24th March 2010: 10:45am to 12:15pm

Abstract: There is a strong moral argument why local authorities and their partners should work to improve the heath of their communities and to reduce the inequalities gap, but investing in preventative public health also makes sound business sense.
The public sector is already under financial pressure as a result of the current economic climate, this pressure is set to increase in the years and decades to come as the age of the population and long-term health conditions increase. Improving the health of the population can help to ease this burden as well as creating efficiency savings and leading to better service outcomes.
The Healthy Communities Programme has been working to raise awareness of this business case argument and highlight how efficiency savings and improved outcomes can be achieved through health improvement. Local authorities will be supported to develop their own local businesses cases and to capture and evaluate the financial impact of their activities.
This workshop will present the work of the Healthy Communities Programme to date and include discussion of the opportunities and challenges for local authorities and their partners.

24th March 2010: 10:45am to 12:15pm

Abstract: Being a leader in the local health inequalities agenda is challenging, enabling others to see their potential leadership role can be even more challenging.
Being a leader in the local health inequalities agenda is challenging. Enabling others to see their potential leadership role can be even more challenging.
Following their joint conference in 2008, representatives from the Association of Directors of Public Health (ADPH), the Association of Directors of Adult Social Services (ADASS) and the Association of Directors of Children's Services (ADCS), agreed to examine in more detail how they can work together to best support their members, to effectively address health inequalities locally.
A scoping report undertaken by Shared Intelligence and commissioned by the IDeA (Improvement Development Agency for Local Government) revealed that joint working between the three directors appears to be well embedded, but to move the agenda forward at a local level other key partners and services which influence the wider social determinants of health need to be engaged. Through presentations from current directors this session will explore:
How we can develop an understanding of what good look like with regard to joint appointments and partnership working for health and wellbeing
How joint appointments and integrated working between directors can be used to best effect and to meet expected budget shortfalls
How a range of council services and partners can be engaged in tackling the wider determinants of health and taking preventative action upstream
We hope the session will provide an impetus for delegates own partnership working and opportunity to share the different approaches being taken across the country.

24th March 2010: 10:45am to 12:15pm

Abstract: The alliance of nine regional TPHNs has three years' experience of creating effective partnerships for developing capacity to deliver better health. The TPHNs are unique in systematically leading development of public health capacity and capability among the wider public health workforce, whose potentially critical contribution to health improvement and the achievement of Wanless' ‘fully engaged' scenario, has otherwise been largely neglected.
The session will disseminate effective TPHN initiatives, which could readily be rolled out in other areas.
The TPHNs' initiatives cover a very wide range of interests and target audiences. These include, for example, engaging the Third Sector in improving health, enhancing Teacher Training courses to include relevant public health content, developing local capacity to tackle child obesity, ensuring that Town Planners are taught the relevance of public health, and providing a tailored inclusive CPD solution to a region's public health community.
The session will demonstrate the core determinants of building the wider public health workforce and integrating their role effectively with that of the local public health specialist workforce. It will additionally highlight key searchable content of the new national TPHN alliance dedicated searchable website.

24th March 2010: 10:45am to 12:15pm

Abstract: "If you think you are too small to make a difference, trying sleeping in a closed room with a mosquito" (African Proverb)These initial presentationswill be followed by facilitated discussion to share our learning on taking a range of different types of action, including advocacy with decision-makers nationally and internationally; the use of social marketing to help citizens, organisations and decision-makers to change their behaviour; focusing on accessibility rather than mobility; enhancing social capital and community resilience drawing on the Transition Towns movement; learning from the corporate sector and leading edge NHS organisations; the importance of access to nature and the prospects for lower-carbon healthcare.

24th March 2010: 10:45am to 12:15pm

Abstract: To support the Alcohol Harm Reduction Agenda and to inform local areas, East Midlands Public Health Observatory (EMPHO) have created maps using other data sources in addition to the more commonly used hospital admissions data. These include People 2 Places (P2), InterestMap data on location of pubs and clubs and ambulance pick-up data.
Data available from InterestMap showing pubs and clubs has been used to create a measure of pub and club density by Output Area, with four cities being found to have more than 40 pubs in a single output area. EMPHO have also created a proxy for alcohol related ambulance pick ups and used this to map alcohol related ambulance pick ups against pubs and clubs in the East Midlands. Due to accurate time recording on the ambulance data this can be used to illustrate the night-time economy within cities and the movement of the alcohol related harm throughout the night.
EMPHO have used P2 data from Beacon Dodsworth to create rates of hospital admission for alcohol related harm by P2 branch. The branches with the highest rates have been mapped to inform social marketing interventions within the East Midlands.

24th March 2010: 10:45am to 12:15pm

Abstract: Alcohol consumption is a major public health issue which affects not only the person drinking the alcohol but also their family, their surroundings and society. Deaths related to alcohol use have seen a steady increase over the last decade (IC, 2008). In addition the number of admissions to hospital has more than doubled from 1995/6 to 2006/7 (IC, 2008). Furthermore the demand for treatment across England has seen an increase of 20% in prescriptions for treatment of alcohol dependence between 2003 and 2007 (IC, 2008).
Access to alcohol treatment services in rural North East of England area has been sparse. A report in 2004 had indicated that there were around 500 peopleunable to access alcohol treatment. As a result the local Drug and Alcohol Action Team (DAAT) commissioned a service which provides both clinical support for home detoxification and psychosocial support. The service is provided by a primary care provider and a voluntary organisation in full partnership.
This presentation will describe the service and explore the experiences of service users, carers, family members and referring agencies in accessing and utilising the service. The need to maximise the public health outcome for service users will also be discussed.

24th March 2010: 10:45am to 12:15pm

Abstract: Alcohol related violence is a major public health issue placing considerable strain on health resources (Faculty of Public Health 2005).

Domestic violence and abuse (DVA) is the leading contributor of death in women aged 15 - 44, being responsible for more of the disease burden than many well known risk factors such as high blood pressure, smoking and obesity. (WHO 2005)

Alcohol is estimated to be a factor in a third of all DVA incidents (Finney 2004). Survivors and victims of DVA may use alcohol as a coping strategy. DVA perpetrators have disclosed using alcohol pre-emptively to excuse their behaviour. The complex relationship is starting to be explored in research.

In Bristol, a joint training programme for alcohol and DVA workers was oversubscribed and a need for further networking was identified.

The strategies for both have been linked and a formal network established that was praised by the Alcohol National Support Team. Care pathways, brief interventions and protocols are being developed and expertise shared. Currently, we are bidding for a post to support referrals from alcohol agencies and MARACs (multi agency risk assessment conferences) for families at very high risk of serious assault or murder.

This workshop will link DVA and Alcohol work in Bristolwith reducing repeat victimisation and chronic ill health .

24th March 2010: 10:45am to 12:15pm

Abstract: The School Food Trust was set up as a Non Departmental Public Body in 2005 with the unique remit of transforming school food. Since then, the Trust has worked with a range of stakeholders to establish itself as a leading authority on improving food for school aged children. A key activity of the Trust since its inception has been to guide and support stakeholders to achieve compliance with the phased introduction of mandatory food-based and nutrient-based standards for school food in England (by September 2009). This has been achieved by identifying and developing solutions to the barriers to improving the provision and the take up of school food.This workshop will include a brief overview of the work of the Trust followed by presentations on engaging key stakeholders. A Local Authority caterer will talk about practical issues in implementing the changes needed to meet the new standards. Two nutritionists will present abstracts on research into pupil engagement. Lastly, the Trust will present evidence for the benefits of improving school food provision and dining experiences on children's food consumption and learning behaviours and how this evidence is being used to influence policy and to engage stakeholders. The session will conclude with a panel discussion chaired by the Trust's Director of Nutrition and Research.

24th March 2010: 10:45am to 12:15pm

Abstract: The pre-school years are an ideal time to establish healthy lifestyles. Although parents have the main responsibility for their child's nutrition and activity, childcare providers also have an important role. Increasing numbers of under-5's are spending long periods of time in childcare. The Northwest has 226,400 childcare places and 12,484 providers. Childcare providers have a unique position to influence not only the nutritional intake and activity levels of the babies and children in their care, but also the knowledge and attitudes about food and activity that form behaviours and can impact on health and wellbeing in later life. The Statutory Framework for the Early Years Foundation Stage states that children should be provided with healthy meals and snacks that are balanced and nutritious and have opportunities to be active and interactive. However, there is a lack of specific practical guidance for those providing childcare. ‘Best Start for Life', developed and disseminated through the Northwest Early Years Cluster aims to address this. The Cluster is a collaborative partnership including health and education professionals, Ofsted, Sub-regional Public Health, and the Food Standards Agency. This presentation will describe the engagement process achieved and the results of an evaluation of the Guidelines.

24th March 2010: 10:45am to 12:15pm

Abstract: HENRY (health exercise nutrition for the really young) is cited in key government documents including the Healthy Child Programme. It introduces ways of working with parents that improve their motivation to change by developing strengths-based and solution-focused strategies to explore key lifestyle issues. It meets the need for community and health practitioners to develop confidence and skills in working with families of young children to promote a healthy lifestyle and address issues of overweight.
DH North West in collaboration with Children and Learners (GONW) and the Sub-regional Public Health Networks is providing an opportunity to increase skills and capacity in early years childcare across the Region through the commissioning of HENRY in the North West. The Programme will ensure that HENRY training courses for community and health practitioners are available throughout the Region. This presentation will describe the collaborative partnership and engagement process required at national, regional, sub-regional and local levels to deliver HENRY on a regional footprint within a defined timeline and budget. Barriers and enablers will be identified and the evaluation framework identified.

24th March 2010: 10:45am to 12:15pm

Abstract: A Social Marketing campaign was designed by the newly formed Breast Feeding Steering Group, with the aim ofincreasingbreast feeding rates in lower socio economic white indigenous mumswho were identified as having low uptake.The campaign included design of the Coventry Super Baby, health messages and logo. The campaign included posters on 50% of the buses, bus stops / phone booths in target areas. The local radio station/ newspaper ran a series of interviews and BBC radio provided a live commentary on the launch day. Lady Godiva and the Lord Mayor opened the campaign. Following advice from the target group mums on role models, 2 DVD filmswere produced on the advantages and difficulties of breastfeeding whichincluded actresses from the Holyoaks soap series, health professionals and mums and dads. Plus a training DVD for use with health professionals and colleges.

The work has supported the achievement of all regional/national targets with an overall increase of 12%. The work has been closely monitored by Dr Stephen Handsley an external consultant/researcher. He has attended the monthly meetings and focus groups and has produced an Executive Summary and a very detailed research report of all aspects of the work.

24th March 2010: 10:45am to 12:15pm

Abstract: The ‘community health management to enhance behaviour' project (CHANCE) was a project funded across six countries through the EU GRUDVIG (Lifelong Learning) programme. The aim of the study was to evaluate aspects of community health management in specific, targeted, less affluent communities and develop a community based intervention to address a specific health need.
Baseline information was gathered using a structured questionnaire jointly developed by all partners. In Liverpool a partnership was formed with a local voluntary sector organisation to facilitate access to unpaid carers based in South Central Liverpool. One hundred and thirty four questionnaires were returned and analysed. The questionnaire covered demographic data as well as questions regarding knowledge and behaviours relating to health, nutrition and community cohesion. To gain a more in-depth understanding of the issues facing thisgroup twenty face to face interviews were also conducted.
After considering both sets of data a number of interventions were developed and delivered. Examples ranged from food hygiene training; a DVD highlighting food hygiene principles; a health awareness day; and food and mood relaxation sessions.
In conclusion there still seem to be unmet needs in relation to health in this community; a strong sense of isolation and limited sense of community cohesion, and limited positive health related behaviours.

24th March 2010: 10:45am to 12:15pm

Abstract: The WHO states that over the third of the burden of disease in Europe stems from five modifiable risk factors: high Body Mass Index (BMI); high blood cholesterol, high blood pressure, excessive alcohol consumption and smoking These are the primary risk factors for cardio-vascular disease (CVD), which are, to a significant extent, determined by people's lifestyle. The modifications of these risk factors have been unequivocally shown to reduce CVD.
People's lifestyle is largerly shaped by their economic status and the different aspects of the environment in which they live, for example, availability of green spaces or safety.The 'New Public Health' agenda in Europe acknowledges the key role of Cities in promoting the health of their populations. This means that city-level decision makers are responsible for creating an environment that enhances a healthy lifestyle.
In order to support city-level decision makers in their endeavour to create an environment that encourages a healthy lifestyle , we have designed an innovative economic modelling tool: Sheffield Health Effectiveness Framework (SHEFTOOL).SHEFTOOL uses scientific evidenceto inform city level decision makers of the potential impact of their investment on cardio-vascular health and how various investments translate into financial savings.

24th March 2010: 10:45am to 12:15pm

Abstract: Purpose - To describe the experience of, and response to, the impact of the recession on health and well-being in two local authority areas in Wales
Methods - A systematic review of the literature on effects of previous recessions on health and the effectiveness of interventions and policy responses; interviews with professionals concerned with mental health, debt, housing, family support, education and regeneration in two local authority areas: one with high overall deprivation and the other with high internal inequalities; a policy seminar with relevant national and local policy leads to discuss emerging findings.
Preliminary results – Reduced funding for support services for vulnerable people have already affected their quality of life. Further reductions are expected to have a disproportionate impact on areas where public services are the main employers. Negotiating the benefits system, and perceived unfairness of payments and training opportunities, are an additional strain on those already under pressure through illness, low income and unemployment. Shortage of training and employment opportunities is likely to result in a cohort of young people remaining unemployed with implications for their health in the longer term. This paper will also include the response of policy makers to this report.

24th March 2010: 10:45am to 12:15pm

Abstract: The recent economic downturn in the UK has been presented by many politicians as apocalyptic, demanding “savage” cuts to public spending. Yet leading economists, of all political persuasions and none, have argued that severe cuts are not needed and indeed would be harmful to economic recovery. In this paper we first propose a framework for considering the potentially broad range of implications for health of any cuts and then summarise the findings of our studies of past financial crises, identifying their health consequences and those factors that either exacerbate them (e.g. access to cheap alcohol, cuts in social protection) or promote resilience in populations (e.g. social networks). We then set the UK's economic performance in context of both contemporary international and historic levels of debt, concluding that the scale of the “crisis” is being talked up for political purposes by those seeking to reduce the role of the state, as was done in Canada in the 1990s for example. We conclude with a brief review of the health sector responses of other European countries, noting that almost all have made substantial efforts to protect health spending, often coupled with specific targeting of vulnerable groups.

24th March 2010: 10:45am to 12:15pm

Abstract: The demographic and epidemiological shift in industrialised nations towards chronic illness and “lifestyle” conditions are placing increasing burden on an over-stretched economy. They have impacts on scarce health resource with increasing admissions, accident and emergency and outpatient attendances and more and more expensive drugs, technologies and other services. There is also a burden on the wider economy in ill-health absence from work, long term social security benefit and the economic costs of unpaid carers.
We describe the use of a remote telephone based Health Coaching service which targets those most at risk of needing secondary care in the future with proactive tailored health campaigns. Risk is calculated using a sophisticated predictive modelling algorithm using routine health service data. The Health Coach builds a relationship with the patient and through educating and providing supporting information empowers them to better manage their own health and navigate through health care services using a variety of techniques including behaviour change and shared decision making. The aim of this process is to improve self-management, as the better a patient cares for themself the less likely expensive secondary care resources will be needed. We shall also present case-studies of services users and some of the practical challenges in setting up an evaluation system for such a scheme.

24th March 2010: 10:45am to 12:15pm

Abstract: The presentation poses the question: How does public health most effectively influence and inform local transport policy and practice? Building long term relationships with other professions outside of the NHS and embedding public health concerns within their work ethos is an ambition reflecting long recognised challenges to effective pubic health work (eg Ottawa Charter). The workshop aims to explore the potential for public health placements into local government transport departments in order to achieve more beneficial health impacts arising from transport policy and practice. This will first be contextualised within a wider programme of PCT work with Bristol City Council to influence social and environmental determinants of health.

The presentation will provide a summary of the range of projects and programmes the placement has engaged with in the first 18 months to help steer and support transport policy and practice. This case study will highlight specific work programmes addressing:
· road danger reduction;
· provision of evidence based support
· 20mph speed limits
· tailored support for the Cycle Demonstration City team

The presentation will also address the added-value of being there which in Bristol has enabled a number of public health entrees to areas of policy and practice (eg Development Control) where otherwise health is not a consideration.

24th March 2010: 10:45am to 12:15pm

Abstract: The Department of Health West Midlands commissioned the development of an accessibility standard for healthy food (fruit and vegetables) across the West Midlands region.
Primarily, this standard has been developed for use within the next phase of local transport plans and regional strategies to firmly anchor principles of healthy lifestyles within accessibility planning. If adopted, it will allow for greater comparison across the region.
Other objectives of the research included a review of the current evidence base and a region-wide mapping exercise using quantitative (GIS mapping) and qualitative (market research survey) evidence to provide a baseline.
The main challenges in the research were agreeing a definition of ‘healthy food' and the variation in quality of food premises registers maintained by local authorities.
The standard developed was: “Percentage of households within 20 minutes, by walking, cycling or public transport, of a place where fruit and vegetables are sold”
This accessibility standard represents a shift in thinking about the future of transport, planning and ‘healthy food'. The standard can be used in a variety of ways from food security planning by identifying areas with good and poor local provision to informing community planning and regeneration by focussing support for local outlets.

24th March 2010: 10:45am to 12:15pm

Abstract: The government has acknowledged that action is required on a range of food policy issues and while its advisors have recognised that determining the ingredients of a low-impact diet, identifying best practice for sustainable and healthy food procurement, and developing strategy for increasing consumption of domestically produced food are all early priorities (DEFRA, 2009), there is no certain acknowledgement of the need to ensure that the goal of a sustainable and healthy diet is secured and resilient against environmental and economic threat.
In this presentation, the author, will draw on evidencefrom regional resilience teams in government offices which suggest that 'food preparedness' work is largely limited to crisis food supply and proposethat, in a climate of water scarcity, fuel disruption and peak oil, climate chaos, and significant economic challenges, a healthy and resilient, continuing food system is a necessity.
The presentation It will discuss the characteristics of diversity of supply and flexibility of such a system, and look at developing a framework for food system continuity which seeks to incorporate these characteristics into a system which meets the needs of a healthy population in the longer term

24th March 2010: 10:45am to 12:15pm

Abstract: Healthy Weight Healthy Lives – the UK's cross governmental strategy to reduce obesity announced plans to test town-wide approaches to tackling obesity and the obesogenic environment. In October 2008, Middlesbrough was one of 9 towns in England to be awarded ‘Healthy Towns' status.Our programme aims to develop a sustainable andcollaborativetown-wide approach to increase physical activity and healthy eating. Social marketing approaches have been used to develop a customer (and ‘community') focus at all times supported by a town-wide marketing strategy and campaign to support on-going delivery of the objectives, which are:
1. To develop a town-wide programme of urban farming.
2. To enhance the physical environment across the town to increase the number of people using public places for recreation, play, walking and cycling
3. To work with specific employers and schools to address the cultural, institutional and sociological barriers that discourage physical activity and active travel
4. To work through schools, providing training and support, to develop a junior health trainer programme.
Leadership from the elected Mayor and Lead members has been critical to establishing strong partnership arrangements and the successful implementation of the £8.9m programme. The presentation will describe our creative approaches and current evaluation outcomes in further detail.

24th March 2010: 10:45am to 12:15pm

Abstract: Programmes utilising the skills and resources of volunteers and lay workers are increasingly common in public health practice within the UK. There is, however, a lack of research on how service users see those volunteer roles, as much of the evidence is about the interventions not the people delivering them. One of the objectives of the People in Public Health study was to investigate the perspectives of community members with experience of public health services delivered or led by lay people. Qualitative interviews were conducted with 46 service users from three case study projects; a breastfeeding peer support project, a walking for health scheme and a neighbourhood health project. This presentation will use those findings to explore how service users viewed the function and responsibilities of volunteers and how those roles provided personalised support and improved access to local services. The presentation will provide some interesting insights into experiences of volunteering in public health and the boundaries of community practice. It will juxtapose professional and lay views on the qualities and attributes required for these roles to stimulate discussion on whether current career frameworks reflect the most appropriate competencies and skills for a lay workforce.

24th March 2010: 10:45am to 12:15pm

Abstract: Too often the public are seen as part of the problem not the solution. The predicted squeeze on public spending provides an opportunity to debate the wider adoption of approaches where community members deliver health activities. While citizen empowerment can be seen as critical to improving public health, particularly in those communities that are seldom heard, it cannot be achieved without a level of investment. This presentation will draw on the findings of the People in Public Health study to stimulate discussion on different options for those seeking to establish and sustain programmes involving lay workers and volunteers. The study involved a scoping review of published literature and case studies of five community health projects, where over 80 interviews were conducted with commissioners, practitioners and community members. The focus of the presentation will be exploring the thorny issue of remuneration and rewards. Using the study findings, we will look at the relative merits of volunteer and employment models and explore the tension between ensuring fair rewards for valued work and stifling community activism through professional controls. The presentation will conclude by introducing a planning matrix covering the different building blocks required to achieve sustainability.

24th March 2010: 10:45am to 12:15pm

Abstract: “I have my life back, I'm in control … life is good,” one client sums up the benefits of working with the Cornwall & Isles of Scilly Health Trainer Service (HTS). The project targets the most deprived areas of the county which experience the highest levels of health inequalities. The Indices of Multiple Deprivation, 2004 ranks Cornwall as the second most deprived county, with 33% of households in areas ranked within the 25% most deprived nationally.

The HTS tackles health inequalities through a dual approach; supporting communities and individuals to make positive changes that result in improved health and well-being and social capital for individuals and their communities. Community Health Development Workers support local people through a community development approach while Health Trainers work with individuals on a one-to-one basis; this approach aims to develop local capacity in a more meaningful way. The HTS empowers local people to make positive changes to their lives. Taking a holistic view of health, support ranges from healthy eating and physical activity, to reducing isolation, debt problems and supporting people into work/volunteering.

The HTS supports people to improve their lives and ultimately their health. This presentation will showcase the work of the HTS in Cornwall.

24th March 2010: 10:45am to 12:15pm

Abstract: Health inequality strategies have traditionally targeted life-style factors and services to improve health and reduce inequalities. However these do not take into account the role of communities, social networks and the social environment in improving population health and mental wellbeing, and reducing inequalities. The Government's report Mental Health and Social Inclusion (2004) highlighted the role of social networks and community cohesion in improving and maintaining mental health. Further, evidence summarised in the Health Development Agency's report Social capital for health (2004) suggests that elements of social capital and social networks, such as participation and integration into local communities, may be related to better self-reported health, even after controlling for socio-economic factors. A boost of the Health Survey for England was commissioned in 2006 for London by a consortium of local health and government bodies to measure inequalities across London in terms of health behaviour and mental wellbeing. The presentation will present the results of this survey on social capital and cohesion and their relationship to mental and general health inequalities. The presentation will also explore the implications of these findings for strategic planning to reduce health inequalities and how these concepts and measurements can be used at a local level.

24th March 2010: 10:45am to 12:15pm

Abstract: Not feeling good about where you live is associated with significantly poorer mental health. Little is known about the impact of improving residential areas on mental health of the residents. Based on existing research into the key factors in the physical and social environment that impact on mental wellbeing, Feeling Good About Where You (FGAWYL) is a partnership project between NHS Greenwich, Greenwich Council, the Metropolitan Police and local residents. A cross-cutting approach to delivery will be undertaken to maximise the effectiveness of existing routine services and funding. working to improve mental wellbeing at estate level.
The project brings together existing community engagement mechanisms and service delivery with residents on the estate to improve the environment, bring people together, what's on in the area, feeling safe in the local environment and home comfort. The project is working with residents to support them to identity interventions and to assist them to develop strategies to positively address factors in the physical and social environment to improve health.
The presentation will report on initial outcomes from the baseline study and environmental audits of the estate, engagement strategies used and the intervention programme, including lessons learned in the first phase.

24th March 2010: 10:45am to 12:15pm

Abstract: This paper reports a study commissioned in order to examine what children and young people themselves perceive to be important in affecting their mental health for good or ill and was undertaken in the form of a systematic review of both published peer-reviewed and ‘grey' literature. The review forms part of a wider piece of work being undertaken in Scotland to develop a set of mental health indicators that could be used to create a summary mental health profile for Scotland. The work was undertaken in collaboration with NHS Health Scotland, who use ‘mental health' as an umbrella term to refer to both the concepts of mental health problems and mental wellbeing.
Establishment of an agreed search string, searching of databases and screening of abstracts were a prelude to quality assessment of studies and synthesis of the data therein.
The results demonstrate a paucity of literature collected without undue adult influence, but the studies included show that children and young people view mental health in somewhat different ways from adults. The results have challenged the existing framework of indicators being developed and have helped it to develop in ways which are informed by young people's own priorities.

24th March 2010: 10:45am to 12:15pm

Abstract: The Health Inequalities National Support Team (HINST) has completed visits to62 'Spearhead' authorities in England, representing the 20% with a combination of severest deprivation, lowest life expectancy and highest mortality from major killer conditions. The visits have combined appraisal of systems and processes in place, with support in de-mystifying how the 2010 targets to reduce inequalities in life expectancy and mortality from the major killers, might be achieved.

The detailed intelligence obtained from these visits, and subsequent follow up reviews of progress, represents a major resource. This is embodied as the learning and understanding developed by the team, captured as the growing database of good practice, and identified common weaknesses and gaps in system, scale and sustainability. This learning has been immediately utilised by HINST to develop an Enhanced Support Programme to help Spearhead communities 're-double' efforts to address the 2010 targets.

However, the learning is also being fed in to the Marmot Review process to strengthen common elements of delivery as the focus broadens to encompass inequalities in the social determinants of health 'beyond 2010'.

This presentation will describe the main elements of practical learning captured as the Enhanced Support Programme, and how this learning will continue to be relevant as medium and long term inequalities goals are established.

24th March 2010: 10:45am to 12:15pm

Abstract: Objectives
To demonstrate a method of adjusting a commonly used summary measure of inequality (the Gini Coefficient) to remove the effect of random small number variation on observed differentials, and to assess the impact of this adjustment onapparentlevels of health inequality both between and within PCTs in the South West.

Methods
Gini Coefficients were calculated to measure inequalities in

24th March 2010: 10:45am to 12:15pm

Abstract: The 2009 World Class Commissioning Assurance Framework included a new health inequalities indicator: the slope index of inequalities (SII) for life expectancy calculated using deciles of deprivation defined at lower super output area (LSOA) level.
An accompanying paper explains the background to the indicator and the methodological choices made. The resulting dataset has been used to analyse the relationship between health inequalities (and trends in health inequalities) and a range of other population and geographical characteristics.
This paper presents the results of this analysis. The factors that have been found to be associated with variations in health inequalities are described. Statistical modelling methods are used to assess the significance and relative importance of various factors including geographical variables, population size, deprivation and underlying socio-economic inequality. Systematic underlying regional variations are explored along with, factors that may explain whether the inequalities gaps are narrowing or widening.

24th March 2010: 10:45am to 12:15pm

Abstract: It is felt by many that tobacco control is done and dusted and thatother public health messages should now take precedence.Smokefree legislation and the subsequent success has done much to cement the view that little more needs to be done.Howeverwe have now seenthe introduction of a new Tobacco Control Strategy with the message that tobacco control is far from done. It is still the biggest killer, it is still a major contributor to health inequalities. It is interlinked with infant mortality and is the major contributor to the main killers, CHD, Cancer and COPD. The National Support Team has developed a new modelfor tobacco control which we would like to present to enable all those involved in tobacco control to understand how they can contribute to this agenda as part of a joint partnership. The model explains the key elements of tobacco control and how to interlink the levers for change into their own local tobacco control strategies. This is an example which can be used in many other settings to ensure that all opportunities are fully explored for maximum impact. The model also shows how to engage the senior level and the accountability structure and explores commissioning and providing an integrated apporach to tobacco control across all partners.

24th March 2010: 10:45am to 12:15pm

Abstract: 22% of 14-17 year olds in the North West currently smoke. Smoking remains the region's greatest health inequalities challenge and “turning off the tap” is one essential element to tackling this.
“Smoke&Mirrors” is an NHS funded, region-wide youth advocacy project aimed at maximising youth participation in denormalising the tobacco industry and its products. International research has concluded that tobacco industry denormalisation themes in campaigns might reduce tobacco use above and beyond more traditional communications that target social norms only.
The project includes:
• Multi-agency Regional Stakeholder Sounding Board and Young People's Advisory Group
• Creation of resource packs for schools and youth groups which highlight negative industry practices
• Use of social media and a microsite www.seethroughtheillusion.co.uk
• A campaign weekend for 100 young people to engage with international experts on industry practices and campaigning
• A short film competition for 14-18 year olds
• Three winning entries voted for by young people to be made into viral films with one film being shown in cinemas
• Supporting five key campaign areas chosen by young people
• Process and impact evaluation
The presentation will describe the results of the evaluation including young people's views of the project and the films.

24th March 2010: 10:45am to 12:15pm

Abstract: Secondhand smoke is still a threat to children's health and a 2009 YouGov survey showed some parents still do not realise the serious and long lasting effects it can have on children. The cocktail of chemicals in tobacco smoke cause cot death, asthma and respiratory illnesses.
In order to raise awareness of the harmful effects of this invisible killer and encourage people to change their smoking behaviour, especially around children, Smokefree South West, launched a hard hitting regional campaign.
Using social marketing principles, the campaign was launched on TV, radio, posters, newspapers and online, across the region in October 2009. Every new mother in the South West also received information about the dangers of secondhand smoke.
With a primary target audience of smokers who have families, careful consideration was given to when and where the advertising was shown, such as on poster sites near nursery schools.
Does using a marketing campaign to highlight the dangers of secondhand smoke achieve the desired behaviour change and prompt smokers to think again about what effect their habit is having on their babies, children and non-smokers around them?

