Health Promotion Action 2018-2019 Year in Review Directors Report Welcome to another year of the Central Coast Health Promotion Service’s work and achievements.
Each year our annual report focuses on a theme approved, fifteen presentations at conferences or principle that underpins our work. Previous and seminars, one journal article accepted in the editions have focussed on partnerships and Health Promotion Journal of Australia, earned advocacy. This year is all about how we research two Central Coast Local Health District (CCLHD) and evaluate our work, and how we are growing Quality Awards, and submitted four projects the capacity of our team in this area. to the 2019 Premier’s Awards and NSW Health Quality Awards. Health Promotion has a strong track record in evaluating our work to ensure we are delivering To continue to evolve and improve our the most effective and efficient health promotion capacity in research and evaluation, we have projects. On display is a demonstration of how prioritised significant professional development Health Promotion Action the team integrate this into all projects - with all opportunities and sought out new partnerships 2018 - 2019 the challenges of ‘real world’ evaluation, where to further strengthen the skills we have across there often has to be some creativity and lateral our whole team. Year in Review thinking to achieve the outcomes we aim for. It has been another busy year as we evolve with I invite you to read about our flagship research shifting priorities and challenges. However, Central Coast Health Promotion Service project - Thirsty? Choose Water! - which aims as always, the Health Promotion team has to encourage young people to swap sugary responded with the energetic passion, Level 1, 4-6 Watt Street drinks for water. This project has grown from the commitment and professionalism that continues Gosford NSW 2250 seed of an idea initially piloted on the Central to define our approach. I thank the whole team Coast, then tested in Illawarra Shoalhaven sincerely for their hard work and hope you enjoy T 02 4320 9700 Local Health District, before being awarded reading about the contribution we make towards F 02 4320 9725 Translational Research Grant Scheme funding improving the health of the Central Coast for two years to be delivered in 61 schools community. healthpromotion.com.au across three Local Health Districts. Following successful implementation, this project has now Further copies of this document can be downloaded from the secured further funding to test the approach in Health Promotion Service website. two regional Local Health Districts through the Medical Research Future Fund (MRFF). Director We have significantly increased links with our Health Promotion Director, Nicole Kajons - photo by Gina Stuart Research Office and have been very busy in and Population Health Improvement disseminating our work. Over the past 12 months Central Coast Local Health District we have had six quality improvement projects
Nicole Kajons | 4320 9704 | [email protected] 3 Contents
Healthy Eating Active Living Thirsty? Choose Water! 6 Activate Your Space 8 The Active Over 50 program – a 2 year follow up 12 Implementing Routine Growth Assessment of Children 14 Munch & Move/Move like a Mariner 16 Go4Fun 20 Live Life Well@School 22 Central Coast Healthy School Canteens 24 Personal Development, Health & Physical Education (PDHPE) Network 26 Central Coast School Garden Interest Group 28 Be Well, Teach Well 30 Future Directions for Physical Activity - a qualitative investigation 32 Get Healthy Information and Coaching Service 34
Alcohol Alcohol Sales to Minors 36
Tobacco Reducing smoking in pregnancy 38 CCLHD’s smoke-free by-law 40 Quit smoking support from financial counsellors 42 Smoking cessation support in mental health 44
Falls Falls Are Preventable – 65+ living independently in the community 46
Research Partnership Projects SWAP IT 48 PA4E1 51 PACE 51 Short & Sharp NSW Healthy Food and Drink Framework 52 COHEAL 52
Health Promotion Website 54 Publications, Presentations and Major Committees 56 Awards and Research & Quality Improvement Projects 58 Our Team in 2019 60 Students were surprised at how much sugar was in drinks. After the lessons more students could identify how long it takes to “walk off” a can of soft drink (90 minutes) and identify the effects of dehydration by checking the colour of their wee!
After one year more than 167,196.5 litres of water was consumed from the 31 chilled water stations. This would overflow a 6-laned, 25m swimming pool.
Thirsty? Choose Water! A Translational Research Grant Scheme (TRGS) Research Project After intervention, the percentage of students who reported carrying a water bottle every Why are we doing this? Shoalhaven and South Western Sydney Local day increased from 50.93% at baseline to Health Districts (LHDs). It is now being offered 54.01%. A proportion of students reported Can a behavioural intervention and chilled water in 2 regional areas for 2019-2020 – Mid North stations, alone or combined, increase water Coast and Hunter New England LHDs. a decrease in Sugar Sweetened Beverage consumption and affect changes in students’ consumption at home and after sport. knowledge, attitudes or consumption of Sugar Achievements Sweetened Beverages (SSB) in year 7 secondary • 61 schools from 3 LHDs took part in the school students? research project The Thirsty? Choose Water! research project • All 61 participating schools now have chilled promotes drinking water by installing chilled • Some schools recorded over 20,000 water off’ a can of soft drink (90 minutes) and the water stations installed water stations and providing supporting bottle refills effects of dehydration on the colour of their wee! • Over 60% of year 7 students completed the education in secondary schools. It aims to • Water is the drink of choice on a daily basis online survey Partners increase students’ water consumption and for most young people surveyed displace or reduce Sugar Sweetened Beverage • School Immunisation Nurses were engaged • South Western Sydney Local Health District • In the intervention group, a statistically (SSB) consumption. from the 3 LHDs to support the ‘drink water’ significant reduction in the daily consumption • Illawarra Shoalhaven Local Health District message in the 15-minute waiting period after How did we do it? of SSB was seen from Time 1 to Time 2. • Secondary schools in the 3 LHDs vaccination by providing pull up banners and The project is a randomised controlled trial and a board game for students to play • An increase in the number of students who • NSW School Infrastructure – Hunter Central uses a two by two factorial study design to see reported carrying a water bottle every day Coast, Illawarra and South West Sydney if education alone or combined with providing • Website material was added and updated to • Most teachers found the lessons and chilled water stations makes a difference to reflect information needed by the schools to • Thirsty? Choose Water! Advisory Group resources ‘very useful’ or ‘useful’ and would secondary students knowledge and behaviour in support the research teach the content again. For more information, go to: regards to their water and SSB consumption. • More than 365,000 litres of water were • Students knowledge increased after the www.choosewater.com.au The project has been offered to secondary consumed from 31 chilled water stations after lessons: for example, more students could schools across the Central Coast, Illawarra one year correctly identify how long it takes to ‘walk
6 Contact | Justine Gowland-Ella | 4320 9705 | [email protected] 7 Figure 1
Monthly Participation at Central Coast parkruns 2018-2019 Monthly Participation at Central Coast Parkruns 2018-2019. 1200
800
400 Number of Participants
0 Jan- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Feb Mar Apr May Jun Jul 19 San Remo 466 966 1006 461 406 446 353 442 629 327 376 443 546 526 582 432 351 431 325 The Entrance 769 594 767 509 509 483 458 425 606 301 568 705 874 665 730 640 540 531 398 Woy Woy 712 524 878 445 465 623 654 548 535 449 427 471 448
Activate Your Space
Why are we doing this? How did we do it? Infra-red people counters and onsite visual • Proportion of participants by age-group, observations were used as objective measures to postcode, and estimated physical activity Does reactivating under-utilised outdoor space A literature overview provided insight into determine if parkrun contributed to an increase level. increase physical activity opportunities, and lead strategies to increase the use of outdoor space, in overall pathway traffic: to a more physically active community? participation in physical activity, the concept • Comparison with attendances at other of ‘place making’, and the use of infra-red • Infra-red sensors recorded the daily number parkruns Activate Your Space aims to increase physical of pathway users by time of day for 12 technology. Parkrun successfully attracted the intended activity in local communities by encouraging months. Sensors were installed on the San target group: the use of outdoor environments. The project Stakeholder consultations within the San Remo shared pathway and a comparison targeted families with children aged 16 years and Remo community helped to assess both the pathway at Chittaway Bay. • 43% of participants were from the 2262 and under living in the North Wyong postcodes of community interest in participating in a weekly 2263 postcodes. Another 38% were from • Onsite visual observations counted the 2262 and 2263, and in particular, those who are parkrun event and the best site to host a nearby 2259. insufficiently active. parkrun. Partnerships were formed with parkrun, number of people by sex, estimated age, the San Remo Neighbourhood Centre, and transport mode, time of use, and whether • 26% were young people (<=17 years) and 44% Phase 1 of Activate Your Space involved starting Central Coast Council, which facilitated the people were alone, in a group, walking a were 30-49 years (likely being children and a weekly parkrun event at San Remo, using implementation of the San Remo parkrun and its dog, or pushing a pram. Counts occurred parents) the existing shared pathway which hugs the seasonally on 8 separate occasions between ongoing promotion. • 71% were estimated to be insufficiently active picturesque Budgewoi Lake. December 2017 (baseline) and December Marketing activities included: at registration. Parkrun is an organisation that offers free 2018. weekly 5km walk or run events in 360 Australian • Social media promotion on Facebook and Monthly participants ranged from a minimum Achievements - parkrun locations. The parkrun model was considered Instagram. of 327 in October 2018, to a maximum of 1006 favourable for Activate Your Space because Outcomes for parkrun were measured by in March 2018. Participation appears to be • Promotional flyers delivered to over 7000 it has proven sustainability, high participation, analysing data from parkrun participants to largely influenced by the weather, with higher homes in San Remo/ Blue Haven (2262). encourages community connectedness, and is examine: participation in warmer months. Other Central open to everyone. • Cross promotion of parkrun at the PDHPE Coast parkruns follow a similar pattern. • Number of weekly participants Network and Go4Fun program in Blue Haven.
