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NORTHERN NSW LOCAL HEALTH DISTRICT

HEALTH PROMOTION BUSINESS PLAN

July 2019 – June 2020

HEALTH PROMOTION BUSINESS PLAN – NORTHERN NEW SOUTH WALES LOCAL HEALTH DISTRICT - 2019-20 2

NNSW LHD Vision, Purpose and Values

Vision

Better Health – Excellence in Healthcare

Values

Collaboration – Improving and sustaining performance depends on everyone in the system working as a team.

Openness – Transparent performance improvement processes are essential to make sure the facts are known and acknowledged, even if at times this may be uncomfortable.

Respect – The role of everyone engaged in improving performance is valued.

Empowerment – There must be trust on all sides and at all levels with responsible delegation of authority and accountability.

Goals1 The key goals of the NSW public sector health system are to keep people healthy and out of hospital and to provide world class clinical services with timely access and effective infrastructure. Achieving these goals requires clear priorities, supportive leadership and staff working together, underpinned by the core values of the Local Health District (LHD).

STRATEGIC OBJECTIVES This section includes goals and initiatives that directly contribute to achievement of Service Agreement (SA) Key Performance Indicators (KPIs) between NSW Health and Northern NSW Local Health District (NNSW LHD) and Strategic and Operational Plans.

1 New South Wales State Plan-NSW 2021 A PLAN TO MAKE NSW NUMBER ONE


GOAL INITIATIVES TARGET/KPI

1: Health Literacy 1. Improve Health Literacy of NNSW LHD and private health services in the Northern Rivers

a) Website: Expand and improve the health literacy website, adding actionable case studies and new consumer resources. Drive increased traffic to the Health Literacy website and increase registrations. Design and develop an interactive health literacy self-assessment tool for health services to identify areas for health literacy improvement.

b) Resources: Develop a NNSW LHD guideline/process for resource development and promote the use of the health literacy website as a repository for standardised patient care resources. Develop a suite of clear and easy to read consumer health information resources

c) Projects: Lead health literacy improvement with at least four new projects in LHD and/or NCPHN

d) Communication: Design and run media campaigns/promotions to empower consumers to take charge of their health.

e) Training: Improve health professionals’ health literacy knowledge, skills and confidence.

f) Capacity Building: Build an active database of consumers to co-design and review health information. Implement Health Literacy Ambassador program in LHD to drive health literacy improvement in health services.

g) Sustaining action: Provide consultation to enable LHD to meet new Standard 2: Partnering with Consumers Health Literacy criteria. Embed health literacy at strategic and management level in line with aims of CEC NSW Health Literacy Framework. Develop outcome framework for Health Literacy Project.

a) >2 case studies added. >4 consumer resources added. >50 new registrants, >1800 new site visits. Interactive tool in use.

b) >4 new consumer resources developed, at least 80 health resources reviewed (PHN and LHD) and at least 60 published

c) >4 new projects underway d) Community and Health professional campaigns developed, launched and evaluated

and at least 20 consumer facing promotions/skills building activities completed. e) >20 workshops held, >200 professionals receive health literacy content as part of

educational activities (100 primary care health professionals) f) >10 consumers in Health Information Feedback Group. Health Literacy

Ambassadors trained and monitor contact and impact of program. g) Provide health literacy content and training as part of NNSW LHD Consumer

Engagement Strategy 2019-2021. Develop guide to embedding health literacy in policy, 4 local documents (plans, policies, etc) include health literacy either directly or indirectly. Guideline developed and number of resources on health literacy website increased to >80 in total. Outcomes of health literacy improvement projects demonstrated for >2 projects and plan in place for future outcome monitoring.

2: Hearing Disadvantage 2.1 State-wide Infant Screening for Hearing Program (SWISH)

Coordinate newborn screening in all birthing facilities in NNSW and Mid North Coast Local Health District (MNC LHD) by appropriate allocation of resources and timely referral of

a) ≥ 98% of babies born in LHD facilities have hearing screening within 1 month of age.

b) Babies who need follow up are referred for diagnostic audiology before 6 weeks of



babies for further assessment. age 3: Healthy Eating and Active Living 3.1 Improve children’s nutritional intake and physical activity participation rates.

