The Whitecraig Story

  The following has been written by  Maureen Black (Play Advisor)- hopefully other ‘stories’ about the impact of early years interventions will follow.

Lena & Maureen

‘Support from the Start’ is about ensuring that mainstream services are doing all that can be done to improve the health and well being of children and families in the early years of life in areas of East Lothian where there is a record of health disadvantage.

We will know we have succeeded if: –

1) if children and families are engaged with the key health improvement challenges,

2) parents can access support for healthy living when they need it,

3) parents and children have good quality child friendly environments, and

4)  those most at risk of poor health receive the most support

How did we tackle this in Whitecraig? 

First of all we had to look to see what was already in place for the families within Whitecraig.  There is a primary school, community centre, a shop, a Post Office and an hourly bus service to Musselburgh; the library bus also visits the school every second Friday.  The services offered by the community centre to families with young children had become depleted over several years and last year consisted of a Toddler Group meeting twice a week with 2/3 parents and 3 /4 children attending.  There were few toys and equipment and children spent most of the time running up and down the main hall screaming and shouting and seemed to constantly eat sweets and crisps and drink juice.  

I was asked by Lena Hutton to come up to observe and offer any advice that I could to help create a better atmosphere.  I came in and spoke with the parents and children and observed the group.  A stalwart of the group told me that once it had been a very busy group and there had been lots of activities going on but nobody seemed to come now.  (I couldn’t blame them to be quite honest).  However I did get the impression that to try and change this group I would be up against fierce opposition so I decided to offer an alternative that did not interfere with anything already offered.  As it so happened the school was having their 50 years open day in September and the community centre was being used for some of the entertainment.  So in consultation with Lena we decided to have some messy play sessions for the under fives.  This would hopefully let me meet and talk to other parents and carers in the village and find out if they would be interested in coming to a group in the centre.  The day was a success and several people expressed and interest in coming along.  It was decided to have six sessions from October to Christmas, every Friday morning in the centre.  Thus Stay and Play was created. 

It was a mad rush round to beg and borrow equipment however we managed to open the first morning with a good collection of toys and activities.  There were a few rules attached to coming to Stay and Play – the main one was as a parent or carer you had to stay and play.  Anyone with children up to the age of going to school could attend.  It would be £1 per family regardless of the amount of children. 

The first few weeks, even months were hard.  I felt I was tested in many ways.  My ‘stalwart’ had not come but managed to put spokes in the wheels from afar.  I was constantly questioned about ‘ the council’ was this something they were just doing for a wee while and taking away – as they usually did.  We had the odd person who tried to drop their child off. However as I turned up week after week barriers began to break down and numbers started to increase.  Everyone started to become involved – someone collecting the money, some making snack. *, Others cleaning and tidying the playroom, washing up, even holding and entertaining other people’s babies so everyone gets a little time to themselves to enjoy a cuppa.  On the register** now have fifteen registered parents/ carers and 22 children.  Not that everyone comes every week some weeks can be very busy and others only a few, we have mums, dads, grannies, aunties and a childminder everyone is welcome.  

A year down the line Stay and Play is very much a part of the community.  Why does it work?  I think it is because it is a safe controlled environment –when perhaps much of your life is chaotic there is an oasis of calm you can come to for a couple of hours a week and switch off.  There is always something to laugh about and people to laugh with you. Having a playleader has many benefits

·     Keeps the ideas fresh – always something different to do – creates activities that mean parent and child have to work together – however there is always paints etc if you want to be creative and many sit creating long after the children may have lost interest in the activity.

·     Its controlled by someone who is not part of the community- who does not sit in judgment and who treats everyone fairly.

·     Someone is there to ensure that everyone is included and involved in decision making

·     To discuss behaviour and other issues regarding child development ***

·     To give new ideas you can try at home

·     Just being there to listen and support or even just have a moan to or a blether with or to signpost you to other services.  To notice not just the children but the fact you have had your hair cut, or to ask how you got on a parent’s night. 

The best thing to happen is ‘my stalwart’ eventually decided to give us a try  and is now a regular and cannot speak highly enough of Stay and Play.

What other things have happened?

There is now a baby group on Monday morning.  This was supported by funds from NHS Lothian Community Health Grants.  This has focused on the 0-2 age group but has been mostly populated by the 18month to two-year age group.  The group has benefited from input from the play workers simply for the reasons highlighted above and it is envisaged that this will continue for some time yet.

A playgroup has opened two morning a week, ten places, and is just about to open for another morning after the Easter holidays to accommodate the ever increasing waiting list. 

The children are involved in Childsmile and brush their teeth after snack every morning.  We have been offered the garden at the church next door so children can be out more in the fresh air. The children are offered a health snack every morning. 

