Yhunger: healthy living skills for at-risk young people

Sydney Local Health District Quality Award winner – 2014

The Yhunger program is a healthy eating and physical activity capacity building program for the youth sector, particularly specialist youth homelessness services.

The program has developed youth-friendly food and physical activity resources (cookbooks, games, fact sheets and checklists).  Training workshops for youth services are offered on the integration of these resources into their service provision and policies.

Youth workers use Yhunger’s ‘learning by doing’ approach to provide interactive and safe opportunities for young people to experience and practise healthy eating and physical activity skills at their services.

The Yhunger program is managed from Youthblock Youth Health Service in Sydney Local Health District (SLHD) and works in partnerships with Yfoundations, Settlement Services International, South Western Sydney LHD and the NSW Refugee Health Service, South Eastern Sydney LHD, Northern Sydney LHD, Western Sydney LHD, Northern NSW LHD and local councils.

Aim

To help young people aged between 12 to 25 years old who are experiencing, or at risk of, homelessness and who use youth health and community services to develop skills in healthy eating and physical activity.

Benefits

  • Improve the development of life skills and the health of young people experiencing, or at risk, of homelessness
  • Youth workers have youth friendly resources and skills to engage young people through experiential ‘learning by doing’ approaches to healthy eating and physical activity.
  • Youth workers, and thus youth services, have the resources and skills needed to prepare, cook, provide and store healthy food and drinks.
  • Youth services have additional skills to develop and implement policies and practices in their services to assist young people increase their living skills in healthy eating and physical activity.
  • Youth settlement services, refugee health and educators have access to inclusive resources on healthy eating and physical activity to offer young people from culturally and linguistically diverse backgrounds.

Project status

Key dates

  • July 2013 - Project start date
  • 2014 - Winner of Sydney Local Health District (SLHD) 2014 Quality Award, 'Patients as Partners' category
  • June 2015 - Publication of Tabletalk and Brainfood
  • July 2015 - Pilot training programs. First pilot workshop held in Lismore.
  • 2018 - Youth settlement services, refugee health and education providers
  • November 2019 - Evaluation started

Project status

Sustained – The project has been implemented, is sustained in standard business.

Background

In 2016-17, New South Wales (NSW) had just over 5,000 children and young people (aged 12 to 18 years) presented on their own to a homelessness service to seek support and/or a place to stay.1 Young people who are homeless or at risk of homelessness often have experienced disrupted education, poverty, and family trauma and/or breakdown.2

At-risk young people need assistance finding accommodation, income support, and employment, and/or to continue training or education from youth services. Living skills, including how to prepare healthy and affordable food, are important for supporting the young person’s transition to independence, stability and wellbeing.

Young people from refugee and asylum seeking backgrounds experience similar problems, and also need community assistance as they resettle in Australia.3 From 2013-14 to 2017-18, 6,618 young people (aged 12-24 years) were settled in NSW on Humanitarian Visas, with the majority resettling in Sydney.4 For refugee and asylum seeking youth, food and nutrition issues can be complex due to resettlement issues, disruption to education, cross cultural and intergenerational differences, limited finances, trauma and unfamiliarity with the local food supply.5

Research findings indicate that young people who received support, including the development of independent living skills when leaving care and/or supported accommodation, were more likely to complete compulsory education, be currently employed and living independently, and less likely to become young parents .6

Other studies on the effectiveness of such programs to improve health and social functioning have identified strong relationships between youth workers and young people, participation, flexibility, and appropriate education and support to acquire instrumental living skills as essential characteristics to those outcomes.7

The Yhunger program has been informed by needs assessment research with fifty young people using eleven youth homelessness services in central and south western Sydney, and with managers and staff at those services.8,9

The needs assessment found:

  • more than two thirds of young people interviewed experienced food insecurity, with inadequate intakes of vegetables, fruit, dairy products, and bread and cereals
  • youth services staff believed their services could play a greater role in helping the young people they assisted to develop healthy eating skills.

