1.      what is the title of the strategy

2.      what was the strategy aiming to achieve

3.      what theories relate to, or may have informed the

development of this strategy and its implementation

4.      what stakeholder tensions might have existed in the development of the strategy

5.      how might this strategy be communicated to different segments of the population to manage public perceptions of risk and to support individual choice

6.      how was the strategy implemented

7.      what was the impact on the public’s health

8.      what was the impact on service delivery

2.      The strategy was aiming to reduce smoking prevelance by offering those smoking a different method of quitting smoking

3.     The success of NRT alongside the social acceptance of e-cigarettes prior to the strategy

4.      Political tensions around whether people should be helped to come off cigarettes. Regulations around vapes becoming stricter meaning that manufacturers are being penalised more

5.      With great consideration, that vaping is a harm reduction method for quitting smoking and should not be used by those that dont smoke. This has been proven difficult to promote, especially to kids

6.      The strategy was implemented through the comissioning of the Khan Review (2022). This was funded by the DHSC to make smoking prevelance a top priority.

7.      A reduction in smoking prevelance but also raised the profile of vapes as a result of this. The publics voice was being heard more on the subject, directing the attention away from cigarettes and allowing tobacco companies to continue working in the background whilst vape companies got scrutinised

8.      Service delivery became very successful with the delivery of vapes to the service. Vaping became more trusted as a result of the service promoting vaping. Although this can still be misinterpreted.

1.     

 Supervised Toothbrushing Scheme in Schools

2.     

 Improve children’s oral health by increasing the frequency of toothbrushing, Reduce the number of children experiencing tooth decay, reducing the number of children needing tooth extraction

3.     

 Behaviour Change Combi Model – enablement and supporting environment, education, empowering people

Lack of access to dentists, best start to life

Evidence review – learning best practice – other countries that have implemented and seen positive outcomes

4.     

 Whose responsibility is it to brush children’s teeth?

Schools already under pressure

Funding , capacity, priority

5.     

 Commissioning and implementation guidance to Local authorities

Guidance to schools,

Information for parents/care givers – opt out, rational

6.     

Schools selected based on greatest need and poorest outcomes  

Local authorities commissioned organisations to train school teams to deliver intervention

Centralised stock of toothbrush packs distributed to schools

7.     

 Reduction in presence of tooth decay, children actively brushing their teeth more

Overall reduction in NHS costs – tooth extraction

8.     

Schools were able to build activity into school day quite easily and make it regular daily practice  

Despite concerns didn’t require lots of space , still able to deliver regular lesson content, children happier at school, learn more, attend more, social confidence,

Increase in people accessing dental appointments (or joining waiting lists)

 The Tobacco and Related Products Regulations 2016

2. what was the strategy aiming to achieve

 reduce misleading tobacco packaging, making it standardised. discourage people from using tobacco products, encouraging people to give up using tobacco products. Protect young people from the harms of tobacco. Implementing elements of the World Health Organization Framework Convention on Tobacco Control

3.  what theories relate to, or may have informed the

development of this strategy and its implementation

World Health Organization Framework Convention on Tobacco Control

EU Tobacco Products Directive 2015

4.what stakeholder tensions might have existed in the development of the strategy

 Lobbying from the tobacco industry prior to the regulations being implemented.

5. how might this strategy be communicated to different segments of the population to manage public perceptions of risk and to support individual choice

 Locally public health teams did proactive comms to make consumers aware of the changes and the reason for the changes. Comms was also circulated by the government to manufacturers and to retailers to inform them of the change.

6. how was the strategy implemented

 top-down approach - government made the decision and this was communicated downwards.

7.  what was the impact on the public’s health

Smoking rates amongst CYP and adults have decreased in the UK since the introduction of the regulations. However, this reduction cannot be wholly attributed to these regulations, were due to a mixture of tobacco control regulations.

8.  what was the impact on service delivery

more awareness of the harms of tobacco due to increased publicity around the regulations. potentially more pressure on public health teams to provide information to local communities about the changes. also more pressure on stop smoking services to provide support.

2) To improve individual health, improve household, create better safer communities, reduce hospital admission, reduce RTC,

3) Nuffield Ladder, COM B behaviour change model - legislation and regulation. Evidence that low cost alcohol that is high strength is contributing to NHS admissions

4) Threat of job losses from Whiskey manufactures,

5) It was communicated via news and political information and then the price of alcohol increasing.

6) Making alcohol manufactures/retails sell alcohol at a minimum price -

7) Better health outcomes especially those on low income, less alcohol related incidents

8) It highlights the need for more support about alcohol consumption

 Water fluoridation

2.      what was the strategy aiming to achieve

 Reduce dental decay and dental caries, reduce dental health inequalities

3.      what theories relate to, or may have informed the

development of this strategy and its implementation

 Inequalities in dental care result in some populations having less access to care. Lower income households may not prioritise buying dental hygiene products. Tooth extractions caused by decay are the main reason for hospital admissions in children and young people. Water fluoridation schemes have shown a decrease in dental decay in those areas.

4.      what stakeholder tensions might have existed in the development of the strategy

 Individual liberty/choice. It is a policy/intervention imposed on the public rather than a behaviour linked with choice. Other tensions around other unintended consequences of fluoride being added to water supplies. Anti-fluoridation groups protest and try to influence other members of the public.

5.      how might this strategy be communicated to different segments of the population to manage public perceptions of risk and to support individual choice

 Through public health messaging, emphasising the benefits to the population of these schemes. Getting local media outlets on board to help promote the scheme and its benefits. Through dental practices - promotion of the scheme which can link to a conversation about individual dental hygiene practices.

