HEALTHIER BOROUGH BOARD by wuzhenguang

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									                  HEALTHIER BOROUGH BOARD
                       Tuesday, 28 July 2009
                             2:30 pm
                Committee Room 2, Town Hall, Barking

Members of Board
Maureen Worby        Chair, NHS Barking and Dagenham Board
Councillor Herbert   Executive Portfolio Holder for Adult Services, LBBD
Collins
Anne Bristow       Corporate Director of Adult and Community Services, LBBD
Matthew Cole       Joint Director of Health Improvement, NHS Barking and
                   Dagenham/ LBBD
Sheila Delaney.    CEN/VCS Representative (Barking and Dagenham Racial
                   Equalities Council)
Dave Reed          Metropolitan Police – Deputy Borough Commander
James Goddard      Group Manager, Housing Strategy
Paul Hogan         Head of Leisure and Arts, LBBD
Stephen Langford   Interim Chief Executive, NHS Barking and Dagenham
Roger Luxton       Corporate Director of Children’s Services, LBBD
Jacquie Mowbray    Director of Mental Health Services, NELFT/ LBBD
Claire Ramm        CEN/VCS Representative (Chief Executive, Age Concern)
Glynis Rogers      Head of Community Safety and Preventive Services, LBBD
Paul Sinden        Director of Commissioning, NHS Barking and Dagenham
Doreen Stevens     CEN/VCS Representative (Barking and Dagenham
                   Crossroads)
Tudur Williams     Head of Adult Commissioning
Rob Whiteman       Chief Executive, LBBD (ex officio)
LBBD Officers / Advisers
Errol Lawrence    Policy and Partnership Officer, LBBD
Guests
Adewale Kadiri    Audit Commission – CAA Lead for North East London
Chris O’Connor    Group Manager, Children’s Services Engagement, LBBD
Christine Pryor   Head of Integrated Family Services, LBBD

                        Contact Officer: Masuma Ahmed
                                Tel. 020 8227 2756
                                Fax: 020 8227 2162
                             Minicom: 020 8227 2685
                       E-mail: masuma.ahmed@lbbd.gov.uk
                                     Agenda

                                                 Presented    Time         Pages
                                                    by       allowed

1.    Apologies for Absence                        Chair     2 minutes        -

2.    Appointments                                 Chair     5 minutes        -

      The Board is asked to acknowledge that
      Claire Ramm has stepped down from
      the Board.
3.    Declaration of Members' Interests            Chair     2 minutes        -

      Members of the Board are asked to
      declare any personal or prejudicial
      interest that they may have in any
      matter which is being considered at this
      meeting.
4.    Minutes - To confirm as correct the          Chair     5 minutes (Pages 1 -
      minutes of 26 May 2009                                           6)

5.    Outstanding Items Update                     Chair     5 minutes (Page 7)

      To note the updates provided on
      outstanding actions / items agreed at
      earlier Boards.
6.    Comprehensive Area Assessment              Adewale     15          Discussion
      (CAA)                                       Kadiri     minutes

      Discussion with Adewale Kadiri, CAA
      lead for North East London Audit
      Commission.
7.    Health and Well Being Strategy             Matthew       15        Discussion
      Update                                      Cole       minutes

8.    Consultation Results with Children           Chris       15        (Pages 9 -
      and Young People around Health             O’Connor    minutes     150)

9.    Sexual and Reproductive Health for         Christine     15        (Pages
      Children and Young People 2008 -            Pryor      minutes     151 - 170)
      20013

10.   Fit For Work Programme Update                To be       10             -
                                                 confirmed   minutes

11.   Public Service Board and Sub-boards Members of           10          Verbal
      Update                              other Boards       minutes       update

12.   Forward Plan                                 Chair       10        (Page 171)
                                                             minutes
13.   Information Items                     5 minutes   -

14.   Any Other Business                    5 minutes   -

15.   Date of Next Meeting

      Tuesday 24 November 2009 at 2.30 pm   1 minute    -
      Civic Centre Chamber
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                                                                          AGENDA ITEM 4




                         HEALTHIER BOROUGH BOARD
                                 Tuesday, 26 May 2009
                                   (2:30 - 4:30 pm)

Members Present: Councillor H J Collins, Karen Ahmed, Anne Bristow, Matthew Cole,
James Goddard, Paul Hogan, Stephen Langford, Jacquie Mowbray, Glynis Rogers and Paul
Sinden

Advisers, Officers and Guests Present: Masuma Ahmed, Peter Gluckman (Change-fx),
Andrew Goddard, Meena Kishiani, Stephanie May and Guy Swindle

Apologies: Maureen Worby, Simon Standish and Errol Lawrence


                                                                          Action By
29.   Declaration of Members' Interests

      None.

30.   Minutes - To confirm as correct the minutes of 24 February
      2009

      Agreed.

31.   Fit for Work Programme

      Stephanie May outlined a report on the Fit to Work Programme,
      which was noted by the Board. The report was provided to advise
      members of an expression of interest bid submitted to the
      Department of Health on behalf of the Barking and Dagenham
      Partnership for the Healthier Borough Board to sponsor
      participation in the Government’s Fit for Work Service –
      Programme of Piloting.

      Stephanie May advised that out of the 70 applications made, 63
      had been moved on to the next phase. She added that
      applications had been sorted into three tiers and that our
      application had made the highest, which increased our chances of
      getting funding.

      Members questioned whether there was support for the scheme
      from employers within the private sector and GPs and also
      commented that officers should look into whether any care homes
      or pharmacies would endorse the scheme. The Board felt that it
      may be beneficial to invite interested parties to an event giving
      them information about the programme.

      Stephen Langford stated that it was the role of the PCT to make


                                       Page 1
      sure that GPs understood the importance of and supported the
      proposed scheme.

      It was noted that the links between work and health were also a
      proposed priority for the joint draft Health and Well Being Strategy
      being discussed later on the agenda.

      Overall, members expressed their support for the bid and agreed
      with the recommendations of the report.

32.   Health and Wellbeing Strategy

      Matthew Cole delivered a presentation on the Health and
      Wellbeing Strategy for the Borough. He explained that the Board’s
      officers group was working on the strategy and had put forward
      priorities to be incorporated within the strategy for consideration by
      the Board. The priorities were taken from the Barking and
      Dagenham Joint Strategic Needs Assessment, a document which
      would soon be available on the PCT and Council website, as well
      as areas identified in the World Class Commissioning review. The
      date proposed for completion of the joint Health and Well Being
      Strategy was 30 September 2009.

      Although the officers group came up with a draft list of ten
      priorities, the view was that there were other important issues such
      as dementia and domestic violence, which were dealt with under
      the ‘Additional Priorities’ part of the presentation. The programme
      around the strategy was slightly off track due to staff commitments
      around the swine flu pandemic. It was agreed that members would
      not receive different versions of the document as they were
      updated but the final version of the strategy.

      The specification around the document stated that the focus
      needed to be on ten different priorities. The priorities put forward
      by the officers group were:

         •   Smoking
         •   Diet & Exercise
         •   Sexual and Reproductive health
         •   Depression
         •   Alcohol
         •   Immunisation
         •   Health and Work
         •   Public Health Screening Programmes
         •   Worklessness

      Members had a discussion around whether local people would
      agree that these were also their top ten health and wellbeing
      priorities. It was felt that whilst local people would probably agree
      with many of them, they may also opt for the inclusion of other
      priorities such as care of the dying and domestic violence. Some
      members felt that as domestic violence rates in this borough are



                                           Page 2
significantly higher than others and because it affects a wider
range of people in different ways, it was important for the Board to
consider whether it should be included in the priorities. It was also
felt that serious consideration should be given to the issue of care
of the dying as it was anticipated that more people will be dying in
the home as less people are being hospitalised.

The Board were in agreement that diet should be included in the
priorities because of the long term affect it has on people’s health
and its link to income and skills. Members were of the opinion that
the priority should be described as ‘healthy eating’ as opposed to
diet because of the connotations associated with the word ‘diet’.
Similarly, members thought it might be worth describing exercise
as ‘physical activity’ so that it was clear that any type of exercise
such as housework or walking could be beneficial for health.

In relation to the priority of sexual and reproductive health, the
Board were in clear agreement that this should be a priority.
Councillor Collins commented that it was important to take into
account that society seems to hold females more responsible for
teenage pregnancies whereas in reality responsibility lies with both
sexes.

Members had a discussion around whether depression should be
renamed ‘mental health’ or ‘depression and anxiety’. The Board
agreed that this should be included as a priority because it affects
large numbers of people. The Board also felt that although
depression could be caught in the primary stage of care, the
treatment given at this stage was usually in the form of pills
whereas better treatment could be given at the secondary stage by
psychologists or psychiatrists.

It was agreed that immunisation and screening should be merged
to form one priority. The Board considered what strategic actions
could be taken if this were included as a priority. It was felt that
working with professionals whose views affect public perception
such as teachers, health professionals and the media would need
to be addressed in the strategy. It was also felt that making access
to screening easier for all segments of the community should be
addressed in the strategy.

The Board agreed that whilst it was an important issue,
worklessness was better placed under the Business, Jobs and
Skills Board. The Board noted that there were many priority areas
where potentially there would be input required from or
contribution made to the work of other partnership boards. In the
case of the Joint Health and Well Being Strategy, priority areas
that have an interface with the work of another Board would be
clearly identified with which Board was doing what.

The Board discussed the possibility of including support for people
with learning disabilities as a priority. It was felt that this group


                                   Page 3
      were of a small number but high need and issues that the strategy
      could address were the proper take up of health care check-ups,
      ordinary pathways and reasonable adjustments.

      The Board concluded that the first five priorities highlighted in the
      presentation should be a part of the strategy. It also agreed that
      the maximum number of priorities should be ten, given that the
      longer the list, the more difficult it will be for those involved to focus
      their efforts on them.

      Members felt it necessary to allow more time for them to consider            ALL
      what the remaining five priorities should comprise. It was agreed
      that they would quickly send their thoughts to Matthew Cole who
      would assemble members’ comments and report these back at the
      next meeting. Meanwhile, and by incorporating these further views
      of Members, the Board’s officers’ group would meet and complete
      the work of identifying the top ten priorities. Work on the agreed
      priorities would then be allocated to existing joint groups where
      these were in place to undertake them or could do so with minor
      changes to their terms of reference. Anne Bristow noted that
      where no suitable joint group existed, then one should be
      established through the joint working arrangements.

      Stephen Langford noted that the priorities identified in the joint
      Health and Well Being Strategy would almost certainly require
      sustained joint effort over several years.

      Matthew Cole welcomed members to make suggestions about the
      use of language to make the strategy more accessible.

33.   Experian Presentation

      Matthew Cole delivered a presentation on the Experian Customer
      Segmentation Project, which is a customer segmentation
      approach aiming to describe households in the Borough, establish
      ways to communicate with them more effectively and improve the
      level of uptake of services accordingly. The key groups in the
      borough, statistics on what percentage of the population they
      make-up and current service usage by different key groups were
      outlined.

      One of the aims of compiling this data was to create ten minute
      walktime catchments around each pharmacy and calculate the
      potential need for CVD screening within each catchment.

      The presentation will also be given to the other LSP Boards for
      their information. Within the presentation, data protection issues
      were outlined including different levels of access for the public and
      staff. The approach to training PCT staff on using this method as
      well as the quick wins for the PCT listed below were covered:

         1. Identifying gaps in community service provision with respect
            to high need areas


                                             Page 4
         2. Uptake of CVD screening

         3. Reducing the inappropriate use of A&E

         4. Addressing DNAs

         5. Encouraging the uptake of smoking cessation services

         6. Reducing frequent flyers

         7. Accessing residents not registered with GPs.

      The Corporate Management Team will be asked on 1 July 09 to
      agree:

             the segmentation approach
             the approach to training and data protection
             the quick win projects

34.   Public Service Board and Sub-boards Update

      Glynis Rogers provided an update of the Safer Borough Board
      where members discussed the following:
         • The rise in serious crime and domestic violence
         • The Specials Recruitment scheme whereby employers
             release chosen staff for up to 2 months to train as a special
             constable
         • The number of people entering drugs
         • Analysis on the involvement of young people in gang crime

      Meena Kishinani provided an update of the Children’s Trust and
      stated that the number of young people going to university was on
      the rise. There was no rise in number of looked after children and
      the number of children in the Child Protection Register was on the
      increase.

      It was agreed that a written update of the LSP Boards should be
      provided where those who could provide verbal updates were not          EL
      present.

35.   Information Items

      Anne Bristow advised that there will be a partnerships conference
      on 11 June 2009.

36.   Items of Good News

      Members were pleased with the speed in which the ‘Catch It, Bin
      It, Kill It’ campaign was put out in relation to addressing the swine
      flu outbreak. Members requested that a statement regarding              Matthew Cole
      planning for epidemics for the Autumn period be submitted to



                                         Page 5
      them.

37.   Date of Next Meeting

      Noted, details of the next meeting:

      28 July 2009 at 2.30 pm
      Room 2 of Barking Town Hall

38.   Any Other Business

      Matthew Cole advised that the Dagenham Town Show would be
      held in July 09.

      Anne Bristow advised that there would be a Young Carers DVD
      launch including a premier event on 12 June 09.




                                            Page 6
         Healthier Borough Board- Outstanding Items / Reports

         Issue                Minute Day   Month Year   Action Requested by Meeting        Responsible for     Current position /
                               No.                                                         Action / Feedback   (date update given to
                                                                                                               Board)

         Health and           32    26     May   2009   Health and Wellbeing               Matthew Cole
         Wellbeing Strategy                             Strategy:
                                                        Members to send comments
                                                        regarding the five priorities to
                                                        Matthew Cole before the next
                                                        meeting


         Epidemics            36    26     May   2009   Statement regarding planning for Matthew Cole
                                                        epidemics for the Autumn period




Page 7
                                                                                                                                       AGENDA ITEM 5
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               Page 8
                                         AGENDA ITEM 8




3rd Annual Children and Young People’s
              Conference

  ‘5-11 year olds Health Conference’

          26th February 2009

          Evaluation Report




                   1
                Page 9
Contents Page
Summary                                   p.3

Workshop Outcomes                         p.8 - 26

Digipads consultation                     P.27 - 31

Feedback from children and young people   p. 31




                                2
                              Page 10
1.0 Summary
The London Borough of Barking and Dagenham held its third conference for
children and young people aged between five and twelve years on the 26th
February 2009 as part of its on-going commitment to young
people’s engagement and participation.

The conference was based on Health and it was an opportunity for children
and young people to give their views on a range of health issues. The four
themes were 1) Fit, Healthy and Happy 2) Controlling your Demons, 3) Sexual
health and relationships, 4) Healthy Eating and living

Over 71 children and young people attended representing 23 infant, junior
and primary schools. The children and young people were joined by teachers
and officers from the Council.

The young people had the opportunity to attend two of 8 different workshops.
Hosts and MC’s for the day were former BBC Radio presenter, stand-up
comedian and former teacher, Geoff Schuman and Young Consultant Tom
Rowe.

The conference’s highlight was World Champion, Paralympic Champion,
European Champion, Paralympic World Cup Winner, Flag Bearer Beijing
2008 Danny Crates key note speech to the young people, which was well
received by all, teachers and workshop facilitators included.




                                    3
                                 Page 11
Picture 1 – Key note speaker Danny Crates




                                 4
                               Page 12
Picture 2 – Young People tuck into a Healthy Lunch




                                  5
                               Page 13
Picture 3 – Wii Fit Health Boards




Picture 4 – Virtual Tennis on the Nintendo Wii




                                      6
                                    Page 14
Picture 5 – Dagenham & Redbridge FC Players, Peter Gain and Jacob
Erskine with Treasure Hunt Winner Igla




                                 7
                              Page 15
3.0 Workshops Outcomes
3.1 Workshop 1 – Childhood Obesity

Little Miss Health meets Super Food Man!

Aim: To raise the issue of overweight and healthy eating with the group, and
to discuss ways in which healthy eating can be promoted to children and
parents.

Workshop description: The workshop began with group introductions. It was
ascertained whether the group were familiar with such terms as ‘NHS’,
‘healthy eating’, and ‘obesity’. Following this the group did an activity in which
they answered a number of healthy eating related questions (see appendix 1).
They voted for their answers by a show of hands.

Following the questions session, the group were shown a number of ‘healthy
eating messages’. These were:
    1. Watch your weight
    2. Eat a balanced diet
    3. Cut down on sugary foods such as sweets, chocolate and fizzy drinks
    4. Cut down on fatty foods such as burgers, chips and pizza
    5. Drink more water
    6. 5 A Day
    7. Eat together as a family
    8. Don’t eat too much salt
    9. Eat a rainbow (for this health message the group were asked what they
        thought it meant – it means to eat a variety of different coloured food)
    10. Cut down on fast food

The group had a discussion around each of the health messages and decided
which of the messages they thought were most important. Following this
discussion, the group were shown pictures of Tony the Tiger (Frosties),
Ronald McDonald (McDonalds) and David Beckham (Pepsi). They were then
asked to design their own character, or choose a celebrity to promote the
health message that they thought most important. In the centre of the table
were crayons, felt tip pens, and cut out heads, bodies and legs of celebrities,
normal people, animals and cartoons.

Once the group had all created a character, they gave them names, and often
a slogan, and then fed back to the group why they had chosen their particular
character and where their character would appear (i.e. on posters, on TV, in
magazines, etc).


Group 1
At the initial question asking session, the group were unanimous in thinking
that healthy eating is important and that they are themselves in charge of
healthy eating, not their parents. They all felt that it should be a teacher’s



                                       8
                                     Page 16
responsibility to teach/inform them about healthy eating. For full details of the
questions asked and the answers given, please see appendix 1.

The group had a very positive discussion about which healthy eating
messages are most important to them. They chose ‘Eat a balanced diet’,
‘Watch your weight’, ‘Eat 5 a day’ and ‘Eat a rainbow’ as their group priorities.
Perhaps most surprising and interesting was the choice of ‘watch your weight’
as this is a message that the group are unlikely to have been exposed to as
much as other messages. ‘Eat a rainbow’ evoked the longest discussion as
this was not a phrase that the group had heard before. When asked what the
message means, answers were, ‘eat what you like – eat your dreams’, and
‘eat different coloured fruit’. Indeed the message does mean to eat a variety
of different coloured foods, so the group did very well to identify this. The
group unanimously felt that this was a really good and simple message for
children.

For the ‘character making’ exercise, the youngest children from year 1 and 2
did require support and assistance from their accompanying teacher, and the
concept was difficult for them to fully understand initially. The children in
years 3 + however were very engaged with the process. One year 4 pupil
from Five Elms created an excellent collage of pictures of celebrity women –
Beyonce, Jennifer Lopez, Cheryl Cole and Myleene Klass. Underneath she
wrote, ‘I picked these people because they are slim and they can tell me what
they done to get slim….Eat 5 a day! Try this for a diet!’ It is encouraging that
the celebrities chosen by this individual are all known as being more curvy
and natural looking than certain other celebrities (with the possible exception
of Cheryl Cole). Another pupil from year 2 at Five Elms chose to focus on the
‘watch your weight’ message, creating ‘unusual’ looking characters such as a
person with a cat’s head, in order to shock people into paying attention to the
message. Finally a pupil from Dorothy Barley Infant School drew a picture of
parents. This prompted a group discussion during which time the entire group
decided that contrary to their original comments that healthy food should be
taught by teachers, they now felt that parents should actually play a role in
this as well. The activity therefore seemed to be successful in making the
group think more deeply about healthy eating and where the information
should come from.

Group 2
At the initial question asking session, the group were again unanimous in
thinking that healthy eating is important and all but one felt that they are
themselves in charge of healthy eating, not their parents. Unlike the first
group, a roughly even number of the group felt that it should be a teacher or a
parent’s responsibility to teach/inform them about healthy eating. Three also
felt that celebrities should play a role in this. For full details of the questions
asked and the answers given, please see appendix 1.

Once again the group became very engaged in the discussion about which
healthy eating messages are most important. They chose ‘Eat a balanced
diet’, ‘Drink more water’, ‘Eat 5 a day’, ‘Eat less sugary food’ and ‘Eat a
rainbow’ as their priorities.


                                        9
                                     Page 17
For the ‘character’ making exercise, the children were very imaginative and
productive. The group were also very helpful to each other in terms of sharing
materials and complementing each others ideas. Some ideas include the
following:
Sharron Beagle – an overweight body with a large dogs head. This has the
slogan ‘Fast food will make you like animals’. This was an innovative and
original idea based on the idea that when you eat too much food, too often
(grazing), you are acting like an animal and will therefore start to look like one.
Sally the Strawberry – a large strawberry with arms, legs and a face, with
two little fruit friends. This was for the 5 a day message and was excellently
presented.
Rainbow Bear – this was from one of the youngest group members. With her
teacher she came up with the idea of having a rainbow coloured bear to
communicate the message ‘eat a rainbow’.
Claire Louise – this was a picture using the head and body of two separate
glamorous and curvy celebrities. The message was, ‘I eat 5 portions of fruit
and veg everyday, and it keeps me healthy all the way!’ Again, it is interesting
that the participant chose a natural looking celebrity rather than one of the
thinner celebrities.
Water Man – This excellent character was a drawing of a glass of water with
face, legs and arms. The message was, ‘drink plenty of water’.
Leon the lion – This was a very good idea of a character with a sporty human
body with a lion’s head. The slogan was, ‘eat a rainbow and you will grow up
nice and strong like me’.
Balance lady – This depicted a celebrities head and body pasted together,
and promoted a balanced diet. The celebrities chosen were curvy and natural
looking.
Balance man – Same premise as the above. This depicted a famous rapper
and his slogan was, ‘eat fruit and veg 5 times a day!!!’
Jeff the Chef – This character promoted a balanced diet. This was packed
full of good ideas, the body of the character was a chef, and he was carrying a
bag that was made of the balanced diet plate. The slogan was, ‘eat run, have
sum fun!’
Galactic balance man – This was a picture of David Beckham in a suit, and
also Dame Kelly Holmes. There is a speech bubble coming from David
Beckham saying, ‘Eat a rainbow kids’, and the slogan was ‘eat like me and
you’ll end up fit & healthy’.

These were all excellent and innovative ideas, and the group were all kindly
willing to let the facilitator keep their pictures in order for their ideas to help
shape future healthy eating campaigns for children in the borough.
Interestingly, at the beginning of the session, the group all felt that school and
the internet were the best places to find information about healthy eating, but
following the workshop and the development of their characters, they
unanimously decided that their characters would be most effective if used on
the TV.




                                       10
                                     Page 18
Workshop Conclusions
Throughout both workshops the participants were enthusiastic and shared
insights and ideas on the topic of healthy eating. All participants were familiar
with the terms ‘balanced diet’ and ‘healthy eating’ and the group were also
familiar with the ‘5 a day’ message exhibiting a good knowledge of what the
message is about. Across the two groups 95% of the participants agreed that
they are in charge of their own healthy eating (rather than their parents being
in charge). There was also general agreement that teachers should be the
main source of information regarding healthy eating, although parents should
also be involved in this process.
It was particularly interesting to see that the female members of the group felt
that they would prefer curvy ‘natural’ looking celebrities to put across healthy
eating messages (e.g. Jennifer Lopez, or Myleene Klass), rather than ‘thin’
celebrities like Victoria Beckham. A number of the boys decided to create
characters that were sporty and athletic (e.g. Beckham, Owen, and a
cricketer). The ‘eat a rainbow’ healthy eating message is one that appeared
to really appeal to the groups and that they found easy to understand.