24th March 2010: 10:45am to 12:15pm

Abstract: English Health Profiles present information describing the health of each local authority, county and region. They are intended to assist councils, Primary Care Trusts and partners to plan health improvement. In Autumn 2008, users participating in the external evaluation of Health Profiles requested that such information be presented at more local level to encourage members of community groups and other local interested citizens to be more engaged in planning and prioritising health and care services.
The South East Public Health Observatory and NHS Choices are working with Shared Intelligence to determine how to produce community health information:
• More closely related to natural communities
• Free from unnecessarily complicated technical language
• Focussed on a small number of priorities from the Health Profiles indicator set
• Compatible with the national Health Profiles produced for the local authority
A qualitative study is underway to assess the demand for such community-focussed health profiles from potential users in different geographical and demographic populations. This presentation will report the study findings and will encourage discussion of different options for community health information in terms of content, presentation and dissemination (in particular digital technology) compared to the expected benefits in terms of additional community engagement.

24th March 2010: 10:45am to 12:15pm

Abstract: It is well established that people who live in disadvantaged circumstances are more likely to experience worse health outcomes than those living in more affluent circumstances. This has led to a plethora of area-based initiatives targeted on areas of disadvantage, designed to improve the health and lifestyles of local residents. Target Wellbeing in the Northwest of England, funded by Big Lottery, is an example of such an initiative. Primarily delivered through the voluntary and community sector, the initiative comprises 91 individual projects ranging from community walking projects to back-to-work courses.
This paper reports on a 3-year, qualitative research project, the purpose of which is to explore the consequences of this public health initiative. Using one area targeted by the initiative as a case study, this research examines the ways in which networks of interdependencies between people shape individual behaviours. This paper summarises available evidence on the health impact of area-based initiatives, and critically examines some of the concepts (such as social capital) used to explain how place impacts on health. The paper will present emerging findings and explore how a sociological approach that focuses on networks of interdependencies can shed light on the mechanisms through which health might be improved.

24th March 2010: 10:45am to 12:15pm

Abstract: Champions for Achieving Better Health in Sheffield (C.A.B.S.) - targeted interventions, engaging with men Purpose:Design & methodologyFindings:

25% of the drivers were at high risk of CVD.
10 drivers from a total group of 80 were at very high risk of CVD

3. Delivery proved easier through one central provider -use of 'Darzi Centres' to reduce health inequalities

24th March 2010: 10:45am to 12:15pm

Abstract: Purpose and Learning Outcomes

To show how a regional action plan was developed
To share the findings and recommendations from the research
To describe how the regional winter planning process was used.

Background: The North East is the coldest of the 9 English regions, suffers from high levels of economic deprivation, health inequalities and poor housing. Excess Winter Deaths figures show no pattern of decline, averaging 1,685 between 1991 and 2007, despite many schemes to address it by improving housing, insulation and access to benefits.
Aims: The research aimed to improve regional public health action to address fuel poverty. The winter planning work aimed to make all NHS organisations address fuel poverty.
Methods: In 2009 the North East Public Health Department commissioned research to review evidence, professional attitudes and produce an action plan. The research was conducted by National Energy Action (NEA) and two independent consultants. It included literature and good practice reviews, and field research. In parallel, the Public Health Department and the North East SHA built a requirement to consider fuel poverty into the winter pressure plans of all NHS organisations.
Results: A comprehensive action plan has been adopted. There is growing activity and commitment to addressing fuel poverty and recognition of the health links by NHS organisations.

24th March 2010: 10:45am to 12:15pm

Abstract: Blackpool is spearhead unitary local authority in Lancashire due to high levels of deprivation and poor health experienced by the residents. The most recent Department of Health life expectancy figures showed that its residents have the lowest life expectancy in England.
Blackpool has an aging population. The proportion of those aged 65 and above is higher than the regional and national averages. Older people are most prone to experiencing adverse health outcomes during the winter including excess winter mortality (EWM).
The adverse health outcomes are also associated with the level of fuel poverty. A significant proportion of the residents experience fuel poverty. In spite of a raft of affordable warmth measures available for residents aimed at reducing fuel poverty many are unable to access these measures.
Project Counter Attack is a partnership project between the Scottish Power Energy People Trust, NHS Blackpool, the Blackpool Council and Age Concern. It aims to:
• increase access to affordable warmth measures particularly targeted at the most vulnerable.
• understand the reasons for the low uptake of available affordable warmth measures.
The presentation will describe the outcomes of the project and how these outcomes have informed the Affordable Warmth Strategy in Blackpool.

24th March 2010: 10:45am to 12:15pm

Abstract: Housing has long been understood to be an important determinant of health, whether in relation to the effect of build quality on overcrowding and infectious disease; or the effects of neighbourhoods on mental health.
The potential impact of climate change on housing is enormous. Focus to date has been on energy efficiency, exemplified by the code for sustainable homes for new homes. However, 70% of the housing stock required by 2050 is already built, so adaptation of existing homes must become more important.
An investigation is needed to assess how the drive to reduce carbon emissions from homes, and the impact of new building technologies, may impact on occupant health. Energy saving is likely to have a net benefit; however more knowledge is needed to predict the likely impact on indoor air quality and health, and further analysis is needed to determine the information needed by occupants to maintain appropriate ventilation and a healthy indoor environment.
In September 2009 a whole day symposium on Healthy and Sustainable Homes and Communities was held at the annual Health Protection Agency Conference which explored these issues. This presentation will convey the key messages from this symposium, and present the ongoing work of the HPA in understanding the health impacts of housing in a time of ecological change

24th March 2010: 4:00pm to 5:30pm

Abstract: Whilst the focus of the recession has been on the impact on jobs, housing repossession, debt problems and financial markets and institutions, more and more attention is being given to the effects on broader social problems such as drugs, homelessness, mental illness, domestic violence and family breakdown. The Audit Commission's report, When it comes to the crunch, warns of the social consequences that will affect communities in the face of greater austerity and calls on councils to avoid complacency.
Yet, there is other evidence to suggest that community and population health can thrive in difficult economic times. For example, increased leisure time can be used for friendships, exercise and physical activities. Having friends is known to be good for health; whilst adverse health behaviours such as smoking, excessive use of alcohol and overeating decline in times of recession. Cohesion between diverse communities can also improve during economic downturns, which in turn can add to people's sense of well-being and belonging and is a contributor to mental well-being.
Having a sound analysis and understanding of the negative health impacts of the recession on local communities is a critical first step for local authorities to mitigate any negative effects. But as local authorities seek to build economic recovery locally it is important that their approach to economic renewal has a strong focus on supporting social goals.

24th March 2010: 4:00pm to 5:30pm

Abstract: Preventing violence and abuse
Violence and abuse can affect anyone. 1 in 4 people in the UK will have experienced some form of violence and abuse their lifetime. But violence and abuse are often spread unevenly creating inequalities for people, groups and communities. The impacts of violence and abuse are widespread and can continue for many years after the events, acting as a silent determinant influencing poor physical and mental health, and wider development.
But violence and abuse are not inevitable; they are preventable. There is a growing evidence base around the scope and impact of violence and abuse, as well effective interventions and approaches to prevent them. A public health approach to violence and abuse prevention aims to intervene early and tackle wider determinants. This is though improving parenting, family support and parental mental health; improving mental health and well-being in all children and encouraging safe, respectful social and emotional development and relationships; developing safe, green spaces and improving environments, including tackling alcohol; and by working in partnership to share information, support victims and manage perpetrators.
This presentation will outline the evidence within a public health approach to prevention of violence and abuse. It will aim to generate discussion on how such an approach could be delivered.

24th March 2010: 4:00pm to 5:30pm

Abstract: Analysis of the Hospital Episode Statistics database (HES) for England suggests that numbers of patients admitted to hospital for assaults involving stabbing injuries peaked in 2006/7. This supports the trend in violent knife crime reported by the Metropolitan Police, hailed by Jack Straw as a “…combination of excellent police work, … and the courts following the Lord Chief Justice's much tougher guidelines …”, but appears to contradict medical evidencesuggesting that some major trauma hospitals are reporting increases in the numbers of people treated for serious stab injuries.HES records confirm that Injuries involving a knife or sharp instrument have indeed decreased since 2006/7 for both assaults and accidental injuries, and whilst this is a positive development to be welcomed, the parallel decrease in accidental injuries might imply that police involvement is not the sole cause of any decrease in assault admissions. Moreover, admissions for sharp object injuries classified as either undetermined or self-inflicted showed an increase post 2006/7. This presentation looks at trends in these admissions and the apparentcontradictionswhich are masked by the recently reported overall decreases, in particular multiple admissions to the same patients, increases in female admissions and increases in urban areas.

24th March 2010: 4:00pm to 5:30pm

Abstract: Abstract

Glasgow has a long history of gang violence, focussed on its most social excluded communities. Scotland has one of the highest homicide rates in Europe with violent deaths in young men contributing to maintaining Scotland's unacceptable health inequalities. A determined attempt is now being made to tackle these challenges through an ambitious Public Health Initiative, the Community Initiative to Reduce Violence (CIRV).

The author is the principal evaluator to the Violence Reduction Unit who are running the programme. He will explain the programme and present for the first time the evaluation strategy with its focus on a multilevel and mixed methods approach. He will describe the technical challenge and political sensitivity of evaluating this complicated £5Million multiagency intervention which operates at the interface of Public Health and Applied Criminology. He will share emerging data from the programmes first 18 months of operation.

Learning outcomes

1) That those attending should better understand the extent of gang related violence in the East end of Glasgow and its contribution to maintaining health inequalities
2) To inform those attending about the Community Initiative to Reduce Violence (CIRV)
3) To describe for the first time the evaluation strategy for CIRV

4) To present emerging findings 18 months into the programme

24th March 2010: 4:00pm to 5:30pm

Abstract: Public health is a knowledge business. It is a science and an art.
The Informing Healthier Choices Programme has seen the investment of a large amount of DH money tocreate tools for learning and tools for analysis,and to strengthen the capacity of individuals and organisations to work in partnership to make a difference.IHC has beena partnership with the Faculty of Public Health, the Association of Public Health Observatories, and The Information Centre.
The future is something that we have to imagine, design and make. These tools equip people in PH to have the skills to shape and deliver the future.
In thisfinal phase of the IHC Programme the full range of products – including e-learning, health profiles, prevalence modelling, public health library, health impact assessment, strategic environmental assessment, the ‘desktop' one-stop access point - will be demonstrated to show how they have and are being used to make a difference on improving population health, WCC, health needs, partnership working, preventing and managing chronic diseases, interventions to improve well-being, developing the workforce and more.
This interactive workshop shows the tools available, how theyhave beenusedandlistens tohow they can be improved, which will feed into the legacy and next steps.

24th March 2010: 4:00pm to 5:30pm

Abstract: There is a considerable and growing research literature linking home overcrowding with a number of adverse health and educational outcomes.
London Citizens, a community-based organisation, became aware that many households with children at primary schools in the London Borough of Wandsworth were living in conditions so crowded that their health, welfare and educationalprogressappeared to be affected. A sample survey of 125 households with children at three schools was carried out over the period October 2008 to June 2009.
The survey found that about 80% of the homes were overcrowded by Wandsworth's own generous space standards and about 20% by the less satisfactory national standards they are about to adopt. The survey was backed up by two public hearings where evidence was taken and a number of home visits to see the conditions at first hand. In somecases up to five children of very different ages aresharing a bedroom. Over 60% of the parents judged that the home conditionsare adversely affecting their children in a number of ways - including adverse effects on physical and mental health and social development.
The report will be finalised and publicised, with endorsement from the UKPHA,in November 2009.

24th March 2010: 4:00pm to 5:30pm

Abstract: Objective
Poor housing conditions have a profound effect on the health of its residents but the precise degree remains unanswered. Can this question be addressed by linking health and housing datasets?
Background
An innovative method has been developed linking Local Authority housing and NHS health data sets using house location, to provide detailed joint housing and health profiles. The technique offers the potential to study and explore local housing and health indicators in depth to measure the effectiveness of new/improved housing projects.
Method
We have used the National Land Property Gazetter (NLPG) to link health and housing dataset addresses to specify a Unique Property Reference Number (UPRN) for each home. Where no consistency exists in address format, sophisticated addressing algorithms have been used to generate UPRN's. Joint housing and health profiles are created by linking UPRNs. An Infant Mortality Prototype has been developed as an outcome indicator.
Results
The prototype indicated 5.4% of birth and 6.2% of death data were lost due to failure on generating UPRN or tenure. Infant Mortality rates were lowest in Council homes followed by Private homes and highest in Registered Social Landlord (RSL) properties.

Conclusions
The feasibility of linking health and housing data and the utility of this method has been demonstrated.

24th March 2010: 4:00pm to 5:30pm

Abstract: Sandwell is ranked 11th most deprived area in England and has high levels of non-decent housing. 40% of households in the private sector are vulnerable and it has consistently had the highest rates of Excess Winter Deaths in the West Midlands.
Sandwell's Housing and Health Group, which reports to the Local Strategic Partnership, is multi-agency in composition and has developed a Housing and Health Strategy. This strategy has identified joint commissioning and effective translation of policy into action as key success criteria.
It can be straightforward to get agreement in principle to the idea that poor housing can lead to poor health, but it is another thing altogether to secure funding from commissioners, particularly in these difficult financial times.
Sandwell has applied the Buildings Research Establishment / Chartered Institute of Environmental Health's cost calculator to quantify the costs to the NHS of non-decency.
This paper describes how Sandwell is working to overcome the hurdle going from agreement in principle to actual investment and joint working. It details the course taken so far, the business case for investment and how buy-in from stakeholders from housing, health and social care was achieved to ensure a shared and sustained approach to health-related housing interventions.

24th March 2010: 4:00pm to 5:30pm

Abstract: After being unquestionable ‘givens' in the UK throughout most of the 20th Century, modern economics and the concept of growth have recently been thrust into the spotlight. First by the threat of climate change, and then more sharply by the near collapse of the global economy. Even though it is increasingly common to hear talk of concepts like ‘zero-growth economy', few people have the basic knowledge of economics necessary to understand terms like this and why they may (or may not) be a good idea.
This presentation will provide a basic description of some of the core tenets of modern economics. It will then review of some of the major issues involved in the current discussions about why we need economic growth, if it is sustainable, and whether we should be looking at other indicators to guide our society. Does economics deserve its current standing, or is it in fact inherently both socially unjust and environmentally unsustainable? Why does having a debt-based financial system lead us to seek infinite economic growth? Is ‘development' the same as growth, and can either be sustainable? Is economic growth making us ‘better off'? Is it making us happy? If not what would?

24th March 2010: 4:00pm to 5:30pm

Abstract: Obesity and climate change are Wicked Problems. They are linked to another, causative Wicked Problem: increasing car ownership and use.
Policies to bring about modal shift away from cars are conventionally based on framing car use as an externality, addressable by policies such as taxation or regulation. These policies are typically unpopular with the public and, consequently, with policy makers.
We start instead with the individual, combining insights and methods from behavioural economics and social marketing: we propose shifting the focus by considering car ownership and use not as an externality to be addressed in the aggregate, but as the product of individual behaviours and lifestyle choices.
We propose that the conceptual frameworks, analytical methods, and insights from behavioural economics and social marketing are applied to car ownership and use: behavioural economics can help to uncover the heuristics and cognitive biases behind car-dependent behaviours, using concepts such as framing, choice architecture and salience. Social marketing builds on the premise that people will only change their behaviour given sufficient personal motivation.
This paper is designed to stimulate debate on how these, and related, concepts can be used to shape interventions aimed at addressing these Wicked Problems.

24th March 2010: 4:00pm to 5:30pm

Abstract: The International Energy Agency warned in 2008 of the real risk of an oil supply crunch by 2015 'we are not yet running out ofoil but we are running out of time'.
Current systems for healthcare delivery, food production, waterand transport are heavily dependent on cheap oil.Potential alternative fuels are either not production-ready, or they require replacementor upgrading of infrastructureto implement them. Some alternative fuels have thepotential for far higher greenhouse gas emissionswith a corresponding negative effect on climate change.
We need to prepare systems of food production, transport and healthcare delivery that will be viable once oil supply can no longer match global demand, and that meet carbon reduction requirements. This presentation will describe the problems faced, and some potential solutions. It is based on the results of ;
- work commissioned by The Bristol Partnership, fora 2009 report 'Building a positive future for Bristol after Peak Oil'. This work included assessements of oilvulnerability and preparedness of all major public sector organisations.
- three workshops run during 2009 with a range of expert participants, that looked at future planning for health and healthcarein the event of energy shortages and high energy costs.

24th March 2010: 4:00pm to 5:30pm

Abstract: JSNAs became a statutory duty for all upper tier local authorities and PCTs in 2008.
Despite inconsistent progress, there is strong commitment to JSNAs across national, regional and local audiences. This is not surprising given continued imperatives for stronger integration, rising pressures on services and a growing recognition of the case for integrated commissioning of preventative investment around the wider determinants of health. In this context, the need to reach beyond existing silos of health and social care commissioning is clear. JSNAs offer a fundamental first step to a comprehensive, local picture of health needs and inequalities, and to agreement of clear, overarching, evidence-based local priorities around health and wellbeing to commissioning.
The paper and workshop brings together learning from the past 6 months that has been produced through various sources, including collaboration with 9 JSNA pilot sites, a development programme with commissioners and work with the third sector.
The presentation will give the latest position with regard to JSNAs in England including:

Focus on health inequalities – and key areas like mental health, PSA16, alcohol and homelessness, children, and the preventative case for joint approached to the wider determinants of health.
Engagement with commissioners and third and community sectors
Use of qualitative data and local voice
QA: What the regulators think

24th March 2010: 4:00pm to 5:30pm

24th March 2010: 4:00pm to 5:30pm

Abstract: The City of Westminster has a diverse population, both in ethnicity and in socio-economic status. Life expectancy is longer than average and death rates are lower than in London and England, however men living in the 20% least deprived areas of Westminster live on average 12 years longer than those in the 20% most deprived areas.
NHS Westminster has commissioned the Healthy Futures programme to work from 2007 to 2011 on a yearly rotational basis within the most deprived super output areas, to reduce health inequalities. It centres around identifying the barriers to health in the short, medium and long term in each specific area and develops a programme to address them. It supports residents to make informed choices, facilitates multi-agency partnership development between mainstream and voluntary/community sector service providers and seeks to secure adjustments to mainstream service delivery to improve access and outcomes. It represents an innovative approach to breaking a cycle of poor health and well being in some of Westminster's most vulnerable neighbourhoods. A crucial component of the programme is community development, ensuring the outcomes of the project are sustained in the long term.
The findings of evaluation to date will form part of this presentation.

24th March 2010: 4:00pm to 5:30pm

Abstract: Background:
Evaluation is fundamental to improving health promotion practice. Measuring the effectiveness and efficiency of an intervention is often complex because of the nature of health promotion and its fundamental principles and goals. Evaluation frameworks, models and theories exist, but these need to be critically assessed in terms of their relevance for evaluating the multifaceted nature of health promotion projects. A Knowledge Transfer Partnership (KTP) funded research project between NHS Harrow and Brunel University is undertaking this assessment. The results will form the basis for developing a generic evaluative framework that will result in more relevant and convincing evaluations of all health promotion projects delivered through NHS Harrow. The findings of this research and the evaluative framework will be disseminated nationally and internationally.
Aim:
To develop a generic evaluative tool that can be used across a range of health promotion interventions.
Methods:
A critical appraisal of the literature on evaluation frameworks, models and theories will identify suitable components of evaluation for health promotion practice. These components will be used to develop an evaluative framework for health promotion.
Results:
The evaluation framework will be ready for dissemination in March 2010.

24th March 2010: 4:00pm to 5:30pm

Abstract: Sub-Saharan African women in the UK are disproportionately affected by HIV infection. They come from countries with high HIV prevalence and from cultures dominated by gender, cultural, social, economic and political inequalities. This paper explores to what extent African women in Scotland discuss sexual issues in their new environment with their spouses and to determine if there has been any cultural adaptation (acculturation) has taken place in the UK.
A mixed method was used which comprised of two phases: Phase 1 was a quantitative method using survey questionnaires and Phase 2, a qualitative method using focus group discussion
Nearly half (45%) of sexually active African women in this study have never discussed sexual issues with their partners. 72% do not like using condoms, 76% said their partners do not like using condoms. They see unfaithfulness, non-condom use, non-disclosure of STI /HIV status and secrecy in sexual issues as threats to their sexual health. African women still find it difficult to talk with their partners about sexual issues, because of cultural and religious taboos, the sensitive nature of the subject, fear of accusation, and lack of knowledge and low-risk perceptions.
African women need information, skills, training and support to exercise their sexual rights and protect themselves from infection, or coercion or abuse.

24th March 2010: 4:00pm to 5:30pm

Abstract: Unsafe sex and unintended pregnancy are sexual health problems prevalent globally, reflected in United Nations and World Health Organisation policies. Outcomes of unintended pregnancy include unplanned childbirth and abortion and are associated with negative physical and psychosocial health implications for women.
In Scotland, the Scottish Sexual Health Strategy (SSHS) has the overarching goal of improving the sexual health of the people of Scotland. One of the goals of the SSHS is to reduce rates of unintended pregnancy and one policy intended to achieve this is ‘widening access to emergency contraception' (EC).
Thisresearch examines the success of the SSHS with reference to the implicit link it makes between national policies and local strategies which expand access to emergency contraception, and improving its effective use, thereby reducing rates of unintended pregnancy.
The key conclusion is that this link is a weak one, since there is evidence that efforts to expand access to EC in the UK have failed to reduce rates of unintended pregnancy. The pursuit of maximum access to EC as a distraction from the goal of reducing rates of unintended pregnancy is discussed, and potential future approaches both to expanding access toeffective contraceptionand reducing rates of unintended pregnancy in the UK are explored.

24th March 2010: 4:00pm to 5:30pm

Abstract: There remain significant differences in teenage conception rates across the UK and within individual counties including in areas with similar levels of deprivation and contraceptive and sexual health services. There is a paucity of evidence to explain the underlying mechanisms that determine this differential in conception rates.
This study explored what young women believe to be the underlying causes of teenage conceptions. Eight major themes were identified, three of which were reported by all participants; attitude to school, self-esteem and aspiration. There was significant interrelationship between these themes which remained strong during the focus group. Participants agreed that the psychosocial theory of health inequalities provided an explanation for low self-esteem, aspiration and attitude to school.
The locality in which the young women in this study lived appeared to determine their self-esteem, aspiration and attitude to school with young women in one of the localities more likely to have low self-esteem and aspiration seeing school as irrelevant to their life course. Successful interventions to reduce teenage pregnancy need to focus on raising self-esteem and aspiration and offering a wider programme of study at school. The root cause of teenage pregnancy is inequality; interventions to raise self-esteem and aspiration will only have

24th March 2010: 4:00pm to 5:30pm

Abstract: There is increasing interest in health systems worldwide. World Class Commissioning in England has emphasised the need to access comparable information and intelligence from sources outside the UK, and from our near neighbours in Europe.
Traditionally, international comparisons are made at national level; however, such comparisons hide important differences within countries. Public Health Observatories have been working with European equivalents to develop a set of comparable benchmarks for all the regions in Europe.
This presentation will describe one such project which is funded by the European Commission (I2SARE). This project will produce health profiles for every region in Europe during 2010. The data collection stage has been completed and a classification system for identifying similar regions has been developed. The details of this will be presented
Learning objectives
This session will
Provide an oversight of information sources to measure health improvement internationally, particularity across Europe.
Consider the difficulties and challenges in making international comparisons
Make recommendations and plans for improving international collaboration in this field in the future.

24th March 2010: 4:00pm to 5:30pm

Abstract: As the recession starts to bite minds, once again, start to focus on tangible organisational, short term savings, in the form of bed days saved, admissions avoided and targets met. The social costs of poverty, exclusion and social fragmentation do not feature on the NHS financial balance sheet. While evidence of the long term impact of these issues is generally not contested, evidence of effective intervention, which sits neatly within a quantifiable paradigm of cause and effect or invest to save, is harder to find.
To make the case NHSBristol Public Health Directorate have developed a new conceptual model which links world class commissioning outcomes directly to key prevention themes, drawing on the New Horizons for Mental Health framework. The model illustrates how disinvesting, or under investing in key areas of prevention - such as ensuring a positive start in life, staying safe and connected cohesive communities will inevitably lead to higher costs and worse health outcomes for diseases such as cancer, heart disease and dementia and issues such as alcohol, smoking and obesity.
We will describe the conceptual model, and invite critical discussion about ways in which this approach could be developed and applied.

24th March 2010: 4:00pm to 5:30pm

Abstract: A major aim of the district's Joint Strategic Needs Assessment is to shift expenditure along the pathway from acute to community or preventive care. Two areas were chosen for consideration: heart disease and mental health. Both of these are serious problems for the district, with higher than the national average prevalence rates.
To assess both the current situation and potential areas for change, expenditure pathways - based on patient pathways - were developed, following consultations with strategic and operational managers in both health services and the local authority. These pathways showed areas where movement of funds was already happening and identified points where changes in commissioning arrangements might allow the shift towards preventive care.
The model developed during 2008-09 has now been partially populated. Given the intention was to use routine data the timeliness of its availability has been disappointing. The potential contribution of programme budgeting is being explored, and pointers for this work nationally are emerging. A major output has been establishing links between the JSNA and other strategies e.g. housing, children and young people.
Initial results will be used locally to maximise leverage:
• to ensure resources are shifted upstream
• to drill down in programme budgeting

24th March 2010: 4:00pm to 5:30pm

Abstract: The WHO Commission argued that “Health inequities are the result of a complex system operating at global, national, and local levels which shapes the way society, at national and local level, organises its affairs and embodies different forms of social position and hierarchy. The place people occupy on the social hierarchy affects their level of exposure to health-damaging factors, their vulnerability to ill health, and the consequences of ill health.”
Research suggests that Gypsies and Travellers have the worst health status of any ethnic minority in the country.
Despite isolated initiatives designed to improve health outcomes for the Travelling Communities, achievements are not being cascaded or embedded and declining health outcomes continue.
The presentation Chronic Exclusion and the Growth in Inequalities faced by Gypsies and Travellers will reflect upon the graduated model of inequality presented to the Marmot enquiry and increasing evidence of the failure of the current Equalities agenda to bring tangible improvements for those at the bottom of the ladder.
The work of three organisations keen to improve the plight of Britain's 300,000 Gypsies and Travellers, will be described in detail in order to demonstrate the effectiveness of joined up and multi disciplinary working to influence/change policy .

24th March 2010: 4:00pm to 5:30pm

Abstract: In 2007 a Community Food Worker (CFW) project was established in Salford, in the North West, to offer local people support to improve their diet and thus contribute to the reduction of health inequalities. Salford is an area identified as being significantly worse than the national average in a number of key health indicators. Throughout the project CFWs liaised with local people in a participatory way to develop bespoke interventions, aimed at improving knowledge, skills, confidence and behaviour in respect of healthy eating.
Evaluating such interventions has been identified in the literature as ‘confusing' and furthermore there is a lack of user friendly tools available that are able to effectively measure the diversity which exists in community food projects. However, there is increasing emphasis in public health for the evaluation of such initiatives, both at a national and local level in order to strengthen the evidence base and secure further funding.
This paper seeks to explore the complexity of using a bricolage of evaluation methods to capture the effectiveness of the CFW Initiative. These methods included bespoke ‘pre' and ‘post' questionnaires and focus groups (with participants), reflective workbooks and interviews (with CFWs). This paper aims to present an outline of the findings, including lessons learnt and key recommendations.

24th March 2010: 4:00pm to 5:30pm

Abstract: Increasingly community and voluntary organisations are working to demonstrate their impact in social, health and economic terms. Economic pressures and the developing outcome focused climate reinforce the need to demonstrate the true value of community based health initiatives.
In Scotland work has been undertaken to explore the theory of economic evaluation and how this relates to community based health initiatives. This work, commissioned by NHS Health Scotland, has stimulated activity and dialogue amongst community/voluntary organisations and commissioners/funders. Community Food and Health (Scotland) have further explored the practical application of economic evaluation with two additional community food initiatives – the Happy Jack project and The Food Train. These commissioned case studies present an opportunity to consider the application of different approaches to gathering economic evidence with two very different models for addressing barriers to access and uptake of healthy food.
The completed reportswill be used to share findings and lessons learnt from gathering and analysing economic evidence. Preliminary findings demonstrate the benefit of using economic evidence and the value of this approach for highlighting the true impact of community food initiatives.

24th March 2010: 4:00pm to 5:30pm

Abstract: The Department of Health's South West Regional Healthy Weight Healthy Lives team are undertaking a programme of Peer Review across the region focused on Adult Obesity work.
The aim of the Peer Review Programme is to create a clear picture of the present status of work on Adult Obesity in all geographical areas of the South West, to identify good practice, focus attention on elements of this work where improvements could be made and to build consensus among stakeholders on priorities for the future.
All 14 PCT areas in the South West, including the PCT and partner organisations from their Local Strategic Partnership, will undergo a review. This will involve a desktop search followed by a series of face-to-face interviews with a panel of reviewers drawn from around the region.
The outcomes of the Peer Review Programme, which concludesin April2010, will include recommendations for each local area to take forward to improve the delivery and impact of their work on Adult Obesity. It will also provide a consolidated analysis of, and report on, progress, issues and challenges across the region with regard to programmes/services targeting Adult Obesity and enable sharing of best practice and learning across the region.

24th March 2010: 4:00pm to 5:30pm

Abstract: A highly interactive workshopwill engage the audience in discussion of the effective partnership working, leadership and improvement skills required to deliver real change on the ground in the complex adaptive systems which characterise local public sector services and partnerships. The session will combine theory, practice, discussion and debate and will draw on the learning and experience from deliveringthe 'Leading Improvement for Health and Well-being Programme' for senior managers as well as community and voluntary sector activists from across local strategic partnerships.
Professor David Hunter will outline the changing national context and invite discussion on the challenges and implications for public health at a time of unprecedented political change and financial constraints.
Trevor Hopkins will examineand invite responses toa number ofrecent local solutionsdesigned to address the national imperatives includingnew models of leadership, how to lead more effectively inlocal partnerships and theleadershipchallenges ofTotal Place.
Dr Catherine Hannaway will outline how we can support the leadership development needs of individuals and teams tasked with achievingimproved health and well-being.She will invite suggestionson what is theappropriate support requiredto develop the leadership knowledge and skillsrequired to fulfil this challenging agenda.
The ‘Leading Improvement for Health and Well-being Programme', designed and delivered by the session leads is a new partnership approach to improving health and well-being. A unique feature is its focus on the development of leaders skilled in collaborative leadership and partnership working, engaging others and developing and applying skills of improvement science.

