Better Health and Physical Activity Tackling The Toughest Challenges in Calls 4 Action
UKRCS Clive Grace and Shana Thomas Public Health Wales Conference 1st November 2016
We know that in Wales:
Regular physical activity is key to better health 63% males and 54% females do 150 minutes a week Inactivity = 11% of coronaries, 13% Type 2 diabetes, 18% breast cancers Cost = £51m to NHS and £314m to economy annually, £57m from working age - death Reproduces health inequality Also a major effect on mental health and general wellbeing Some groups participate less than average, and especially poor people, BME communities, disabled people, and women and girls There are barriers of confidence and motivation, and of access, opportunity and experience How to tackle those challenges is much less understood and practised C4A aims to do that
2 C4A Devised and delivered by Sport Wales with Lottery support Positive action to address inequality; Change lives through sport; Encouraging new approaches; and increasing regular and frequent activity Reflects national goals of a healthier, more equal, and more resilient Wales Key ways of working are innovation, collaboration, and involvement Engages with a wide range of existing and new partners Focus on four target groups into regular and sustained sport and physical activity Operates through 20+ partnerships over 2-3 years throughout Wales. OUTPUTS Annual Target Progress Number of Participants impacted upon 11,404 9,904 Number of regular participants attracted 3,317 1,793 Number of new activities delivered/offered 415 712
Number of activity sessions delivered weekly 2,803 2,037 Number of New Coaches/Leaders developed 328 443
New Volunteers recruited/developed 265 219 3 Phase 2 Projects
Project based, aimed at new partners and innovative methods
11 Projects: - Brecon Beacons NPA - Rhondda Cynon Taff Homes - Public Health Wales (Aneurin Bevan) - Bridgend CBC - Mind (Time to Change) - Street Football Wales - Girl Guiding Cymru - Welsh Cycling Union - StreetGames UK Ltd - Welsh Gymnastics - Cricket Board of Wales
Focus Areas: Girls & Young Women Young people living in poverty (up to 24yrs) People with a disability People from a BME background
The budget commitment for the programme is £3million in total: £1.5million for Girls & Young Women £1.5million for Poverty; Disability & BME 4 Evaluation of the Programme
Based on innovative character. Evaluation of:
Phase 1 Impact (minor part of the overall evaluation - complete)
Phase 2 Process (minor part of the overall evaluation - this report)
Phase 2 Impact (majority of overall evaluation – this is the first interim report)
Longitudinal over 3 years, and in real time
Our role as evaluators – independent, but also to generate useful real time learning
5 Programme, Projects, Participants
Programme: Strategic Lens
Funders’ objectives Programme Impact Lessons learnt Projects Value Added
Projects: Community Lens
Participants Organisations’ involvement Existing data / evaluation review Data collection and analysis Criteria for selection Case study analysis
Participants: Individual Lens
Tracking of individual participants Self-reporting / Self-efficacy Longitudinal element Involvement of non-participants 6
The results and impact of C4A
The first Phase of C4A projects succeeded in widening participation, but through relatively less innovative partnerships and approaches. Phase 2 has been more innovative, and has applied the lessons of Phase 1. However, Phase 1 projects did contribute valuable learning on issues such as the engagement of health care professionals in sign posting disabled people to sport and physical activity. We assessed projects’ impact across a series of domains, including: Numbers of Participants Participants as individuals and within geographical and other communities The organisation delivering the Project Staff in and associated with the Project Professionals and their perspectives on sport participation and disadvantage Policy of project sponsors and/or significant others
7 Brecon Beacons National Park Geocaching Project Project Aims: Engage young people living in poverty and with low participation in sport and adventurous activity in recreation in the natural environment through the medium of Geocaching so they are ‘hooked’. Key project resource/cost: 2 x part time Project Officers. £75,000 over 2 years, £8,000 from BBNP and £67,000 from SW.
The project has relatively straightforward aims, and is generally meeting target numbers of youth leaders trained and participants booking places to experience geocaching. They have experienced a consistent high (50%) rate of cancellations between booking and planned group visit. This is attributed to the challenging and sometimes chaotic nature of the lives of some of the target groups. This gap has been partly off-set by a recognition of just how severe the problems are in connecting with some of the very disadvantaged young people in the target group, and the very positive impact the project has had on some particular individuals.