All of the findings and suggestions from these workshops will be fed back at
the next child obesity task group meeting, and ideas where possible will be
incorporated into future healthy eating campaigns aimed at primary aged
children. The fact that 74% of the children felt that the cafes and shops in
their area do not offer enough healthy food, backs up the Primary Care Trust’s
financial investment into developing social food outlets in economically
deprived areas of the borough.


Appendix 1.

Group 1 (8 participants)
Who is in charge of healthy eating?
Me – 8(100%)
My parents – 0
Who should teach you about healthy eating?
Teachers – 8 (100%)
Parents- 0 (but by the end of the workshop, over half of the group had
decided that parents should actually be involved in this).
Celebrities – 0
Does healthy eating matter?
Yes – 8
No – 0
Are there enough cafes and shops where you live that offer healthy
food?
Yes – 4
No – 4
Where do you want to find info on healthy food?
At home – 0
At school – 4
TV – 0
Internet – 4


                                      11
                                    Page 19
Magazines – 0

Group 2 (11 participants)
1 yr 4 pupil from Manor Primary School (male)
2 Yr 6 pupils from Grafton juniors (one male, one female)
3 yr 2 pupils from Grafton Infants (one male, two female)
5 pupils from St Margaret’s Primary school (2 were yr 6 and female)
Who is in charge of healthy eating?
Me – 10
My parents -1
Who should teach you about healthy eating?
Teachers – 6
Parents – 5
Celebs – 3
Does eating healthily matter?
Yes – 11
No – 0
Are there enough cafes and shops where you live that offer healthy
food?
Yes – 1
No – 10
Where do you want to find out more information about healthy eating?
Home – 0
School – 5
TV – 0 (although at the end of the workshop all 11 decided that in fact this
would be a good source of information)
Internet – 4
Magazines – 2


3.2 Workshop 2 – ‘Healthy schools’
Facilitator: Jason Hatherill, Advisory Teacher – Healthy Schools and Drug
Education


During this workshop young people shared their views on the criteria which
schools must meet if they are to achieve Healthy School Status. The
discussion included a range of strategies which school adopt to meet the
various National Healthy Schools Standards.

During the first activity participants took part in a short health quiz based on
the Change4Life programme which aims to promote healthy eating and
physical activity amongst primary school children in particular.

During the second activity, the young people were asked to discuss a range of
strategies which schools can adopt to meet the National Healthy Schools
Standards. The young people constructed a ‘diamond nine’ summary of their
discussion to reveal what they considered to be the most and least important
Healthy Schools activity arranged in five levels. Level one being the most



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                                     Page 20
important, level 5 being the least important. The young people also added
their own suggestions and ideas.

The ‘diamond nine’ summary is as follows:

Level 1
   How to live a healthy way (healthy lifestyle) x 4
   Healthy eating x 2
   Keeping clean x 2
   Preparing meals cooking
   Alcohol, drugs and medicines
   The importance of exercise


Level 2
   Healthy eating x 3
   Why smoking is bad for you x 2
   The importance of exercise
   The importance of drinking clean fresh water
   How much exercise is needed to keep healthy
   Keeping teeth healthy
   Friendships
   How to be a healthy weight
   What smoking does to our body
   Take ten (ten minutes of physical activity each day)


Level 3
   Keeping teeth healthy x 3
   Buying healthy food
   What should be in a healthy lunch box
   What should be in a lunchbox
   How to get help outside school
   Drinking fresh water
   How to get help in school
   Healthy eating
   Drinking clean fresh water
   Exercise and how much should be done
   The importance of exercise

Level 4
   Preparing meals
   Buying healthy food
   How to live a healthy way
   30-60 minutes of exercise a day
   How to exercise well
   What should be in a lunchbox
   Alcohol
   Healthy eating
   How to get help outside school


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                                    Page 21
   What should be in a healthy lunchbox
   Keeping our teeth healthy
   The importance of cycling or walking to school
   How much exercise is needed to stay healthy


Level 5
   Why smoking is bad for you x 2
   How to get help in school.
   How much exercise you need
   Drinking milk
   Preparing meals
   Sports equipment
   How to get help outside school
   Alcohol
   Tenergy (ten minutes of physical activity each day)
   Going swimming
   What should be in a healthy lunch box
   Preparing meals (cooking)


Next Steps

    A significant number of young people felt that being taught about how to
live a healthy lifestyle is important. The Local Healthy Schools Programme
will support primary schools to engage with the Change4Life strategy to
deliver help deliver the outcomes in the Government Obesity Strategy –
Healthy weight, healthy lives.

    A Healthy Eating and Physical Activity training day will be held for schools
staff provided by the School Improvement Service and NHS Barking and
Dagenham. This will provide school staff with suggestions on promoting
healthy eating and physical activity.

    Links will be strengthened between the NHS Barking and Dagenham Stop
Smoking Service and schools which will include briefings for school staff,
visits to lessons, assemblies and school health events.

    The Local Healthy Schools Programme will establish links with the NHS
Barking and Dagenham dental service. Training will be provided for school
staff by the Oral Health Therapist on how to teach young people about
keeping their gums and teeth healthy. Educational materials will also be
provided for schools.




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                                    Page 22
3.3 Workshop 3 – ‘This is me’

This is me! – Facilitator Lynn Jones. Advisory Teacher PSHE

As an introduction, the young people were presented with negative images of
young people as they are sometimes portrayed in the media. The purpose of
our session was to look at young people more positively, and decide what the
important issues were for them.

Our first task was to negotiate Ground Rules for our session, since at this
table we’ll talk about sensitive issues. We agreed the following:
    1. Don’t call people names
    2. Don’t swear here
    3. Support each other when discussing
    4. Keep personal things to yourself
    5. Don’t share other people’s business
    6. Try to be nice to each other
    7. If you don’t want to say what you think or feel, you don’t have to (but try
       and join in if you can).

We then did a “Diamond 9” task, young people being asked to work in pairs to
prioritise their agreed statements about the differences between boys and
girls.
There was plenty of discussion over statements such as “Girls are better
behaved than boys”, “Girls and boys are equal” and “Girls and boys are the
same”. Deep thinking was necessary!

We split into gender groups and completed Mind Maps entitled “What’s
special about a boy” /“What’s special about a girl?”, swapping maps for further
debate.

The final element of the session was for young people to work individually on
designing a presentation entitled “This is me!” Boys and girls portrayed
themselves in positive terms. See below:

Example 1                                        Example 2
Boy 9 years old:                                 Girl 9 years old
Like football and rugby                          I’m a careful person
Love maths                                       Try my best
Caring for family / pets                         Love Hannah Montana
Smart                                            Loving person
Polite                                           Smart, talk a lot
Like building / business                         Love to dance
Eating                                           Love to sing
Drawing                                          I have 2 dogs
Games
Making money
Fixing




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                                    Page 23
3.4 Workshop 4 – ‘Get it sorted – Stop Bullying’

AM workshop          10 children [year 5 and 6] 3 adults
PM workshop          7 children [years 2, 4, 5] 2 adults


After an introductory warm up exercise children worked on a joint definition of
bullying that included the three key elements of a] intentionally hurtful
behaviour, b] repeated over time, c] where there is an imbalance of power.
Both groups arrived at similar joint definitions.

Both groups identified why bullying is an important issue and recognised that
where children are sad or unhappy at school, they are likely to under perform
academically.

They looked at motives for bullying – by thinking about the thoughts and
feelings of a bully, and considered the effects of bullying by looking at the
thoughts and feelings of an individual who might be bullied.

As a group they considered the role that witnesses have to play in either
making bullying more or less likely to take place. They considered what
actions might be helpful to stop bullying – these included befriending the
person who is being bullied or trying to divert a bully by including them in a
game.

Finally the groups suggested some ideas that schools could consider to make
bullying less likely to happen. These included increased surveillance by adults
on duty or the use of cameras.

Both groups were well motivated and all were able to make useful
contributions to the group discussions. In both groups the 45 minute slot was
not long enough to cover all the planned material, and enable everyone to
contribute fully.




3.5 Workshop 5 – ‘My Big Mouth’

Me and My Big Mouth –

Aims
       Children to appreciate why their teeth are important to them.
       Explore possible reasons why some children in this area do not attend
       the dentist regularly.
       Create an ideal dental surgery?
       Understand that it is their responsibility to help care for their mouth.




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                                     Page 24
    The morning workshop consisted of eight children but the afternoon
    session was so crowded we had to add two more chairs to the table giving
    a total of twelve in the group. Apparently the morning session had looked
    so exciting which meant that so many students wanted to join the
    afternoon workshop, we had to turn some away because the table was
    full.
    The groups discussed not only the functions of teeth, but why they were
    important. Everyone agreed that although we could still eat without teeth,
    a crispy bacon roll would not be as appetising when pureed.
    Attendance at the dentist for children under twelve years in Barking and
    Dagenham is below 50%. In the morning group, one child had never
    attended the dentist, the other children’s attendance ranged from going
    every six months to only attending once or twice. In the afternoon group,
    all of them had been at least once but only 50% went regularly.
    The groups came up with reasons why they thought children might not
    attend.
             Scared of pain
             Smell taste and feeling of rubber gloves
             Needle hurts
             Do not know what happens at a check up.
             Parents do go so why should they!
             Parents do not go so they do not bother to take children
             Taste of dental materials
             Noise of drill
             Horror stories of dentists

The groups also listed the positive reasons on why children attend the dentist.
         Stickers
         Braces
         Dentists cleans teeth and that looks and feels good
         Given toothbrush, leaflets etc.
         A check up is part of being healthy.


We then decided to create our “Ideal” dental surgery, the type of place that
everyone would like to go to for regular check ups and/or treatment. Both
groups came up with very similar suggestions.
         TV or videos projected onto the ceiling
         Mirror on the ceiling so that they could watch their treatment
         Dental chair to be big and comfortable
         Blue curtains or walls as blue is a unisex colour
         Flavoured gloves
         Flavoured water to rinse out
         All dentists to use the magic cream before an injection
         Extra staff to support patient
         Music ( both headphones and background)
         Dental bib to be bright and colourful
         Waiting area to have games
         Waiting area to have arcade games or an Xbox


                                     17
                                   Page 25
          Healthy snacks
          Prize if good

The children then took part in a pretend dental check up. The smaller group
had time to be a dentist and then the patient, but the sadly the larger group
could only role play one. Latex free gloves were used by the children and
each had a plastic mouth mirror which was taken home.

Although visiting the dentist is an important aspect of mouth care, the children
learnt that it was also their responsibility to help take care of their own mouth.
Tooth brushing if carried out correctly maintains healthy gums and
strengthens teeth (if fluoride paste at an appropriate level is used). The
children all agreed that they had brushed their teeth that morning; but when a
disclosing solution was used it showed up the germs they had missed. The
children then had fun brushing their teeth and gums properly. It was certainly
an enjoyable way of learning how to brush properly. (Consent to take part in
this activity was obtained from the parent/carer prior to this workshop).


Workshop Conclusions

       Both groups understood teeth were important in enjoying food. They
       agreed that David Beckham would still be able to play football without
       teeth but he would not be as wealthy because no one would want him
       to endorse their products.

       What was very interesting was that both groups were aware of horror
       stories regarding dental treatment yet no one had ever experienced
       anything remotely off putting.


       The children came up with ideas for an ideal dental surgery, most of
       which could easily be achieved by most local dentists. What is
       interesting about the children’s suggestions is that no one wanted to
       change anything to do with the actual treatment; they understood that
       the work had to be carried out.

        The children loved role playing a dental check up. They wanted to
       have a real check up so that they could relate the dental terminology
       that they had learnt to their own mouth.


       Using a disclosing solution is a really effective way of showing children
       where they are not brushing properly. The children recorded the areas
       that needed more attention and took this home. The children also took
       home a pack containing their brush and paste, a two minute timer, their
       dental mirror and a list of local NHS dentists. This should enable them
       to continue their mouth care at home.




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                                     Page 26
      All the children agreed that although their parents made some
      decisions on the families mouth care, the correct way of tooth brushing
      was their responsibility.
      They agreed that parents would not always know about disclosing
      solutions.

      The children felt that sessions on brushing and role play of a dental
      visit should be part of school lessons.




Picture 6 – Young People practising dental checks




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                                  Page 27
3.6 Workshop 6 – PCT Marketing


Workshop:

“Once upon a time”- gender roles reversed
Aim:

Explore
– the gender stereotypes children in Barking and Dagenham are aware of
   or employ
– the understanding and position on stereotypes by children in Barking and
   Dagenham
Ensure
 – that the participants understand the difference between stereotype and
    reality
 – that the participants feel empowered to break with gender stereotypes


Part 1 – storytelling

The participants were asked to listen carefully to a story and notice if they
heard anything different about it. The story was Cinderella with reversed
gender roles, with a male Cinderella, stepbrothers, male fairy and a princess.
Throughout the story the participants were asked if they noticed anything
different about the story, and the storytelling continued until everybody had
noticed something.

Q: How did you like the story?
Most of the children really liked the story, but some were annoyed about the
story being changed.
Q: What was unusual?
Most of the children had noticed that the roles were reversed and the point
they paid most attention to was that the boys in the story cared about clothes
and looks.


Part 2 – gender stereotypes exploration

It was explained that things often seem unusual when they differ from what
we’re used to. In stories most boys and girls behave in certain ways and have
certain qualities, and we expect real life to be similar.

The participants were asked to think about examples of typical things that girls
and boys do, both in stories and in real life. They filled out the chart below in
plenary




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                                    Page 28
Usual                      Boys/men                    Girls/women
 Characteristics            Brave                      Quiet
                            Strong                     Angry
                            Cool                       Chatty
                            Violent                    Lazy
                            Drunk                      Show offs
                            Annoying                   Pretty
                            Attitude                   Attitude
                            Moody                      Imaginative
                            Lazy                       Boast
                                                       Care about looks
Activities                  Play football              Gossip
                            Fight                      Cat fights
                            Sports                     Play
                            Video games                Clean
                            Work                       Make beds
                            Eat                        Clean up
                            Rugby                      Exercise for looks
                            Watch TV                   Dress up games (on
                            Read comics                video games)
                            Weight lifting (exercise   Cook
                            to be big)                 Diet



 Both of the groups managed to fill out this chart easily, with some
 disagreement within the group on what was actually true.

 Q: How do you feel when you see this chart? Is it fair/true?
 Most of the children felt quite agitated by the depiction of their own sex and
 felt it was unfair. They didn’t think that the chart was a true description of
 reality; however, some expressed the view that the things were truer about
 adult than children. For example, young girls were not necessarily cleaning
 or making beds, but most mothers or women were. Also, the young boys
 were not lifting weights to get big but older men were.

 Q: Do you know any stories or TV shows where the characters do the things
 in the chart?
 The first group that was slightly older mentioned Home&Away, East Enders
 and similar shows. Some of the girls thought that some of the girls in these
 shows were stupid and therefore bad role models for them.
 The second group with younger members found it more difficult to find
 examples of this, but when Disney was mentioned they could come up with
 a number of films. They did not have a specific opinion on what they thought
 about these characters.




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                                   Page 29
 Part 3 – Challenge of stereotypes

 The participants were asked to think back to the story and together fill out
 the chart again, now listing the unusual characteristics and activities of the
 people in the story. They were then asked to think about specific examples
 from Barking and Dagenham with people who are doing things that are
 unusual compared to the first chart made. The examples could be from
 school, the family or someone they know about. The chart is shown below.


Unusual                    Boys/men                    Girls/women
Characteristics:           The story:                  The story:
                           Obedient                    Determined
                           Unhappy                     Forward
                           Kind
                           Upset
                           Quiet


                           Examples from B&D:          Examples from B&D:
                           Dad care a lot about        Brave
                           family                      Cool girls
                           Care about clothes
                           Clean at home

Activities:                The story:                  The story:
                           Clean                       Ask to dance
                           Wearing fancy clothes
                           Sing


                           Examples from B&D:          Examples from B&D:
                           Dress up                    Play football
                           Ballet                      Karate
                           Play games girls usually    Fight
                           play                        Read comics
                           Cooking
                           Cleaning
                           Use perfume
                           (aftershave)


The process of finding local examples was initially quite hard for both groups,
however when they came up with a couple of examples it got much easier.
Most of the examples were of specific people they knew, and all of these
examples were expresses as being positive.




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                                    Page 30
Part 4 – Understand what stereotype is

The participants were presented with the word stereotype on a flip-chart.

Q: Do you know what this word means?
None of the children knew exactly what stereotype meant.

The word was explained with the aid of the first chart and the story, pointing
out that they noticed something different with the story because the
characters were different than the first chart.

Q: What do you think about stereotypes?
As most of the children disagreed with the accuracy of the first chart, they
thought stereotypes are bad. One boy asked if it was the same thing as
sexism. The first group discussed whether gender stereotypes were as bad as
being racist.

Q: What can we do to make sure all children in Barking and Dagenham have
the opportunity to do whatever they want without thinking about whether it’s
ok for boys or girls?

The suggestions were:
You should not laugh at boys who want to dance ballet.
More girls should play football and there should be more teams just for girls.
Boys and girls should learn from each other and take the good points from
each other. For example, girls shouldn’t fight but they can become brave and
boys shouldn’t gossip but they can become kinder.
More dads should spend more time helping out at home.


Summary:

The exercise shows that children in Barking and Dagenham are aware of the
gender stereotypes prominent in society, however most of the children have
reflected on this somehow before.
The workshop worked better with children that were above 8 years, however
even the youngest children engaged with the topic. The power of popular
culture was very prominent in their comments, exposing that the expectations
they are measured up against start at a young age.
The agitation towards gender stereotypes was prominent with both groups
when the specific activities and characteristics were made applied to their own
lives. They would like both children and adult to be more accepting towards
those who choose to do activities that are outside of their gender stereotype.
It is important that the schools work with giving children the confidence to do
whatever they want to do.




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                                   Page 31
3.7 Workshop 7 – School Dinners


The Workshop

The group were given background information on the government’s nutritional
standards for school meals. To assist in understanding the wider issues linked
to diet and lifestyle information was also provided on the health of the nation,
the rise in obesity and how a school meal can influence sensible eating
patterns in and out of school. To further support the activity the group were
also provided with the current school meals 3 week menu cycle and how the
current menu endeavoured to attract a broader customer base by offering
dishes from other cultures. Furthermore the menu now provided a wider range
of home produced items as well as meeting the standards.

To set the scene for the workshop the group were made aware of the barriers
that are encountered when trying to promote healthy eating this includes
competing with powerful marketing messages from companies involved in
producing foods that are not healthy and contribute to the fast food fix.

Case study

The challenge for the group was to create a poster linked to a marketing
campaign designed to promote the benefits of healthy eating and conveys a
value for money service

To stimulate the mind during the workshop the children enjoyed fruit kebabs,
a low fat healthy cake and fruit juice.

To assist the following resources were provided:-
      Food for life leaflet
      Abridged Government Nutritional Standards
      Current Catering Services School Meals menu

The group were really enthused about the project. The posters showed
vibrantly coloured fruit and vegetables and included key information such as
the selling price of a meal and name of school. There was definitely some
evidence of including a punchy tag line, good examples were:

“I want fatty food out of my life”

“Five a day is a good way to stay healthy everyday”

Workshop Conclusions

       There was a clear understanding of the challenges that the nutritional
       standards create
       As a result of the activity there was a better understanding of the need
       to eat sensibly
       Most of the group already understood the need to eat 5 a day


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                                     Page 32
       At the end of the session there was a better understanding of costs
       There was a request to offer more promotions because it allowed for
       greater freedom in menu planning and created a fun dining
       environment
       It was identified that different arrangements exist for the purchase of
       meals i.e. some schools do not allow meals to be purchased on a daily
       basis. Which can have an overall damaging affect on meal uptake?
       Some parents felt meals were expensive and therefore did not allow
       children to stay
       Many in the group had observed packed lunches brought in from home
       and seen items that were not healthy
       Overall both the morning and afternoon sessions were enjoyed by the
       participants. They like working with our team and found an interactive
       session beneficial to their learning


3.8 – Workshop 8 – ‘Get Wet! Swim for Free’

Question                                  Response
Group 1
Have you signed up for Free               1             7
Swimming?
Have you used your card?                  1            7
Where do you swim most often?             0            4             4
Who do you mostly swim with?              0            1             7
What do you enjoy most about              Water slides, Water, Jumping in &
swimming?                                 splashing, Pushing people in
Does anything make it difficult for you   Family usually too busy, Busy, Didn’t
to access free swimming?                  know, Playstation, Dancing Likes
                                          home, Playing with relatives, Visitors,
                                          Takes to buses to get to pool
Has free swimming changed anything        Hasn’t used yet, Made it fun
in your life?
What could we change to improve           Make it closer so its easier to travel,
free swimming for you?                    inflatables, More activities

Question                                  Response
Group 2
Have you signed up for Free               4             3
Swimming?
Have you used your card?                  2             5
Where do you swim most often?             2             1           3
Who do you mostly swim with?              0             3           5
What do you enjoy most about              Water, Getting out on my own,
swimming?                                 Learning more things, Deeper depths,
                                          Practicising, Diving, Games, Getting
                                          wet, Having fun
Does anything make it difficult for you   Rain
to access free swimming?


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                                    Page 33
Has free swimming changed anything    Made me a good swimmer, Let me
in your life?                         swim on my own, Improved
                                      backstroke, Get better at swimming
                                      Do lots of good things
What could we change to improve       A teacher to help us, To have lots of
free swimming for you?                fun, After school classes, More
                                      swimming lessons for schools,
                                      Deeper water, more equipment,
                                      Harder levels, Go in the deep end,
                                      Deeper water




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                                  Page 34
4.0 Consultation and Feedback




                                  27
                                Page 35
  28
Page 36
  29
Page 37
  30
Page 38
4.0 What happens now?
All the suggestions put forward by children and young people in the
workshops and throughout the day will be forwarded to NHS Barking and
Dagenham and lead officers responsible. Everyone who attended the
conference will receive a progress report in six months updating progress on
work towards achieving these suggestions.




For more information contact

Chris O’ Connor
Group Manager, Engagement
Integrated Family Services
Children’s Services,
London Borough of Barking and Dagenham
Bridge House, 150 London Rd
Barking, IG11 8BB

Tel: 0208 227 5557
Email: chris.o’connor@lbbd.gov.uk




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              Page 40
Trinity Children and Young People’s Conference

          ‘Your health, your future ’

               2nd March 2009

              Evaluation Report




                       1
                    Page 41
Contents Page
Summary                                                 p.3-4

Feedback from children and young people                 p.5

What did you enjoy about the conference?
What did you learn?
What did you think of your workshop?
Would you come back to another event like this again?

Outcomes of the workshops                               p.6-17

What happens next?                                      P.18

Appendix 1                                              p.19 - 20




                                    2
                                  Page 42
1.0 Summary
The London Borough of Barking and Dagenham in partnership with NHS
Barking and Dagenham Trust held its first conference for children and young
people aged between eleven and nineteen years on the 2nd March 2009 at
Trinity Specialist School as part of its on-going commitment to young
people’s engagement and participation.

The conference was an opportunity for children and young people to give their
views on a range of key health issues such as promoting healthy eating and
the impact of bullying on mental health.

