What: WTG – Weigh To Go - A weight management programme for 12-18 year olds
Who: Julie Gordon – Health Improvement Lead and Coordinator, Youth Health Services
Youth Health Service Nurse - Kate Dods
Business Support Assistant (Ryan Hughes during Pilot phase)
Qualified in 1984 with a BSc in Nursing from Dundee, quickly moving into Primary Care and Community Nursing, gaining a Diploma in District Nursing (Glasgow) in 1989, followed by a post in Practice Nursing for an inner city GP practice. Thereafter, she gained her family planning qualification (1991) and worked in the area of sexual health with a particular interest in young people, ultimately securing the position of Lead Nurse for young people at the Sandyford Initiative, Glasgow. In 2000, following an arts based consultation with local young people, in her role of Clinical Youth Co-Ordinator, Julie set up the first holistic service for young people aged 12-19 years of age, in the Maryhill area of Glasgow. The aim of which was to respond to complex issues using a “one stop shop” approach.
Julie Gordon has presented at the Approaches Conference (Glasgow 1995); Association for Young People’s Health (London 2008) and the World Health Organisation (Edinburgh 2009). Julie Gordon has also been a guest Lecturer at Glasgow Caledonian University for a period of five years.
With the creation of Community Health Care Partnerships in Glasgow, Julie Gordon became the Lead for Youth Health, both clinically in delivery of Youth Health Services (YHS) and also from a Health Improvement perspective in the North West of the City, as a result of various organisational changes, within North West of the City. There are currently three YHS in this area, targeting areas of greatest need, offering the same holistic approach. In her current role, her focus is on addressing the inequalities of health for young people living in the North West Locality of Glasgow City Health and Social Care Partnership. In 2014, with colleagues and following a successful application to the British Heart Foundation to become a Hearty Lives Pilot Project, she was tasked with the implementation of the researched model for weight reduction in young people. Initially this targeted 16-18 year olds.
Location: Glasgow City Health & Social Care Partnership (HSCP) – North West Sector
Speciality: Health Improvement
What is the initiative and or project you are involved in?
Weigh To Go was a weight management programme for young people 16-18 years of age in some of Glasgow’s most deprived neighbourhoods. Originally funded by the British Heart Foundation as part of its Hearty Lives initiative, the pilot was managed by Glasgow City HSCP – under the umbrella of the North West Youth Health Service. In light of the obesity epidemic, this pilot project was designed to support young people aged 16-18 years of age, who have a BMI of over 25, to lose weight and consequently reduce their cardiovascular risk. Young people were provided with regular support from Youth Health Service/Outreach nursing staff, and free access to commercial weight management. The longer term aim was to contribute to the evidence base about successful interventions which address the issue of obesity in young people.
What prompted the work
People living in the poorest areas of the country are, on average, more likely to die from cardiovascular disease than people living in the most affluent. Glasgow, as a city, experiences marked inequalities of health with multiple areas of deprivation, consequently, young people from Scottish Index of Multiple Deprivation (SIMD) 1 & 2 were targeted.
The British Heart Foundation funded a number of Hearty Lives initiatives in communities at greatest risk of heart disease and stroke to tackle these health inequalities.
The pilot was prompted by a range of factors:
- official figures for Scotland, between 1995 and 2012, the proportion of people aged 16 to 64 who were overweight or obese increased from 52.4% to 61.9%. Currently the rate of obesity in teenagers is approx 30%.
- young people who are obese are more likely to develop risk factors for cardiovascular disease, such as high cholesterol, high blood pressure and type 2 diabetes
- lack of evidence on the most effective obesity intervention programmes for young people
- gap in NHS Greater Glasgow and Clyde service provision for young people who are overweight or obese
- the opportunity to secure funding from the British Heart Foundation for projects which aim to reduce the risk of cardiovascular disease for children and young people across the UK
- health inequalities in Glasgow.
How did you initiate the work?
A business plan was presented to British Heart Foundation based on local surveillance data and a proposed model informed by extensive consultation with young people.
The programme was implemented in 3 of the most deprived areas in the North West Glasgow, with a comprehensive marketing campaign. The publicity and marketing materials were developed and influenced by young people to address the potential challenge of recruiting and retaining young people.
From a monitoring and evaluation perspective robust data collection tools were created to support reporting to NHS GG&C and the British Heart Foundation.
Young people were screened for inclusion to the programme and a 1:1 assessment tool repeated at various intervals. The young people were supported by Youth Health Service/Outreach nursing staff for up to 24 weeks. Benefits included:
- regular contact with nurses, face-to-face and/or by phone, to check on progress and offer advice and help
- free access to weight management support through a contracted arrangement with Scottish Slimmers / Weight Watchers and ultimately solely Slimming World (using BMA approved programmes)
- encouragement to engage in physical activity, especially walking.
Measures of success include:
- weight loss; weights recorded by commercial weight management services, on a weekly basis- 5% weight loss being considered as clinically significant
- participation in physical activity; noted through 1:1 assessment
- levels of motivation, confidence and self esteem; measured using approved tools e.g. Rosenberg Self-Esteem Scale (Rosenberg, 1965)
- behavioural change; measured using research-based questions to identify behaviour modification. For example: Fizzy Drink or Take away consumption
- roll out of the programme across Glasgow City HSCP (years 2 and 3).
What difference has the project or initiative made?
From the 75 participants recruited from across Glasgow:
- 78% achieved weight loss, between week 0 and 12
- 55% achieved a 3% target weight loss.
On average, improvements in behaviour change were noted for example increased consumption of fruit and vegetables, and participants reported improved confidence and self esteem.
Individual case studies showed broader benefits for example, a reduction in prescribed medication, and engagement with volunteering opportunities.
What are the long term aims for the work?
The long term aim of the work was to contribute to the evidence base on models, which work in terms of supporting young people to lose weight and impact on cardiovascular risk. The pilot has been adopted by the Glasgow City HSCP following the end of funding from the British Heart Foundation. The age has been expanded to include young people from age 12 years and the service has been rolled out to the other 5 HSCP areas in NHSGG&C. At a celebration event in October 2017 in the Glasgow Science Centre, young people and families described the benefits to them via a short pre recorded film. Some young people have lost ½ their body weight. Some have gained employment and some describe how much more confidence they have and that they are happier. Other young people have become volunteers and gained youth achievement awards after engaging with the programme.
The Weigh To Go project was nominated for a number of awards and was successful in winning the British Heart Foundation - Hearty Lives Impact Award in 2015.