The project themes of social inclusion and health and wellbeing through recreation in the natural environment are mainstream NPA themes as reflected in the recently launched National Parks Wales Health and Wellbeing Positions Statement and the Social Inclusion and Child Poverty Strategies, and in the overarching NP Management Plan.
The governance of the project is integrated with that of the sponsor organisation, which resolves all the week to week management and accountability issues, but which may weaken sustainability unless the key project themes become ‘mainstreamed’ in BBNP itself.
The project’s ‘theory of change’ as reflected in the application continues to have validity, but should be consciously revised to include the learning about the impact on individuals, the difficulties of engaging with the target groups, the 8 gender dimension of confidence in outdoor physical activity, and the varying ease with which even slightly different age groups respond to the geocaching activity.
Time To Change Wales Project
Project Aims: To overcome barriers for those with mental health issues within a local population and to generate a legacy of organisation that can understand & address mental health stigma.
Key project resource/cost: Funding £104,000 (Marketing approximately 50%; set fund £8k for clubs projects).
The project has a dual purpose of supporting both individuals but also to raise awareness via its #wewearthesameshirt campaign. The national campaign appears to have gone well but not been aligned to local promotion as the numbers involved in the first 2 club tranches have been disappointing.
The very positive impact has been that once in, participants stay and are frequently active. In addition the project has had a great positive impact on most individuals in terms of mental health and the engagement of club officials.
WFT & MIND jointly led : MIND =marketing /network: Football =delivery element a learning process in working together. Data Development around empowerment/social inclusion /360 case studies/drinking & smoking rates.
Coaches have found that mental health can be challenging so more generic support is needed. Also locally targeted comms is required in the future. The health sector is a complex challenge for sports.
The project’s ‘theory of change’ continues to have validity, but should be revised to include the learning about the impact on individuals, the time involved in dealing with referrals from the medical sector and greater emphasis on the activities to drive up numbers else the vfm issue will loom large. The buy in from other clubs appears positive however the health sector needs to also to see that the well being benefits make a good contribution to its strategy. 9 Both of these points are crucial to the projects long term sustainability. Bute Gymnastics Club Project (in association with Welsh Gymnastics and Diverse Cymru) - SH Project Aims: To create a sustainable women and girls only gymnastics club in Butetown which is run by the community for the community, with a focus on ethnic minority females.
Key project resource/cost: Total Project cost £178,512 with C4A grant awarded £157, 089; grant funds part time Project Coordinator and Community Coach; WG investment funds head coach, research plus other investment of voluntary roles.
Project has clear outcomes and activities and in the main remains true to its application. It is hitting its targets and is at full capacity with a waiting list. Community engagement has led to clear ownership. The project had an existing pilot scheme in place. C4A enabled easier and quicker upscaling from after-school club to community gymnastics club.
The impact of the project has been far reaching – both intended and unintended. Clear governance structure in place (lead and project), undertaking own ongoing evaluation and conscious ‘exit strategy’.
There has been a lot of learning from the project which has been integrated as the project developed. Two key highlights:
Importance of understanding the barriers to participation within this focus area and to address them in an open and transparent manner
Partnership working is core and required investment of time and appreciation of different organisational cultures, working practices and roles. Note also the role of SW Case Officer as advisory and facilitation.
The project’s ‘theory of change’ as reflected in the application continues to have validity, although could consider 10 developing to reflect unexpected learning. Key will be ensuring the independence and sustainability of the club.
Key learning issues
Timing and pace: It has taken longer to achieve target numbers because of the need for thorough marshalling and engagement as precursors to effective participation by target groups. Predicted outputs: Have been met for the most part by most of the projects, indicating that at both project and programme level the ‘logic’ of this funding intervention has been largely sound. Participation: Sometimes been a ‘numbers’ shortfall - but also been evidence of very considerable positive impact on individuals experiencing multiple disadvantage and exclusion Value for money: Needs a stronger focus going forward. Governance and partnership: Effectiveness and sustainability closely related to the governance arrangements and the added value derived through effective partnerships. Different ways of working: Assess effectiveness with different target groups. Understanding barriers to participation, including age, identity, and group membership, ‘marketing’ and ‘tailoring’ the offer, ‘precision delivery’), and the conditions for confidence and trust. Demonstrate value: Especially to the work other agencies - collateral and difficult to measure benefits associated with their work, e.g. positive impacts on isolation and self confidence.
Structural change: Some areas of structural change may be needed to achieve the goal of major increases in 11 participation amongst the target groups, such as changes to the coaching curriculum.