The conference was attended by 48 young people who had the opportunity to
attend three workshops on different health issues and highlights of the day
included a motivational speech by Paralympian Danny Crates and the chance
for each young person to have a go on a Nintendo WII Fitness Board. Host
and MC for the day was Radio presenter, stand-up comedian and former
teacher, Geoff Schumann.

Cllr Jeanne Alexander, Executive Member for Children's Services, said:

"Children make such a positive contribution in this borough and we want to
hear from them about what they think of our community and how we can
make Barking and Dagenham a better place to live. This conference will be
one of many similar events we will be holding in the future to find out more
about what children think."




                                     3
                                  Page 43
Picture 1 - Geoff Schuman gets the audience going




Picture 2 – Head Teacher, Peter McPartland kicks the day off




                                  4
                                Page 44
2.0 Feedback from children and young people on the
overall day.

2.1 What did you enjoy about today?

‘The Wii Fit and the Catering Services workshop’ – Jamie Graham

‘Learning about different things’ – Claire Biggs

2.2 What did you learn today?

‘Eat more fruit and Veg’ – Connor Guy

‘I learnt about healthy food and sport games on the Wii’ – Junior Osinaike

2.3 What did you think of your workshop?

‘Cool’ – Nancy Davies

‘Very good’ - Junior Osinaike

2.4 Would you come back to another event like this again?

‘YES’ - All




Photo 3 - Paralympian Gold Medallist Danny Crates inspires the
audience



                                     5
                                  Page 45
3.0 Outcomes of the workshops
Workshop 1

                                 Aim:
To highlight the importance of healthy eating & physical activity, and to
                    look at methods of promotion.

In each of the three workshops, there were 12 participants plus one teacher.

The workshop

Part 1: Discuss why healthy eating is important. Run through some short
questions on a flipchart.
List some healthy foods and unhealthy foods and discuss what makes them
‘healthy’ or ‘unhealthy’.
Part 2: Go through a number of health message sheets. Ascertain which
health messages the participants are familiar with and which ones they are
not familiar with.
Part 3: Create a ‘character’ for the borough who can promote healthy eating
and physical activity. Or, draw a picture of what ‘healthy eating’ means.

The write up

Part 1: The group were asked to volunteer words that they would associate
with healthy eating. The majority of responses were different fruits such as
apple, banana, watermelon etc, as well as a smaller number of vegetables
(most often across the groups, broccoli and carrots were mentioned). With
prompting, the group also listed fish, chicken, milk, and jacket potatoes. In
the third group, a couple of the participants also brought physical activity
ideas into discussion – it was very positive that the link between healthy
eating and physical activity was being made in this way, without prompting. It
was also encouraging that across each of the groups there appeared to be a
wide knowledge of the names of different fruits.

Following this, the groups were asked ‘Who is in charge of healthy eating’.
There was a real mix of opinions to this question, with around half feeling that
parents are in charge as they do the cooking, and half feeling that they are in
charge of healthy eating themselves. Just two participants felt that teachers
should be in charge of healthy eating. A number of participants also
commented that both they themselves and their parents should be in charge
of healthy eating.

The group were then asked, ‘Where would you like to find information about
healthy eating?’ Suggestions included:

   o   TV
   o   Internet
   o   Magazines or local papers
   o   Mum and Dad/family


                                      6
                                    Page 46
   o   Friends
   o   Carers
   o   Nurse, doctor or clinic
   o   School
   o   Celebrities – participants mentioned Leona Lewis, West Ham Utd
       players, and High School Musical.

Finally, the group were asked if they thought healthy food was boring. Most
encouragingly, across the three groups, all participants felt that healthy food
was not at all boring.




Photo 4 – Workshop in session

Part 2:

The group went through a number of health message sheets and were asked
which ones they had heard of. The list of health messages can be found on
appendix 1. The majority of participants within the three groups did not feel
that they had heard of any of the health messages, but encouragingly a small
number (approximately 2-3 in each group) had heard of the following:

       5 a day!
       Watch your weight
       Eat less salt
       Eat a balanced diet
       Eat less junk food
       Drink more water




                                       7
                                    Page 47
The group were faced with a relatively unknown healthy eating message –
‘eat a rainbow’. After a short discussion, with some minimal prompting, each
of the three groups managed to work out that this message meant eating lots
of different coloured foods. This message seemed popular with the groups,
and may be a useful way in future to communicate the ‘balanced diet’
message to some target groups.

Part 3:

Group 1 and 2 then created some pictures of what they considered to be
‘healthy’. Where possible, some participants drew characters that could
promote healthy eating to other young people, and others drew healthy food
items. The most popular item that participants chose to draw was fruit, but
other items included a jacket potato, an onion, sweet corn, a pint of beer with
the thumbs down sign next to it, and fruit juices.

Throughout the workshop, group 3 had shown a strong interest in discussing
physical activity. Therefore, a different activity was run with this group. This
group designed a potential after school/weekend physical activity club. They
suggested that they would be interested in participating in the following
activities:

Golf, running, swimming, football, darts, exercises, rugby, gymnastics, going
to the gym, bowling, cricket or Kwik-Cricket, walking, drama, and basketball.
Football was the most popular sport listed.

The group discussed how long they would like a club to be, and unanimously
agreed on two hours. They felt they would want it to be held after school or on
a Sunday. Mostly, the group felt that they would like the club to be for girls
and boys, although one or two participants did state a preference for a ‘boys
only’ club. They also felt that the club should be open to everyone in all
schools across the borough. The group felt strongly that they enjoyed
competition and suggested boy Vs girl matches.

When asked for suggestions for a name for the club, one participant
suggested that the club be named West Ham United (those participants who
were not West Ham United fans were less keen on this option), FEC Club, or
Trinity School Sports Club.

The group did not feel that this club should also cover healthy eating, but felt
that a healthy eating club should be separate. They suggested that a healthy
eating club should be 3 hours long, and could be entitled ‘Master Chef’ or
‘Trinity cookery Club’. The group felt that they would like to learn to cook
spaghetti bolognaise, and jacket potatoes. One participant suggested that it
would be good to learn how to cook things they enjoy eating (e.g. burgers) in
a healthy way. Another participant suggested that in order for this club to be
effective, parents should be involved.

The group then discussed how to promote the club to other young people.
Suggestions included:


                                      8
                                    Page 48
   o   Posters in all secondary schools
   o   Teachers promote to their classes
   o   Email
   o   Tell carers and parents
   o   Send out a letter to all families via schools
   o   Advertise in local papers




Photo 5 – Workshop outcomes

Summary

All groups participated in the workshops enthusiastically. The participants
showed an interest in healthy eating, and certainly understood that fruit and
vegetables are a key part of a healthy diet. The term ‘balanced diet’ was
identified as an area that the groups had heard of but did not feel that they
fully understood, so some more work could be done on this area.

It can be concluded from the activities in part 1 and 3 that the groups
associated fruit most strongly with healthy eating. Vegetables were also
associated with healthy eating but not as strongly.

The comments and ideas from these workshops will be fed back to the child
obesity task group at the next meeting in April 2009.
Appendix 1:

Health messages

   1. Eat 5 a Day!


                                       9
                                    Page 49
   2. Watch your weight
   3. Eat a balanced diet
   4. Cut down on fast food
   5. Eat together as a family
   6. Breakfast is the most important meal of the day
   7. Drink more water
   8. Choose wholemeal/brown bread instead of white bread
   9. Cut down on sugary foods like fizzy drinks, sweets and chocolate
   10. Don’t eat too much salt
   11. Eat a rainbow




Photo 6 – Eat 5 a day!




                                    10
                                  Page 50
Workshop 2 - Anti Bullying Workshops

Objectives of the workshop were:
   1      To share an agreed understanding of what bullying is
   2      To talk about the thoughts and feelings of someone who is bullied
   3      To talk about the thoughts and feelings of someone who bullies
          others
   4      To discuss what actions can be taken to take to help stop bullying

All three sessions were well attended – with between nine and twelve young
people in each group who all made positive contributions to the workshops.

There was some lively discussion and debate in all three sessions. Everyone
was encouraged to participate in small group conversations, and to share
their ideas in front of the group.

In summary all three groups agreed that bullying involved a range of
deliberate behaviours such as hitting, kicking, punching, spitting, swearing,
name calling, taking people’s things, hand gestures or ignoring.

Some of these behaviours involve the use of ICT – mobile phones, MSN, text
and email.

Usually, if it is bullying, some of these behaviours will be repeated or will
happen more than once.

In most cases bullying is a behaviour that is done by someone who is
relatively strong against someone who is seen to be smaller or weaker.

People who have been bullied may feel scared, angry, frightened, shaken,
sick, nervous, lonely, cross and may not want to attend school

Those people who bully others may have been bullied themselves, or may
feel jealous, angry, disappointed. They might think that it is a game, or might
feel more powerful or more in control.

It is important to be able to discuss bullying as it is the first step towards trying
to stop it.

Some useful strategies suggested included telling a family member about the
bullying, telling a teacher, or if it persists telling the Headteacher, telling
someone you could trust, blocking your MSN, showing text messages/emails
to teacher or parent, asking the bully to stop, greater use of CC tv cameras.

Well done to everyone who took part in the workshops.


Nick Evans
Educational Psychology Service



                                       11
                                     Page 51
Photo 7 – Anti-bullying workshop in session




Photo 8 – Interactive and fun




                                  12
                                Page 52
Photo 9 – Anti-bullying workshop outcomes




Photo 10 – Anti-bullying workshop




                                13
                              Page 53
Workshop 3

School Meals and Hospitality - Catering Services

In each of the 2 workshops there were 12 participants

The Workshop

The group were given background information on the government’s nutritional
standards for school meals. To assist in understanding the wider issues linked
to diet and lifestyle information was also provided on the health of the nation,
the rise in obesity and how a school meal can influence sensible eating
patterns in and out of school. To further support the activity the group were
also provided with the current school meals 3 week menu cycle and how the
current menu endeavoured to attract a broader customer base by offering
dishes from other cultures. Furthermore the menu now provided a wider range
of home produced items as well as meeting the standards.

To set the scene for the workshop the group were made aware of the barriers
that are encountered when trying to promote healthy eating this includes
competing with powerful marketing messages from companies involved in
producing foods that are not healthy and contribute to the fast food fix.




Photo 11 – School dinner service workshop




                                      14
                                    Page 54
Photo 12 – Attendees try some food

Case study

The challenge for the group was to create a poster linked to a marketing
campaign designed to encourage healthy eating and stimulate meal uptake

To stimulate the mind during the workshop the children enjoyed a mixed fruit
platter and fruit juice.

To assist the following resources were provided:-

      Abridged Government Nutritional Standards
      Current Catering Services School Meals menu

Before creating the poster the group had a discussion about their favourite
foods and the benefits of a healthy diet

The group were really enthused about the project. The posters showed
vibrantly coloured fruit and vegetables. Both groups utilised a wide range of
art materials to create a 3D effect




                                     15
                                   Page 55
Photo 13 – School dinner workshop




Photo 14 – School dinner workshop




                                16
                              Page 56
Conclusions


      As a result of the activity there was a better understanding of the need
      to eat sensibly
      Most of the group already understood the need to eat 5 a day

      Overall both the morning and afternoon sessions were enjoyed by the
      participants. They like working with our team and found an interactive
      session beneficial to their learning

      The fruit provided was a big hit and the children said it contributed to
      their enjoyment

      Both groups enjoyed working with our managers on the project. So
      much so there was time for some to create a Mothers Day Card with a
      healthy theme. A clear solution to increasing parent awareness and
      getting the message home




Photo 15 – Healthy eating




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                                   Page 57
4.0 What happens now?
All the suggestions put forward by children and young people in the
workshops and throughout the day will be forwarded to the lead officers and
organisations responsible; Teachers and Governors at Trinity School and the
Children’s Trust in the form of an evaluation report. All children who attended
the conference will also receive a copy of the evaluation report and everyone
who attended the conference will receive a progress report in six months
updating progress on work towards achieving these suggestions.




For more information contact

Chris O’ Connor
Group Manager, Engagement
Integrated Family Services
Children’s Services,
London Borough of Barking and Dagenham
Bridge House, 150 London Rd
Barking, IG11 8BB

Tel: 0208 227 5557
Email: Chris.o’connor@lbbd.gov.uk




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                                    Page 58
Appendix 1

Attendee’s

Aaron Cossington
Adam Kaspar
Alexander Ulitin
Alfonso Matias
Andrew Smith
Attia Anwar
Ben Reeves
Bradley Barber
Bradley Savill
Claire Biggi
Cody Lote
Conaleigh Hayward
Connor Guy
David Skinner
Dee Horsfall
Donna Crawler
Edward Humphries Pester
Elliot Gatward
Emma Tidesley
Esther Nwobi
Faik Hussein
Gareth Bettis
Gemma Butler
Hayden Day
Ian Huckle
Jack Melhuish
Jamie Graham
Jordhen Corbett
Junior M'Fum
Junior Osinaike
Laura Fairbrass
Michael Mater
Molly Brawl
Nancy Davies
Rachel Humm
Rachel Rymer
Rebecca Bangi
Robbie Rowell


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                          Page 59
Sarent Marina
Semiloore Olatunji
Shauna Skinner
Steven Collis
Suleiman El Hosny
Thomas North
Tonderai Zindi
Trevor O'Nwere
Victoria Lee
Wayne Guy
Zaharan El'Hosny




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                     Page 60
3rd Annual Young People’s Conference for 11-19
                  year olds

          ‘Your Health, Your Future’

               17th March 2009

              Evaluation Report




                       1
                    Page 61
Contents Page
Summary                               p. 3 - 6

Outcomes of the workshops             p. 7 - 39

Digipads Consultation                 p. 40 - 43

What happens next?                    P. 43




                              2
                            Page 62
1.0 Summary
The London Borough of Barking and Dagenham held its third conference for
young people aged between eleven and nineteen years on the 17th March
2009 as part of its on-going commitment to young people’s engagement and
participation and funded by NHS Barking and Dagenham.

The conference was based on Health and it was an opportunity for children
and young people to give their views on a range of health issues. The four
themes were 1) Fit, Healthy and Happy 2) Controlling your Demons, 3) Sexual
health and relationships, 4) Healthy Eating and living

Over 90 young people attended representing eight nine secondary schools
and voluntary organisations such as PACT. The children and young people
were joined by 30 teachers and officers from the Council and partners.

The young people the opportunity to attend two of 11 different workshops.
Hosts and MC’s for the day were former BBC Radio presenter, stand-up
comedian and former teacher, Geoff Schumann and Young Consultant
Sophie Haggar.

The conference’s highlight was World Olympic Champion, 2004 for Rowing
Alison Mowbray who gave a key note speech to the young people, which was
well received by all teachers and workshop facilitators.




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                                 Page 63
Picture 1 - Geoff Schumann and Sophie gets the audience going




Picture 2 – Alison Mowbray inspires the audience




                                 4
                               Page 64
Picture 3 - Alison Mowbray’s Olympic Gold medal




                                 5
                              Page 65
Picture 4 – Young people feed back from their workshops




Picture 5 – Lunch time Wii Fitness




                                  6
                                Page 66
3.0 Outcomes of the workshops
3.1 Workshop 1 – Childhood obesity ‘Celebrities and Us – How
important is body image?’

                                   Aim:
  To highlight the importance of living a healthy lifestyle, and to look at
       the issue of body image and how it affects the way we feel.

Part 1: Discuss why healthy eating and physical activity are important. Run
through some short questions on a flipchart.
Part 2: Look through magazines and internet resources, and discuss how
they address weight issues. Is there an expectation on celebrities to look a
certain way? Is there an expectation on every day people to look a certain
way? Does this differ for men and women?

Group 1: Part 1:

1. Who should be the main person to teach you about healthy eating?
   o A skinny person
   o Mum/parents
   o An expert on the subject
   o Doctor
   o A person who is comfortable with their own body and weight
   o An athlete

2. Does eating healthily matter?
4 said yes it does matter, and 2 felt that it only matters a little bit really.

3. Are there enough cafes and shops where you live that offer healthy
food?
The group all felt that there were no cafes and shops that offer healthy food.
One participant commented that ASDA was the only place she could think of
that had anything healthy in the area.

4. Where would you like to find information about healthy eating?
   o Internet
   o Leaflets
   o Books
   o Maybe from a PE or science teacher
   o Not from parents.

5. Would you like to be more physically active?
4 people in the group said that they would like to be more physically active,
and 2 commented that they wouldn’t because they already do a lot of sport
etc.

6. What could we do to help you to become more physically active?
   o More access to gyms for young people – There is occasionally access
     at Goresbrook Leisure centre gym for young people but it costs £4 per


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                                       Page 67
       hour which they cannot afford. The group suggested that the cost
       should be somewhere between £1.50 and £3, or possibly £5 for a
       week’s membership, or £10 for a month’s membership. They enjoy
       using treadmills and rowing machines the most. They are happy to
       have mixed boy and girl sessions, but wouldn’t want adults to be
       present (other than instructors and staff) in case there were any
       ‘weirdos’.
   o   Parks should be made safer and more inviting.
   o   Introduce outdoor gyms. Two participants were aware of the outdoor
       gyms in Havering and felt that these were a good idea. They wouldn’t
       want these to be located by schools as they would want to visit them at
       weekends, not in or around school times.
   o   Boxing club
   o   Horse riding

7. What could we do to help you eat more healthily?
   o Make young people more aware of the dangers of not eating healthily –
     use scare tactics
   o Promote the benefits of eating healthily




Photo 6 – Workshop in discussion

Part 2:

The group discussed body image and the world of celebrity. The key points
raised were:

   o The group discussed bullying, and how overweight people become
     isolated. One participant commented that she couldn’t be friends with


                                     8
                                   Page 68
       a really overweight person because they’re different and probably
       wouldn’t want to do the same sort of things that she does. Another
       person commented that if you spend time with an overweight person
       who is bullied, you may get bullied too. It was suggested that bullying
       about weight would upset primary school aged children more than
       secondary school pupils as it is in teenager’s own control to do
       something about it. One boy told the group that he has been bullied
       about his weight, and that it made him feel really upset.
   o   The way celebrities look puts pressure on people to look a certain way
   o   Women with curves like Beyonce are what a real woman should be
   o   There is more pressure on women than men to look good – no one
       slags off fat celebrity men (like Jack Black) but fat celebrity women are
       slagged off.
   o   People should be happy with the way they look
   o   Some people are naturally curvier than other people, so it is dangerous
       to compare yourself with others.
   o   Healthy people are much prettier than people who have gone on a
       crash diet and lost too much weight.

Group 2: Part 1:

1. Who should be the main person to teach you about healthy eating?
   o Teachers
   o Parents

2. Does eating healthily matter?
3 felt that is does matter, and one felt that it doesn’t matter.

3. Are there enough cafes and shops where you live that offer healthy
food?
The group all felt that there were no cafes and shops that offer healthy food.

4. Where would you like to find information about healthy eating?
   o Internet
   o Magazines
   o Parents
   o Media
   o Sainsbury’s

5. Would you like to be more physically active?
3 people in the group said that they would like to be more physically active,
and 1 felt that they wouldn’t.

6. What could we do to help you to become more physically active?
   o Start sports clubs
   o Youth clubs – this will also keep kids off the streets

7. What could we do to help you eat more healthily?
   o Promote the benefits of eating healthily in schools



                                        9
                                     Page 69
Part 2:

The group discussed body image and the world of celebrity. The key points
raised were:

   o There is a lot of fake ness in the media – botox, implants etc, and this
     means that people are trying to look like something that’s almost
     impossible to achieve. Magazines are unrealistic, airbrushing sets
     impossible standards.
   o Pressure in the media to be skinny
   o We need to change the global perspective of skinny being beautiful
     before we can change individual and local perspectives
   o Even in the 21st century women are still lagging behind men – they try
     to look good to benefit men rather than themselves
   o You are not supposed to be skinny and you are not supposed to be fat
     – you should just be who you are.
   o If you are overweight and you lose weight, your confidence and self
     esteem increases.
   o People think fat is all inherited so don’t make any effort to be healthy
   o If you like yourself, others will like you – you should be content with
     who you are, and if you’re not content, you should do something about
     it.
   o Probably 75% of our weight is in our own control
   o The benefits of a healthy lifestyle are that you will live longer, have a
     better metabolism, and improve you immune system
   o The group disagreed on how you should broach the topic of
     ‘overweight’ with a friend. One participant felt that if your friend is
     overweight, you should tell it to them straight – be honest. Another
     participant commented that overweight family or friends should be
     supported – rather than telling them to be more physically active, do
     more physically active stuff alongside them. Rather than telling them
     that they’re fat, ask them if they’re happy.
   o This group felt that boys have just as much pressure on them to look
     good.
   o Why do we criticise celebrities when they lose or put on weight?
     Jealousy
   o Why do we criticise normal people when they lose or put on weight?
     Because everyone has an idea of what someone should look like. In
     particular, there is an expectation on the opposite sex to look a certain
     way. I.e. men expect women to look a certain way, and women expect
     men to look a certain way. Women do not have such high expectations
     on each other to look a certain way.
   o There is an understanding that yoyo dieting is really bad for you
   o Victoria Beckham is a bad role model. After she had a baby she hid
     away until she’d lost all of the fat, as if she were ashamed of it.
   o Real women are better role models. The group highlighted J-Lo,
     Beyonce, Tyra Banks (now she has put on a bit of weight), Trisha, Eva
     Longoria and Alesha Dixon.
   o One participant suggested that whole day events should be held on the
     topic of body image, so that people can really think about it.


                                     10
                                   Page 70
   o The group concluded that magazines like Heat, that criticise women’s
     body shapes and portray women unrealistically, should be boycotted
     by young people in this borough. They all felt prepared to be involved
     in protests and presentations to other schools to put across their
     message.

Summary

All groups participated in the workshops enthusiastically and with insight and
passion. In the second workshop, most participants after having spoken on
the topic decided that they wanted to share their views with other young
people in the borough and be involved in a local boycott of magazines that
place unnecessary pressure on young people to look a certain way, and
damage people’s self esteem. They felt that more work needs to be done in
the borough on raising people’s self esteem and enabling people to be
healthy and happy.

Both groups felt that healthy and natural looking celebrities were far better
role models than overly skinny celebrities, and that the media places undue
pressure on people to look a certain way. It was agreed that in society,
weight is seen purely as a vanity issue rather than a health issue, and that
people should want to become a healthy weight for them, rather than for other
people’s unrealistic expectations on them.

The comments and ideas from these workshops will be fed back to the child
obesity task group at the next meeting in April 2009.




                                     11
                                   Page 71
3.2 Workshop 2 – ‘Alcohol’

Workshop: Alcohol

Facilitator: Jason Hatherill, Advisory Teacher – Healthy Schools and Drug
Education

During this workshop young people shared their knowledge and views about
alcohol. During the first activity participants took part in a short quiz on alcohol
followed secondly by a discussion about alcohol in the context of a safe and
healthy lifestyle. During the third activity, the young people were asked to
identify the actions which schools could take to educate young people about
alcohol more effectively.

Young people’s views

Young people felt that:

   The alcohol component of drug education programmes in secondary
schools needs to be strengthened or emphasised.

    More needs to be done to highlight the fact that there is no researched
daily ‘safe limit’ for alcohol consumption for those under the age of 18 years.

   The recent Chief Medical Officer’s guidance on the risks associated with
alcohol consumption under the age of 18 needs to be highlighted in schools.

