social marketing – Support from the Start

Piloting a Social Marketing approach to healthy eating at First Step Community project

The final report on the pilot of social marketing at First Step Community Project as a technique to influence health related behaviour change is linked below.

The following is the conclusion of the report

Conclusion: The pilot project has delivered on its four main objectives to: work collaboratively with parents to identify health issues, and approaches to address these; to make links with appropriate agencies and to share the learning gained from using a social marketing approach.

The impact of this pilot on behaviour change is less clear however this may have been due to the timing and methods used to gather this information, rather than a lack of impact. Small shift in behaviours that are not easy to quantify and measures have been observed by First Step staff who work closely with the parents and grandparents Whether this is directly attributable to the social marketing developments or is reflective a combinations of approaches used in and by First Step is difficult to determine.

Advantages of the social marketing approach were that some principles did direct the steering group to consider certain issues in more depth than they may have with other health improvement methodology. Examples of this were considering barriers and competition to healthy behaviours and the notion of an exchange value (giving up one behaviour for another had to have some value in it)

It was felt that a number of the principles, such as, customer orientation, segmenting and using a theory base were common to other approaches. However as these principles were described in new terminology there was some confusion as the group searched for new meaning or different principles behind the terms.

Social marketing is a valuable health improvement tool to be familiar with and can offer other organisations some unique principles to follow. It worked well within an organisation that; already worked alongside their clients in a partnership way; could support small groups with intensive developments and were familiar with similar approaches such as community development.

First Step Social Maketing Report

First Step – Cooking, Food and Health

Direct work with parents and carers in First Step has been going on since Sept 2011 in each of the four agreed goals of the social marketing group.

The main focus of work since January has been to support and build confidence with cooking and basic skills. Nine people attended food hygiene training in January which enabled staff and parents to take forward cooking demonstration sessions. To date sixteen people have participated in these sessions, getting involved in menu suggestions, sharing the preparation work and the sample the dishes.

At the last steering group meeting staff commented on the changes with some of the young mums. For example, they noticed during Yummy Mummies group time that some of the mums were looking at recipe books and discussing the meals – something staff said they had never witnessed with this group before. Other examples included the story of a young mum who previous didn’t cook at all and predominately ate take-away food. Since participating in the cooking sessions she has had friends/family over for dinner – which she cooked.

Recently the parents had a Bring a Dish day to celebrate their newly acquired skills and progress. They have also offered to cook a lunch meal for the Social Marketing Steering Group, which the group warmly welcomed.

Work has recently begun with graphics company Creative Link to develop a “Healthy Eating Keepsake”. This will be a printed folder, with recipes from parents and “Top Ten Tips” suggested by parents and carers designed onto the front of the folder. Focus groups to generate the Top Ten Tips will be conducted with First Step users and staff. The idea with the tips is that they are short pieces of advice around healthy eating – breakfasts, snacks, cooking or general parenting, mealtime and other eating issues, but very much in the parents and carers own words. The aim is to have the product completed and available by June so they can be given to First Step users at an end-of-term event.

The Steering group is now identifying ways to share the learning from the pilot project. One of the ideas is to present at the local Health Bites seminar.

A final report will be produced and disseminated widely including a link to it on this blog.

FOOD PRACTICES AMONG MOTHERS OF YOUNG CHILDREN

Want to know about the difficulties faced by some people in eating healthily? Then read the attached report on Food Practices among Mothers of Young Children by Dr Jeni Harden, Dr Adele Dickson, Ms Naomi Mason

Food practices among mothers of young children – a preliminary report

This report sought to develop an understanding of food practices in socio-economically disadvantaged families. There is a complex interplay between social constraints and individual lives which shapes food practices in the home. This study identified multiple, interlinking social factors which shape parents’ food practices and so which shape young children’s eating behaviour. At a societal level, effective policy and practice should therefore seek to address the wider contexts within which food practices are experienced by those living near to or below the poverty line. It is recognised that this is both a very long term goal and one that has proved challenging for successive governments therefore more focussed recommendations can also be offered from the main findings.

Parents have knowledge of healthy eating practices, but are restricted by their financial and social circumstances

All the mothers in the study had a sound knowledge of what food they ‘should’ be providing for their children. The limitations to practising this ideal were both financial and social. To address the issue of cost and time, more advice on preparing quick meals on a budget could be offered.

