Dr Michelle Jones

Implemented by Southern Primary Health of Southern Adelaide Health Service and Murray Mallee Community Health Service

Program Evaluation for Program Evaluation for Healthier CommunitiesHealthier Communities

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EWBA Organisational ChartEWBA Organisational ChartEWBA Project Management

Committee

EWBA Evaluation Academic Team

Dr Jim Dollman

Dr Anthea Magarey

Dr Fiona Verity

EWBA Manager (1.0FTE)

EWBA Morphett Vale SPH:

Project Coordinator (1.0FTE)

& Admin support

Evaluation Coordinator(0.6FTE)

EWBA Murray Bridge, MMCHS:

Project Coordinator (1.0FTE)

& Admin support

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Guiding Principles and Values of Guiding Principles and Values of ewba Interventions and ewba Interventions and

EvaluationEvaluation

• Community Development Approach

• Capacity building

• Equitable

• Sustainability

• Cultural sensitivity

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• Aim: To contribute to the healthy weight of children, young people (0-18yo) through increasing healthy eating & physical activity

• Funded $1.5million over 3 years, by SA Dept Health

• 2 demonstration communities: • Metro: Morphett Vale (pop 24,000)

– Southern Primary Health

• Rural: Rural City of Murray Bridge (pop 18,000)– By Murray Mallee Community Health Service

Implemented by Southern Primary Health of Southern Adelaide Health Service and Murray Mallee Community Health Service

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Community Community consultationconsultation

1. What does the community look like?

– Mapping existing infrastructure, programs, policies & capacity

2. What does the community say?– Barriers to healthy eating & physical

activity

– Potential strategies to address barriers

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Consultations with:Consultations with:• Agencies

– eg local gov., welfare, housing, police, health

• Education sector – ie FDC & child care; pre, primary & high school

• Community members– eg school & kindy parent committees, new mother’s

groups, physical activity providers, F&V providers

• Aboriginal workers & community members• Children including

• Young peopleAboriginal students

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• Consulted with almost 500 people, in 36 sessions over 3 months

• Detailed data to inform development of locally relevant Action Plans

• Built awareness, support & ownership

• Early capacity building of stakeholders

• Identified key members for Advisory Groups & project ‘champions’

Outcomes of Outcomes of community community

consultationconsultation

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Community-Community-identified barriers identified barriers

to…to… HEALTHY EATINGHEALTHY EATING• Poor knowledge &

skills• High availability of

unhealthy foods• Poor access to water• Lack of policies• Commercial

advertising of foods• Cost of healthy foods• Facilities not

supportive of breastfeeding

PHYSICAL ACTIVITYPHYSICAL ACTIVITY• Lack of affordable

organised opportunities• Poor facilities/space/

equipment• Lack of parental time• High cost of involvement• Poor access to

facilities/spaces• Lack of/high cost of

transport• Parental safety concern• Public liability insurance

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Multiple sources to Multiple sources to inform Action Plansinform Action Plans

Community data ranked

Ranked barriers prioritised

Ranked strategies prioritised

Community refinement & endorsement

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Action PlanAction PlanPortfolioPortfolio

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InterventionsInterventionsMeaningful & diverse community

input+

Best available evidence framework+

Project guiding principles=

Well supported, feasible & locally relevant interventions

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Examples of InterventionsExamples of Interventions

• Development of physical activity and nutrition policies

• Infrastructure• Peer education and workforce

development• Community development• Promotion and marketing

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Peer education/leadershipPeer education/leadership

• ‘Active Foodies’

• ‘Eat Well’ peer leadership program

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Healthy School CanteensHealthy School Canteens

• ‘Canteen calendar’

• ‘Kids eat fresh in the canteen’ program

• Canteen support network meeting

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Drinking waterDrinking water

• Installation of Pura taps or classroom drinking water facilities installed

• Further drinking water facilities will be installed in coming months

• ‘Crunch & Sip’ fruit, veg & water break program launched

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Day Care & OSHC programsDay Care & OSHC programs

• “Playing for Life” physical activity workshop

• Start Right Eat Right training

• 2 Active Play train-the-trainer workshops

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Schools InitiativeSchools Initiative• Continued support for schools to join Active