   The general reduction in alcohol consumption (apart from amongst specific
groups) amongst young people should be emphasised to make the point that
most young people do not drink alcohol or choose not drink to excess.

   Awareness needs to be raised about the role of alcohol as a strong
depressant and as a possible cause of sleep disturbance / poor quality sleep.

   Drug education programmes should address the risks associated with
alcohol consumption and possible risky sexual behaviour.

Next Steps

    The School Improvement Service Personal Development Team will review
the schools’ minimum expected year groups standards in relation to alcohol
to incorporate as many young people’s views as possible.

   The Advisory Teacher for Healthy Schools and Drug Education will
continue to liaise with the local Drug and Alcohol Action team (DAAT) and
schools to strengthen programmes of drug and alcohol education.

    The Advisory Teacher for Healthy Schools and Drug Education will provide
training for school staff to identify young people who might be vulnerable to
alcohol misuse and to ensure that they receive the help they need.


                                        12
                                      Page 72
   Schools will be asked to highlight the local drug and alcohol support
service, Subwize, during PSHEE lessons.

   The School Improvement Service Personal Development Team will ensure
that relevant school staff have up to date knowledge of the issues relating to
alcohol and young people.




Photo 7 – Workshop 2 in action




                                     13
                                   Page 73
3.3 Workshop 3 – ‘School Dinners’

School Meals and Hospitality
Catering Services

Participants: Workshop1. 5
               Workshop2. 10

The Workshop

The group were given background information on the government’s nutritional
standards for school meals. To assist in understanding the wider issues linked
to diet and lifestyle information was also provided on the health of the nation,
the rise in obesity and how a school meal can influence sensible eating
patterns in and out of school. To further support the activity the group were
also provided with the current school meals 3 week menu cycle and how the
current menu endeavoured to attract a broader customer base by offering
dishes from other cultures. Furthermore the menu now provided a wider range
of home produced items as well as meeting the standards.

To set the scene for the workshop the group were made aware of the barriers
that are encountered when trying to promote healthy eating this includes
competing with powerful marketing messages from companies involved in
producing foods that are not healthy and contribute to the fast food fix.




Photo 8 – Food tasting session




                                      14
                                    Page 74
Case study

The London Borough of Barking and Dagenham have commissioned your
services as Marketing Consultants to launch and manage their next Marketing
Campaign. The service is already is popular and well supported providing for
approximately 50% of the pupil population

You will need to create a Marketing Plan that includes a range of activities
designed to promote the excellent work already being done in school meals

You plan must include the following
      A Poster promoting a launch theme day menu
      Suggestions for partnership working with others that would promote
      healthy lifestyle
      A Brand for secondary schools that would encourage increase sales
      An incentive scheme that young people would find appealing

Any activities must meet:

      Govt. Nutritional Standards
      Promote 5 a day
      Link to Healthy School Standards

The group were really enthused about the project. Both groups responded
enthusiastically to the project. There was lively discussion about spending
patterns the use of brands and logos. The groups used their out of school
high street experiences to come up with ideas. At the end of the sessions as
consultants the recommendations were to introduce the following:

       A Loyalty Card linked to making healthy choices gets you a free lunch
       Spend a £1 at morning break receive a free lunch after 4 days
       consecutive spending
       Smoothy Bars using only fresh ingredients
       A poster for healthy eating which showed the body as items of food
       The New Brand for Barking and Dagenham Secondary schools is The
       Shield of Healthy Living based on a heraldic Shield using Fresh
       Ingredients and crossed baguettes to create the imagery

Conclusions

      There was a clear understanding of the challenges that the nutritional
      standards create
      As a result of the activity there was a better understanding of the need
      to eat sensibly
      The groups had broadened their understanding of the need to be
      financially viable
      The groups utilised commercial high street solutions to respond to and
      promote healthy eating in schools meals



                                     15
                                   Page 75
3.4 Workshop 4 – ‘This is me so what’’

Facilitator: Lynn Jones, Advisory Teacher – Personal, Social and Health
Education

This workshop focused on young people being able air their thoughts about
issues to do with the responsibilities that accompany sex and relationships.

For purposeful conversation around this sensitive topic, we agreed to abide by
our negotiated Ground Rules:
      Don’t ask or answer personal questions
      Think carefully about the private business you share
      Don’t make people feel bad by laughing at what they say
      Keep street language for the street.

Our second activity was to take stock of what the young people felt about the
sex and relationship education they’d been taught in school. We used a
strategy known as “Diamond 9“whereby in small groups young people
prioritised 9 statements about SRE. This involved considerable discussion,
consensus within the small groups then as a table group. The age range of
the young people gave the need for explanation and clarification of
terminology and ideas e.g. contraception, confidential, exploitation.

The next element involved clarification of values related to sex and
relationships. Young people were asked to indicate individually their
agreement / uncertainty /disagreement with the statements below by holding
up a green / amber / red card to each statement. Individuals were asked to
justify their card colour; others could challenge those views.

   1. Schools should teach about the importance of respect, love and care.
   2. Homosexuality can be discussed as part of school lessons.
   3. You don’t have to be married to have a strong and supportive
      relationship.
   4. SRE should teach you to make choices, not tell you what to do.
   5. Schools should tell young people not to have sex
   6. Marriage is the best relationship in which to bring up children.
   7. Couples should live together before marriage.
   8. You should always keep your friends secrets.
   9. Young people should always follow advice from grown ups.

The discussion generated by this was very broad ranging. The Ground Rules
proved to be very useful, and were largely adhered to with occasional
reminders. The biggest challenge was for young people to refrain from
sharing personal anecdotes.

The young people were then asked to select a resource e.g. leaflet, handout,
booklet which covered SRE issues and in pairs write on Post-its answers to
the following questions

   1. What is this?


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                                   Page 76
   2. Who do you think it’s for?
   3. Do you think it’s any good?

The resources prompted lots of questions, discussion and laughter. The post-
it responses will be useful for me when choosing classroom materials. The
young people chose resources to keep.

Throughout both sessions, young people felt that they needed:
      more knowledge and skills to be taught around the connection between
      drugs, alcohol and sex
      more information about where to go for confidential help
      exploration of different types of emotions and how to deal with them
      knowledge about being a parent
      information about abortion and pregnancy choices
      greater knowledge about choices of contraception
      to understand the laws about sex
      to know more about Sexually Transmitted Infections, including HIV

Next steps

The School Improvement Service Personal Development Team will
incorporate the views and expressed needs of young people in their future
planning and discussions with school PSHE Co-ordinators and relevant
partners.




Photo 9 – Workshop 4 in action



                                      17
                                    Page 77
3.5 Workshop 5 – ‘Stop Bullying’

Each workshop contained 4 secondary school students – who all made
significant contributions to group discussion

Both groups arrived at a shared definition of bullying that contained the three
main components: intentional anti-social behaviour that aims to make the
target feel bad about themselves; it is something that is repeated or happens
more than once; it is usually by a more powerful individual against someone
who is less powerful.

All students carried out an “attitude to bullying survey”, at the start and at the
end of the workshop, where attitudes were measured on a 10 point scale.
Shifts in attitude were observed in relation to the idea that people who were
bullied needed to stand up for themselves – students disagreed more with this
statement at the end of the workshop; and the idea that bystanders or
witnesses can and should do something to prevent bullying – students agreed
more with this statement at the end of the workshop.

Students discussed the short, medium and long term adverse effects of either
being the target of bullying or of being a bully, and discussed strategies that
could be implemented to help reduce or prevent bullying.


Nick Evans
Assistant Principal Educational Psychologist
Barking and Dagenham




Photo 10 – Key standards for anti-bullying


                                       18
                                     Page 78
3.6 Workshop 6 - ‘Teeth – why bother’

“Teeth, Why Bother” – Aims
       Explore their attitude towards dental attendance
       Explore what they would like at a dental surgery
       Discuss dental problems caused by fizzy/acidic drinks
       Look at the pH levels of popular drinks
       Debate if schools should have unhealthy vending machines/tuck shops

The morning workshop consisted of eight young people all from Trinity
School, with three teachers/support staff. The afternoon session had nine
young people from Jo Richardson, Warren and All Saints schools. The
sessions began by exploring the attitudes young people have about attending
the dentist. In Barking and Dagenham 61% of 12 -17 year olds attend the
dentist. (This figure does not show if they are regular attendees or one offs).

In the morning group, four students said that they did not attend a dentist.
Reasons given ranged from never attending because they do not think that
they have a problem to only attending if they are in pain. Four students
attended on a regular basis with one attending the dental department at the
hospital they attend. In the afternoon group, six students attended the dentist
regularly and the other three only attended when they were in pain. Both
groups came up with reasons why they thought young people might not
attend.

           Scared of pain
           Smell taste and feeling of rubber gloves
           Needle hurts
           Noise of drill
           Not cool to attend the dentist
           Water /suction makes them jump
           Do not see a need to go.
           Smell of dentists

We then decided to create our “Ideal” dental surgery, the type of place that
everyone would like to go to for regular check ups and/or treatment. Both
groups came up with very similar suggestions.

          TV or videos projected onto the ceiling
          Mirror on the ceiling so that they could watch their treatment
          Dental chair to be big and comfortable
          Flavoured gloves
          Music ( both headphones and background)
          Dental bib to be bright and colourful
          Waiting area to have games
          Waiting area to have comics
          Waiting time to be very short
          Positive pictures on the wall
          Pain killing drink instead of an injection


                                     19
                                   Page 79
          Go to sleep and have treatment done
          Lady dentists
          Being able to understand the dentist (Speaks clear English or does
          not speak through a mask).
          Nice smell.

We then went on to look at a dental problem that is on the increase especially
in young people. Dental erosion is the loss of tooth substance caused by the
direct action of chemicals on the tooth surface. This mainly preventable
condition affects 60% of school aged children. (National Diet and Nutrition
Survey 2002). Frequent consumption of fizzy drinks, pure juices and fizzy
sweets are linked to this problem.

The groups looked at how much sugar was in their favourite drinks and also
the pH levels. This caused great conversation because most of the young
people believed that the sugar free versions were healthier for their teeth.
Another interesting point raised was the promotion of sports drinks being
healthy yet some have a pH value of 3.36 and tooth enamel will dissolve at
values below 5.5.

We discussed why some schools have vending machines that contain fizzy
drinks and if the immediate financial gain to the school was then lost later by
students having time off for dental attendance and dental pain. We looked at
the wider implications of unhealthy drinks with obesity linked to type II
diabetes, heart disease strokes and cancer.

The morning group from Trinity school did not have vending machines in their
school but they did have a tuck shop and they were allowed to bring in
anything to eat or drink from home. In the afternoon group, two schools did
not have vending machines but one school did although the fizzy drinks were
restricted to lucozade and sports drinks. All schools allowed the students to
bring in drinks from home.

The final aim if the workshop was to form a debate between the students on
the subject, “Should schools allow vending machines/ tuck shops to sell
unhealthy drinks and snacks”. With the morning session of Trinity students I
decided that we would all just discuss the pros and cons of school vending
machines and tuck shops. The young people then came up with their own
ideas of what they would like their own school to not only sell but actually be
allowed to bring in from home. We made allowances for some students who
are used to a very restricted eating pattern.

The afternoon group took to the idea of debating with great energy. Two
young people did not understand at first why they could not pick what side
they wanted to represent, but they soon got the idea of the debate.
The group representing the motion that schools should be allowed to sell
anything in their vending/tuck shops raised some interesting points.
       Stops pupils bunking off and going to local shops
       Gives you energy to concentrate in lessons
       Only the same products that you can bring in


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                                    Page 80
      Gives the school a modern look
      Makes the students happy

The group against the motion also worked hard to come up with valid reasons
as to why their school should not sell junk drinks and food.
       Gives students an easy access to unhealthy foods. If they had to walk
       to the shops they might not bother or that in its self would be some
       exercise.
       Encourages students to spend their lunch money on snacks this could
       result in them not being health or not being able to concentrate during
       the afternoon session.
       Less electricity used by the school if no vending machines
       Posters put up around the school to explain why vending machines
       could be bad for their health.
       Time off school for illness, pain or to attend dentist/doctor.

Unfortunately we did not have anyone else to listen to the debate and make a
decision based on the arguments presented however I asked the young
people to vote only on how well each side was debated.
The result was that schools should have vending machines/tuck shops that
could sell any snacks and drinks.

Conclusions

      What was very interesting was that both groups were aware of horror
      stories regarding dental treatment yet no one had ever experienced
      anything remotely off putting.
      The young people came up with ideas for an “ideal” dental surgery,
      most of which could easily be achieved by most local dentists. What is
      interesting about the suggestions is that no one wanted to change
      anything to do with the actual treatment; they understood that the work
      had to be carried out they just wanted more comfortable surroundings.
      The students were shocked by the pH levels of the drinks especially
      drinks sold as healthier options i.e. Ribena, a carton contains 6
      teaspoons of sugar and pH value of 2.72. They felt that manufacturers
      should be honest and display these details on the cans/cartons.
      Trinity school wanted to have a suggested list of safer snacks and
      drinks that students could bring in from home.
      Although the afternoon debate resulted in the students wanting vending
      machines that sold a variety of foods and drinks, they then came up
      with their own guidelines. These were to switch the machines off
      between lessons, display posters to promote healthier choices and to
      make manufacturers more responsible for what is actually in their
      product.




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                                  Page 81
3.7 Workshop 7 – PCT Marketing

“Adbusting – reclaiming our health”

Aim:
         To know what health issues young people care about
         Understand what young people want more information about or want to
         change
         Make young people aware of the power of advertisement and
         conflicting messages contained within marketing
         Develop understanding of what sort of designs and messages attract
         the attention of young people in B&D

Part 1

Participants were asked to think for 5 min about health issues they are
worried or want more information about. They were asked to write one issue
on each piece of paper in front of them. The papers were collected and put in
the middle of the table face down.

Results:

Group 1
      Will my doctor tell my parents if I want something?
      Is cannabis better than cigs
      Best way to give up cigs if you’re a teenager
      STD’s are more common
      Free condoms
      Can stress lead to obesity?
      Food being more expensive now
      Is all cheap food bad for you?
      How much should we exercise in a day/week/month?

Group 2
      Condoms
      Sex
      STI
      Sexual health
      Air pollution
      Drink
      Healthy eating x 2
      Being healthy
      Weight
      Drugs
      Body image
      STD’s
      Mental health
      Spots/acne



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                                   Page 82
         HIV and Aids
         Sexual health
         Stress
         Friends
         Emotions
         Stress
         Relationships
         Body weight
         Spots
         Scared of the dentist
         Physical appearance




Photo 11 – Busting the myths around advertising

Part 2

Almost 30 different adverts for various products were placed on the table.
Participants were asked to move around the table and look at them. Then
they were asked to pick two or three adverts each they were specifically
attracted to. This was not necessarily the product the ads were selling but the
design or other things that made them notice the ads.
After about 10 min they were asked to sit down and present the adverts they
had chosen.

The following adverts were chosen by the young people:

Big favourites



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Kit Kat: http://www.ibelieveinadv.com/commons/kitkatbench.jpg
This ad was chosen by a lot of the participants. They said it was very clever
and the bench made then think about Kit Kat and fancy the chocolate. None
of the participants had actually noticed that the product was not even in the
picture. We discussed the power of certain brands, like Kit Kat.

Compania Athletica: http://haha.nu/consumerism/advertisements/athletica-
company/ . This advert shows a muscular man pushing out of a silhouette of a
fat man drinking. The first group initially thought the advert was for water. This
ad generated a lot of debate around what ideal we are actually looking for.
The message was identified as there being a fit person within every fat
person, however is this very muscular man what we want? The young people
thought the advert was clever and in general had a good message. It was also
showing something they could aspire to. However, some of the participants
were keen to get fit as the person in the photo in order to increase their
attractiveness, not to achieve something in sports.

Burger King Ketchup: http://zakstar.files.wordpress.com/2008/06/veg-
city_oct.jpg
This advert was very popular among the boys. The main reason was the
drawings and style of the advert. One of the boys thought it was advertising
vegetables because of all of the tomatoes in the picture. The girls were
indifferent to this advert. Some of the participants suggested we should
produce something similar for healthy food, since the drawings are cool,
however not use the Halloween theme.

Royco Chicken Cubes: http://www.ibelieveinadv.com/2009/01/royco-chicken-
cube-cow-cube/
This ad was chosen by a few of the participants, everyone thought it was
clever but the majority of the group thought it was disgusting. This was
because it was a real animal stuffed in a box, and some even thought it was
an anti-meat advert. They liked the provocative nature of the advert.

Chosen by one or two:

Campaign for real beauty (dove):
http://www.businessweek.com/the_thread/brandnewday/archives/blog%20dov
e%20group.png
This advert was chosen by one boy because he thought the women were
attractive. None of the participants linked this advert to the campaign
message; they thought these girls were “normal” models.

Paul Frank sunglasses http://www.ibelieveinadv.com/commons/paulfrank1.jpg
Chosen because it was really clear what the ad was selling. Only very few
noticed the naked bodies in the background. The groups then discussed how
the bodies were used in a way that made it look like you got them rather than
the actual product if you bought it.

Romtelecom: http://www.ibelieveinadv.com/2009/01/romtelecom-comedy-
cinema-rock-paper-scissors-big-bang/


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                                     Page 84
One girl chose this advert because she thought the pictures were really
creative and the advert looked very different from anything she’d seen. Some
of the others thought the ad was untidy and busy and not eye-catching
enough to make an impact.

Grazia: http://www.ibelieveinadv.com/commons/graziatester.jpg
A few of the girls from both girls chose this ad. They said the message was
really clear, the picture was interesting and it made them curious. In addition
they thought the message make them think.

Durex: http://www.durexhibit.co.uk/posters/love-is-blind--herpes-123/
This advert was chosen by boys from both groups. They liked the ad because
it was subtle but still powerful. They liked a sexual health advert without sex(y
people) or condoms in the actual picture.

Marmite rice cakes:
http://shapeandcolour.files.wordpress.com/2008/09/marmite3.gif
One person liked this picture because of the innovative mix of picture and
simple design.

NHS 5-a-day poster: One girl chose this advert and she was attracted to it
because it was very straight forward. However, she said that it wasn’t really
aimed at her age group and she thought adults would like it more. The other
group did not like this advert at all, comments included boring and
oldfashioned.

These ads were discussed but not chosen:

Armani underwear:
http://images.teamsugar.com/files/upl1/0/88/04_2009/1995db6c3826ce1e_Be
ckhams-For-Armani.jpg
Only one boy liked this advert, he said that wearing Armani underwear
increased your pulling power. Most of the others thought the pictures didn’t
really appeal to them and they were sick of the Becs.

Pregnancy test: http://www.ibelieveinadv.com/commons/epregnant1.jpg
Most of the participants were intrigued and visibly curious about this picture.
However, no one chose this as a favourite. This could be because the target
group is slightly older.

Essalunga veg: http://www.adsideas.com/esselunga-fruit-vegetable-ads/
The participants liked the pictures but they didn’t think it would make them eat
more fruit and veg. They said they were more likely to eat fruit and veg if it
was presented as tempting food rather than funny figures.

Burger King: http://nutritionresearchcenter.org/healthnews/wp-
content/uploads/2008/03/burger-king-ad_v200.jpg
Some of the participants expressed that they would like fast food when they
saw this advert. However, in competition with the others this didn’t win
through as a favourite with anyone.


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                                    Page 85
Other ads mentioned in discussion:
Cadbury films – the two films were mentioned by the participants in group 2
as examples of really famous ads that did not feature the product (chocolate).

These ads were not chosen or discussed further:

Skinny food: https://www.idasattic.com/store/image.php?type=P&id=16501

Coca Cola: http://home.comcast.net/~p-l-
m.blogspot/ThingsGoBetterWithCoke.jpg

Silvikrin Shampoo: http://www.ibelieveinadv.com/commons/silvikrinveil.jpg

Miracle Whip: http://www.ibelieveinadv.com/commons/miracleseesaw.jpg

Cotton Candy:
http://imagecache2.allposters.com/images/pic/APP/LM0154~Fair-Time-
Cotton-Candy-Posters.jpg

Anti-gas ad with plastic hot dog:
http://www.ibelieveinadv.com/commons/gasxhotdog.jpg

Kit Kat: http://www.ibelieveinadv.com/commons/mini-sudoku.jpg

Throughout the discussion of the adverts the participants put up key words on
a flip chart that summarised what a good advert was. The following key
features were noticed:
Clever
Clean design
Funny
Makes you notice it
Nice, cool drawings
Nice picture
I feel like it speaks to me (I’m the target group)
Strong branding – I know what I’ll get
Sexy

We discussed how the NHS competes with the very rich commercial industry
to reach them and how very unhealthy and bad things were depicted as
rights, identities or healthy choices in these adverts.

Part 3

The papers with issues were brought out again and in plenary divided into
broad categories.

The categories were (in order of size):
Healthy eating
Mental health/wellbeing/relationships


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                                   Page 86
Sexual health
Physical activity
Drugs, alcohol and cigarettes
Skin

The participants were then asked to vote for the categories they wanted to
work with for the rest of the workshop. Each participant was given two pieces
of red paper they could vote with, either separate or together.
First group chose: Healthy eating & physical activity
Second group chose: Mental health & sexual health

The groups was then divided in two and was asked to discuss ideas on how
we could employ the tools of the marketing industry to inform more young
people about the specific issue.

Healthy eating: Adverts should contain healthy food that looks really tasty and
tempting. Something comparing how much unhealthy food you can have
compared to healthy food would be really informative. However, in general
they thought this was a really difficult one to advertise to young people.

Physical activity: The group spent the time discussing the advert they had
seen with the fit man in relation to what they wanted to see in B&D. They
concluded they didn’t want to see half-naked, muscular bodies. They wanted
clear tips on how you can get more physically active.

Mental health: Picture of young person with lots of conflicting things in a
bubble over their head. Emotions were important, they wanted something that
shows that everyone’s got emotions and feelings and struggle with these now
and again. They were also interested in adverts that explained what to do if
they thought someone else had some issues and how to get more information
about different mental problems in order to understand. For example, a couple
of people had seen others at school with cuts on their body that seemed self-
inflicted. The participants didn’t seem to know anything about self-harm and
were expressed that they were confused or scared.
This group also wanted ads on body image and something that could show
that a lot of people see themselves very differently to how everyone else sees
them. Other important issues were friends and stress with school.

Sexual health: The group working with this issue were concentrating more on
the various sub-issues they wanted information about. This included STIs,
how contraception works and where to get condoms. In terms of campaigns
they wanted something highlighting that STI’s can affect anyone and
something around sexuality (they mentioned heterosexual, homosexual and
bi-sexual).

Group 2 had more time and below are some follow-up questions from this
group.




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                                   Page 87
Q: You noticed how branding works to promote products without even having
the product in the picture. For example the kit kat advert makes you think of
chocolate. What do you think of when you see NHS?

       Boring
       Blue coloured things
       Accidents
       GPs
       Old people
       A&E

None of the participants knew that there was someone in NHS in the local
area that worked with information and campaigns for young people. They
really liked the idea.

Q: How do you think NHS should communicate with you? What ways and
what places?
      We only watch TV
      Leaflets are boring and I don’t read them
      Maybe internet. Ads on Face book are good, but most people don’t
      click on them.
      Posters on busses and bus stands.
      Things through school but we don’t really want too much info just from
      our teachers.
      We like the Frank branding and NHS Barking Dagenham should
      develop a mascot just like Frank has.
      You need to make sure all your material has nice colours and is easy
      to read.

