NSW Healthy Children Initiative Equity Toolkit. NSW Office of Preventive Health

Transcription

1 NSW Healthy Children Initiative Equity Toolkit NSW Office of Preventive Health

2 Contents 01 Background 02 Equity principles 03 More about the HCI Equity toolkit 04 Overview 05 Community assessment 06 Case studies 07 Collaborative action 08 Equity and sustainability 09 Working group contributors NSW MINISTRY OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) Fax. (02) TTY. (02) This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the NSW Ministry of Health. NSW Ministry of Health 2014 SHPN (CPH) ISBN Further copies of this document can be downloaded from the NSW Health website November 2014

3 01 Background The New South Wales Healthy Children Initiative (HCI) delivers programs for children from birth up to the age of 18 years. The HCI aims to increase levels of physical activity and fruit and vegetable consumption by children in early childhood services, schools, and recreational and community settings. The HCI will be evaluated by population changes in children s weight, average daily servings of fruit and vegetables, and their physical activity levels. HCI programs targeting children are evidence-based. Where evidence is currently lacking HCI promotes promising programs that are being actively monitored to provide evidence about the efficacy of these programs. A high priority for HCI is to ensure that all children have opportunities to participate in health promotion and preventive health programs. How? By ensuring greater access to HCI programs by children who are at greater risk for poorer health. These include children in rural and remote areas, children from low income families, children from culturally and linguistically diverse communities, and Aboriginal and Torres Strait Islander children. Improving the health status of people from these population sub-groups has been a longstanding policy priority for the NSW Ministry of Health. The graphs below show that children in the lowest quintile of socioeconomic status (SES) have more sedentary behaviour and lower vegetable intake than children in the highest SES quintile.

4 02 Themes Equity principles Health promotion and preventive programs such as those delivered through the HCI can contribute greatly to service improvement and health equity principles. The NSW HCI Toolkit is informed by these principles and is intended as a practical resource. These health equity principles include a recognition of the need for more coherent planning, the importance of strengthening the infrastructure that underlies the delivery of services, and the need to increase partnerships between health and other government-delivered services. Some of these health equity principles are evident inthe government and health policy documents listed below. Four steps towards equity: a tool for health promotion practice. This resource aims improve the way health promotion addresses and supports equity based health promotion action at the local and state level. Click to view online resource NSW State Health Plan: Towards 2012 The NSW State Health Plan provides a strategic framework for NSW Health priorities Click to view online resource The Healthy Eating and Active Living Strategy This strategy aims to encourage the people of NSW to make healthy lifestyle choices and to be supported in their choices by health-focused planning, built environment and transport initiatives, as well as improved access to healthier foods and improved food labelling. Click to view online resource Graph to go here

5 03 More about the HCI Equity toolkit More about the HCI Equity Toolkit Who is its audience? The HCI Equity Toolkit is for health promotion professionals that can make a positive contribution to children s health. What is its purpose? To outline equity principles, platforms for action and examples, to guide delivery of HCI programs to ensure access and participation from HCI priority groups. What are its broader aims? To invite users to consider: Equity considerations when planning and implementing programs aimed at children. Adopt an integrated multi sectoral approach which considering equity issues. When should it be used? Ideally, the HCI Equity Toolkit should be used early in the planning of HCI programs and consulted throughout program delivery and evaluation. Who are HCI Priority Groups? Children living in low socioeconomic population groups. Aboriginal & Torres Strait Islander children. Children from culturally and linguistically diverse (CALD) backgrounds. Highly marginalised children and youth. Children from remote NSW. Children from single parent families.

6 04 Overview Overview of the HCI Equity Toolkit The Healthy Children Initiative seeks to meet the needs of children from vulnerable families who are at a higher risk of being overweight or obese, eating poorly, and engaging in low levels of physical activity. The HCI therefore aims to ensure that these children have equitable access to healthy eating and physical activity programs and resources. Equity principles The following equity principles are important when planning and delivering health promotion programs targeting children. Identify barriers that prevent or limit children from priority groups from participating in HCI programs. When necessary, tailor programs to meet the needs of priority groups. Promote the sustainability of equity principles by building them into the policies and programs. Monitor and evaluate programs in terms of their accessibility to and impacts upon priority groups. Platforms for action This toolkit identifies three broad opportunities where equity principles can begin to be introduced into health promotion programs targeting children. These three broad opportunities are referred to in the toolkit as platforms for action. On the following pages, the toolkit provides examples and case studies to illustrate how health promotion professionals can integrate equity principles into health promotion programs targeting children. Overview of three platforms for action 01 Conduct a community needs assessment When first assessing the needs of a target group or community, consider the following: access and use as much relevant data as possible pinpoint barriers that may prevent or limit children from priority groups from participating in HCI programs consider factors that might support priority group individuals to participate in HCI programs in HCI programs pinpoint issues that pose a risk to the program s success. 02 Identify opportunities for collaborative action Consider how to build broad support for a program by: identifying opportunities to collaborate with a range of agencies that have a stake in equity principles and HCI programs identifying the specific resources that collaborating agencies can commit to a program share strategies that address equity evaluate partnerships. 03 Prioritise equity and sustainability of programs Deliver programs that meet the specific needs of priority groups. Use strategies to raise participation rates of priority groups in HCI programs. Where possible, build equity of access principles into service delivery plans. Earmark dedicated funding directed at increasing access to programs by at-risk groups.