24th March 2010: 4:00pm to 5:30pm

Abstract: From existing studies and service data It was unclear to what extent NHS stop smoking treatments are proportionate to levels of smoking and socioeconomic disadvantage. A prevalence estimation model was developed that provided age, gender and deprivation adjusted smoker estimates at neighbourhood and GP practice level in Sheffield. The aim was to assess to what extent NHS treatments were aligned to need, and to apply the modelling approach to identify communities having large numbers of untreated smokers for targeted intervention. We found rates of treatment rose in proportion to the number of smokers in both neighbourhood and practice populations, although weaker for successful quitting outcomes. We also found a favourable trend of increasing treatment rates with increasing deprivation, however the treatment rate per 100 smokers fell-off in most deprived neighbourhoods, revealing a residual inequality not apparent from crude population rates. Large reservoirs of smokers not accessing treatment were identified in both high and low smoking prevalence neighbourhoods. An intensive multi-agency community programme in these underserved neighbourhoods resulted in large proportional increases in treatment and quitting outcomes, and eliminated the treatment gap in the most deprived areas. The presentation will outline the modelling method and analytical results, the multi-faceted community intervention and programme evaluation.

24th March 2010: 4:00pm to 5:30pm

Abstract: Smoking during pregnancy is detrimental to babies and can cause increased risk of miscarriage, stillbirth and low birth weight. For mothers, the risks of smoking are no less apparent – smoking remains the main cause of preventable illness and premature death in England. Giving up smoking, therefore, remains the most effective action women can take to protect their own health and the health of their unborn child.
We looked at the smoking patterns of pregnant women in NHS Stoke-on-Trent using hospital data (2006/07-2008/09) and found: the percentage of women smoking during pregnancy increased from 19.0% in 2006/07 to 23.4% in 2008/09; pregnant women aged 17 and under were most likely to smoke; smoking during pregnancy was highest in the most deprived ward; smoking during pregnancy was highest among the most deprived quintile of deprivation; smoking during pregnancy varied by Mosaic group.
Building on local social marketing work undertaken in 2007/08, which looked at understanding the needs of pregnant women, we are now using the Mosaic population segmentation tool to help drive forward further service development. Mosaic is a profiling tool that helps describe different types of people living in particular areas, what their needs are and how best to engage with them.

24th March 2010: 4:00pm to 5:30pm

Abstract: The campaign incorporated 2 key features:
1. Local BME organisations identified community champions to deliver stop smoking sessions.
2. An Incentive scheme of a reward system over a four week period totalling £100 which would appeal to all BME audiences.
Sessions were held in local restaurants from 5pm to midnight. During busy periods sessions were held in the kitchens so staff could speak to advisors while working. In some establishments waiting areas were used for those only seeing an advisor.
The local International Food Store held stop smoking sessions. One session was during peak trading time after prayers had finished in the nearby Mosque. All store staff successfully quit and became unofficial champions by referring customers to the scheme.
Home visits increased for ladies who were chewing tobacco. This accessed a section of the community previously difficult to target.
Prior to the scheme, 4 week quitters from BME communities each year, on average, totalled 27.
The 4 months of the campaign achieved 326 quitters.
In July 2009 6 month follow ups on all quitters from January 2009 showed 39 out of 56 self reported as still being quit. 12 self reported as relapsing and 5 were lost to follow up.

24th March 2010: 4:00pm to 5:30pm

Abstract: The Health Inequalities Intervention Toolkit contains evidence to support planning to achieve the Public Service Agreement target to reduce inequalities in life expectancy. The new version of the toolkit contains latest available data to allow areas with the worst health and deprivation indicators (the Spearhead Group) to compare their life expectancy to the population of England as a whole. The toolkit also lets users examine health inequalities within every English local authority.
This presentation will demonstrate how the toolkit shows users the causes of death which are driving health inequalities in their areas, as well as presenting breakdowns of inequality gaps by age group and sex. It will also explain how the toolkit helps users to assess the impact that evidence-based interventions can have on reducing inequalities in life expectancy, such as by increasing numbers of smoking quitters or targeted prescribing of antihypertensives and statins.
The toolkit has been developed by the Association of Public Health Observatories and Department of Health to support Primary Care Trusts and local authorities in evidence-based local service planning and commissioning to achieve national targets to reduce health inequalities. It can also inform Joint Strategic Needs Assessments and national priorities within the 2007 Operating Framework.

24th March 2010: 4:00pm to 5:30pm

Abstract: Design and Method:
The Department of Health (DH) leads England's health improvement interventions and sets policy direction for the priority areas of obesity, mental health, drugs and substance misuse, sexual health, smoking, alcohol abuse and physical activity. The Healthy Foundations Life-stage Segmentation Project surveyed the population of England looking at all health priority areas.
The overall objective is to provide a more coherent view of the nation by segmenting the population into different target audience groups, based on their life-stage, the environment they live in and their motivation to live healthily.
A stratified random sample of 5000 people were surveyed, followed by a large scale qualitative research project.
Results:
A hierarchical cluster analysis was used to divide the population into five motivational segments derived from a range of psycho social variables. They are Balanced Compensators, Hedonistic Immortals, Live for Todays, Unconfident Fatalists, Health Conscious Realists.
Conclusion:
The Healthy Foundations Life-stage Segmentation Project has created a robust model to gain a holistic understanding of how the population develops unhealthy behaviours. Themodel addresses the core themes of the Marmot report by providing an evidence-based approach to tackling health inequalities and ways in which the evidence can be translated into practice. It is also a sophisticated and standardised approach for measuring behaviour change.

24th March 2010: 4:00pm to 5:30pm

Abstract: Population health measures have stagnated due to health inequalities between socio-economic classes. Norman Daniels, argues that one strategy to counter this stagnation resides in ‘flattening' the gradient between socio-economic classes, such as by the enactment of policies that promote equity through social justice(SJ). This presentation supports Daniels' theory by demonstrating a physiological link between SJ and health by merging his theory with allostatic load(AL) biomedical research. We also demonstrate that by quantifying AL, decision-makers can obtain methods to evaluate the efficacy of policies that promote SJ in terms of benefit in public health.
Allostasis refers to adaptive biological responses to environmental stressors. Prolonged activation exerts strain, or AL, on these same systems via maladaptive recalibrations that increase susceptibility to disease. Conditions of chronic stress increase as one proceeds down the socio-economic ladder. This trajectory embedded within social inequalities is measurable using allostasis biomarkers predictive of adverse health outcomes. By triangulating knowledge of health inequalities, social justice, and allostasis, we provide evidence that promoting social justice can improve population health. The ability to minimize AL by interventions such as poverty alleviation, suggest that measuring AL at the population level could be a means to assess public health policies that promote SJ and improve health.

24th March 2010: 4:00pm to 5:30pm

Abstract: Smallsteps4life website has evolved from a Food Standards Agency research pilot that explored the impact of a health challenge in primary and secondary school pupilsin Kent.
In the pilot there were organised group challenges such as dance and walking a mile a day, and personal challenges such as trying new healthier foods. As well as having fun, two-thirds maintained some challenge activity 4 months after the health challenge. The findings suggest that the health challenge helped to raise awareness of healthy lifestyles. And, in addition, the active participation and mutual support provided young people with practical skills to make healthier choices.
Based on this research, and now linked to London 2012 and Change4life, the interactive Smallsteps4life website inspires and supports young people to take their own small steps to improve their health and well-being. Choosing from achievable lifestyle challenges young people can embrace the excitement of the community and competitive nature of the Olympiad. Recognised as an outstanding project, Smallsteps4life will spearhead delivering the Games' lasting legacy.
The presentation will describe the inspirational Kent research, introduce the website and local engagement work, provide a taster challenge, and discuss how to get involved.

24th March 2010: 4:00pm to 5:30pm

Abstract: Since the Healthy Schools Programme was re-launched in 2004 the South West has been highly successful with over 85% of schools gaining Healthy Schools Status (Government target 75%) and over 99% of schools participating. The challenge has been to move schools and local healthy school programmes onto focusing on bringing about healthier behaviour outcomes and addressing health inequality issues.
SW Healthy Schools Plus has been designed to help schools identify local and school health issues which are universal and target specific groups in challenging circumstances in order to bring about healthier behaviours. Schools that are locally defined as the most deprived are prioritised. At present over 500 schools are following the programme.
This presentation will show how local programmes worked collaboratively to develop and roll out this programme, using acommunity development model. It will also look at methodological developments required to assist schools to identify and prioritise needs, provide a baseline of current behaviour, and formulate appropriate healthier behaviour outcomes. The range of evidence-based/best practice interventions will be shown. It will also illustrate how SW Healthy Schools Plus has become a vehicle for engaging partners to work with schools to achieve place objectives. Early success indicators will be highlighted as well early evaluation results.

24th March 2010: 4:00pm to 5:30pm

Abstract: HOUSE is an award winning campaign for young people to promote public health messages on smoking, alcohol, drug misuse and sexual health. Using social marketing principles, HOUSE is unique and innovative and steps back from a provider or service led approach. Young people told us they wanted a safe, comfortable and cool environment close to where they naturally congregate in 12 town centres in Kent. Sited in empty shop premises, dressed as a theatrical set resembling “a mate's house”, and equipped with Wii Fit, computers, coffee machine, dance machine and activities (from music rapping, MCing and DJing to Chlamydia tests). HOUSE is designed, owned and valued by young people and has attracted over 10,500 visits many from groups considered hard to reach.
There is no formal publicity for HOUSE and it uses only “guerrilla advertising” and word of mouth. The branding and lack of official agency logos is innovative and key to the enormous success of HOUSE and we are proud that its success has won Gold in the APG Creative Strategy Awards 2009. The award citation said about the House campaign that “Imaginative and effective channel thinking like this is rare and precious”.

24th March 2010: 4:00pm to 5:30pm

Abstract: Drawing from case studies from different Primary Care Trusts, this workshop will review how different population insight and engagement projects have enabled local partnerships to commission more efficiently and effectively to reduce health inequalities and target, reconfigure and prioritise services.
Particularly, we will focus upon the benefits of segmenting your population to benchmark the different needs of local communities; the importance of joined-up intelligence for effective partnership working; and how targeted engagement strategies can reach those most at risk.
A selection of local work is presented from a range of PCTs, from more deprived inner city areas through to large shire counties.

This session will illustrate;
1.How better intelligence and population insight can help PCTs identify where they might achieve significant cashable savings.
For example, in one PCT, for just three conditions where the level of hospitalisation is significantly higher than expected given the local demographic profile, potential savings of over £1m were identified.
2.How population segmentation and specific targeting of interventions can help PCTs reach high risk populations more effectively and efficiently.
For example, how a social marketing campaign to reduce smoking prevalence and health inequalities achieved a more than 50% uplift in the number of quit dates.
3.How efficient data integration, knowledge management and partnership working can promote locality profiling and reduce the analytical burden of reporting and monitoring key outcomes.
For example, how the analytical demands of World Class Commissioning, the Joint Strategic Needs Assessment and Directors' Annual Reports can be achieved through a combination of online tools, local knowledge and partnership work.

24th March 2010: 4:00pm to 5:30pm

Abstract: Warwickshire has a growing population of older people with a diverse range of needs. In 2006, Warwickshire County Council set up PHILLIS, a brokerage service for people 50+ who were developing low-level needs within a wider policy context of increasing emphasis on early intervention; putting in place a ‘little bit of help' to prevent or delay the need for more costly/intensive services and to improve quality of life. PHILLIS goes beyond signposting, supporting older people in identifying their needs and increasing the choice of services available to them to meet those needs.
A key element of PHILLIS's development involved building relationships with service provider organisations to develop a network that could better address need through stronger links and smoother referral pathways. This encompassed a vast range of services including but not limited to housework assistance, befriending, health promotion, advocacy and benefit entitlement checks. Organisations spanned the statutory, commercial and voluntary sectors. This paper explores the PHILLIS team's experiences of attempting to build this network and the role of network analytical techniques in the evaluation of this process. The paper identifies examples of best practice and the opportunities and barriers to developing such networks.

24th March 2010: 4:00pm to 5:30pm

Abstract: The South West has the longest life expectancy in England. In the South West the proportion of mature adults is higher than in any other English region and people above age 50 make up nearly 40% of the population. There are now more people aged over 50 than under 25 years in the South West, a reversal of the position in the 1970s. The South West has a greater percentage of over 80 year olds than other regions. The changing demographic profile of the region is set to continue.
We identified the changing patterns of mortality and morbidity for this older age group and the impact on health inequalities. Inequalities were explored in relation to lifestyle, economic and social factors as well as health care interventions and the patterns of NHS and social care activity.
The best tools for projection and prediction of future disease burden were identified and used to produce analyses of changing morbidity patterns for the region. This analysis will ensure that the report is meaningful and useful for health and social care commissioners.
This work is being produced as a South West Public Health Observatory report to follow up the earlier ‘Second Blooming' report.

24th March 2010: 4:00pm to 5:30pm

Abstract: This paper reviews inequalities in access to cancer care in South Central SHA for the four most common cancers: lung, colorectal, breast and prostate. The analyses use routine health service data (Hospital Episode Statistics, Cancer Waiting Times data and cancer registration data) to examine variations in the proportion of patients:
1. Urgently referred under the two week wait scheme
2. Admitted to hospital, including the proportion of emergency admissions
3. Receiving treatment of curative intent within six months of diagnosis.
The analyses were broken down by age (under 75 and 75+), sex and deprivation quintile; this paper focuses on the findings for age, in line with the conference theme on ageing and inequalities.
There was no evidence of age bias in the likelihood of being referred under the two week scheme, except for breast cancer where older women were more likely to be referred urgently. In contrast, emergency admissions made up a significantly higher proportion of all hospital admissions among the 75+ age group for all four cancers.
Other findings to be presented include trends by deprivation for admission rates, and geographical variation in the distribution of risk factors, hospital admission rates and the proportion of patients receiving treatment.

: 3:02am to 3:02am

Abstract: Every year thousands of children are injured in preventable accidents at home and on our roads. LV= Streetwise works closely with like-minded agencies and organisations to deliver the preventative education that will help to reduce both the tragic heartache of lives lost or ruined and the financial cost of avoidable accidents to the services involved in dealing with the aftermath.
LV= Streetwise is an award winning interactive safety education centre - a life-sized indoor village where children discover how to keep safe and what to do in an emergency - learning about accident prevention at home and on the roads, fire safety, responsible behaviour and good citizenship in an exciting and memorable way. The centre is also extensively used by the emergency services for
'real-life' role play training.

25th March 2010: 12:00pm to 1:30pm

Abstract: To coincide with one of this year's keynote conference speakers Professor John McKnight from Northwestern University one of the originators of Asset Based Community Development, the Improvement and Development Agency will run a workshop to explore the progress that has been made developing this approach and the potential that is has in delivering improved health outcomes. John McKnight himself will chair this workshop.
At last year's conference the I&DeA's Healthy Communities Team ran a workshop to introduce the concept of using asset approaches to challenge health inequalities. A year on, our ideas are much more fully formed and several pilots using asset based approaches are now running in Councils and PCTs across England. An I&DeA publication, written by Jane Foot and Trevor Hopkins, will be launched at this session. Available to all delegates it will make the case for an Asset Based Approach and detail the approaches and techniques that policy makers and practioners can use to ensure effective community development which offers a real challenge to health inequalities.

25th March 2010: 12:00pm to 1:30pm

Abstract: Elected local councillors have a democratic mandate to act as leaders in their communities. Since 2001 Councils have had a remit to review and scrutinise local health issues and services and to hold commissioners and providers to account for how effectively they are meeting local health needs. But how can these powers of ‘health scrutiny' be effectively harnessed by public health professionals to help deliver health gains in communities?
The Centre for Public Scrutiny is commissioned by the Department of Health to run a support programme for Councils and NHS partners to improve the effectiveness of health scrutiny. This session will draw on learning from this programme from across England, as well as a specific project looking at the role of Councils' scrutiny committees in informing Joint Strategic Needs Assessments and influencing commissioning decisions.

25th March 2010: 12:00pm to 1:30pm

Abstract: Widening health inequalities, an increased interest in health improvement, and the current major public health challenges demand a strong interdisciplinary response. This requires a more up-skilled and wider inter-disciplinary public health workforce and the alleviation of “siloed” workforce planning which inhibits the achievement of interagency collaboration. These drivers necessitate a vehicle equipped to help partner professions understand and incorporate integrated workforce planning into practice and commission training and development on the basis of collaborative approaches to service delivery.
To respond to this, the West Midlands Teaching Public Health Network and Supporting Public Health (formerly PHRU) have developed “PHILEAS” , an interactive, inter-professional training needs assessment process using the Public Health Skills and Career Framework, through a series of pilot projects undertaken in West Midlands and North East England .
The PHILEAS process identifies workforce capability, competence and knowledge within and across sectors, and has the potential to reduce training duplication in a multi-organisational environment. It can be used to identify: the parameters of the wider public health workforce that needs to be engaged in delivering on public health topics; the learning and development needs linked to a particular public health theme; and the best approach to commissioning training.

25th March 2010: 12:00pm to 1:30pm

Abstract: Background: Recent policies identified nurses as key to reducing health inequalities using public health strategies, resulting in increased public health content in pre-registration nursing curricula despite evidence that tackling inequalities requires greater attention to socioeconomic determinants of health (SDH). A surprisingly limited literature explores nurses' perceptions of their role in SDH, given that some nurses now contributing to public health agendas have only recently considered themselves as public health practitioners.

Aim: This research project aims to explore nurse educationists' interpretation of public health principles and the influence of recent United Kingdom public health policy on their everyday nurse education practice.

Methods: 26 higher education institution-based public health nurse educationists participated in this qualitative study. Systematic analysis of semi-structured interview data revealed two tendencies. One maintains that redressing health inequalities requires reconfiguration of societal systems so everyone has genuine opportunities to access good health and wellbeing. The other insists people have control over their health and wellbeing, and addressing inequalities requires healthcare and health services improvements so everyone has genuine chances to utilise available services.
This presentation demonstrates emerging shifts in nurse educationists' interpretation of public health as justification for social justice.

25th March 2010: 12:00pm to 1:30pm

Abstract: One way to avert a public health crisis is to ensure that public health really is everybody's business. An important group to whom this mantra applies is front line health professionals, whose day to day work should contribute to improvement in population health and prevention of disease.
With this in mind, LTPHN was commissioned by DH to develop a series of teaching units aimed at undergraduate health professional courses, including nursing, physiotherapy, medicine, pharmacy, nutrition and others.
The presentation will describe how key partnerships were developed to deliver this project in order to create teaching materials of practical use to clinical teachers faced with teaching public health at the NHS front line including content often outside their own teaching experience.
The partners included universities and teachers responsible for delivery of pre-qualification courses, health regulators responsible for defining curricula and standards of professional practice, public health academics and the students themselves. The outcomes of the project, including several challenges that were tackled, will be shared – including how to include public health content in routine clinical teaching and how to make it a desirable ‘must have' element of clinically oriented courses.

25th March 2010: 12:00pm to 1:30pm

Abstract: This paperassesses the degree towhich community pharmacy in England has been successful in developing new roles in public health. We discuss the continuing barriers to accomplishing these roles, drawing on a review of the pharmacy practice literature together with insights gleaned fromparticipation in recent professional development settings. We argue that despite formal government support in terms of policy documents and White papers, plus guidance from professional bodies (all of which re-confirm support for the new public health activities for community pharmacy), and considerable enthusiasm within the profession for change, it remains the case that public health roles have not replaced dispensing and sales of over-the-counter medicines as key activities (and remuneration streams) for pharmacy. Indeed, the vision of a ‘public health' pharmacy remains a distant prospect, despite some evidence of progress. We suggest that many empirical studies (and indeed contemporary policy analyses) have failed to graspthe range of factors which continue to thwart changein this sphere. In particular, we draw attention to pharmacy's subordinate position (to medicine) in the healthcare division of labour, and emphasise the growing corporatization of community pharmacy (with concomitant impacts on professional socialisation and autonomy). We discuss how pharmacy might address these barriers in its attempt to forge new public health roles.

25th March 2010: 12:00pm to 1:30pm

Abstract: As the ecological and economic crisis deepens, the links between sustainability and health and wellbeing are increasingly being recognised. These links are multifaceted, often engaging with a wide range of factors and agencies that are not primarily regarded as being concerned with health.
This presentation reports on a study (commissioned by the UKPHA Scottish Committee) that is exploring some of these links through a series of Scottish case studies. The case studies focus on the wider ecological infrastructure of health and wellbeing in the context of recent Scottish developments at both grass roots and devolved policy levels. By using a systems approach, and by describing what works in response to the crisis, the study is intended to make connections, build networks and promote action, while at the same time raising issues for the future.
The case studies focus on four particular themes.
· Food, sustainability, and health and wellbeing
· Physical activity, active travel, greenspace and health and wellbeing
· Sustainable procurement policies and their contribution to health and wellbeing
· Developing sustainable, resilient and healthy communities
The case studies raise wider issues about the relationship between human and ecological health and wellbeing and these will also be discussed.

25th March 2010: 12:00pm to 1:30pm

Abstract: The World Health Organisation considers climate change to be one of the biggest public health challenges of the 21st century. The Department of Health is committed to sustainable development and the NHS Sustainable Development Unit, NHS Confederation, Faculty of Public Health and British Medical Association have all recommended that the NHS should lead the way in improving public health by addressing climate change and promoting sustainable communities.
Climate change is set to increase health inequalities and committed leadership from health professionals now and in the future will be critical to mitigating its impact. Advocacy is required at both individual and organisational levels to influence Government and NHS policy.
We describe our actions, as public health trainees, to advocate for change in our Deanery region. This includes setting up a working group, measuring and aiming to reduce the carbon footprint of public health trainees as well as strategies to raise the debate among public health professionals in our region about the relevance of climate change.
We recommend that climate change and sustainable development become an integral part of the curricula for trainee health professionals so that we can develop the champions of the future.

25th March 2010: 12:00pm to 1:30pm

Abstract: “Public health practitioners are increasingly being urged to lead a societal response to the threat of climate change and resource depletion. Public health can make its best contribution by adopting a new mindset, discourse, methodology and set of tasks.
The Transition Town movement is a grass-roots response to growing environmental concerns. Of very recent origin, it is spreading rapidly worldwide. The Transition approach is practical and health-enhancing, focussing on building strength and resilience in local communities. It encourages those involved to work closely to build and rediscover community spirit. Transition supports local businesses and suppliers, encourages learning how to grow food in back gardens, community orchards and allotments, reducing dependence on external food supplies. Transition encourages the sharing of traditional and new skills across generations. There is no single Transition model, but most work on common concerns, such as energy, transport, food, local economies, biodiversity, and community capacity building.
Groups from the conurbation of Poole, Bournemouth and Christchurch have adopted the Transition approach, and are working with local authorities, voluntary groups and health services on a number of recent initiatives. Local people involved with setting up “Transition BH Hub” and its associated groups will describe its formation, successes, vision and future challenges. “

25th March 2010: 12:00pm to 1:30pm

Abstract: Concerns about well-being permeate political debate and influence policy making. The discipline of Public Health also routinely incorporates ‘well-being' into its discourse, but often with minimal scrutiny. We therefore present a rough guide to understanding this complex and contested territory. We map three main pathways through multiple literatures, encompassing evidence, theory and speculation en-route. The first pathway takes us through the shifting sands of well-being research itself. Here we discover some very different forms of understanding about what well-being actually is. The second pathway takes us onto the sharp ground of critical territory: here we find that current understandings of well-being have been shaped by the particular demands of a capitalist economic system, with harmful implications for well-being. Our third pathway is an uphill trek through a more radical discourse, one which extends the critique of consumer culture's influence on well-being to the context of global problems. This pathway provides the widest perspective for the public health traveller but may be the most difficult to navigate. It takes us into ecology, ethics and much else, and suggests that we may need to reconsider what it means to be human, and how to live, if we are to survive and thrive.

25th March 2010: 12:00pm to 1:30pm

Abstract: This paper presents the effectiveness of an innovative joint "Gym for Free" scheme between the Local Authority and Primary Health Care Trust in relation to its access, utilisation, perceived health and wellbeing of the target population and its sustainability in prevention and management of obesity. Methods of data collection were survey, and focus group interviews. 257 participants of the scheme were recruited for survey and 17 informants for 3 focus group interviews. Quantitative data entered into the SPSS package, and analysed using both descriptive and inferential data analysis. Focus group interviews recorded and transcribed, and analysed using Krueger's framework (2000. Findings suggest that the scheme has been successful in increasing the uptake particularly amongst the most economically disadvantage group. There was a marked difference between the use of leisure facility before and after the introduction of the scheme, and particularly in relation to the frequency of use. The scheme had multiple benefits including physical, mental and emotional. It also promoted social networking and lifestyle changes such as: eating more fruit and vegetables less fatty and sugary food less binge drinking. One third of participants reported 3-7 kg weight loss. In conclusion, the scheme had a positive impact on their health and wellbeing within the first 6 months and widened participation.

25th March 2010: 12:00pm to 1:30pm

Abstract: This project aimed to have a positive impact on the mental health and well-being of staff who are on extended sick leave and whose return to work is being delayed due to depression, lack of confidence or lack of motivation. A programme of creative activities was designed to help achieve the following outcomes for staff participating in the project: Improved mental health and well-being; More positive attitude towards work; Staff return to work earlier than expected. The staff that attended the programme were referred by the Occupational Health team. They came from all roles and grades within Cornwall's NHS and suffered from a range of health issues that prevented them from working. The sessions took place in a neutral non-NHS setting. Participants self-assessed their mood, self-esteem, anxiety levels and decision-making processes before and after the project. and were also assessed by the Occupational Health team. The outcomes exceeded all expectations with a significant number of participants returning to work much sooner than anticipated and all reporting improvements in their mental health and well-being and support networks. Planning is currently underway to expand this programme to enable more staff, and the NHS as a whole, to benefit.

25th March 2010: 12:00pm to 1:30pm

Abstract: Collection of accurate information relating to people's attitudes and behaviour surrounding alcohol informs public health strategy & policy and predicates useful assessment of intervention effectiveness.
As an alternative to annual formal representative surveys, NHS East of England has recently undertaken an internet-based survey to monitor people's attitudes and behaviour surrounding alcohol, on a more up-to-date basis. This was conducted via an online questionnaire using a combined sample of the Ipsos MORI online panel and members of the general public over the age 18, between 11th December 2008 and 31st March 2009.
Our study identifies the extent to which people's actual alcohol consumption correlates with their perception of whether they are drinking heavily and potentially harming their health. While nearly 25% of the 6969 respondents exceeded recommended limits (with 7% of men and 4% of women drinking at high-risk levels) only 5% and 1% considered themselves heavy drinkers and very heavy drinkers, respectively. This suggests that people are unaware that they are drinking at levels that can put their health at risk.
This presentation will further describe analysis of risk perception in groups that drink to different levels, as well as their respective views regarding the acceptability of different alcohol-control policies.

25th March 2010: 12:00pm to 1:30pm

Abstract: Alcohol fuelled antisocial behaviour has a profound effect on the physical and mental health and well-being of perpetrators and victims. The Crime and Disorder Act 1998 required the establishment of the Crime and Disorder Reduction Partnership (CDRPs) encompassing the Police, Local Authorities (LA), Probation service, Health Authorities, local residents and businesses to identify local issues and concerns. These partnerships then were then required to develop strategies and use the statutory interventions to improve the quality of life in their communities.

To evaluate the efficacy of a local authority community partnership intervention designed to tackle alcohol fuelled antisocial behaviour within an identified “hotspot”.

Qualitative and quantitative research methods were used which involved face-to-face, semi structured interviews with residents and stakeholders. The interview transcripts were analysed, quantitative data was interpreted using Microsoft Excel, and qualitative data was thematically coded using contrast comparatives.

Following the implementation of a CCTV covert operation a reduction in ASB complaints. The qualitative data revealed fear and scepticism amongst residents and CSW's that the ASB reduction would be short lived because the root cause of the problems had not been addressed.

25th March 2010: 12:00pm to 1:30pm

Abstract: Background
A strategy was developed based on Government guidelines ‘Safe, Sensible, Social Alcohol strategy local implementation toolkit'.
Aim
To reduce the negative effects of alcohol, in relation to criminal activity, anti-social behaviour, physical and mental health and family welfare and ensure that Dorset's population can enjoy alcohol safely and responsibly.
Methods
Data gathered to inform the strategy included local alcohol profiles for 2006/07, 2008 Dorset lifestyle survey, qualitative data from young people and a health needs assessment on alcohol misuse in Dorset, undertaken in 2006.
Results
The strategy was launched in April 2009, following extensive consultation. Data has shown that 70% of people are consuming alcohol, most of whom are drinking within recommended limits. Respondents most frequently reported drinking between 11 and 20 units per week (27%), with most alcohol consumed on respondents reported drinking the most on Saturdays. 84% reported their alcohol consumption as typical for them.
Conclusions
A successful alcohol strategy will not be judged merely by its effect in three years but over a much longer period. Progress will only be maintained if there is a strong collective will to give alcohol misuse a high priority. Good baseline data will enable effective monitoring over time.

25th March 2010: 12:00pm to 1:30pm

Abstract: The paper will analyse the health needs of Eastern European migrants to Britain. It will explore their understanding of the UK health system and their experiences of accessing a range of health services including GPs, hospitals, community nursing services and specialist services such as physiotherapy and smoking cessation.

The data are taken from a survey of Eastern European migrants in NW England undertaken by Lancaster University Depts. of Sociology and Statistics in collaboration with NHS Central Lancashire.

A central feature of the paper will involve how Eastern European migrants perceive the NHS and the linguistic and cultural barriers that they encounter in everyday interactions with health professionals. The paper will include a discussion of how health services in Eastern Europe, particularly Poland, affect their frames of reference in accessing services in Britain.

