Change4Life and Start4Life

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2 Change4Life and Start4Life Change4Life is a social marketing movement supporting families to eat well, move more and live longer. Since its launch more than 2.7 million people have signed up to Change4Life Start4life aims to help children get the best start in life. The Start4Life Information Service for parents provides /text support to parents and has more than 400k sign-ups

3 The Challenge Five of the top-ten risk factors for the total burden of disease in adults are initiated or shaped in adolescence (smoking, physical activity, overweight, unsafe sex and alcohol use) We still have poorer outcomes for our young people than many other high income nations: Overall the UK ranks 16th in a league table of child wellbeing Teenage pregnancy rates continue to be very high The UK has one of the highest alcohol abuse rates in year olds despite the recent downward trends Information and content about health issues are fragmented and hard to find. Most content is aimed at older audience with a stark gap in information tailored for younger teenagers/tweens Emerging trends in negative behaviours amongst young people - Relationship abuse/consent/impact of online porn on relationships/self-harm

4 The Opportunity Adolescence is key life-stage for influencing behaviour that will preserve life-long health and wellbeing Investing in adolescence is the most effective way to consolidate interventions in early childhood and reduce inequality The World Bank has identified young people successfully transitioning through adolescent as key driver of economic productivity Digital technology has democratised access to information and has the capability to curate and deliver highly personalised content to individuals Young people use digital technology as a core communication tool Presentation title - edit in Header and Footer

5 Gossip Analytics and Content Peer pressure / banter Planning and procuring Cyber bullying Intimidate disclosures Research years is a time of transition and rapid physical and social change Existing Services, Teachers, Influencers and Stakeholders Letter to teacher written in our user research Understand the life of young people Siblings have significance, often sitting in their own segment outside other family Family is important and is often split off from cousins / siblings, showing they provide a different type of support Close friends usually consists of 4-5 people Cousins often provide a big section of the support network for young people (especially lower SEGs) Tweendom: a time when relationships and roles are in constant flux

6 What Young People have told us Health per se is not a top of mind concern; stress and social pressure dominate. Social life is inextricably linked to health for teenagers; they want support for emotional and social aspects of growing up. Need to be spoken to in a language they understand and relate to that isn t directly about health. 2/3 of young people create and share visual content; constant connection increases speed and intensity of relationships and creates anxiety Young people need to be entertained and immersed in an experience; they want activity to be personalised to give them a real sense of ownership Young people trust peer led information and support but will not seek help when they would benefit from it. They are curious about these topics but find it hard to talk about these issues. Young people have role models and people they admire that they follow closely.

7 Innovative strategy built on latest evidence around relationship between risky behaviour and resilience Desk research Academics Previous work Young people Extensive desk research (over 700 articles reviewed including Cochrane Reviews, NICE and WHO Prevention guidelines) Interviews with academics, industry experts, practioners and NGOs working in the field (e.g. Brook, Childline) Behaviour change theory on addressing exploratory behaviours in the youth audience (Gibbons and Gerrard: The Prototype Willingness Model of adolescent risk behaviour) Evidence from resilience theory (Daniel and Wassells s Domains of Resilience, Aumman and Hart, Resilient Therapy Strategies) and peer-led approaches (ASSIST programme). Links with KS3 and KS4 PSHE curriculum Evaluating impact of other campaigns (both UK and international) directly related to health, but also incorporating learnings from work directed at the audience (e.g. Home Office campaigns) Test-learn-refine approach: We conducted a year of pilot to test a range of approaches and channels for triggering conversation across our topics. We had 5 million views of our content across our pilot activity in by young people. Co-created current approach with over 1,500 young people Qualitative research with young people, parents, teachers, youth & social workers

8 Addressing risky behaviors and core health topics by building resilience via the topics that matter to this audience. OGD Issues Online safety Relationships Resilience Friendships Teen road safety Violence Health Topics School pressure Mental health Risky behaviours Smoking, drinking, drugs, sexual health Exercise Confidence Employment Awkward conversations HPV Vaccine Diet Family pressure Crime Bullying Future aspiration Teenage relationship abuse Teen issues Identify sense of self Sexual exploitation Health Issues

9 Building Resilience: Conversations help create resilient young people and impact behaviour Information only Awareness Didactic don t work Youth-led Specific conversations Pre-onset lifeskills So, we need to: - Stimulate thought: Get them thinking and seeing situations from new angles - Rehearse scenarios: in a safe space and experience outcomes of action - Solidify intent: Highlight there are others who think in the same way (social norms) - Build resilience: Through providing skills to understand and manage risk work

10 The Idea To inspire and empower young people from the age of 11 upwards to make positive choices for their health To build a social movement that will encourage mass participation of young people, parents, teachers, youth workers and carers both on and off-line To create a world-class digital programme and campaign for youth health, owned by young people and supported by a coalition of partners Presentation title - edit in Header and Footer

11 A Model to Reduce Uptake BUILDING RESILIENCE 10 Conversations to have before you are 16 Activities that help young people build protective assets LEARN Content that provides factual information, mythbust and highlight positive social norms SHARE Model, trigger and guide the influential peer conversations PREPARE Play, create, practice and share language, tools and techniques for scenarios REDUCING UPTAKE: Preparing and equipping young people (11-16 year olds) with resilience skills to make healthier lifestyle choices BELONG Mass peer social movement that helps young people draw strength and new positive social norms Presentation title - edit in Header and Footer CHANGING SOCIAL NORMS

12 Our content approach Fits with finding the sweet spot between what the brand and audience care about Drinking Drugs Smoking Sexual Health BRAND TOPICS What the Brand wants to talk about Engaging Relevant Content AUDIENCE INTERESTS What the audience care about Body Confidence Stress (school pressure, bullying) Relationships (all aspects) Family Difficulties A further consideration: Not all the topics will be strong enough to elicit a response, or act as a prompt to trigger action when used in a broadcast environment.