Conclusion:

It doesn’t seem like young people in Barking and Dagenham in general reflect
a lot on the advertisement industry’s power and large place in their life.
However, this workshop showed that it didn’t take much for them to get a
more nuanced view on marketing. The workshop also emphasise that public
sector needs to raise its marketing standards in order to catch the attention of
young people.

Key findings:
       Most of the chosen adverts did not feature people. In the ones that
       featured people, the body size and shape became an issue of
       discussion. This could suggest that positive marketing on healthy
       eating and physical activity should either have illustrations of people or
       avoid this all together.
       Healthy food has to be made to look tempting, not funny or just pictures
       of the fruit and veg unprepared. However, none of the participants
       chose the advertisement for junk food with pictures of the food in the
       ad because all of the other adverts were more interesting and
       attractive.


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                                    Page 88
NHS needs to change its image with young people, moving from being
a dry, clinical institution into a brand associated with health and
wellbeing. We also need to explore the channels we employ in order to
communicate with young people.
Young people like clear, clever adverts and not necessarily ads trying
to imitate youth culture as this could be seen as patronising.
Mental health featured heavily in the debate with both groups and
issues like relationships, stress and body image needs an increased
focus from NHS and other youth services.




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                           Page 89
3.8 Workshop 8 – ‘Sports Commissioning’

Question 1) what sports do you like to participate in:

Answers Included:
     Football
     Badminton
     Basketball
     Multi Sports Sessions
     Swimming
     Gym
     Athletics

However, there was mixed feelings on whether the sports sessions should be
mixed with male & females. Some of the males preferred to have only sports
activities solely for them, as they felt that some females ‘were not good
enough’ to play in the same team.

Question 2) what sports do you have access to out of school and
where?

Answers included
     Football
     Basketball
     Swimming

The majority of the young people said that they went to the park to play sports
such as football and basketball, and went to a leisure centre for swimming.
However, there were a couple of discussions around barriers, which led into
my next question.

Question 3) what are the barriers that prevent you from accessing sport
activities within Barking & Dagenham?

Answers included
     Travelling – across borough on buses etc.
     Money – some activities are too expensive
     Not knowing what is available and where to find out WHATS ON!
     Not knowing if anything is available within their own area
     Timing of sport activities are not at the appropriate times
     Laziness – by young people
     Parents – not allowing them to attend

Some suggestions from the young people were:

      Travelling – provide mini buses and don’t always have the activities in
      the same location.
      Money – more free activities or cheaper rates



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                                   Page 90
      Not knowing what is available and where to find out WHATS ON! –
      Website, big banners, through schools, newsletters, letters, texts,
      email.

The young people were explained that there is a new children and young
people’s website that they could access to find out what is on in B&D.




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                                  Page 91
3.9 Workshop 9 – ‘Smoking cessation’

Aims:
        To understand young people views on smoking prevention/cessation
        messages
        To identify acceptable and potentially effective approaches to help
        young smokers to quit.

  1. Discussion around awareness of the health effects of smoking.
  All those in the group were aware of the common side effects of smoking
  e.g., lung cancer, heart disease but were less aware of many of the other
  effects of smoking.

  2. Group were shown several pictures/props of the harmful effects
     of smoking. The following questions were then asked.
     How do pictures/props make you feel?
     Does it make you think about stopping?
           Effective at putting you off smoking
           Makes you not want to start
           More gory the more effective it is
           Makes you realise what can happen to you


  3. If asked to design a poster/leaflet what messages/information
     would you put
     in it?
         Health effects of smoking.
         Pictures more effective than words
         Pictures should be graphic and shocking
         Messages need to be short and sharp

  4. Discuss around sources of health information for young people
      The most common places young people would access health
  information are:
         Internet
         Adverts – but these need to be hard hitting like the car speed
         adverts
         Health professionals

  5. Who would young people like to receive support to stop smoking
     from?
           Prefer someone they don’t know
           Someone you can trust
           Young person but not someone younger than them


  6. Where would they like to receive from?
          Out of school
          Places they can go with friends


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                                   Page 92
             Places young people go out of school (youth clubs)


Additional information – A discussion was had around information given in
schools in relation to smoking. The group felt that they were given little
information on smoking. Most students did not really take it seriously as the
information they were given is limited and not presented in an interesting way.
They think it should be more visual and include props/pictures shown to day.
Information was given by teachers and young people felt it would be better
given by someone with more knowledge on the subject, someone from
outside the school. Most young people don’t think smoking will affect them so
the information should relate to how it can affect them.




Photo 12 – Smoking cessation in practice




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                                   Page 93
3.10 Workshop 10 – ‘Drugs’

Workshop: Drugs

Facilitators: S Sreedharan DAAT, YSDS Youth Volunteers Nikosa & Lauren,
D Dunkley CRI Subwize.

During this workshop young people shared their knowledge and views about
drugs. The first activity asked them to identify some of the reasons as to why
Young people may use drugs and then look at some of the barriers as to what
prevents them accessing services.

The next exercise asked them to try and think about some solutions to
overcome the barriers they had earlier listed. The final task was to help
identify local known hotspots in the borough which are known areas for drug
and alcohol use for young people to be used to help in form the new outreach
service model.

Young people’s views

Young people felt that:

Reasons why young people may use drugs:

       Peer pressure to socialise
       Experimenting
       Depression
       Stress escape problems/ bad experiences
       Thinks its cool
       Helps them to relax.
       Its easy to get hold of
       All mates are doing it

Barriers:

             Scared
             Don’t want anyone else to know - parents
             Don’t see them selves as having a problem, in denial
             Don’t want to give up
             Lack of trust
             Being judged
             Embarrassed

Solutions:

       Services going into schools at break and lunch time informally
       More education
       Outreach – mobile pod



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                                     Page 94
       Use of Ex adult or Young people service users for education in
       schools
       More workshops in schools
       Drop in @ school
       Advertising campaigns using the following mediums:
           1. my space
           2. TV/Radio
           3. youth clubs
           4. posters
           5. public centres
           6. bus stops
           7. competition for young people to design posters
      have a freephone number
      use of social networking sites
      texting
      hold events @ school


Known hotspots top three:

      Most of parks across the borough were highlighted by young people
      Goresbrook
      Thames




Photo 13 – Key priority areas and problems discussed




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                                 Page 95
3.11 Workshop 11 – ‘Get Wet! Swim for Free’

1a)   Have you signed up for Free Swimming?
      YES: 4      NO: 4

      Issues:

1b)   Have you heard of Free Swimming?
      YES: 8      NO: 1

2a)   Do you swim?
      8 out of 9

2b)   Last time you swam?
      1 Month:     13
      Last Week: 2
      Last Year: 2
      3 weeks ago
      Last Halloween
      6 months

2c)   Where?
      Goresbrook, Dagenham, Abbey, Sea on holiday, Sea in UK,
      Haven Holidays

2d)   Who with?
      Mates, school?

2e)   Good Vs Bad Experiences:

      GOOD:
      Awards, Water parks, Diving, Temperature of pool,
      Change body shape fast, Number of life guards, Playing,
      More Funsplash

      BAD:
      Temperature of pool, Number of life guards, Too many people,
      Peeing in the pool, Pervy Boys, Misunderstanding skin conditions,
      Attitude of pool staff >> Understanding people with a disability,
      Swimwear too revealing, Needs 13-16 session, Old people


What do you enjoy most about swimming?

Being with mates, Slides, In the water, Feeling good all day from moving
swim, Family swim

Does anything make it difficult for you to access Free Swimming?

      Bus route Vs Leisure Centre


                                      36
                                    Page 96
       No Cars
       Disabled session time
       Better equipment, more floats, more ramps
       Not allowed into Dagenham on my own because I am disabled
       Parents refused to be in lesson with child to support disability
       Lack of support for disability
       Increased training for pool staff


Has Free Swimming changed anything in your life?


What could we do to improve Free Swimming for you?


Swimming and the Future?
     Sport
     Career
     Disability swim too lack?
     Bullying
     Old people’s attitude


Do you swim?

5 out of 5


Have you got a GWSFF card?

YES: 0       NO: 3

Have you used it?

YES:         NO:


Where do you swim?

       Goresbrook
       Other Pools
       Back Garden
       Fullwell Cross
       Aunt’s Place


When did you last swim?

       Last year:          2


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                                   Page 97
       January:
       5-6 months ago:     2


Who do you swim with?

       Sister
       Brother (x2)
       Mates
       By myself
       With friend


GOOD:
    Increase physical health – quick results
    Big weight loss
    Fun
    Water slide
    Sociable

BAD:
       Cost of membership
       Pay per session
       Idiots pulling me under
       Bad behaviour
       Hygiene – Goresbrook Men’s stink
       Cleanliness – Men’s loos


What do you enjoy most about swimming?

       Relaxation
       Water slides
       Floating
       Sense of wellbeing with no aches and pains


What makes it tough to access Free Swimming?

       Can walk or take bus


What could we do to improve Free Swimming for you?

       Send forms to small units


Why Swim?
What’s happening with Free Swimming in Barking and Dagenham?


                                     38
                                   Page 98
Good & Bad things about swimming?
What we want to see improved in Free Swimming?




Photo 14 – Free swimming discussion




                                 39
                               Page 99
4.0 Digipads Consultation Results




                          40
                       Page 100
  41
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5.0 What happens now?
All the suggestions put forward by children and young people in the
workshops and throughout the day will be forwarded to the lead officers and
organisations responsible and presented to the Children’s Trust. Everyone
who attended the conference will receive a progress report in six months
updating progress on work towards achieving these suggestions.




For more information contact

Chris O’ Connor
Group Manager, Engagement
Integrated Family Services
Children’s Services,
London Borough of Barking and Dagenham
Bridge House, 150 London Rd
Barking, IG11 8BB
Tel: 0208 227 5557
Email: Chris.o’connor@lbbd.gov.uk




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             Page 104
Young Adults Health Survey

For the London Borough of Barking and Dagenham




March 2009

QA Research,
Brackenhill, St Georges Place, YORK, YO24 1DT
01904 632039
www.qaresearch.co.uk

Company registration: 3186539




                                           Page 105
                                               Young Adults Health Survey, March 2009
                                                              Page 2


Contents


1. Introduction ...................................................................................................................... 4
2. Aims and Objectives .......................................................................................................... 4
3. Methodology ..................................................................................................................... 4
4. Key findings ...................................................................................................................... 6
  4.1       Health information and advice ................................................................................... 6
     Source of health information ............................................................................................ 6
     Ease of using local health services.................................................................................... 7
     Preferred source of health information.............................................................................. 8
     Issues would like information on ...................................................................................... 9
     Feeling comfortable asking for health information ............................................................10
     Having a say in the quality of health information and services...........................................11
     The best method to have a say .......................................................................................12
     Health personnel and confidentiality ................................................................................13
  4.2       Healthy eating .........................................................................................................14
     State of health ...............................................................................................................14
     Eating healthily ..............................................................................................................14
     Weight ..........................................................................................................................15
     Focus group discussion-diet ............................................................................................16
     Reasons choose to eat unhealthy food.............................................................................17
     Focus group discussion-Reasons why eat unhealthy food..................................................17
     Concerns relating to a bad diet .......................................................................................18
     Healthy food at home .....................................................................................................19
     Healthy food at school ....................................................................................................20
     Fruit and vegetables .......................................................................................................21
     Focus group discussion-food choice at home....................................................................21
  4.3       Smoking, drinking and drugs ....................................................................................22
     Parents smoking.............................................................................................................22
     Smoking habits ..............................................................................................................22
     Focus group discussion-Smoking .....................................................................................23
     Focus group discussion-The effect of parents drinking smoking.........................................24
     Drinking habits...............................................................................................................24
     Focus group discussion-alcohol .......................................................................................25
     Focus group discussion- The effect of parents drinking alcohol..........................................25
     Illicit Drugs ....................................................................................................................26
  4.4       Relationships...........................................................................................................27
     Best age to have a baby .................................................................................................27
     Worries and concerns .....................................................................................................28
     Focus group discussion ...................................................................................................29
     Worries and concerns .....................................................................................................29
     Sex Education ................................................................................................................30
     Reasons why young people don’t use condoms ................................................................31
     Pressures to have sex.....................................................................................................31
5. Conclusions ......................................................................................................................33
6. Appendix..........................................................................................................................35
     Appendix 1 – Demographics............................................................................................35




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     Appendix 2 – Verbatim ...................................................................................................36
     Appendix 3 - Survey .......................................................................................................37
     Appendix 4 - Focus Group Script .....................................................................................43


Project number:         STAKE02-4524
Title:                  Young Adults Health Survey
Location    S:\ProjectFiles\L\London_Borough_Barking_Dagenham\STAKE024524_Childrens_Health_Survey\Reports\Report_V1.doc
Date:                   March 2009
Report status:          Draft
Approved by:            Michael Fountain
Authors:                Dawn Marston
Comments:               Dawn.Marston@qaresearch.co.uk




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1.     Introduction
QA Research (QA) was commissioned on behalf of the London Borough of Barking and
Dagenham (LBBD) NHS to find out young adult’s views on a range of health issues ranging from
diet to sexual health.

This report provides details of the methodological approach, key findings and main conclusions
derived from our analysis of the research findings.

2.     Aims and Objectives

The aim of the project was to gather views of young people in relation to health issues such as
smoking, drinking and sexual health issues. Further to gathering perceptions on these topics the
research aimed to measure how comfortable young people were asking for advice, if they had
ever sought advice and how they would like information given to them.


3.     Methodology
The research undertaken consisted of both a quantitative and qualitative element.

The quantitative aspect of the research consisted of a 5-page survey with a brief explanation of
the questionnaire’s content included on the front page (please see appendix 3). Due to the
sensitive nature of some of the survey content it was decided a postal survey would not be
appropriate, therefore a more innovative approach was taken. Three interviewers went along to
the under eighteen night at Flex nightclub in Dagenham on February 13th and Friday 20th
February to survey young people queuing up for the event. Surveys were distributed and filled in
via assisted self-completion so as any questions respondents had could be answered and
reassurance given.

Respondents also had the option of entering a prize draw of £50 in high street vouchers to
encourage participation

Overall, 100 survey were returned. All surveys were completed by young people living in the
LBBD area, aged between 11 and 17 years. Once all completions were received, the results were
input and analysed using SPSS. The data was analysed as overall (frequency) results and a series
of cross tabulations created to explore any relationship between responses and age, gender,
ethnicity and location.

To gain further insight and understanding into young people’s views and also to discuss topics
not deemed suitable for the survey method, focus groups were also held. Separate sex
discussion groups were held with young people aged 11-16 from a mix of ethnic backgrounds.
With the permission of participants discussions were audio-recorded to ensure accuracy of
transcription.

Activity sheets were used to generate ideas and to ensure all the respondents were able to
contribute all their ideas to the research. A copy of the discussion guide used is included in the




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appendix. Respondents were given an incentive of £10 in high street vouchers in order to
encourage participation.

The findings from both methods of research have informed this report.

The structure of the report has been led by the quantitative data whilst the qualitative findings
illustrate the ‘whys’ behind the statistics. Sensitive topics discussed only in the focus groups are
included as a separate section in the relevant part of the report. All verbatim comments and
‘other’ responses can be found in the appendices. However, ‘other’ responses are low as
although respondents ticked the ‘other’ option many did not actually write in their ideas.

Sometimes results have been netted so that ‘very’ and ‘quite’ are combined; ‘not that’ and not at
all’ are combined and so on throughout the text. However all charts and tables show results in
full.

Please note that due to a relatively small number of responses all differences between
respondent groups are not statistically significant. Therefore although findings give a good
indicative picture they should also be treated with a degree of caution.




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4.     Key findings

This section provides an overview of the findings taken from the survey and focus group.

4.1    Health information and advice

Source of health information

Respondents were asked if they had ever asked for information about health and if so where.

As can be seen from the chart below, respondents most frequently stated they asked people
close to them; their parents (34%) and their friends (33%). Nearly a quarter of respondents had
gone onto a website (23%). Respondents were least likely to have asked the school nurse (15%)
whereas 17% had never asked for information on health. No ‘other’ sources were given.

                                Q1. Have you ever asked for information about health? If so, where?



                  I've asked my parents                                                                34%


                       I've asked friends                                                             33%


                           On a website                                              23%


          At a Youth Information Centre                                   17%

         I've never asked for information
                                                                          17%
                   about health

                          A school nurse                               15%


                                                                                      Base: 100 (all respondents)
                 Source: QA Research 2009


Unsurprisingly younger respondents, aged 11-14 were significantly more likely to have never
asked for information than those aged 15-17 (26% compared to 9% respectively). Furthermore
young people who stated they were either ‘quite’ or ‘very’ worried about their parents were
significantly less likely to have asked them for health information than those who were either ‘not
that’ or ‘not at all’ worried about their parents (21% compared to 47% respectively).




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Ease of using local health services

Respondents were asked to rate how often they felt local health services for young people were
easy to use. The scale ranged from ‘always’ to ‘never’ with an additional ‘don’t know’ option.
‘Most of the time’ was the most frequent rating given by young people (39%). A further third
(33%) stated it was ‘sometimes’ easy whilst 11% said they found it was ‘always’ easy. Positively,
the least frequent rating was ‘never’ (8%).

                   Q2. Do you feel local health services (like the doctor) are easy for young people
                                                        to use?

                                    39%

                                                        33%




                 11%
                                                                             8%                   9%




                Always        Most of the time       Sometimes              Never         Don't know-never
                                                                                          tried to use them

                                                                        Base: 100 (all respondents)
                       Source: QA Research 2009



Further analysis reveals that 7 out of the 8 people who stated local health services are ‘never’
easy to use were in the 15-17 years age group.




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Preferred source of health information

Following on from where respondents currently got information on health, they were further
asked how they would like to get information if they had the choice. Websites and posters were
the most popular choices (27% each) followed by leaflets (23%). Obtaining information from
social networking sites such as Facebook was least frequently chosen by respondents (17%),
whereas 15% stated they did not want any health information.

                             Q3. How would you like to find more information about health if you could?



                    Through a website                                                                            27%


                         From posters                                                                            27%


                         From leaflets                                                                    23%


     From a Youth Information Centre                                                              21%


                  From text messages                                                      18%

         Through social networks (like
                                                                                        17%
                 Facebook)

  I don't want to find more information
                                                                                  15%
              about health


                                                                                            Base: 99 (all respondents)
          Source: QA Research 2009




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Issues would like information on

Young people were also asked what topics they would like information on, if any. ‘Healthy eating’
and ‘drugs’ were most commonly stated by respondents (38% each). A further third (33%) of
respondents stated they would like more information on ‘alcohol.’ Young people were least likely
to want information on ‘jabs/immunisation’ (14%). Although a box was left to write in any other
issues they would like information on, none of the respondents used the space.

                         Q4. What issues would you like to have more information about, if any?



                 Healthy eating                                                                     38%
                         Drugs                                                                      38%
                        Alcohol                                                              33%
                  Sexual health                                                       29%
                           sex                                                    27%
                  Relationships                                                   27%
                       Bullying                                    18%
              Jabs/immunisation                            14%
                         None                                       19%




            Source: QA Research 2009                                       Base: 100 (all respondents)

Males were significantly more likely than females to state they would not like any information on
any issues (29% compared to 10% respectively) whereas females more frequently stated they
would like information on ‘healthy eating’ (48% compared 27% respectively).

Further analysis also reveals that those respondents who feel ‘worried’ about friendship were
significantly more likely to state they would like information on ‘relationships’ than those who said
they were not worried (34% vs. 14%).

The issues young people would like information on also affect the method they would prefer to
receive information. For example respondents who stated they would like information on ‘sex’
were significantly more likely to state they would like to find more information out through a
website (41%) than from a youth information centre (14%). Over half of young people who said
they wanted information about ‘sexual health’ stated they would prefer to get health information
via text message (56%), a notably larger proportion than leaflets and posters (both 26%).




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Feeling comfortable asking for health information

Respondents were presented with a list of people and were asked how comfortable they would
feel asking that particular person for information on health. The list also contained ‘Internet
sites/ forums’ and ‘through a text message’.

             Q5. How comfortable would you or do you feel asking about health from the following people?

                                                8%
                             Friends                                        32%
                                                                                                           60%
                                                     12%
                Internet sites/forums                                               40%
                                                                                           47%
                                                         16%
                             Parents                                                      45%
                                                                                  38%
                                                         16%
             Through a text message                                                             50%
                                                                             34%
                                                             19%
                         GP (doctor)                                                           49%
                                                                            32%
                                                                      27%
                     Youth Workers                                                         47%
                                                                   25%
                                                                      28%
                       School nurses                                                            51%
                                                               21%
                                                                                   39%
                           Teachers                                                      44%
                                                         16%
                                                                                     41%
                        Other adults                                                    43%
                                                        15%
                                                                                    40%
                              Other                                                                        60%
                                        *
                      Not comfortable             Quite comfortable               Very comfortable


                                                                                    Base: variable (all
         Source: QA Research 2009                                                   respondents)


‘Friends’ are the people the largest proportion on respondents would feel ‘very comfortable’ going
to in order to ask about health (60%). In line with where respondents stated they have
previously got health information from, young people also frequently stated they felt ‘very
comfortable’ asking ‘parents’ (38%).

However, the second most frequently stated source that young people said they would feel ‘very
comfortable’ getting information from was ‘Internet sites/forums’ (47%), a source allowing more
privacy and no human interaction. Furthermore more respondents stated they would feel ‘very
comfortable’ receiving information via text message (34%) than asking other people such as
‘teachers’ (16%) and ‘school nurses’ (21%).




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Females were significantly more likely to state they would feel ‘very comfortable’ using ‘Internet
sites/forums’ than males (57% compared to 37%). There were also significant differences in
responses depending on the young person’s age. Respondents aged 15-17 were notably more
likely to state they would be ‘not comfortable’ asking their parents than respondents aged 11-14
(23% vs. 8% respectively). Similar findings were found in regards to talking to the doctor and
are therefore interesting for GPs; 45% of respondents aged 11-14 stated they would be ‘very
comfortable’ asking their doctor compared to only one-fifth (20%) of 15-17 year olds. 15-17 year
olds on the other hand were much more likely to state they would feel ‘not comfortable’ talking
to the doctor than those aged 11-14 (27% compared to 8% respectively).

In regards to ethnicity, non-white respondents more frequently stated that they would feel ‘not
comfortable’ asking ‘youth workers’ than white respondents (45% vs. 21%).

Having a say in the quality of health information and services

The young people were asked if they wanted more of a say in how good health information and
services are for young people in Barking and Dagenham. Responses were cut evenly with 51%
saying ‘yes’ they would like a say and 49% stating ‘no’.

Albeit based on a small sample size of 68 white respondents, 23 non-white respondents and 7
unknown respondents, non-white respondents were less likely to want a say in the quality of
health information and services than white respondents, with 70% of non-white respondents
compared to 43% of white respondents answering ‘no’.

Furthermore, females more frequently stated they would be interested in having a say than
males (61% compared to 40%).




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The best method to have a say

Respondents were then asked what they thought the best way was for them to be involved in
how good health information and services are for young people. One-fifth of respondents stated
they thought the best method was through ‘a survey’ (21%). ‘Through a health website’ (19%)
and ‘through a young people’s health network’ (17%) were also popular responses. ‘Through text
messages’ (5%) was an option not chosen by many.