The paper will also provide the results of a parallel survey of health professionals in Central Lancashire. This probed the attitudes and experiences of a wide range of health professionals in relation to working with Eastern Europeans.
The paper will finish with a discussion of the health initiatives undertaken by NHS Central Lancashire to improve the access to healthcare for Eastern European migrants over the last year.

25th March 2010: 12:00pm to 1:30pm

Abstract: The healthof Gypsy Travellers is amongst the worse in any UK population group and the health inequalities are striking between thisminority ethnic group and other socio-economically disadvantaged people. This actuality continues despite the government's drive to reduce health inequalities through far-reaching and costly measures. If improving the health of this andother disadvantaged communitiesis to be achieved there has to be better understanding of the underlying factors that contribute to their poorer health status and ofattitudes, beliefs,behaviours and cultural factors relating to health. This qualitative research study, using grounded theory methodology, was undertakento learn more about cultural influences, attitudes and behaviours directly impacting on health amongst a local Gypsy Traveller population. Five key themes emergedthat provides useful insight into possible origins of key behaviours that may directly contribute to ill health in later life. These include the strong fatalistic outlook on life and health shared by the women; the relationship between fatalism and stress; howhealth related information, beliefs and behaviours arepassedfrom one generation to the next andperhaps the most significant, the deeply embedded difficulty in saying ‘no' tochildren that leaves theirchildren unable to learn self-regulation and self-control which may have lasting adverseconsequences to their health

25th March 2010: 12:00pm to 1:30pm

Abstract: Migration from Nepal to the UK has traditional largely been through the ‘Ghurkhas'. However, over the past two decades Nepalese migrants have come to the UK to work in varieties of field including health care. This qualitative study explores (a) reasons behind the health worker migration from Nepal and (b) Nepalese health worker's experiences in the UK.
In-depth interviews were conducted with Nepalese doctors (n=6) and nurses (n=9), who are currently living and working in the UK.
Both push and pull factors were identified. Major push factors were: low pay and poor working conditions; political instability (especially clashes between Maoist and the Government over past decade) ; poor work place security; lack of recognition; being sent to the remote and rural areas of Nepal; unemployment; corruption; lack of skill development opportunities and increasing access to the global labour market. Whilst pull factors to the UK included: higher pay and condition; better resources and higher living standard. Furthermore, 'peer group pressure' was an important factor for Nepalese health workers who had migrated to the UK.
Most doctors and nurses felt insecure due to frequent policy changes by the UK government. Most reported some kind of discrimination where they worked and lived.

25th March 2010: 12:00pm to 1:30pm

Abstract: NICE produces evidence based guidance which impacts all of us. To improve its uptake across different care settings a Field Team engage on programmes tailored to specific audiences, cognisant of factors such as prevailing national and local circumstances, feedback from previous programmes and developments with NICE itself. They allow us to advise of relevant NICE information, listen to feedback on how NICE affects local services and people and enable us to share examples of better practice.
The evaluation of these programmes, encompassing hundreds of visits, help us to improve how and what we develop in the future. In meetings with Directors of Public Health especially, a number of issues were identified such as communication and distribution methods, the role of evidence, the difficulties faced by cross-organisational working and links with joint planning processes such as Local Area Agreements.

Recently , with both lay and professional input,NICE have developed the first few of a series of Quality Standards – clear unequivocalstatements of what we would expect from high quality services to help commissioners, providers and others aspire to deliver,and receive,even better care. Dementia and Stroke are just two of the early themes and we would like to share details of this ambitious programme with you.

25th March 2010: 12:00pm to 1:30pm

Abstract: No standards yet exist for a generic ‘public health organisation'. Standards exist for healthy schools, healthy universities and health promoting hospitals. These suggest that a public health organisation might be described as one that is a good employer, protects employees and clients from ill health, promotes employee health and reduces the organisation's carbon footprint. In the case of a health care organisation add to this providing high quality, evidence based services and using every opportunity to promote health, and the potential to positively influence the health of the local population economically, socially, environmentally and physically, is vast.
In summer 2009 Liverpool PCT provider services commissioned the Public Health Resource Unit to work with the organisation to develop a framework for being a ‘public health organisation' and identify the benefits. The framework was used to diagnose the extent to which the provider arm of the PCT delivers a public health function in its broadest sense, at strategic and operational levels. The results of the diagnosis informed a 12 month action plan to take forward the services, approach and ethos of a public health organisation.
The framework and action plan, emerging issues, barriers, benefits and cost will be described and discussed.

25th March 2010: 12:00pm to 1:30pm

Abstract: Across the country, primary care has a key role in reducing health inequalities; partnership with Public Health is vital.
Tower Hamlets is one of England's most deprived boroughs, with wide inequalities and poorer than average health, especially in diagnosis and outcomes for Long Term Conditions (LTCs).
Accordingly, in 2009, NHS Tower Hamlets increased annual primary care investment by 40% to £12m through development of:
• Networks/Federations comprising groups of GP practices delivering more integrated health and social care with a range of local organisations.
• Care Packages for LTCs: clinical guidance to effectively use staff and reduce variations in patient care
This presentation demonstrates the pivotal contribution public health has had in driving these developments:
• Identified unmet need through analysis of demographics and disease prevalence;
• Informed Care Package topics prioritisation
• Input into development of ‘best-practice' packages; supporting Networks in patient stratification;
• Creation of effective partnerships; engaging with sectors traditionally not involved in “health”
• Providing referral pathways into Healthy Lifestyle interventions
• Sharing network learning and performance;
• Modelling the impact of population changes.
This presentation details the role of public health in supporting primary care networks/federations and will provide recommendations for others.

25th March 2010: 12:00pm to 1:30pm

Abstract: Crime and the fear of crime impact directly and indirectly on health. Annual health related costs of crime are significant. Tackling crime and disorder can impact positively on key public health priorities. There is an increasing focus on neighbourhood policing in the UK. Arguably the police role in protecting the public can be seen as analogous to the health professionals' role in promoting health.
This presentation will present the results of a case study analysis of the role of a Metropolitan Police Safer Neighbourhood Team in a deprived area of London, from a health promotion perspective. It identifies a health promoting element of the police role at community level, recognising that this is not necessarily recognised by the police.
The study suggests that there are five key ways in which the police can positively influence health: preventive activities; acting as role models; supporting individuals to take control of their lives, working with individuals and encouraging behaviour change. The study concludes that the opportunities to improve health through the police are underexploited and offers recommendations to the NHS and to the Metropolitan Police.

25th March 2010: 12:00pm to 1:30pm

Abstract: Purpose
Policy, empirical research (and WCC) call for joined-up public services, to overcome silo-working and address cross-cutting social determinants of health and well being. Progress is slow. Relying on individual hard-work and goodwill is insufficient with major contextual factors impinging on success – opening this contextual black-box remains a research challenge. An in-depth case study explores the practical actions, barriers and opportunities encountered in cross–sector public health working.
Methods
Local authorityorganisedmutli-sector development workshops presented evidence syntheses to allow action groups to form and plan for local uptake. Four groups were followed to identify perceived progress against their own plans and aspirations at 6 months. Methods included: interviews (group members, colleagues, superiors, service recipients); documentary analysis; and other activity (eg. service changes).
Results
Findings highlight the role and impact of ongoing performance pressures, a changing context, political pressure and varying governance, research and practice cultures on unfolding events and perceived progress. Many factors diffuse efforts and stall progress. Pragmatic solutions to cross-sector working are detailed.
Conclusions and Contribution
Two contributions emerge: longitudinal evidence of the embedded complexity and challenges inherent in cross-sector working (getting research evidence, information and best practice flowing to inform services); facilitative practical steps for policy-makers and practitioners are suggested.

25th March 2010: 12:00pm to 1:30pm

Abstract: an educational tonic - Art on Prescription
A unique provision
PETROC (formally North Devon College) has been successfully running the Arts on Prescription activity for four years. The programme is aimed at adults with mild to moderate depression and anxiety. It uses art as a means to improve self-esteem, confidence and reduce the isolation felt by sufferers. The project has been designed in conjunction with the Community Mental Health Team, the Primary Care Trust and local GPs and takes referrals from Medical Centres, GP Practices, the Community Mental Health Team and the Volunteer sector.
The Project is an Excellent Example of providing a quality, professional art and design curriculum offering learners genuine opportunities to respond to ‘real' briefs gaining experience, a sense of achievement and accomplishment.
The Project Challenges. Art on Prescription illustrates that through innovation, with a learner group that has been stigmatised and misunderstood, can be given the opportunity to produce professional quality outcomes, achieve and progress.
The Project is Inspirational. Such achievements are NOT to be isolated to one particular subject group, but can be applied across a breadth of initiatives.
The Project is Responsive. An example of how joint agency collaboration, can offer learners a supportive package to enable them to attain their goals and to progress. An example of the potential of fully embracing widening participation, going out to the local community, listening and providing an exemplary provision.

25th March 2010: 12:00pm to 1:30pm

Abstract: The prevalence of overweight and obesity is increasing in both adult and child populations throughout the world. Although there is no consensus over a definition of overweight and obesity in children and measurement inconsistencies make it difficult to produce an overview of the prevalence of overweight in this group, there is evidence to suggest that overweight in children is a serious public health issue and childhood overweight is now common in the United Kingdom (UK) as in other developed countries. The widespread nature of the obesity epidemic across geographical, ethnic, age and sex groups suggests that there must be pervasive environmental and/or behaviour changes underlying it, although specific environmental influences are unclear. There is also increasing evidence that the development of overweight starts very early in a child's life. Against this background, this paper reports on the birthweights, eight week weights, eight month weights and 40 month weights of successive birth cohorts, between 1994 and 2006, in Halton, North West England. The paper will conclude by considering how weaning, as a process, might be an important influence on early growth trajectories and outline how, through a qualitative study, the approaches taken by mothers to weaning their infants are to be explored.

25th March 2010: 12:00pm to 1:30pm

Abstract: Results of the National Childhood Measurement Programme (2007/2008) showed that for Year 6 children in Lambeth, 23.2% were at risk of obesity and 15.4% were at risk of overweight. Mind Exercise Nutrition Do it! (MEND) is the first structured evidence based children's weight management programme to be delivered in Lambeth. The programme, aimed at children between the ages of 7 and 13 was funded through the Big Lottery and matchfunded by NHS Lambeth and has been running in Lambeth since May 2007. The purpose of the evaluation was to assess the implementation of Lambeth MEND and its impact on participants and their families over the last two years. The intention was that the evaluation would enable the identification of components of a weight management programme that are essential in meeting the needs of the population in Lambeth. The evaluation consisted of both quantitative and qualitative analysis including qualitative insight with stakeholders. Results showed that overall there were positive outcomes for participants in relation to mean BMI reduction and other proxy measures. However cultural and age sensitivity, as well as programme flexibility would need to be further considered in future weight management programmes to meet expressed needs in Lambeth.

25th March 2010: 12:00pm to 1:30pm

Abstract: Obesity levels are rising in almost all parts of the world, including the UK. School food offers children in Great Britain between 25% and 33% of their total daily energy with vending typically offering products high in fat, salt or sugar. Government legislation of 2007 to improve school food quality now restricts what English schools can vend.
This research aimed to assess the effect of the legislation on the quality of English secondary school vending provision. A longitudinal postal and visit-based inventory survey collected vending data from a representative sample of 279 English secondary schools annually between 2006 and 2009. Products were categorized and analysed by product type, nutrient profiling and by Eurocode 2 food groups. Interviews of school staff explored issues of compliance.
Schools have moved towards compliance with the new vending standards, with particular success when adopting ‘whole school' approaches. Drinks vending predominates and is largely compliant whereas food vending, often now perceived as uneconomic, is significantly reducedandmostly non-compliant. Sixth form vending takes a disproportionate share of non-compliance. Although government legislation has significantly improved provision quality, vending provision overall has declined. Some school staff linked this trend with student accessibility to less healthy snacks off-site.

25th March 2010: 12:00pm to 1:30pm

Abstract: The public health movement has a strong tradition of identifying health problems and tackling these through economic, social and environmental improvments, and through advocacy for people's rights and entitlements. Since 9/11, floods, foot and mouth, and fuel crises, the UK government has introduced the notion of resilience and sought to shore up public health defences against all hazards. In the tradition ofprimary prevention,public health practitioners must harness new knowledge about ecology and climate change as well as new economics and sustainable development. The best efforts to prevent environmental and public health disasters will also be green promoting, and protective of human and environmental health as well. The presentation will include local examples from the borough of Sandwell in the West Midlands, showing how the quest for a sustainable food system and for accessible physical environments for walking and cycling, contribute to safety, health and a more resilient community . The presentation will describe developments including the Sandwell Healthy Urban development Unit between town planners and public health and the work of community development agencies to createmore cohesive communities, better able to meet their own needs and respond to hazards and threats to everyday life and health. 200 words
Conference Themes :
Creating healthy communities
Health in economic and ecological crises

25th March 2010: 12:00pm to 1:30pm

Abstract: The percentage of overweight 10 and 11 year olds in Bournemouth and Poole is among the highest in the south west (DH, NCMP, 2007). Bournemouth and Poole PCT, the two councils and Sustrans have established a package of interventions promoting active travel to children andfamilies.
This includes a four-year Sustrans Bike It programme, engaging schoolchildren through a mixture of practical activities and incentives. Bike It, currently working with some 600 schools and 90,000 children across England, has a proven record, systematically doubling the number of children who cycle daily to school and helping pupils become more active (Sustrans, 2009 Bike It project review).
Active Travel and Play, funded by DH South West, works with the two councils and PCT to maximise strategic planning, infrastructure and behaviour change approaches to active travel and active play. This includes work to embed active travel in children's centres andoutdoor play provision.
To create a more activity-friendly environment, both councils and Sustrans are investing in the walking and cycling infrastructure, improving active access to schools, early years settings and outdoor play.
This presentation will describe the programme experience and report outcomes, including quantitative analysis of changes in school travel behaviour.

25th March 2010: 12:00pm to 1:30pm

Abstract: The Foresight obesity report and other key documents have identified the built environment as having a significant impact on public health. Propensity to walk and cycle is determined by availability of suitable connections and environments. Mental health and social inclusion are also affected by our surroundings. Built environment practitioners thus are essential in promoting and securing healthy communities through planning and design of urban areas, their green spaces and connectivity. Education institutions training planners, architects, landscape and transport professionals of the future need to make these professionals ‘health aware'.The ‘Education Network for Healthier Settlements', initially funded by the Department of Health, is a forum for higher education institutions supporting under-graduate and post-graduate provision to make the essential connections between health and the built environment.The network covers a range of built environment disciplines and is helping to prepare case studies of best practice and draw out key issues and priorities in teaching. Core members are collating evidence into usable and searchable web-based resources and helping to make relevant material more easily available to a wider teaching audience. The presentation looks at activity of the network as they share successes and draw out new ideas for education in the future.

25th March 2010: 12:00pm to 1:30pm

Abstract: Historically little attention has been paid to the relationship between maleness and mental health. Yet gender is a fundamental determinant of the sense of self. There are several important manifestations of psychological distress where maleness is a central factor. The most widely acknowledged is suicide, where three quarters of deaths are in men - but there are others thatare equally demanding of attention. For example, the great majority of drug misuse deaths are in men; men are three times more likely to be alcohol dependent; 90% of rough sleepers are male; and 95% of prisoners are male (mental health problems are greatly more commonamong prisoners). National policy guidance to improve mental health services for women was published in 2003. Since then,most mental health trusts have developed local strategies for women's mental health. Until recently there has been no parallel impetus to develop gender-sensitive approaches for men. In 2009, the National Mental Health Development Unit (NMHDU) commissioned from the Men's Health Forum (MHF), a review of the most important issues in male mental health. This presentation will discuss the findings of that review. NMHDU has subsequently recommissioned MHF, in partnership with Mind, to develop guidelines for good practice. This workshop will also invite participants to submit ideasto that process.

25th March 2010: 12:00pm to 1:30pm

Abstract: The UK has an ageing population and a rising prevalence of long-term health conditions. The burden of long-term ill-health is felt disproportionately by lower socioeconomic groups and is often accompanied by socioeconomic inequalities in access to health services.
Many individuals with long-term ill-health have more than one condition simultaneously. However, research to date has tended to focus on single morbidities, with consequent limited understanding of health needs and service use by individuals with complex and overlapping health problems.
This presentation will describe the findings from an ESRC-funded study involving secondary analysis of data from SHAIPS 2, a morbidity survey undertaken in Sheffield in 2000 with over 10,000 respondents and a 66% response rate. The study focuses on respondents with multi-morbidity, particularly in relation to depression, and explores the relationship between potential predictors of multi-morbidity, such as age, sex, level of social support, and area-level deprivation. A key feature of the study is the linkage of morbidity information from the survey to both area-level deprivation data (via postcodes) and NHS and mortality data (via the NHS numbers of respondents). This enables examination ofNHS hospital service use over the last nine years and the calculation of survival rates of respondents.

25th March 2010: 12:00pm to 1:30pm

Abstract: Tower Hamlets has severe deprivation and poverty, ranked third in England for inner city patterns of severe inequality. Although there are a relatively small proportion of older people (8%), we are recording earlier presentations of dementia due to increased risk factors.
The National Dementia Strategy recommends that each PCT carries out a needs assessment. The scope of the assessment was defined to include both functional and organic mental illness. Older people's services provide for all types of mental health conditions, including dementia. A cross-partnership with the PCT, Local Authority, Mental Health Trust and third sector organisations was formed to carry out the assessment.
Multi-agency data was used to determine prevalence according to three broad definitions of mental health: depression, dementia and severe mental illness. Regional/national comparators showed a high level of need and service usage. An online survey identified mental health need in accommodation providers and social work teams.
Only 25% of expected dementia cases were known to primary care services. Accommodation providers and social work teams observed that 35% of clients had some form of mental health condition. Public consultation highlighted the need to improve mental health awareness and the lack of age-appropriate services for younger dementia patients.

25th March 2010: 12:00pm to 1:30pm

Abstract: In Gateshead life expectancy for men is 75.4 compared with 77.3 for England, with a 10 year difference in life expectancy between the best and worst districts. In June 2008 Gateshead Strategic Partnership adopted a proposal to develop and apply Health Inequalities Impact Assessment (HIIA), following an Overview and Scrutiny Review of the gap in life expectancy. We report successes, and challenges in relation to this strategic approach to embedding Health Inequalities Impact Assessment (HIIA) into policies and developments.
Local HIIA Champions are leading ‘demonstration projects' in HIIA across a range of different interventions (including building, planning and service provision) in different sectors (health, housing, leisure). These projects also vary as to their timing, before, during or after implementation of initiatives. They illustrate potential of benefits of action on wider determinants of health: broadening public awareness and action for health and wellbeing; enhanced social sustainability and social value of projects; equity of access and equality of health and social wellbeing.
The 'demonstration projects' also highlight some challenges include: building capacity for HIIA, disseminating good practice and local guidelines; working more effectively with the voluntary sector; and applying HIIA to capital programmes.

25th March 2010: 12:00pm to 1:30pm

Abstract: Stoke-on-Trent is a WHO Healthy City with one of the highest levels of deprivation in the Midlands, England and the UK. Key issues are the decline of the old potteries and mining industries, high levels of long term limiting illness and an outward migration of skilled and young people.

Health impact assessment of regeneration masterplans is an effective way of ensuring that public health themes for creating healthy and sustainable communities are examined and incorporated into regeneration processes.

This HIA programme used an innovative approach to health proofing the masterplan through a review workshop, based on the WHO healthy urban planning principles. It examined the masterplan drawings in detail and provided feedback on key elements of the vision, objectives and the draft designs.

Through this HIA work we realised that potentially 50%-60% of the value of a HIA can be garnered by reviewing the draft and final masterplan design drawings.

A 'Health proofing masterplan designs' guide is being developed for the public health community on how best to review masterplans in a systematic way.

The aim is that this guide will support work to embed HIA and public health input into Stoke-on-Trent's and North Staffordshire's planning processes.

25th March 2010: 12:00pm to 1:30pm

Abstract: Background
The Pathways Advisory Service (PAS) provides Jobcentre plus employment advisors in primary care to tackle worklessness and improve health (Waddell & Burton 2006) as part of the government's Health, Work and Wellbeing strategy. East Lancashire PAS advisor works in GP practices with deprived, largely ethnic minority populations, with poor health and high rates of worklessness. Evaluation of employment advice provided by Tomorrow's People in a London practice showed reduction in GP consultations and antidepressant prescribing following referral to the advisor (Rawson 2005).
Methods
Similar methodology was used to collect GP consultation data, including anti-depressant and pain relief prescribing, from approximately 200 PAS referrals in two practices with follow up employment outcome data.
Results
57% of PAS referrals were men, commonly with mental health problems (55%), while more women had musculoskeletal problems (50%). 23% returned to work, men being 30% more likely and those with a job 5 times more likely to go back to work. Mean GP consultation rate increased significantly following PAS referral, while antidepressant and pain relief prescribing fell. There was evidence of GPs and PAS working together to tackle complex combinations of health and social problems. Further analysis and qualitative work exploring patient experience is planned.

25th March 2010: 12:00pm to 1:30pm

Abstract: British children are among the unhappiest in the developed world (UNICEF, 2007) and 1 in 10 childrenhave a mental health disorder (BMA, 2006). Traditionalservices are failing to meet the needs of childrenat the preventive and treatment stage (Kelly et al, 2005).Prevention of mental health problems is seen as cost effective and enhances quality of life.Cognitive behaviour therapy isa highly effectivetreatment for a wide range of mental health disorders.Many of the strategies within this approach areclear and practical to use. An innovative programme is taking place in asecondary school with 14 to 15year old students which employs cognitive behavioural techniques. A pilot study is being conducted by a school nurse and classroom teachers to increase knowledge of mental health issues and teachhelpful strategies to strengthen resilience.Evaluation is showing promising results. Young people have found the lessons 'educational, helpful, serious and interesting'. A quiz is also used to test recall of the content of sessions. This shows a high level of acquired knowledge. This work is based on the psychological evidence base for CBT but is entirely new. It is in the early stages of development but could provide a valuable strategy for improving children and young people's mental health.

25th March 2010: 12:00pm to 1:30pm

Abstract: There is a lot of research on public health and young people, but often young people have not been actively involved in the planning or process of this research. The National Children's Bureau (NCB) PEAR project, funded by the Wellcome Trust, supports children and young people to contribute to the UK public health agenda by:

Helping young people to learn about, inform and influence public health research and policy
Developing links between young people and public health researchers and policy makers
Producing and distributing information about public health issues and research to young people
Demonstrating the impact of young people's involvement in public health research, and how this can be applied to policy and practice

The project includes regular meetings of two young people's groups (in Leeds and London) where group members work with public health researchers and receive training; a website (www.ncb.org.uk/PEAR) and conference (in October 2010); and a small research project which the group has commissioned.

This presentation explores the successes and challenges of the project, and the lessons for the involvement of children and young people in public health research and policy. Young people involved in the project will talk about their experiences of being involved, and their priorities of public health.

25th March 2010: 12:00pm to 1:30pm

Abstract: Young people are all too often vilified by the press as lager-swilling, violent hoodies scaring old ladies on street corners. This perception is not only misplaced but can lead to young people feeling marginalised and disconnected from wider society resulting in low aspirations and feelings of lowself-esteem.
This young people led project sought the views from both adults and young people on the portrayal of young people in the media and how a social marketing approach could be used to challenge these negative perceptions. The young people leading this project gained personal prestige through their involvement particularly when supporting other vulnerable young people to have their voice heard.
The next stage of this campaign will focus on positive images ofyoung people with mental health problems and disability.

25th March 2010: 12:00pm to 1:30pm

Abstract: The negative effects of caring on carers' health and quality of life include financial, health, emotional and social. Psychological consequences include stress and, in some cases, depression. The 2001 Census has shown that 22% of people providing care for more than 50 hours per week are in poor health compared to 11% not providing care .
In the 2005 Kent survey 50.1% reported that caring had ‘adversely affected their health'. 5% of those providing care for 50 or more hours per week reported their health as ‘much worse' than it was a year ago compared with 1% providing low levels of care (tending). The negative impact of caring was particularly marked for those providing intensive care. 79.9% of intensive carers reported care as having a negative impact on their health compared to 42% of those providing lower levels of care.
Smoking was more prevalent amongst younger carers than the general population, care related stress may be a contributory factor. The survey includes a lot of information about attitudes to smoking; this will be explored further in the paper. Poor mental health was specifically highlighted amongst younger people who have given up work to care. The paper will highlight in more detail the effects of caring on mental health.

25th March 2010: 12:00pm to 1:30pm

Abstract: The Scottish Executive (Care 21 Scottish Executive 2006) identified that unpaid carers are the largest group of care providers in Scotland and thus constitute the most significant of the Scottish care workforce. A major initiative by the Scottish Executive (Care 21, Scottish Executive 2006) called for a brave new vision for supporting family carers underpinned by two primary goals: to ensure that carers are fully recognised as partners in, and providers of, care: and to establish a rights based framework to addressing the needs of carers. This paper reports on a study designed to collaboratively develop and pilot a training resource to enhance community nurses understanding of partnership working and to strengthen the core skills underpinning its delivery. Social participatory research methods were used involving nurses, individuals and family carers.The construction of the draft tool was informed by a synthesis of exciting evidence and findings from focus group and telephone interviews. The resource uses a community of practice learning framework promote the collaborative spirit of finding shared implementation solutions through negotiated relationships, which are at the heart of partnership working. Our discussion provides an overview of the resource and its research based underpinnings and key pilot findings.

25th March 2010: 12:00pm to 1:30pm

Abstract: The Department of Health's Dignity in Care campaign was launched in 2006 and has just marked its third anniversary with an impact assessment. A major thrust of its vision is patient and public engagement in shaping policy and practice around dignity and zero tolerance of abuse in all care. Ten thousand 'Dignity Champions' have been recruited and the policy was 'co-produced' and trialled with service users in the North West of England. This study looks at the model of participation and involvement associated with the development of the strategy and its campaign and assesses whether engagement has led to potential health gains and empowerment for vulnerable groups .

25th March 2010: 12:00pm to 1:30pm

Abstract: There are recommended levels of physical activity to remain healthy and maintain a normal weight, and attempts are regularly made to monitor activity against the target. While self-reported data on activity must be regarded with caution, ‘questionnaires are the most practical and cost effective way of measuring physical activity in large-scale epidemiological research' (Health Survey for England 2006).
6000 responses from adults in the Kent survey of health and lifestyle are used to identify factors that are associated with physical activity, using tests of association and logistic regression. Variables in the analysis include health status, long-standing illness or disability, body mass and socio-demographics. The analysis also looks at the range of activities being undertaken, the barriers people perceive to doing more, and whether other lifestyle factors are potential explanatory factors associated with exercise levels. A follow-up survey of the same people has been carried out and will be used to show how individuals are changing their physical activity over time.
Compared to the Health Survey for England, the Kent survey provided results for local authority areas and at lower cost (but with a poorer response rate), and compared to Active People it covered all activity and not just sport.

25th March 2010: 12:00pm to 1:30pm

Abstract: The delivery of brief interventions in primary care has been identified as one of the most cost efficient and effective methods of affecting long-term patient behaviour change.
Specifically, the National Institute for Clinical Excellence (2006) clearly states that Health Care Practitioners have a wider public health role to play in encouraging greater levels of physical activity.
With the direct cost of physical inactivity to the NHS estimated at £1.06 promoting physical activity in primary care has a significant role to play as the economic climate continues to deteriorate and the burden of lifestyle related chronic disease continues to increase.
Although there is a clear role for practitioners degree to which health care practitioners are aware or have an understanding of; how to assess individuals physical activity levels, current guidance on physical activity levels, the benefits of being physically active and approaches to enable and elicit behaviour change are not well evidenced.
This presentation will provide an overview of findings from a research study of 1750 health care practitioners in west London on their views, attitudes and beliefson the role of health care practitioners inpromoting physical activity in primary care.

25th March 2010: 12:00pm to 1:30pm

Abstract: The ‘Am I Bovvered?' project is a three year study aiming to develop, implement and evaluate sustainable exercise-based interventions with girls aged 11-15 years in order to improve their engagement in regular physical activity. Overall, the study increases our understanding of the underlying attitudes and beliefs of girls about taking part in sport and exercise. The research has helped to develop practical initiatives and guidelines to increase physical activity levels for this cohort. The insights gained into the lives and experiences of the girls can also be of benefit to services and professionals in order to identify key motivations and barriers to physical activity.
Our study reveals that adolescent girls recognise the importance of physical activity and perceive it as fun and sociable. However, the findings also indicate some significant barriers and de-motivating factors that are worthy of consideration by professionals seeking to increase the participation of girls in sport. Our study has shown that a continued input is needed to change the attitudes and beliefs of young girls in order to facilitate much greater participation in physical activity.

: 3:03am to 3:03am

Abstract: The eco friendly ‘land train' will take delegates to Boscombe Spa Village along the seafront.

Bournemouth Borough Council's innovative £13.5 million Boscombe Spa Village regeneration scheme has transformed an economically and socially deprived coastal suburb, re-branding it into a year round 21st century surf lifestyle destination creating a centre-piece attraction as Europe's first artificial surf reef. The scheme has directly levered in additional £48.8 million of private sector investment including Barratt Homes flagship Honeycombe Beach residential complex. Since completion, 91 new long term jobs have been created on site, visitor numbers have increased 32% and incidents of anti-social behaviour are down 40%.
The project both in funding, function and innovation sets a bold template for other Local Authorities to follow.

25th March 2010: 2:30pm to 4:00pm

Abstract: Councils have been encouraged by Government to carry out scrutiny reviews of local health services since 2001. Health Scrutiny is seen as a lever to improve the health of local people, ensuring that their needs are considered as an integral part of the delivery and development of health services. However in undertaking reviews, scrutiny committees in the main still prefer to focus on services that are tangible rather than the more complex issue of health inequalities.
The Centre for Public Scrutiny is therefore leading a programme to raise the profile of scrutiny as a tool to promote community well-being and help councils to undertake more complex scrutiny reviews of their local health inequalities.
Outputs from this work include:
· Examination of scrutiny reviews and their effectiveness in reducing inequalities;
· Recruitment of 4 Scrutiny Development areas to help to develop and test a Scrutiny Resource Kit to help other areas when undertaking reviews;
This presentation will explain the role of scrutiny in tackling health inequalities; give an overview of effective models of scrutiny and how they are being used. The audience will also be able to find out more from one of the Scrutiny Development areas, and how they are using scrutiny to tackle Health Inequalities in their area.

