Discussion of Dance For Life Program - Case Study Example

Fit for Purpose: A Case Study Word count: 2169 Page count: 6 Discussion of "Dance for Life" Program The "Art" of Health Promotion Mary Hampshire in Health Development Today (2004) writes about a program called Dance For Life and in this article talks about the importance of community-based plans to either prevent disease or enable people to deal with disease in themselves. The program was started in 1992 by the Bradford Heart Health Strategy Group, a collection of people from housing and health authorities to the Yorkshire Arts group. Their primary aim is said to be to combat the high incidence (30% higher than the national average) of coronary heart disease in Bradford. Nearly a third of the population are under 16 years old and this compelled project director, Cathy Middleton, to establish this program for children in ethnic and economical areas that are often deprived of "good practice" health promotions. The 40 different weekly sessions involved in the program have drawn an initial 1,500 people in the first year to its current 20,000. Most of the people involved are under 18 and almost half come from minority ethnic communities. Classes in Dance For Life include salsa, street dance, modern dance and dance exercise, as well as others. (Dance for Life). The program has only been funded for three years but Middleton has gotten the support of many civic groups and has the program running strong. Their website discusses their objectives in detail, which include their focus on empowering young people to deal with obesity and stress. In addition to these weekly classes, Dance For Life has a professional dance group, Stance, that has workshops in the Bradford District at schools and youth groups. This company of 5 dancers have arrangements that "talk" about social issues including bullying, communication and how they feel "living in their own skin" (Dance for Life). Teachers comments have included: "Children all enjoyed the workshops and were fully engaged throughout" and "Excellent performance - pupils totally absorbed". The kids involved have commented positively as well. The following is an example of the classes offered: 1. Asian Women's Exercise Women only; informal classes run by Dance for Life for Asian women; Thursday mornings at Attock Community Association 2. Belly Dancing @ Cafe West Informal classes run by Dance for Life for children and young people; Thursday evenings at Cafe West, Allerton 3. Breakdance for Children and Young People Informal classes run by Dance for Life for children and young people; YMCA, Little Horton 4. Classes for Children and Young People Informal classes run by Dance for Life for children and young people; various times and locations throughout the Bradford area 5. Contemporary Dance Informal classes run by Dance for Life; Tuesday evenings at Bradford College Using multiple agencies as support has been one of Middleton's primary efforts, and has organizations such as the Health Improvement Fund, the Children's Fund, the Bradford Council and other community service groups included. A common agenda among these groups is disease prevention and health education of the public, especially about non-communicable diseases that have surpassed communicable disease in global mortality (Scriven 2003:2). A new public health agenda in the UK has emerged and building multi-professional understanding and capabilities has become crucial to the success of their programs. Health promotion The whole idea of health promotion was only coined in the 1970's and has loosely been explained as a confluence of "health education, self-care movements, public health, preventative medicine and the women's movement" (Scriven 2003:1). But defining health promotion has brought about many different points of views from egalitarian to radical politics. In the article by Scriven, health promotion is called "the radical militant wing" of public health. There are four types of health promotion (Scriven 2003:6). The primary level focuses all of its energy toward the general public and hopes to prevent disease. The secondary level has individuals and groups where a particular health issue is already occurring as its focus, and is often working with low economic or ethnically challenged people. The third level targets people who are chronically ill or disabled and tries to empower them and cause more functionality. The last, quaternary, level would aim at those who are dealing with terminal stages of disease (Scriven 2003:7). Good in Practice Dance for Life is largely a secondary type of health promotion but has prevention as its larger goal and so involves primary health promotion techniques. The children that are drawn into this program benefit in many ways besides the obvious physical conditioning, or reconditioning, as the case may be. Because of its underlying intentions that deal with issues of obesity, emotional factors and lifestyles within the framework of low income or ethnic minority environments, the program looks to be "good practice" in the field of health promotion. Children are not turned away from the activities because of physical impairments or inabilities. Positive models are put before the children that help to develop their picture of good health and healthy living. Obesity According to BBC reports from 2001-2003, surveys conducted by the Human Nutrition Research Centre at the Royal Victoria Infirmary (RVI) and others found the incidence of obesity in children growing at a startling rate in the 1980's. This occurred despite the improved nutritional factors of lower fat diets. Professor Rugg-Gunn of the RVI in Newcastle states, ". . . children's energy intake did not increase between 1980 and 1990 but their energy output has decreased. In short, they are not doing as much exercise as they should." (BBC 2001) But in a BBC news story 5 years later, it was stated that "the bid to halt rising child obesity by 2010 will fail unless government shows more leadership." Authorities say that there is "good work" on health promotion at local levels but that government leadership needs to offer more guidance. Again levels have risen for obese children from 9.6% in 1995 to 13.7 in 2003 (BBC 2006). The children that are growing up already obese will become adults that develop diabetic conditions and heart disease. Lifestyle changes and behavior issues need to be addressed along with dietary information. Projects such as Dance for Life offer the exercise and motivation to make changes in lifestyles. Diabetes A study on diabetes prevalence in England in 2001 shows several characteristics that emphasis the need to address children and ethnic minorities with health promotion and prevention programs. Ethnic minority groups, Black African/Caribbean, South Asian and "other" groups had a higher "crude" prevalence than White Europeans. It is also shown that women develop diabetes