Children are not the passive recipients of food

The mothers described ways in which children, from a very young age, were are able to influence and sometimes dictate what food they were eating. Policy relating to healthy eating needs to recognise the role that children play, both in terms of children’s rights within the family, but also as part of the challenges faced by parents. More support around parenting strategies in relation to food may prove useful to parents. This could be addressed in the context of pre-school provision, working with both parents and children together.

Food practices are transmitted through generations

Most of the mothers described the ways in which their own childhood experiences with food had shaped their own practices as parents. However this awareness of the links to their own past, did not seem to alert them to the potential difficulties in maintaining a ‘do as I say not as I do’ practice in relation to food. Advice and services could be targeted to parents on the issue of their own diet in relation to the longer term implications for themselves and for their children.

The significance of age

There were little differences found in the study between the younger mums and the older mums. Most of the issues were shared across both groups and the age of the mother did not appear to be significant in shaping food practices.

First Step Social Marketing Project

GOOD FOOD, GOOD HEALTH

First Step Community Project with backing from Support from the Start are piloting a practical example of using a social marketing approach within a community based early years organisation. The aim is to develop capacity within a group of parents and grandparents to identify and respond to their community health needs in the early years. The project will utilise the expert knowledge of the parents and grandparents to develop appropriate intervention for health improvement. At an early stage the food and health was chosen as a focus.

Who’s involved?

We have worked with service user from various groups who attend First Step which has included our Young Mums Group (yummy mummies) grans group, me time group (mums from all the areas of the project), Wednesday Group (families affected by substance misuse), Dad’s Work, parents who use the playrooms and staff to try to identify and respond to community health needs in early years.

After an attempt to get a “voices” or champions core group together, we realised that at the early stage both staff and those in the community were uncertain and unclear about what social marketing meant.

Health Survey

To raise the profile of the project and to try to enter into meaningful debate with the all service users we then carried out a health survey. This was collated using Survey Monkey. In the introduction to this survey we brought together the gran’s group and the “me time “group for a discussion to give us an intergenerational insight into their thoughts about health. We also had a discussion with the young mum’s group. There were 55 respondents in total to the survey.

Once this was collated we brought the Me-time and Grans Group together again to discuss the findings from the survey. The discussions and feedback of this focus group was videoed.

Social Marketing

Around this time two members of the steering group attended a three day training course, delivered by NHS Tayside and the National Social Marketing Centre as part of the Scottish Government Social Marketing pilot. This training was helpful in understanding the principles and processes of the Social Marketing approach. The learning from this was shared by providing training to First Step staff during an in-service day.

Scrapbook Project

As part of a wider project Support from the Start were asking groups to complete a Scrapbook and take photographs in response to the question “Does the physical space of our communities contribute to creating good health in the early years and support parents in raising healthy children”? First Step participated in this activity with input from five families. A session was arranged with Jane, Tina and Morag from the Steering Group and parents who had taken part in this project. Various insights were gleaned from this process and the discussions that took place reflected common themes. The group successfully put together a scrapbook which was then presented at a wider community event.

Nutrition in Young Mums

Around the same time and independent of the Social Marketing project, Dr Jeni Hardin, Senior Lecturer at Napier University approached First Step to interview young mums as part of her research into nutrition. The findings from this preliminary research were presented to the steering group and copies of the report made available

Focus on Food

Information from the survey, focus groups, the Scrapbook and Dr Hardin’s research provided insight into local health concerns and informed the priority issue for the social marketing approach. The evidence from these scoping activities identified food and health as the focus for the social marketing project.

A New Concept

One of the difficulties about this project was that social marketing was a relatively new concept for staff, steering group members and First Step parents and grandparents. It has taken time to develop an understanding and agree how best to proceed. Additionally there have been changes and transition of staff within our organisation so it felt that we were always on catch up.

The initial proposal for a small group of First Step users to take this forward did not work because it was difficult to communicate what they were required to do. However in working this through in other ways we now have a core of parents who are interested in taking this forward.