Implement Healthy Children’s Initiative: Munch & Move to Early Learning Services: SERVICES WITH CHILDREN AGED 0-12 MONTHS ONLY Live Life Well @ School to Primary Schools:

a) Meet with 80% of services preferably face to face b) ≥ 85% (n = 121/142) (by 2025) of all NNSWLHD Early Learning Services are

implementing the Munch and Move program. c) ≥65% of participating Early Learning Services to achieve ≥70% of Munch & Move

program practices (PH-008A) d) Meet with 80% of schools preferably face to face e) ≥ 85% (n = 143/169) (by 2025) of all NNSW LHD Primary Schools are implementing

the Live Life Well @ School program. f) ≥65% of participating primary schools to achieve ≥ 70% of Live Life Well @ School

program practices (PH-008B) Live Life Well @ School Practice 5 -Supportive environment for healthy eating. School canteen complies with the NSW Healthy School Canteen Strategy.

To be determined by the Ministry of Health

Implement Go4Fun program to treat children (and their families) who are above a healthy weight

a) Implement up to 7 mainstream Go4Fun programs b) Implement at least 4 Aboriginal specific Go4Fun programs c) Achieve 100% target participation (76 eligible families) (PH-008C) d) ≥85% participants complete the program (n=65) (PH-008D)

Build capacity in NNSW LHD Family Day Care settings to encourage children’s healthy eating, active play and reducing small screen recreation time

a) 40≥ % (n = 2/4) of all NNSW LHD Family Day Care providers are implementing the Munch and Move program. (PH-TBC)

b) ≥60% of participating NNSW LHD Family Day Care providers to achieve “agreed proportion” (≥60%) of Munch & Move program practices (see 3.1 Munch & Move (PH-TBC)

a) Conclude the Sweet Smiles translational research project. b) Work with Oral health services to embed growth monitoring and brief interventions (BI) regarding sweet drinks into routine children’s dental appointments across the LHD.

a) See 9. b) Control area (Clarence) starts to implement BIs in their practice. At least one follow-up meeting/training with dental therapists is held to support continuation of growth monitoring and BIs in routine practice.

3.2 Implement routine weight and height screening of children in NNSW LHD services

a) Implement a comprehensive education program to relevant NNSW LHD clinicians by promoting and encouraging participation in online training, employing Clinical Nurse Educator(s) to deliver face-to-face training, supporting NSW Health to visit NNSW LHD to deliver workshops, and providing other opportunistic education

a) At least 750 NNSW LHD clinicians attend/complete education related to routine weight and height screening of children

b) 70% of children less than 17 years with height/length and weight recorded during the reporting period or within the previous 90 days of the first encounter



when possible b) Support provision of related equipment and resources to

NNSW LHD hospital, community health and outpatient services

c) Link routine referral of patients identified as above a healthy weight to Go4Fun and Get Healthy Coaching programs as appropriate

3.3 Food security for youth (Y-Hunger)

Coordinate training and resources for Y-Hunger, a program for staff working at youth organisations to improve food access and physical activity options for young people 12-24 who experience or are at risk of homelessness.

At least 10 organisations attend Y-Hunger training and are resourced to run the program at their youth organisation

3.4 Support adults to lead healthier lifestyles

Promote the Get Healthy Information and Coaching Service Continue collaboration with the PHN on the Exercise as Medicine project to promote referrals by the participating centres’ staff.

≥ 384 referrals from health professionals received (PH-011b) (this number includes ≥ 229 referrals from Midwifery services

Promote Get Healthy at Work Three forums are held to promote Get Healthy at Work to the business sector. 3.5 Support women to achieve a healthy weight during pregnancy

Promote the Get Healthy Information and Coaching Service for pregnant women a) Provide workshops on GHIP in Grafton and

Murwillumbah and enable interventions designed by midwives at these sites

b) Provide/present GHIP in-services to midwives during shifts or at changeover times on the ward

≥ 306 referrals from NNSWLHD midwives are received (contributes to the 3.3 target, not additional to it)

3.6 Improve staff health

a) Continue to provide administration services for Fitness Passport

b) Promote Fitness Passport through global emails, Northern Exposure newsletter and targeted emails

a) ≥ 1000 LHD Staff have Fitness Passport membership b) ≥ 1200 family members of LHD staff have Fitness Passport membership

3.7 Improve healthy eating choices for staff and visitors in hospitals

a) Embed existing 13 Healthy Food & Drink Choices in NSW Health Service Facilities for Staff and Visitors (“Healthy Choices in Health Facilities”) key practices across NNSW LHD particularly targeting The Tweed Hospital Gift Shop, vendors that are not 100% compliant and the new café at Grafton Base Hospital

b) Implement Healthy Choices in Health Facilities supplementary audits in October/November 2019 and further audits in February 2020

a) 100% compliance with existing 13 key practices by 31 December 2019 b) Audits completed