more than men. The total estimate of diabetes in 2001 was 4.4% but self-reported diabetes underestimates "the true burden of diabetes" (Forouhi, et al. 2001) that is being dealt with now and will be in the future. Risk behavior in adolescents Another point to programs such as Dance for Life is to get children that are pre-teens and young teens involved in healthy lifestyles so that they will be less inclined to get involved in risk behaviors, such as smoking, drinking, and drugs. Data from the Research with East London Adolescents Community Health Survey (RELACHS) (Viner, et al. 2001) that sampled 2,789 children ages 11-14 and were 73% non-Caucasian resulted in almost 11% of the children reporting one risk behavior and 3% reporting two risk behaviors (Viner, et al. 2001). The survey also found that the better the family support of these children, the less likely they were to engage in risk behaviors. Overall, there did not seem to be correlation between ethnicity and risk behavior. It just seems that children of any ethnicity are likely to try risk behaviors if they are not otherwise engaged. Economics Fees for classes, workshops and sessions are as low as nothing to small fees for children who engage in them. The funding the program receives defrays costs and allows the staff to offer services for very little to those who need them most (Dance for Life). Reducing self-blame and encouraging personal responsibility among the focus groups (Scriven 2003:11) is an essential component in low income and ethnic minority health promotion. Personal empowerment can be the key to overcoming chronic health issues in the community such as the incidence of heart disease. Acquiring skills that include decision making, personal communications and assertiveness are crucial to self-empowerment (Scriven 2003:11). Very often people in low income areas feel unable to cope or develop a good self image. A program such as Dance for Life provides much of this to these sectors of the city. Strengthening the Initiative Developing strong links to the nursing profession and allied health professionals who already have their own health promotion programs in place would be one way to strengthen the Dance for Life initiative (Scriven 2003:14). When health promotion is coordinated throughout a city's agencies, the attitude of the citizens becomes one that reflects the goals of the promotion, i.e. long distance running for a non-profit organization's annual fundraiser is also sponsored by the health institutions and schools and gets a wider audience and participation. Education is very necessary to self empowerment as the information about disease and also about support systems will show the public realities they may have been previously unaware of and the options they have. But as stated in Debates and Dilemmas in Promoting Health: A Reader, "modern health promotion involves more than simply handing out leaflets and putting up posters" (Sidell 2003:45). Dance for Life is one of the best kinds of initiatives because it is not just a leaflet or poster but a program that interacts with the people most at risk. The participants involved can ask questions and get feedback from the staff, and also find out where to pose more questions or get answers. In addition, the dilemma of "personal risk taking" that is related to many diseases can be dealt with and conjoins the increase in the "self-care" movement that exists today (Sidell, et al. 2003:48). The more community involvement occurs in programs such as Dance for Life, the more funding the program is likely to receive, depending on current political environments, and the more people are encouraged to develop these programs, and the better the health of all involved (Scriven 2003:12) (Sidell, et al. 2003:47). There are many examples of community based programs that became big successes for themselves and for the community as a whole, such as the Young Men's Christian Association (YMCA) that now has facilities throughout the United States, and offers numerous health-related programs for all members. Ethical considerations In an article by Thomas, Saleem and Abraham of the Department of Haematology at Guys' and St. Thomas Hospital in London that screened 135 people of black minority groups on their perception of cancer screening, data shows that there are barriers to their understanding of this issue. Language can create barriers with health professionals, and cultural or religious belief systems, as well as unhelpful health professionals make the problems larger (Thomas, et al. 2005). When a program such as Dance for Life interacts with the local community, often barriers such as the ones described above will begin to break down. Children of ethnic minorities often transfer information to their family members from these programs and also help to make the family feel more comfortable with authority figures and health professionals (Thomas, et al. 2005). The understanding that is needed by authorities and health professionals about religious or cultural customs of these minorities is also aided by the interaction of the children and their families in community based programs. References Childhood obesity soars in UK. 2001. BBC News story. http://news.bbc.co.uk/2/hi/health/1101139.stm. Accessed 2/28/06 Dance for Life. http://www.danceforlife-bradford.org.uk/homepage. Accessed 2/28/06 Forouhi, N., Merrick, D., Goyder, E., Ferguson, B., Abbas, J., Lachowycz, K., Wild, S. 2001. Diabetes prevalence in England, 2001 - estimates from an epidemiological model. Yorkshire and Humber Public Health Observatory. www.ncbi.nlm.nih.gov/entrez/query.fcgiCMD=Display&DB=pubmed. Accessed 2/28/06 Hampshire, M. 2004 Dance for Life. Health Development Today. Dec/Jan. 2004 issue. Katz, J., Perberdy and Douglas. (eds.) Promoting Health, Knowledge and Practice. Palgrave Macmillan. 2nd Ed. http://www.palgrave.com/pdfs/1403934118.pdf. Accessed 2/28/06 Sidell, M., Jones, L., Katz, J., (eds.) 2003 Debates and Dilemmas in Promoting Health: a Reader. Palgrave Macmillan. 2nd Ed. Pp.45-52, 174-180 Scriven, A., (2003) Promoting Health: Perspective, Policies, Principals, Practice. In Promoting Health, Knowledge and Practice. Palgrave Macmillan. 2nd Ed. Pp. 1-14 Thomas, VN., Saleem, T., Abraham, R., 2005. Barriers to effective uptake of cancer screening among black and minority ethnic groups. Department of Haematology. Guys' and St. Thomas Hospital. London, UK. Pp. 562, 564-71 www.ncbi.nlm.nih.gov/entrez/query.fcgiCMD=Display&DB=pubmed. Accessed 2/28/06 Viner, RM, Haines MM, Head JA, Bhui K, Taylor S, Stansfeld SA, Hillier S, Booy R., Variations in associations of health risk behaviors among ethnic minority early adolescents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16387249&query_hl=1&itool=pubmed_docsum Accessed 2/28/06 Warning over child obesity push. 2006. BBC news story. http://news/bbc/co/uk/1/hi/health/4756370.stm. Accessed 2/28/06 Read More