25th March 2010: 2:30pm to 4:00pm

Abstract: This presentation reports on an innovative whole-systems approach to improving uptake of breast screening in Tower Hamlets, a deprived borough in the East End of London with a large minority ethnic population. The approach, developed by the public health team at NHS Tower Hamlets, draws on analysis of needs and existing literature about effective interventions to promote breast screening. Social marketing research led to a campaign targeted at Bangladeshi women, together with a range of initiatives to promote breast screening via primary care services and community outreach through local well-known organisations. The breast screening service itself was upgraded and a new service specification is being introduced from April 2009. Preliminary findings indicate significant improvements both in processes and uptake, which rose from 44.5% in 2005 to 63.4% three years later. Further improvements can be anticipated as a result of recently introduced interventions.

25th March 2010: 2:30pm to 4:00pm

Abstract: Tower Hamlets has one of the highest CVD mortality rates in England. The inequality gap continues to widen compared to other PCTs. CVD is most prevalent amongst the socially deprived Bangladeshi population.
DH sponsored NHS Health Checks respond to the unmet need of under-diagnosis of CVD. This facilitates prevention and management, which improves quality of life and life expectancy.
We chose to respond to the differential health needs of our population by stratifying predicted risk as a means of prioritising order for patients to attend a Health Check. GPs were incentivised financially to conduct an initial risk assessment based on data available on their computer systems, with practice averages entered for missing fields. Patient attendance was in order of their predicted QRISK2 score. Practices were funded to employ health care assistants to conduct clinical measurements, who had completed a novel locally-devised accredited training course.
57% of patients had a QRISK2 score >20% (indicating highest risk of CVD). 73% were commenced on statins and 72% subsequently had blood pressure controlled below 140/90. This indicated that the right people were being identified, assessed and treated. A 12 month evaluation of this approach is planned, building on these initial findings.

25th March 2010: 2:30pm to 4:00pm

Abstract: The National Anticipatory Care programme aims to increase the rate of health improvement by focusing on early intervention for those at a high risk of coronary heart disease. To address health inequalities, health board areas delivering the national programme have developed local approaches of targeting and promoting engagement of populations less likely to access health services. To support staff in better engagement and communication skills with hard to reach populations, a national training programme has been developed whichprovides generic skills development in communication and engagement skills to deliver opportunistic as well as targeted engagement.
The training incorporates learning from recent research findings on:
• motivators and barriers of populations to health checks. It classifies target populations as • ‘Health involved' ,‘Healthy enough and ‘Health wary'.
• strategies for reaching the target population, where local engagement strategies in health boards include practice-based approaches; local authority/private sector partnership approaches; wider NHS approaches; outreach approaches and community-based approaches
The presentation will provide an overview of:
• development of training programme aimed at front line, multi-agency staff
• plans for developing a national engagement skills training and peer support programme for roll out
• effective learning methods and ongoing support for practitioners
• key findings from training evaluations

25th March 2010: 2:30pm to 4:00pm

Abstract: The Department of Health in 2004 introduced a multi-sectoral, multi-level skills escalator approach to Public Health workforce development. Carlson and Wight argued that networks need to be able to adjust to this changing climate if they are to support the public health workforce in the delivery of the public health agenda. (Griifths and Hunter, 2006)
chances4change is a 4 year South East progarmme funded by the BIg Lottery Fundto address healthy eating, physical activity and mental well being. 62 projects led by various statutory, voluntary and social enterpriseorganisations provides a useful network.Staff involved have varying skills and knowledge e.g. public health theories, outcome-based evaluation, social marketing etc.
As skills and knowledge development isthe legacy of chances4change, various inititaives were developed in collaboration with partners. The aim ofthe capacity building project 'Building Blocks' has this role. Learning skills analysis was done initially with ongoing feedback. The presentation seeks to share the type of collaborations and more importantly, successesachieved and challenges faced.
References:
Department of Health 2004 'Securing Good Health for the whole population.
Griffiths, S; Hunter D.J. (2006) 2nd Edition 'New perspectives in public health -Chapter by Alison Thorpe Networks: supporting public health. Radcliffe Publishing

25th March 2010: 2:30pm to 4:00pm

Abstract: The South West Regional Public Health Workforce Strategy 2008-2013 recognises the need to develop the wider public health workforce to ensure the delivery of effective programmes to promote health and wellbeing and prevent avoidable disease. It recognises that the public health workforce encompasses a diverse range of backgrounds including those working in the NHS, local authorities, third sector and the criminal justice system.
In 2008, the Department of Health published A High Quality Workforce NHS Next Stage Review which highlighted the need for medical trainees to explore areas of expertise not covered by their own speciality, including public health.
In response to these issues, the South West Strategic Health Authority has established a number of innovative programmes to strengthen public health capacity and capability within region.
This presentation describes a bursary scheme set up to increase the public health skills and competencies of community and public sector staff through the University of the West of England and Plymouth University. It examines the extended general practice public health leadership scheme and programme of public health fellowships to broaden public health skills of other medical specialities through the Severn Deanery. Finally, it explores the regional programme to enhance the public health intelligence functioning across the South West.

25th March 2010: 2:30pm to 4:00pm

Abstract: Some people say that transport policy and practice causes more deaths off the roads, than on the roads, because of the contribution to inactive lifestyles from our car based lives.
The new round of Local Transport Plans (LTP3) currently being prepared by highway authorities across England is an opportunity to encourage more investment in active and healthy travel facilities and services.
This presentation will share what we are doing across the South West to influence local transport plans. It will look at the case we are making, the probing questions we are posing to transport planners and look for evidence of our impact so far. It aims toequips health professionals to be more confident in engaging with the transport sector.

25th March 2010: 2:30pm to 4:00pm

Abstract: Achieving a sustainable and healthy future for all is the underpinning tenet of Welsh Assembly Government strategy. Health Impact Assessment (HIA) is a component of this, contributing to improving the population's health and aiming to reduce inequalities within it. Its use has been extended into traditional ‘non-health' sectors such as transport planning and publication of the Welsh Transport Assessment Guidance (WelTAG) in 2008 specifies that HIA must be used in all new road builds or improvement schemes.
This paper discusses/describes the practical issues of working within this sector and the challenges faced by all on the very first HIA (a small town road improvement scheme) to follow WelTAG and its findings.
It identifies the learning gleaned by both transport planners and public health personnel in developing options; compares/contrasts the different use of language and understanding of engagement; describes planners' concern with the flexible nature of the HIA process in comparison with tighter EIA/SEA procedures; discusses tensions in considering the validity of differing forms of evidence. Finally it argues, in presenting the final transport options chosen, that the HIA ensured that the road improvement scheme considered wellbeing in ways that would not otherwise have been possible.

25th March 2010: 2:30pm to 4:00pm

Abstract: A nine year gap between the wards with the highest and lowest life expectancies exists in Bristol (Joint Strategic Needs Assessment 2008). The target areas for the social marketing programme also showed low levels of physical activity participation, with only 30-32% reporting moderate physical activity 5 times a week. Body Mass Index (BMI) registers also indicated high levels of adult obesity (31%) as well as a predominance of family clusters 1, 2 and 5 from ‘Healthy Weight, Healthy Lives' analysis.
A series of four creative workshops were delivered by a local community media centre. Focus groups with residents identified the key barriers and facilitators to participation in active travel modes. Many of these linked to social and environmental determinants of health. Participants were then asked to explore places to walk and cycle to develop local maps and resources for encouraging and accessing local facilities and open spaces. The programme of work used a range of creative media to produce on-line and print resources andthe use of local advocates.
Learning objectives
• to offer an insight into the views of participants
• to show social marketing techniques being applied
• to feedback initial results of the evaluation.
• to link to economic and climate change issues

25th March 2010: 2:30pm to 4:00pm

Abstract: Dear Organizers,
If it is interest to your organizing team, I would appreciate the opportunity to present our paper on public health emergency communication decision making at your conference. The topic and argument presented may lend itself well to a facilitated discussion, as well. The piece was published last month in the WHO Bulletin, and the abstract is below.
Many thanks,
John Rainford
Abstract
Effective management of public health emergencies demands open and transparent public communication. The rationale for transparency has public health, strategic and ethical dimensions. Despite this, failure on the part of government authorities to demonstrate transparency is not uncommon. It is argued that a key step in bridging the gap between transparency rhetoric and reality is in defining and codifying transparency in order to put in place practical mechanisms to encourage open public health communication for emergencies. The development of a Public Health Emergency Information Policy is put forward as an example of this approach and the authors set out a process for public health authorities to follow towards its implementation.

25th March 2010: 2:30pm to 4:00pm

Abstract: A 13 year old girl died shortly afteradministration ofHuman Papilloma Virusvaccine as part of the national campaign. A number of other girls were reported to be ill, andone transferred to hospital. This generated significant media and regulatory interest beginning within a matter of hours of her death, and requiring the PCT to respond to the following;
• public concerns
• investigating the cause of death, and the cluster of associated events
• Maintaining confidence in the HPV programme.
Root cause analysis was conducted by 3 agencies involved in the care of the girl. The batch of vaccine was quarantined,seized for testing and subsequently withdrawn voluntarily by the manufacturers. An independent home office pathologist was appointed by the Coroner to undertake a post mortem,providing a preliminarycause of death due to a malignant tumour of the chest, and highly unlikely to be related to HPV vaccine.
This resulted in disruption to the local HPV programme, with some schools cancelling vaccination programmes. All girls who had been consented prior to the death have been re-consented, and there has been a significant fall in the uptake of the vaccine.
This session will review the lessons learned and some of the ethical dilemmas faced in the glare of the media spotlight.

25th March 2010: 2:30pm to 4:00pm

Abstract: Directors of Public Health are responsible, at no notice, for forming and chairing STACs to provide advice at strategic and tactical levels, in theevent of major incidentsin their area. STACs were formed following the Buncefield Inquiry into Europe's biggest ever fire.
The STAC grab-bag is an interactive suite of documents whichhas the following features:
*guidance on the essential, and optional members needed at a STAC, depending on incident-type
* contact details for all the key personnel for emergency and other first responder services
*all the latest guidance on 20 different types of major incident, from Aviation to Zoonoses.
*hyper-links to the Health Protection Agency and other websites to provide instant, incident-specific information
*full text official reports and recommendations from previous major incidents.
The STAC grab-bag has been developed for use in Dorset and Somerset, but can be readily adapted to any UK location.

25th March 2010: 2:30pm to 4:00pm

Abstract: Evidence from around the world shows that active travel – walking and cycling for daily trips – is an accessible and practical type of physical activity for people who are insufficiently active (see www.the-evidence.org.uk). Government policy, guidance (eg NICE) and expert opinion call for local environments which promote active travel instead of sedentary, motorised transport. A shift to active travel also contributes to climate change emissions reduction, with additional public health co-benefits.
The problem for public health is that the professions which actually shape the environment are not fully implementing this guidance. Decisions made in transport and planning departments determine whether individuals are able to choose active travel. To engage with and influence colleagues in these fields, the public health community must speak their language, know how their decisions are made and what the timetables are.
This presentation will remind delegates of the evidence base for active travel, briefly review the wealth of policy and guidance advocating it, and outline the scale of potential travel behaviour change. It will then explain the mechanisms by which regional and local transport planning and investment decisions are made, and outline how public health professionals can best influence them.

25th March 2010: 2:30pm to 4:00pm

Abstract: The Marmot Report has highlighted that to tackle inequalities requires a co-ordinated approach. The financial situation means that it is imperative to eliminate waste of resources. While health promotion and social marketing have the shared goal of improving health and well-being, previous work (NSMC/RSPH 2008, Stronger Together, Weaker Apart), identified some misunderstanding amonst commissioners and providers about when to usethe range ofknowledge and skills the two areas have to offer, and a degree of professional territorialism in some.
The Department of Health, through theNational Social Marketing Centre, therefore commissioned the Public Health Resource Unit to undertake a Delphi consultation. The purpose was to consider ways to harnessexpertise and resources across both health promotion and social marketing. A UK-wide panel of health sector experts examined theissues, with three rounds of questionnaires and a national workshop.
The consultation generated a number of recommendations to make better use ofthe contributionsof both sectors:

Strengthening mechanisms for national leadership across health improvement;
Providing practical resources for commissioners and providers to harness effectively the contributions of both health promotion and social marketing;
Developing national occupational standards for health improvement, for all levels of the workforce, drawing on the contributions of both disciplines; and
Developing clearer career pathways

25th March 2010: 2:30pm to 4:00pm

Abstract: Since the publication of It's Our Health (NCC, 2006) and the Department of Health's (DH) strategic response to the paper, Ambitions for Health (2008), the number of PCTs and Local Authorities using social marketing to reduce health inequalities and improve health outcomes has increased. However, with public budgets due to shrink, future social marketing efforts need to be informed by best practice and demonstrate behavioural outcomes.
In 2007, the National Social Marketing Centre set up ten learning demonstration sites. The projects, funded by DH, were established to help develop an evidence base for social marketing and understand how to best apply it at a local level.
An academic organisation was commissioned to conduct an independent process evaluation of the learning demonstration sites scheme. Data collection consisted of two phases of semi-structured interviews (33 in phase one, 29 in phase two) with those closely involved in the sites. Where possible, the same individuals were interviewed in both phases for continuity.
These findings provide a unique insight into the challenges and opportunities when undertaking social marketing in England. The presentation will be of interest to public health practitioners and commissioners and will identify models of effective practice.

25th March 2010: 2:30pm to 4:00pm

Abstract: Social marketing has emerged as a well-promoted conceptual and practical approach for achieving lifestyle behaviour change. However its development has been matched by a growing unease amongst some public health professionals, that this approach may in itself be a ‘marketing trick' spun by the communications industry to promulgate its NHS business interests.
The paper is in two parts. Firstly a review is presented of published evidence on the growing uptake of social marketing approaches within PCTs, highlighting how commissioners view their benefits in contributing towards evidence based public health interventions, and where the reservations lie.
Secondly, the potential for enhancing the scientific credibility of social marketing is considered, for instance in building greater capacity to highlight and address health inequalities. Recent techniques in customer segmentation and ‘customer insight' are explored, together with the segmenting potential of geo-spatial tools such as ‘Health ACORN'.
Two case studies are examined to test the strengths and limitations of these enhanced techniques, in the context of (a) pro-environmental behaviours based on an analysis of barriers and motivators for recycling; and secondly on segmenting the data from a PCT-based alcohol prevalence survey in order to add better focus to promotional campaigns within the PCT's alcohol strategy.

25th March 2010: 2:30pm to 4:00pm

Abstract: When the Cold War ended, politicians from left and right ,east and west, believed there must be a benefit from reducing arms expenditure and pointing themilitary industrial complex towards peaceful, socially usefulenterprises. This becameknow as the 'Peace Dividend' .Applying the same model to turning unhealthy industriesto healthier onesin Sandwell, weresearched localanti-health forces to see how theycould diversify into healthier enterprise- studies of tobacco, food and alcohol retail all suggestedthe potentialto converttowards healthierproduction and consumption. Bythe same score we lookedat how technical ingenuity in the West Midlands manufacturing base, for solong massively in the pay of the military, could be diversified towards products and services for socially useful ends. With the the credit crunch andObama's ' greenrecovery', there has never been a greater opportunityto create meaningful socially useful employmentto tackle climate change, improve health and independence. The potentialfor technology to promote health, environmental sustainability and independence for disabledpeople has never been greater. The timefor the peace dividend, health dividend andthe inclusion dividend is now.

190 words
UKPHA theme: Health and well-being in a time of economic and ecological crises

25th March 2010: 2:30pm to 4:00pm

Abstract: Intervention Generated Inequalities can occur when policies, programmes or strategies are so designed or delivered in ways that do not engage with, or impact on those that they are intended to - or those that are in the greatest ‘need'.
The Welsh Assembly Governments multimillion pound regeneration programme has been developed around 5 key priority themes:
• An attractive and well used natural, historic and built environment
• A vibrant economic landscape offering new opportunities
• A well educated skilled and healthier population
• An appealing and coherent tourism and leisure experience
• Public confidence in a shared bright future.
This presentation will set out how intervention generated inequalities are being avoided through the programme. It will describe how we have ensured that the work ongoing around the themes stretch back into our most disadvantaged communities, and how these are set as part of a progressive pathway towards regeneration.

25th March 2010: 2:30pm to 4:00pm

Abstract: Regeneration can help improve health and health equity. This project describes a systematic and evidence based model for developing indicators that monitor health within regeneration.

In Belfast, the five local Area Partnerships have developed Strategic Regeneration Frameworks for each city sector. This provided an opportunity to develop health indicators relevant to regeneration, by a partnership led by Belfast Healthy Cities and Belfast City Council. The project is part of the Building Healthier Communities project, which has 10 participant cities from across Europe and is funded by the EU through the Urbact II fund.

A Health Impact Assessment workshop was conducted on the East Belfast framework with local stakeholders, which resulted in a list prioritising health determinants and impacts. From this basis a set of validated indicators for monitoring health and health equity impacts was identified and refined, initially with East Belfast Partnership. The final outcomewill be a flexible, conceptual model, which identifies overarching headline indicators as well as indicator subsetscovering economic, social, environmental and access issues. This will allow users to tailor the model to different projects, within the overall framework.

The final indicatorset is developed with all Area Partnerships and will be presented to Belfast Regeneration Office in 2010 to inform the Office's strategy for tackling inequalities in health through regeneration.

25th March 2010: 2:30pm to 4:00pm

Abstract: The World Class Commissioning Assurance Framework (Year 2) specifies that NHS Primary Care Trusts (PCTs) have up to ten outcomes for assessment and review which include two national outcomes (improving life expectancy and reducing health inequalities) and up to eight locally determined outcomes which should reflect meeting the identified health needs of the population. PCTs have been asked to set an aspiration for improvement, aligned to their strategic goals, over the next five years against each of the priority outcomes they have chosen.
Modelling of different scenarios for each outcome was the method NHS Lambeth used to prioritise interventions which would provide measurable, demonstrable and ambitious levels of improvement for the outcomes for each of the next five years. Of the six local outcomes chosen by NHS Lambeth, two are health improvement outcomes – ‘Smoking Quitters' and 'Prevalence of Obesity in Year 6 children'. The presentation describes the process adopted by NHS Lambeth in the modelling of 5 year trajectories using evidence of effectiveness, cost benefit and other evidence for these two outcomes. It also outlines some of the benefits and challenges of modelling these health improvement outcomes as part of the world class commissioning assurance process.

25th March 2010: 2:30pm to 4:00pm

Abstract: Health inequalities is by no means a new subject. While work within academic institutions and health organisations has been published for decades, national health inequalities targets were introduced only in 2001, and have been followed by Spearhead targets and further targets for Local Area Agreements. All of these targets used gaps between a specified subset of the population and the rest. However, health inequalities are better described as a gradient, with no arbitrary cut-offs.
The Association of Public Health Observatories was asked to define and produce a new health inequalities indicator for the World Class Commissioning Assurance Framework. The slope index of inequalities (SII) for life expectancy was calculated for each PCT, using deciles of deprivation defined at lower super output area (LSOA) level.
This paper will give an overview of the new indicator, including an explanation of the analytical, practical and political reasons why the SII, life expectancy, deciles of LSOAs and the Index of Multiple Deprivation were chosen for this indicator.
The paper will also present initial conclusions that can be drawn from the indicator, including geographical patterns in both health inequalities and trends in health inequalities.

25th March 2010: 2:30pm to 4:00pm

Abstract: As the NHS faces leaner times, it is becoming increasingly important to focus on productivity and outcome. However, all too often this comes at a price: focussing on efficiency can widen existing health inequalities as the focus shifts to maximising ‘bang for buck'.
We have been incentivising local productivity and innovation, whilst focussing on addressing health inequalities. Using national frameworks coupled with local intelligence, the public health team has been trailblazing the development of quality outcome metrics for contracts with acute and community service providers. These measure provider performance by pre-agreed clinical and public health outcomes, patient reported outcomes and experience, and equality and diversity.
To help address perverse incentives, 2009/10 will see us piloting innovative adaptations to the national Commissioning for Quality and Innovation (CQUIN) framework in our provider contracts: using pre-defined baselines, we have developed a logarithmic incentivisation framework to reward/penalise provider performance. By explicitly linking incentives to ambitious provider performance, it is hoped we will ensure we are only rewarding the delivery of truly high-quality care across our entire diverse population, including the hardest to reach.
Lessons learned and to be shared include: measuring metrics success; developing meaningful and measurable outcome measures; maximising clinical engagement; difficulty of monitoring the volume of data items; addressing perverse incentives.

25th March 2010: 2:30pm to 4:00pm

Abstract: On 15th September 2009, a motion was proposed at a full Council meeting calling for Wiltshire Local Authority to withdraw from the Nottingham Declaration on Climate Change, on the basis of a lack of evidence for man-made Climate Change. This motion was dismissed by 84 votes to 6.
Wiltshire Council and NHS Wiltshire have utilised local reactions to this event to raise awareness of the issues and build momentum into local action to tackle Climate Change. In partnership, the two organisations are now moving forward on a range of projects within their own structures starting with carbon footprinting. In addition, outward looking programmes of activity with the local community are planned; leading by example, raising awareness and supporting other local organisations and community groups to enable the people of Wiltshire to play their role in local sustainability. Both organisations recognise and are acting on their mutual responsibility in preparing for the impacts of unavoidable climate change on the well-being of the population.
This presentation will look back at progress 6 months on from the full council meeting and consider the direct and indirect impacts that this event has had, negative and positive, on progressing the Climate Change agenda in Wiltshire.

25th March 2010: 2:30pm to 4:00pm

Abstract: The health impacts of air quality in the UK are almost twice those of physical inactivity and obeisity (Defra Air Quality Strategy 2007, Chief Medical Officers Report 2004) yet the former fails to receive quite the level of media attention of the latter. Similarly, some studies have suggested that exposure to traffic pollution poses a similar level of risk to passive exposure to tobacco smoke but there have been no moves to ban traffic.
The UK has had a Local Air Quality Management (LAQM) process in place for over 10 years. This has resulted in over half of local authorities identifying locations where people are regularly exposed to concentrations of pollution that exceeded the health-based standards. However, there is little evidence that the process has achieved many significant health benefits. This presentation looks at a project intended to assess the degree to which the LAQM process has acted as a targeted “health intervention mechanism”. It will look at the way LAQM has failed to integrate with other key policy areas, such as health, and pose some questions regarding why we have allowed our air quality to ‘flat-line' or even worsen over the last 10 years.

25th March 2010: 2:30pm to 4:00pm

Abstract: Within Gloucestershire there are a number of landfill sites including a hazardous waste site. Community concern over these led NHS Gloucestershire to facilitating a community health impact assessment (CHIA) of the sites. Aim - To facilitate a community based Steering Group to undertake a CHIA of the waste treatment and landfill sites. Methods - NHS Gloucestershire facilitated the establishment of a community Steering Group. The Group examined the potential impacts of the sites on the physical, mental health and wellbeing of the community in terms of information collected during the process. Results - The process of facilitating a CHIA was not without challenges for NHS Gloucestershire, the Group and key agencies and stakeholders. The CHIA has identified a number of key gaps in the current knowledge that are essential to further inform this area and require follow up. Conclusions - The community has significant concerns about the sites and have identified a number of key actions for a variety of agencies to undertake. However the CHIA process has identified limitations for future work of this nature including the need to ensure a tight project brief and the need to manage expectations amongst the Group, those who will read the report and how the key areas of action can be effectively followed up.

25th March 2010: 2:30pm to 4:00pm

Abstract: FitFanswas commissioned in conjunction with the desire to create a Single Point of Access for weight management services endorsed by NHS Hull. FitFans, which focuses on men aged 40-65, is aresult of understanding the poor take up of services by adult males in Hull. Local insightshowed that men wanted a service that was scientific, fun and focussed on fitness. Weight loss was a by product of getting fitter. FitFans has beendeveloped taking into account what the customer wants.
Participants follow a 12 week programme.Weekly sessions consist of 20/30 minutes of classroom style discussion followed by 40 minutes of physical activity.Classroom sessionsbuild up the knowledge of various aspects of fitness and weight management. The physical activity section has three key elements; cardio vascular work, core stomach strengthening exercises and muscle toning using flexible bands. Each client participates at a level suitable to their ability. Participants are encouraged to build regular 10 minute exercise sessions into their daily routines. The main goal is for participants to modify their behaviour and to adopt a healthier lifestyle in the short and long term. Retention rates are about 90%, over 50% of those who complete the programme achieve minimum 5% weight loss and sustain it for at least 12 weeks.

25th March 2010: 2:30pm to 4:00pm

Abstract: A sustained increase has been noted locally in the number of overweight and obese adults; the consequences of which are complex and costly to the NHS. NHS Dorset is piloting an innovative weight management programme Healthy Choices: small changes big differences, partnering with commercial weight loss providers. It offers practical support and guidance for adults with a body mass index greater than 28, to attain and lead healthier lifestyles. Specifically, it aims to reduce patient weight by 2.5kg over a 12 week period, sustained over a further 3 months.
A referral hub model links health professionals, commercial weight loss providers and the Dorset population, ensuring overweight and obese individuals access the service and are supported when making essential lifestyle changes. The hub receives referrals from health professionals, providing support and guidance for individuals choosing a weight loss group. It then liaises with the selected weight loss group to ensure a smooth introduction. Patients are provided 12 ‘free' weight loss vouchers for sessions at the selected weight loss group.
Preliminary results, which this presentation will explore, show 2911 individuals have successfully engaged with weight loss groups as a result of the programme; of these 1118 (54%) have lost at least 2.5kg.

25th March 2010: 2:30pm to 4:00pm

Abstract: In response to the increasing trend towards obesity and recognition that, in some London Boroughs, about a third of children leaving primary school are obese, we were commissioned by the Regional Public Health Group to develop an intervention to address this trend. The presentation will describe the steps taken to develop, and then to deliver and evaluate, a community based family intervention for families with children aged 4-7 years, targeted at the issues of healthy and unhealthy weight in children, who are being weighed universally across England in school Reception classes.
By working with local communities, we were able to develop a programme that would be acceptable as well as based on best available evidence, consistent and yet flexible in delivery, and able to be delivered by trained representatives from the local community through a local capacity building initiative. We shall share how we tackled health inequalities by ensuring the programme would be accessible to all and delivered in a range of familiar, though sometimes unlikely, locations. Results of evaluation will demonstrate some unexpected positive impacts of the programme, over and above the direct impact on programme participants, all of which offer hope for the future.

25th March 2010: 2:30pm to 4:00pm

Abstract: Successfully Addressing Social Isolation amongst Older People in Dorset - "Sharing the Experience....."

Eleanor Jack, Dr Ann Hemingway, Bournemouth University
Dorset has the highest proportion of elderly people of any county within the UK, indeed 27.4% of the population over 65. The Brendoncare charity , recognising the need for services that support older people, set up over 70 weekly “Friendship Clubs” across Dorset and Hampshire with 1600+ members. The clubs provide free transport for members, ask a minimal weekly fee, and provide a range of entertainments, hobbies and educational/physical activities to enjoy. The charity commissioned Bournemouth University to explore impacts of the clubs on social isolation and the results, thus far, suggest that by successfully tackling social isolation, the clubs are not only positively addressing key drivers for social exclusion but are also addressing inequalities in health by tackling threats to wellbeing in older people eg. isolation and loneliness are know to contribute to poor physical and mental health especially in the elderly (Isolation and Loneliness Help the Aged 2008).
This presentation will be collaborative between Bournemouth University (Research Staff), and Brendoncare members themselves who will describe the positive impacts the clubs have made on their lives and wellbeing, and how these findings link to current national policies for older people.

25th March 2010: 2:30pm to 4:00pm

Abstract: REACH promotes partnership work between public health and arts organisations. In Bristol AWP Mental Health Trust is working with community organisations Dhekbal and the Chinese Women's Group to reach out to BME older people who are vulnerable to mental health and not accessing services. Facilitated by Willis Newson, Arts and Well-being Clubs will explore the challenges to communication and engagement within these groups. In Devon the Devon Partnership Trust identified isolated older people in rural communities as vulnerable to mental health problems. Aune Head Arts and Villages in Action are managing artists' residencies in which older people and young people create programmes for community radio. In Dorset a GP practice identified a lack of provision for people experiencing mild anxiety, depression and low mood. As part of Improving Access to Psychological Therapies, people are offered a course with an artist and writer where they explore their responses to nature. In Somerset the PCT wanted Take Art to explore the barriers to healthy lifestyles for young people aged 13-15. A photography/film artist and a drama practitioner worked with young people from two schools. The evidence will be used to inform Somerset PCT policy. Step Ahead Research are evaluating the whole REACH initiative and the initial findings will be available by March 2010.

25th March 2010: 2:30pm to 4:00pm

Abstract: The need to increase physical activity levels in the UK population is well highlighted and as a matter of urgency to reduce the rising mortality and morbidity rates. However, it is known that those with severe mental illness are twice as likely, to succumb to premature death than the general population and that the majority of these deaths are linked to lifestyle related causes. Increasing physical activity is effective in improving both mental and physical health but people with mental health problems commonly find it more difficult to commence and maintain regular exercise for a range of reasons.
In this project, we provide physical activity opportunities to mental health clients accessing community based mental health services in Harrow. We address the health inequality and social exclusion, which those with severe mental illnesses commonly face. Our project involves the delivery of individually tailored physical activity plans through personal trainers and assists clients to engage in a range of activities within a community and facility setting.
This presentation will highlight the background to and design of the programme, the quantative outcome-based evaluation and the qualitative evaluation of the views of participants themselves.