This is the story of the centre but there is also the story of the people and the impact on their lives, their children’s lives and of their futures.  If we are to have an impact on these families it must be from the very start. 

Notes

*Snack – in the beginning although we stressed snack was provided – parents still came with juice, crisps etc three and four year olds were still drinking from baby bottles.   Now a year on we have toast, milk, water and lots of fruit – no constant grazing. Young children drinking from cups not bottles.  Parents have time to sit down and have tea/ coffee and toast together.  The children all sit together at one big table and are learning lots of skills that will become invaluable to them in life.  The first being sitting at a table, sharing, enjoying the company of others – it is a lovely sociable time for everyone. 

** Register – at first we started with three or four families and then numbers started to increase by word of mouth – the only way we advertise.

*** Child Development – there is no tag of parenting skills attached to Stay and Play however indirectly lots of problems are handled and dealt with in the playroom.  The play leader dealt with situations in a positive way and be it by example or through discussion issues can be dealt with.  However being is such a positive environment children quickly and easily learn what is acceptable.  Parents and carers have the opportunity to have positive interaction with their children and this can only help their relationship to develop.  Lots of praise is encouraged and this includes lots of positive interaction with the parents and carers too.

Health Inequalities seminars

The NHS Lothian Health Promotion Service organises a regular seminar on health inequalities. The details for the next one are below – it may be of particular interst as it has a local star – Lena Hutton –  as one of the guest speakers.

Community Health Development Grants

 Grass roots innovation for change-

tackling health inequalities in local communities 

Tuesday 27th April 2010

12.30pm- 2.30pm

 Chair:             Tracy McLeod, Senior Health Promotion Specialist

 Speakers:

Midlothian:     Liz Hare, Cecilia Rose, Brenda Marr, Pentland House Citadel Arts Group

East Lothian: Lena Hutton, Whitecraig Community Centre ABC Group

West Lothian: Janet Wood, Community Learning & Development, West Lothian Council

Edinburgh:     Hayden Kilpatrick, The Junction: young people health & wellbeing

 For many years NHS Lothian Health Promotion service has offered Community Health Development grants to community groups and projects to develop work based on community development principles.

 The principles of community development approaches to health include:  

  • Community participation
  • Collective action
  • A holistic approach 
  • Addressing inequalities
  • Collaborative work between agencies
  • Addressing discrimination

This seminar will give you an opportunity to hear about some of the work that has been developed across the Lothians.

 Midlothian – Citadel aims to improve the mental health and wellbeing of frail elderly through reminiscence work

East Lothian – ABC brought together some young parents who had already expressed an interest in their child’s health into a more structured group, where they could become informed, trained and empowered

West Lothian – Free ears is a youth group who formed to support each other cope with difficulties faced at school, particularly in relation to mental health and wellbeing.  They developed a DVD on the stigma and discrimination to be used in staff training and CPD to raise awareness of the issues some young people are facing. 

Edinburgh -5 a day young people’s way: involved young people in exploring health using participatory action research & documenting this using photography.

 Please contact Linda Head to book a place

Tel:  0131 536 3505. Fax:   0131 536 3501
Email: linda.head@nhslothian.scot.nhs.uk

New wave

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Afternow is a new and well presented website with a number of thoughtful discussion and presentation on public health themes. It is linked to Glasgow university

 What’s next for the health of society?  In this introductory video Phil Hanlon highlights a number of daunting challenges for public health in the 21st Century.  He explains how what might be called the dominant mindset of the modern age can be characterised by its ability to understand, predict and control the natural world – an approach which was subsequently extended to the social world.  In Public Health, this ability led to a number of  ‘waves’ of health improvement in the period since the Industrial Revolution, many of which remain with us and are important for health today, even though they peaked in effectiveness some time ago.  However, we now face emerging problems such as depression and anxiety, obesity and a number of other addictive behaviours – problems which are not amenable to the ‘understand-predict-control’ approach which worked in the past.  And in the context of modern society the earlier waves of health improvement now seem to provide diminishing returns. Phil suggests that modernity itself may have reached its peak and may now be declining, which leads him to conclude that a new public health ‘wave’ is needed, but that this will need to be more radical than anything that has gone before. 

 

 Dr Hanlon is an interestng and insightful speaker – so worth a view

 Get started by watching video one “New Wave” »

Professor Phil Hanlon and Dr. Sandra Carlisle

University of Glasgow, Glasgow G12 8RZ,

For further information contact: Sandra Carlisle on 07812465104, email s.carlisle@clinmed.gla.ac.uk

Vulnerable Families Pathway Project

NHS Quality Improvement Scotland have been leading the development of the Vulnerable Families Pathway Framework which aims to ensure that vulnerable children (from conception to age 3) and families in all parts of Scotland receive equity of support that is proportionate, effective and timely.

