Child obesity figures in Medway were roughly in line with England averages. The proportion for adults, however, was around 30% – compared to a national figure of about 24%. Medway council wanted to break this ‘pathway’. Instances of obesity were mainly concentrated in areas of high deprivation, where there was low social mobility with problems passing from one generation to the next. Medway Council were using MEND, a ten week programme for overweight children aged 2-13, which addressed food tasting, fussy eating, label reading and active play. However, rates of drop-off were also too high and referral rates too low.
How we approached it
Working to a tight timescale we did depth interviews with 50 parents and another 50 stakeholders – as well as focus groups with children across the age range. Applying our Values Modes approach using a ‘diffusion of innovation’ theory of change, we tried to understand where resistance to new ideas about healthy weight was coming from. We focused on estates in the six most deprived wards, where trust of the council and health professionals was low, and where local people were often mistrustful of interventions from outside the immediate community.
We found that the Settler values group was the most cynical about the council, and also disproportionately likely to have overweight children. The MEND programme was not resonating with them because referral pathways were too impersonal, courses were not local enough, and messaging focused on science- and health-based benefits, rather than happiness.
We set out a five step theory of change, incorporating wide approaches like social marketing, right through to specific process-driven innovations, such as suggesting the FLO at the child’s school broach the topic of weight, rather than someone from the council. This resulted in a restructuring of weight management services by Medway Council. A new scheme, built around values and designed to meet the needs of the hardest to reach, was piloted in 2016.