Chronic diseases and health promotion

Part Four - Taking action: essential steps for success

Chapter One: Providing a unifying framework - the role of government

Advocacy initiatives. Spotlight: England

As reviewed in Part Three, advocacy initiatives can support the initiation of national policies for chronic disease prevention. Advocacy includes a range of strategies for communicating risk, increasing motivation to change, and disseminating ideas through communities and societies.

Implementation steps and suggested milestones

STEP 1 CORE: Opinion leaders are identified and engaged systematically to inform others about the growing burden of chronic diseases, the existence of effective interventions, and the comprehensive response that is needed.

STEP 2 EXPANDED: Advocacy initiatives are strengthened to promote risk factor reduction among target populations.

STEP 3 DESIRABLE: Comprehensive and integrated advocacy initiatives are implemented and incorporate multiple communication channels.

Spotlight: Promoting fruit and vegetable intake in England

Current average consumption of fruit and vegetables in the United Kingdom is around three portions per day. The 5 A DAY Programme aims to increase this to the recommended daily level of around five portions, thereby contributing to the achievement of national targets on reducing mortality rates from cardiovascular disease and cancer, halting the year-on-year rise in obesity among children, and reducing inequalities in life expectancy.

The programme consists of several areas of work underpinned by an evaluation and monitoring programme. The 5 A DAY communications programme provides information and advice for consumers through television and radio advertising, leaflets, posters, booklets, a web site and magazine adverts and articles, and a 5 A DAY logo has been developed. Local and national partners include industry, government departments and other agencies. The School Fruit and Vegetable Scheme has led to nearly 2 million children aged four to six years receiving a free piece of fruit or vegetable each school day. A survey in October 2003 found that over a quarter of children and their families reported that they were eating more fruit at home after joining the scheme, including in lower socioeconomic groups. Research from December 2004 indicated that 37% of people claimed to have eaten “a lot more” or “a little more” fruit and vegetables over the previous 12 months. There was a year-on-year increase in awareness of the 5 A DAY message from 43% in October 2000 to 58% in October 2004.