Population surveys can provide us with valuable information on healthy behaviours, including the influence of education, access to resources, and the availability of safe spaces for physical activity.
Understanding how these behaviours play out on a local level is crucial to develop effective policies and interventions which that empower and support the needs of the local population.
As no known local evidence from Richmond residents exists, Healthwatch Richmond, was commissioned by Richmond Council’s Public Health Division to create a study to investigate the factors influencing healthy living in the community. The study aimed to uncover the needs, barriers, motivations, and influences related to healthy eating, physical activity, alcohol consumption, and smoking cessation among Richmond residents.
Healthwatch is your health and social care champion. If you use GPs and hospitals, dentists, pharmacies, care homes or other support services, we want to hear about your experiences. We use your feedback to better understand the challenges facing the NHS and other care providers nationally, to make sure your experiences improve health and care services for everyone. We can also help you to get the information and advice and you need to make the right decisions for you and to get the support you deserve.
Wherever you live in England, you’ll have a local Healthwatch. Part of our role in understanding people’s experience is also to conduct research, such as this research project. This type of work is important to us because the findings of this study will influence the healthy lifestyle offer and public health campaigns to support good health and reduce ill-health in the community we support.
In this study we focused on demographic groups at higher risk and aimed to identify the extent to which these factors varied across different localities in the Borough of Richmond.
To gather data, we designed a self-administered survey with open-ended questions to allow residents to express their views freely. The survey was distributed through various channels, including hard copies distributed during outreach sessions, engagement in public areas, and postal distribution. Additionally, online survey links were shared via social media and GP text messaging services to residents' phones.
The distribution of the survey was strategically carried out using purposeful sampling in areas with higher levels of deprivation and populations at risk. With this approach we aimed to capture a diverse range of perspectives and between May 2022 and July 2022, we received a total of 815 responses.
To delve deeper into the survey findings and to understand the interventions that could be designed from the findings, we also conducted focus groups. These groups involved 22 survey respondents and representatives from the Council's Public Health Division.
By utilising a combination of methods, including surveys and focus groups, we were able to collect robust qualitative data, ensuring a thorough exploration of residents' experiences and insights.
Surprisingly, our research revealed that healthy living needs in Richmond were not solely determined by locality. In fact, the findings demonstrated remarkable consistency across the borough, with residents experiencing similar influences and barriers regardless of their location.
Although collecting full postcode-level data could provide more detailed insights in this type of research, it presents challenges due to the complexity and large number of postcodes in areas like Richmond. Nonetheless, the study highlighted the residents' strong desire for local support and services, even when locality itself wasn't the driving force behind differences.
Among the lifestyle factors examined, healthy eating emerged as the area where individuals had made the most behavioural changes in the past. Participants expressed their desire to maintain and improve their current health in order to age healthily, achieve weight loss and improved appearance. Although many residents utilised multiple sources of information, such as social media and blogs, professional support was identified as a key influencer for improving eating habit alongside motivation from friends and family.
Despite Richmond being perceived as a relatively affluent borough, many participants had concerns about the expense of a healthy diet and emphasised the necessity of more reasonably priced groceries, and better access to healthy food in their local area to improve their diet.
I don't have enough money to change my behaviour. I have just enough to get some cheap fast food. That's all I can afford, it's all I can get. If I earned more or if healthier food was cheaper, I would consider it.
The survey revealed a strong desire among Richmond residents to engage in physical activity. Residents were largely motivated by improving general health, enhancing physical appearance, and healthy aging.
To be healthier so in the long run I don't depend on others to care for me.
However, many participants perceived physical activity as an expensive and structured endeavour, often requiring gym memberships or classes. There was a clear demand for affordable council-run facilities and activities, with an emphasis on availability and accessibility outside of working hours. Social factors also played a role, highlighting the importance of support from friends and family but also using physical activity as an opportunity to socialise.
In the study, parents, particularly women, made it evident that the availability of childcare services at exercise facilities would greatly impact their motivation to engage in physical activity.
While over one-third of residents in our study reported consuming more than 14 units of alcohol per week, only 17.5% expressed intentions to change their behaviour. Health reasons emerged as the primary motivator for those considering reducing their alcohol intake. Moreover, greater awareness of the health risks associated with alcohol and the benefits of moderation was identified as a key factor in prompting individuals to modify their drinking habits.
However, residents told us that social settings and pressures, along with limited availability of alcohol-free alternatives had a big influence on their behaviour to continue to consume alcohol. Therefore several participants emphasised the need for better education on alcohol risks and increased access to alcohol-free options.
It would be great if more brands could advertise lower alcohol content or zero alcohol content - there’s not many adult alcohol-free options at pubs and restaurants.
The majority of respondents reported being non-smokers. However, among those who expressed an interest in modifying their smoking habits or quitting altogether, health concerns and influence from their family and social circles emerged as the primary motivating factors. Nevertheless, overcoming the habitual nature of smoking and dealing with intense cravings posed considerable challenges for them.
Former smokers who had successfully quit emphasised the effectiveness of medication or professional help in managing cravings. Interestingly, current smokers seemed to be less informed about the potential effectiveness of these interventions.
As with all the behaviours examined in this study, it was apparent that social support and motivation from social networks played a pivotal role in the successful cessation of smoking.
During the course of this study, it became evident that promoting healthy living and reducing lifestyle-related illnesses in Richmond requires a collaborative partnership involving various stakeholders. This could range from businesses providing alcohol-free alternatives and affordable groceries to professionals advocating for healthier lifestyles, or simply the influential support of friends and family.
The insights gained from this study provide a solid foundation for individuals, organisations, and public bodies to support healthier living in the community. By addressing the barriers we have identified and leveraging support from different sectors, Richmond can empower its residents to make positive lifestyle changes. Every individual or organisation is a stakeholder, and has a role to play in fostering a healthier future for all in Richmond!
Read the full report.