25th March 2010: 2:30pm to 4:00pm

Abstract: Due to more enlightened attitudes and improved care, people with disabilities are now living for many years longer than previously, and individuals with disabling childhood conditions are surviving into adulthood. Their carers, often their parents, are therefore maintaining caring responsibilities into their own later life, a new phenomenon that gives rise to issues only just being encountered. These carers, in their later years, are becoming frailer and carry a burden not only of continuing caring responsibilities, but also of concern about the future of their loved one. These enduring responsibilities often mean that carers' own health and welfare needs become secondary to their caring duties. Public health initiatives to promote the mental health wellbeing of older carers require taking account of complexities around the experience of older carers.
Providing educational opportunities for the diverse public health workforce can be challenging. The aim of this presentation is to describe an initiative to create e-learning materials that were developed in partnership with older carers, Through interaction with authentic 'voices' the materials are designed to develop knowledge and understanding concerning promoting the mental health and wellbeing of older carers.

This initiative was funded by the East Midlands Teaching Public Health Network.

25th March 2010: 2:30pm to 4:00pm

Abstract: The Government acknowledges that the life expectancy gap continues to widen and that 15 million adults in England have literacy skills below Level 2 (A – C GCSE) and 20 million having poor numeracy. The link between poor skills and health outcomes is well attested. For example, at age 33, women without GCSEs are 4.7 times more likely to smoke than the rest of the population.
Skilled for Health (SfH), delivered through an innovative partnership at national and community levels, aims to tackle health inequalities by using health related learning materials with basic skills embedded within them. This allows a flexible approach using a variety of delivery models in different sectors, organisations and community settings, reaching deep into disadvantaged communities. It uses health and learning opportunities as the hook for recruiting and retaining participants who would benefit most from such an initiative.
This presentation shows, from the evaluation of phase two (March 2009), the success of this approach. Evidence suggests that SfH reaches traditionally forgotten groups whom professionals find hard to reach, in settings such as prisons and libraries. It reflects on the evidence of health related outcomes and participants' wishes to progress to further learning due to the positive nature of the SfH learning experience.

25th March 2010: 2:30pm to 4:00pm

Abstract: Extending access to health literacy is crucial to addressing cross-Government policy drivers (eg employability, inequalities in health and education) and supporting the achievement of health and skills improvement programmes.
The Departments of Health (DH) and Business, Innovation and Skills (BIS) jointly developed the health literacy programme - Skilled for Health (SfH) - which delivers Language, Literacy and Numeracy skills in a health context. Often working closely with the DH Health Trainer (HT) programme, it reaches out to people and communities who experience poor health and skills outcomes and lack health literacy skills.
There are currently no qualifications covering health literacy to provide the building blocks into the lower levels of the health / healthcare workforce (eg HTs).
The national evaluation of Skilled for Health (Tavistock Institute and Shared Intelligence, 2007-2009) demonstrated how formal recognition of learners' achievements is not only of value to employers but also of immense personal value to individuals who have not engaged previously.
This presentation will set out the background to this development, the outcomes achieved from working across workstreams, and progress made in gaining formal accreditation for a Level 1 qualification and identifying associated public funding.

25th March 2010: 2:30pm to 4:00pm

Abstract: The 2008 White Paper, Pharmacy in England: Building on strengths, delivering the future set out a vision for the development of pharmacies as ‘healthy living' centres promoting healthy living, wellbeing and self care.
The health of the Portsmouth population is generally worse than the England average. Although life expectancy is increasing, there is a widening gap in life expectancy within the City. Nearly two-thirds of the gap in life expectancy can be attributed to circulatory disease, respiratory disease and cancer and nearly half to vascular disease alone. Lifestyle factors contribute significantly to the gap and these are all key public health priorities in the PCT's efforts to improve health and reduce health inequalities.
NHS Portsmouth believes community pharmacy can make a larger contribution to reducing health inequalities. The PCT has developed a framework for a Healthy Living Pharmacy which it is starting to implement. This presentation will describe the Portsmouth framework and outline how it is being implemented in Portsmouth City.

25th March 2010: 2:30pm to 4:00pm

Abstract: Good jobs – good for health and good for business
Employers who offer good jobs are consultative, supportive and flexible, creating conditions in which their people can succeed and thrive at work. The result is a healthier workforce and a more profitable, high performing and productive workplace.
London Works for Better Health is a London Health Commission programme with two fundamental aims: to promote healthy employment and to improve health and reduce health inequalities through work and enterprise. Its employer campaign: Good jobs – good for health and good for business includes a wealth of practical advice to spark new ideas and new ways of working for London's employers. Its business breakfast series is jointly hosted by prominent London employers with inspiring stories to tell about their workplace health initiatives: Deloitte, London Fire Brigade, Tate and Lyle, Transport for London, Royal Mail Group, Pizza Express, Happy Ltd, Alara Wholefoods, LOCOG, BT and others. Chaired and facilitated by partners from City law firms they will stimulate debate and action amongst London employers.
This paper shares the simple messages the London Health Commission has developed to help businesses, describes the opportunities and challenges of developing partnerships with the private sector to promote public health messages and reports the findings from the debates.

25th March 2010: 2:30pm to 4:00pm

Abstract: To reach hard-to-reach men at risk of obesity, hypertension and cardiovascular disease (CVD) and less likely to visit GPs for check-ups, free NHS health checks are offered to men in workplaces. The checks follow national NHS health check guidelines. An outcome form is sent to every client's GP and clients with risks followed up by telephone contact. 141 clients have been seen since launched in June 09. 11 % were referred to GPs for follow up of CVD risk, 26% for diabetes risk, 23% for high BP, 18% for high Chl:HDL ratio, 4% to stop smoking and 7% to weight management services. The feedback from clients and businesses has been very positive with clients reporting improved lifestyle and weight loss as a result. Many men were surprised of being at risk or having hypertension. Several businesses have asked for more information about promoting health and wellbeing in their workplaces. We will evaluate the first 6 months of health checks in relation to outcomes, follow up of referrals to other services and in relation to socio-economic deprivation. Offering health checks in workplaces can identify people at risk of CVD, reduce barriers to seeking health advice and improve quality of life.

25th March 2010: 2:30pm to 4:00pm

Abstract: The issue
The current economic environment has put pressure on organisations to cut costs and increase workforce productivity. However, in times of uncertainty and change, employee stress and anxiety invariably increases, which can lead to reduced productivity and increased absence.

The economic downturn has taken its toll on employees in the public sector, with annual absence standing at 10.3 days per employee, costing organisations £732 per person per year. For a public sector organisation with 1,000 employees, the cost of absence adds up to around £732,000 annually.
The solution
In this session we will show you how vielife promotes and manages well-being to reduce absence and increase productivity. We believe it is important to identify the potential health risks of an organisation before implementing a programme to mitigate those risks. Our approach really works - we have helped to reduce absence by over 20% in public sector organisations - in a company with 1,000 employees, this would translate into a saving of £146,000.

25th March 2010: 2:30pm to 4:00pm

Abstract: This paper will examine a range of recent health initiatives commissioned by NHS Central Lancashire to provide health screening and information to traditionally socially excluded groups. These include innovative partnerships with professional football and rugby clubs as well as with religious organisations within the ethnic minority communities in Preston.

It considers the issues of health inequalities experienced by different social groupings, and the need to engage with such excluded communities in radically new ways. There is strong evidence that many hard to reach individuals prefer to access health services in social contexts other than traditional health care settings such as hospitals and clinics.

A central feature of the paper will be the presentation of strong evidence that different strategies are needed to reach different types of people with potential health need, in particular those with long-term conditions such as diabetes and cardio-vascular disease.

The paper will conclude with a range of practical suggestions for extending this model of community health engagement.

25th March 2010: 2:30pm to 4:00pm

Abstract: The Healthy Lifestyle Roadshow (HLR) is a multi-disciplinary team established to target those with greatest health needs within the ethnically and socially demographically diverse London Borough of Hounslow (LBH). The team of a doctor, nurses, dieticians, health trainers and specialists in physical activity, health promotion and public health are from a partnership of health care providers from acute and community trusts, local authority and various charities.

Identifying target populations is undertaken using health intelligence from NHS Hounslow Public Health Department. HLR provides a NHS health check for those between 40-74 in an informal setting; clients can go from stall to stall and ask questions of highly qualified health professionals. Venues include Mosques, Churches, Refugee, shopping, civic and leisure centres, The vascular risk score is calculated (QRISK) derived from measurement s of lipid profile, blood pressure, BMI, medication, family history and demographic details. The results can be discussed with the doctor or nurse and the information is then forwarded on, with the clients consent, to their GP.

Early findings indicate that between 5-10% of clients attending the HLR have a risk score between 10-20%

This presentation will describe the findings from NHS Health checks undertaken in LBH through the community outreach work of the HLR.

25th March 2010: 2:30pm to 4:00pm

Abstract: Purpose Ideal for All's Salop Drive Market Garden is a unique ‘local' food scheme, three acres reclaimed from derelict allotments and developed into a productive site by disabled people and the local community.
Approach People were engaged in a participative process, designed, and managed in a ‘community led' framework.
Results The site houses a glasshouse, polytunnels, community garden, allotments, wildlife area, outdoor beds. A wide range of produce is sustainably grown and sold locally via ‘bag your share'. Other activities include healthy eating advice, cooking, short courses, training, health walks, and schools visits.
Practical Implications In 2008 1,695 adults participated in activities, and over 1000 vegetable bags were delivered. 645 school children participated, and 200 under fives visited. The project meets public health targets at grassroots and strategic levels. It supports policy development around issues of food access, healthy eating, obesity, and prevention of diet related illness.

Originality/Value The project models links between health and environmental regeneration. In 1997 Sandwell death rates from strokes were almost a quarter above the national average. Against a community background of high poverty levels, diverse ethnicities and unemployment, a radical approach was taken to improve food access, morbidity and mortality rates, leading to the adoption of Growing Healthy Communities a community agriculture strategy for Sandwell.

25th March 2010: 2:30pm to 4:00pm

Abstract: Background
NHS Bedfordshire have been developing - working in partnership with a number of agencies and organisations in Bedfordshire – a programme to get health messages across to as many people as possible living and working in the area, particularly the vulnerable and those in deprived areas. The main aim is to have ‘Health Champions' trained and in place to help individuals and groups to improve and/or develop a more healthy lifestyle, whilst having an impact on reducing cost and pressure on the workforce of NHS Bedfordshire. HMP Bedford is one of the partners.

Intended outcomes
Prisoners in HMP Bedford to be trained as ‘Health Champions' to support and provide information to their peers (other prisoners) to encourage a more healthy lifestyle (including healthy eating whilst in prison) and to provide a platform for re-entry into the community achieving a recognised qualification

Activity
The programme started in July 2009 with prisoners chosen through a robust interview process to become ‘Health Champions', undertaking the RSPH Level 2 in Understanding Health Improvement Award. A team of support staff within the prison is available to these selected prisoners should they want help within implementation and information. Early feedback has been very positive.

25th March 2010: 2:30pm to 4:00pm

Abstract: Offenders experience a high level of disadvantage and are at a high risk of poor health. Working in partnership with prison and Primary Care Trust staff, including PE, education, disability liaison, healthcare and stop smoking staff, a successful Health Trainer service has been established at HMP Erlestoke (a Category C prison) in Wiltshire. A group of prisoners has achieved the level 3 City and Guilds Health Trainers qualification, including one prisoner who is fully deaf. The course was adapted to reflect the restrictions of the prison environment. The Health Trainer service was launched in July 2009. The Health Trainers promote behaviour change and support clients to reach their health goals. To date, the Health Trainers have supported clients to lose weight, increase healthy eating and physical activity, and reduce or stop smoking. In addition, Health Trainers have engaged with isolated prisoners and encouraged prisoners to undertake numeracy and literacy courses. The Health Trainers themselves are leading healthier lives and have developed skills and confidence that will assist with employment opportunities on leaving prison. There is increasing evidence that increasing self-esteem and improving health among offenders has a wider impact in reducing reoffending.

24th March 2010: 3:30pm to 4:00pm

Abstract: Excess alcohol consumption represents a major determinant of morbidity, mortality and health inequality. Key to understanding and addressing this problem is the collection of accurate information regarding people's attitudes and behaviour surrounding alcohol. This informs public health strategy and policy and predicates useful assessment of intervention effectiveness.
Traditionally, information has derived largely from ‘snap shot' annual formal representative surveys, for example the Health Survey for England.
Here we explore use of an internet-based survey,to providealternative methodology for collecting information on a more up-to-date basis, with sensitivity to change on a temporal basis. The East of England survey was conducted via an online questionnaire using a combined sample of the Ipsos MORI online panel and members of the general public, with significant numbers of self-selecting participants. Nearly 7000 online surveys were completed by East of England residents over the age of 18 between 11th December 2008 and 31st March 2009.
This presentation will quantify the extent to which the online surveygives a similar result to annual formal surveys -a key step to it's validation as a reliable tool to monitor both attitudes and behaviour surrounding alcohol as well asthe effect of interventions, on a real-time basis.

24th March 2010: 3:30pm to 4:00pm

Abstract: Alcohol is a major preventable cause of health and social harm. Alcohol-related hospital admission rate [National Indicator (NI) 39] is one of up to 35 indicators that Local Authority (LA) led partnerships can include in their 2008-11 Local Area Agreements (LAA).
We decided to investigate whether including NI39 in the LAA would lead to greater improvement. In this report we describe the characteristics of LAs that included NI39.
More than half of 150 LAs had included NI 39. Inclusion of NI39 was associated with inclusion of NI 123 (smoking); inclusion of NI 32 (domestic violence); low percentage of Asian population, and low levels of deprivation. There were however regional differences, and inconsistencies, in the proportion of LAAs with NI39. Regions with a high level of harm from alcohol-related ill-health, and crime sometimes had the lowest rates of NI 39 inclusion.
By throwing some light on the reasoning behind inclusion of an alcohol harm indicator in LAAs, these results offer some evidence that local service managers are fairly consistent in their response to local needs. We plan further research to study the impact of inclusion of NI39 in the LAA on the rates of alcohol related admissions.

24th March 2010: 3:30pm to 4:00pm

Abstract: Alcohol misuse has a negative effect on individuals and society putting added strain on health, criminal justice and emergency services and with great financial and human costs. Figures show that the most deprived fifth of the population tend to suffer two to three times greater loss of life attributable to alcohol.
Lambeth is in the UKL top five areas for hospital admissions directly related to alcohol misuse. In 2007, Public Health completed an Alcohol Needs Assessment and updated this in 2009. The Needs Assessment estimated that within Lambeth some 53000L residents aged 16-64 were drinking at hazardous and harmful levels including at least approximately 10,000 residents who could be catagorised as dependent drinkers.
These findings formed the rationale for the development of an alcohol prevention strategy and a 3-year Action Plan. The aim of the Strategy is to reduce the harms of problematic alcohol use in Lambeth. The Strategy has identified key evidence-based deliverables through a 3 year Action Plan and includes partnership working, health promotion activities, Public Health input into licensing conditions, increasing capacity and resources including the recruitment of alcohol specialists in A&E implementing screening and brief interventions.

24th March 2010: 3:30pm to 4:00pm

Abstract: The relationship between regretted sexual activity and alcohol consumption in young people is clearly documented but it is less clear what young people believe to be the causal factors in this relationship. In this project creative methodologies enabled young people to describe sex they regret after alcohol consumption and debate the social marketing approaches that might be successful in reducing regretted sex.
A ‘Barbie and Ken' activity enabled vulnerable young people to describe alcohol fuelled nights-out culminating in violence, infidelity and other risky behaviours juxtaposed with nights-out without alcohol which were characterised by love and romance.
The findings of this project have informed a ‘taster' poster campaign focused on local pubs and clubs which attract young people for ‘nappy nights'.

24th March 2010: 3:30pm to 4:00pm

Abstract: The National Alcohol Social Marketing Strategy has a strand of work to explore ways to reduce alcohol consumption through self help approaches.
The Department of Health East Midlands (DHEM) worked with the national alcohol policy lead for social marketing and COI to use a Direct Marketing approach to ‘acquire' respondents to request self help materials. This work built on a pilot project undertaken in the NW region which had tested a range of messages to trigger action and the development of self help materials through national research and insight. The evaluation of this initial pilot was focused on the process of acquisition with no follow up on behavioural outcomes.
The EM wished to extend the learning from this regional project to understand the impact of the acquisition of the materials on changes in behaviour, to explore how direct marketing approaches can be improved and what further or ongoing support respondents might need to initiate or maintain behaviour change.
This poster describesthe results of the evaluation carried out to understand the impact the self help booklet had on drinking behaviour in order to provide recommendations for future use of direct marketing projects.

24th March 2010: 3:30pm to 4:00pm

Abstract: BackgroundMethodsResultsConclusion
The results appear promising with an overall improvement in substance misuse risk and high service satisfaction.

24th March 2010: 3:30pm to 4:00pm

Abstract: Internationally violenceisapublic health concern, from Boston's public health approach to violence prevention, to the Cardiff Model of reducing violence in the night time economy. London is a culturally diverse city with 7.7 million residents and thousands more travelling into the city daily. It has a thriving night-time economy. Among the lights and glamour, London suffers from a darker side, one ofalcohol, crime,andviolence.
London's Regional Public Health Group joined with the Government Office London, Home Office and Metropolitan Police to implement a public health lead programme to involve Accident and Emergency Departmentsin sharing and working with their local communities. Whilst not being the same as the Cardiff model, it has been developed from the work of Professor Jonathan Shepherd at Cardiff University. The aim of the model is to share data between hospital trusts and Crime and Disorder Reduction Partnerships to inform police and community safety team activities. This approach takes local partners on a journey, from forming working groups to developing local plans, working as part of local teams and on a regional basis to understand local solutions for regional and local needs. The aim is to make London safer, happier and healthier through using public health approaches and partnership working to reduce alcohol related violence.

24th March 2010: 3:30pm to 4:00pm

Abstract: Violence has a significant impact upon society and on our health and wellbeing. Since January 2008, 28 teenagers have been killed in London as a result of stab injuries – 90% of those killed were from minority ethnic groups. Approximately 75% of those presenting in A&E as a result of a violent incident do not report the crime to the police and hence do not feature in crime statistics. A&Es can make a valuable contribution towards community violence prevention through the sharing of anonymised data with the local crime and disorder reduction partnership. In addition – they have an important role identifying and signposting vulnerable young people into appropriate services.
This presentation will describe a collaborative approach taken to tackle violence involving young people in the boroughs of Lambeth and Southwark. Lambeth and Southwark are two inner London boroughs characterised by high levels of deprivation and a large young, multi-ethnic population.
Our approach includes:
introduction into A&E departments of anonymised data sharing to inform targeted policing and prevention
establishment of dedicated youth outreach workers to work with vulnerable young people and signpost into services
qualitative study detailing young people's knowledge, attitudes and beliefs on violence and knife crime.

24th March 2010: 3:30pm to 4:00pm

Abstract: The Safety and Health Enhancement (SHE) Framework is a comprehensive toolkit for use by health care planners, providers, researchers and policy makers in developing evidence-based health care models to support women experiencing violence in their relationships. An extensive review of the literature found that most previous research in this area was quantitative in nature, often based on untested assumptions about what is beneficial for women in abusive relationships, and rarely examined the impact of various responses on women's lives or health. A research project was designed to incorporate the perspectives of women experiencing abuse, and generate hypotheses to explain how health-care experiences affected their health. Through the constant comparative method of data collection and analysis, we interviewed women who had experienced abuse / violence in their relationship and learned what was helpful, what was not, and why. From this, we developed a clear framework to support women's safety and health strategies in health care.

24th March 2010: 3:30pm to 4:00pm

Abstract: The health and local authority commissioning partnership formed in Leicester City and Leicestershire have been selected for the Government's Fit for Work Service pilot. Targeted at areas of deprivation, the service will help around 2,000 people return to work in 2010/11.
The Fit for Work Service will provide personalised vocational rehabilitation to people who fall ill, assist them in their recovery and help them to stay in work rather than claim benefits. Via GP referral, this service will help people avoid the long term health problems associated with being off work for an extended period of time.
Case managers will co-ordinate access to a wide range of services including physiotherapy, psychological therapies, education or re-training, workplace interventions and home and personal interventions (such as housing and debt advice), to help people return to work more quickly.
This presentation describes the collaborative work between Primary Care Trusts, Local Authorities, Business and the Third Sector in developing a case managed approach to long term sickness absence, bringing vocational rehabilitation closer to mainstream primary care. By engaging GPs with the health and wellbeing at work agenda, we are moving the management of sickness absence away from the medical model into personalised vocational rehabilitation.

24th March 2010: 3:30pm to 4:00pm

Abstract: Employed people are generally healthier and happier than people who aren't employed. As well as improving income, employment boosts confidence and self-esteem, and, as our health and well-being affects people around us, work benefits our families and communities.
The economic impact of worklessness is well documented (working age ill-health costs £100 billion a year – nearly the annual budget of the NHS), however the importance of the physical and mental health of working age people in relation to personal, family and social attainment is insufficiently recognised in our society.
The DoH and DWP have formed a strategic partnership to deliver a national public health initiative to address this. The Greater Merseyside Condition Management Programme supports people in receipt of Incapacity Benefit by providing clients with the tools they need to overcome the health conditions that reduce their ability to sustain meaningful work.
Using a bio-psychosocial model and utilising a cognitive behavioural approach, CMP encouragesclients to engage with a multi-disciplinary teamto overcome and manage their physical and mental health barriers to employment.
Today, returning to meaningful work is even more important and 22% of CMP graduates are sustaining paid employment. This has a positive impact on the health and well-being of those individuals, their families and their communities.

24th March 2010: 3:30pm to 4:00pm

Abstract: NHS Cancer services must plan for the effect of a growing and aging population over the coming years. The population of the South West is expected to grow from 5.3 million in 2009 to 5.8 million in 2020; the number of people aged over 75 will increase from 500,000 to 648,000 over the same period. The rise in overall cancer incidence rates seen over recent years is expected to continue. We combine these trends together to forecast the number cancer diagnoses each year up until 2020.
Population projections from the Office of National Statistics were combined with published predicted cancer incident rates to produce regional and local estimates of cancer incidence.
In 2006 30,000 cases of cancer (all malignancies excluding non-melanoma skin cancer) were diagnosed in the South West Region. In 2020 we forecast 38,000 will be diagnosed, an increase of over 27%. The forecast varies across the region, ranging from 10% in Bournemouth and Poole to 38% in North Somerset.
The presentation will describe the forecast in greater detail for different cancer sites and discus the impact this will have on NHS cancer services in the South West

24th March 2010: 3:30pm to 4:00pm

Abstract: Residents of one street in the West Midlands expressed concern that fifteen cancers had apparently arisen since the installation of a nearby mobile telephone base station. This presentation will describe an investigation to respond to residents' concerns by exploring whether the base station could be responsible for the cancers.
Living patients were asked for their written permission to request details from their GP and hospital records. Where granted, GP practices and oncologists were approached to provide information. Data on cancer incidence and mortality were obtained from the CIU.
There were no significant differences in SIRs or SMRs (for the Ward compared to the West Midlands) for any cancers diagnosed since the base station's installation. The collection of cancers did not fulfil the criteria for a cancer cluster, as cases represented a variety of common cancers; no single type was dominant and none were seen in a group not usually affected by that cancer. We could not therefore conclude that the base station was responsible for cancers in these residents. The presentation will also highlight some of the difficulties associated with this type of study, and will present a graphical method that we developed to assist with the investigation.

24th March 2010: 3:30pm to 4:00pm

Abstract: Introduction: Advice regarding the need for cervical screening in lesbians is confusing, and there is concern about low uptake in this group. Non-attendance for screening puts these women at risk of late diagnosis of cervical cancer, resulting in poorer prognosis. This review aims to clarify the need for cervical screening in lesbians using the current evidence base.
Methods: Literature review searching PubMed and the Internet for articles on lesbians, cervical cancer and cervical cancer risk factors.
Results: Case reports and prevalence studies show that HPV can be transmitted sexually between women. It is not known whether prevalence of HPV or cervical cancer differs between lesbians and heterosexual women. Lower uptake of screening in lesbians is linked to a belief that lesbians are less susceptible to cervical cancer and have less need for screening. Despite sharing most of the same risk factors as heterosexual women, lesbians are much less likely to undergo regular screening.
Conclusions: Advice regarding need for cervical screening in lesbians needs to be clear and consistent. Both the health care and the lesbian communities must be made aware that regular cervical screening is as important in this group as it is in the heterosexual female population.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background: Prostate cancer is the most common cancer diagnosed among men in the U.S. The incidence and mortality rate of prostate cancer is highest for African-American men.
Objective: The purpose of this study was to quantify the effect of race on the prevalence of self-reported Prostate cancer screening.
Methods: Cross sectional study of 2006, BRFSS Survey analysis involving 96,991 Males aged 40 years and above.
Main Outcome Measure: Self-reported Prostate cancer Screening using PSA test .
Results: African-American men accounted for approximately eight percent of population screened for prostate cancer. After adjusting for confounders, PSA Screening rates were found to be highest for African-American population (Adjusted OR=1.21{1.15, 1.27}) whereas Hispanic (Adjusted OR=0.77{0.74, 0.81}) and other racial groups (Adjusted OR=0.55{0.52, 0.58}) had a lower PSA screening rate as compared to white.
Conclusions: African-American men were more likely to be screened for prostate cancer as compared to Whites. The higher screening rate for the African- American men is possibly due to more awareness, and facilitation of discussion on prostate cancer screening by their health care providers.

24th March 2010: 3:30pm to 4:00pm

Abstract: Introduction: Celebrity diagnoses can have important effects on public behaviour. UK television celebrity Jade Goody died from cervical cancer in 2009. We investigated the impact of her illness on media coverage of cervical cancer prevention, health information seeking behaviour, and cervical screening coverage.
Method: All national UK newspaper articles containing the words “Jade Goody” and “cancer” from date of diagnosis until after death were examined for public health messages. Google Insights for Search was used to quantify Internet searches as a measure of public health information seeking. Cervical screening coverage data was examined fortemporal associations.
Results: Of 1,203 articles, 116 (9.6%) included a public health message. The majority highlighted screening (8.2%). Fewer articles provided advice about vaccination (3.0%), number of sexual partners (1.4%), smoking (0.6%), and condom use (0.4%). Key events were associated with increased Internet searches for “cervical cancer”, and “smear test”, although there was only a weak association with searches for “HPV”. Cervical screening coverage increased at this time.
Conclusions: Increased public interest in disease prevention can follow a celebrity diagnosis. A minority of newspaper coverage included public health messages, but these typically focussed on secondary instead of primary prevention. There is further potential to maximize the public health benefit of future celebrity diagnoses.

24th March 2010: 3:30pm to 4:00pm

Abstract: Sun exposure is a major preventable risk factor for both melanoma and non-melanoma skin cancers. The underlying message of global and UK skin cancer prevention strategy has been the recommendation that people should reduce their sun exposure. Such advice does not necessarily lead to behaviour change and this has been cited as problematic in skin cancer prevention work with adolescents. This paper presents a study that aimed to explore the sun-related experiences of young women in order to explain their behaviours in the sun. A qualitative, grounded theory method was used. Sampling was purposive and theoretical and twenty female participants aged 14 to 17 years old were involved. The main method of data collection was semi-structured interview. Data was analysed using the constant comparative method of data analysis. Data collection, analysis and theory development occurred concurrently. The grounded theory developed in the study proposes that when young women are in the sun they direct their activities toward meeting their physical and psychosocial comfort needs. Overall the issues that affected the participants were complex and this indicates the need for young people to be partners in service planning.

24th March 2010: 3:30pm to 4:00pm

Abstract: A questionnaire was sent to schools within Caerphilly County Borough to determine the level of sun protection provision and education available in schools. The findings showed that there was much disparity across the borough. Advice was sought from the early years development group, healthy schools officer and eco schools officer. Local sun protection policy guidelines were then developed for each of the settings. These guidelines were modelled on those produced by Cancer Research UK and are in line with the Welsh Assembly Government's cancer targets.
Skin cancer, although increasing in the UK, is a competing priority for public health especially in an area like Caerphilly. Therefore, the guidelines were developed in a user friendly format to make it easy for each setting to develop their own policy. Hard copies were sent with downloadable CDs and all documentation was available on the Internet. Each setting could then register online that they had developed a policy and this could be used as evidence towards various targets within the Healthy Early Years, Healthy School and Eco Schools Schemes.
This presentation will highlight the process of developing these guidelines in partnership with key stakeholders. And how developing these guidelines has made it easier for early years and school settings to develop sun protection polices.

24th March 2010: 3:30pm to 4:00pm

Abstract: Aim: To successfully implement HPV vaccination programme across Nottinghamshire, ensuring all girls (3990) are offered vaccination with no inequalities in access.
Barriers to implementation: NHS Nottinghamshire County comprises 6 PCTs which have merged into one. Historically, ways of working in the north and south of the county have been very different; this posed a huge challenge for implementation of the programme.
E.g. In the north, school nurses had not vaccinated for 4 years and therefore required training before they could administer vaccine, yet in the south of the county, school nurses had maintained a vaccination service.
Barriers which arose once programme underway:
Ensuring girls attending school in Derbyshire but registered with Nottinghamshire GPs were offered vaccination.
Overcoming barriers: Working groups established; all stakeholders represented. Regular meetings held to share information and tackle problems arising.
Extra training commissioned and provided. PCT corresponds frequently with neighbouring PCTs.
Outcomes: The programme has encouraged partnership working and addressed the north-south divide. We are beginning to have a shared vision as a county PCT.
Programme running successfully. Uptake rates of 1st, 2nd, 3rd doses of 87.5%, 86% and 80% respectively.
Collaborative working has positive impacts for other areas of public health, not solely the HPV vaccination programme!