7 05 Community assessment 1. Conduct a community needs assessment What to consider when planning: identify the target group of the health promotion program Pinpoint issues that pose a risk to the program s success Access and us e as much relevant data as availabl e find data that describes lack of access to a program, poor health status and/or behaviours of the target group identify the specific equity issue you plan to target Pinpoint barries that ma y prevent or limit children from at-risk gr oups from participating in HCI pr ograms identify the resources you need programs, people, resources, budget, buy-in varying needs of children from different priority groups. The Table below provides examples of the kinds of issues and considerations health promotion professionals might need to consider when planning a health promotion program targeting children. Platforms for action Examples of approaches Examples of data sources Access and use as much relevant, evidence based data as available Access and analyse population health data Access and analyse non-health data such as levels and types of education, income, transport, language, housing and unemployment among priority groups Australian Bureau of Statistics, Health Statistics NSW, Monitoring reports, eg, Physical Activity and Nutrition Survey, focus groups, and interviews with relevant priority groups Local data on settings and implementation data. Pinpoint barriers that may prevent or limit children from priority groups from participating in HCI programs Consider factors that might support priority individuals to participate in HCI programs Consider what clients believe to be achievable and effective. Focus groups, interviews, conversations with priority group members. Pinpoint issues that pose a risk to the program s success Existing literature or evaluations Findings from group interviews/focus groups or conversations

8 06 Case studies Case studies These case studies illustrate how health promotion professionals can integrate equity principles into health promotion programs and engage in effective partnerships with supportive organisations. 01 Case Study 02 Case Study Applying equity to the Live Life School program Collaborating with Queanbeyan City Council Program planners in Western Sydney Local Health District used a measure of equity to consider schools relative advantage /disadvantage so that they could be mindful of disadvantaged groups when planning delivery of the Live Life School program.. They considered the following: socioeconomic factors Aboriginal and Torres Strait Islander background refugee status cultural and language background schools for specific purposes schools receiving funding for literacy and numeracy factors from the Australian Early Development Index. Program planners used this information to prioritise schools during program recruitment and by assisting staff in those schools with additional resources and incentives. Queanbeyan City Council is collaborating with agencies such as Barnardos, The Smith Family and the Australian Red Cross to deliver Healthy Communities Initiative programs, including a cooking club, gentle physical activity, and healthy eating programs. Health promotion professionals from the Southern NSW Local Health District are leveraging this engagement to bring non health agencies to support Healthy Children Initiative programs. For example, Queanbeyan City Council is promoting Go4Fun as part of their community development strategy. Go4Fun is a free, 10 week healthy lifestyle program for children aged between 7 and 13 years and their families. The program is fun, interactive, and supports families to adopt a long lasting and healthy approach to living.

9 07 Collaborative action 2. Identify opportunities for collaborative action What to consider when building collaborative action: Evaluate partnerships Share strategies that address equity Identify opportunities to collaborate with a range of agencie s that have a stake in equity principles and HCI pr ograms Identify the specific resources that collaborating agencies can commit to a program Which organisations could support the strategy? Leverage existing relationships, where possible What capabilities will collaborators require to assist the strategy Which best practice principles can be shared? The table below provides examples of the kinds of issues and considerations health promotion professionals might need to consider when they plan to collaborate with other professionals and agencies. Platforms for action Identify opportunities to collaborate with a range of agencies that have a stake in equity principles and HCI programs Examples of approaches Conduct a community needs assessment. See helpful resources: Capacity building framework. Click to view online resource Identify the specific resources that collaborating agencies can commit to a program See helpful resources: VicHealth Partnership checklist Click to view online resource Share strategies that address equity Organise forums aimed at sharing useful skills, programs and approaches. In particular, encourage the following: awareness of the strengths and limitations of program delivery knowledge, expertise and examples of equity building improving skills and sharing resources. Evaluate partnerships Be strategic when considering what elements of the partnership to evaluate

10 08 Equity and sustainability 3. Prioritise equity and sustainability of programs What to consider when considering how to achieve equity of access: Earmark dedicated funding directed at increasing access to pr ograms by at-risk gr oups Where possible build equity of access principles into service delivery plans Deliver programs that meet th e specific needs of at risk gr oups Using strategies to raise participation rates of at risk groups in HCI programs How will the program be implemented? How will program activities be delivered? How will participants be reached? The table below provides examples of the kinds of issues and considerations health promotion professionals might need to consider when they consider equity and sustainability issues. Platforms for action Examples of approaches Deliver programs that meet the specific needs of priority groups Complete the HCI CALD Checklist to raise awareness of multicultural issues. Tap into communication channels used by priority (at risk) groups. Consider grants and incentives to attract priority (at risk) groups. Using strategies to raise participation rates of priority groups in HCI programs Prepare program logic for local delivery; examine the assumptions and contextual factors that underpin the logic. Assess if there are gaps in the program logic. Where possible, build equity of access principles into service delivery plans Assess your team s annual objectives and consider if equity of access to HCI programs is sufficiently addressed. Identify the resources and staff required to work on equity strategies. Seek buy in and commitment to equity objectives. Continue to evaluate and monitor program implementation and impacts. Earmark dedicated funding directed at increasing access to programs by priority groups Tailor resource allocation to specific strategies directed at improving equity.

11 09 Working group contributors NSW Healthy Children Initiative Equity Toolkit Working Group Dr Bev Lloyd Manager Evaluation and Strategic Projects, Office of Preventive Health Ms Lorraine Doubis Manager, Health Promotion Services, Southern NSW, Local Health District Ms Helen Ryan Coordinator Partnerships Program, Western Sydney Local Health District Ms Libby Powell Program Coordinator, Healthy Children Initative, South Eastern Sydney Christine Innes-Hughes Manager, Healthy Children Initiative, Office of Preventive Health Project coordinator Janice Biggs Program Manager, Healthy Children Initiative, Office of Preventive Health.