HEARTY LIVES Craigavon HEARTY LIVES CRAIGAVON PROJECT FINAL EVALUATION REPORT January 2013 – February 2016 February 2016 28448 SHSCT Hearty Lives Craigavon Project Report Books.indd 1 26/02/2016 08:00 HEARTY LIVES CRAIGAVON PROJECT FINAL EVALUATION REPORT Contents Introduction to Hearty Lives Craigavon 3 Context 5 Evaluation Strategy and Methodology 8 Project Development and Delivery 12 Hearty Lives Craigavon Partnership 16 Case Studies Hearty Lives Craigavon: Health Assessments 18 Hearty Lives Craigavon in the Workplace 32 Engaging with the Irish Traveller’s Community 37 Engaging with BME Community Groups 47 Community Development and Community Planning 55 Appendix Hearty Lives Craigavon Steering Group Members 63 References 63 Jane Turnbull Education and Development February 2016 2 28448 SHSCT Hearty Lives Craigavon Project Report Books.indd 2 26/02/2016 08:00 INTRODUCTION TO HEARTY LIVES CRAIGAVON The Project Partnership The Hearty Lives Craigavon Project was funded for three years by the British Heart Foundation (BHF) and managed by the Southern Health and Social Care Trust (SHSCT). The Hearty Lives Craigavon project aims to improve heart health for Black Minority Ethnic (BME) and Irish Traveller Communities. The Project commenced in January 2013 and the existing funding stream ceased in March 2016. The Hearty Lives Craigavon Project was led by the Southern Health and Social Care Trust, developed in partnership with Armagh City, Banbridge, and Craigavon Borough Council (the Council), Craigavon Traveller Support Committee, Community Intercultural Programme, and the Public Health Agency; and was funded by the British Heart Foundation. In addition to the formal cross-sectoral Steering Group partnership, the basis of Hearty Lives Craigavon was that this would be a Project delivered in partnership at all levels. Operationally partnerships have been built with community and voluntary organisations, workplaces, education, GP Surgeries, and Pharmacies. The Project The BHF funding was used to appoint a part time Hearty Lives Coordinator (30 hours a week) to coordinate and deliver the Hearty Lives Craigavon initiative with the Irish Traveller and BME populations within the Craigavon area. The Project Coordinator has a nursing background. There were eight core objectives for the Hearty Lives Craigavon Project: 1. To increase awareness of Heart Health within the Traveller and BME communities through health improvement approaches; 2. Awareness-raising and brief intervention training for workplace managers, GPs, community workers and local healthcare professionals; 3. To plan, co-ordinate and deliver assessment services for CVD risk factors to BME and Traveller communities; 4. Liaison with community leaders, health professionals and employers for the effective implementation of this service; 5. To develop and oversee enactment of referral pathways to ensure that Travellers and BME community are navigated into appropriate primary or secondary care services; 6. To network with organisations and initiatives focused on reducing the risk of CVD, e.g. community-based stop smoking services, local walking and cycling initiatives, weight management programmes, nutrition and healthy eating programmes, etc.; 7. To work with the providers of community-based health and wellbeing initiatives to ensure that these programmes can be orientated towards the specific target groups; 3 28448 SHSCT Hearty Lives Craigavon Project Report Books.indd 3 26/02/2016 08:00 8. To follow up with individuals to assess and record the impact of both the screening and treatment/intervention services in relation to health behaviour on themselves and their families where appropriate. There were ten specific Project outcomes: 1. There will be increased knowledge and skills to support heart health within Traveller and BME communities, support workers and organisations /employers; 2. CVD screening will have been accessed by 140 adults in the Traveller community over 3 years; 3. CVD screening will have been accessed by 600 adults in the BME/migrant communities over 3 years; 4. 56 members of the Traveller community will have accessed primary care for management of CVD risk factors. 