13 The 4.01 show Public health first: a weekly YouTube show which encourages young people to talk about health issues. To date the show has received almost 2m Views Evaluation has shown that the show has helped equip young people with confidence to vocalise negative attitudes towards risky behaviors and equipped with strategies for saying no. hey guyz :) It really helped my bestfriend. I'm very happy for her coz after we talked she then told her mum about her prob and thank God her mum and dad wasn't really that mad :) and they're now supporting her. :) Thank you so much Carrie, yesterday i was with some friends and they started smoking and i was just about to ask them one but then i remembered this video and i decided i was never going to smoke and that's ok, i love you and really see you as a role model, thank you

14 Equipping young people with confidence, skills to deal with anything life throws at them. We re about: Active choices Open and honest conversations Facing adversity positively Collective strength Presentation title - edit in Header and Footer

15 An engaging web-hub Use a mix of Created, Commercial and Charity content Based around top-ten conversations Youth Editorial Board Range of interactive games e.g.: - Up to You - Relationsticks - Made Up Opportunities for sharing and personalisation Extensively tested with over 1000 young people (11-16 year olds) across 9 local authorities. Showcasing content and activity across the site strong indications that young people were more prepared directly (e.g. ability to say no) through the activities and content that we provide on the website In the first 2 days I went back to the site again and again. It was really interesting and fun - Female, 14

16 Rise Above influences young people in various ways Multiple perspectives Rehearsing Scenarios Building confidence Stimulating thought Encourages them to see situations from new angles and other people s points of view An opportunity to experience situations, and the outcomes of decisions made, in a safe environment Confirming that their intentions are right and that others think the same way Brings issues into focus and encourages reflection Now I know what I d do if someone offered me cigarettes Female, 13, Birmingham It made me feel happier...it s good to know you are not the only person who feels this way - Isabella, 12

17 Rolling out Rise Above Objectives Building a community Driving a conversation Yr1 our AtL comms task will be to drive mass awareness of Rise Above amongst 11-16y/o Building a safe and trusted community within which teens can make active positive choices through collective strength Encouraging and fuelling active participation in RA to best equip teens with the tools to have the open and honest conversations in the real world Active Engagement Engaging with the RA site and core content (initial and repeat) Active Participation 1. Sharing RA content 2. Contributing RA content

18 Promoting Rise Above Implementing a two-phase approach, initially focusing on Youth through peer led communications, followed with increased focus on parents and partners. Youth Youth, Parents and Partners Rise Above Topic Teen Pressure Drinking, smoking & drugs Christmas Stress Drinking, smoking & drugs Health Bodies Puberty conversations Valentine s Issues Relationship conversations Drinking, smoking & drugs Anxiety Vloggers PR /Media Local Authority, Parent and Partner activities Digital media Search and display paid media Ad hoc local authority support and awareness

19 Channel Measures Intermediate Measures Desired Response Key Question EXPOSURE PARTICIPATION OUTCOMES SOCIAL IMPACT Reach them where they are How we will evaluate it? PHE will work with academics to assess the effectiveness of the programme. Make information easily available and accessible Boost resilience skills Popularise positive norms Undermine risk-takers Delay and prevent uptake of behaviours Has our audience been exposed to Rise Above? Have young people engaged with our activity? Has RISE ABOVE equipped young people with skills to negotiate risk situations? Has RISE ABOVE re-balanced beliefs about the prevalence of risk-taking? Has RISE ABOVE undermined positive perceptions of risk-takers? Are fewer people practising risky behaviours? I ve heard about Rise Above Rise Above speaks about issues that affect me, I want to find out more I feel confident saying no to the offer of X Most of the people I know don t take drugs, sex, smoke or drink I don t think smokers, binge drinkers, drugtakers are cool I don t smoke or take drugs, and I drink and have sex responsibly Brand Awareness and Favourability Hub (and event) visits Sign-ups, activity completions, Claimed Behaviour Survey Responses & Rise Above social mentions Positive Conversation SOV Prompted Recall Unprompted Recall Impressions CTRs Origin of Site Traffic Online Mentions Search volumes Press Mentions Web visits Roadshow attendees Video views Hub registrations Length of visit Content Likes Content quality (site survey) Activity sign-ups Activity completions Subscription length Shares of content Return visits Social media followers Buzz Monitoring Academic work with Gibbons and Gerrard Lifetracker survey Smoking, Drinking, Drug Use (NHS Info Centre) Under-18 conception rates STI rates Sex attitudes & behaviours (NATSAL)