3.8 Provide low cost physical activity options, particularly to older people

a) Provide a range of CHEGS exercise classes including Gentle Exercise, Qi Gong/Tai Chi, Light Pace, Stretch and Strengthen and Cross Training.

b) Trial new CHEGS exercise classes in underserviced locations or for underserviced populations

c) Provide quality assurance and improvement opportunities for CHEGS Leaders

a) Conduct at least 35 weekly programs with an average of 400 total participants b) Trial:

i. Strength (for Women) Class ii. Classes in Tweed Heads region

iii. Exercise Physiologist-led, low cost exercise groups for people with chronic conditions or for those who require greater supervision during exercise

c) Provide: i. One accredited training program

ii. One CPR training update 3.9 Engage a local community to help residents eat well, move more and sit less

Healthy Town Challenge – Kyogle. Community chose to: a) Recruit residents to Get Healthy Coaching & Info Service b) equipment and resources for vegetable gardens and cooking sessions at two primary schools and one preschool c) offer free activity sessions for local residents: yoga for children and adolescents, gym membership to group of Goori ladies and friends, self-defence classes for women, 12-week gym challenge, 4-week outdoor gym sessions d) resources for bushwalking group, women’s and young men’s group e) paint playground stencils in local parks f) advocate to Kyogle Council for water bubblers in the CBD, healthy catering policy

a) Activities completed b) grant report completed c) Submit application for Healthy Town Challenge 2020

3.10 Delivery of Healthy Communities Action Plan for a whole of community approach to healthy eating and active living

a) Launch Healthy Communities Action Plan b) Help coordinate Active Living NSW training workshops

for council c) Co-ordinate Youth health and wellbeing showcase d) Coordinate Healthy Workplace forum(s) e) Launch and deliver community grants targeting HEAL

initiatives for young people

a) Annual evaluation of progress b) Staff from 7 LGAs trained c) Showcase held with representation from at least 10 organisations d) Forum held and resulted in an increase in number of sign ups to Get Healthy at

Work e) small grants delivered

4: Environments that promote healthy living

4.1 Promote food and water security

a) Maintain maps of Farmer’s Markets and drinking water outlets and promote their use to community and other stakeholders

a) Maps are promoted

4.2 Promote active and public transport

a) Work with other transport and social development stakeholders to increase access to active travel for

a) Two strategies trialled to increase active transport, e.g. promote bike week



Northern NSW residents

4.3 Promote healthy urban and rural development

a) Use the Healthy Urban Development Checklist and general HP principles to provide feedback on local policy and plans that affect healthy food and active transport.

a) Responses provided to regional planning instruments/documents

4. 4 Increase healthy environment strategies in council strategic planning processes

a) Organise Active Living NSW Local Government HEAL planning workshops

b) Provide comment on new Local Strategic Planning Statements (LSPS) being developed by councils

a) Workshop held b) Submissions to councils on LSPS

4.5 Increase access to low cost physical activity

a) Promote installation of outdoor gym equipment (OGE) and promote with free classes

b) Assist community members to set up groups or activities that involve physical activity. E.g. Heart Foundation walking groups and parkrun events

a) Free OGE classes run in Kyogle and Tweed and evaluation of OGE classes complete. b) Assist at least one regular community physical activity group to be formed.

4.6 Promote healthy environments and policies

a) Promote healthy environment grant opportunities

a) Councils informed of healthy environment grant opportunities

5: Reduce Risky Drinking

5.1 RRISK: Reduced Risk Increase Student Knowledge. Program to reduce young people’s risk around alcohol, and driving

Implement and evaluate the RRISK program across NNSW a) Five seminars held in Lismore and Tweed Heads b) RRISK Save a Mate sessions are held in schools in weeks

before and after seminars c) Parent information sessions are held in two schools in

the district d) Evaluate students and teachers’ satisfaction with the

program.

a) Seminars held and 27 (>80%) North Coast High schools participate in RRISK program in 2018

b) At least 65% of participating schools conduct in-school RRISK Save a Mate session c) Process evaluation data is collected, analysed and reported on.

5.2 Feedback on liquor licence applications

a) Submit a response on behalf of the LHD to liquor licence applications including new and modified ones (e.g. extended hours).

