Healthy Children, Healthy Weight - Points of Intervention to Disrupt the Cycle of Poor Health




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Dec 12, 2018
by Oscar Tollast
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Healthy Children, Healthy Weight - Points of Intervention to Disrupt the Cycle of Poor Health

Salzburg Global Fellows reflect on points of intervention which can effectively disrupt cycles of marginalization and poor health Participants considered what points of intervention can most effectively disrupt the cycle of marginalization and poor health affecting children and families

During Healthy Children, Healthy Weight, the value of relationship-building emerged during a fruitful discussion on ways to disrupt cycles of marginalization and poor health.

Participants were asked, “What points of intervention can most effectively disrupt the cycle of marginalization and poor health affecting some children and families?”

Guided by four speakers, participants reflected on their professional experiences and discussed key points within their table groups.

For some families, intervention can feel intrusive and demanding. It is better to co-produce, according to one participant. The wellbeing of the adults surrounding children is just as important. Within health, there needs to be a focus on time, relationships, listening, and communicating with families.

If a child feels disengaged from their society or community, such an event can “impoverish the soul.” The participant who put forward this view reflected on work which was taking place in New Zealand. This work includes a youth mentoring service developing models of best practice supporting young people at risk.

In this scenario, this participant suggested intervention involves creating an ongoing relationship with the young person, providing hope, and enabling them to reach their full potential.

Participants learned more about the two-generation approach and the importance of supporting families holistically. A new speaker discussed the success of programs which have focused on early childhood education and provided development opportunities for parents.

She suggested social capital was the “secret sauce” of the two-generation approach. Programs and policies should be rooted in core principles. The duration and intensity of these programs also remain crucial.

For a program to be successful, the speaker said the outcomes for children and adults had to be measured simultaneously. The voices of families also have to be heard during the conceptualization and implementation of the program. This action helps identify cracks in the system.

Also, programs should ensure equity and be aligned and linked with funding systems. Programs should foster innovation and evidence together. Leadership matters. Cultural change matters. Participants were told to remember, “Nothing about us without us, and start where families are.”

The final speaker retold the “River Story,” a parable often used to describe primary prevention and the need to address the root causes of a health problem.

She discussed the need to have someone at every point of the journey and spoke, in detail, about what the health care delivery sector can do at “the immediate point of entry.”

In the short term, clinical strategies can be implemented to understand where patients are. The speaker said these strategies fitted into two buckets: social needs informed care and social needs targeted care.

Social needs informed care can involve incorporating information about social context into clinical care decision making. If a patient does not own a refrigerator, do not prescribe medication which needs to be refrigerated. Social needs targeted care, meanwhile, involves connecting people with specific actionable needs with the resources that they need.

Commenting on all four reflections, one speaker discussed the need to unpack what relationships are, to examine their characteristics, and understand what authentic engagement entails. All the work participants do is “quintessentially relational,” he said. Once people know what they have to do, they can be purposeful and productive.

He said there is also a need to make sure families have the support they require, and there needs to be a recognition of the cascade effect which affects all relationships. Just as children need “someone to be crazy about them,” so do the parents.

As the discussion concluded, another participant reminded others of the work they were already undertaking and to consider how to scale this further.

The program Healthy Children, Healthy Weight is part of Salzburg Global's multi-year series Health and Health Care Innovation. This year’s program is being held in partnership with the Robert Wood Johnson Foundation.