PACO IIIAruba 5 – 7 June 2013

What can we learn from the Belgian case?

Prof. em. Jan VinckHasselt University (Belgium)Expert Committee Viasano

What can we learn from the Belgian case?

• Adaptations are necessary at regional and local level

• Is the program effective?

LiègePepinster

Rochefort

Comines-Warneton MouscronFlobecq

Schilde

Dilsen-Stokkem

Aarschot

Jette

Marche- en-FamenneMons

Viasano by EPODE in Belgium16 cities, 655 275 inhabitants

Braine-le-Comte

WoluweSt Pierre

Huldenberg

Hasselt

Belgium

Complex country: at crossing of latin and nordic Europe a.o.– 3 regions with own goverment, political traditions– 3 languages– different organization of health promotion

Een gezonde levensstijl voor de inwoners van

jouw gemeente

LiègePepinster

Rochefort

Comines-Warneton MouscronFlobecq

Schilde

Dilsen-Stokkem

Aarschot

Jette

Marche- en-FamenneMons

Viasano by EPODE in Belgium16 cities, 655 275 inhabitants

Braine-le-Comte

WoluweSt Pierre

Huldenberg

Hasselt

Viasano characteristics

• 16 cities in 3 regions• 100% private sponsoring• Overall Epode methodology• Dual approach (social marketing &

environmental)

Example of environmental approach:

Esseghem

9

Bruxelles, Ville-Région en SantéLe diagnostic en marchant

• Jette• Parc de logements sociaux• Immeubles de grand gabarit (blocs)• Forte densité de population

10

Bruxelles, Ville-Région en SantéLe déroulement

11

Bruxelles, Ville-Région en SantéLe déroulement: nouveau projet

12

Bruxelles, Ville-Région en SantéLe site d’Esseghem: une fête

13

Bruxelles, Ville-Région en SantéLe déroulement: tonnelles

14

Bruxelles, Ville-Région en Santé Le site d’Esseghem: les graffeurs

15

Bruxelles, Ville-Région en Santé Le site d’Esseghem: atelier wok

What can we learn from the Belgian case?

• Adaptations are necessary at regional and local level

• Is the program effective?

Regional adaptations

• Political tradition: decision regional or communal?

• Health promotion system: strongly organized?• Language: simple translation is not enough

Local adaptation: role of local program manager (LPM)

Adaptation of interventions to local situation and population

- identify relevant populations/subgroups - identify relevant actors (control relevant aspects of

environment)- mobilize these actors- inspire local action- organize collaboration

Is the program effective?

• Evaluation study in 2 towns in French Community (Mouscron and Marche)

• BMI of all school going children ages 3-4 and 5-6– Measured by trained nurses– Measurement points 2007 and 2010– N= 1300 and 1484

• Control population: all other school children of French Community of same age at same periods – N= 76864 and 79602

Results (1) evolution overweight: in pilot towns

9.5% 7.4% change in pilot towns significantly greater than in control population (p=0.047)

Results (2) evolution overweight plus obesity: in pilot towns

13.5% 11.2% change in pilot towns significantly greater than in control population (p=0.046)

Evolution in obesity alone: non-significant trend for greater decrease in pilot towns

Conclusion

• Implementation requires carefull adaptation of the program to the local situation

• Results of evaluation study are very encouraging: effect even after 3 years

Thank you