24th March 2010: 3:30pm to 4:00pm

Abstract: A national programme of colorectal cancer screening using faecal occult blood testing (FOBT) is underway in Scotland. Invitees (50-74 years) receive the test kit by post to complete at home and then return for laboratory analysis. Overall uptake (return of the kit) in the pilot scheme for the programme was 54.4%, but varied by age, gender and deprivation.
Pre-notification has shown increased response to postal questionnaires; a trial of pre-notification two weeks before invitation was therefore carried out to assess impact on screening uptake within the Scottish programme.
Subjects were randomised to receive the pre-notification letter, the pre-notification letter+booklet or the usual method of invitation. Overall, 59,958 subjects were included in the trial between 13/04/09 and 29/05/09 and were followed to 27/11/09.
Uptake was significantly higher with both the letter (59.0%) and the letter+booklet (58.5%) compared to the usual invitation (53.9%, p

24th March 2010: 3:30pm to 4:00pm

Abstract: Background: The health and wellbeing and life expectancy of people living within NHS Norfolk is continues to improve. As the population ages, the occurrence of chronic conditions such as Coronary Heart disease is increasing. Disease prevalence figures show that NHS Norfolk has higher figures than England or the East of England. This presentation uses under 75 years of age CHD Mortality a proxy measure of need and informs the planning and delivery of services for reducing inequalities.
Method: Under 75 years of age Directly age-Standardized Mortality Rate (DSR) from CHD as primary diagnosis for each gender, local deprivation quintile, district for the periods 2006 and 2007 were calculated and compared.
Result: The equity audit shows that there are great disparities in the Mortality within the geographical area and that worse outcomes as expressed by the DSR are associated with increasing deprivation.
Recommendation: In order to reduce inequity of health in a position consistent with government targets, NHS Norfolk should invest in innovative services aimed at the most deprived.

24th March 2010: 3:30pm to 4:00pm

Abstract: In April 2008 Alan Johnson, Secretary of State for Health, announced plans for the NHS to introduce a systematic and integrated programme of vascular risk assessment and management. In 2009, Bromley PCT launched a programme of vascular checks for its 1,142 staff, with the aim of:
• Improving their vascular health
• Increasing staff knowledge
• Enhancing communication and ambassadorship of vascular checks
An external provider carried out the vascular checks between February and June 2009 across 24 PCT sites. Data was captured using a secure database on the PCT server, which was made anonymous following the check.
Everyone attending was offered lifestyle advice including physical activity, smoking cessation and weight management if needed.
For staff over the age of 40 years there was a full vascular risk assessment.
Individuals were given results with option of the results being forwarded to their GP. Following completion of the programme all staff were offered a satisfaction survey exploring why they did and did not take up the offer of the vascular check.
Of the 1,142 PCT staff, 455 took advantage of the vascular checks.
This presentation will describe programme set up, and results of evaluation of the programme including the staff survey.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background
CVD is the most common cause of premature mortality and health inequalities in Teesside (population 550k). Proactive case finding linked with appropriate pharmaceutical management and targeted lifestyle interventions provide significant benefits to those individuals most at risk of developing CVD.
Implementation
We implemented a vascular risk assessment programme across Teesside approximately one year ahead of the launch of the nationalassessment programme. The programme is being delivered through 3 main routes: GP, workplace and community pharmacies. All GP practices in Tees (n=84) have signed up to a LEStargeting the eligible populationestimated to be at highest risk using an integrated prioritisation tool.NHS provider services and local pharmacies are contracted to deliver assessments in targeted workplaces and community venues. Social marketing approaches were used to gain insight into the target groups and develop strategies to engage with them.
Results
Patient numbers to date:

Risk Assessments = 24,476
Community/workplace assessments = 3,500
Identified with a >20% risk = 11,097
Number commenced on statin = 10,597
Newly diagnosed with diabetes = 177
Newly diagnosed hypertensives = 930
Identified with a BMI of >30 = 7,586

Conclusions
Important lessons have been learned.Further analysis of the data is required to understand the impact of the programme on reducing inequalities and engaging with those in greatest need.

24th March 2010: 3:30pm to 4:00pm

Abstract: The Tees Vascular Assessment Programme (TVAP) is an early adopter of ‘NHS Health Checks' offering screening for cardiovascular disease (CVD) to people aged 40-74. Primary care teams (PrCTs) in general practice in Tees Valley have been supplied with lists of people from their registered population who are estimated with a CVD event risk of >20% in ten years.
PrCTS have been invited to
• Sign up to a Local Enhanced Service (LES) to deliver TVAP assessments
• Submit an ‘Action Plan' which includes their aspiration for the number of assessments they will carry out
• Call in for assessment individuals from their ‘high risk' list, or with known hypertension.
We report from the first stages of the evaluation on the willingness of PrCTs to undertake CVD primary prevention, an analysis of their aspirations for team activity, and objective data for assessments actually completed. This data is linked to known Ward-based health indices, giving advance intelligence of the extent to which TVAP is likely to meet its objective of providing equitable access to CVD risk assessment.

24th March 2010: 3:30pm to 4:00pm

Abstract: CHD produces more deaths in England, and locally in Somerset, than any other disease. National targets for reducing mortality and standards for the prevention, diagnosis and treatment of CHD are widely reported. This presentation considers whether these standards are met and whether CHD health inequalities are present for Somerset residents.

Somerset has a relatively healthy population with low levels of deprivation and a life expectancy which is higher than the national average. Standardised CHD death rates are lower than the England average although given Somerset's older population the actual number of deaths is considerable.

Detailed analysis across a range of CHD interventions utilising lifestyle, mortality, GP Practice and hospital activity data was undertaken. This analysis covered primary and secondary prevention, identification of CHD patients and access to secondary care and considered inequalities by local authority, deprivation, gender and age.

The results identified inequalities covering primary prevention, prevalence registers and access to angiography and revascularisation within a range of population groups including the most deprived, females and residents of Mendip local authority. How these inequalities can best be addressed will be discussed which will include consideration of referral threshold into secondary care.

24th March 2010: 3:30pm to 4:00pm

Abstract: Stroke Registers have a vital role to play in reducing the current and future burden of strokes, especially among the elderly. In North Staffordshire, a Stroke Register (SR) was established in 2000 and aimed to provide information on the following: needs assessment for service development and planning; monitoring effectiveness of services; outcomes of care.
Compared with 2003/04, findings from the 2007/08 SR showed that: the average age of patients was 73; the median length of stay in hospital was 12 days (2003/04 = 18 days); 78.6% of patients received their care in a specialist stroke unit (2003/04 = 34.5%); 96.9% of patients had a CT scan (2003/04 = 77.6%); 80.4% of patients received a CT scan within 24 hours of admission (2003/04 = 24.1%); 94.3% of eligible patients received antiplatelet/anticoagulation treatment (2003/04 = 68.3%); 61.4% of patients returned to live on their own following discharge (2003/04 = 62.6%); 14.5% of patients died (2003/04 = 22.1%).
There continue to be major improvements in the management and provision of care offered to stroke patients in North Staffordshire. The SR continues to be used to support planning for the Fit for the Future and Intermediate Care project planning.

24th March 2010: 3:30pm to 4:00pm

Abstract: Recent papers published show that prior induced abortion (PIA) leads to increased risk of preterm birth (PTB) for subsequent pregnancies. Yet this risk is not mentioned on the abortion consent forms in the UK .
We consider evidence from over 100 published papers, including the biological plausible pathway, Bradford Hill criteria- and meta-analysis for this risk with ORs>1.6 and a dose-response relationship .
This is a serious and deteriorating public health issue in 2010. Terminations have increased in the UK with over 200,000 English abortions performed last year. Correspondingly PTB's have also increased. The risks of brain damage and death to the newborn infant increase in relation to the degree of prematurity.
Hidden financial costs to the NHS also rise as a function of degree of prematurity and attributable risk. Included in costs to the NHS, are both the extra costs of neo-natal care and potential lifelong care for those with residual disability. Costs attributable to PIA will be discussed.
The case for linking English termination data to female health records to investigate this risk is strong. Currently this is not possible since abortion data are only published as cross-sectional data in England , so that sequelae cannot be explored.

24th March 2010: 3:30pm to 4:00pm

Abstract: PSA 12.1, 6-8 week breastfeeding prevalence, requires strategies to ensure that women are supported to continue to breastfeed, that services support them to make positive,choices, and that these are evidence based and economically sound.
The main aims of project were to:
• collect data on breastfeeding services across London for electronic mapping at the level of the PCT and individual Trusts
• develop and test a bespoke database for data entry, analysis and mapping of regional service data with routine demographic, breastfeeding and health outcome data
• provide a directory and map of services across London to promote awareness of services for their users
Data were collected via an on-line questionnaire completed from June to September 2009. One hundred percent of PCTs (n=25) and Maternity Units within an Acute Trust (n=24) with an Infant Feeding Lead in post participated in the mapping project.
The need for improved targeting was clearly demonstrated by this study; only 27% of all Trusts were delivering targeted services to any priority population group(s), with only 8% of all breastfeeding services across London being targeted on the basis of local need. This work broke new ground for mapping as a methodological tool to inform service commissioning.

24th March 2010: 3:30pm to 4:00pm

Abstract: Abstract
Keywords
Teenage Breastfeeding; Social Marketing
NHS data indicates a particular problem with initiation and retention of breastfeeding by teenage mothers. The authors investigated how social marketing may be able to help increase breastfeeding amongst this group. A large scale qualitative research project was completed, interviewing over sixty mothers who breast and bottle fed, grandmothers, partners and some health professionals. We obtained insights into the typical mindsets and used these to test social marketing concepts. Key findings led to recommendations that social marketing be used for three strategies: focusing on creating and communicating personal benefits to the mother; re-designing service and support functions (such that for example peer supporters are used); and, longer term, creating social norms.

24th March 2010: 3:30pm to 4:00pm

Abstract: Achieving an increase in rates of “breastfeeding initiation” and “duration of breastfeeding” is a local strategic priority for NHS Berkshire West and its partners. The Reading breastfeeding peer support programme was launched in 2007 to increase breast feeding initiation rate. It was developed from evidence that peer support programmes, providing information and listening support to women both the antenatal and postnatal periods, can be effective in increasing initiation and duration rates.

Since the start of this programme nearly 100 Peer Supporters have been trained to work as volunteer peer supporters. Trained peer supports now provide services at various community clinics and also feeding into the antenatal programme run at the local hospital. The aim of the evaluation is to evaluate peer supporters own experience of the training and its adequacy in preparing them in their role in becoming peer supporters; to evaluate the personal benefits of being a peer supporter and to assess the parents' experience of receiving peer support,

Focus group discussions will be carried out to obtain peer supporters' and service users' view by the end of November and early December, 2009. The findings of this evaluation will provide information on effectiveness of the programme and also be beneficial for future local commissioning model.

24th March 2010: 3:30pm to 4:00pm

Abstract: Mood changes following childbirth are common among new mothers, with most care being carried out in the community. Postnatal depression has a significant impact on the early mother infant relationship because depression limits the mother's ability to engage positively with her baby in social interactions, fundamental for healthy cognitive and emotional development. Dance movement therapy (DMT) groups are a new group therapy approach for mothers with young babies. Led by a skilled therapist, DMT groups aim to support secure attachment by improving communication through interactions such as touch, holding, eye contact and voice. This evaluation aimed to explore mothers and referrers' perceptions about the processes and meanings of DMT using focus groups and telephone interviews. Findings suggest DMT groups appear to meet criteria for being an enabling and empowering health promotion intervention. For some regular attenders DMT played a role in turning lives around, from feeling disempowered and lacking in confidence, to being skilled, confident and supported. Since participants were mothers with young babies, the group's long-term impact is significant, although hard to quantify. If even a few managed to avoid further parenting problems and involvement with health and social care practitioners, the intervention is likely to have been cost-effective.

24th March 2010: 3:30pm to 4:00pm

Abstract: Reducing social and ethnic inequalities in infant mortality rates is a key element of public health policy in England and Wales. We aimed to support evidence-based policy makers and service commissioners by describing and synthesising evidence on interventions to reduce infant mortality, with a focus on evidence relevant to the UK setting.
We compiled an ‘Evidence Map' describing the existing systematic review literature relating to the effectiveness of interventions targeting: (a) infant mortality and its major medical causes; and (b) major potentially modifiable risk factors for infant mortality. The Map, which includes 355 published systematic reviews, is presented in two User's Guides with hyperlinks to facilitate rapid access to the evidence.
We conducted two systematic reviews to evaluate the effectiveness of (a) alternative ways of organising/delivering antenatal care as a means of reducing infant mortality/preterm birth in disadvantaged and vulnerable groups of women; and (b) interventions to increase the early initiation of antenatal care in disadvantaged and vulnerable groups of women. The reviews cover over 20 distinct groups of interventions targeting both socioeconomically disadvantaged women in general and specific groups such as teenagers and substance users. The quality of evidence was generally poor but we highlight interventions that we considered ‘promising' and potentially worthy of more robust evaluation in the UK context.

24th March 2010: 3:30pm to 4:00pm

Abstract: Bournemouth has a fascinating but little known public health role in the history of the fight against Tuberculosis. This poster will describe thefirst TB sanatorium in theWorld, purpose built by London's Royal Brompton Hospital and opened in 1855,to take advantage of Bournemouth's clement weather, the 'health-giving sea air'and the scent of pine trees planted in the chinesthat was believed could relieve the symptoms of consumption. Alsothe pioneering introduction of pasteurised milk for local school children and leading the country in implementingBCG vaccination.

24th March 2010: 3:30pm to 4:00pm

Abstract: Clostridium Difficile (C. diff) is a bacterium that is present naturally in the gut of around 3% of adults. C. diff does not cause any problems in healthy people; however, some antibiotics that are used to treat other health conditions can interfere with the balance of bacteria in the gut and cause disease. Since 1999 C.Diff infection has become a significant cause of mortality and morbidity in hospital admissions. In 2007 there were 8,324 deaths in the UK (Office of National Statistics). In the South West Strategic Health Authority (SWSHA) all deaths where C.Diff is implicated should be reported via the Serious Untoward Incident (SUI) Reporting System. It is important that the SWSHA have an assurance process in place to determine the accuracy of the SUI reporting. Although the reported numbers of deaths from C.Diff is declining, the question is how accurate is the data?
Information was collected via the SUI database as well as from centrally held death certificates. All Directors of Infection Prevention and Control at acute trusts were contacted and asked for there own internal audits of the quality of death certification related to C.Diff. The data from both these sources will be presented.

24th March 2010: 3:30pm to 4:00pm

Abstract: Meningococcal infection is caused by the bacterium Neisseria meningitidis. Serious infection can manifest as meningitis, and/or septicaemia. Children under 5 years are most frequently affected, followed by teenagers. Between 1995 and 2001, 114 meningococcal clusters were reported in schools and preschools in England and Wales. Unless they are efficiently managed, clusters have the potential to cause substantial anxiety among students, parents and staff and adverse publicity.
In January 2009, two pupils from a Hampshire primary school were admitted to hospital as clinically probable cases of meningococcal septicaemia within 2 weeks of each other, meeting the definition of a cluster. An incident team was established, with representation from the Health Protection Agency, the NHS and the education sector, and a decision was made to offer prophylaxis to all children and staff.
We outline the way the cluster was managed in order to achieve a prophylactic uptake of 99.8%. Close collaboration between agencies, a service level agreement between primary care and acute trust pharmacy, a proactive communication strategy and strong school leadership resulted in fast and efficient management, causing minimal concern and disruption. In the future, Primary Care Trusts will need to consider how cluster management resources are coordinated once provider and commissioning arms are separated.

24th March 2010: 3:30pm to 4:00pm

Abstract: The purpose of this project was to investigate whether food premises inspections reduce food poisoning incidences.

Questionnaires were sent to a random selection of Local Authorities in England and Wales to determine their views on food poisoning and food premises inspections.
Findings from the project indicated that food premises inspections do not reduce food poisoning incidences, partly due to the fact that traditional inspections are being used to review HACCP based systems. Outbreaks such as E.coli O157 in South Wales in 2005 recognised that such methods do not suit the new system, thus resulting in food safety concerns being missed.
Local Authority Officers, recognised that food poisoning should be tackled using a multidisciplinary approach. However, their views appeared to be affected by their position at the Local Authority, with managers generally being more positive about the effectiveness of food premises inspections.
The project concluded that the only effective method of reducing food poisoning incidences was through tackling the problem at source, such as vaccinating chicken flocks against Salmonella enteritidis.
In addition to this, the project highlighted that it's difficult to measure whether the methods used are effective because there's no direct intervention method to reduce food poisoning incidences in England and Wales.

24th March 2010: 3:30pm to 4:00pm

Abstract: Evidence continues to suggest that mishandling of food plays a major role in the occurrence of food borne illnesses, in fact improper food handling may be implicated in 97% of all food borne illnesses associated with catering outlets (Howes et al, 1996). This raises serious questions for training providers, including local authorities, and the catering industry about the effectiveness of food hygiene training in reducing levels of food borne illness. This study, in common with research elsewhere, revealed that many officers have doubts related to the effectiveness of food hygiene training.
Research elsewhere has highlighted that enforcing authorities must work with the FBOs to change their food handling practices, their attitude and their behavior to achieve safe food (Stryker, 2005). Several authors have concluded that enforcing authorities need a change of mindset so that EHOs may take on a consultant role with a clear focus on the outcome of the risk based inspection process, rather than on number of inspections (Boehnke, 2000; Stryker, 2005; Wheeler, 2006; Reske et al 2007).
This study concludes that enforcing authorities should be providing this advice and assistance and installing a culture of food safety within an organization by educating workers and FBO's from the ‘top down'.

24th March 2010: 3:30pm to 4:00pm

Abstract: The combined MMR vaccine was first introduced into the United Kingdom (UK) in 1988 and has since then had a positive impact on reducing mortality and morbidity associated with measles, mumps and rubella. However since 1995 uptake of the vaccine has declined markedly with subsequent increases of in particular measles concerning health professionals.
This study used a phenomenological approach and semi-structured interviews to explore the factors that influenced parental decision making as regards immunisation against measles, mumps and rubella. Health Visitors working in West Kent in the South East of England were asked to recruit parents to the study who had recently made a decision to vaccinate or not a child with the combined MMR vaccine; 19 interviews were carried out, 10 with parents who had used the combined MMR vaccine and 9 who had not.
This presentation will describe the key factors elicited during the interview process and illustrate how these differed between the two groups. Recommendations based on the study findings will also be made concerning what health promotion and public health strategies might have a positive impact on future vaccination campaigns; an area of particular importance given the current swine flu epidemic.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background
Consulting with and understanding the needs of our population is at the core of World Class Commissioning. Dorset lacks robust data on its population. The last survey in 2001 was unrepresentative of the Dorset population. To address local needrobust local data is essential, rather than synthetic estimates based on national surveys.
Aims
The aims were to collect baseline information about the health status of the local population, to find out how satisfied Dorset residents are with their local NHS services and to establish a panel to provide regular feedback on public health subjects.
Methods
Postal survey of22,000 Dorset residents.
Results
31% response rate. 2000 residents agreed to join the panel. Overall satisfaction of health services were good and general health and lifestyles were better than average, compared to the rest of England.
Conclusions
People aged 18-34 were under-represented both in the survey and agreeing to join the panel. Further work has been undertaken to boost numbers in this age range. The next step is to carry out further survey work with panel members on particular topics. Priority areas are sexual health and alcohol. Results of these panel surveys will be available by December 2009.

24th March 2010: 3:30pm to 4:00pm

Abstract: Synthetic estimates of health and lifestyles are available for boroughs but applicability to deprived, multi ethnic areas has been questioned. Tower Hamlets has a very distinct atypical population with apparently high levels of need; key to measuring delivery and appropriate targeting of healthy lifestyle interventions is to know your population
To address these concerns NHS TH commissioned IPSOSMori to undertake a health and lifestyle survey undertaken in 2009 using:
• Random probability survey
o addresses chosen at random from post office address file
o over 16 respondent chosen at random from household
• Fact to face interviews of approx 20mins
• Sample size of 2400 to produce values of +/- 2% at PCT level
• Bangladeshi boost of 400 to produce values of +/- 3% at PCT level

The survey has provided key lifestyle data such as smoking prevalence, diet, exercise, alcohol consumption and mental wellbeing based upon a robust methodology.
The results of the survey and observations on how they compare with synthetic estimates will be compared. The potential for locally commissioned surveys to add value to targeted lifestyle interventions will be explored and how this can be integrated into existing data sources such as Experian to construct a bespoke segmentation model.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background
NHS Bedfordshire have been developing a network of people to ensure that particularly the vulnerable and those in deprived areas can have information and support on developing and/or improving healthy lifestyles. The main aim is to work in partnership with a number of agencies to gain support for local ‘Health Champions' whilst helping to reduce costs and pressure on the PCT's workforce.
Intended outcomes
To enable individuals and groups - particularly deprived or vulnerable - to improve and/or develop a more healthy lifestyle.
To provide easy access to health information and support
To reduce costs and pressure on the workforce to NHS Bedfordshire.
To get the message across that ‘health is everyone's business'
To provide an opportunity for people who generally have been low achievers or not in work to receive a nationally recognised Award
Activity
Starting in July 2009, three events have taken place; all attendees achieved the Award. Organisations are now supporting and implementing the ‘Health Champion' programme in partnership with NHS Bedfordshire. A strong team identity will enable similar work to progress government strategy in supporting and developing healthy lifestyles.

24th March 2010: 3:30pm to 4:00pm

Abstract: Purpose
Recommendation 13 of the Department of Health's Organ Donation Task Force Report, states “There is an urgent requirement to identify and implement the most effective methods through which….. the ‘gift of life' can be promoted…. specifically to the BME [black and minority ethnic] population.” BME patients are likely to wait more than twice as long for a transplant, in part due to proportionately fewer BME donors.
Methodology
Our research study highlighted the need for more resources for BME communities to inform decision-making on this sensitive subject. Hence, our established Peer Educator model was further developed in collaboration with local NHS health trainers, training and supporting seven Peer Educators, representative of local communities.
Results
The Peer Educators engaged with and attended over 60 events, making contact with over 2000 people, increasing knowledge of and engagement with organ donation, to the extent that there was a significant number of participants (>150)who registered as donors onto the NHS Organ Donor Register. This does not include those reached through consequential media contacts (e.g. websites and community publications). Participation in this important debate has progressed. It is hoped that in the longer term, empowerment of local people will further reduce inequalities in availability of this scarce resource.

24th March 2010: 3:30pm to 4:00pm

Abstract: Tower Hamlets is a multicultural inner city London borough with a large Bangladeshi community.
Chewing tobacco is estimated to be undertaken by 40-50% of women and 25% of Bangladeshi men and is recognised by the community as an integral part of community culture. Repeated chewing of tobacco is strongly linked with oral precancerous changes, oral cancer and may be harmful during pregnancy.
The Tower Hamlets Tobacco Control Alliance has a strategic approach to tackling this. This presentation will outline a pilot intervention which used local Bangladeshi women to work as layAmbassadors to inform and educate Bangladeshi women about the health impacts of using oral tobacco using a novel approach wherby women gathered in groups to disseminate and discuss this information.
84 sessions were held with 290 women and a rich body ofqualitative knowlledge was generated as well as 36 women being directly referred to a bespoke comissioned service for this target group.

24th March 2010: 3:30pm to 4:00pm

Abstract: The presentation will describe the results of research commissioned to support the Marmot Review by generating additional data and insight on the theme of empowerment amongst vulnerable groups.
Eleven focus groups were carried out with 74 participants in total across three locations: Moss Side/Manchester, Haggerston/Birmingham and Hackney/London. Participants were from groups within deprived communities identified from a literature review as particularly disadvantaged.

Black and Asian people with mental health issueswere more dissatisfied with their experiences both within their communities and in their interaction with services than any other group. Issues of social isolation and lack of confidence characterising BME groups with mental health issues are compounded by perceptions and fear of racism.
Single mothers in deprived communities are living under financial and emotional stress as they struggle to bring up children on low wages or benefits. This stress is compounded by unhealthy physical environments lacking in resource, and characterised by anti-social behaviour and a local drug culture. Job opportunities and avenues for self-improvement for themselves and their children are perceived to be limited.
Participants expressed ideas for local action focused around both communities of place and communities of interest and were enthusiastic about community empowerment as a means of tackling some, if not all,of the issues raised.

24th March 2010: 3:30pm to 4:00pm

Abstract: To support community engagement and integration of health interventions at a Neighbourhood level by the appointment of three community Health Development Officerswho will provide thefocus and local coordination role for the 'virtual' health teams/partnersworking to support health improvementsand access to services indeprived communities.
Coventry isa Spearhead Authoritywitha mixed ethnicand deprived population.The largest age groupis 20/24 years of age with33% of all birthsto womennot born in the UK. Coventry's diverse and often deprivedpopulation presentsconcerns with regard to knowledge, empowerment , engagement and accessto services.
In 2005/06 acommunityhealth intervention pilot was trialledin a deprived area.This projectwas evaluated byexternal researchers usingHealth Impact Assessmentwhich ensured theuse ofboth qualitative and quantitative measuresandincorporated the views of users.The results showed a high degree of success in all areas.
ACoventry wide 3 year projecthasbeen establishedandis being evaluated by Dr Alan Dolan, Associate Professor, Warwick University.Theprojectis designed toprovide the model/evidence toassisthealth practitionersto improvethe health and wellbeing of the most difficult and 'hard to reach' communities.

24th March 2010: 3:30pm to 4:00pm

Abstract: The BSc (Hons) Complementary Therapies at the University of Wales Institute Cardiff is an integration of body-therapy skills, biomedical and social sciences, and research methods and analyses. In the final year of the programme, students are professionally qualified in three body –therapy skills (massage, aromatherapy, reflexology). This programme enhances the availability of complementary therapies to people in the community in two ways:
Firstly, final year students practice and evaluate their skills, through stakeholder engagement, in a work placement setting. The placement organisations include schools for children with multiple disabilities; providers of palliative care; drug interventions programmes; and a women's safety unit. Feedback from these host organisations has demonstrated the value of this service for improving the wellbeing of service users and providers.
Secondly, final year students run a complementary therapy clinic which is open to the general public at a subsidised rate. Referrals by word of mouth have made this a busy clinic. A preliminary evaluation of the clinic has shown significant improvements in symptoms and activity levels reported by clients. Further research will be conducted to test the validity of these findings, using psychological assessment tools.

The poster will elaborate on the provision and evaluation of these services.

24th March 2010: 3:30pm to 4:00pm

Abstract: While research has shown links between income inequality and health, it is important to remember that employment is not universally healthy. For example, sole traders, those in precarious work and the unemployed fare worse than do workers in secure, protected and well-paid positions. Often lying somewhere between paid and unpaid, employee and volunteer, lay people in public health roles are in somewhat of a limbo. It is tempting, for example, to see such roles as simply offering the first step to a career in public health. Yet volunteer roles and any potential jobs will make demands on health. The consequence is a parallax, or alternative viewpoints, between enabling employment and making working lives healthier. The People in Public Health (PiPH) study combined site visits and interviews with commissioners, practitioners and lay people to build up detailed case studies of five health-promoting projects from across the UK. This presentation will use these case studies to explore links between utilising lay people in public health roles and their health as potential or actual employees.

24th March 2010: 3:30pm to 4:00pm

Abstract: A large patient notification exercise was undertaken in June 2009 involving three PCTs in the South West and following reports of a serious infection control failures in a dental practice. A full Regional evaluation of the exercise is underway but this presentation focusses on key operational learning points that emerged fromcollaborative public health action involving several Directorates of the PCT where the problem came to light , health protection and GUM Services in Bournemouth.
Several thousand patients in the Bournemouth area were informed about the infection control failures and were offered screening for blood borne viruses using the dried blood spot method. This form of testing is less invasive than whole blood testing. This was the first patient notification exercise in the UK to use this technology and positive results were validated at the national reference laboratory. No patient to patient transmission of blood borneviruses was identifiedfrom this exercise.
The learning points cover the initial assessment of risk to public health, developing a communications strategy,choosing a testing method,setting up a help line, setting up testing clinics, building a database and informing patients about results.

24th March 2010: 3:30pm to 4:00pm

Abstract: Traditional public health postgraduate programmes have tended to focus on the narrow specialism of the Faculty of Public Health curriculum, and candidates wishing to operate at public health consultant/specialist level within the public sector. The need for a multidisciplinary approach to public health training and practice is now well recognised. Key competences and standards for public health specialism and practice have been identified, and a multidisciplinary framework for career development in public health produced.
At a 2006 Welsh Assembly Government conference on future directions of public health training, University of Wales Institute, Cardiff committed to develop a postgraduate Applied Public Health programme, aimed at public health practitioners and the wider public health workforce, across all disciplines and sectors. The programme, launched in 2009, provides a range of pathways and opportunities for students to define their own areas of specialism, with the aim of developing reflective public health practitioners.
This session will discuss the developmental process for the programme, incorporating the Public Health Skills & Career Framework and relevant National Occupational Standards. It will report evaluation of the programme design based on comments from external stakeholders, validation committee and the first student cohort, alongside future training & development opportunities in Wales.

24th March 2010: 3:30pm to 4:00pm

Abstract: This paper will present the findings of the PHORUS project, funded by JISC. This project aims to:
1. Critically assess the enablers and barriers to releasing learning resources in Public Health for open access and develop a conceptual framework to inform OER implementation and enhance the student learning experience.
2. Identify and work towards openly releasing existing Public Health learning resources.
The provision of free online learning resources has the potential to aid the development and divergence of the Public Health workforce in a global context, enabling inter-professional teams to learn and work together.
A Delphi technique was used for this research, which combined workshops, telephone interviews and online rating of themes. This was undertaken between September 2009 and March 2010. Preliminary results suggest that enablers may include; demonstrating positive corporate and social responsibility, opportunities for marketing, a supportive political climate and employer engagement. Barriers seem to include; intellectual property right issues, concerns about lack of professional recognition and fear of peer criticism.
The development of a sustainable online Public Health community of practice and learning will contribute to sharing across related disciplines, and may provide a method for developing global learning opportunities to reduce inequities in public health education.

24th March 2010: 3:30pm to 4:00pm

Abstract: In 2007 NHS Education for Scotland commissioned the development of 'Bridging the Gap', an on-line health inequalities educational resource.
Bridging the Gap aims to provide Health Practitioners, students and lecturers, and others involved in tackling health inequalities in Scotland, with a flexible learning resource that introduces some of the key evidence, issues and themes in health and social inequalities.
This presentation will offer an insight into the resource itself, by identifying the key policies, background, findings and recommendations associated with developing Bridging the Gap and show where and how it has been used to date. It will also explore the wider issues around what skills and knowledge, and educational solutions are involved in developing a health inequalities aware NHS workforce, and how this programme of work is being developed in Scotland.