Public Health Benefits of C4A
Project the outputs and outcomes of C4A Projects against key Public Health Wales research and documentation ‘Making a Difference’: C4A projects impact directly on improving physical health across obesity, cancer, diabetes, and coronary disease ACE (Adverse Childhood Experiences): C4A projects engage participants who have suffered themselves with one or more, and where being active helps improve lives Mental health: C4A projects are showing an impact on participants’ mental wellbeing, with some extraordinary individual stories Social and community engagement: C4A projects typically involve participants as members of teams and local sport or physical activity organisations
The task now is to develop, scale and sustain these activities, and to communicate their value to the public and to policy makers 12
Annex
13 Bute Gymnastics Club Project: Logic Model: Performance Metrics
Outcomes Project indicators Baseline data Targets Source of data Frequency Responsibility To develop and sustain a The continuation of 0 1 WG Club registration and Annually Project Coordinator women and girls club in the club following the diversity monitoring and then on-going Butetown area of Cardiff with end of funding and the (collected through Welsh through the Club the main focus on ethnic number of girls from Gymnastics Database of Committee minority females the community registered clubs) accessing provision The club run by the Community ownership No current club – Self-Sustainable Project reports (collected Annually Project coordinator community for the of the club with all pilot and all initial club run by the through Welsh followed by club community with the support decision and delivery decisions delivered by community with Gymnastics Registered committee with of Welsh Gymnastics made by the club Welsh Gymnastics support from WG Club records) support from the Welsh Gymnastics Community and Club development Officer Learning about how to Diversity and make-up Ethnic makeup of the To engage with and Feedback from Parents / Monthly Project Coordinator overcome the barriers to this of the ethnicity of Butetown community. have Gymnasts and community Club Committee participation group to be able participants in the club Questionnaires and representatives (collected through Welsh Gymnastics Research Officer to replicate the project in and utilization of the anecdotal evidence to from all ethnicities questionnaires and other areas. information to use in identify trends and within the feedback) establishing other best practice community clubs 14 Bute Gymnastics Club Project: Logic Model: Performance Metrics 2
Outputs Project indicators Baseline data Targets Source of data Frequency Responsibility Number of female participant Increase in BME females 24 510 Project records (collected through 6 monthly Welsh Gymnastics – that the project impacts experiencing gymnastics Club and session registers and (formally) project and staff upon project data members Number of regular female Increase in regular 24 376 Club membership data (collected Monthly Club committee participants accessing participation in BME through Club registers and WG Project coordinators provision females membership data base WG community officer Number new activities Number of gymnastics 1 3 Club and project records (collected 6 monthly Club coaches offered opportunities available to through project reports) the community Number of activity sessions Number of sessions 1 11 Project Records (collected through Quarterly Club Committee and delivered delivered in the club and Class registers, coach records) coaching staff the numbers participating Number of new Coaches and Members of the community 0 119 Project records (collected through Quarterly WG Workforce leaders to be trained and identified and trained to WG coaches data base development officer deployed run and support gymnastics Training records) Project Coordinator sessions Number of new volunteers Members from the 0 15 Project Records (collected through Quarterly Project Coordinator engaged and trained to lead community identified and Training records and attendance at committee meetings) the club trained to run the club 15 Bute Gymnastics Club Theory of Change Narrative
The intended ultimate outcome is to create a sustainable women and girls only gymnastics club that targets ethnic minority females from Butetown. The key activities seek to build a new, trusted partnership with Diverse Cymru, Mount Stuart School and parents to engage new participants and recruit/train new coaches and leaders. The intermediate outcomes and outputs are increased sustainable physical literacy specifically amongst young girls within BME communities achieved as a result of identifying and then overcoming the barriers to participation. One key outcome is the development of a ‘safe and acceptable’ environment that the girls (and parents) are eager to attend to be coached gymnastics. In turn, the girls have increased confidence and motivation which has wider impacts on issues such as health and more far reaching impacts such as reducing isolation within the BME community. Another intermediate outcome is the successful partnership and collaborative working built on developing an appreciation of different organisational cultures and ways of working and the establishment of a management committee for the club with positions filled by members of the community.
16 Bute Gymnastics Club Evaluation Project Assessment
Impacts on various dimensions Participants: Mums, Aunts & Sisters:
17 Bute Gymnastics Club Evaluation Project Assessment
Impacts on various dimensions Sport Wales Stakeholders
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