8 9 Figure 2
Monthly Participation Traffic by Infra-Red Count over 12 months San Remo (intervention) and Chittaway (comparison) Shared Pathways
Achievements – pathway traffic Strengths Pathway usage at both San Remo and Chittaway • Stakeholder consultation gains local Bay fluctuated similarly, with increases during knowledge and support school holidays and decreases in colder weather • Infra-red sensor count gives accurate trends (except July). See figure 2. of pathway traffic At the 12 month follow up, there was a small • Objective and qualitative measures combined increase in overall pathway usage at both San adds depth to results and future directions Remo and the comparison site. The unexpected increase at the comparison site was likely due to Look out for… the installation of a new children’s playground in July 2018. Future work will explore other initiatives to increase outdoor space usage and may include: A total of 1720 pathway users were observed on assessment of playground usage, follow up the 8 separate observation days. Walking was physical activity profile of insufficiently active the most commonly observed transport mode parkrun participants, implementation of parkrun (58% of pathway users), followed by cycling in other locations, and installation of exercise (33%). equipment along the San Remo shared pathway. A more detailed pathway usage report of the Partners infra-red monitoring and observed counts is available from the Health Promotion Service. • parkun This evaluation suggests that increasing the use • Central Coast Council of outdoor space requires multiple strategies. • San Remo Neighbourhood Centre
10 Contact | Gina Stuart | 4320 9702 | [email protected] 11 The Active Over 50 program
Why are we doing this? Strong partnerships and collaboration changed Achievements • Assessing the types of classes that are the physical activity landscape on the Central currently on offer For two decades, Central Coast older adults Coast. This included the Health Promotion After careful consideration, the Health • Surveying former Active Over 50 instructors enjoyed the benefits of Active Over 50. This Service and Fitness Australia, the local fitness Promotion Service decided that the Active Over to assess the proportion of former Active physical activity and falls prevention program industry, fitness instructors, GPs, allied health 50 program was sustainable enough to continue Over 50 classes remaining was initiated and coordinated by the Health professionals, registered training organisations, independently, and ceased coordinating the Promotion Service between 1996 and June and other fitness industry educators. The result program in June 2017. Providers of Active Over Look out for… 2017. It offered over 100 organised physical was a reputable and effective program, strong 50 classes were given 12 months’ notice to activity classes each week in 30 venues, and local fitness industry infrastructure, a skilled prepare for the transition and were encouraged The findings from this follow up will be used to was delivered collaboratively with fitness centres workforce specifically trained to deliver older to continue their classes. Providers were also inform future physical activity initiatives for older and fitness providers in the community. Classes adult physical activity, and a demand for older encouraged to register their classes on the NSW adults by examining: included aqua fitness, ballroom dancing, gentle adult physical activity in fitness centres and Government ‘Active and Healthy’ website, a free • the number of former Active Over 50 classes exercise, strength training and tai chi. Annual community venues. website that promotes physical activity classes still available attendances peaked at 58,000 in 2009. Over for older adults. this time, the program evolved and improved By December 2015, an audit showed 14 centres • new providers of physical activity for older It is now two years since the Health Promotion into a product of high demand (67%) provided physical activity classes for older adults adults - 38% offered Active Over 50 classes, Service transitioned out of the Active Over • reasons why classes may have ceased or How did we do it? and 29% offered ‘non’ Active Over 50 classes 50 program. An evaluation was conducted to continued (older adult classes without the support of the determine the ongoing sustainability of the When the program first started, falls prevention Health Promotion Service). It was evident that program by: • use of the ‘Active and Healthy’ website and physical activity programs for older adults the demand for organised physical activity for were non–existent, particularly in fitness • Completing an audit of organised physical older adults was strong enough to motivate centres; specialised fitness instructor training activity classes for older adults currently some fitness centres to offer classes without the was lacking; and availability of physical activity available in Central Coast community venues support of the Health Promotion Service. programs into which allied health staff could and in fitness centres refer clients was limited.
12 Contact | Gina Stuart | 4320 9702 | [email protected] 13 Implementing Routine Growth Assessment of Children
Why are we doing this? Health Promotion staff were active members Look out for... in the Premier’s Priority Childhood Obesity All children who receive care from CCLHD Steering Group, which directed and supported Health Promotion will continue contributing to facilities are required to have their growth this work. the Implementing Routine Growth Assessment assessed on a routine basis. This allows staff to in Children project, in partnership with CCLHD identify when a child is above or below a healthy Achievements clinical teams. weight, and offer parents/carers advice, support • Development of family friendly resources and referral to other services. Partners including the ‘How tall am I’ chart • Central Coast Kids and Families How did we do it? • Development of clinical resources including • Nutrition Services CCLHD In partnership with CCLHD departments, Health the Model of Care Service Directory, to Promotion developed resources for clinical support staff when reviewing and responding • Oral Health Service teams and parents/carers. This aimed to assist to assessment of growth in children • CCLHD Premiers Priority Childhood Obesity clinical staff in providing supportive care with • Partnership between Health Promotion and Steering Group guidance for where to refer patients and their CCLHD clinical teams to provide locally families as needed. Family friendly resources also tailored resources, in response to identified encouraged the family to seek ongoing support needs by using a local service directory.
14 Contact | Nina Kingon | 4320 9721 | [email protected] 15 Munch & Move
Why are we doing this? The NSW Office of Preventive Health (OPH) four per cent of the Central Coast’s Munch and high schools to participate in the staff provides training for educators, resources, and & Move services have adopted at least 65% wellness evening ‘Be Well, Teach Well’ The importance of the first 2000 days of events such as conferences and Healthy Menu of the practices, which is 4% above the key • Three Cooks Network meetings were held life (conception to age 5) to a child’s health Planning workshops. The Health Promotion performance indicator target for the state. with up to 15 service cooks at each meeting throughout their lifespan is now well recognised. Service supports this locally with: In November 2018, 13 participating services It is a critical time for cognitive, social, emotional Look out for... and physical development. However, statistics • local workshops were acknowledged at a special 10 year anniversary breakfast. These services had been demonstrate that almost one in four Australian • consultations with services on practice • Munch & Move training is now available self- active participants in Munch & Move since the children are overweight or obese by age 5. achievement paced online. We’re aiming to have more The early childhood education and care sector beginning of the program in 2008! educators trained using this resource. • Cook’s Network meetings provides an ideal setting to provide much of More than 50 services requested our Munch & • We will be encouraging more services to have the physical activity and nutrition that children • menu and policy reviews Move transition to school resources, including their menus reviewed by Nutrition Services require. healthy lunchbox information and a storybook, • development of local resources Current Australian guidelines are for children 1-5 and a games card to encourage families to get Partners • local promotion of OPH organised events active every day. years of age to be physically active for at least • CCLHD Nutrition Services 180 minutes every day. However, a recent study Success is evaluated by the number of services Training offered: • NSW Office of Preventive Health of childcare services in the Illawarra area of NSW achieving the 16 practices, participation levels found that children move for less than 20% of in local activities and participant evaluation • The Healthy Eating and Active Play • Local Health Districts their time in care. This reinforces the project’s surveys. Conference in March was attended by • Central Coast Early Childhood Education and aim to support childcare services in promoting 42 service directors and lead educators Care Services and providing opportunities for physical activity. Achievements representing 34 Central Coast services • Central Coast Early Childhood Educator’s The level to which Munch & Move is established • Forty-four cooks and directors from 28 How did we do it? Network on the Central Coast is reflected by the high services attended Healthy Menu Planning Munch & Move is a state-wide program with participation rate and the proportion of Munch workshops • TAFE NSW Ourimbah Campus local support. It provides a framework of 16 & Move practices that are adopted – 130 of the • Thirty-five educators and directors from practices addressing physical activity, healthy Central Coast’s 139 services (94%) are currently • Ngiyang Child and Family Health Service 22 services joined teachers from primary eating and screen time for services to achieve. actively participating in Munch & Move. Sixty- NSW Department of Education
16 Contact | Jeff Smith | 4320 9765 | [email protected] 17 Move Like A Mariner
A local highlight this year was the successful running of a joint initiative with A-League football team the Central Coast Mariners. The 6-week ‘Move Like A Mariner’ program addressed some of the Munch & Move physical activity practices, particularly around having daily opportunities for fundamental movement skill development. Thirty-four services from across the Central Coast participated with 1918 children actively huffing and puffing as part of the project. Each participating service received new physical activity equipment sponsored by the Central Coast Mariners. One hundred and seven early childhood educators attended the Move Like A Mariner training workshop, and 80% of services reported doing the Move Like A Mariner activities every day of the 6-week program. Surveys conducted pre- and post-program demonstrated that: • educator confidence to teach fundamental movement skills rose from 35% to 97% • participation in daily physical activity rose by 30% Feedback from services included:
“Thank you. A great initiative supported by both government and local sporting identities to have our children being more active and being of healthy mind and body”.