6.      how was the strategy implemented

 Secretary of State is responsible for the decision-making about water fluoridation schemes. They liaise with the local Water companies who implement the safe levels of fluoride into the water supplies. Secretary of State is also responsible for the funding and payment to the water companies.

7.      what was the impact on the public’s health

 Reduced dental decay in children, particularly children with primary teeth. Reduced hospital admissions for decay-related tooth extractions. Increased public awareness of importance of individual dental hygiene habits, aside from funded schemes.

8.      what was the impact on service delivery

Funding allocation for schemes. Water companies require extensive engineering assessment to ensure that the agreed areas for the scheme are receiving the intervention and it's not infiltrating into other areas.

HIOW Infant Feeding Strategy

2.      what was the strategy aiming to achieve

create a positive infant feeding culture, increase healthy and safe feeding practices and ensure infant feeding support is evidence based and timely and contributes to a reduction in health inequalities

3.      what theories relate to, or may have informed the

development of this strategy and its implementation

Behaviour change

systems leadership/collaboration

Top-down approach/

4.      what stakeholder tensions might have existed in the development of the strategy

differing/conflicting stakeholder perspectives - parents perspectives vs service provider perspectives

stakeholder's power and involvement in the strategy (public were consulted but did not participate in creating the strategy actions therefore having that top-down approach, less empowerment)

5.      how might this strategy be communicated to different segments of the population to manage public perceptions of risk and to support individual choice

6.      how was the strategy implemented

Top-down approach. Has not been implemented yet but intends to be implemented by local delivery plans underpinned by the strategy (will be tailored to local populations, resources, processes and systems which vary between areas of the region). Local delivery includes public health teams, maternity and midwifery services, health visiting, children and community services and all orgs working within infant feeding as well as the wider workforce but oversight provided by local boards.

7.      what was the impact on the public’s health

it intends to support increase of breastfeeding rates - first feed and prevalence, increase healthy start uptake, contribute to positive child and maternal health outcomes e.g. reduce childhood obesity, infant infections and hospital admissions, building close infant and parent relationships and reduce infant feeding relation inequalities

8.      what was the impact on service delivery

Increased collaborative working between services working within the field of infant feeding - local infant feeding partnership groups and networks

increased use of data, intelligence and evidence to inform decision making - e.g. how to better target current resources to groups most likely to experience inequalities or not access services

increased service delivery - increasing variability in support offer, means higher workload and the need for increased service capacity, may need more funding

Health Improvement Policy

2.      what was the strategy aiming to achieve:

 Enhance overall health & wellbeing of individuals and communities living in Wakefield.

Promoting healthy lifestyles

Preventing chronic diseases

improving mental health and wellbeing

reducing health inequalities

creating supportive environments

empowering individuals and communities.

3.      what theories relate to, or may have informed the

development of this strategy and its implementation.

NHS Long term Plan

NICE Guidelines

Theory / stages of change

behaviour change models

4.      what stakeholder tensions might have existed in the development of the strategy:

Public Health Vs Economic priorities - balancing population health benefits with economic growth

Short term results Vs Long term outcomes - Political pressures Vs evidence-based learning

Some stakeholders might frame health as a matter of personal choice, while others argue that poverty and education etc play a bigger role

5.      how might this strategy be communicated to different segments of the population to manage public perceptions of risk and to support individual choice:

Tailor messages to audience - Clear, jargon free language, focus on benefits and saving money.

Vulnerable / marginalised groups - culturally sensitive, translated materials, with visuals.

Young people - use social media influencers or interactive content

older adults - emphasize maintaining independence

Stakerholder / partners - use datashowing value for money

6.      how was the strategy implemented:

Strategic planning / coordination

Setting clear objectives - indicators

multi-sector partnerships

targeted interventions / services

community engagement

workforce training

communication campains

monitoring / evaluation

7.      what was the impact on the public’s health:

Improved health behaviours

reduction in health inequalities

better health outcomes

increased community engagement

8.      what was the impact on service delivery:

More preventative, early intervention services

improved access / equity

increased collaboration across other services

2)The Healthy Futures Initiative aimed to reduce the prevalence of lifestyle-related diseases such as obesity, type 2 diabetes, and cardiovascular conditions.

3) Health Belief Model (HBM): highlights the importance of individual perceptions about the severity of health issues and their susceptibility to them, which likely shaped the messaging around the risks of unhealthy lifestyles.

4)Government and Private Sector

5)General public , young people, hard to reach groups businesses

2: reduce air pollution levels across Greater London - Protect vulnerable populations from harmful emissions NO₂, PM2.5.

Achieve World Health Organization air quality guidelines by 2030.

Support climate change goals through sustainable transport and cleaner technologies.

3: Health Belief Model

Ecological Model

Precautionary Principle

Environmental Justice Theory

4: Motoristes / logistics compagnies - Local Authorities - Reisdents

5: targeted public health campaigns

Community engagement

Accessible materials for non-English speakers and neurodivergent populations.

Incentive schemes

Transparency dashboards showing local pollution reductions and health impact improvements.

6: Policy measures: Expansion of Ultra Low Emission Zone, stricter emission standards, school streets, and clean bus routes.

Investment in active travel

Monitoring: Upgraded air quality sensors in boroughs.

Partnerships: Collaboration with NHS, schools, local councils, and environmental charities.

7:Reduced respiratory and cardiovascular conditions, particularly among children and older adults.

Improved life expectancy in highly polluted areas.

Lowered hospital admissions for asthma and COPD.

Greater awareness of pollution-related health issues among the general public.

8: Increased demand on active transport infrastructure

Enhanced cross-sector coordination between health, transport, and planning services.

Improved data integration for air quality and health outcomes.

Challenges for transport/logistics services adjusting to new emissions regulations.