An evidence based response is submitted to all local applications deemed appropriate to respond according to potential community harm criteria

6: Reduce falls injury in older people

6.1– Screening and Falls prevention plans for people in NNSW

a) Support the Nursing and Midwifery Directorate Clinical Nurse Consultant Falls to plan, implement and evaluate initiatives as required

a) Attend and report at NNSW LHD Inpatient Falls Committee at least six times b) Work in partnership with Nursing and Midwifery Directorate Clinical Nurse

Consultant Falls on at least one joint project



LHD facilities

b) Promote NSW Health/Clinical Excellence Commission best practice and falls-related research developments across NNSW LHD

6.2 Minimise risk of falls in NNSW LHD facilities

a) Support the Nursing and Midwifery Directorate Clinical Nurse Consultant Falls to plan, implement and evaluate initiatives as required

b) Promote NSW Health/Clinical Excellence Commission best practice and falls-related research developments across NNSW LHD

a) Attend and report at NNSW LHD Inpatient Falls Committee at least six times b) Work in partnership with Nursing and Midwifery Directorate Clinical Nurse

Consultant Falls or other relevant stakeholders on at least one joint project

6.3 Support and promote uptake of exercise programs for older people at risk of falls

a) Implement Stepping On program across NNSW LHD b) Prepare for local implementation of new state-wide

program for people aged 60+ years and Stepping On for people aged over 70 or very frail from 2020

a) Conduct at least 22 groups with at least 220 participants by 30 June 2020 (PH-021a and PH-021b)

b) Programs implemented as directed by NSW Health

6.4 Preventing falls in community dwelling older people by providing them/families/carers with information about action they can take to reduce the risk of falls and injury from falls

a) Implement the “Standing Tall” research project b) Events:

i. Organise and present at relevant major educational events in NNSW LHD

ii. Present at relevant large community events in NNSW LHD

iii. Organise and implement Roadshow event in partnership with CHEGS, Stepping On and Exercise Physiologist

c) Complete and disseminate “Strong Men, Sexy Legs” resource

a) Recruit at least 100 Standing Tall participants i. At least two major educational events

ii. At least three large community events iii. At least one Roadshow

b) Resource completed and available via Stepping On, CHEGS, Community Health, Health Promotion website, and other appropriate mediums

7: Reduce smoking levels 7.1 Provide standardised best practice smoking cessation interventions across the LHD.

a) All of LHD Tobacco Strategy endorsed by LHD Executive b) Ensure the NSW Health Smoke-free Health Care Policy is

implemented and monitored across NNSW LHD and compliance issues are raised, discussed and acted on by an Executive-endorsed governance structure

c) Liaise with LHD Media Coordinator to develop a NNSWLHD Tobacco Communications Plan

d) Delegate responsibility for coordinating, evaluating and improving treatment of nicotine dependence across

a) Plan endorsed by Exec b) Governance established by December 2019 c) Communications Plan established by December 2019 d) Position established by September 2019 e) Review completed by June 2020 and there is a timeline to provide feedback into

other relevant policies as they are updated f) At least one policy updated by 2020 and communicated to relevant staff g) At least one barrier identified and addressed h) At least one change made to eMR to support evidence-based treatment to nicotine



NNSW LHD to an existing NNSW LHD Health Promotion Service member via an EOI process. This person will be responsible for coordinating the review of policies etc, training and the development of resources.

e) Review NNSW LHD policies, procedures, guidelines and other clinical tools related to tobacco

f) Update of NNSW LHD policies, procedures, guidelines and other clinical tools related to tobacco to align them with latest evidence and ensure consistency across NNSW LHD as required

g) Identify environmental and organisational barriers to NNSW LHD to clinicians providing evidence-based treatment to nicotine dependent patients and co-design solutions with relevant clinicians and experts

h) Make new improvements to clinical data systems to support the delivery of evidence-based treatment to nicotine dependent inpatients. These might include:

o Prompts, reminders, tools and templates o Decision support, referral and follow-up systems o Activity Based Funding

i) Provide information and support for people on the elective surgery waitlist to be smoke free in the lead-up to surgery

j) Work with NNSW LHD Emergency Departments to ensure they offer NRT to all patients who are nicotine dependent as per Substance Abuse Screening

k) Work with Pharmacy departments to provide all adult inpatient units with Nicotine Replacement Therapy Demonstration Packs and information

l) Monitor and evaluate population level anti-tobacco mass media campaigns, and campaigns and interventions for priority populations locally as required by NSW Health