               Q7. What's the best way for you to be involved in how good health information and services are
                                       for young people in Barking and Dagenham?


                          Through a survey                                                                      21%

                   Through a health website                                                               19%

    Through a Young People's health network                                                        17%

                         On a Youth council                                               14%

                    Through online blogging                                            13%

     Through social networks (like Facebook)                            8%

                     Through text messages                     5%

                                 Other way               3%



             Source: QA Research 2009                                        Base: 86 (all respondents)



‘Through a young people’s health network’ brought up significant age and gender differences.
Males were more likely to choose this method than females (29% compared to 7%) as were 11-
14 year olds compared to 15-17 year olds (32% vs. 8%). 15-17 year olds on the other hand
more frequently chose ‘through a survey’, ‘through a health website’ and ‘on a Youth Council’ (all
19%).




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Health personnel and confidentiality

Respondents were asked if they thought health personnel like doctors and school nurses pass on
things they tell them to parents. The results are shown in the chart below. The largest majority
of respondents stated they thought information is always passed on if a young person is under
16 (45%). One-fifth (21%) thought that health personnel will always pass what they tell them
onto their parents, thus many young people are misinformed about their rights to confidentiality.

Nearly a further one-fifth of respondents (18%) said they did not know if information is passed
on.



                    Q8. Do you think health personnel, like doctors and school nurses, pass on things you tell
                                                       them to parents?



                        They always do                                       21%



      They always do if you're under 16                                                                          45%



         They have to tell me if they do                             16%



                           I don't know                                 18%



               Source: QA Research 2009                                       Base: 97 (all respondents)



Further analysis shows that males were significantly more likely to think that health personnel
‘always’ pass on information they tell them to their parents (30% compared to 12%).




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4.2    Healthy eating

State of health

Respondents were asked to rate how healthy they think they are. The scale used ranged from
‘very healthy’ to ‘very unhealthy’. Over four out of five respondents stated they felt they were
either ‘quite’ or ‘very’ healthy (82%).


                                            Q9. How healthy would you say you are?




                      Very healthy                           25%



                      Quite healthy                                                      58%



                   Not very healthy                13%



                    Very unhealthy         4%



                     Source: QA Research 2009                       Base: 97 (all respondents)



Overall, younger respondents were more likely to state they were healthy, with 92% of 11-14
year olds compared to 72% of 15-17 year olds stating they were either ‘quite’ or ‘very’ healthy.

Further analysis also shows that those who were ‘worried’ about ‘being healthy’ were also
significantly more likely to state they thought they were ‘unhealthy’ than those who stated they
were ‘healthy’ (27% compared to 7%).

Eating healthily

Respondents were asked how often they ate healthily on a scale ranging from ‘always’ to ‘never’.
‘Most of the time’ was the most common response. A quarter of respondents stated they
‘sometimes’ eat healthily (26%) whereas one in ten respondents (9%) said they ‘never’ eat
healthily.

Although a higher proportion of females than males stated they ate healthily either ‘always’ or
‘most of the time’ (73% compared to 56% respectively), 6 females compared to 3 males said
they ‘never’ eat healthily. Older respondents were also more likely to state they ‘never’ ate
healthily (7 respondents aged 15-17 years old vs. 2 respondents aged 11-14 year olds).




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                                         Q10. Would you say you eat healthily...?




                        Always                           19%



                Most of the time                                                            45%



                    Sometimes                                     26%



                         Never                9%



                   Source: QA Research 2009                         Base: 99 (all respondents)



Weight

The young people were asked how they would describe their weight. Options ranged from ‘too
thin’ to ‘very overweight’. Positively ‘normal weight’ was the most common response (72%), with
‘too thin’ and ‘overweight’ receiving the same proportion of responses (13%). Only 2% of
respondents described themselves as ‘very overweight’.

                                   Q11. How would you describe your weight?

                      72%




                                          13%                    13%
                                                                                         2%


                 Normal weight          Too thin             Overweight             Very overweight



                       Source: QA Research 2009                    Base: 99 (all respondents)

Further analysis suggests a link between healthy eating and weight; respondents who stated
they had a ‘normal weight’ were significantly more likely to state they ate healthily ‘always’
(89%) or ‘most of the time’ (84%) than ‘sometimes’ (50%) or ‘never’ (33%).




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Furthermore respondents who stated they could get healthy food at home ‘all the time’ were
significantly more likely to say they had a ‘normal weight’ (90%) than those who said they could
eat healthily ‘most of the time (72%) and ‘sometimes’ (47%).1

Focus group discussion-diet

Both males and females were aware of the importance of a balanced diet. Eating food deemed
‘unhealthy’ such as chocolate bars and MacDonald’s was seen as ok as long as it was eaten in
moderation. Further to this there was an awareness of different food types and their benefits to
health:

‘You need carbohydrate, protein, fibre, fibre helps the food to digest in your throat so it don’t get
 stuck there, you need vitamins such as apples etc...you need minerals like water, calcium, milk,
                                         cheese’ (Female)

                         ‘They can have it in moderation [unhealthy food]’ (Male)

‘It’s alright to have a little bit [of unhealthy food] as a treat but not having it every time’ (Female)

In line with quantitative findings, the healthy eating activity showed that participants ate a varied
diet with both unhealthy and healthy aspects to it. For both sexes toast was a common breakfast
as well as cereal. Vitamin drink, milk, tea and orange juice were cited as breakfast drinks, nobody
wrote down snack type food such as crisps, chocolate or sweets.

Lunch showed more variance as although many participants said they ate sandwiches, cheese
rolls, pizza and pie were also mentioned. Many different fruit types were mentioned such as
orange, apple, banana, strawberries and grapes as well as chocolate bars and crisps.

Young people also ate a range of food for dinner. Some examples were roast dinner, stir-fry,
pasta, sausage, chicken salad, chicken and rice and homemade chinese/curry.

It was also recognised by both groups that being healthy went further than your diet and that
exercise plays an integral part. Many male participants said they ate chocolate bars everyday but
because they had an active lifestyle they were not concerned with becoming over weight.
Females shared the same view,

                              ‘It’s alright for me cos I go to the gym’ (Female)

With this in mind males suggested that providing free sporting facilities could be an effective
method in fighting obesity and making young people healthier. It was mentioned that they had
access to free swimming in the summer but this should be available all year round.

                  ‘I think the gym should be free for children under seventeen’ (Male)



1
  The base size of respondents who stated they could ‘never’ eat healthy food at home was too small to allow a significant
comparison




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                     ‘Introduce more activities but not expensive ones’ (Male)

Having separate sex gym facilities also needs consideration as females commented on a male
presence making them feel uncomfortable. This may deter young people from using the gym.

‘Yeh but everytime you go to the gym there were all these like sixth form boys with like big, huge
                             muscles, sort of glaring at us’ (Female)

Reasons choose to eat unhealthy food

Respondents were asked why they sometimes choose to eat unhealthy food. As can be depicted
from the chart below, the most common reason was because ‘it tastes better’ (45%). The
reasons, because ‘it’s cheaper’ and ‘it makes me feel good’ received a similar number of
responses (28% and 25% respectively).

                          Q12. Everybody eats unhealthy sometimes-why do you choose to eat
                                              unhealthily when you do?
                       45%



                                             28%
                                                                   25%




                                                                                         4%


                  It tastes better        It's cheaper     It makes me feel good     Other reason


                                                                     Base: 96 (all respondents)
                         Source: QA Research 2009



There was an ethnic difference regarding the reason ‘because it tastes better’, with white
respondents significantly more likely to state that this as a reason than non-white respondents
(52% compared to 27%).

Other reasons given were ‘just when I want a snack’ and ‘because sometimes it tempts you to’.

Focus group discussion-Reasons why eat unhealthy food

Both females and males agreed that the single most contributing factor to eating an unhealthy
diet is price. The general consensus was that healthy food was much more expensive and was
not as filling, therefore with the lunch money they are given they opt for the less healthy options.

‘Unhealthy food seems cheaper than healthy food, you can go down to the local and get sausage
  and batter and it only costs you two quid but if you want like salad, potato...it most probably
                                  comes over two pound’ (Male)




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So if my mum gives me two pounds and the healthy food’s two pound ten and the healthy food’s
                            one pound, what can I buy?’ (Male)

                        ‘Yeh chicken and chips innit, it’s cheap’ (Female)

    ‘There was like some sandwich and it was like one pound fifty and I was like maybe not’
                                          (Female)

The quality of the healthy food on offer is also a factor which discourages young people buying
it; one female participant commented that people do not eat the fruit in the vending machine as
it looks dirty inside. Therefore although participants recognised that their school canteen was
trying to offer healthier options the taste of the food let it down. This is something that needs
attention because, as the quantitative survey results show, people do eat unhealthy food simply
because they find it tasty.

      ‘The thing is all the healthy food the canteen serves up is really disgusting’ (Female)

The convenience and prevalence of unhealthy food was also viewed as a contributing factor to
food choice. Both females and males commented on the large number of fast food places and
lack of cafes/shops offering healthy options. This could also override the efforts of the school to
encourage healthy eating as when students are allowed out on a lunch time they are presented
with a wide range of food places offering quick and cheap food which they find tasty.

‘There’s more fish and chip shops than healthy shops...if you turn the corner [and go] round here
  you see like four takeaway....there’s lot of like chicken and chips...you will hardly see healthy
                                        eating place’ (Male)

The issue of peer influence was also raised:

 ‘The sixth formers come back yeh and think...they buy it and then they walk then they wait til
they get into the school to show off and then.....to get most of us jealous, they open their boxes
                                with kebabs and chips’ (Female)

Concerns relating to a bad diet

Respondents were presented with a list of possible consequences of a bad diet and were asked
to tick which ones, if any, worried them the most. Almost half of respondents (47%) stated they
were concerned about ‘becoming overweight’. Respondents stated they worried about other
possible consequences much less frequently; ‘having low self-esteem’ received the least
responses at 8%. This may suggest that young people have a rather simplistic view of a bad diet
and do not think of the consequences it can have on a person, past the obvious effect on body
shape.




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                   Q13. Below are some things that might happen if you have a bad diet. Which, if
                                        any, would worry you the most?
                 47%




                                  16%
                                                  10%              9%              9%                8%




               Becoming        Having low       Getting        Having bad    Having bad skin Having low self-
               overweight       energy        concentration      teeth                          esteem
                                               difficulties
                 Source: QA Research 2009                               Base: 86 (all respondents)



Further analysis shows that males more frequently stated they were worried about ‘becoming
overweight’ than females (59% vs. 36% respectively). Albeit small sample sizes of 45 females
and 41 males, females more frequently stated they were concerned about issues such as ‘having
low self-esteem’ (11% compared to 4% respectively) and ‘having low energy’ (20% compared to
12% respectively).

Healthy food at home

Using a scale ranging from ‘always’ to ‘never’ respondents were asked how often they had the
opportunity to eat healthy food at home. Nearly half of respondents stated they had the choice
of healthy food at home ‘most of the time’ (47%). Positively, the least common response was
‘never’ (2%).

                       Q14. Do you have the opportunity to choose healthy food at home if you
                                                    want to?
                                            47%



                       30%

                                                                    20%




                                                                                            2%


                     Always             Most of the time         Sometimes                Never


                                                                      Base: 99 (all respondents)
                        Source: QA Research 2009




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Healthy food at school

In the same respect respondents were asked how often they had the opportunity to eat healthy
food at school. The chart below shows responses. ‘Always’ (31%), ‘Most of the time’ (36%) and
‘sometimes’ (27%) all received a similar amount of responses.

                    Q15. Do you have the opportunity to choose healthy food at school if you
                                                 want to?
                                          36%
                    31%
                                                                 27%




                                                                                         5%



                   Always            Most of the time         Sometimes                Never


                                                                   Base: 99 (all respondents)
                     Source: QA Research 2009



The age of respondents showed up some differences in responses; respondents aged 11-14
more frequently stated they ‘never’ or ‘sometimes’ had the choice of healthy food at school
(54%) than 15-17 year olds (14%). On the other hand, 86% of 15-17 year olds said they had
the option of food ‘always’ or ‘most of the time’ compared to 46% of 11-14 year olds.




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Fruit and vegetables

Respondents were asked how many portions of fruit or vegetables they usually eat in one day.
The most common response was 3-4 portions (39%) followed by 1-2 (37%). Only 12% of
respondents said they ate the recommended 5 portions or more.

                       Q16. How many portions of fruit or veg do you usually eat in one day?


                                                                   39%
                                            37%




                                                                                          12%
                       7%




                      None                   1-2                    3-4                5 or more


                                                                     Base: 99 (all respondents)
                       Source: QA Research 2009



Nearly one in five females (19%) stated they ate ‘5 or more’ portions of fruit or vegetables a day;
this was significantly more than the 4% of males.

Focus group discussion-food choice at home

As well as the options available at school, the food available at home also affects a young
person’s health. Overall participants said they ate healthily at home; having home-cooked, well-
rounded meals for their dinner.

                                 ‘Oh I eat healthy at home’ (Female)

                     ‘Everything’s cooked from scratch in our house’ (Female)

Parents have a significant influence on a young person’s diet, especially if they provide their child
with lunch for school. This was evident in one participant’s comment regarding the snacks he
eats:

                     ‘It depends what my mum puts in my pack lunch’ (Male)




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4.3    Smoking, drinking and drugs

Parents smoking

Respondents were asked if one or more of their parents smoked. Nearly two-thirds of young
people surveyed said their parents did not smoke (64%).


                                   Q17. Do one or more of your parents smoke?
                                                   64%




                            29%



                                                                            7%



                             Yes                    No                 Don't know



                    Source: QA Research 2009                     Base: 99 (all respondents)



Smoking habits

The young people were then presented with a list of statements describing different smoking
habits ranging from ‘I have never smoked a cigarette’ to ‘I smoke cigarettes everyday’ and were
asked to state which one best applies to them. Respondents were also given the option of ‘I
prefer not to say’. Almost a half of respondents (49%) stated they have ‘never smoked a
cigarette’. The next most common response was ‘I have smoked once or twice’ (14%), thus it
can be asserted these respondents have tried cigarettes but have not yet taken up the habit.
Nearly one in ten respondents stated they smoke at least once a week (9%).




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                                     Q18. Which of the following statements best applies to you?


                                I prefer not to say                 17%

                                I smoke every day       3%

               I smoke cigarettes regularly, once a
                                                           6%
                         week or more
               I sometimes smoke cigarettes, but I
                                                        2%
                    don't smoke every week
               I used to smoke cigarettes regularly
                                                             8%
                        but don't anymore
                I have smoked a cigarette once or
                                                                  14%
                            twice

                  I have never smoked a cigarette                                             49%

                    Source: QA Research 2009                              Base: 99 (all respondents)



The number of young people who smoked regularly was too small to show any significant
relationship between parents smoking habits and their children. However, respondents who said
their parents did not smoke were significantly more likely to state they had never smoked a
cigarette than to state they had smoked a cigarette once or twice (82% compared to 21%
respectively).

Focus group discussion-Smoking

The young people were asked about pressure to smoke. As with drinking females viewed young
people smoking as part of growing up, again it was the curiosity and wanting to experience it.

                          ‘People smoke just to experience it really’ (Female)

It was evident from the discussion that for some males smoking still has a element of ‘coolness’
about it. Even though young people are more informed than ever before about the effects of
smoking it is still viewed as having a ‘trendy, grown-up’ edge to it.

 ‘It don’t look like it hurts cos when they do it out their nose they can say ‘aw that looks cool’ so
                                   they wanna try and learn’ (Male)

‘When you’re a child it looks good, when you see people doing it, it looks cool but when you get
older and you learn what it does it’s just like no....it’s just a dusky habit, and your breathe stinks
                                      like nothing else’ (Male)

Male participants identified pressure from friends as being an important factor in young people
smoking. Females knew a lot about the ill-effects of smoking and thought it was ‘stupid.’ For this
reason they said that even if their friends smoked they would not feel any pressure to take up
the habit or try it. However, as mentioned above, they did understand why people try smoking.

              ‘I thought maybe peer pressure might push them into smoking’ (Male)




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  ‘No [I wouldn’t smoke if my friends did] cos I know what it does to my body, it gives me bad
                   teeth, bad breath, makes all your nails go yellow’ (Female)


Focus group discussion-The effect of parents drinking smoking

There were mixed views regarding parents smoking. Participants thought it may make it more
acceptable for them to smoke if a parent smokes and make the habit seem normal. However,
females also talked of how they hated smoking, left the room when a family member lit a
cigarette and told them off for having the habit. The smoking in public places ban also appears to
have had a positive effect on the likelihood of young people smoking for practical reasons-
having to go and stand outside was seen as too much of a hassle.

       ‘My granddad smokes, I go out the room when he smokes, I don’t like it’ (Female)

        ‘In some cases it can make people think if my mum can do it I can do it’ (Female)

                          ‘If your parents smoke you might start smoking’ (Male)

 ‘No...because whenever they go out [for a cigarette] they have to go outside and like you just
  [see] them, pouring down with rain outside and you’re like why would you bother’ (Female)


Drinking habits

Respondents were then asked to choose the statement that best described their drinking habits.
Options ranged from ‘I have never had an alcoholic drink’ to ‘I have been drunk three or more
times within the last four weeks’. Respondents were also given the option of ‘I prefer not to say’.
The largest proportion of young people surveyed stated they had ‘never had an alcoholic drink’
(40%), a further fifth of respondents said they had ‘never been drunk (21%).

                                  Q19. Which of the following statements best applies to you?



                       I prefer not to say                         15%

         I have been drunk three times or
                                                  2%
          more within the last four weeks
       I have been drunk twice within the
                                                   3%
                last four weeks
       I have been drunk once within the
                                                         8%
                last four weeks
      I have been drunk once or twice but
                                                            10%
                 not recently

                 I have never been drunk                                   21%

       I have never had an alcoholic drink                                                        40%



              Source: QA Research 2009                                        Base: 99 (all respondents)




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Older respondents, in the 15-17 years age bracket were significantly more likely to state ‘I prefer
not to say’ than those respondents aged 11-14 (20% vs. 5% respectively). Furthermore,
although the difference was not statistically significant, more males than females chose the ‘I
prefer not to say’ option. The 2% of respondents who stated ‘I have been drunk three times or
more within the last four weeks’ were female.

Focus group discussion-alcohol

When asked about drinking alcohol females talked about it from a different view point to males;
whereas males talked about young people using alcohol as a form of escapism females viewed it
as a way for people to have fun.

                ‘I think people just do it [drink alcohol] to have a laugh’ (Female)

‘The parents expect too much of them so they decide to turn to the bottle or something else...or
                                        drugs’ (Male)

 ‘Cos in one of our PE lessons they had like a drink and you could smell that it wasn’t water and
  they all got really laughy afterwards and one of the girls, they had like most of the bottle and
                                    then she fell over’ (Female)

‘My uncle died from alcohol, he died cos he..used to drink beer, he used to have like maybe five
               beers a night, but over that period of time...that’s not a lot’ (Male)

Furthermore, rather than feeling pressured to drink alcohol, females voiced a personal curiosity
as to what it felt like to be drunk. Friends being drunk was discussed and laughed about.
However, even though drunken behaviour was seen as funny it was evident that participants
thought people can go too far and this was something they did not find funny or attractive.

         ‘It doesn’t make me feel pressurised but....you wanna experience it’ (Females)

 ‘I think that people drink to show off and act big, they have fun and enjoy themself but they go
     over the top then you see them like walking stupidly, they’re sick and it’s not very ladylike’
                                             (Female)

Focus group discussion- The effect of parents drinking alcohol

Participants were asked if they thought young people seeing their parents drink alcohol
encouraged or discouraged them to do the same. What came out was that it wasn’t seeing them
drink the odd glass of wine or can of beer that affected young people, it was the relationship
their parents had with alcohol- if they saw their parents having fun drinking alcohol it was
thought this might encourage them; however if young people had experienced parents in a bad
state from alcohol this may deter them.

 ‘More likely, unless you see them like in a really, really bad way, if they just drink it every now
  and again and they look like they’re having fun then it makes you more likely to drink’ (Male)




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In the same respect it was thought that seeing their parents drunk the odd time would not really
affect a young person.

‘I’ve seen my mum and dad drunk before but it doesn’t encourage me to get drunk but it doesn’t
                              discourage me either’’ (Female)

One female respondent said she would copy the drinking habits of her parents as they seem to
have a healthy relationship with alcohol.

 ‘My parent have a limit where they stop like when they go to parties but when they’re at home
   they just drink their glass, I have never seen them drunk before never..I’ll just follow their
                                        footsteps’ (Female)

Illicit Drugs

The young people surveyed were asked if they had ever taken any drugs that were not medicine.
Once again respondents were given the option of ‘I prefer not to say’. Almost two-thirds of
respondents (64%) stated they had not, whereas 12% said they had. Nearly a quarter of
respondents (24%) chose not to say.


                            Q20. Have you ever taken drugs (not including medicine)?

                                                     64%




                                                                               24%

                            12%




                            Yes                      No                 I prefer not to say



                  Source: QA Research 2009                          Base: 99 (all respondents)



Further analysis reveals significant gender differences with males more likely to say they had
never taken drugs (77%) than females (52%). A third of females (33%) chose the ‘I prefer not
to say’ option, a figure notably higher than males (15%).

There were also differences in regards to ethnic background; non-white respondents more
frequently stated they had never taken drugs than white respondents (74% compared to 64%
respectively) whilst white respondents more frequently chose not to say than non-white
respondents (27% vs. 9%).




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4.4    Relationships

Best age to have a baby

Respondents were given a blank box and were asked to write down what they thought the best
age to have a baby was. The chart below shows the various ages given. The lowest age given
was as young as 14 whilst the oldest ideal age was 30. The most frequent age respondents
viewed as the best age to have a baby was 20 (20%) followed by 25 (15%). The mean age of all
responses given is 23.


                         Q21.What do you think is the best age for having a baby?



                             30                    6%
                             28                  5%
                             27                    6%
                             26          2%
                             25                                            15%
                             24                                  11%
                             23                       7%
                             22                            9%
                             21                                  11%
                             20                                                        20%
                             19          2%
                             18          2%
                             16          2%
                             14       1%


        Source: QA Research 2009                                   Base: 100 (all respondents)



The youngest ideal age of ‘14’ was given by an 11-14 year old female.




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Worries and concerns

The young people surveyed were presented with a list of possible concerns and were asked to
rate how worried they were about each. The scale used ranged from ‘very worried’ to ‘not
worried at all’.

                                                    Quite           Not that     Not
                                  Very
                                                   worried          worried    worried at
                                 worried
                                                                                  all
Getting pregnant                     5%               30%              25%       40%
Sexually Transmitted Infections      12%              33%              37%       18%
Boyfriends/girlfriends               7%               13%              39%       18%
Being popular                        10%              35%              35%       20%
Passing my exams                     22%              42%              24%       11%
Crime                                18%              45%              26%       11%
My looks                             11%              47%              25%       16%
Being bullied                        8%               35%              32%       25%
Friendship                           12%              51%              22%       14%
My parents or family                 21%              27%              30%       21%
Being healthy                        11%              43%              34%       11%
My future                            23%              35%              31%       11%
Other                                24%              31%              24%       21%
Base: variable (all respondents)




‘Passing my exams’ concerns respondents the most, with two-thirds (65%) stating they were
‘very’ or ‘quite’ worried about the issue. Other issues that were commonly cited as issues
respondents were ‘very’ or ‘quite’ worried about were ‘crime’ (63%) ‘friends’ (63%) ‘my looks’
(59%) and ‘my future’ (58%).

