Between 2023 and 2024, Small Steps Big Changes (SSBC) commissioned the Royal Society for Public Health (RSPH) to carry out a process and impact evaluation of the Healthy Lifestyles Pathway (HLP). Designed to prevent childhood obesity, HLP provides tailored, home-based support to families with children aged 0–4 in some of Nottingham’s most deprived areas. The evaluation aimed to understand how the intervention works, how it supports families, and what contributes to its effectiveness.
Our Evaluation Approach
RSPH used a theory-informed, mixed-methods approach to build a full picture of the intervention’s design and delivery. Key elements included:
Co-developing a Theory of Change (ToC)
We worked closely with the HLP delivery team and parent champions to map out how the intervention is intended to work, including its key activities, assumptions, and expected outcomes. This ToC served as a framework for structuring our evaluation and interpreting findings.
Speaking to Families
We conducted semi-structured interviews with participating families, exploring how they experienced the service, what worked well, and what barriers they faced. These conversations captured the lived experience of the intervention and revealed what aspects families found most valuable.
Engaging Professionals
We interviewed professionals in the Health Visiting Team to understand how HLP fits within existing services, how referrals are made, and how the intervention supports their work with families.
Analysing Service Data
We reviewed data from 199 families, including demographic information and lifestyle indicators collected at various stages of the intervention. This helped us explore participation trends and behavioural outcomes over time.
The findings
The evaluation found that families developed sustainable eating and activity habits, reduced sugary drink consumption, and felt motivated to sustain changes, though structural barriers like poverty and limited access persisted.
Conclusion
This robust, collaborative approach ensured the evaluation was grounded in both evidence and lived experience, offering practical insights to inform service improvement and future commissioning.
Testimonial
The RSPH team brought expertise and professionalism to every stage of the process, and their analysis of the service data was especially valuable.
Lynn and Katie, Healthy Lifestyles Pathway Service, Nottingham
By helping us make sense of the trends and outcomes across nearly 200 families, RSPH gave us a clearer picture of how the service is working and where we can strengthen it. Their findings have already informed improvements to how we deliver and target support.
The evaluation has given us the confidence that we’re making a difference, and the insight to keep building on that impact.