m) Monitor smoking uptake, prevalence, and quit rates, particularly for priority populations locally as required by NSW Health

dependent inpatients. i) All elective surgery patients who smoke are identified during preadmission

assessment and receive counselling for nicotine dependence and/or referral to Tobacco Treatment Staff (D&A consulting & liaison team staff) at least eight weeks before surgery when possible

j) NRT is offered to all patients who are nicotine dependent in at least one emergency department

k) Nicotine Replacement Therapy Demonstration Packs and information available in all adult inpatient units

l) Relevant NNSW LHD clinical data indicates positive results/trends. Relevant population health indicators (reported through HealthStats NSW) show positive results/trends

m) Support NSW Health to monitor and evaluate population level anti-tobacco mass media campaigns, and campaigns and interventions for priority populations in NNSW LHD

n) Website is reviewed and updated. Podcasts and Video are reviewed, finalised, endorsed and uploaded to website

o) Grant reports finalised and submitted



n) Website is reviewed and updated to better suit needs of both staff and consumers. Podcasts on addiction and triggers are finalised and updated to website. Video on smoke-free homes is finalised and uploaded to website

o) Cancer Institute and Heart foundation grant reports are finalised and submitted

7.2 Increase clinical staff capacity for smoking cessation

a) Support Drug and Alcohol to deliver evidence based treatment to nicotine dependent inpatients and community based patients via face to face, and telephone sessions in either one on one or group settings.

b) Work with Mental Health Drug and Alcohol to develop a NNSW LHD Mental Health Tobacco Treatment Plan which includes:

o Best practice examples of nicotine dependence interventions in NNSW LHD and other similar inpatient and community settings across NSW/Australia

o Barriers to consistent delivery of best practice nicotine dependence interventions in NNSW LHD inpatient and community settings and strategies to overcome them

o Mental Health and Drug and Alcohol staff that have received training in nicotine dependence and tobacco treatment in the last five years

o Current practice and new opportunities to introduce tobacco treatment in healthy lifestyle interventions appropriate to each service/setting

o Where nicotine withdrawal has been a contributing factor in Mental Health Acute Seclusion Occurrences and develop remedial actions

c) Designate Health Promotion Officers to targeted facilities to guide and support smoke free healthcare initiatives. These staff will roll out:

a) Training provided to Drug and Alcohol staff to commence Helping U 2 Quit clinics and inpatient counselling. At least 12 patients are counselled for nicotine dependence each day by Tobacco Treatment /consulting and liaison Staff and documented in medical records

b) Working Group established and 5-year action plan developed c) Health Promotion Officers identified to support all 8 sites (Tweed, Murwillumbah,

Ballina, Byron, Lismore, Casino, Maclean and Grafton) • Standardised protocols developed for all sites in relation to tobacco treatment • Staff identified and trained to drive standardised interventions in each sites • Working groups established • Baseline audit conducted • Gaps identified and reported • Site strategies developed • Standardised treatment pathways established • Seven comprehensive audits conducted and results included in site specific

action plans (see 7.5) and distributed to appropriate managers.



• Training & education • Resources & information • Standardised clinical protocols • Ensure the supply of NRT is standardised and

available • Tobacco Treatment Champion grants and support

staff within each facility to embed practice locally • Working with WHS committees • Promote practice change tools – BAP,

mentoring/coaching staff • Standardised treatment pathways • Audits of adherence to NSW Health Smoke Free

Health Care policy (included in 7.5 environmental audit)

7.3 Patients are supported in the community to quit smoking and remain smoke free

a) Encourage clinicians to refer patients who smoke to community based cessation support post discharge

b) Encourage clinicians to include information on treatment for nicotine dependence on discharge summaries

c) With patients’ consent, send more detailed written communications to General Practitioners providing information on nicotine dependence treatment when required

d) Routinely review relevant Northern NSW Health Pathways to ensure all elements including clinical content, forms and web links are up-to-date

e) Support the commencement, continuation and/or expansion of smoking cessation programs tailored to motivate Aboriginal people to quit smoking that are delivered by Aboriginal Services in Northern NSW

a) Target reached for referrals to Helping U 2 Quit, increased referrals to quitline b) Treatment for nicotine dependence included in all Discharge Summaries for

admitted smokers in one site c) Letters sent to patients’ General Practitioners d) Smoking Cessation, Smoking Cessation Support, Nicotine Replacement Therapy

(NRT) and any other relevant Health Pathways are reviewed annually e) Aboriginal population smoking rate is less than two times the rate of Non-