 

The objectives are to:

• Develop a multiprofessional and multi-agency framework for pregnancy and early years to implement or enhance local pathways of support for children and families with additional needs.

• Support the delivery of GIRFEC as the common approach to ongoing seamless assessment and care planning from pregnancy through the early years within a multiprofessional and multi-agency context.

• Develop guidance to support a consistent approach to meeting the needs of children and families.

 

What the framework does:

The framework draws together the available evidence and gives clarity of application.

 

The framework ( draft-framework1) is now out for consultation. The consultation period is from Monday 8th March 2010 – Friday 11th June 2010. Please take the time to read and consider this framework and send your comments, as an individual or a group of professionals. Comments can be sent using the feedback template to vulnerablefamilies.qis@nhs.net or via an on-line survey which can be found on our project website http://www.vulnerablefamilies.org/.

 

In East Lothian, if you would like a hard copy of the draft framework please contact Pauline McLaren, pmclaren@eastlothian.gov.uk , 01620 829947

Growing Up in Scotland

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Growing Up in Scotland (GUS) is the research study following the lives of 8,000 children and their families from birth through to the teenage years.

 

The focus of interest in the study lies in the characteristics, circumstances and experiences of Scotland’s children in their early years and subsequently through to adolescence. The main areas to be monitored and evaluated will be:
• childcare,
• education
• social work
• health
• social inclusion

 Growing up in Scotland has an annual event to launch new findings from the first four years of the study. Details of this years free event are below :-

 

Date: Thursday 29th April 2010

Time: 9.30-1.00

Venue: Hilton Edinburgh Grosvenor (2 minutes walk from Haymarket

Station)

 

This event is free to attend.

 

Topics:

* Health inequalities in the early years

* The circumstances of persistently poor children

* The social, emotional and behavioural characteristics of children at entry to primary school

* Maternal mental health and its effect on child development

 

Who should attend:

Anyone working with and for young children and their families.

 

For more information or to book a place, please follow this link:

http://www.crfr.ac.uk/gus/events.html

 

Link to venue:

http://www.hilton.co.uk/edinburghgrosvenor

 

For more information about GUS please visit:

http://www.growingupinscotland.org.uk/

Who should pay?

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A couple of weeks ago I was persuaded by my wife and daughter to give up a Saturday to go to Glasgow and demonstrate against cuts in Education services.  ‘No if, no buts, no education cuts!’

These days demonstrating about anything is not my preferred way of using a Saturday – but my wife appealed to my paternal instinct, by saying that it was likely to be the only way that we would see our son who is currently studying at Strathclyde university when he is not demonstrating against, or occasionally for, something or other.

As it happened I met not only my son and his girlfriend but a couple of old university friends. These were people who I had been on many a demonstration with in our youths – Maggie, Maggie, Maggie – Out -Out – out. Like me they had been stirred to marching once again after twenty years  of immersion in family and work. Two of them are curently teachers and one a civil servant married to a teacher.

The demonstration was polite and extra-ordinarliy quiet by the standards of my youth – giving lots of time to catch up on mutual acquaintances and reminisce about by-gone times.  Eventually we talked about what it was that had drawn us out of our normal weekend activity to once again demonstrate – even though we all had a sense that it was a somewhat futile effort. They were all motivated by a sense of injustice that ordinary people were being asked to pay for the mistakes of the super rich in our society. A feeling that I admit I share but wouldn’t have acted on if it weren’t for family persuasion.  The demonstration organisers had adopted a slogan along the lines of  ‘Why must our children pay?’ and it seemed to hit the mood of the people who were marching.

I had intended to duck out of the speeches at the end of the demonstration and head to a restaurant with son and his girlfriend – but was out voted – as they  all wanted to listen. In a passionate speech the EIS speaker picked up on the theme of  ‘Why must our children pay’ for a crisis that was remote to all but a very small minority. She attempted to undermine the logic that says the national debt incurred in bailing out the banks has to be paid for by reducing public services – stating that how it was paid for was a matter of political choice. She ended by saying that this demonstration was only the start – but notably failed to say what came next. It maybe that the sense of injustice, which turned out ‘the old farts’ to demonstrate, may just drive the next steps rather than politicians and union leaders.

Who should pay – history tell us  it is most likely that ordinary people will pay the most – but does it have to be that way?

Homestart – civic conversation invite

 

Homestart

We’d like to welcome you to a networking opportunity to exchange information about issues and processes around Mental Health.

Those of us who work within agencies supporting parents of pre-school children, would benefit greatly from this ‘conversation’, in order to be better informed about issues and challenges within Mental Health resources.