“Thank you for letting Explore and Develop Wamberal be a part of the Move Like A Mariner program. It provided educators with new ideas of fundamental movement skills and engaging activities for the children”.
Services can’t wait for Move Like A Mariner to run again. We’ll be enhancing the resources and welcoming more services in the second year of the program, which commenced in August 2019. Partners • Central Coast early childhood education and care services • Central Coast Mariners
18 Contact | Jeff Smith | 4320 9765 | [email protected] 19 Overall, digital marketing and radio were the • Go4Fun was hosted by a local primary school most successful strategies. Facebook promotion for the first time appeared most successful when ‘organically’ • Integration of Go4Fun with other health shared ie posted by a local organisation to their promotion projects was achieved. online community. • 790 children have participated in Go4Fun • equity and strategic distribution of over the last 8 years programs - there are greater proportions of children above a healthy weight in areas of • Among Central Coast children attending the disadvantage. In consideration of this, six program between term 1 2017 - term 2 2019: of the seven Go4Fun programs delivered - 68% of participants increased the number in 2018/19 were held in areas of greatest of days that they met the National Physical disadvantage: Blue Haven, San Remo, The Activity Guidelines Entrance, Woy Woy, and Berkeley Vale. Programs were also distributed across - 64% of participants decreased the geographical areas of the Central Coast, frequency of sweet snack food making the program more accessible to consumption families. - 60% of participants decreased the • partnerships - new partnerships aimed to frequency of confectionary food increase reach, awareness and registrations consumption for Go4Fun: ‘We loved Go4Fun. My kids really looked - Schools as a host venue: School led forward to it every week.’ - Kelly advertising and promotion via social media, newsletters, flyers, word of mouth, ‘My job as a mother became much easier parents/carers association, and electronic due to this program’ - Inga noticeboard. - Cross-promotion: A partnership with Look out for... parkrun promoting a flyer and location • Aboriginal Go4Fun, to be delivered in specific Facebook group. partnership with Yerin Aboriginal Health - Clinical staff: GP packs distributed Services and in-services conducted to Oral • Continued communication strategies Go4Fun Health, Physiotherapy, Paediatrics and including radio, digital marketing and MMS Occupational Therapy within CCLHD. messaging Why are we doing this? How did we do it? • integration - Go4Fun promotional activities • Launch of a new state-wide Go4Fun website Go4Fun is a free 10 week healthy lifestyle This year has had a strong focus on improving were integrated with current school health program available to children 7-13 years of access to Go4Fun for Central Coast families via: promotion activities, for example at PDHPE Partners age who are above a healthy weight, and their • innovative promotional activities - the CCLHD Network meetings, joint presentations to • Central Coast Primary Schools families. Go4Fun encourages children to develop Go4Fun Campaign focused on encouraging school staff and, via the SWAP IT program. healthy habits, fosters families learning together, • Community organisations healthy lifestyles, family participation and and supports parents/carers to provide healthy Achievements fun, and included advertising on radio, • Children and families home environments. Facebook and digital marketing. The two key • Digital display and radio were identified as the • CCLHD clinical staff On average, children who completed the objectives were to: most successful media strategies to increase program achieved statistically significant reach, awareness and registrations. We will • Office of Preventive Health - increase awareness and reach use this information to guide the promotion improvements in self-esteem, increases in • parkrun vegetable, fruit and water consumption, and - increase registrations of other HPS projects. increases in physical activity.
20 Contact | Nina Kingon | 4320 9721 | [email protected] 21 Live Life Well @ School
• Transition to school resources are offered to Why are we doing this? • Q4:H2O, to promote water as a drink to year 3 with local schools, Local Health District staff, all schools to provide to families of children and 4 students and the education sector. The review will Since 2008, the Live Life Well @ School program starting school the following year. look at the program’s aims and objectives, has supported primary schools to enable and • How RU travelling?, to encourage physical • New infographics with healthy eating and desirable practices, branding, resources, and promote healthy eating and physical activity activity, healthy food and active travel to physical activity messages are emailed to ways that technology can be used to facilitate to students and their families. The state-wide school to year 5 and 6 students program is delivered through the NSW Office of schools each term for distribution to families implementation. Preventive Health, and aims to: via the school newsletter or Facebook page. Transition to school resources continue to be well utilised, with 50 schools distributing over Partners • Additional resources are also offered, • get more students more active, more often 3,000 of each resource to parents of children including playground stencils and gymnastics • Central Coast Primary School Principals and starting school in 2019. • improve healthy eating habits equipment to borrow, and Crunch&Sip® and staff Fruit and Veg Month resources. How did we do it? As a result of ongoing review and feedback with • NSW Department of Education teachers and parents, two new resources were A variety of professional learning opportunities Achievements developed: • Central Coast School Education Region and resources are offered to schools: Workshops and resources were provided to • Make Their Meals Count- a series of photos of • Broken Bay Diocese Catholic Education • Regular professional development workshops support schools to adopt the 11 state-wide Live meals and snacks which demonstrate how to Commission Life Well @ School practices. Central Coast and network meetings including the PDHPE feed a child healthy foods over the day • Association of Independent Schools Network and Central Coast School Garden schools continue to meet these practices which • How will you get active today?- to encourage Interest Group for teachers, as well as the promote healthy eating and physical activity, • NSW Ministry of Health and enhance student’s fundamental movement children to become more physically active Central Coast Canteen Network for canteen • Office of Preventive Health managers. Workshops are registered to skills. New infographics were produced each term and • Local Health District Live Life Well @ School provide NESA professional development Health Week activities were conducted by emailed to all primary schools on healthy eating, project officers points. 47 schools in term 2, 2019. Resources were physical activity and screen time. These are regularly used in school newsletters. • All schools are offered curriculum based distributed to over 10,000 students, including: • Nutrition Service CCLHD health activities as part of an annual • Vege Adventure, to promote fruit and Look out for... • Healthy Kids Association ‘Health Week’ in term 2. These stage-based vegetables during Crunch&Sip® break for The state-wide Live Life Well @ School program programs include student cards to complete, kindergarten, year 1 and 2 students background information and teacher guides, is under review in 2019 with a view to implement and information for families a new model in 2020. Consultation is underway
22 Contact | Jane Whatnall | 4320 9714 | [email protected] 23 Central Coast Healthy School Canteens
Why are we doing this? How did we do it? • providing subsidies to become members Look out for... of the Healthy Kids Association, enabling School canteens have been identified as a We supported school canteens by: canteens to gain access to valuable resources Ongoing support for school canteens will be critical component in influencing the decisions provided in the year ahead, to continue the • evaluating their menus and providing and information students make with food and drink choices. fantastic work that has happened over the past feedback on areas of improvement • providing primary and secondary schools with 12 months. We will continue to encourage all From the ‘What NSW Children Eat and Drink’ • providing funding incentives for canteens to local recognition through the Central Coast Central Coast school canteens to lead the way in report published in 2017, it is known that: purchase equipment that would help them Healthy Canteen Award helping students make healthier food choices. • only 1 in 20 children (5%) eat the improve the food and drink choices available Achievements recommended amount of vegetables daily to students Partners In the past 12 months the Central Coast has • 1 in 2 children (50%) are eating unhealthy • holding Canteen Network meetings for both • Nutrition Services CCLHD accomplished 75% of public primary schools and snacks everyday primary schools and secondary schools, to 60% of public secondary schools achieving the • NSW Healthy Kids Association provide opportunities to network with others • nearly 1 in 2 children (45%) regularly NSW Healthy School Canteen Strategy. about a range of canteen related topics • NSW Ministry of Health consume sweetened drinks. Four Canteen Network meetings were held for • supporting the Central Coast Canteen • Central Coast Canteen Managers We aim to work with school canteens to primary schools, with a total attendance of 79 Managers Facebook group to allow easier increase the number of healthier food options across all 4 meetings. Four meetings were held • Central Coast School Principals communication and collaboration between available. This work is guided by the NSW for high schools, with a total attendance of 36. and with canteens • P&C Staff Healthy School Canteen Strategy. Thirty-one primary schools and 10 high schools • NSW Menu Check Service were represented at Canteen Network meetings over the year.