180 members of BME/Migrant worker communities will have accessed primary care for management of CVD risk factors; 5. A minimum of 30 Travellers will have embedded lifestyle changes in support of heart health; 6. A further 100 Travellers including adults and children will benefit from the programme; 7. A minimum of 180 adults in BME/Migrant communities will have embedded lifestyle changes in support of heart health; 8. Enhanced ways of working will have been developed, tested and evaluated that demonstrate how to engage marginalised groups to improve health; 9. Local HSC professionals and GP’s knowledge and awareness about the health status of the population groups in relation to CVD will have increased; 10. Champions will have been identified and trained within the population groups to further develop this approach. The Final Evaluation Report The Final Evaluation Report presents the wider context within which HeartyLives was delivered, the evaluation strategy and methodology, the Project development and delivery to meet the needs of the Irish traveller and BME communities, and the way in which the Project worked in partnership strategically and operationally. The Report also presents five Case Studies; which each include the delivery process, impact for the target groups, lessons learnt and the legacy. Each Case Study is a stand alone document; together the five Case Studies provide a comprehensive understanding of the Hearty Lives Craigavon Project. 4 28448 SHSCT Hearty Lives Craigavon Project Report Books.indd 4 26/02/2016 08:00 CONTEXT Heart Disease Hearty Lives Craigavon is part of the British Heart Foundation £12 million UK-wide Hearty Lives programme to reduce geographical inequalities in heart disease. Through this initiative, BHF works in partnership with local health and social care services and local authorities to tackle geographical inequalities in heart disease. There have been 31 Hearty Lives Projects around the UK including three in Northern Ireland (BHF funding of Hearty Lives Cookstown finished in 2014 and the Project has been sustained by funding from another source; Hearty Lives Carrickfergus is funded by the BHF until June 2016). Cardiovascular disease (CVD) is a major cause of death and disability in Northern Ireland. In 2012 more than one in four deaths (27%, 4,001 deaths) in Northern Ireland were due to diseases of the circulatory system.i As heart disease is one of the main causes of death and disease in the Craigavon Borough Council area and in an effort to address this British Heart Foundation (BHF) Northern Ireland awarded £100,000 funding for the Hearty Lives Craigavon project. The prevention of cardiovascular disease is dependent on the reduction in major risk factors such as smoking, high blood pressure, hazardous alcohol use, diabetes, cholesterol, waist- circumference and physical inactivity.ii Research conducted to investigate the reduction in coronary heart disease mortality in Northern Ireland found that 65% of this decrease was as a result of reductions in the cardiovascular risk factors of cholesterol (40%), smoking (24%) and blood pressure (40%). However, it also raised concerns about the future impact of the growing trends in diabetes, physical inactivity and obesity on the cardiovascular disease burden.iii The relationship between socio-economic disadvantage and cardiovascular disease (CVD) is well established. Cardiovascular disease remains one of the main contributors to the differential in life expectancy.iv Access to cardiovascular services may be reduced for people living in deprived areas, Irish Travellers, and BME community. Changes in cardiovascular disease (CVD) risk factors can be brought about through intervention at both an individual level in terms of behaviour change and at population level though development of appropriate policy and legislation.v As illustrated below, cardiovascular health is also influenced by other social and economic factors such as housing, employment and transport.vi 5 28448 SHSCT Hearty Lives Craigavon Project Report Books.indd 5 26/02/2016 08:00 Source:Source: Putting Putting a health a health inequalities inequalities focus focus on the on Northernthe Northern Ireland Ireland cardiovascular cardiovascular service service frameworkframework summary summary report. report. Health Health impact impact assessment assessment Northern Northern Ireland Ireland cardiovascular cardiovascular serviceservice framework. framework. Belfast: Belfast: Public Public Health Health Agency, Agency, 2011. 2011. LocalLocal Context Context TheThe Southern Southern Health Health and andSocial Social Care Care Trust Trust took took on board on board evidence evidence that thatIrish Irish Travellers Travellers and and BMEBME communities, communities, including including migrant migrant workers workers within within the theCraigavon Craigavon area, area, are areat greater at greater risk risk of theof riskthe riskfactors factors associated associated with with CVD CVD and andof developing of developing heart heart disease disease than than the restthe restof the of the population.population. Therefore, Therefore, the purposethe purpose of the of Heartythe Hearty Lives Lives Craigavon Craigavon Project Project was was to increase to increase engagementengagement with with the Irishthe Irish Traveller Traveller community, community, the BMEthe