24th March 2010: 3:30pm to 4:00pm

Abstract: There is little literature evaluating CPD for the multi-disciplinary public health workforce. This is the first evaluation of a multi-disciplinary public health CPD programme in the South West region.
The Peninsula Teaching Public Health Network (PTPHN) is a satellite network (412 members) of the South West Teaching Public Health Network, which was launched as one of nine regional networks by the Department of Health in 2006. The PTPHN incorporates the Peninsula Public Health CPD Programme which has been active for six years.
The Faculty of Public Health (2008) defines CPD as the component of learning and development that occurs after the formal completion of postgraduate training and that it is: 'purposeful, systematic activity by individuals and their organisations to maintain and develop the knowledge, skills and attributes which are needed for effective professional practice; CPD is a professional obligation for all public health professionals.'
Our study included a review of past CPD events, an online needs-analysis survey, and interviews with members of the PTPHN. The following outcomes will be presented:

Ten priorities identified for multi-disciplinary CPD content.
Benchmark criteria for inter-professional public health learning.
Benchmark criteria for running successful public health CPD programmes.

24th March 2010: 3:30pm to 4:00pm

Abstract: Delivering the priorities for public health a skilled workforce is essential. In a time of resource depletion continued support must be sustained and the opportunities to share good practice grasped.
The East Midlands Healthcare Workforce Deanery (EMHWD) Public Health team has developed an integrated approach to training education and workforce development. Through partnership working and sharing of resources organisational needs have been met, providing expertise across all tworkforce levels. Many transferable lessons have been learnt through this process
By making this commitment the EMHWD, Regional Teaching Public Health Network and Regional Health Trainer Hub Manager have achieved:
• support a regional public health workforce development plan
• marketing strategy to promote careers in public health including posters and DVD.Training lectureship in public health in the primary care division
• Influence with commissioners and providers of education, workforce leads and third sector
• hosting the development of the Public Health Online Resources for Careers, Skills and Training (PHORCaST)
• Promoting healthy ageing theme across the EM
• Smalls Grants award scheme supporting projects to develop the public health workforce including; E-learning Resources to Support Mental Health and Wellbeing of Older Carers; Images for learning public health; Re-usable Alcohol Learning for Public Health
• Team building events with local voluntary public health related organisations

24th March 2010: 3:30pm to 4:00pm

Abstract: Authors: Thompson S., Chambers D., McGarry J., University of Nottingham
Nurses have long been designated as key players in the delivery of the public health agenda. Nurses' work ranges from supporting patients and their families with lifestyle change, through to partnership working to develop and implement public health policies and programmes. It is therefore essential that nurses are provided with the skills to ensure they are able to work effectively.
The presenters have been funded by the East Midlands Teaching Public Health Network to develop video and still images for use in problem based learning (PBL) on a pre registration nursing programme at the University of Nottingham. Using multi - media computer images which are truly representative of the mixture of gender, age, social class and ethnicity seen in practice, encourages learners to engage with real life scenarios, addresses health inequalities and provides a more holistic picture. Learners are able to observe, interpret and discuss events from their own and others perspectives and interpret non-verbal cues; their learning is, therefore, more meaningful and enduring.
The presentation will showcase the development of images and PBL cases for teaching public health and promote discussion around their future use
Once evaluated the images will be made available via the Open Courseware Consortium.

24th March 2010: 3:30pm to 4:00pm

Abstract: The South East is one of the most affluent regions of England. The health of its population is on average good and yet such good health is not shared by all and significant inequalities exist. Many individuals and organisations in the South East are working together to address those inequalities and improve health. The Wellbeing South East website is the first of its kind in the south east region and has been created to support and facilitate that work.
The website is an online resource for those working to promote healthier lifestyles. It's an information resource and a sharing and networking tool, providing practitioners with access to relevant policy, guidance, evidence and case studies. It has an events calendar, news section, forum function along with a regional Chang4Life section. Membership of the website now totals over 600 with new members from a broad range of sectors joining all the time.
A recent evaluation of the website with users highlighted how much practitioners valued the website as a resource and source of information. The website has been developed to enable practitioners to submit items to the website, enabling them to take ownership and add to a regional evidence and information bank.

24th March 2010: 3:30pm to 4:00pm

Abstract: Workforce solutions to Public Health Challenges: developing a collaborative approach for the North West
Locally and regionally, the North West is committed to developing a public health workforce with the capacity and capability to meet future challenges.
Three Public Health Workforce Development Managers are funded by NHS North West and located within sub-regional Public Health Networks. The Managers work in partnership with the Teaching Public Health Network. Co-ordinator.
The geographical spread of the Team, and their location within fully engaged networks is crucial in meeting the key objective of identifying organisational champions and developing commitment and systems for developing the public health workforce. The Team has commissioned a series of tools to support these emerging systems, including a training needs analysis; mapping the Public Health Skills and Career Framework to the KSF; scoping the Leadership training provision and future needs and an on-going programme of work around commissioning effective behaviour change interventions.
Other key priorities include strengthening the partnerships with academic public health, working with the acute sector and with local authorities, including environmental health. The Team co-ordinates a dynamic CPD programme. It is networking across organisations to ensure that public health is fully represented and engaged within the emerging responses to worklessness.

24th March 2010: 3:30pm to 4:00pm

Abstract: The Eastern Region Public Health Observatory (erpho) developed training in health intelligence for the wider workforce, including health improvement staff and commissioners from Primary Care Trusts and local authorities, after a gap in training in the region was highlighted. Although health improvement staff and commissioners use quantitative data in their work, they are often not given training to be able to interpret it properly or get the most out of it, which can lead to less effective decisions being made. Using funding from Strategic Workforce Investment for Tomorrow, erpho developed a two day course to address these gaps, with an aim to improve understanding of health intelligence to enable commissioners and health improvement staff to make informed decisions, and also to improve commissioners' awareness of the importance of public health in their work.
To date, erpho has delivered the course three times and will run5 more over the next year. The course has received positive feedback and is continually being improved. The Association of Public Health Observatories is interested in rolling the course out nationally.

This presentation will explore the challenges of developing a course appropriate to the audience, summarise feedback and describe how erpho is taking it forward.

24th March 2010: 3:30pm to 4:00pm

Abstract: The healthcare support workers (HCSW) are seen as an integral part of National Anticipatory Care (Keep Well and Well North) programme delivery. They undertake a range of roles and responsibilities, traditionally undertaken by qualified nursing staff. There was a need to develop the role of HCSWs, to confidently deal with enhanced expectations of their roles and to provide safe and effective services.
The National Working Group was set up to take forward the following strands of work:

Strand 1: Adaptation of national developments such as guidance on implementation of standards for HCSWs; national guidance on education and training
Strand 2: Developing a suite of competencies for HCSWs (AC) to support role development
Strand 3: Plan and deliver area specific pilot projects to inform use of national resources and roll out of good practice.

The presentation will provide an overview of work undertaken by national working group:
a)key findings ofscoping exerciseconducted to examine and map role, existing and required competencies; role boundaries within different service delivery modelsandskills gaps. Examples of local good practice of use of HCSWs (AC) in providing safe and effective care will also be provided.
b)overview of resources developed and implementation of strand 3 – area specific piloting within local areas will also be highlighted.

24th March 2010: 3:30pm to 4:00pm

Abstract: This Health Inequalities Action Learning Programme developed from:
· The aim of NHS Manchester Public Health Directorate to commission a programme to cultivate clinical champions as public health leaders;
· The development of a Health Inequalities Strategy for Manchester Community Health identified as an exempla of best practice by the Health Inequalities National Support Team.
The key objectives were:
· To identify clear links for key stakeholders between the Health Inequalities Action Learning Programme, Manchester Community Health (MCH) strategy and NHS Manchester Commissioning Strategic Plan.
· To gain support from key senior managers/leaders in MCH.
· To develop a multi-faceted health inequalities programme that would have demonstrable impact on current services.
· To commission an action learning programme as a key component of the health inequalities programme.
· To recruit and retain clinical champions on the programme from a wide range of community services/specialities.
· To build a portfolio of impact of the programme on MCH services.
· To evaluate the impact of the health inequalities programme and the perceptions of participants.

Each participant on the action learning programme led a health inequalities project, written-up as an individual case study. Evaluation reflected the impact of the programme on supporting clinicians to lead health inequalities practice.

24th March 2010: 3:30pm to 4:00pm

Abstract: The development of a career framework for health visiting across NHS West Midlands aims to support the development of wider health visiting teams, new roles and new ways of working to improve the health and wellbeing of children and reduce inequalities. The project, commissioned by West Midlands Strategic Health Authority and conducted by the Applied Research Group in Public Health at Coventry University, follows on from the 2008 ‘Health Visiting Framework: NHS West Midlands' project that aimed to ensure that the West Midlands Health Visiting Workforce and the associated education commissions were fit for purpose. It was prompted by the publication of ‘Facing the Future ‘and its recommendation ‘to reform the existing health visiting service into a fully integrated preventative service for children and families within a public health context'.In partnership with Skills for Health and the regions Health Visiting Leads development of the career framework involved collating existing role profiles and mapping and aligning the NHS West Midlands Health Visiting Capability Framework competencies with the Skills for Health National Occupational Standards. The completed health visiting career framework links into the Public Health Skills and Career Framework to inform and complement role design and development within health visiting teams.

24th March 2010: 3:30pm to 4:00pm

Abstract: Given many recent policy initiatives stressing the importance to Public Health (PH) of the frontline workforce, it is important to consider its information needs. Research has shown that little is known about these needs, whether they are being met and barriers to meeting these needs.
In a qualitative study, semi-structured interviews were conducted with one representative of each of eight categories of frontline PH professional: Children's Centre Manager, Community Development Worker, Community Midwife, District Nurse, Health Visitor, Pharmacist, Practice Nurse and School Nurse; to determine their PH role, information needs, and barriers to meeting needs.
The presentation will describe the results of this research and the implications for meeting these needs, both for library and knowledge services, and for managers. Basic structural barriers need to be addressed: lack of IT equipment and training, lack of time to access information, lack of funding for courses and professional development, and lack of communication of information from higher levels. Changes need to be made in communication of PH strategy, and engagement improved between higher managerial levels and the frontline. The research also revealed a reduction in the PH capacity of this workforce.

24th March 2010: 3:30pm to 4:00pm

Abstract: Purpose
This paper revisits the importance of our collective perspective for positive change to occur, based on the universal mind theory, as applied to health service practitioners (Hegel and Marx in Singer, 2000).
The recent pandemic flu planning has required hospitals to appeal to the flexible working ability of each health service practitioner in order to provide for people in the event of a crisis.This has particularly challenged staff who have become comfortable in particular care settings and do not immediately view their skills in the global sense of hospital NHS provision.
Using whole systems methods this research facilitates thinking around NHS staff being allowed to think of themselves as global health practitioners e.g. a global nurse. Put simply , it encourages the practitioner to positively believe that within their level of competency they are able to move between for example different sections of the hospital. Simultaneously, this may enhance our attitude toward the emergence of a global health service www.coch.nhs.uk/absolute/en/documents%5CKisiizi%5Cdocs%5Cother%20documents%5CJUNE%2008%20wholly%20spirit.pdf., 2008).
The results will emerge out of the real-time research exercise and the conclusion will be a work in progress with the end product would aim to be an NHS funded web-page allowing contributions.

24th March 2010: 3:30pm to 4:00pm

Abstract: PHORCaST stands for Public Health Online Resource for Careers, Skills and Training.
The poster will describe PHORCaST's development, the piloting process, the structure and value of the website, and the scope for future development of the site.
Public health (including health and wellbeing) is a shortage speciality at a time of worsening public health issues. The PHORCaST website provides a resource to aid the recruitment, retention and development of a high calibre public health workforce at all levels. It is a UK-wide initiative funded by the Department of Health and the devolved administrations of Scotland, Wales and Northern Ireland, and developed by the East and West Midlands TPHNs and PHRU.
PHORCaST is a one-stop shop for comprehensive advice on a range of public health careers in the four UK countries. It provides information about what public health is, why public health is an important and attractive career choice, and how to get into public health. It also informs users about the qualifications and training needed for particular roles (with inspirational career stories from people working in those roles), where to obtain information about training, education and employment opportunities, and about continuous professional development once in a public health role.

24th March 2010: 3:30pm to 4:00pm

Abstract: The PH practitioner training scheme is a two-year programme. It includes a MSc in PH or equivalent, placements and learning sets that would be likely to meet the proposed UK Public Health Register requirements for practitioner registration by portfolio submission. Individual learning needs are assessed according to the competences outlined on the PH Skills and Careers framework (Skills for Health, 2008) and developed as part of the scheme to NHS Agenda for change band 7 competency levels.
The scheme is being qualitatively evaluated through analysis of perceptions from trainees, mentors, line managers and has looked at the views from learners on MSc courses that lack the components of the scheme.
Our results suggested that thjere is a demand for practitioner development in the region. Trainees developed PH know how (74%) and shows how (70%) competwnces to a band 7 on the framework. They have reported having gained a broader understanding of public health through the different cross organizational experiences in NHS provider, commissioning organizations, government agencies and local authorities.
This novel local scheme for developing knowledge, skills and competences in adequate PH learning environments contributes to increased capability and equity across levels (to band 7).

24th March 2010: 3:30pm to 4:00pm

Abstract: Back ground

24th March 2010: 3:30pm to 4:00pm

Abstract: Objective
To evaluate the screening accuracy of haemoglobin A1c (HbA1c) for the detection of impaired fasting glycaemia (IFG) in people at increased risk of type-2 diabetes.
Methods
Design: A cross-sectional study of 1552 general practice patients in Norfolk, United Kingdom, at increased risk of developing type-2 diabetes.
HbA1c was the screening test of interest. Two reference standards were used: IFG as per the WHO definition (fasting plasma glucose (FPG) ≥ 6.1 mmol/l (IFG1)) and IFG as per the ADA definition (FPG ≥ 5.6 mmol/l (IFG2)).
Results
1242 people (80%) had FPG < 5.6 mmol/l, 202 (13.2%) had FPG between 5.6 mmol/l and 6.1 mmol/l and 108 (6.7%) had FPG > 6.1 mmol/l. An HbA1c with a cut-off value of 5.7% (39 mmol/mol) was 89.8% sensitive and 71.3% specific in detecting IFG1. A cut-off point of 5.5% (37 mmol/mol) was 81.7 % sensitive and 45.6 % specific in detecting IFG2. HbA1c had an area under the receiver operating curve (AUROC) of 0.90 (95% confidence interval (CI) 0.87, 0.93) for detecting IFG1 and AUROC of 0.75 (95% CI 0.72, 0.78) for detecting IFG2.
Conclusion
HbA1c could be an accurate screening tool to detect IFG1 in people who are at an increased risk of developing type 2 diabetes.

24th March 2010: 3:30pm to 4:00pm

Abstract: The London Borough of Tower Hamlets has a high prevalence of diabetes (4.2% compared to 3.7% nationally), which is predicted to rise by over 1% in the next 10 years. People with diabetes are at greater risk of renal and vascular disease than the general population, we know 70% of our patients have co-morbidities indicating a recognised need for improved secondary prevention.
A diabetes package of care has been devised setting stretch targets for combined control of blood pressure, blood glucose and cholesterol that balances increased control with financial incentives. The package promotes a multi-disciplinary care planning approach, stratifying patients to target those at greatest risk first with monitoring and assessment at network level. Networks consist of 4-6 GP practices located in the same geographic area. The enhanced service delivers additional resources to the network, above those of the individual GP practices, allowing them to allocate resources to achieve targets set for the network. Peer-to-peer motivation, encouraging support for more challenged practices is one of the key strengths of this methodology.
Initial findings indicate 22.5% control of all three indicators, which will be tracked over 6 months by March 2010, with particular attention to more challenged practices.

24th March 2010: 3:30pm to 4:00pm

Abstract: Research has identified a need for Black andMinority Ethnic(BME) populations to have access to adequate information about their disease as well as treatment (LanceleyandCox, 2007). There arethree specific recommendations from the Acheson Report (Department of Health, 1999) that should be considered in relation to BME access to health care provision and raising awareness. These are:
• The needs of minority ethnic groups are considered specifically in the development and implementation of policies aimed at reducing socio-economic inequalities.
• The further development of services sensitive to the needs of minority ethnic people and which promote greater awareness in health.
• The needs of minority ethnic groups are considered specifically in needs assessment, resource allocation, health care planning and provision.
The purpose of this presentation is to address BME access to retinal screening and raising awareness ofthe need for screening.
References:
Department of Health (1999) Acheson Report into Inequalities in Health. London: Her Majesty's Stationery Office.
Lanceley, A. and Cox, C. (2007) “Cancer information and support needs of statutory and voluntary sector staff working with people from ethnically diverse communities”, European Journal of Cancer Care, Vol 16, No 2, pp 122 – 129 ISSN 0961-5423

24th March 2010: 3:30pm to 4:00pm

Abstract: Wheelchairs play a hugely significant part in the mobility, health and quality of life for over 110,000 (2%) people in the South West. Wheelchair provision is extremely varied and not nearly as good as it could be. In a recent national report of provision (Out and About DoH 2006) it was highlighted that in some cases wheelchair users were having to wait for up to 18 months. One particular area of concern was the significant inequality of the service across the country.
The South West Strategic Health Authority Review of Wheelchair Services was set up in June 2009 to investigate the current level and to highlight areas of good practice. This knowledge would then be used to spread best practice and help commissioners ensure a higher standard of provision for their users. The steering group consists of a wide range of stakeholders – from users to provider centre managers.
Actions taken include:- direct involvement of users, accessing data from the commissioners, and visiting provider sites. Over the next few months this knowledge will be disseminated to all the commissioners and providers. This presentation will describe the results of the review and the first steps of service improvement.

24th March 2010: 3:30pm to 4:00pm

Abstract: There are approximately 120,000 people in Scotland with Learning Disabilities (LD) and Scotland spends £365 million annually to meet the health and social care needs of people with Learning Disabilities. People with LD face significant inequalities in access to mainstream health provision, education, employment and public life. Such inequalities lead to social exclusion and poor health outcomes.

In 2000 the Scottish Government conducted a major review of LD Services. This led to the recommendation that Scottish Local Authorities and Health Boards employ Local Area Coordinators (LACs) to support people with LD.
The LAC model began in Western Australia in 1988, becoming successfully embedded across disability services. In Scotland LACs are employed by Health and Social Care organisations to work with individuals (n50-60), within their communities. LACs build relationships with individuals/families, to enhance social inclusion at a community level and improve access to information and services. LAC is highly flexible and personalised. There are now 75 LACs in Scotland.

A national evaluation of LAC in Scotland raised important issues and opportunities for LAC development that will be discussed in this presentation, along with a description of the values/principles of the model; implementation challenges; and the vision for LAC development in Scotland.

24th March 2010: 3:30pm to 4:00pm

Abstract: Aiming High for disabled children (DFES, 2007) highlights the need to provide a range of short breaks for disabled children but children and young people and their families in Nottinghamshire tell us that there is a lack of appropriate, community based provision delivered by appropriately trained staff echoing a national picture.
Nottinghamshire is a 'pathfinder' for developing Short Breaks, the County Council and PCT are working closely together to ensure disabled children and young people are able to enjoy activities that their non disabled peers enjoy. In this current economic climate it is paramount that funding is used 'wisely' and targeted at provision that children, young people and their families tell us they need. Developing new services can be a lengthy process, especially if recruitment is required;resulting in 'slippage money' being available. A process has been set up (within procurement guidance) to use 'slippage money' in a 'quick win' format. This enabled any service, support group, children's club etc. to put an application in to receive some short term funding (6 months) to provide short breaks/activity services to disabled children, young people and their families. The presentation will briefly describe the simple process so others can replicate it, it will also include an evaluation from the providers, children, young people and their families.

24th March 2010: 3:30pm to 4:00pm

Abstract: A poster outlining how the drug database system operates nationally and regionally and how itfeeds into the National Drug Strategy to support key stakeholders in monitoring and achieving their targets on a monthly basis,how this fits into the year end reporting functionsand the challenges affecting funding streams,

24th March 2010: 3:30pm to 4:00pm

Abstract: This poster presents the journey and cost- cutting views of recoveringsubstance misusers (and their carers)living with Hepatitis C from ‘first contact' in one city to 'Specialistcare' in another city. It explores: How much? How long? How far? Who pays?aimisto improve patient acceptability, Guidance implementationand cutcarbon footprints.methodology was to review the current service provision,estimatethedirect and indirect health care costs and collate the views of relevant stakeholders.findings- Providing a service locally will mean a tenth of patients costs, in terms of distance travelled and public transport fares and halving of travelling time and carbon footprint.Recommendation to the PCT was to pilot a satellite Specialist service in a local GP-led walk-in health centre.This service re-design would be closer to home, easier to navigate, accessible to all and value for money.

24th March 2010: 3:30pm to 4:00pm

Abstract: Substance misuse is a global health challenge that affects user and carer health and wellbeing. The National Drug Treatment Monitoring System (NDTMS) collects data about clients attending structured drug and alcohol treatment with the main function of helping the Government work towards PSA target 25: to reduce the harm caused by alcohol and drugs. In order to achieve this, the data collected by NDTMS from treatment services must be accurate, of good quality and timely.
NDTMS works with treatment providers and other stakeholders to ensure that the data submitted accurately reflects the work taking place at the services. For this reason the NDTMS West Midlands team is currently working on implementing various different training packages that will emphasize to stakeholders the importance of the NDTMS data collection.
This poster will show the various different training packages and materials offered by the NDTMS West Midlands team to ensure that the data collected is accurate, of good quality and timely in order to support PSA target 25. Examples of training materials will be given, for example training for treatment providers in the importance of NDTMS data collection, training for relevant stakeholders to raise awareness of the NDTMS data collection in the form of presentations, toolkits, leaflets and quick reference guides.

24th March 2010: 3:30pm to 4:00pm

Abstract: Society in the 21st century has been characterised as a risk society (Beck, 1992; Adam, Beck and Van Loon, 2000; Giddens, 2006). Risk is a socially constructed concept and as such the ways in which people perceive and respond to risk are significantly determined by the groups to which they are attached (Zinn and Taylor-Gooby, 2006). Taylor-Gooby and Zinn (2006) go on to argue that risk perceptions are often linked to an individual's social identity and that risk is a product of society itself. The conceptualisation of an individual as a rational choice actor was put forward by New Right theorists (Kemshall, 2002) thus the emphasis is on personal choice and responsibility.
Recreational drug use appears to be a growing problem in European countries with an increasing number of young people experimenting with drugs and continuing to use drugs into adulthood (Williams, 2006). Indeed the government has identified recreational drug use as an area that needs tackling and produced a 10 year drugs strategy, “Tackling drugs to build a better Britain” (HMSO, 1998). This literature review will investigate from an interdisciplinary viewpoint how young professional adults who use recreational drugs receive support and assistance with their health issues but at the same time are criminalised by present government policy.

24th March 2010: 3:30pm to 4:00pm

Abstract: We report on an exercise to estimate prevalence of injecting drug use (IDU) and associated harms in a single primary care trust
Methods: Covariate capture-recapture methods to estimate (I) IDU prevalence; respondent driven sampling to measure (II) prevalence of HCV and HIV; record linkage to measure (III) mortality risk.
Results: (I) The overall estimated number of IDU was 5540 (95% CI 4710-6780) for all cases and 3280 (95% CI 1940-4610) for cases matched to primary care register i.e. a prevalence of 2.2% and 1.3% aged 15-54 respectively. (II) The prevalence of HCV, Hepatitis B, and HIV was:- 53%, 32% and 0.7%. Over 70% of IDU in Bristol reported having at least one vaccination for HBV; more than half of those who were HCV positive were undiagnosed. (III) The all cause and overdose mortality rate for IDU was 0.75% and 0.4% respectively; and the SMR was 7.8 (95% CI 5.4 to 10.8).
Conclusions: Locally specific and useful intelligence on injecting and its health consequence can be generated to inform local public health action, and may contribute information to validate national prevalence estimates.

24th March 2010: 3:30pm to 4:00pm

Abstract: Under social contract theory, “citizenship” refers to the rights and responsibilities expected of individuals. Often the term is used to refer to “active citizenship,” which describes the participation of an individual towards community betterment. Using this context to examine the role of “citizen” requires the discussion of many civic duties and privileges. Among these responsibilities are voting, paying taxes, military or civil service and abiding by governing laws. It is assumed that this allegiance provides one with the rewards and benefits of a particular society.
This abstract proposes an examination of immigrant participation in European democratic societies; including a critical look at civic participation and the privileges expected. Certainly, this relationship plays a role in population health; influencing religious freedoms, cultural havens and language expectations-- characteristics which often help define the identity of immigrant populations. When these aspects are examined as determinants of health, we see what an important impact these relationships can have. In fact, these expectations may even serve as hurdles to the civic participation of immigrants. Additionally, this project will look into the use of voter participation in elections as a model for public assimilation and health, specifically among immigrants.

24th March 2010: 3:30pm to 4:00pm

Abstract: A student module in primary care for ethnic minorities was undertaken at a GP practice in Accrington, Lancashire. Around 80% of patients under the care of this practice are of Pakistani origin, and live in an area that is very socially deprived according to official statistics. The literature notes that Asians from the Blackburn area have a 12-fold increased risk of recessive genetic disorders; this is thought to be due to a cultural preference for consanguineous marriage. This work investigated the prevalence of β-thalassaemia in this population, as a more common example of a recessive genetic disorder. Comparing national estimates of numbers of thalassaemia carriers to results derived from this practice's records showed an apparently low prevalence in Accrington. However, it seems likely that the size of the thalassaemia problem in the population is underestimated due to poor screening and case classification practice. Family tree construction proved a valuable method of detecting index cases and indicating children requiring testing for the thalassaemia gene. The presentation will discuss the report findings, together with various initiatives that could help this at-risk population make more informed decisions about their marriage and reproductive options, thus decreasing the prevalence of recessive disorders over time.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background
Long Term diet related conditions is on the increase and associated with social deprivation, poverty and isolation. Significant numbers of community groups are isolated and hard to reach. Empowering community members to work within their own groups is particularly effective with hard to reach groups. Lay-people working within their own communities can gain an accurate picture of the needs of that community as well as deliver information in a culturally and linguistically appropriate way. It js recognized they can enhance sustainability of health improvement initiatives. An ability to develop capacity working with other partners. Ensure duplication and dilution of health programmes are reduced. Effect interventions that are transferable, easy to modify and adaptable to local environment.
Methods
1) Creation of a partnership and structure 4) Supervision
2) Documentation and governance 5) Monitoring
3) Recruitment / training 6) Evaluation
Findings
In total 9 volunteers have been recruited. Volunteers have completed food and health training. Placement activities have been carried out within Age Concern sites, NHS Darlington and Darlington Borough Council sites. They are currently moving on to being Health Trainer Champions

Conclusions
The programme has demonstrated a process arrangement that can enhance sustainable approaches in reducing health inequalities by engaging with the public. The activities undertaken by numerous partners have strongly evidenced good partnership working.

24th March 2010: 3:30pm to 4:00pm

Abstract: The FitFans social marketing project uses imagery and language that resonates with the adult male population in Hull. There is a strong sporting tradition in the area which hosts a premier league football team and two super league rugby league teams. Images of overweight/obese male supporters on the terraces without any shirts on are the main focus of the social marketing campaign. Using text copy associated with being overweight but also relating to common football and rugby phrases. An offering or exchange of 'Time to change your tactics?' is shown and an invite to ring a local telephone number to enable adult males engage with the Fit Fans weight management service.
A mix of correlated methods has being utilised to market the new service. The creative images developed from the insight have been used on billboards on main routes into and around the city, bus panels, washroom panels in pubs, A3 posters and information leaflets. Posters and information leaflets have been widely distributed to health professionals and at events across the city.
30 second radio ads have been developed using the supporters theme, looking as if they are getting fitter and chanting the telephone number to access the service. These were played at regular intervals on local radio stations Viking FM and Magic FM.

24th March 2010: 3:30pm to 4:00pm

Abstract: Background/Epidemilogy

Since 1980 the prevalence of obesity has nearly tripled and it continues to increase. Like smoking, obesity has a clear demonstrated link to deprivation, making it a key cause of health inequalities between deprived communities and the general population.
NHS South West Essex covers a geographical area that encompasses some of the most affluent and most deprived wards in England and lies within three local authorities; Thurrock Unitary Authority, Basildon District Council and Brentwood Borough Council and the prevalence of adult obesity is 23.3%.
Potentially 30% of patients seeking obesity treatment may have binge eating disorder, or some level of binge eating. Binge eating disorder may affect around 2.5% of women, and 1% of men.

Method/outcomes
The Psychological Support for clients with BMI>30 aims to facilitatelong term weight management through increasing understanding of the psychological factors that contribute to eating and exercise patterns. Barriers to weight lossare identified and strategies to overcome these difficulties developed, to enable individuals to implement their knowledge around developing a healthy lifestyle.

A group protocol driven by Cognitive Behavioural Therapy and Motivational Interviewing has been developed, and preliminary outcomes are positive, with evidence of weight loss and psychological change. Short-term follow-up indicates that improvements are maintained.

24th March 2010: 3:30pm to 4:00pm

Abstract: In Liverpool, 40% of the adult population is overweight and 20% obese. The NHS in Liverpool spends £5m a year on treating obesity-related illnesses, which go on to cost the city's wider economy £15m a year. In an effort to tackle the problem, the Primary Care Trust launched its Healthy Weight: Healthy Liverpool strategy in April 2008, with the objective of stopping the rise in obesity by 2010 and reducing the level of obesity in the city from 2010. Liverpool's Challenge, a 15-month social marketing campaign, is a strand of that strategy targeted at adults aged over 18 years residing or working in the Liverpool Primary Care Trust area.
The campaign takes the form of a challenge to the city to collectively pledge to lose one million pounds in weight and provides ongoing support to help people achieve this, signposting them to the services available in the Trust - community food workers, dieticians, health trainers - and encouraging them to feel that they are part of a community. The campaign engages with and motivates participants through customer relationship marketing techniques, with regular email and postal communication, practical and accessible help and support from friendly and approachable health care professionals.