Aboriginal people by 2024 (reported through Health Stats NSW). At least 5 Aboriginal Health staff are trained to deliver tobacco cessation advice through Brief Action Planning

7.4 Population-wide public education campaigns prevent tobacco uptake and support people to quit

a) Continue to support the implementation of national and state-wide public education campaigns

b) Work with Aboriginal Health to deliver targeted and innovative community approaches to tackling tobacco uptake and use among Aboriginal people and other priority populations (refer to 7.3)

a) Information and promotional material from national and state-wide public education campaigns are distributed locally through:

• NNSW LHD website update • Health Promotion Facebook • At least 2 Media releases

b) Smoking reduction initiatives incorporated into at least two Aboriginal community



events such as NAIDOC and Koori Knockout 7.5 Avoid exposure to second-hand and third hand tobacco smoke prevented

a) Work with site managers to strengthen and enforce the implementation of smoke-free environments across hospital grounds and health facilities under the NSW Smoke-free Health Care Policy through the development of six Site Improvement Action Plans

b) Progress the removal of the patient waiver form and stop the practice of escorting patients/clients outside to smoke

a) Quarterly surveillance activities show at least 98% compliance with NSW Smoke-free Health Care Policy. Six Site Improvement Action Plans are submitted to relevant managers.

b) Waiver forms are no longer used

7.6 Staff and patients who smoke are supported to become smoke free or abstain from smoking while at health facilities

Ensure support is available for staff who smoke and staff are aware of tobacco treatment support available: a) Annual staff awareness campaigns on workplace tobacco

treatment support including examples of successful nicotine dependence management during work by staff

b) Circulate smoke-free health care cards throughout each facility

c) Education sessions conducted with Pharmacists and NUM on imprest and NIMs procedure regarding NRT –

d) Conduct World No Tobacco Day (WNTD) activities in at least 2 healthcare facilities

e) Investigate, develop and implement an improved local process, preferably electronic, for NNSW LHD Hospital Pharmacies to monitor staff accessing free and cost-price NRT

a) Campaign developed and implemented as part of the tobacco communications plan

b) Smoke free Health care cards distributed c) Training conducted for each pharmacy department d) WNTD activities conducted in at least 2 sites e) Process developed to identify numbers of all staff who access nicotine dependence

support developed and implemented across NNSWLHD

7.7 Identify train and support the workforce and ensure continuing professional development is available on evidence based tobacco treatment practices

a) Undertake a review of current nicotine dependence training and develop a new program for NNSW LHD clinicians and workers in relevant service areas that:

o Is tailored to the NNSW LHD context o Builds capacity to provide basic evidence-based

treatment to nicotine dependent patients and arrange follow-up o Details correct documentation o Details referral process o Can be delivered regularly online and face-

a) Review of training undertaken and training plan developed b) Training provided to at least 400 staff via 40 training programs and/or

opportunistic interactions



to-face (brief and more detailed sessions) o Is included or promoted in new staff

orientation o Includes content for student doctors,

nurses, midwives, allied health professionals and Aboriginal Health Workers

o Includes promotion of smoke free cars and homes

b) Coordinate training to staff 7.8 Address smoking in pregnancy as a system wide priority

Address smoking in pregnancy as a system-wide priority and ensure that all pregnant women who smoke, and particularly Aboriginal women, are offered evidence-based support as part of routine care throughout their pregnancy, birth and post-partum

• Improved identification of pregnant smokers by midwives • At least 80 women are referred to the C&L D&A service (28% of pregnant women in

the LHD who smoke tobacco) • Smoking During Pregnancy – At any time for Aboriginal women and Non-Aboriginal

women decreases annually • Pregnant women quitting smoking by second half of pregnancy increases annually • Greater integration with General Practitioners providing shared-care • Nicotine Dependence Training Program delivered to NNSW LHD midwives (refer to

7.2 and 7.7)

8: Incorporate health promotion and illness prevention into Clinical Services

8. Reorient health services to include a focus on prevention

a) Develop a plan to incorporate health promotion and illness prevention into Violence Abuse and Neglect framework b) work with one other clinical setting to incorporate health promotion and illness prevention into routine work

a) Plan developed and agreed to by VAN staff b) One other clinical setting incorporates health promotion and illness prevention specific to their clinical work

9: Build Health Promotion Evidence, Access and Workforce Development

9.1 Foster Research and Evaluation partnerships and collaborations

Foster research links with relevant academic institutions including joint research and professional development and/or teaching

a) At least two research & evaluation projects conducted in partnership with other organisations:

