1 Challenges and solutions
This section looks at some of the challenges that Karen and Nicola, the managers at the nursery, came across during the nursery’s healthy eating and drinking campaign.
Activity 1 Challenges and benefits to promoting health – Managers’ perspective
Timing: 10 minutes
In the following video, Karen and Nicola describe some of the challenges. As you watch the video, make a note of the challenges that Karen and Nicola describe in the video.
Download this video clip.Video player: Video 1
Transcript: Video 1
[MELLOW MUSIC]
NICOLA FARMER
We had a couple of challenges definitely. The main one I think was the water. We wanted to be a water-only or milk-only nursery. But parents, and staff, and children found that difficult. Didn't they?
KAREN NASH
Yes.
NICOLA FARMER
So we had to try and find ways to overcome that.
KAREN NASH
Give lots of encouragement, I think to the children. I think the staff as well. One of the main things was everybody staff, parents, and children, they've already got established routines, established lifestyles already. And I think some of the information that we were sharing with them highlighted certain things. So I think for us, one of the challenge was changing people's mindsets.
NICOLA FARMER
Yeah.
KAREN NASH
Getting your staff on board.
NICOLA FARMER
And parents as well. It wasn't--
KAREN NASH
The parents.
NICOLA FARMER
It wasn't-- Yeah. Because then another challenge was the lunchboxes that were coming in. So we could control what we were giving out here, but obviously then lunchboxes coming in from home was a different matter. And some of those weren't always the healthiest of choices, but trying to change parents' mindsets without being too-- we didn't want to be judgmental. So it's trying to help and support them, but in a nice kind way. And giving them ideas and activities and ways of doing that.
KAREN NASH
So to remove the barriers, isn't it?
NICOLA FARMER
Yes.
KAREN NASH
So with the leaflets, and information sharing, giving them examples of what they could put in their lunchboxes, I think that's helped. And talking to children when you're having the meals. Talking to them what's healthy, what's good for them, what nutrients and things do to their bodies. Especially including oral health, because that's the big one at the moment, especially with the revised EYFS--
NICOLA FARMER
Yeah.
KAREN NASH
--promoting drinks that don't have lots of sugar in them.
NICOLA FARMER
Yeah. Even down to the parents with the purees and things like that with the babies, and making sure that they're developing their muscles in their mouth by actually starting to chop up the food and not always being pureed. So that was even a challenge as well, that they're frightened that they might choke. So those sorts of things. Wasn't it really talking to parents?
KAREN NASH
And I think having the time. Having the time to develop this research and project with the families.
NICOLA FARMER
Yeah.
KAREN NASH
I think that was one of the biggest challenges as well. Having the time to get the information together, to do displays. We held events for parents to come in and take part in activities with their children, just to encourage healthy eating and healthy lifestyles.
NICOLA FARMER
That was knowing our families, wasn't it?
KAREN NASH
Yes.
NICOLA FARMER
We had to know our families, you know who you can talk to in certain ways, or you might not be able to talk to that parents in that way because it wouldn't work with them. So it's knowing your families first and foremost. And that comes with the staff in the room, the key person, approach. They know their families, don't they? And their children and their parents and that. And getting to those positive relationships, building those up, I suppose, to begin with, and then finding a way over the barriers, I suppose, and over [INAUDIBLE].
KAREN NASH
One of the benefits for the parents was building stronger relationships with them being able to feel confident enough to share information with them without being, as we say--
NICOLA FARMER
Judgemental.
KAREN NASH
Yeah, judgmental with them having some information to give them. Some parents, rather than having something to read, we did lots of visual activities. So we did a display board with sugar contents of all foods and drinks that some of the children are bringing in from home, just to show parents how much sugar is actually in a little carton of orange juice that they buy in the shops that they think is healthy to go in their child's lunchbox.
The visual stimulants and things for children and families. We got lots and lots of feedback with that.