Yhunger’s experiential 'learning by doing' approach is particularly suitable for diverse young people with disrupted education and/or low literacy levels.10 Young people from refugee and migrant backgrounds often face additional barriers (such as cultural norms and expectations, limited English proficiency, and discrimination) to participate in mainstream programs. Programs need to be responsive to these challenges for inclusivity.11

Implementation

  • As of March 2020, 25 workshops with 303 participants from 153 services have been held. Workshop attendees receive a USB with Yhunger resources, including Tabletalk (resource manual), Brainfood (fact sheets for young people) and the two cookbooks.
  • The program is designed for flexible application, to accommodate the wide range of service models and activity in youth services. The Yhunger resources do not prescribe a core set or order of activities: youth workers are encouraged to select activities, recipes and topics for discussion that are the most suitable for their clients and/or service.
  • Yhunger’s experiential ‘learning by doing’ approach is reflected in its training workshops with youth workers and health professionals, in which participants cook Yhunger recipes for the workshop lunch, demonstrating how they can assist young people to develop similar skills and discussing how to mitigate the associated risks of cooking with young people.
  • Since 2018, Yhunger has been working with youth settlement services, refugee health and education providers, to adapt the Yhunger resources to be more culturally acceptable and inclusive for those whose English proficiency and literacy is developing.
  • Health promotion and youth health staff from other metropolitan local health districts (LHDs) have collaborated with SLHD to run Yhunger workshops in those LHDs. A wide range of non-government youth, health and welfare organisations (specialist homelessness services, drop-in youth centres, out-of-home care, disability services, alternative education, family support services, and Aboriginal services) have participated in workshops.
  • Yhunger program resources are used as part of other programs by health services, including mental health and drug health services.

Lead organisation

Sydney Local Health District

Implementation sites

The Yhunger program is co-ordinated from Youthblock Youth Health Service, Sydney LHD. Training workshops are organised with partnering LHDs and local councils.

Partnerships

  • South Western Sydney LHD
  • South Eastern Sydney LHD
  • Northern Sydney LHD
  • Western Sydney LHD
  • Northern NSW LHD
  • NSW Refugee Health Service and Settlement Services International
  • Yfoundations in the training workshop and resource kit development

Results

All Yhunger training workshops are evaluated using pre and post workshop surveys completed by workshop attendees. Survey data has found that after workshop attendance, more than three-quarters of workshop attendees agreed their confidence in identifying healthy eating and physical activity opportunities and implementing Yhunger strategies with young people had increased. Workshop attendees valued the flexibility and relevancy of the resources.12

An evaluation study Assessing implementation of Yhunger after workshop attendance by an online survey was approved by the Human Research Ethics and Governance Office (Royal Prince Alfred Hospital) in November 2019. Its aim is to investigate the extent to which youth, health and welfare workers who attended a one-day Yhunger training workshop from 2015 to 2020 are using Yhunger program resources and its ‘learning by doing’ approach in their ongoing work. This study is now in progress, and invites Yhunger workshop attendees to complete an online survey describing the extent of their use of resources and approach. Youth workers attending Yhunger workshops are from diverse services/organisations such as health and education agencies, housing and support, refugee settlement, mental health, with differing management structures and available resources. These include Local Health District services and non-government organisations. This diversity makes flexible implementation essential.

Additional evaluation questions

  • What organisational, client-related and/or other factors have helped and/or hindered participating services in using Yhunger program resources and approach in their work?
  • How have participating services who received a Yhunger grant/program enhancement used those grants?
  • What organisational, client-related and/or other factors have helped and/or hindered participating services in using the grant?
  • Have participating services made changes to their policies and/or practices on developing living skills, healthy eating and opportunities for physical activity?
  • What organisational, client-related and/or other factors have helped and/or hindered participating services in making changes to their policies and/or practices?

It is anticipated a report on the study’s results will be completed in 2021.