24 Contact | Chad Partridge | 4320 9716 | [email protected] 25 Personal Development Health & Physical Education Network
(PDHPE)
Why are we doing this? How did we do it? • Term 1 2019 - our own Chad Partridge Look out for... The Central Coast Primary School PDHPE Being an advocate for healthy eating and demonstrated how to incorporate physical More exciting and engaging opportunities to Network aims to provide quality professional physical activity, the Health Promotion Service activity in cross curricular subject areas like learn from other high quality presenters will be development opportunities for local schools to provides opportunities for educators to literacy and numeracy. provided in the year ahead. The PDHPE Network up-skill teachers. These are provided across all participate in regular workshops facilitated by • Term 2 2019 - a different approach was taken will continue to strive for excellence in providing areas of the K-10 PDHPE syllabus, particularly highly regarded and experienced presenters: with a very engaging presentation by Dr the best opportunities to not only help our in physical activity and healthy eating. • Term 3 2018 - Pam Williams, a registered Darren Morton focusing on the wellbeing teachers succeed but also to benefit students on Data from a small sample of school principals Ausdance Safe Dance instructor and current of teachers. Darren shared strategies that the Central Coast. in the NSW School Physical Activity and teacher at NAISDA Dance College, facilitated teachers can use in their daily lives to feel Nutrition Survey 2015 (SPANS) shows that a very energetic and creative urban dance their best, and spoke about how this can help Partners teachers in the classroom. 89% perceive that a lack of expertise among workshop. Pam broke down the components • NSW Department of Education Curriculum teachers is a barrier to the delivery of physical of dance and showed how to teach these Achievements Support activity and development of fundamental within the PDHPE syllabus. movement skills. The PDHPE Network aims to Over 130 individual teachers from over 50 local • NSW Department of Education School Sports • Term 4 2018 - the Departments of Education’s address this barrier. schools attend at least one PDHPE workshop Unit School Sports Unit presented an introduction over the past 12 months. and practical session surrounding their iPlay • NASIDA Dance College program.
26 Contact | Chad Partridge | 4320 9716 | [email protected] 27 Central Coast School Garden Interest Group
Why are we doing this? How did we do it? Achievements Look out for... The NSW School Physical Activity and Nutrition Two after-school meetings are held each year, Term 4, 2018 meeting: Many schools run cooking sessions with their Survey 2015 (SPANS) shows that approximately with a different school hosting and showcasing students, often using produce from their garden. • 18 teachers from 13 schools attended the 40% of schools have a school garden. These are their school garden and program. Guest A recipe book collating recipes from local meeting hosted by Narara Public School generally set up and maintained by enthusiastic speakers provide information on topics of schools is currently being compiled to share with teachers and students. For some schools, the interest. • Tour of Narara Public School garden and a this group. establishment of a school garden has extended discussion on the school garden plans Participants are surveyed after each meeting to to a whole of school commitment, by linking the Partners determine the usefulness of the presentations, • Guest speaker: Dave Grant, a horticulturalist garden to: ideas for future topics, and any resources from Bunnings, ran a Q&A session. • Central Coast primary schools • the curriculum that would be useful to support schools with Term 1, 2019 meeting: their gardens. This information guides the • cooking classes development of future meetings and support • 15 teachers from 12 schools attended the • environmental programs (such as worm strategies. meeting hosted by Woy Woy South Public farms, composting and reducing waste) School NESA professional development points for • the school canteen attending the meetings are available to teachers. • Tour of Woy Woy South Public School garden and discussion of their vegetable garden plan. Providing a forum for schools to share their A closed Facebook page allows members to knowledge, ideas and progress of their gardens share ideas and issues. • Guest speaker: Sharon Carson from is valued by teachers. Rumbalara Environmental Education Centre presented on the ‘Wiping out Waste’ project
28 Contact | Jane Whatnall | 4320 9714 | [email protected] 29 Looking after you first
Be Well, Teach Well
Why are we doing this? The guest speaker, Dr Darren Morton, is an Responses to the survey question ‘What scientifically-proven strategies from the internationally recognised wellbeing researcher three key ideas from this evening will you put fields of neuroscience, positive psychology The Health Promotion Service partners with and educator, and Fellow of the Australasian into action?’ were qualitatively grouped into and lifestyle medicine. It has proven results many educational settings to deliver programs Society of Lifestyle Medicine. categories. From these, the most common including ‘clinically significant reductions in to promote healthy eating and physical activity themes participants indicated they would put depression, anxiety and stress’ (American Dr Morton’s inspirational presentation included a for children and their families. These include into action were: Journal of Lifestyle Medicine) and ‘significant summary of the many facets of personal health Early Childhood Education and Care Services, improvements in overall mental health and and wellbeing, and provided many practical skills • Positivity & Using Positive Talk (95.3%) Primary Schools, Out of School Hours Care vitality’ (TEACH Journal). and strategies to improve wellbeing and mood. Services, and Secondary Schools. • Spending Time Outdoors (66%) An analysis of the uptake and perceived benefits We acknowledge the support and the important Achievements • Gratitude (35.8%) of this program will be investigated. This will role staff who work in these settings play. We One hundred and eighteen local teachers help guide our future work in promoting and also recognise the importance of the personal • Improving movement (34%) and educators attended the event with 90% supporting the overall health and wellbeing of health and wellbeing of these educators providing feedback via a survey on the night. • Giving (16%) staff and students in educational settings. and teachers in order to create a healthy Twenty per cent of respondents also indicated environment for children in their care. The most common reasons given by participants Partners for attending the event were to learn strategies they would be taking away these key ideas for • Early Childhood Education and Care Services How did we do it? to manage workplace stress (76.2%) and to learn implementation with students, as well as with other staff in their education setting. Be Well, Teach Well was a professional strategies to manage personal stress (68.6%). • Primary Schools development evening to promote and support Overall the event was very well received, with Look out for... • Out of School Hours Care Services the overall health and wellbeing of staff in Early 85.8% of participants reporting the evening met To reinforce the messages from the event, • Secondary Schools Childhood Education and Care Services, Primary their expectations a great deal. In addition, the all attendees were offered the opportunity Schools, Out of School Hours Care Services, and vast majority of attendees reported finding the to access the online wellbeing program The Secondary Schools. event extremely useful (78.3%). Lift Project. The Lift Project brings together
30 Contact | Jane Whatnall | 4320 9714 | [email protected] 31 Future Directions for Physical Activity
A qualitative investigation • Diabetes- 19% Interviews have been conducted, recorded be gained from moderate intensity bouts of 8 and transcribed. Qualitative data analysis is Why are we doing this? • Bowel and uterine cancers -16% each minutes or more. Where possible, 150 minutes underway using NVivo software. Gaining insight into possible strategies to of moderate physical activity per week is the • Dementia - 14% increase participation in physical activity within Look out for… recommended minimum for adults. • Coronary heart disease-11% the Central Coast community is the key aim of The final report will contain recommendations, this qualitative project. Currently, 56.8% of Central Coast adults are • Breast cancer -11% estimated to be sufficiently active for health which may guide a range of programs and/or Evidence shows that regularly active people compared to 57.2% in NSW. • Stroke - 10% activities aimed at increasing physical activity enjoy physical and mental health improvements, participation. This is expected to be completed longer life, and fewer serious health issues Almost 3% of Australia’s total disease burden How did we do it? by the end of 2019. is attributable to physical inactivity. Physical compared with people who are insufficiently The project combines evidence from a inactivity also increases the risk for chronic active. literature review with expert opinions gathered diseases and contributes individually to the via qualitative interviews with local Health Newer evidence confirms than any physical disease burden of: activity is better than none, and benefits can Promotion Officers.
