- Around 70 HENRY groups across the city are delivered annually by the council's Early Start Service
- The approach has helped cut reception-age obesity in Leeds
Obesity among primary school-starters in England is increasing: 9.6 per cent were obese in 2016/17, up from 9.3 in 2015/16, according to latest data from the National Child Measurement Programme. The rate doubles to 20 per cent by the end of primary school, and Public Health England research shows fewer than five per cent of obese reception-age children reaching a healthy weight by 11. This makes it crucial to embed healthy eating habits early.
The national charity HENRY (Health, Exercise and Nutrition for the Really Young), resulting from a 2007 collaboration between parenting and behaviour expert Candida Hunt and Mary Rudolf, professor in child health at the University of Leeds, supports families of under-fives with five factors associated with later obesity: parenting skills, eating patterns and behaviour, healthy eating, physical activity and emotional wellbeing. Its eight-week programme Healthy Families: Right From the Start with HENRY is now used for group or one-to-one work by 36 authorities, but its chief executive Kim Roberts calls Leeds "outstanding" for its "strategic vision, consistency and reach".
"HENRY gave us an opportunity to work preventatively; supporting families of very young children at a time when many were more open to change," explains Janice Burberry, Leeds head of public health for children and families. "We had children with significant weight issues, whose parents were often challenging to engage because they struggled to identify their child as having a weight problem, with some experiencing feelings of guilt. HENRY enables us to work with families before children develop weight problems." Burberry was drawn to HENRY's strength-based and solution-focused approach. She describes its focus on authoritative parenting and emotional wellbeing as key in helping families sustain healthy lifestyles.
HENRY has been running in Leeds for eight years, now delivered through its Early Start Service: a partnership of health visitors and children's centres. The service uses HENRY as the main intervention on its "healthy weight pathway"; part of its response to the authority's multi-agency Child Healthy Weight Plan. Referrals come mainly from children's centre family outreach workers and health visitors, but Burberry says HENRY is open to any family "interested in raising a child to be a healthy weight".
HENRY groups are mainly facilitated in children's centres by family outreach workers. Up to 15 families, typically with two- or three-year-olds, start with 30 minutes of family time, including healthy snacks and active games, followed by a two-hour parent group, combining information about healthy eating and physical activity with support in parental "self-efficacy"; sticking to boundaries, modelling healthy lifestyles and improving empathy and listening skills. Parents set goals for themselves that are reviewed the following week.
The Early Start Service has an agreement with Leeds public health directorate to run at least three HENRY programmes annually in each of the city's 23 children's centre clusters and around 1,200 staff have now been trained by a six-strong local team to facilitate them. Nursery staff and childminders are also helped to instil healthy eating lifestyles through HENRY's Healthy Start in Childcare training. Community nursery nurses are trained to deliver a one-to-one version for parents for whom groups are inaccessible or unsuitable. Volunteers are also trained to provide this support to families with English as a second language.
Obesity rates among Leeds reception-aged children dropped from 10.3 to 8.7 per cent between 2008/09 and 2015/16. Nearly 86 per cent of participants in 10 HENRY groups in 2014/15 reported a healthier family lifestyle.
A 2016 University of Leeds-led national evaluation, based on 624 pre- and post-programme questionnaires, shows the percentage of children eating fruit and vegetables at least five times daily doubling from 22 to 44 and the percentage doing at least three hours of active play increasing from 52.2 to 57.1. Stage one results of a randomised controlled trial are expected early next year.