NICOLA FARMER
Yeah, I think it shocked them, didn't it?
KAREN NASH
It did, yes.
NICOLA FARMER
It really shocked everybody actually, I think.
KAREN NASH
And they were all laughing [INAUDIBLE] just something that goes in the lunchboxes, or a yogurt, one of the squeeze pouches.
NICOLA FARMER
Yeah.
KAREN NASH
The sugar content was astonishing, I think.
NICOLA FARMER
And that was our family support worker, wasn't it? Actually, at the time, she helped us with that.
KAREN NASH
Yes.
NICOLA FARMER
And she did that. She created all of that, didn't she? And she sort of ran with it, and really built up that parent relationship. And then empowering parents as well, to then go home and look for themselves and see if they can do something themselves. Rather than just always telling them what to do, isn't it?
KAREN NASH
I think especially with the what we've given up the squash in the nursery, and going to a water-only setting. That played a huge impact with parents, and we had lots of feedback from parents where children were going home-- we developed a water song--
NICOLA FARMER
Yes.
KAREN NASH
--for the children. And they going home-- we sent the song sheet home for the parents, so they could learn it at home.
NICOLA FARMER
We even videoed it, didn't we?
KAREN NASH
We did, yes.
NICOLA FARMER
The staff videoed themselves doing it, which was really good of them, wasn't it?
KAREN NASH
Yes, and sent it out to parents.
NICOLA FARMER
And sent it out to parents, which they loved that. And the children loved it as well, didn't they?
KAREN NASH
Yes.
NICOLA FARMER
So it got them on board. And we made it into a fun thing, didn't we? That they were drinking water, it was a competition or--
KAREN NASH
Every time they had a cup of water rather than a cup of squash or something, they put a little counter in a pot so they could see the level building up as well.
NICOLA FARMER
It's the whole approach, isn't it really?
KAREN NASH
I think even staff. They always used to bring in bottles of squash to drink in the room, and it was changing their mindsets as well.
NICOLA FARMER
Yeah.
KAREN NASH
I think we did come across a couple where sometimes children who have got medical conditions. So we'd got one child who suffered a lot from water infections, and needed to drink constantly. So their parent had quite a few concerns with regards to just being water, because of a concern they weren't going to drink enough. So for some, there are exemptions.
NICOLA FARMER
Yeah.
KAREN NASH
So we do take that on board as well, and take that into consideration.
INTERVIEWER
Right. Thank you, very much. And the benefits-- obviously there were benefits, for the children, the parents, and for the staff. And what do you think they were?
KAREN NASH
I think it encouraged them to be physically active--
NICOLA FARMER
Definitely.
KAREN NASH
--to take more of an interest on what they eat and drink, and the impact that it has on them for developing.
NICOLA FARMER
And actually, I think, the eating healthy as well, and going outside more, getting that exercise, it actually enables them to be better learners as well, I think. Doesn't it, with their development?
KAREN NASH
Yeah, I think we noticed a big engagement, didn't we?
NICOLA FARMER
Yes.
KAREN NASH
So they're better off going outside first before they're ready then to come back inside and sit down to do focused activities.
NICOLA FARMER
Get lots of fresh air, wasn't it? And that helped them too.
KAREN NASH
And it did.
NICOLA FARMER
Yeah.
KAREN NASH
I think it improved their attendance. We seem to have fewer illnesses in the nursery as well.
NICOLA FARMER
And I think for parents as well, it benefited them at home then as well, because obviously they noticed a difference in children's behavior at home. And even they were just talking about it. I know, you said didn't you with the water? It's that they were talking to the parents about what they do at nursery, so it's engaging them with the home learning as well.
KAREN NASH
And again, just forming stronger relationships with our families.
NICOLA FARMER
Our families.
INTERVIEWER
And so were there any other benefits of the parents? I mean, that's a huge one what you're saying about improving behavior.
NICOLA FARMER
Yeah.