-Contract SCU CCYP to research taking a student-inclusive approach to changes in canteen menus. -Supervise UWS Medical students to conduct research. of festival goers in Splendour in the Grass re perceptions, attitudes and behaviour associated with festival based alcohol blood level testing (in collaboration with STEER Inc.) -NSW Centre of Oral Health Strategy (COHS). Sweet Smiles Research. See 9.2.a



-NSW HETI re lunch box study. See 9.2.c -Neuroscience Australia re Standing Tall. See 9.2.f -Primary Health Network and Office for Preventive -Health re Exercise As Medicine. See 9.2. g

9.2 Comprehensively evaluate Health Promotion programs

a) Conclude the trial of a new program to reduce sugar sweetened beverages intake among children aged 0-18 years by targeting parents/guardians of children using public dental services in NNSW LHD (Translational Research Grant Scheme).

• Complete and submit final report to TRGS • Nominate Time and Motion study and feasibility evaluation to LHD and NSW Health

Quality Awards • Publish findings from the Time and Motion study and feasibility evaluation in a

peer reviewed Journal • Submit findings regarding impact of intervention or cross sectional data to a peer

reviewed journal b) Conduct evaluation of the RRISK program:

• RRISK program process evaluation re students and teachers’ satisfaction of the program

Process evaluation conducted, brief report prepared and findings disseminated to stakeholders and schools

c) Rural Research Capacity Building Program “Transitional Lunchboxes: A cross sectional study of energy dense nutrient poor foods in the lunchboxes of kindergarten and year six students in Northern NSW.”

• Report written for HETI • Present findings at the NSW Rural Health Research Congress • Publish findings in a peer reviewed journal.

d) Evaluate the impact of embedding the Standing Tall app into falls prevention referral pathways in NNSW (e.g. hospital discharge plans, GP and allied health referrals, Stepping on).

d) Implementation commences. Baseline data collection commences.

e) Evaluate the impact of the Exercise as Medicine pilot on health professionals’ referrals Get Healthy in NNSW.

e) Pilot commences. Data collected and analysed. Findings fed back regularly to PHN and GH.

9.3 Increase access to health promotion information and services

a) Improve, expand and update the website for Health Promotion

b) Expand and coordinate media (including social media) to ensure effective promotion of health promotion programs and services to health professionals and the community

c) Increase capacity of clinical staff to undertake health promotion strategies as part of their clinical work

a) Website updated b) All major population based programs will have a media and marketing strategy that

is implemented and evaluated c) Trial at least one strategy to incorporate illness prevention into routine clinical

care.

9.4 Build the skills, efficiency and effectiveness of the Health Promotion

a) Reduce health promotion vacancy rate b) Support undergraduates and new graduate workers in

health promotion c) Ensure new staff have adequate orientation to the job

a) Maximum staff recruited b) Accept student placements in health promotion and reserve one two-year health

promotion position for a new graduate. c) Line managers use checklists for orientation and provide structured 12-week



team d) Develop ‘blue-prints’ for program handover for two health promotion programs

e) Provide supervision, performance appraisal, targets and work plans for all staff

f) In addition to the Service Agreement Key Performance Indicators, ensure all programs have effective and measurable intermediate indicators that are monitored quarterly

g) Ensure that team have access to Video Conferencing and Teleconferencing courses/seminars from Academic and Health service sources

h) At least two professional development (PD) opportunities offered

i) All staff complete mandatory training j) Include quality assurance (QA) monitoring for each

Health Promotion team to ensure program fidelity and effectiveness.

k) Encourage and support staff to nominate programs and projects for NNSWLHD Quality Awards

orientation and performance plan d) Blue prints developed for two health promotion programs e) All staff have annual performance appraisal, targets and work plans f) Indicators monitored quarterly g) At least two webinars or teleconferenced seminars offered h) At least two professional development (PD) opportunities offered i) All staff complete mandatory training j) Staff undertaking QA activities receive support in project development and the

opportunity to present their QA activity to a panel for feedback and suggestions for any further work arising.

k) At least one application for quality award

9.5 Increase efficiency and sustainability of health promotion strategies and ensure a strong focus on community engagement

a) Identify opportunities to deliver services through contractual arrangements with the non-government sector: Contract facilitators to deliver Stepping On, Go4Fun and CHEGS Exercise Programs.

b) Finalise 5 year Health Promotion Service Strategy and organisational structure

a) Contracts developed and performance monitored b) Strategy Developed and endorsed and Health Promotion structure reviewed c) Work with senior clinicians to routinely report on health promotion KPI

9.6 Arts in Health Report on Arts and Health program as required MoH reporting as required

Abbreviations

AMS – Aboriginal Medical Service AMIHS-Aboriginal Maternal Infant Health Service CHEGS – Community Health Education Groups (exercise program).

