HENRY

Henry Healthy Families: Right from the Start programme has the strongest evidence base of any national early years child obesity prevention programme in the UK and nearly 10,000 families across England and Wales have now benefited from it.

Building relationships based on trust and respect and doing things in partnership with families rather than to them is central to everything we do. Our strength-based and solution-focused approach helps parents give their children the best start in life by focusing on factors known to be associated with later health and wellbeing. These are:

• Breastfeeding
• Parenting skills
• Emotional wellbeing
• Eating patterns and behaviours – i.e. how we eat, not what
• Healthy eating
• Physical activity

Extensive independent evaluation and peer-reviewed research studies overwhelmingly demonstrate the sustained positive impact HENRY interventions have on whole-family lifestyle, health, and emotional well-being. These include:

• More responsive parenting and increased parenting efficacy
• Higher quality parent-child interactions
• Healthier eating for the whole family – more fresh fruit and vegetables, fewer cakes, biscuits and sweets
• Positive changes to family meals – eating home-cooked food together more often, fewer take-aways
• More sociable mealtimes, with less eating in front of the television
• Children who enjoy active play and learning
• Young children who are more able to manage their feelings and behaviour – and so start school emotionally prepared and ready to learn

HENRY has the strongest evidence base of any national healthy start initiative in the UK with ‘statistically significant’ sustained changes in parenting, diet, physical activity, emotional wellbeing and lifestyle habits.

Following a rigorous process, the Early Intervention Foundation awarded HENRY the maximum possible effectiveness score for interventions without a published Randomised Controlled Trial (RCT).

Rooted in best available research about risk and protective factors for future health

HENRY is an innovative intervention to promote a healthy start in life and lay the foundations for a healthier future by focusing on babies and children aged 0-5 and their families. It was originally developed in response to an identified gap: for a practical intervention to deliver the evidence-based messages contained in Professor Mary Rudolf’s report commissioned by the Department of Health in 2009, Tackling obesity through the healthy child programme: a framework for action. Now, it is applicable much more widely than obesity prevention.

The HENRY intervention addresses the research evidence on risk and protective factors for child obesity and a healthy start more widely – including oral health, breastfeeding and school readiness. It adopts a holistic approach which brings together these key factors, focusing on:

• parenting
• family lifestyle habits
• nutrition
• activity
• emotional wellbeing

This approach is multi-layered and brings together:

• workforce development: equipping health and early years practitioners with the skills, knowledge and confidence to tackle a range of sensitive lifestyle issues and enable them to make the most of every contact with families
• preventive parent programmes and subject-specific workshops
• targeted treatment programmes for families with children who need specialist support
• parent-led peer support schemes to promote a healthy family lifestyle with local communities

Evaluation of the HENRY programme

HENRY has the strongest evidence base currently available for any UK early intervention programme designed to support a healthy start. Professor Mary Rudolf, paediatrician and expert in child growth, is HENRY’s academic adviser and supports the programme’s ongoing development and evaluation. Long term academic partnerships have enabled robust evaluation and contributed to research knowledge and understanding about successful interventions to tackle lifestyle issues in children. The HENRY programme is now proceeding to Randomised Control Trial (RCT).

Peer-reviewed and published evidence using validated measures shows that HENRY works.

Specifically, it has demonstrated that:

• Families participating in the HENRY programme make statistically significant improvements to family lifestyle and parenting efficacy which are sustained over time (details below)
• Brief HENRY training has a sustained impact on practitioners’ professional and personal lives
• HENRY training leads to improvement in nutritional policy and practice at Children’s Centres

Read more about academic evaluation of HENRY

Family lifestyle changes

Statistically significant lifestyle changes made and sustained by families who joined a HENRY programme found by Willis et al (2014 and 2016) include:

• increased frequency of happiness and decreased frequency of stress
• increased parenting self-efficacy
• increased consumption of fruit and vegetables and water
• decreased consumption of energy-dense food and sugar-sweetened drinks
• decreased frequency of TV meals and increased frequency of family meal times
• increased family physical activity

Read more about HENRY’s outcomes and impact

Replication and system readiness

HENRY is currently commissioned in around 35 local authority areas. HENRY has embedded evaluation and delivery processes in place to ensure programme fidelity and outcomes:

1. 1.Intervention specificity: target group, outcomes, components and theoretical underpinning are clearly articulated and a detailed manual supports programme delivery
2. 2.Quality assurance: practitioners receive initial training and ongoing supervision to equip them with the skills, knowledge and confidence to deliver the programme and are authorised against specified criteria
3. 3.Evaluation of impact: participating parents are asked to complete baseline, completion and follow-up questionnaires which incorporate validated instruments used successfully in previous HENRY evaluations and adapted for community settings.These are:

• 5-item Parenting Self-Agency Measure
• Hammond’s Food Frequency Questionnaire
• Golan’s Family Eating and Activity Habits questionnaire

Incorporates evidence-based practices

HENRY was developed by Professor Mary Rudolf and Candida Hunt, parenting educator and behaviour change specialist. The HENRY approach to supporting families to change entrenched lifestyle and eating habits incorporates proven models of behaviour change:

• Family Partnership Model
  Emphasises the importance of the parent–practitioner relationship and integrating parents’ expertise with that of helpers. It is associated with positive outcomes including improvements in family relationships, and children’s development, behaviour and emotional functioning
• Strengths-based, solution-focused support
  Based on highlighting strengths and identifying solutions, and widely used in clinical settings (in the form of solution-focused brief therapy), with positive treatment effects
• Motivational interviewing
  Person-centred collaborative form of guiding to elicit and strengthen motivation for change