32 Contact | Gina Stuart | 4320 9702 | [email protected] 33 Get Healthy Information and Coaching Service
Why are we doing this? Achievements The Get Healthy Information and Coaching The Health Professionals referral target for Service (GHS) is a free phone-based coaching 2018/19 was set at 384, and at the end of this service aimed at supporting adults make lifestyle period 838 referrals were made, more than changes regarding: double the target. Within this total a Get Healthy in Pregnancy target of 200 referrals was set. At • Healthy eating the end of the period 486 referrals were made, • Physical activity which is nearly 2.5 times the target. • Alcohol reduction Look out for... • How to reach and maintain a healthy weight, We are partnering with the Pharmaceutical and Society of Australia to deliver a training • Healthy weight gain during pregnancy evening to local pharmacists. Pharmacists will be trained on the GHS and encouraged to It provides information and support designed refer their patients as standard practice. Script to help adults make healthy behaviour changes. covers promoting the GHS will be offered to The GHS is based on evidence that telephone participating pharmacists. and web based coaching are effective in changing healthy eating and physical activity Training offered: behaviours. Six presentations have been delivered to CCLHD The CCLHD Service Agreement with the departments. Ministry of Health identifies a target for Health Professional referrals to the GHS. Partners How did we do it? • CCLHD health professionals including: Midwives, Physiotherapists, Dietitians, The Get Healthy Service has been promoted Occupational Therapists, Sleep Investigation through a number of presentations to CCLHD Unit, Mental Health, and Osteoporosis Re- departments. This has played a key role in fracture Prevention embedding the GHS in clinical practice and • North Gosford Private Hospital Maternity Unit strengthening referral pathways. Consultation with partners is an important component of GHS work locally. This provides guidance around ways for the Health Promotion Service to improve referrals to the GHS. One recent improvement has been the adoption of an ‘opt out’ approach to referrals rather than ‘opt in’. This has contributed towards the meeting of referral targets, and has been well received by both staff and patients. Monthly GHS data from the Office of Preventive Health is reviewed, which helps to ensure we meet our referral targets.
34 Contact | Helen Kale | 4320 9720 | [email protected] 35 Alcohol Sales to Minors
Why are we doing this? is made without checking ID it does represent Gaming in conducting site visits with inspectors Achievements a likelihood of selling to minors at other times. to PLOs that failed to ask for ID. Each interview Current statistics show that 15-17 year olds During 2018/19, three surveys took place with began with an explanation and background • The proportion of sales without checking ID have the second highest rate of alcohol-related retailers failing to check ID between 21% and of the survey followed by the individual PLO’s decreased by 11.9% from the first survey in Emergency Department visits in New South 33% of the time. results dating back to 2012. Results were 2018 to the third survey in 2019. Wales. Early uptake of alcohol is a strong presented both verbally and in writing. This Following each survey, several interventions • Strong partnerships were formed across predictor of problem drinking behaviour later was followed up with two general questions on aimed at retailers were implemented. This sectors. in life. Further, studies indicate that if a minor compliance: purchases alcohol they are more likely to drink standard intervention included: • A news article was published on the Liquor & • Why do you think a sale was made without at riskier levels and take part in binge drinking • Presentations at local liquor accord meetings Gaming NSW website, outlining the project behaviour. requesting ID? and partnership - www.liquorandgaming.nsw. • Conveying survey results to local licencing • What do you think are the barriers to gov.au/news-and-media/mystery-shopper-id- Ongoing studies by the Health Promotion police and Liquor & Gaming Compliance obtaining consistent ID checks? sting-helps-industry-stay-on-right-side-of-law Service between 2012 and 2019 show the Operations for possible surveillance purposes compliance rates of retailers checking the ID PLOs were resurveyed after these site visits to • Mailing a joint letter to all PLOs conveying Partners of young people purchasing alcohol to be determine if there were any changes to practice. details of the survey. This letter was co- • Liquor & Gaming NSW low and inconsistent. The Health Promotion Survey results show that there was a decrease signed by local Police District Superintendent Service recruited teenagers 18-19 years of age in sales without ID being produced from survey • Brisbane Waters Police District Commanders, the Liquor & Gaming to attempt to purchase alcohol from packaged 5 to survey 6 (both conducted in late 2018), and Compliance Director, and the CCLHD Chief • Tuggerah Lakes Police District liquor outlets (PLOs) without producing ID. from survey 6 (late 2018) to survey 7 (mid 2019), Executive. Currently it is illegal for anyone under the age indicating that this intervention may have had an of 18 to attempt to purchase alcohol. Although In addition, in 2018 a new intervention was impact. sales to 18 and 19 year olds are legal, if a sale developed. We partnered with Liquor and
36 Contact | Hannah Bartman | 4320 9706 | [email protected] 37 “I saw the number for the Quitline…I felt quite good after making the call”. Pregnant Mother
Reducing smoking in pregnancy Stopping smoking is the single most important thing you can do as a mother to contribute to the future health of your child.
Why are we doing this? with midwives was a suitable approach. Dr Megan Griffiths Midwives from Maternity Services were surveyed Smoking during pregnancy is harmful to the about their current practice in delivering health of both the mother and the unborn child. smoking cessation support to pregnant women Reducing smoking in pregnancy is a priority set and possible opportunities to enhance this by the Ministry of Health. support. Survey results identified a need for Locally, CCLHD has above average rates of training and resources to improve smoking cessation support, and opportunities to enhance smoking in pregnancy – 13.6% of pregnant Key results from 17 completed midwife surveys Look out for… mothers on the Central Coast smoke, compared referrals to Quitline. included: to 8.8% across NSW. The rate of smoking in Training will be delivered by the State-wide Smoking cessation training sessions were • 59% reported that providing smoking pregnancy is 32.6% among Aboriginal mothers Smoking Cessation Training Team in July and organised with the State-wide Smoking cessation support fits ‘extremely well’ or ‘very (compared to 42.4% across NSW as a whole) August 2019. Following training, evaluation Cessation Training Team, with these rolling out well’ within the scope of providing antenatal and 12.4% among non-Aboriginal mothers of changes to midwives knowledge, skills and from July 2019. care (compared to 7.2% across NSW as a whole). confidence in providing smoking cessation A quality improvement application was • 82% reported being either ‘somewhat support will be conducted. Further evaluation How did we do it? submitted to the Research Office to enable confident’ or ‘unconfident’ in providing will be conducted to determine changes to evaluation of the smoking cessation training practice such as increased referral rates to A partnership was established with CCLHD smoking cessation care workshops and any changes to practice, and Quitline, and the impact smoking rates. Maternity Services, and a midwife was identified determine outcomes in terms of referrals to • Approximately 80% of pregnant women who as a ‘champion’ for the project. This midwife Quitline and rates of smoking in pregnancy. smoke receive smoking cessation support at Partners was supported to attend a behaviour change booking in, and 70% at follow up visits workshop in Canberra with a representative from • CCLHD Maternity Service Achievements • Approximately half of pregnant women who Health Promotion. • NSW State-wide Smoking Cessation Training Partnerships were established with Maternity smoke refuse referral to the Quitline. Midwives Team A behaviour change methodology was then and State-wide Smoking Cessation Training directly referred fewer women to Quitline adopted to develop a system map, and possible Team (33%) as opposed to encouraging women to opportunities for intervention were identified. It contact Quitline themselves (81%) was determined that conducting an intervention
38 Contact | Luke Giles | 4320 9709 | [email protected] 39 CCLHD’s smoke-free by-law Assessing the responses of smokers to requests to stop smoking on CCLHD grounds