Overall younger respondents tended to be less concerned with many of the issues, especially
ones that were less likely to affect younger respondents’ lives. For example three-quarters of 11-
14 year olds (74%) were either ‘not that worried’ or ‘not at all worried’ about getting pregnant
compared to 56% of 15-17 year olds. The same differentiation was found in regards to
‘boyfriends/girlfriends’ (74% compared to 46%), ‘passing my exams’ (53% compared to 23%),
‘my looks’ (55% compared to 30%), ‘my parents or family’ (74% compared to 35%), ‘being
healthy’ (63% compared to 33%) and ‘my future’ (61% compared to 29%).

There were ethnic differences in regards to ‘my looks’ with white respondents more frequently
stating they were ‘very’ or ‘quite’ worried than non-white respondents (67% compared to 43%
respectively). Non-white respondents however were more likely to be ‘very’ or ‘quite’ worried
about ‘boyfriends/girlfriends’ than white respondents (61% compared to 37%).




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Focus group discussion

Worries and concerns

Respondents were presented with a list of possible concerns for young people and were given
five stickers. They were then asked to put a sticker next to their top five worries. Prior to this
they were asked if they could think of anything else that may concern young people to add on to
the list. One female offered the idea of ‘abuse’ and one sticker was placed next to it.2

The most frequently stated concerns for females and males, ‘passing my exams’ and ‘my future’
are intrinsically linked. There was a general feeling that the grades they got in their GCSEs would
determine the path their life would take. Gaining good grades was seen as the key to a
successful career and fulfilment.

                            ‘I don’t wanna have to work in an ice cream van’ (Female)

                                                  ‘To get a good job’ (Male)

          ‘My mum’s just like just try your best but I wanna get somewhere in my life’ (Female)

With so much resting on their grades many females expressed the pressure they felt they were
under, from themselves, parents and teachers.

    ‘If I didn’t get an A in my biology I would have got such a telling off, cos I was predicted an A
       and if I don’t get that then I have to do like everything all over again...she watches me do
                                      revision, it’s off putting’ (Female)

    ‘The thing is yeh with me I worry too much as it is already with just normal tests and with that
                    coming up (GCSEs) it just makes me worry even more’ (Female)

Females spoke of going away to university and losing contact with their friends. This was also a
significant concern when talking about their future. Participants therefore had high aspirations
but were also worried about losing the close relationships they had formed with their friends at
home.

Crime was also a high concern for females. Participants spoke of drug dealers living on their
street and the general fear they felt; participants knew someone who had been stabbed, carried
around old phones to hand over if they were mugged and even resorted to not going out at
night.

                   ‘Someone got stabbed across the road and I know the person’ (Female)

     ‘Cos that’s why I carry round an old phone with me , just in case someone says give me your
                              phone, I’ll just hand them that one’ (Female)




2
    The youth club leader has been alerted about this




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 ‘I just don’t go out, I stay in, I go out during the day and stuff...I go I out at like 11ish, 12ish I
                    just like get a bit anxious when you’re out at night’ (Female)

Getting pregnant and Sexually Transmitted Infections were also commonly cited as a concern.
For males this links to another frequently stated concern of ‘being healthy’, on the other hand no
females stated ‘being healthy’ as a cause of worry. For females concerns about getting pregnant
related back to their future and wanting to get a good job which a baby would make a lot harder.
The same views were held by males who talked about a baby interfering with school work.

                 ‘It’s getting pregnant too young cos it messes you up’ (Female)

‘When people have babies at the age of sixteen they have to cut out their school work and if not
cut out fully they have less time to do their school work, one time on BBC One this fourteen year
         old girl got pregnant and she had to leave school to look after the baby’ (Male)

Dying young and infertility concerned participants in regards to Sexually Transmitted Infections.
Male participants held some strong Christian values such as celibacy. Females did not talk as
much about the subject but did suggest that people should go to the doctor to check for diseases
before they have sex.

 ‘You die early if you get a sexually transmitted disease...if I catch something yeh and I die too
       early then...I won’t be able to look after my kids if I did get it, I’d cut my life span
              short...wouldn’t be able to make as much money as I wanted’ (Male)

 ‘I’d like to have children but if you become infertile through a STD then you don’t really have a
                                         high chance’ (Male)

                         ‘Avoid sex, if you go there, use a condom’ (Male)

‘In the bible it says that you should wait until you’re married and that’s what I wish to do’ (Male)

Sex Education

Participants were asked about sex education at school and if they were shown how to use a
condom. There was gender difference around this subject; males said they were shown how to
put on a condom in year 9 however this was going to be moved forward to year 7. Females
however said they had not been shown but their male peers had. One participant said that some
females in her year had but others had not, thus there was a lot of variance between the young
people. There was no embarrassment around the subject, with one female openly saying she
wanted to be taught how to put on a condom.

Issues and problems surrounding sex education came out in the female discussion group that
need addressing. Firstly there is the problem of students not taking it seriously which can greatly
devalue what the other students take away from the lesson. Having teachers that are not
suitable for the sensitive subject matter is also seen as a problem; this can make the subject
awkward and also makes it less likely students will ask about any queries or concerns.

    ‘You get the immature people that start laughing and all that kind of stuff or if it’s a really
              awkward teacher as well, especially when it’s a male teacher’ (Female)




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 ‘I think they’re like really immature about it boys cos you get them into school and they’re like
 blowing them up and stuff like that and you’re thinking are you gonna be like this when you’re
                                          older’ (Female)

Reasons why young people don’t use condoms

When asked the reasons why young people may not use condoms both females and males
suggested purchasing the contraception was the most significant factor. Females were aware
they could get free condoms from the health centre but said they would not feel comfortable
going to get them. Females held the same view about going into a chemist and said that they
would feel awkward paying over the counter. Methods of obtaining condoms that do not involve
interaction with someone else were thus seen as the easiest way to attain the contraception.
Further to this participants also offered alcohol as a reason young people may not use a condom.

                     ‘They’re embarrassed to get them from the shop’ (Male)

‘No [wouldn’t be comfortable going to a health centre], I think it makes it really awkward, I think
that’s not that embarrassing to get them from the machine’ (Female)

                                        ‘They’re drunk’ (Male)

One female suggested that having no age restriction on sex would make gaining contraception a
lot easier, however this contradicted the groups’ previous discussions about children knowing too
much from a young age. There was therefore a recognition of the debate surrounding giving sex
education to children - is it equipping them with the essential knowledge to practice safe sex or is
it encouraging them to have sex earlier?

‘My sisters are nine and five and have no clue about it [sex] and I think they’re trying to teach it
  really young as well and...it kinda makes them not feel as young..they know too much stuff’
                                            (Female)

‘If they made it legal for like kids under sixteen to have sex then it would be easier to get hold of
                                        contraception’ (Female)

                        ‘I think they know too much at this age’ (Female)

Pressures to have sex

Participants did a pairwise activity to identify where the most pressures come from to have sex.
This involves using a grid format in order to compare and rank different pressures against each
other and ultimately identify who or what young people find most pressurising.

Females said they felt that the biggest pressure to have sex came from boyfriends, especially if
they were older. This was followed by friends who are boys and television or films. Parents and
the females themselves were seen to be the least pressuring factors. Media saturation of
sexualised images was recognised by females as an added pressure to have sex, whereas a
lowering of inhibitions from drinking alcohol was also mentioned.




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‘I think girls get pressured into it especially when they have older boyfriends they get pressured
                                 into it as well or by drink’ (Female)

                    ‘Friends who are boys that’s all they think about’ (Female)

                           ‘Cos it’s everywhere [on television]’ (Female)

For males television or films was seen as the biggest pressure to have sex followed by friends
who are boys and then friends who are girls. Males did not feel as pressured by their girlfriend as
females did their boyfriends suggesting a perceived difference in attitude towards sex between
genders.

‘Girlfriends like to take it slow unless you got one of those you know, off the street ones’ (Male)

     ‘A girl can get called all sorts for doing that kinda stuff but boys are like....then they get
                                        applauded for it’ (Female)

As with females, males said they felt least pressured by parents and themselves however they
felt more pressured by friends who are girls than females. Therefore overall, males considered
themselves to be under more peer pressure than females




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5.     Conclusions
This section outlines the key conclusions drawn from this research.

Conclusion 1: Health information and advice

Young people are most likely to go to the people they have a close and trusting relationship with
for advice and information on health, such as friends and parents. Respondents were less likely
to turn to health professionals or other adults such as teachers or youth workers. This has
significant ramifications as although this can be viewed as positive, information they receive may
be inaccurate and advice inappropriate. Furthermore not every young person will feel they can
turn to their peers or family. For example young people who stated they were worried about
their parents were less likely to ask them for health information. Furthermore, as young people
get older they are less likely to feel comfortable discussing health with their parents.

Careful consideration therefore needs to go into encouraging young people to seek information
from health professionals such as their GP and more importantly how to make them feel
comfortable doing this. The nature of the health professional is thus important, young people
need to be able to establish a trust with that person like they have with their friends. This then
brings up confidentiality. Many young people were misinformed about their rights to privacy
which could potentially act as a major barrier to them obtaining the advice they would like.

However, there still needs to be alternative accurate sources of information that do not involve
talking to others. Some people are always going to be shy talking about more sensitive issues
such as their sexual activity, thus it is important they can still obtain reliable advice. The Internet
and text messages could potentially offer a viable alternative.

Conclusion 2: Healthy eating

The young people had a varied diet which consisted of both unhealthy and healthy elements. In
order to encourage healthy eating the quality of healthy options needs consideration especially at
school. One of the main reasons young people eat unhealthy food is because it tastes nice
therefore it is important that healthy alternatives are fresh and tempting. School canteens need
to be inventive with healthy options and furthermore assess the price they charge for healthy
dishes. The cost of eating healthily is another vital factor which greatly influences the uptake of a
healthy diet, unhealthy food is currently viewed as cheaper and more filling thus schools need to
challenge this perspective. Positive role models among older pupils could also help to achieve
these aims.

Young people are aware that being healthy goes further than the food they eat. Encouraging
participation in sport through free or cheap facilities would not only make being healthy fun it
could offer a new social life to young people, enabling them to meet new friends and get fit at
the same time.




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Conclusion 3: Smoking drinking and drugs

The largest proportions of respondents stated they had never drank alcohol or smoked a
cigarette, however some young people admitted to doing both regularly whilst a considerable
proportion preferred not to say. The same can be said for illegal drugs use. In regards to
deterring young people from engaging in such activities, many young people stated they would
like information on drugs and alcohol thus the dangers and effects of both may need to be
disseminated more.

However, as with smoking, being aware of the health effects is not always enough to discourage
young people. There is an element of curiosity connected to smoking and drinking, young people
want to experience them and see it as part of growing up. Young people are aware of the
extremes of drinking such as alcoholism and using it as a form of escapism but also see it as a
way for people to have fun. With this in mind, nicotine free cigarettes could allow for young
people to try smoking without the addictive element.

Whether parents smoking or drinking encourages their children to do the same is debateable and
different in each circumstance. However as young people are often curious parents may want to
discuss each issue with their teenage children.

Conclusion 4: Relationships

Young people were more concerned with passing their exams than issues relating to
boyfriends/girlfriends. Grades gained were seen as the determining factor in the course their life
would take. Worries related to the future, for example getting pregnant too young were seen as
a major barrier to achieving ambitions.

In regards to sexual health, there are some issues surrounding sex education at school that need
consideration. In order for young people to take away as much as they can from the lessons they
need to feel as comfortable as possible; peers not taking the lesson seriously and teachers the
students cannot be open with all make the subject more awkward. Having separate lessons for
males and females and same sex teachers may help to tackle such problems.

Furthermore as well as knowing how to use a condom actually purchasing condoms is a major
barrier to young people using the contraceptive method. Methods of obtaining condoms that do
not involve interaction with others is something that could help, however this then has moral
implications which would need to be addressed.

The young people spoken to in the discussion groups, especially the males had strong Christian
views on sex and relationships. Although these may not be typical of young people in the area
such findings indicate the positive influence organised youth groups can have on young people’s
lifestyle choices and perspectives. Therefore encouraging attendance at such clubs is an area
that may need attention.




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6.   Appendix

Appendix 1 – Demographics


              Age                                              Count     %
              11-14                                              39     39%
              15-17                                              57     57%
              Unknown                                            4       4%
                                                                100    100%
              Gender                                           Count     %
              Male                                               48     48%
              Female                                             52     52%
                                                                100    100%
              Ethnicity                                        Count     %
              White                                              68     68%
              Non-White                                          23     23%
              Unknown                                            9       9%
                                                                636    100%
              Area                                             Count     %
              Abbey                                               3       3
              Aldborough                                          2       2
              Alibon                                              7       7
              Becontree                                          3        3
              Brooklands                                         1        1
              Buckhurst Hill West                                2        2
              Clementswood                                        1       1
              Cranham                                             1       1
              Eastbrook                                           3       3
              Eastbury                                            5       5
              Gascoigne                                          4        4
              Goodmayes                                           1       1
              Goresbrook                                         5        5
              Hale End and Highams Park                          1        1
              Heath                                               6       6
              Lambourne                                           1       1
              Longbridge                                          2       2
              Loxford                                            1        1
              Mayesbrook                                          3       3
              Parsloes                                           1        1
              River                                               6       6
              Thames                                             5        5
              Valence                                            2        2
              Valentines                                         2        2
              Village                                             7       7
              Whalebone                                          2        2
              Unknown                                            23     23%
                                                                100    100%




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                  Look after adult at home                         Count    %
                  Yes                                                11      11
                  No                                                 88      88
                  Unknown                                            1       1
                                                                    100    100%




Appendix 2 – Verbatim

Question 7- Best way to be involved in how good health information and services are-
‘other’ responses:

Through a health and safety course

Question 12-Why choose to eat unhealthy food-‘other responses’:

It's part of a health diet
Sometimes like a change
Just when I want a snack
Because sometime it tempts you to.




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Appendix 3 - Survey




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Appendix 4 - Focus Group Script




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              Page 150
                                                                             AGENDA ITEM 9




Report to       Healthier Borough Board

Report Title    Sexual and Reproductive Health for Children and
                Young People 2008 - 20013

Report author: Christine Pryor, Head of Integrated Family Services, LBBD and
               Tel: 020 8227 5552. E-mail: christine.pryor@lbbd.gov.uk

                Justin Varney, Joint Assistant Director of Health Improvement (Children
                and Youg People) / Consultant in Public Medicine Health Improvement,
                NHS Barking and Dagenham
                Tel: 020 8532 6350. E-mail: Justin.varney@bdpct.nhs.uk

Meeting date:   28 July 2009

Purpose:        For Decision



1.      Summary

1.1     On the 2 June 2009 the Children’s Trust received the attached report and agreed
        the strategy. The Trust also requested that it also be referred to the Healthier
        Borough Board in view of the cradle to grave health strategies and programmes
        that the Healthier Board is currently working on.

2       Recommendation

2.1     The Healthier Borough Board is asked to note the attached strategy and include it
        in the work that it is undertaking.




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             Page 152
SEXUAL AND REPRODUCTIVE HEALTH
STRATEGY FOR CHILDREN AND YOUNG
            PEOPLE
           2008 – 2013


   D R A F T FOR CONSULTATION
             June 2009




              Page 153
                                              Table of Contents
                                                                                                  Page Number
1.     Introduction .......................................................................................... 2
2.     National Context................................................................................... 2
3.     The Local Picture in 2008 .................................................................... 3
4.     Principles .............................................................................................. 4
5.     Outcomes ............................................................................................. 4
6.     Targets .................................................................................................. 4
7.     Links with Other Strategies and Policies ........................................... 5
8.     Priorities ............................................................................................... 5
Priority 1: Strategic leadership....................................................................... 5
Priority 2: Strong use of local data................................................................. 6
Priority 3: Communication of strong messages to young people, parents and
       partner agencies .................................................................................... 7
Priority 4: Comprehensive Sex and Relationship Education in schools and other
       educational settings ............................................................................... 8
Priority 5: Trusted and accessible young people friendly contraceptive and sexual
       health services ....................................................................................... 9
Priority 6: Targeted SRE and outreach with at risk young people as part of targeted
       youth support services ......................................................................... 10
Priority 7: Workforce training on SRE and sexual and contraceptive advice in
       mainstream partner agencies............................................................... 10
Priority 8: Raising the aspirations and self esteem of young people............. 11
Priority 9: Support for Parents to discuss sex and relationships .................. 12
Priority 10: Strong Integrated Youth Services.............................................. 13
Appendix 1: Definitions of Sexual Health, Sexuality and Sexual Rights144
Appendix 2: Teenage Conceptions: National Data............................... 166
Appendix 3: Sexually Transmitted Diseases......................................... 177




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1. Introduction

   This strategy takes as its basis the World Health Organisation’s definitions of sexual
   health, sexuality and sexual rights (Appendix 1). It seeks to promote sexual rights in
   the expectation that this will result in responsible sexual behaviour. As well as
   promoting sexual rights the strategy aims to prevent, treat or manage the unintended
   consequences of sexual activity in young people.

   Sexual and reproductive health issues have been a focus in Barking and Dagenham
   for many years with high rates of teenage pregnancy. The success of this strategy will
   depend upon how well the social determinants of attitudes and behaviour in individuals,
   groups, and society are addressed. It will also depend on how much parents are
   involved, and how young people friendly and young people centred the interventions
   are.

   The strategy is written according to the ten key priority areas for effective teenage
   pregnancy strategies suggested by the Teenage Pregnancy Unit at the Department for
   Children, Schools and Families. These are supplemented and expanded to reflect the
   local situation, the research evidence, and because the strategy covers more than
   teenage pregnancy.


2. National Context

   Positive sexual health and well being are key aspects of both Every Child Matters
   (2004) and the National Service Framework for Children, Young People and Maternity
   Service (2004). A range of indicators relate to the sexual and reproductive health of
   young people, including:

   • rate of teenage conceptions amongst under 18yr olds;
   • proportion of young people under 26yrs accessing Chlamydia screening;
   • proportion of services providing 48hrs access to genito-urinary health services.

   The National Strategy for Sexual Health and HIV highlights significant inequalities in
   sexual health and the link between social deprivation and sexually transmitted
   infections, abortions, and teenage conceptions. It reports that risk-taking sexual
   behaviour is increasing across the population and that chlamydia, genital warts and
   syphilis has increased in recent years.

    A national target for access to reproductive health care was proposed, starting from
   April 2007, to ensure access for all people requiring contraceptive services. Recent
   guidance from the National Institute for Health and Clinical Excellence (NICE)
   recommends that women should have access to a full range of contraceptive
   methods, including long action reversible contraception. It is also important to provide
   access to information about contraception and contraception to young men. Within
   Barking and Dagenham current services do not fully meet local needs, in particular
   those of young people both male and female.




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    Teenage pregnancy rates in the United Kingdom are among the highest in Western
    Europe. Teenage mothers have poorer antenatal health, have children with poorer
    health, have poorer health themselves and have poorer educational and financial
    outcomes later in life. Key risk factors for teenage pregnancy relate to social
    disadvantage and include poverty, living in a city, poor parental supervision, low
    educational expectations and lack of access to services.

    The Government’s Teenage Pregnancy Next Steps (2006), highlights the partnership
    nature of reducing teenage conceptions which remains a high level indicator for the
    National Health Service and Local Government. Reducing the under-18 conception
    rate by 50% (from the 1998 baseline) by 2010 is one of the Public Service Agreement
    (PSA).

    Historically funding for teenage pregnancy has been delivered through the Teenage
    Pregnancy Grant which is allocated on a proportional basis. However from 2009 this
    funding will no longer be ring-fenced and will form part of the general Area Based
    Grant. Funding and responsibility for provision of sexual and reproductive health
    services has remained a clinical service commissioning issue within the Primary Care
    Trust.

    The likelihood of not using contraception at first sex is higher in young people leaving
    school at 16. Overall, nearly 40% of teenage mothers leave school with no
    qualifications. Black and Minority Ethnic groups are over-represented in deprived
    areas. However sexual behaviour, knowledge and attitudes vary considerable within
    BME groups. Asian groups are under-represented whilst teenage motherhood rates
    are significantly higher amongst ‘Mixed White and Black Caribbean’ ethnicity. Non-
    use of contraception amongst different groups varies considerably. Non-use of
    contraception at first intercourse was most frequently reported among Black African
    males (32%) compared to 23% amongst Black Caribbeans.

    Associated risk factors include being the daughter of a teenage mother; mental health
    problems; being a Looked After Child; sexual abuse; and alcohol and substance
    misuse. Another target group is that of young people with physical impairments
    whose particular rights need to be considered under Every Child Matters.


3. The Local Picture in 2008

Barking and Dagenham has a growing proportion of children and young people. This
coupled with the deprivation that is present in the borough, means that young people’s
sexual and reproductive health remains a top priority for the Children’s Trust. A needs
assessment was commissioned in 2008 on the sexual and reproductive health needs of
children and young people and this is available as a separate document. The data on
national and local teenage conceptions is included as Appendix 2. Data on sexually
transmitted infections is included as Appendix 3.




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4. Principles

   The underlying principles of this strategy are:

   •   to work from a position of respect for young people;
   •   to recognise the diversity of young people;
   •   to work from the young person’s perspective, experience and needs;
   •   to build on the strengths of the young person;
   •   to recognise that services may be ‘hard to reach’ for young people rather than the
       young people being hard to reach:
   •   to support individuals within the context of the family;
   •   to target the social determinants of demand for, access to, and use of services;
   •   to balance promotional messages with preventive ones;
   •   to use behaviour change model(s) to underpin interventions;
   •   to work to change the attitudes and behaviour of individuals, groups, and society in
       settings convenient to them (schools, home, public environments).


5. Outcomes

   The strategy seeks to ensure that all young people will, free of coercion, discrimination
   and violence:

   • attain the highest standard of sexual and reproductive health;
   • avoid the unintended consequences of sexual activity, in particular teenage
     conceptions and sexually transmitted infections;
   • have easy access to young people friendly, good quality, sexual and reproductive
     health care services that are tailored to their needs;
   • be able to receive accurate information related to sex, relationships, and sexuality;
   • be provided with sex and relationship education that balances biological and
     relationship content, and has gender and sexuality specific delivery opportunities as
     outlined in DCSF guidance;
   • have respect for their own and their partners bodies;
   • choose their partner;
   • decide when, if and how to be sexually active;
   • have sexual relations that are consensual from first intercourse onwards;
   • be able to decide whether or not, and when to have children;
   • be able to pursue a satisfying, safe and pleasurable sexual life, without regret.


6. Targets

   • To reduce the number of under 18 conceptions by 50% by 2010.
   • To reduce the number of sexually transmitted infections.
   • To reach the screening targets for chlamydia.




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                                          Page 157
7. Links with Other Strategies and Policies

   It is vital that this strategy links with other strategies which have an impact on the social
   determinants of attitudes, behaviour and health. Of particular relevance are the
   following:
   • Integrated Youth Services Strategy:
   • Community Cohesion policy;
   • NEET Strategy;
   • Parenting Strategy;
   • Domestic Violence Strategy;
   • Attendance Strategy;
   • School Sex and Relationship Education policies;
   • Drug and Alcohol Strategy.