KAREN NASH
I think for us as well, when we did a big push on the healthy lunchboxes, it did have a benefit for the families as well. And I think cost wise.
NICOLA FARMER
Yes.
KAREN NASH
Because I think parents don't always know what to put in their children's lunchboxes, and they tend to put lots and lots of different choices in there. But with the information that was shared, I think it probably saved--
NICOLA FARMER
Saved to cut down on that.
KAREN NASH
Saved them financial cost as well.
INTERVIEWER
And what about the staff? How did it benefit the staff, do you think?
NICOLA FARMER
I think they changed their lifestyles, some of them didn't they?
KAREN NASH
Yes.
NICOLA FARMER
We've got a lot of staff now that are-- they're drinking water throughout the day. So obviously that's better for them [INAUDIBLE].
KAREN NASH
I think it also increased their knowledge and awareness of being healthy, and that it does have an impact on your life so especially now and in your future.
NICOLA FARMER
Yeah. Now we've got staff that have joined gyms, they're looking at how they eat, how they-- and role modeling to the children as well then. So they are being better role models too. Doing the exercises with the children.
KAREN NASH
I think some of them did actually look at what they eat as well. So I think that that's benefited them.
NICOLA FARMER
Yeah.
INTERVIEWER
So what would your advice be to other settings who are planning to develop their work in health promotion? What are the key factors that will make this succeed?
KAREN NASH
It's going to be-- look at what you already do in your setting. Set goals, but make sure that they're realistic.
NICOLA FARMER
They're realistic.
KAREN NASH
Don't try and do too much at a time, do one thing. If you're going to focus on maybe giving up water, or promoting healthy eating, or physical activities, just focus on one thing at a time.
NICOLA FARMER
Because I think sometimes, if you put too much to a parent, they don't get on board with it then because it's too there's too much going on. I think if you single something out, it's a lot better, isn't it? Then you can really, really plow into it. Like oral health, that's something we really want to get into, and promote to our parents.
So that's our next big thing. Again, we have done it before, but we're going to do it again. So we'll have a look at that, won't we?
KAREN NASH
Know your families, I think, know your families. Know how to be able to interact with them. Some parents are better if you have a one-to-one conversation. Some parents are better if you do it in little groups, or you do workshops. So really know your families and build up that relationship with them, I think that's key.
NICOLA FARMER
Yeah. And time.
[LAUGHS]
Make sure you've got enough time to do these things. Set yourselves the targets that are not too time consuming and do one little bit at a time.
KAREN NASH
I think--
NICOLA FARMER
--rather than rushing in.
KAREN NASH
Yeah. And I think the information that you share, so make sure it's not all leaflets and things. Make sure that you do have visual things as well because we find that really, really useful for our parents.
INTERVIEWER
Thank you, Karen and Nicola. It's been really great coming back and hearing what your thoughts are about your health promotion work, and how the toolkit and the five steps helped. Really appreciate your time. Thank you.
Video 1
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Discussion
Karen and Nicola talk about how it was challenging to become a water or milk only nursery. Karen and Nicola point out that changing people’s mindsets and routines can be difficult.
They described how the differences between what happens at home compared to what happens in nursery became more apparent when they introduced the change to a water, or milk, only nursery. Similarly, the different approaches between home and nursery became evident in what was included in lunch boxes that were sent in from home. They often included lots of different choices of food and frequently included less healthy options.
They realised that some of the parents’ reluctance to try healthier options was because of their fears that some foods may put their child at risk of choking. Such fears meant that parents were keen to give their child pureed foods, and were reluctant to give them crunchy foods, for example, carrot sticks. However, as Karen says, if children don’t have the opportunity to eat crunchy foods, this can have an impact on their oral health and can be a cause of tooth decay. A lack of crunchy food means that children aren’t having the opportunity to develop the jaw muscles that are needed to develop speech and language.
The following section looks at some possible solutions to removing barriers and challenges.