietitian | A short course in weight-inclusive care |
Weight-Inclusive Care: Evidence and Best Practices[6]
|
|
London Centre for Intuitive Eating
|
LCIE offer a range of courses for professionals and individuals, along with weight-inclusive guides to a range of conditions. | London Centre for Intuitive Eating Courses[7] |
Websites
| Title | Details | Link |
|
Fiona Willer
|
Fiona Willer, Advanced Accredited Practising Dietitian and lecturer at Queensland University. |
Fiona Willer Website[8]
Health Not Diets[9]
|
|
Ellyn Satter
|
Registered Dietitian and Family Therapist promoting evidenced models: Division of Responsibility (sDOR) and Eating Competence (ecSatter)
|
Ellyn Satter Institute[10] |
|
Intuitive Eating
|
Evelyn Tribole, Registered Dietitian and Elyse Resch, Registered Dietitian. Intuitive Eating, promoting a healthy relationship with food, mind and body. Suitable for adults and adolescents
|
Intuitive Eating[11] |
|
HAES Health at Every Size
|
Health without a focus on weight loss. |
HAES Research Library[12]
HAES Healthsheets[13]
|
| The Feeding Doctor |
Dr Katja Rowell M.D. Responsive Feeding specialist
|
The Feeding Doctor[14] |
Source URL: https://foodactive.org.uk/weight-stigma-local-case-study-a-health-gains-approach-in-a-0-19-service-weight-inclusive-practices-with-children-young-people-and-families/
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