Interim evaluation of an integrated approach to improving health and wellbeing in County Durham, UK

Background:
The County Durham Wellbeing for Life (WFL) service was
developed in recognition that the previous ‘silo’ approach to
provision of single-issue lifestyle services had made little
impact on inequalities. It involves targeting the most
disadvantaged communities locally, as well as specialist
populations at increased risk of poor health. The model
draws on evidence relating to the clustering of unhealthy
behaviours, coupled with calls for behaviour change to be
addressed in a more integrated and holistic manner. The
service launched on 1st April 2015 and this paper reports
interim findings from the academic evaluation.

Methods:
The impact of the WFL service is being evaluated via secondary
analysis of routinely collected monitoring data, which includes
EQ-5DTM and the short Warwick Edinburgh Mental Wellbeing
Scale (SWEMWBS). Data have been analysed descriptively to
examine key characteristics of the WFL user population
(n = 1345). Appropriate statistical analyses have been performed
to assess changes amongst those with data available at
pre- and post-intervention periods (n = 224).

Results:
WFL users are predominantly female (73.4%), white British
(97.6%) and living in the least affluent areas (80.4%). Mean
BMI at baseline was 32.9kg/m2 (s.d. 7.7). Pre/post analysis of
the intervention data revealed significant improvements across
all outcome measures. These were: BMI, physical activity,
alcohol intake, self-efficacy, self-rated health, quality of life and
mental wellbeing. Furthermore, the largest changes were
observed in those with the least positive results at baseline.

Conclusions:
The interim evaluation findings are being used to inform
commissioning decisions and future WFL service delivery in
County Durham. They also add to the evidence base around
complex, community-based interventions that aim to tackle
multiple health-related behaviours using an integrated wellbeing
approach.

Key messages:
An integrated wellbeing approach can be used to reach those
living in disadvantaged areas
Improvements in health, quality of life and wellbeing were
observed amongst service users.