We hope you’ll take this opportunity to meet various agencies, including Mental Health professionals, at the Early Years Centre, Sanderson’s Wynd, Tranent, on Wednesday 31st March 2010 at 12 – 2.30pm with lunch provided.
RSVP 01875 616066

 

 

The Power of Routine

The Scottish Public Health Observatory highlighted this longitudinal survey in a recent e-bulletin

“The Early Childhood Longitudinal Study finds that pre-school children in USA with the 3 household routines of regularly eating the evening meal as a family, obtaining adequate night-time sleep, and having limited TV viewing time, had a 40% lower prevalence of obesity”.

Thats a big difference and certainly more to my knowledge than has been achieved in designed interventions to reduce obesity – even than the EPODE programme in France

 

 

The following links will give you more information on the study

News article: http://news.scotsman.com/health/A-traditional-family-routine-may.6053741.jp
Online journal publication:
http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-0417v1?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Sarah+Anderson&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

What I couldnt get from this information was an analysis of why some families value such routines and why some others don’t.

 The danger with type of research is that it can be another moralistic ‘health stick’ to beat people with. It puts the onus for change on parents without looking at the context of peoples lives.

In the same way the EPIC longitudinal survey of adult health behaviours in Europe also seems to put the onus of change on individuals. The implication is that if you do certain things and don’t do others your chances of living a longer life with less disease improve significantly – the responsibility is yours. Its very easy too come up with a moralistic answer as to why some people don’t engage in the right behaviours for health?

Dr Harry Burns gave the following summary of the EPIC findings from a study by Ford et al Arch Int Med 2009 at a presentation at First Step in Musselburgh. The figures on the right are the percentages by which people who engage in four healthy behaviors are less likely to suffer the disease category on the left than people who don’t have the four healthy behaviours. The figures in the brackets are the range. Hence if you can stick to the four healthy behaviours you are 78% less likely to have any chronic disease than someone who doesn’t.

  4 healthy behaviours

Any chronic disease                 78% (72% to 83%)
Heart Attack                             83% (47% to 93%)
Stroke                                       50%  (-18% to 79%)
Diabetes                                   93% (88% to 95%)
Cancer                                      36% (5% to 57%)

On one level the Early Childhood Longitudinal Study above is really saying something that I believe the vast majority of parents already know and or have been told at some point:-

  • sharing mealtimes is a good thing
    a bedtime routine is a good thing
    too much tele / computer is a bad thing

Perhaps studies like this can help some people to prioritise these behaviours by quantifying what the consequences of not doing them might be.

That said I firmly believe that relying on information alone can make services sound moralising, which will disengage people from the information we are trying to communicate. We need to start from a wider view than the change we want people to make by asking question like.

What is it that supports parents to ‘get it right’, how can service’s build on that?

What is that puts barriers in the way of ‘getting it right’ and how can services help remove them?

Healthy Start

 

With Healthy Start, you can get free vouchers every week which you swap for milk, fresh fruit, fresh vegetables and infant formula milk. In theory you can also get free vitamins. Healthy Start replaces the Welfare Food Scheme. The vouchers have to be taken to a participating retailer – the website has a list of the retailers searchable by postcode.

It is a means tested benefit that an applicaton form has to be filled in for – part of which has to completed by a health professional – it can be applied for online

Have never been keen on means testing as a method of targetting – probably because I have some not very fond memories of standing in the free school meals queue at Sedgefield Comprehensive. Aside from the stigma issue with means testing I would argue that it is often an inefficient way of doing things – creating large bureacracies in order to establish entitlement and then police the system, and by so doing limiting the take up of the very people that are being targeted. (The only evidence on uptake I have been able to find so far suggests that it is similiar to the welfare food scheme it replaced at around 55% of the potential beneficiaries.) Hence, other people have also to invest time and effort in advising and supporting people to make claims – a quick internet search will reveal the level of confusion about healthy start vouchers – who is entitled, how do you make a claim who fillsi in the form and so on. See Emma’s diary Netmums

Having said that a means tested scheme for supporting early years nutrition for pregnant women and parents on low incomes is better than no scheme.

One of the distinctie features of this scheme is the availability of vitamin supplements. However, I am aware that there has been some difficulties with the supply of vitamins The website has the following to say about the vitamins available on the scheme

Why are vitamin supplements important?

You will get most of the vitamins you need if you eat healthy foods. However:

  • your young children may not get enough vitamin A, C and D from their food
  • pregnant and breastfeeding women may not get enough vitamin D or folic acid which may harm their baby

 Ask your health visitor or midwife where to get the free vitamins for you and your children. Take the letter attached to your vouchers with you to claim your free vitamins.

 The Healthy Start vitamins are also for sale at some NHS clinics.

Over the next week will contact all the pharmacies in the Support from the Start target area to ask if Healthy Start vitamins can be obtained and if not why not. I will post the result of this survey here.

Steven Wray