Why are we doing this? • Inform the person of the smoke-free by-law, and that a fine can be issued for smoking on In 2013, CCLHD implemented a smoke-free by- hospital grounds law to enhance existing no smoking policies. The by-law made it an offence to smoke on • Ask the person to extinguish their cigarette, CCLHD grounds, with a $300 fine applicable for and to move off site if they wish to smoke breaches of the by-law. • Provide the person with a cigarette butt bin Enforcement of the smoke-free by-law has been to extinguish their cigarette the responsibility of Health Promotion, Public • Advise the person on the availability of Health and Security, as these departments Nicotine Replacement Therapy have Authorised Inspectors who can issue fines. However, all staff can advise people who After the first 100 interactions, adjustments to smoke that smoking is not permitted on CCLHD the protocol were made to reflect an approach grounds if they feel safe to do so. that all CCLHD staff could make if they were to see someone smoking on site. This included Anecdotal reports suggest that some staff are Health Promotion staff not wearing high visibility hesitant to approach people smoking due to vests and not providing butt bins. concerns of negative or aggressive responses. However, Health Promotion staff who currently Health Promotion staff collect data assessing monitor and enforce the smoke-free by-law interactions using an electronic recording tool. report there is a low risk of aggression. As well as recording data on the details of the incident, staff complete the Modified Overt The project aims to: Aggression Scale (MOAS). Data will be collected • Collect data recording the interactions on 200 interactions. between Health Promotion staff and people Achievements who smoke To date, over 150 interactions have been • Change the perceptions of CCLHD staff in completed. Only 2 incidents of minor verbal regards to approaching and interacting with aggression (‘shouts angrily, curses mildly, or people who are smoking on CCLHD grounds makes personal insults’) have been recorded. • Contribute to the evidence base and share There have been no incidents of physical, self or our findings with other practitioners who may property related aggression. This is indicating be involved in similar work elsewhere. the protocol may be safe and effective way to approach people smoking and request them to How did we do it? stop smoking. During enforcement patrols, Health Promotion Look out for… staff approach people who smoke using a standard protocol. For the first 100 interactions The final findings will be shared with CCLHD the protocol was as follows: staff and through peer-reviewed literature. The intention is that our methodology will provide • Patrol Gosford or Wyong Hospitals in pairs staff with a model of how to conduct an wearing NSW Health ID badge intervention with very low risk of receiving an • Wear a high visibility vest noting staff as aggressive response. ‘tobacco compliance officers’ • Conduct the interaction in a polite manner • Greet the person smoking and introduce the staff
40 Contact | Luke Giles | 4320 9709 | [email protected] 41 Quit smoking support from financial counsellors
Why are we doing this? How did we do it? plus NRT vouchers. The project will determine to Partners what extent each model of intervention supports The prevalence of smoking remains A scoping survey of local financial counsellors low socioeconomic people to quit smoking. • Financial counselling organisations substantially higher among people of a lower was conducted in 2018 to gauge the interest • University of Newcastle/University of New socioeconomic status (13.1% of people in of counsellors in providing smoking cessation The project was pitched to the University of England Joint Medical Program and 3rd year the most socioeconomically disadvantaged support to clients and the need for this. Results Newcastle/University of New England Joint medical students quintile smoke, compared to 4.9% in the from the survey indicated that 53% of financial Medical Program as a research project for 3rd least socioeconomically disadvantaged counselling clients smoke, and counsellors were year medical students to complete. • Pharmacy Guild of Australia quintile). People who are socioeconomically very interested in being able to support their Achievements disadvantaged and who smoke are also more clients to quit smoking. highly dependent on nicotine and are less likely A student group accepted the project and A capacity building approach is proposed to up- to intend to quit. Further, regular smoking commenced working on it in early 2019. Thus far, skill financial counsellors in providing smoking exacerbates financial stress and poverty both for the group has completed a research proposal, cessation support, by training counsellors and adults and children. literature review, and draft research protocol. providing them with resources to facilitate Surveys of people who smoke who are clients referral to the Quitline. This is the standard Look out for… of community services indicate they are open model of intervention. The project will be submitted for Human to receiving smoking cessation assistance In addition, a nicotine replacement therapy Research Ethics Committee ethics review. from these services as they are a trusted (NRT) voucher component will also form a part Following ethics approval, the project will enter source of advice and support and can offer of the intervention. NRT vouchers are to the its implementation stage in 2020. Medical more personalised support. The integration of value of $100 and entitle the bearer to receive students will deliver a portion of the intervention smoking cessation support in organisations any form of NRT to this value from community and complete a report on their component of already working with disadvantaged groups pharmacists. Financial counselling organisations the program by the end of 2020. has been shown to be effective in decreasing will be randomised into receiving the standard smoking rates. model of intervention or the standard model
42 Contact | Lyndon Bauer | 4320 9703 | [email protected] 43 Smoking cessation support in mental health
Why are we doing this? medication. Further investigation is required to assess the current provision of smoking Recent studies have pointed towards substantial cessation support by mental health practitioners, mental health improvement associated with and a broader analysis of the literature on this smoking cessation. A body of evidence which topic. is still under dispute but of great interest links smoking initiation with subsequent mood Achievements deterioration. A rapid fire presentation detailing the concept People with mental health problems remain one of this project was delivered at the 2019 Health of our ‘harder targets’ for smoking cessation, and Promotion Forum. An abstract has also been combined with substance abuse disorders may accepted for presentation at the Oceania make up nearly half of all people who smoke Tobacco Control Conference in Sydney in over 34 years of age. Despite their mental health October 2019. This indicates the potential co-morbidity, smoking related illness is the major interest and appetite amongst the health cause of death in this group. This is generally promotion community to working in this space. well recognised by mental health practitioners, but the immediacy and risks of their mental Look out for… health illness takes priority on the whole where The next steps for this project will be to practitioners feel that smoking cessation is a risk collect data from a sample of Central Coast to their patient’s mental health outcomes. psychologists and psychiatrists to determine This project aims to reorient practitioners their current practice in regards to smoking working in the mental health field to see cessation support, and their willingness to smoking cessation as a potential treatment for implement enhanced support for their clients. mood disorders and not just a secondary long Partners term physical health concern. Central Coast psychologists and psychiatrists How did we do it? A preliminary look at the literature indicates that smoking cessation can have benefits for mental health as great as or better than antidepressant
44 Contact | Lyndon Bauer | 4320 9703 | [email protected] 45 Falls Are Preventable
65+ living independently in the community
Why are we doing this? How did we do it? Achievements Partners A fall can be serious and can lead to loss of Presentations on Active Healthy Ageing were The presentations and resources are in high • Seniors organisations confidence and independence. Approximately delivered to senior groups to help empower demand: • Stepping On facilitators one quarter of people aged 65+ experience a individuals to take actions that reduce their risk • 10 presentations given to 400 people fall at least once a year with 50% falling more of falls. • CCLHD departments including Occupational than once. No other single cause of injury, • 2,000 falls prevention packs distributed to Therapist, Geriatric Rehabilitation Unit, We consulted with partners to produce including road trauma, costs the health system patients Osteoporosis Re-fracture, and Transition Care resources to promote risk factors of falls. Falls more than falls. In NSW each year, falls lead prevention resource packs were provided to • 2,000 Falls are Preventable DVDs distributed to approximately 33,000 hospitalisations and hospital patients who require surgery following to GP Practice Nurses more than 800 deaths.( HealthStats NSW, www. a fall. Additionally, one-on-one or group sessions healthstats.nsw.gov.au/Indicator)Between 2016 were conducted for patients by Occupational Look out for... and 2026, the number of persons aged over 60 Therapists and cross-disciplinary Allied Health • Up-skilling of Aged Care students by on the Central Coast is expected to increase Assistants to address risk factors of falls. Training conducting training on falls prevention as part by 20,295 (23.2%) and comprise 28.9% of the has been provided by the Health Promotion of the TAFE course. total population4. This makes falls prevention Service to facilitate clinicians in delivering these an increasingly important part of Health • Supporting falls prevention work with Home sessions. Promotion work. (Central Coast Council area Care Packages and Commonwealth Home population and age structure – https://forecast. Support Program providers by training staff, id.com.au/central-coast-nsw/population-age- helping them to identify possible falls risks in structure?AgeTypeKey=3) the client’s home.