  Links with Quality and School Improvement, Integrated Family Services, Integrated
  Youth Services, Safeguarding and Rights, the Youth Offending Service and the 14-19
  agenda are fundamental to the effective implementation of this strategy.


8. Priorities

   Priority 1: Strategic leadership

   Preventing teenage conceptions requires coherent and interlinked activity between a
   range of children’s and young people’s services. In Barking and Dagenham we have
   reduced this to four main areas of activity with identified strategic and commissioning
   leads.

   Sex and Relationship Education

    Strategic Lead:            Head of Quality and School Improvement

    Commissioning Lead         Adviser, Personal Development



   Access to sexual health and contraceptive services

    Strategic Lead:            Joint Assistant Director of Health Improvement (Children
                               and Young People)
    Commissioning Lead:        Head of Public Health and Children’s Commissioner


   Targeted youth support

    Strategic Lead:            Head of Children's Policy and Trust Commissioning,
                               Children's Services
    Commissioning Lead:        Group Manager, Integrated Youth Support Services




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                                          Page 158
 Raising aspirations

  Strategic Lead:            Head of Skills and Learning

  Commissioning Lead:


 Support to parents

  Strategic Lead:            Head of Integrated Family Services

  Commissioning Lead:        Group Manager, Parenting Support


In order to ensure the implementation of this strategy, senior local leaders in the Council
and NHS B&D will:

• lead a multi-component programme which makes sexual health everybody’s
  business and promotes the benefits of working together to improve outcomes for
  young people;
• act as champions for the sexual health and sexual rights of young people;
• ensure sufficient resources are made available, targeted and quality assured;
• work collaboratively and pro-actively with partners from a range of agencies to
  ensure understanding and commitment to the strategy;
• ensure that front line practitioners understand why sexual health matters and their
  role in promoting it;
• establish the necessary structures, processes, systems, resources and support;
• use a needs analysis to commission and tailor services;
• be accountable to the Children’s Trust, reporting progress through the Integrated
  Youth Services and Integrated Family Services Boards;
• enlist the support of elected members.


Priority 2: Strong use of local data

We need good knowledge of local data to inform the provision of local services and
targeted action. We need to put in place robust systems across agencies to capture
and share information. We need to make strong use of local data to identify vulnerable
groups, monitor trends and evaluate the impact of interventions on outcomes.

In order to improve the collection, analysis and interpretation of data we will:
• establish good knowledge of local data to inform the provision of, services and
  targeted action on the social determinants of behaviour and health;
• undertake an annual needs assessment to ascertain risks and resilience factors in
  the population;
• conduct regular surveys to ascertain a baseline estimate of sexual activity,
  contraceptive use, sexual competence, the sexuality of local young people and
  satisfaction with services;
• use survey results to design accessible services and appropriate interventions;
• draw together local information and maximise links to data collection in relevant
  National Indicators;
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                                        Page 159
• map local data on population, risk factors, resilience factors and services and use to
  inform commissioning of services;
• compare uptake of services such as condom distribution and emergency hormonal
  contraception with access to these services and use to steer new interventions or
  modify existing ones;
• design a data set that builds on the teenage pregnancy monitoring data set and
  Includes qualitative and quantitative information;
• collect local data from abortion and maternity services for better targeting and more
  timely monitoring of progress;
• undertake research directly with young people to establish the impact of current
  services and development of new.


Priority 3: Communication of strong messages to young people, parents
and partner agencies

In order to change the attitudes and behaviour of young people we will:
• lead a communications campaign to promote sexual and reproductive health;
• work closely with schools, pupil referral units, youth services and other partner
   agencies to ensure local campaigns reach a wide audience;
• ensure local campaigns are developed in accordance with the challenges and needs
   of local young people;
• work closely with front line staff, especially health advisors in schools and youth
   workers;
• work in a pro-active way with the local media to influence messages to the local
   community;
• promote the use of RU thinking through health campaigns in young people’s settings,
   secondary schools the Pupil Referral Unit and colleges.

We will ensure that messages:
• are simple, clear, concise, consistent, and tailored to the various audiences;
• display positive attitudes to young people especially boys and young men;
• are given prominence at certain key times of year ;
• celebrate sexual well-being and sexuality;
• are communicated through a variety of media including the Arts and ICT;
• combat stigma and discrimination;
• clearly publicise services;
• are provided via a dedicated website www.youngpeoplefriendly.co.uk
• are based on the values and principles adopted by the strategy;
• are in line with national campaigns www.SexualHealthProfessional.org.uk




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Priority 4: Comprehensive Sex and Relationship Education in schools
and other educational settings

It is vital that all schools and pupil referral units have up to date policies on sex and
relationship education in line with the current legislation. All children and young people
need to be provided with relevant and appropriate SRE that enables them to develop
the knowledge, skills and attitudes to make positive, safe and responsible choices about
sex and relationships and to experience good sexual health.

Good quality, age appropriate, timely and holistic education about sex and relationships
is fundamental to enabling young people to make informed choices about their lives.
Delivered primarily in schools and other educational settings, through the PSHE spiral
curriculum and extended schools agenda, SRE will be delivered by trained and
supported professionals in a range of formats to engage young people. In line with good
governance arrangements there will be regular bi- annual audit of SRE undertaken in
partnership with schools which will inform the school improvement partnership and
relate to DCSF guidance, Ofsted indicators for Well-being and the validation of Healthy
Schools status.

All young people need to be provided with relevant and appropriate personal, social,
health and economic education (PSHE) which includes effective sex and relationship
education (SRE) that enables them to make positive, safe and responsible choices
about sex and relationships. We will support schools to:
• implement the innovative local Personal Development curriculum across all schools
   and pupil referral units ensuring at least an hour a week is devoted to it;
• ensure the personal development curriculum reflects statutory duties, DCSF
   guidance and the National Curriculum.
• tailor the Personal Development curriculum to enable vulnerable groups to access
   the curriculum;
• adapt the Personal Development curriculum as necessary for BME communities and
   young people with additional needs;
• ensure the Personal Development curriculum addresses the themes that emerge as
   concerns from consultation with young people, currently personal safety, respect,
   and worry about families.
• ensure PSHE/SRE is delivered in a way that does not alienate boys/young men or
   lesbian, gay, bi-sexual or trans-genda. This will mean moderating the biological
   focus, and may mean offering gender specific sessions;
• ensure PSHE/SRE is delivered by qualified and trained teachers (National PSHE
   CPD programme);
• offer information, advice and guidance for parents;
• ensure specific input from health advisers and school nurses to SRE teaching as
   agreed between the health professionals and PSHE team;
• use tools to audit and measure the impact of SRE teaching;
• conduct a Local Authority audit of SRE curriculum and teaching every two years and
   use this to inform the spiral PSHEE curriculum;
• support governors to improve SRE as part of their duty on Safeguarding and their
   new statutory duty to promote pupil well being.




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Priority 5: Trusted and accessible young people friendly contraceptive
and sexual health services

It is essential that young people friendly contraceptive and sexual health services which
meet re “You’re Welcome” quality criteria are universally available in each of the six
localities. Young people must have easy access to the full range of contraception,
including long acting methods.

In order to prevent a conception while having sexual intercourse young people need
access to contraception. Contraception comes in many forms including condoms, the
oral contraceptive pill and long acting reversible contraception (LARC). Access to
contraception should be easy, accessible and provided by trained individuals who can
undertake appropriate assessments in line with Fraser Guidelines and deliver to young
people information and education to enable the choice of the appropriate form and the
correct use of contraception to prevent unwanted conceptions, alongside information on
the prevention of sexually transmitted diseases. Access to contraception is also linked
to campaign and awareness of contraception and services which will be developed in
partnership with young people in the Borough by NHS Barking and Dagenham.

In order to ensure that young people can access services easily we will:
• commission adolescent health services which focus on improving sexual health and
   reducing under 18 conceptions and Sexually Transmitted Infections (STIs);
• ensure equitable access to sexual and reproductive health services across the
   borough reflecting population need and distribution.
• provide services at times and venues which are convenient for young people;
• provide materials which are suitable for all ethnic groups;
• provide comprehensive advice and guidance via our web site;
• provide a full range of contraception, including long acting methods;
• provide on-site health services in (or nearby) secondary schools and other
   educational settings;
• nest sexual health in a range of other services to reduce stigma, promote
   confidentiality and increase choice;
• provide services from non-medical settings such as the Foyer, youth venues,
   children’s centres;
• include proactive contraceptive provision and STI prevention in maternity service
   specifications, to prevent repeat abortion and births;
• ensure services are delivered to clinical guidelines from NICE;
• ensure services are linked to plans to improve access to primary care services for
   young people
• monitor access to services by gender, age and ethnicity, sexual orientation, faith and
   disability in line with the single equality framework.




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                                      Page 162
Priority 6: Targeted SRE and outreach with at risk young people as part
of targeted youth support services


We need to provide targeted work with teenagers at greatest risk and provide services
they can trust and access easily. We aim to reduce repeat births and abortions to
under 19 year olds by 50%.

Some young people will require targeted youth support which reflects their higher risk of
teenage conceptions. This targeted support should be delivered in a way which is
appropriate, engaging and matched to need. Youth workers should be supported with
specific training to enable targeted youth support to reduce unwanted conceptions and
promote use of contraception and the delay of first intercourse. Individuals will be
identified at risk through the implementation of the vulnerable youth risk tool that is
currently in development and through the CAF process.
In addition to providing sexual health and contraceptive services at locally accessible
venues we need to provide targeted support for young people in the following groups:
•   excluded pupils;
•   looked after children;
•   care leavers;
•   homeless;
•   young offenders;
•   teenage parents;
•   asylum seekers;
•   refugees;
•   from families experiencing domestic violence;
•   drug users;
•   with mental health issues.

We will ensure every locality team has a Targeted Youth Support Team. They will hold
caseloads of young people identified at risk. Their role will be to identify through the
CAF, the areas to target and engage the young person in a range of positive activities
including those resulting in accredited outcomes.

Delivered through the locality based teams we will:
• provide early identification of vulnerable young people and their needs
• develop personalised packages for interventions
• improve access to services in order to prevent escalation of problems
• empower vulnerable young people, their families and communities to bring out
  positive change.


Priority 7: Workforce training on SRE and sexual and contraceptive
advice in mainstream partner agencies

We need to ensure that all staff who work with young people are informed about sexual
health and the benefits of working together to improve outcomes for young people. All
managers and front line practitioners need to understand why sexual health matters and
their role in promoting it. All front line workers involved with young people must be
confident and competent to provide advice on sexual health and contraception.
Training will aim to develop positive messages for young people and positive attitudes
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to them. Speakeasy Training, which supports parents/carers and front line staff to talk
to young people about sex and relationships will be extended.
When appropriate, staff from health, education and the youth service will be trained on
PSHE/SRE together so that they can share their perspectives and approaches.

Workforce training will be included as part of the common induction programme for all
Council and PCT employees. It will include the following elements:
•        Stages of human development – physically and emotionally
•       attitudes to masculinity/femininity;
•       behaviour change theory, models and competencies;
•       the social determinants of behaviour;
•       sexual health;
•       sexual health services;
•       identifying high risk children or families.

Specific training on improving the sexual health of young people will be provided to the
following groups:
    •    school nurses;
    •    health advisers;
    •    PSHE/SRE teachers;
    •    social workers;
    •    foster carers;
    •    youth workers;
    •    family support workers;
    •    parent support advisors.

    The training programme will build on existing national or professional standards
    including:
    • National PSHE CPD programme;
    • Inter-collegiate Adolescent Health project;
    • Family Planning Association sexual health core competencies training programme
      for youth workers;
    • NICE Behaviour Change programme.


    Priority 8: Raising the aspirations and self esteem of young people

    The most recent “Tell Us” survey clearly demonstrated high levels of aspiration of our
    young people to go to progress to further and higher education. We need to support
    our young people to ensure these aspirations become a reality.

    The individual needs of every pregnant teenager, teenage mother and teenage father
    need to be assessed and an appropriate package of support put in place.
    We aim to ensure that 60% of 16-19 year old mothers are in education, employment or
    training by 2010.

    However for many young people, irrespective of their prior levels of attainment, a
    culture of low levels of aspiration and expectation still prevails. For some this
    translates into early, and then often extended motherhood – frequently exacerbated by
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a system of benefits militating against training or employment. In other families where
there is a limited history of access to further and higher education, perceptions based
upon social and cultural competencies result in a view that these opportunities are “not
for the likes of us”.

Together with our LAA partners we need to target the social determinants of low
aspirations by:

•   providing positive role models of young people;
•   improving careers education;
•   providing peer education programmes;
•   creating desirable and attractive alternative to parenthood at age 16/17 years with
    young people;
•   enhancing information, advice and guidance provided to young people;
•   integrating additional SRE interventions and wider health/emotional support to
    school progression and personalisation programmes;
•   focusing on young people at greatest risk of early sex and teenage pregnancy by
    using the risk register to identify cohorts of vulnerable pupils in year 8;
•   ensuring there are ‘significant adults’ to support vulnerable young people
    particularly at key transition points;
•   identifying families with multiple disadvantages (Think Family) and supporting
    them.

In addition, young people who identified as “at risk” will be matched to a mentor. The
current award winning Mentoring Service for Looked After Children is being expanded
and incorporated into the IYSS Service. This service has proven to be extremely
effective in raising aspirations of the boroughs most vulnerable young people and the
levels of attainment of this group has far exceeded all stated targets. Using the data
we have the young people who are at risk of becoming NEET or teenage parents will
identified and matched initially.


Priority 9: Support for Parents to discuss sex and relationships

Healthy parenting builds resilience in young people. We need to support parents to
discuss sex and relationships with their children in a confident way.

We will:
• provide evidence based parenting programmes in every locality to promote
  positive parenting;
• provide targeted parenting programmes for parents of teenagers (e.g.
  Strengthening Families, Strengthening Communities - 10-14yrs; Families and
  Schools Together - F.A.S.T)):
• provide targeted family support to individual parents;
• provide Speakeasy training to enable parents and front line practitioners to have
  open and non-judgemental discussions on sexual issues with children and young
  people;
• provide resources to help parents support their children;
• involve parents in discussions about their responsibilities and what services could
  support them;
• provide specific support for fathers;

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                                     Page 165
    •    disseminate Time to Talk materials through Family Information Services and
         Health services;
    •    integrate SRE into other parenting support programmes and community
         development work;
    •    help Parent Support Advisers in including sexual health prevention and promotion
         messages to parents and their children as part of building aspirations.


Priority 10: Strong Integrated Youth Services

The IYSS Service is organised into four overlapping sections. Each section will
incorporate the issues raised in this section of the strategy:

•       Youth Support and Development Service and Targeted Youth Support – Detached,
        intensive engagement, youth crime diversion, sports, volunteering. Youth centres,
        voluntary sector capacity building.
•       Information Advice and Guidance – Connexions, NEET interventions, counselling
        services, IAG centres across the borough.
•       Youth Commissioning – Teenage Pregnancy Services, commissioning framework
        for Integrated Services for young people underpinning the locality structures.
        Pooling all existing funding streams and resources, workforce development.
•       Mentoring and Support – development of the Mentoring Scheme staffed by
        volunteers. Trusted coordinators etc. Build self-esteem and confidence and help to
        move towards independent life with the five out comes of Every Child Matters.

As part of Targeted Youth Support and the implementation of Aiming High, we need to
commission aspiration building programmes tailored for young people most at risk.

We will:
• integrate additional SRE and contraceptive/sexual health services into the
  progression of services for young people;
• build additional SRE and contraception outreach work , into our positive activities
  programmes and street based work;
• train staff from other agencies/services on how, where, & when to relate to, and
  engage with associated young people;
• help other agencies to recognise and tackle the issues confronting young people
  and their families which result in teenage pregnancy and young people’s poor
  sexual health;
• act as the advocate for young people;
• offer attractive post 16 life alternatives through the roll out of IAG across the
  borough;
• provide support to teen parents, and on the Think Family agenda;
• support the voluntary and community sector to include effective SRE in the
  provision of services from young people;
• ensure Sexual Health Advice Services are based in places where young people go.
• provide outreach services via detached youth workers;




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Appendix 1: Definitions of Sexual Health, Sexuality and Sexual Rights

            Extract from World Health Organisation (WHO) Website

Working definitions
These working definitions were elaborated as a result of a WHO-convened international
technical consultation on sexual health in January 2002, and subsequently revised by a
group of experts from different parts of the world.
They are presented here as a contribution to on-going discussions about sexual health,
but do not represent an official WHO position, and should not be used or quoted as
WHO definitions.

Sex
Sex refers to the biological characteristics that define humans as female or male. While
these sets of biological characteristics are not mutually exclusive, as there are individuals
who possess both, they tend to differentiate humans as males and females. In general use
in many languages, the term sex is often used to mean “sexual activity”, but for technical
purposes in the context of sexuality and sexual health discussions, the above definition is
preferred.

Sexuality
Sexuality is a central aspect of being human throughout life and encompasses sex, gender
identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.
Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes,
values, behaviours, practices, roles and relationships. While sexuality can include all of
these dimensions, not all of them are always experienced or expressed. Sexuality is
influenced by the interaction of biological, psychological, social, economic, political,
cultural, ethical, legal, historical, religious and spiritual factors.

Sexual health
Sexual health is a state of physical, emotional, mental and social well-being in relation to
sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health
requires a positive and respectful approach to sexuality and sexual relationships, as well
as the possibility of having pleasurable and safe sexual experiences, free of coercion,
discrimination and violence. For sexual health to be attained and maintained, the sexual
rights of all persons must be respected, protected and fulfilled.

Sexual rights
Sexual rights embrace human rights that are already recognized in national laws,
international human rights documents and other consensus statements. They include the
right of all persons, free of coercion, discrimination and violence, to:
   •   the highest attainable standard of sexual health, including access to sexual and
       reproductive health care services;
   •   seek, receive and impart information related to sexuality;

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   •   sexuality education;
   •   respect for bodily integrity;
   •   choose their partner;
   •   decide to be sexually active or not;
   •   consensual sexual relations;
   •   consensual marriage;
   •   decide whether or not, and when, to have children; and
   •   pursue a satisfying, safe and pleasurable sexual life.
The responsible exercise of human rights requires that all persons respect the rights of
others.




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Appendix 2: Teenage Conceptions: National Data

Number of conceptions aged under 18 (1998–2007)
Region      1998    1999   2000     2001     2002     2003     2004       2005       2006    2007

England    41089   39247   38699    38461   39350    39553     39545      39804    39003     42918

London      6042    5975   6041     6210     6512     6467     6211       5863       5680    5686
B&D          156     180    216      215      236      220          209      193      184     203
Source: LAD1 and GOR report under 18 conceptions. 1998-2007

The following table shows the conception rates for the under 18s per 1,000 females
aged 15–17.

Conception rates –per 1,000 females aged 15–17 (1998–2007)
 Region    1998     1999    2000    2001    2002    2003   2004      2005     2006    2007

 Eng        46.6    44.8     44.8   42.5    42.6    42.1     41.5     41.3    40.4    41.7

 London     51.1    50.5     56.6   50.3    52.0    50.8     48.1     46.0    45.4    45.6

 B&D        54.6    61.2     67.5   63.6    73.3    71.9     71.8     64.5    59.6    60.0
Source: LAD1 and GOR report under 18 conceptions. 1998-2007

From the baseline year of 1998 to 2007 the national rate has decreased by 11% and
the London rate has also decreased by 11%. Barking & Dagenham’s percentage
change in conception rate since the 1998 baseline has increased by nearly 10%.
Barking and Dagenham has the highest rate of all North East London PCT’s (Hackney
and City of London, Havering, Newham, Redbridge, Tower Hamlets and Waltham
Forest).

The 2007 conception rate for Barking and Dagenham is still higher than England (41.7)
and the London average (45.6) but it is now at the same level as its statistical
neighbours. There are substantial differences by ward with a conception rate varying
from 28 to 101 per 1,000 for 2004-2006. The rates in Thames and Gascoigne wards
were nearly four times greater than those in Longbridge. However, 15 of the 17 wards
have rates above the national average for 2004-2006 (41.2 per 1,000)

In England and Wales the percentage of conceptions leading to abortion in 2006 was
48% and in 2007 was 50%. In London the figures were 61% and 63%. The
percentages in Barking and Dagenham were 57% and 52%.

In 1996 data was published showing the actual number of under 18 conceptions for
1998 to 2004, by region and PCT. Generally speaking there has been a time lag of
approximately 18 months before figures have been finalised. Between 1998 and 2006,
the number of under-18 conceptions in England decreased from 41,089 to 39,003 (5%),
but 2007 saw an increase to 42,918.

From 1998 to 2007, in London the drop was from 6,042 to 5,686 (6%) but in Barking
and Dagenham there was an increase from 156 to 203 (30% increase).


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                                      Page 169
Appendix 3: Sexually Transmitted Diseases


Chlamydia
In Barking and Dagenham the total number of Chlamydia cases has been rising since
2002. There were more infections amongst women but the number of men with
infections is increasing more quickly than amongst women. For those aged 19 and
under the increases were in line with the population as a whole. In 2006 there were 128
cases of Chlamydia amongst young people under 19yrs attending a sexual health clinic.

In 2007 the Chlamydia screening programme was rolled out for individuals under 26yrs,
in Barking and Dagenham there has been dual testing for Chlamydia and Gonorrhoea.
This will undoubtedly lead to an increase in detection of these sexually transmitted
infections because of screening, as both can be symptom-less in young women.

Gonorrhoea
There were a total of 1,218 cases of gonorrhoea across North East London in 2006 and
there has been a general downwards trend for this STI. However of the 85 cases in
Barking and Dagenham in 2006 approximately a quarter were found in young people
under 19yrs.

Syphilis
Syphilis is a less common STI however rates across North East London have been
increasing over the last three years. In 2006 there were 16 cases in Barking and
Dagenham but two cases were in under 19yr olds which is unusual.

Herpes
There has been little change in the rates of herpes across North East London in the last
five years and in 2006 there were 124 cases in Barking and Dagenham at the
Sydenham Clinic, of which 16 were amongst under 19yr olds.

Genital Warts
Genital warts are the most common sexually transmitted disease and there were 2,482
cases diagnosed in 2006 in North East London. 481 cases were diagnosed in 2006 and
of these 16% were amongst under 19yr olds in one centre in Barking and Dagenham.




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                                     Page 170
                                                                       AGENDA ITEM 12


               LSP sub-group: Healthier Borough Board

                              Forward Plan

Tues 26 May
2009              1.   Fit for Work Programme (Stephanie May)
                  2.   Experian Mosaic (Matthew Cole)
                  3.   Health and Well Being Strategy (Matthew Cole)
                  4.   PSB and sub-boards update (members)


Tues 28 July
2009              •    Health and Well Being Strategy (Matthew Cole – link
                       to Officer Group update)
                  •    Young People – Engagement on Health Issues
                       (Chris O’Connor)
                  •    Sexual and Reproductive Health Strategy for CYP
                       2008-13 (Christine Pryor)
                  •    Fit for Work Update (Stephanie May)
                  •    CAA (Adewale Kadiri, Audit Commission)
                  •    PSB and sub-Boards update


Tues 24 Nov
2009              •    Health and Well Being Strategy
                  •    Update on Fit For Work Programme (Stephanie May)
                  •    Performance (covering everything – delivery against
                       H&WB Strategy)

Tues 23 Feb
2010




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