After Schools Program. • Customised, individual school-based staff

healthy eating training workshops planned for various primary schools

• ewba School Support service continuing individual site support visits to help schools identify & address their priority areas

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High Schools InitiativeHigh Schools Initiative

• ‘In the Mood for Food’

• Nutrition Education Resource Expo

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Epistemological influences on Epistemological influences on evaluationevaluation

• Nutrition Sciences

• Physical Exercise Sciences

• Community Development

• Lived and experiential knowledge

• Evaluation knowledges

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EvaluationEvaluation FrameworkFramework

Media Analysis

– Content

& Discours

e

Qualitative

Interpretive

Quantitative Positivist

Schools Surveys Breastfeedin

g Friendly Sites

Student Survey – Nut & PA

Parent Survey

LDC Survey

FDC Survey

Anthropometrics – 4-5 & 10-12

yrs

Post box

Stakeholder

Interviews

Focus Groups

On the Spot interviews

Case Study Analysis Snapshot

Action - Reflections

Intervention Outputs

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Health outcome (weight)Health behaviours (PA & HE)Attitudes, knowledge, skills

1800 Yr5-7 (2 intervention + 2 comparison sites)

Direct measure & self report

Evaluation:Evaluation:

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Attitudes, knowledge, skillsEnvironment eg policy, physical,

sociocultural, economic

1000 Yr5-7 Parents, 4 sitesSelf report

Evaluation:

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Evaluation:

4 sites, self report:40 Primary schools

+ OSHC + Canteens10 High schools16 Pre schools

9 Long day Care38 FDC Providers

Attitudes, knowledge, skillsEnvironment eg policy, physical,

sociocultural, economic

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Evaluation:

Community capacityEnvironment eg policy, physical,

sociocultural, economic

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Evaluation:

Monitor project’s ‘context’ including

media

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Evaluation ChallengesEvaluation Challenges

• Quantitative measurement of health promotion project

• Matching ‘comparison’ communities• Statistically significant sample sizes• Comparison to National guidelines

and existing data• Short funding timeframe

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Evaluation Challenges con’tEvaluation Challenges con’t

• Multiple layers of evaluation data• Evaluation approach and methods

consistent with intervention values• Respect for competing

epistemologies• Ability to bring all of the components

and layers of evaluation into coherent whole

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What does this look like in What does this look like in practice?practice?

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In Murray BridgeIn Murray Bridge

• MMCHS – changes to morning tea• One R-12 school – significant rubbish

reduction since wrapper free lunch intro

• One Primary school reports difficulty in keeping up with demand for fresh fruit

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In Murray BridgeIn Murray Bridge

• Since introduction of fruit and water breaks - reports that the children least likely to bring fresh fruit are prioritising fruit purchase at canteen to participate

• Shoplifting issue at one school has seen preference for fruit over previously preferred junk food thefts.

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In Morphett ValeIn Morphett Vale• One primary school – no chips sold at all in

Term 1. Due to lack of demand chips have been taken off the menu.

• This same school has seen sales of spring water increase, sausage rolls sales have halved, sandwich roll sales have increased and they are now selling plain milk and have sold 100 in 5 weeks

• One HS commenced staff fruit club

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In Morphett ValeIn Morphett Vale

• Most schools have changed staff meeting catering from chips and chocolate to fruit, vegies and dips

• One PS has all teachers now providing daily morning fitness sessions prior to their fruit/veg/water break

• One R-12 school have prioritised healthy fundraising

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In Morphett ValeIn Morphett Vale

• 2 Kindies and one preschool have made definite changes to their fundraising – healthy food at events, no chocolate fundraisers and structure PA into existing fundraisers – one has developed an obstacle-a-thon for non-stop PA

• One PS has phased out all soft drink and lollies and introduced healthy options

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In Morphett ValeIn Morphett Vale

• Mission Australia Youth agencies have switched to healthier catering for their events and are developing a healthy eating policy to firmly establish the changes

• R-7 school with no canteen have replaced their once a week hamburgers and sausage offer with Subway. Also provides a fundraising aspect back to school

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