Learning from practice

Karis Neighbours Scheme proposes to run an “Obesity and Well-being Project” as a pilot programme over a six month period. This pilot is one part of a much larger Ladywood Well Being concept which is currently being developed.
• A 6-session programme run by a dietician will teach people about losing weight, eating healthily, dealing with comfort eating, and exercise.
• Alongside this a programme of 10 sessions run by a dietician and a counsellor for people who have a significant psychological component to their obesity.

The latter will be for people identified by their GP; the first will be widened out to include people recruited through local community organisations. Participants will be encouraged to give each other longer term support through on-going self-help groups.

Evidence of Need
Based on National Audit Office data reported in 2001, 21% of women were obese (BMI>30) and 19% men in 1998. The prevalence of obesity in England has almost tripled since 1980. People in lower socio-economic groups have an increased risk of obesity. Dietetic data shows that on average 30% of obese adults have some form of disordered eating requiring psychological support.

No local provision addressing these issues is available.

The local GP Practice is concerned about the level of obesity amongst their patients and are therefore happy to refer their clients to us for these programmes.

The counsellor and dietician have recognised the need in some of their clients. They have discussed the possibility of a programme with them.

Karis Neighbour Scheme has been working with the population of Ladywood by providing befriending, practical tasks and advocacy, and sees many examples of well-being needs that they are currently unable to meet: relationship issues, low self-esteem, previous emotional trauma, excessive stress and obesity issues. We are seeking to provide a well-being project that addresses all well-being needs. This programme will form part of the provision to accomplish that vision

We have links to the Karis Medical Centre to refer patients, and access to the expertise to run the programmes

What we will do, where and how
1. Talk with local GPs to develop referral policy
2. Create programmes
3. Create evaluation for well-being change
4. Set venue and dates of programmes
5. Devise flyer to circulate to other organisations
6. Run 6-session (fortnightly) and 12-session (weekly) programmes concurrently.
7. Evaluate each programme and individual well-being change on last session
8. Create evaluation report for funders

Benefits and beneficiaries
• Increases support in communities for weight loss and management
• Creates greater skills & knowledge in the community around diet & exercise

Overweight people
• People with eating disorders, who tend to suffer from low self-esteem, depression, are often unemployed, and may have difficulty building relationships.
• The majority will be white and of African Caribbean in origin, with some Asian people ( on account of the local demographic factors)


Direct Beneficiaries
• 40 beneficiaries (12 in each of the 6-session programmes; 8 in each of the 12-session programmes).
• Found by referral from GP and advertising through the local Healthy Living Centre organisations.
• Short-term benefits – support while learning and losing weight; long-term – fitter, healthier lifestyles, raised self-esteem, on-going support to remain healthy, reduced risk of diabetes, stroke, heart disease, osteoarthritis

Ultimate Beneficiaries
• 100 ultimate beneficiaries: the families of the participants will benefit from the knowledge gained about healthy eating and exercise, as this knowledge is passed to them.
• Families will also benefit in the long-term by the improved self-esteem and the reduced disability of the participant, and through a reduced burden of care in families due to the obesity and associated health problems, such as osteoarthritis, stroke, heart failure, diabetes.

How local people are involved in planning, decision-making, or delivery
There are currently no services for this need in the area. Local people with obesity have been consulted on the need for such a programme and whether they would use it when they have come into the GP practice, or when they have consulted the counsellor or dietician. They will be further consulted when they become participants on what further programmes they need to improve their well-being.

A focus group is being drawn together to consult about well-being needs, venues, etc

How and when we will measure success
We will measure success by the numbers who come on the programmes; participants will be weighed at the beginning and the end of the programmes; each participant will complete an evaluation form in the last session, and the increase in their knowledge of healthy eating, exercise and the strategies to lose weight. Their change in well-being will be evaluated.

There is evidence that 10kg loss will make a marked improvement in health.

Costs Total £7660 (inc VAT)
• Counsellor: 68 hours including preparation @ £30 per hour £2040
• Dietician: 48 sessions at £115 per session including preparation , travel and management support £5520
• Advertising and admin support £100

Sustainability
Big Lottery funding is being sought to develop a more comprehensive Well Being project which will provide further programmes to address the well-being needs of the people of Ladywood.
We also propose to engage with the Practice Based Commissioning process of our 2 local PCTs with the intention of reducing health inequalities and promoting well being through this project. This may involve producing a business with the PCT and negotiations with a local GP practice regarding use of “freed up resources”.

The participants on completion of the course will be referred back to the nurse at their surgery who will provide on-going monitoring and support and will reinforce strategies they have learnt.

Capacity to manage and deliver the Project.
• Dietician: B.Sc, state-registered dietician
• Counsellor: PG Diploma in Counselling

There will be a contract between the two organisations and KNS will manage the finances. KNS have been the holders of funding for other organisations on several occasions.