Co-producing with the local community an action plan to reduce consumption of high fat, sugar and salt foods in Newham.

伦敦纽汉区2型糖尿病和超重/肥胖人群的发病率很高。这些情况给全科医生和医院服务造成了沉重负担，也与Covid-19导致的健康结果恶化有关。纽汉是一个种族多元化的城市，73%的人口来自少数民族背景。该区的贫困程度也很高；与英格兰其他地区相比，纽汉位于最贫困地区的20%之列。虽然目前有预防2型糖尿病和鼓励减肥的服务，但这些都是国家制定的项目，不太适合低收入、种族多样化的人群；这意味着这些项目实际上可能会扩大像纽汉这样的地区的不平等。我们建议与当地居民一起开展食品冠军干预，其中食品冠军将代表人民采取行动改善纽汉的饮食。共同制作干预措施将确保任何拟议的活动都为当地居民所接受，并解决他们认为与他们有关的问题。建议的方法：系统方法旨在考虑对行为（如饮食）的众多影响。我们将采用一种系统的方法，与当地居民合作，制定工作描述、培训和资源，以减少高脂肪、糖和盐食品的消费。1)第一阶段将涉及快速审查已发表的文献和报告，这些文献和报告涉及不同种族的低收入成年人口。这次审查将提供信息，说明以前的粮食冠军计划在哪些方面取得了成效。这也将使我们能够为干预创建一个初步的变化理论模型，该模型概述了食品冠军干预如何改善纽汉居民的饮食。2)在进行审查的同时，我们将绘制一张我们认为参与纽汉食品生产、销售和消费的所有人的地图，即食品系统的利益相关者地图。整个纽汉的总体地图将被构建，当地居民将有机会编辑它，为纽汉的8个官方社区创建8个独立的地图。2)利益相关者地图将用于招募10个小组的人员，旨在实现种族，性别和年龄的适当平衡。两个小组将由从总地图中确定的利益相关者中邀请的人员组成。其他八个小组将由来自八个社区的人士和每个地区的相关利益相关者组成。10个小组每组将参加2个讲习班。在研讨会期间，参与者将被要求画出他们认为纽汉市不良饮食的原因和后果的地图。在这个研讨会之后，研究者将构建一个系统图，显示在研讨会1中确定的原因和后果，以及这些因素是否相关。在工作坊2期间，参与者将更新这个系统地图，直到他们觉得它是准确的，然后使用这个地图来确定在纽汉采取行动改善饮食的领域。体验促进者将指导参与者完成整个过程。3)将成立一个干预发展小组，由社区成员、研究团队、纽汉的公共卫生团队和负责提供干预的团队组成。将根据研讨会的调查结果和建议的可操作领域构建干预措施的最终变革理论模型，该模型将概述粮食冠军将采取行动的因素。干预措施的内容将在社区成员和提供粮食冠军计划的人员同意后最终确定。4)将编制培训手册草案和任何其他必要资源。

The London Borough of Newham has high levels of Type 2 diabetes and people living with overweight/obesity. These conditions cause a high burden on general practice and hospital services, and are also associated with worse health outcomes from Covid-19. Newham is ethnically diverse with 73% of its population coming from an ethnic minority background. Levels of deprivation are also high in the borough; when ranked against other areas in England, Newham is in the 20% most deprived areas. Although there are existing services to prevent Type 2 diabetes and encourage weight-loss, these are nationally devised programmes that are not well-suited for this low-income, ethnically diverse population; this means that these programmes may actually be widening inequalities in an area like Newham. We propose to develop a Food Champions intervention with the local population, where a Food Champion will act to improve Newham's diet on behalf of the population. Co-producing the intervention will ensure that any proposed activities are acceptable to the local population and are addressing issues that they feel are relevant to them. Proposed methods: Systems approaches aim to take account of the multitude of influences on a behaviour such as diet. We will use a systems approach and work with the local population to develop the job description, training and resources needed for a local Food Champions programme to reduce the consumption of high fat, sugar and salt foods. 1) The first stage will involve a rapid review of published literature and reports on Food Champion programmes with ethnically diverse, low-income adult populations. This review will provide information on what aspects of previous Food Champion programmes have worked. This will also allow us to create a preliminary Theory of Change model for the intervention, which outlines how a Food Champions intervention could improve the diet of Newham residents. 2) Whilst the review is being conducted we will draw a map of all the people we believe are involved in producing, selling and consuming food in Newham - known as a stakeholder map of the food system. A general map for the whole of Newham will be constructed and local residents will have the opportunity to edit this to create eight separate maps for the eight official Community Neighbourhoods in Newham.2) The stakeholder maps will be used to recruit people to ten groups which will aim to have an appropriate balance of ethnicities, genders and ages. Two groups will consist of people invited from the stakeholders identified in the general map. The other eight groups will be consist of people invited from the eight Community Neighbourhoods and any relevant stakeholders from each area. Each of the ten groups will attend 2 workshops.During the workshop 1, participants will be asked to draw maps of what they perceive as the causes and consequences of poor diet in Newham. After this workshop, researchers will construct a systems diagram showing the causes and consequences identified in workshop 1 and whether the factors are related. During workshop 2, participants will update this systems map until they feel it is accurate, then use this map to identify areas for action to improve diet in Newham. An experience facilitator will guide the participants through the process.3) An intervention development group will be set up consisting of community members, the research team, the public health team at Newham and the team that would be responsible for delivering the intervention. A final Theory of Change model for the intervention will be constructed using the findings and suggested actionable areas from the workshops which will outline which factors the Food Champions will act on. The content of the intervention is will be final when agreed by the community members and those who will deliver the Food Champions programme. 4) Draft training manuals and any other necessary resources will be developed.