Family Engagement

Unique to our approach was the involvement of the First Step families to identify the health concern in the first instance. Most other social marketing projects are set a health challenge from policy or research e.g. a “top-down” issue. It has been time consuming to reach this point however the steering group was comfortable with the “bottom-up” approach that we had to adopt from the start as it was in keeping with the underpinning social marketing principle of “customer orientation “.

Wider Involvement

The local community have been involved in all aspects as described above and based on the insight gained through this involvement it has been agreed that “food and health “ will be the issue to take forward and work with.

Next steps

Drawing from all the information we will be setting behavioural goals around food and health. We are finalising the statements to make them more user friendly, but the overarching goal will be to maintain and improve healthy food practices amongst First Step users. The draft sub goals are:

To start the day with a healthy breakfast
To replace one unhealthy snack a day with a healthy snack
To be able to cook more healthier meals on a budget
To be able to cook more meals from scratch
To learn to share parenting strategies around food and children
To understand the relationship between adult (parent) food practices and their children’s food practices

We plan to use participatory appraisal techniques to test the phrasing and interest in these behavioural goals. We are also considering what baseline information we need to gather. We hope to tie some of this work into the First Step 21st birthday celebrations. Following this the identification, development and implementation of “interventions” to achieve the behavioural goals will go ahead. The Steering group is considering appropriate means to map existing food and health activity, services and information.

Fact & figures

55 respondents to survey
20 Me time and grans focus groups X 2 sessions
9 yummie mummies focus group
8 young mums in research
5 Scrapbooks
Training for staff
5 young mums at Cooking Bus
12 staff attended in-service training on Social Marketing Approach

Financial report

The funds were allocated to:

Part of salary cost
Additional hours for other key members of staff.
Crèche facilities for focus groups.
Staff training

Scrapbook project

The logic model that guides the work of the test site in East Lothian has four short term learning outcomes. One of these is about the physical or built environment in the target communities and how well it supports children and families to lead healthy lives.

To develop a better understanding of this we have started a small project based on work we learnt about from the Equally Well test site in Glasgow city. The idea is to bring communities together with services responsible for the built environment in a dialogue that uses a common language. The planners in Glasgow City understood that the professional language they use about the built environment is not one shared by all, and tried to get round this by getting people to keep scrapbooks of images and thoughts about their communities – what was valued, what could be improved? In this way it was possible for the planners and the community members to have a more equal conversation.

We are asking parent and community groups in the Support from the Start target area to keep a scrapbook of their thoughts and views about their environment from an early years perspective. When the scrapbooks are complete we will hold a dialogue session and ask services and professional to come and view the scrapbooks and hear what the thinking is behind them. So far a preschool nursery, a parents group, a dads group and a community group are keeping scrapbooks if you would like your early years group to take part in this project let me know and I will arrange for you to get the scrapbooks and disposable cameras.

Steven Wray

Social Marketing and First Step

Social Marketing

Hopefully this will be the first of many blogs describing the developments of a practical example of the social marketing approach with First Step, a community based early years project in Musselburgh

What is Social Marketing? In a nutshell “social marketing is an approach used to achieve and sustain behaviour goals on a range of social issues”. It is based on marketing concepts and techniques but applies these for a “social good or purpose” rather than the sales and profit goals of commercial marketing.

Social marketing is not a theory itself but draws on familiar disciplines such as health promotion, community development, sociology etc and offers a logical planning process to help achieve behaviour change

There are a number of core concepts and principles underpinning social marketing and for more detail there are two very helpful websites to explore: the National Social Marketing Centre http://www.nsmcentre.org.uk/ and the Scottish version which is currently hosted at the following address http://www.socialmarketing-taysidetoolkit.com

What’s Happening Locally?

Social Marketing presentation to First Step staff in March
Steering group set up to oversee developments. This group will be reporting into the Support from the Start Planning Board. The steering group is chaired by myself and has membership from Health Visiting, Community Learning and Development, First Step, CHP Health Improvement Team and ELC Early Years and Childcare.
Initial scoping started with parents and carers that attend First Step
3-day Social Marketing training attended by two steering group members
Representatives from West Dunbartonshire Equally Well test site invited to the Steering Group to discuss their social marketing approach with tobacco use

Next Step

To support First Step users identify their priority health behaviour issues

For any further information on this development, please get in touch with Morag.nicholson@nhslothian.scot.nhs.uk or tel 0131 536-3535