46 Contact | Helen Kale | 4320 9720 | [email protected] 47 Research partnership projects
SWAP IT lunchbox. HNELHD received a Translational Research Grant to extend the SWAP IT program Why are we doing this? to CCLHD and Mid North Coast Local Health District (MNCLHD). The SWAP IT program aims to support parents and carers to pack healthier lunchboxes by How did we do it? providing information about how to swap ‘sometimes’ foods for ‘everyday’ foods. The SWAP IT includes four main interventions: primary outcome of the SWAP IT trial is to • Development of tailored School Lunchbox reduce the average energy content (kilojoules) guidelines of discretionary food and drinks packed in the lunchbox. • Resources to support change, for parents and children It is based on the knowledge that: • Series of 10 SkoolBag messages direct to • 86% of students bring a packed lunch from parents home • Curriculum resources based on the Australian • Food in school lunchboxes accounts for up to Guide to Healthy Eating. a third of a child’s daily energy intake Evaluation of the SWAP IT program includes • Studies with Australian primary school a ‘lunchbox look’ and surveys for students, children reported that the average lunchbox teachers and principals. The ‘lunchbox look’ contains more than 3 serves of ‘sometimes’ consists of photos of all the lunchboxes of foods consenting students, with subsequent nutritional Few interventions have targeted the nutritional analysis. content of school lunchboxes. Systematic Achievements reviews of these interventions have found a limited impact in reducing the overall average Health Promotion has worked in partnership energy content of school lunchboxes. with HNELHD to provide this program to Central Coast schools. Four Central Coast schools were SWAP IT encourages swaps from ‘sometimes’ recruited to the trial and those randomised foods to ‘everyday’ foods. This is to increase to the intervention arm have commenced the the quality of lunchbox foods, reduce fat, sugar implementation phase. and salt, and reduce the overall kilojoule content from ‘sometimes’ foods and drinks. Look out for… SWAP IT recognises that a barrier to improving Results of the SWAP IT trial will be available foods packed for children is a difficulty to after the project’s completion. This will inform effectively reach parents. Therefore, SWAP the future direction of SWAP IT for CCLHD. IT uses an existing school smartphone app (SkoolBag) to deliver healthy lunchbox Partners messages direct to parents. • Hunter New England Local Health District A pilot randomised control trial of SWAP IT (lead) was conducted in 2017 involving 12 Hunter New • Mid North Coast Local Health District England Local Health District (HNELHD) primary schools. It found a decrease in average energy content of discretionary foods packed in the
48 Contact | Nina Kingon | 4320 9721 | [email protected] 49 Physical Activity 4 Every1 Good for Kids. Good for Life. (PA4E1) physical activity program - Physically Active Children in Why are we doing this? Education (PACE) Currently, most adolescents are inactive, with 81% not achieving recommended levels Why are we doing this? of physical activity. Physical Activity 4 Every1 The aim of the PACE program is to support (PA4E1) is an innovative whole-school physical primary schools and teachers in scheduling 150 activity program for NSW secondary schools. minutes of planned physical activity each week, The aim of PA4E1 is to increase physical as required by the Department of Education activity and promote a healthy weight among (DoE). adolescents. Schools are an ideal environment to promote physical activity in young people Eight Central Coast primary schools are as they have the curriculum, facilities, resources participating in this research program in different and access to adolescents to help them be more capacities. The program highlights the potential active. benefits in improving physical activity levels among children including academic, physical, How did we do it? mental and social health outcomes. Schools were supported to implement and How did we do it? maintain 7 practices over 2 years (2017-2019). These evidenced-based practices have been In order to improve the physical activity shown to make a positive difference to students’ health outcomes among students, schools physical activity levels and their overall health. are supported by a local support officer to Implementing the practices in schools is a team implement six key strategies: effort, which is why a suite of support strategies • Increasing participation and the amount of were developed to work with schools to help time students are active during PE lessons them make positive changes for their school and students. • Increasing participation and the amount of time students are active during school sport Schools are supported by a local support officer to implement 7 physical activity practices based • Introducing active energisers into the on the Health Promoting Schools framework. classroom Most practices are based around school • Integrating physical activity into other subject sport and PE lessons, but some are ‘whole of areas like maths and English school’ practices, including the development of supportive policies, linking with community • Developing policies to make a commitment to sporting groups and communicating with increase physical activity and scheduling this parents. into classroom lessons • Making links with families about the Achievements importance and benefits of physical activity. Schools participating in the PA4E1 intervention have had access to higher quality PDHPE Achievements lessons, and have had notable increases in the The trial is due to be completed at the end of number of students participating in a wider term 3 2019, so keep an eye out for the results in range of physical activity opportunities. the following months. Look out for... Partners The trial is due to be completed at the end of • Hunter New England Local Health District term 3 2019, so keep an eye out for the results (lead) soon. • Mid North Coast Local Health District Partners • Central Coast primary schools • Hunter New England Local Health District (lead) • Mid North Coast Local Health District • Kincumber High School • St Joseph’s Catholic College East Gosford
50 Contact | Chad Partridge | 4320 9716 | [email protected] 51 Healthy Removal Availability Quality Product size Marketing Food & of sugar (75% everyday (Health Star Drink sweetened foods) Rating ≥ 3.5) practice drinks CCLHD 100% 84% 100% 98% 95% Short & sharp NSW 96% 62% 93% 91% 80%
NSW Healthy Food & Drink Framework Childhood Obesity and Healthy Eating Partners Health Promotion continues to demonstrate Active Living (COHEAL) subcommittee • Regional NSW (previously Department of strong leadership in implementing the NSW Together with the Regional NSW (previously Premier and Cabinet) Healthy Food and Drink Framework at CCLHD Department of Premier and Cabinet), CCLHD • Central Coast Council facilities. Since the first stage of Framework and various local government agencies have implementation in 2017 which saw the removal been working together to tackle childhood • Transport for NSW of sugary drinks from sale, healthier food choices obesity on the Central Coast. In line with the • Department of Planning and Environment have increased across staff and visitor cafés NSW Healthy Eating and Active Living Strategy, in 2018/19. CCLHD performed above the NSW the cross agency committee are implementing a • Department of Education – Central Coast state-wide results for all of the Framework’s 13 refreshed action plan for 2019-2020 to support • Office of Sport – Central Coast practices. Some key achievements over the last our community to make healthy lifestyle changes • TAFE NSW 12 months include: and create an environment that supports • Providing more everyday food choices in staff healthier living. • Department of Communities and Justice and visitor cafés (previously Family and Community Services) • Greater marketing and promotion of everyday foods rather than occasional foods
52 Contact | Liesl Greenwood | 4320 9711 | [email protected] 53 www.healthpromotion.com.au
We are excited with the fresh new look and feel What did we achieve? We host a YouTube channel, CCHealthPromotion, 5. Game Sense - Video Six - Invasion Game: of the Health Promotion website! which houses video content produced by the 2,469 views Since the launch of the new website earlier service. The videos capture various parts of With this update comes a greater level of: Key demographics of YouTube channel viewers: this year, www.healthpromotion.com.au has our work, including PDHPE Network meetings, • what we can deliver to our community recorded: Aboriginal art project videos, project overviews, • 69% female and short interviews with Health Promotion • how we can engage our community, and • 8,175 users • 86% 25-34 years Officers. • how we can measure elements of our projects • 9,903 sessions The top countries of YouTube channel viewers In 2018/19, our YouTube channel had 42,378 through this medium were: • 18,749 page views views, and 89,108 minutes of content was The new platform enables project officers to • An average session duration of 1:36 watched by our audience. The average view • Australia: 24.8% plan more strategically and record specific duration was 2:06. Our videos received 137 likes • United States: 16.3% process and outcome measures when people • 80% of the audience being from Australia and 399 shares. engage with the website. • United Kingdom: 13.4% Some of the most viewed web pages were: The videos with the most views on our channel Features include: 1. Home page: 1,767 views were: Most traffic to our videos came from within YouTube: • short video clips that introduce project 2. The Magic Lunchbox: 1,712 views 1. Game Sense - Netball - Session One - Team officers and their project Warm-up: 8,022 views • Suggested videos: 30.1% 3. Kids and Families: 945 views • scroll features friendly to all devices 2. Warm-up for Primary School Children: 6,100 • YouTube search: 28.6% The most downloaded resources included: • sections for professionals and the general views Twenty-six per cent of traffic came from external 1. The Magic Lunchbox book: 644 public 3. Getting off the floor safely after a fall: 6,062 web sources such as Google searches and www. healthpromotion.com.au. • interactive components allowing people 2. The Magic Lunchbox teacher resource: 431 views to register for events and courses, provide 3. The Magic Lunchbox food cards: 385 4. Falls Prevention - reducing hazards at home: feedback, download resources and more 2,873 views • more detailed data tracking and collection