Lessons learnt

  • As youth health and homelessness programs are funded from several sectors, policy changes in one portfolio can have cascading effects on other programs. Policy changes, including funding and/or organisational changes, can affect staffing levels and turnover in youth services, with flow-effects to the implementation of Yhunger.
  • Youth services are diverse in size, resources available, organisational structure and activity, and so a flexible approach is needed.
  • Results from pre and post Yhunger workshop surveys indicate experiential ’hands-on’ learning is just as relevant for youth workers as it is for young people.
  • In response to our earlier needs assessment, adaptations to the Yhunger resources have been developed, pilot tested, revised and included in the Yhunger kit with young people from refugee and asylum-seeking backgrounds living in Sydney.
  • The training workshop has also been adapted and pilot tested with youth settlement services, refugee health and education providers to better support healthy eating and food skills with young people in resettlement programs and community engagement.

References

  1. NSW Ombudsman’s Office (2018) More than shelter: addressing policy and legal gaps in supporting homeless children. A special report to Parliament under section 31 of the Ombudsman Act 1974. 21 June 2018. https://www.ombo.nsw.gov.au/Find-a-publication/publications/reports-to-parliament/-community-services-reviews-and-monitoring-reports/more-than-shelter-addressing-legal-and-policy-gaps-in-supporting-homeless-children
  2. Australian Institute of Health and Welfare, (2016) Vulnerable Young People: interactions across homelessness, youth justice and child protection. 1 July 2011 to 30 June 2015. Cat.no.279. Canberra: AIHW.https://www.aihw.gov.au/getmedia/944d5eb5-a940-41be-b1a6-f81f95636aa5/20475.pdf.aspx?inline=true
  3. Rioseco, P and Liddy, N (2018). Settlement outcomes of humanitarian youth and active citizenship (Building a New Life in Australia Research Summary). Melbourne: Australian Institute of Family Studies. https://aifs.gov.au/sites/default/files/publication-documents/1804_bnla_settlement_outcomes_of_humanitarian_youth_research_summary.pdf
  4. Multicultural Youth Advocacy Network, Australia (2019) Youth Settlement Trends in Australia: a report on the data 2017-2018. https://myan.org.au/wp-content/uploads/2019/06/national-snapshot-myan_2019full.pdf
  5. Lawlis, T. Islam T and Upton P (2018) Achieving the four dimensions of food security for resettled refugees in Australia: a systematic review. Nutrition & Dietetics 2018; 75: 182–192.
  6. Everson-Hock E et al (2011) Supporting the Transition of Looked-After Young People to Independent Living: A Systematic Review of Interventions and Adult Outcomes. Child Care Health Dev 37 (6): 767-79.
  7. Barker, J, Humphries, P, McArthur, M, & Thomson, L (2012) Literature Review: Effective interventions for young people who are homeless or at risk of homelessness. Canberra: Australian Government Department of Families, Housing, Community Services and Indigenous Affairs. https://www.dss.gov.au/sites/default/files/documents/06_2012/literature_review.pdf
  8. Crawford B, Yamazaki, R, Franke, E, Amanatidis, S, Ravulo, J, Steinbeck, K et al. Sustaining dignity? Food insecurity in homeless young people in Australia. Health Promot J Aust 2014 25(2): 71-78.
  9. Crawford B, Yamazaki R, Franke E, Amanatidis S, Ravulo J, Torvaldsen S. (2015). Is something better than nothing? Food insecurity and eating patterns of young people experiencing homelessness. Aust N Z J Public Health. 2015; 39(4):350-4.
  10. Gross Z and Rutland S (2017) Experiential learning in informal education settings. International Review of Education February 2017 63:1-8.
  11. Multicultural Youth Advocacy Network (Australia) (2018) Not “Just Ticking A Box”: Youth participation with young people from refugee and migrant backgrounds. http://myan.org.au/file/file/MYANYouthParticipationResource.pdf.
  12. Yamazaki R (2018) Cookups, conversations and connections: experiential learning in the Yhunger workshops. Poster presented at Community Health Research and Evaluation Showcase, Sydney Local Health District, 5 December 2018.

Contact

Rowena Yamazaki
Community Nutritionist for Young People
Community Health Services
Sydney Local Health District
Phone: 02 9562 5640
rowena.yamazaki@health.nsw.gov.au

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