Bone Fun Days
Project concept
The "Bone fun days" are annual bone health awareness days aimed at 14 year-old school children. It is a joint initiative between the local NHS Trust, Education Board and the District Council involving 150 school children over two days. The children visit the leisure centre for a hands-on day of interactive workshops on all aspects of bone health.
Introduction
The ‘Bone Fun Days’ project developed as a result of a pilot study carried out in 1995 to assess Osteoporosis among at risk patients referred by GPs. A drug company funded an osteoporosis screening programme involving over 2,000 women and this revealed that 25% of women had low bone density. A need for prevention was identified following the study.Subsequently, a steering group comprising hospital consultants, managers and representatives from Health Promotion and Dietetics was set up locally to develop a strategy for the prevention of osteoporosis among the adolescent age group. Fermanagh District Council were approached and asked if they would lend their support to the scheme through the Lakeland Forum Leisure Centre.
Additional strategic context for the ‘Bone Fun Days’ initiative was provided by the publication in 1996 of ‘Eating and Health; A food and nutrition strategy for Northern Ireland’ which highlighted osteoporosis as an important issue. In 2002, health promotion was assigned greater priority in DHSSPS planning when ‘Investing for Health’, a framework document for improving health in Northern Ireland, was published.
The Bone Fun Days have been conceived in an ethos of cross-community involvement with both Catholic and Protestant pupils taking part along with children from ethnic minorities.
Partners
- Sperrin Lakeland Health and Social Care Trust
- Fermanagh District Council
- Fermanagh College and local schools
- Western Education and Library Board.
Purpose & Objectives
The overall aim of the ‘Bone Fun Days’ is to:
‘Raise awareness of bone health and prevention of osteoporosis among adolescents’.
The health professional practitioners involved drew up the aims and objectives for the project with direction from the (Osteoporosis) Steering Group. Specific project objectives are :
- Explain the role of diet and lifestyle in bone formation
- Identify lifestyle practices which are detrimental to bone health
- Produce appropriate resources for this age group
- Encourage peer education
- Make the learning process fun.
Target audience
The project is specifically targeted at 14 year-olds. This age group were chosen because:, during adolescence, diet and lifestyle play an important part in achieving optimum bone health and preventing osteoporosis later in life, there was very little literature and support material available for teenagers (most was found to be aimed at primary school age children).
All 16 schools in the district are invited in writing to take part each year with the majority responding positively. A cross-section of ten pupils are chosen (Year 10 Group) from each school giving a potential audience of up to 160 pupils.
Methodology
The "Bone Fun Days" follow the same format each year and are usually held in October, as close as possible to the week of World Osteoporosis Day.
Children are transported in from participating schools to the Leisure Centre for a session that lasts 4 hours. The timetable consists of a series of 4 workshops (Nutrition and bone health, Volleyball, ‘Pot the Cabbage’ (netball with cabbages)/circuit training and trampoline/skipping/step aerobics) followed by a healthy lunch, a team quiz and prize giving.
The staffing levels involved to manage each of the days consists of 12-15 students, 6 health care professionals, and 1-2 fitness staff. 3-4 teachers are usually present as observers.
Each year pupils from one special school take part. They receive extra help during the Nutrition and Bone Health workshop and the fitness professionals from the Leisure Centre facilitate their needs by doing stretching exercises or some other activity with the less physically able children.
At the end of the day each pupil receives a copy of ‘hyper’ magazine (resource produced for the event), a Tshirt and the worksheets they completed. The students from Fermanagh College receive a certificate and a T-shirt.
Funding/timing
The first "Bone Fun Days" were held in 1999 and have been held annually. Initial funding was from money sourced for the original pilot Osteoporosis study and ‘goodwill donations’. Fermanagh District Council have continued the free use of the Lakeland Forum Leisure Centre (2 days) and two fitness instructors’ time during the sessions).
In 2003 mainstream funding was secured from the Health and Social Care Trust, with a commitment for the future from the Western Education and Library Board (responsible for schools funding). The local business community also contributed with goodwill donations such as:
- Milk supplied by the Dairy Council for Northern Ireland and a local dairy. Fruit supplied by Safeways supermarket
- ‘Fermanagh Spring Water’ provide bottled water for the children over the two days
- Gift vouchers and sports prizes for competition winners were partly donated by a number of local shops.
The planning and running of the days involves a large multidisciplinary team drawn from these partners and including, an osteoporosis nurse, school/community nurses, sports students (from local College of Further Education), dietician and dietetic assistant, fitness staff, Health Promotion Officer and a Health Promotion Co-ordinator.
Barriers
Practitioners commented that the biggest barrier had been securing funding for ongoing implementation of the project, which has an annual funding cycle. Each year there is uncertainty regarding the source of funding, which for a number of years was the result of small amounts being made available from a number of different sources.
Funding is now more secure as a result of a greater health promotion commitment and moves towards effective partnership working with the Western Education and Library Board.
Supervision of the children during the fun days has been possible each year because students (usually studying a sports course) the local College have taken part in running the project. Participation in the planning and delivery of the days is a practical project as part of these students course.
Evaluation
After the first year the project was evaluated through pupil and teacher questionnaire. This feedback has gone into planning for subsequent days.
The following data has been collected:
- Knowledge of pupils pre- and post- the ‘Bone Fun Days’
- Evaluation of satisfaction of the day among school teaching staff
- Feedback from pupils taking part
Children from participating schools are encouraged to share their learning with the rest of the school through a follow up competition three months later. Assessed are based on four criteria: knowledge base, innovation and creativity, research and impact on year group. The Dietitian /Health Promotion Co-ordinator visit schools for an assessment (cash prize of £100 for winning school). Uptake of the competition has been low (four - five schools) but those who take part demonstrate good knowledge uptake from the days.
There are plans to follow up the knowledge questionnaires with participating pupils six months after attending the ‘Bone Fun Day’s but this has yet to be implemented.
Sustainability
Mainstream funding has been gained from the Sperrin Lakeland Health and Social Care Trust in partnership with the Western Education and Library Board. Secured funds will assist the expansion of the project to the Omagh District.
It is the vision of the steering group to make the ‘Bone Fun Days’ available to all schools throughout the district covered by the Education and Library Board. Additionally, the Osteoporosis Nurse would like to develop education/information ‘events’ for different age groups, adapting some of the materials used on the ‘Bone Fun Days’. In particular she is keen to develop a project for pre and post-menopausal women and the over 65 year-olds.
Lessons Learnt
Ensure sufficient support (in kind) at the outset, from interested parties from different disciplines, so that everyone has an input to the project planning stage.
Recruitment of students to help manage pupil supervision for the ‘Bone Fun Days’.
Ensure participating parties are fully briefed at the outset so that everyone has a clear understanding of their role.
Consider assigning a coordinator to the project to ensure a seamless progress from the planning stage through to implementation and for coordination of the evaluation process.
Secure funding at the start and cost out the project more fully to include:
- coordinator’s time
- clerical or administration support
- cost of evaluation (preferably external).
- what information to collect and when
- what tools to use to collect the data
- who will be responsible for co-ordinating evaluation and
- how it will be funded.
Contact
Lead contact: Claire Holmes,
Job Title: Community Dietician,
Address:
Sperrin Lakeland Social Care Trust,
Erne Health Village,
Erne Road,
Enniskillen,
BT74 6NN.
Tel: 028 6634 2444.
Email: cholmes@slt.n-i.nhs.uk