54 Contact | Monique Wilding | 4320 9707 | [email protected] 55 Presentations Major Committees
Australian Health Promotion • Activate Your Space: Increasing Outdoor CCLHD Breastfeeding and Infant Munch & Move Key Contacts Group Space Usage in a Disadvantaged Community Symposium on the Central Coast of NSW – oral Feeding Reference Group Guides and supports the implementation of • Critical reflections on health promotion presentation Supports the implementation of a the state-wide Munch & Move program in early practice – poster presentation comprehensive and integrated plan for childhood education and care services. • A protocol for intervention with smokers on breastfeeding on the Central Coast in line with • Move Like A Mariner: partnering with a hospital grounds. Simple but important steps the policy framework document. Thirsty? Choose Water! Advisory Group professional sporting organisation to increase to ensure a safe low stress and successful physical activity in early childhood education outcome – lightning talk Supports the Translational Research Grant project. and care services – poster presentation CCLHD Premier’s Priority Childhood Health Promotion Forum Obesity Steering Group Tuggerah Lakes and Brisbane Waters Public Health Prevention Conference • Smoking cessation as a treatment for mental Directed and supported the implementation of Liquor Accords • Utilising intersectoral partnerships to increase health routine growth assessment of children. identification checks of young people Aim to improve safety and reduce alcohol-related • Alcohol sales to minors anti-social behaviour, offences and violence. The purchasing alcohol – oral presentation COHEAL subcommittee • Nicotine Replacement Therapy in vending Accords are made up of local liquor retailers • Thirsty? Choose Water! Enticing secondary machines Delivers an integrated approach to enhance including pubs, clubs, and packaged liquor outlets, school students to choose water as their drink the health and wellbeing of children both now NSW Liquor and Gaming, Police, Central Coast – Public Health Prevention Conference – oral Other presentations and into the future through cross-agency Council, Roads and Maritime Services and CCLHD. presentation • Central Coast testimonial – the art of collaboration • Make Their Meals Count improves indicators partnerships – presentation at state Get Tobacco Control Network of food literacy for parents – table top Healthy Service face-to-face network meeting Health Promotion Forum Steering Shares information about projects, ideas and presentation Committee challenges in local areas as related to Tobacco Control and Smoking Cessation and the CCLHD Research Symposium Supports the organisation and delivery of the implementation of the NSW Tobacco Strategy. • Thirsty Work! The story of Thirsty? Choose Publications annual Health Promotion Forum professional development day for the NSW health promotion Water! From a Pilot to a Translational Smoke-free Health Care Working Group Research Grant – oral presentation workforce. Health Promotion Journal of Australia Works to implement the NSW Health Smoke- • Move Like A Mariner: partnering with a Healthy Food and Drink Policy free Health Care Policy by ensuring that CCLHD professional sporting organisation to increase • Implementing and enforcing a smoke-free Implementation Group grounds are smoke-free, and that staff and physical activity in early childhood education policy and by-law on hospital grounds at patients are supported to manage their nicotine and care services –oral presentation Central Coast Local Health District. Guides the delivery of the Healthy Food and Drink Framework on the Central Coast. dependence. • Creating a smoke-free Aboriginal community through art – lightning talk Live Life Well @ School State-wide Key • Bite & Bounce at OSHC, a partnership Contact Group between the Health Promotion Service and Outside School Hours Care (OSHC) to Guides and supports the implementation of the promote healthy eating and physical activity state-wide Live Life Well @ School program in for 5-12 year olds and their families – oral primary schools. presentation
56 57 Awards
CCLHD Quality Awards 2018 Bite&Bounce@OSHC – 1st place, Keeping People Healthy category Activate Your Space 2262 – Chief Executive Award, Caring for the Coast category
Premier’s Awards 2019 Make their Meals Count – A guide to feeding your child over a day (pending outcome) Reducing Primary Supply of Alcohol to Minors (pending outcome)
NSW Health Quality Awards 2019 Thirsty? Choose Water! Enticing secondary students to choose water as their drink (pending outcome) Reducing primary supply of alcohol to minors (pending outcome)
Research & quality improvement projects
Ethical clearances Amendment to Thirsty? Choose Water! to include Mid North Coast LHD and Hunter New England LHD under original approvals for Translational Research Grant
Quality Improvement projects
Alcohol Sales to Minors (AS2M) - Investigators: Hannah Bartman & Lyndon Bauer
Be Well, Teach Well - Investigators: Nicole Kajons & Jane Whatnall Evaluation of the resource known as Make their Meals Count - A guide to feeding your child over a day (4-8 year olds) - Investigators: Jane Whatnall & Lesley Marshall
Future Directions for Physical Activity on the Central Coast - Investigators: Gina Stuart Investigating the behavioural drivers of the provision of smoking cessation support by midwives in CCLHD Maternity Service - Investigators: Luke Giles, Nicola Morley & Lyndon Bauer
Reducing smoking in pregnancy Evaluating a comprehensive approach to the delivery of smoking cessation brief interventions to pregnant women - Investigators: Luke Giles, Nicola Morley & Lyndon Bauer
58 59 Our team This year we are introducing team members who lead, guide and support research and evaluation within our service.
Sam Batchelor | Manager, Health improvement projects underway; as well Gina says that evaluation is crucial. “It allows In his work outside Health Promotion, Lyndon as awards, conference presentations, and not only the measurement of achievements, but works as a General Practitioner and has Promotion Service publications by the team. an opportunity to critically reflect on project conducted research around the provision of Sam has been with us now for almost 4 years! outcomes – either positive or negative – to emergency primary care, which ultimately She has worked in health for over 20 years in Gina Stuart | Health Promotion Officer inform future work”. resulted in the establishment of two clinical clinical, project, research and evaluation, and after-hours services. Lyndon is also a conjoint Gina Stuart is a senior health promotion Gina has a background in nursing and midwifery, management roles. Sam has experience across senior lecturer with University of Newcastle officer with over two decades of experience in and is nearing the completion of a Master of a range of settings including health promotion and provides training for medical students. He population health. Gina has worked in tobacco Public Health. When not at work, you can find and public health, mental health, palliative care is currently supervising two student research control, overweight and obesity, falls prevention, Gina somewhere in nature, camera in hand! and aged care. She is an Occupational Therapist and physical activity. projects. by training and also has a Graduate Certificate Dr Lyndon Bauer | Health Promotion Demonstrating achievements in population Liesl Greenwood | Team Leader, in Public Health Research and Evaluation and a Officer Masters of Public Health. health has been at the core of Gina’s work since Healthy Eating Active Living the beginning. Taught by great mentors, Gina Lyndon has always had an interest in research, Sam has a strong interest in Research and Liesl was appointed to the Health Promotion learned early on that an outcomes approach, and was known as the ‘mad scientist’ in his Evaluation, and is a member of the CCLHD Service’s new position - Healthy Eating Active together with a sound evidence base and good school days. He started working in the Health Operational Research Committee. She has been Living (HEAL) Team Leader in late 2018. Liesl local knowledge, helps to plan and implement Promotion Service to research the outcomes an author on several peer reviewed journal had previously worked on the Munch & Move measurable, realistic objectives. Some of Gina’s of brief smoking cessation interventions versus papers and also enjoys the opportunity to be a program, and prior to that worked as the implementation and evaluation work includes: intensive smoking cessation interventions in reviewer of academic papers. Community Relations Manager at Hornsby various settings. He has also completed work • Results of a smoking cessation intervention Ku-ring-gai Hospital. Liesl also has previous In her role, Sam provides support to the Director, to map the places where tobacco could be for Wyong Hospital pre-admission clients management experience during her time at the oversees the tobacco and alcohol portfolios, and purchased across the Central Coast, and to Australian Sports Commission. work to enhance the Research and Evaluation • Motivation of older adults to attend organised survey high school students on their smoking capacity of the service. Along with Gina and physical activity status. More than a decade of work on tobacco Liesl oversees a well-established and Lyndon, Sam supports the team on all areas of • Results of strength training programs for availability and sales to minors resulted in knowledgeable team as they continue to lead Research and Evaluation, and liaises closely with older adults in Central Coast fitness centres world leading changes to the enforcement of HEAL initiatives across the Central Coast the CCLHD Research Office. prohibition of tobacco sales to minors. community. Liesl works closely with the Director • Change in shared pathway traffic following to continue to forge strong partnerships across Sam has observed a growing interest within Lyndon is a published author in several journals, implementation of parkrun, using infra-red government and non-government agencies to the service regarding research and evaluation, with articles on the topics of tobacco sales to people counters and onsite observation. ensure HEAL is prioritised. with Thirsty? Choose Water! securing two minors, compliance of ID checks in bottle shops, rounds of competitive funding; several quality cannabis and road death, and iodine deficiency in primary school children.
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