Cpd – cigarettes per day BAP - Brief Action Planning C&FH- Child and Family Health DoE- Department of Education eFRAMP Falls Prevention Screening Tool


FDC- Family Day Care Service GP – General Practitioner HETI - Health Education Training Institute HEAL Healthy Eating Active Living team HP – Health Promotion MNC Mid North Coast MNDI- Management of Nicotine Dependent Inpatients MoH - Ministry of Health NNSWLHD - Northern NSW Local Health District NGO – Non Government Organisations NNSW LHD- Northern NSW Local Health District NRT – Nicotine Replacement Therapy

OGE - outdoor gym equipment OOSH – Out of School Hours care program PC- Program Coordinator PD – professional development POTF – putting out the fire (Aboriginal smoking cessation campaign) QA – quality assurance SFHC – smoke free health care SCU – Southern Cross University SSB – Sugar sweetened beverages WH&S – Work Health and Safety

Appendix 1 Program explanations (listed alphabetically)

Go4Fun® Program Is a treatment program to reduce childhood overweight and obesity by assisting parents and children to develop a long lasting and healthy approach to living. The primary target group for the program are children aged 7-13 years of age who are overweight or obese and their parents. The program is free and runs for 10 weeks.

Healthy Urban Development Checklist

NSW Health guide for health professionals to advise local government and other planners how plans and polices on urban development can influence healthy lifestyles and contribute to better health outcomes for the community.

Helping U2 Quit Clinic and group education programs to reduce smoking

Infant Group program for parents of children 0-18 months to increase healthy eating and physical activity in an age appropriate way for their developing infants

Koori Knockout Challenge aims to address obesity, unhealthy eating and lack of physical activity in Aboriginal communities through a team-based competition linked to the Rugby League including the NSW Rugby League Knockout.

Live Life Well at School Program that aims to get more primary school students, more active, more often, as well as focusing on healthy eating habits. The program helps develop teachers’ knowledge, skills and confidence in teaching about nutrition and fundamental movement skills as part of the school syllabus. Health Promotion staff assist schools with training and resources to support the program and offer additional activities aimed at parents to help make it easier for children and their families to be active and eat well. They also work with schools to ensure the school environment is conducive to healthy living by providing a healthy school canteen, fruit and vegetable breaks and active playgrounds.

Make Healthy Normal (MHN)

Social marketing campaign to increase healthy eating, increase physical activity and reduce overweight and obesity

Munch and Move program Supports the healthy development of young children by promoting physical activity, healthy eating and reducing small screen time (TV, DVD, computers and smart phones). Childcare service workers (including Long Day Care, Family Day Care and Preschools) are provided with training, information, resources and ongoing support to implement the program. Health Promotion staff assist schools with training and resources to support the program and offer additional activities aimed at parents to help make it easier for children to be active and eat well.

RRISK (Reduce Risk, Increase Student Knowledge

is a resilience building program that extends the school based drug education and road safety curriculum by providing opportunities for senior high school students to develop knowledge, attitudes and skills to reduce risk taking and develop safer celebrating strategies. It incorporates factual presentations on risk taking, alcohol, drugs, safe celebrating, safe driving and vehicle safety and is enlivened by drama, life stories and role models. Research conducted by the George Institute of International Health has found that participation in RRISK resulted in a 44% reduction in road crashes.


Stepping On

exercise and information program is designed for people who are living at home and who have fallen or are fearful of falling. The program covers a range of topics, including vision, medicines and practical exercises to improve strength and balance. The group-based sessions run for two hours a week for seven weeks, followed by a refresher session three months later. Stepping on is run by our Community Health Education Group (CHEGS) exercise facilitators.

SWISH (NSW State-wide Infant Screening – Hearing

The program aims to screen all new born babies and identify babies born with significant permanent bilateral hearing loss by 3 months of age, and for those children to be able to access appropriate intervention by 6 months of age. Early identification and intervention are important, with research suggesting that intervention commencing by 6 months of age may result in optimal speech and language development and minimise the need for ongoing special education.

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