The Big Lottery Fund conducted research ‘What works for Wellbeing’ which outlines a range of learning about what works in wellbeing projects. Our experience is strongly in line with those findings.
The following factors have been crucial to the success of Target: Wellbeing.
Holistic nature of wellbeing
Participants have noted that projects that explicitly tackle one area of wellbeing have in fact helped them in other ways. This is most notable in terms of the mental health benefits of physical exercise. We have also noted that many of our projects have achieved outcomes that were not expected – for example physical activity projects that did not set out to tackle healthy eating have done so indirectly through raising personal aspirations for a healthy lifestyle.
Safe spaces and venues
People who took part in Target: Wellbeing projects have often reported their sense of feeling safe. People have valued a non-judgemental atmosphere, and there is evidence that this has particularly benefited people with mental health problems who have struggled to take the first steps towards a more active life. The majority of our projects are not located in venues with an NHS or
governmental focus – something which we feel helps to build confidence to attend.
The staff working to deliver our outcomes are the real heroes of Target: Wellbeing. We have seen countless examples of people going the extra mile to help people get the most from our projects.
Every person’s needs are different and they require support in different ways to become healthier. Our best projects have understood this and have been able to tailor their programmes effectively to the needs of participants.
Beneficiary recruitment and retention
Successful projects have a range of methods of recruitment and referral rather than relying on just one source of new participants. We’ve observed the following recruitment pathways through our evaluation:
- Word of mouth
- Outreach by staff
- Referrals by GP
- Referrals by community centre staff / churches etc
- Marketing via leaflets, posters and newspaper adverts
Retention of participants after the first contact is often due to the social atmosphere even more than the enjoyment of the activity on offer:
Value of long-term programmes
Target: Wellbeing’s longevity is unusual for this type of funding stream. Often, initiatives scrape funding together year-by-year, coping with ever-changing targets and expectations. This longevity has allowed our most long-standing programmes to hone their provision based on lessons learned over years rather than months.
Health by stealth
Our projects are generally not framed in terms of health and do not take place in health-focused venues. This has helped to attract people to get involved who might feel intimidated by attending a ‘healthy’ activity. Our most successful projects have delivered ‘health by stealth’ – they have helped people become more active and positive about themselves without lecturing or
Free at the point of delivery
Our projects have been free and that has proved crucial to attracting those beneficiaries who are most in need. Free access has enabled many participants to attend, as has other practical support such as free childcare or subsidised transport. People living in poverty cannot easily make healthy choices if there is an added cost.
The portfolio approach
The portfolio approach of Target: Wellbeing has been a significant factor in success. Our central team, acting as a buffer between the funder and the small local project, has been able to act as a source of support rather than simply a manager of grant funding.
We have been able to network together projects on a geographic and thematic basis which has brought about learning and practical linkages through signposting and referrals.
All of our projects have faced challenges but some have been able to overcome them more effectively than others.
We have identified the following factors as the most difficult challenges faced by our portfolio as a whole:
Not all of our projects have been able to effectively target the people most in need of the interventions available. All too often not enough time is spent at the development stage of projects understanding the target audience and the best ways of reaching them.
Commonly, this ‘social marketing’ is seen as an add-on later when it should be built into the very design of the project.
Understanding the marketplace
We have seen examples of projects failing because they did not adequately understand the existing range of similar provision on offer in the target area and how to complement them rather than try to compete.
Effective evaluation has been one of our biggest challenges. At portfolio level, designing an impact measurement system that can work across a diverse set of projects with differing target groups has been difficult. In our early phases of work our questionnaires for
beneficiaries were much too complex, while our later model has not allowed us to track the progress of individuals.
Projects often underestimate the challenge of carrying out effective evaluation and do not allocate enough resources to do so.
Our learning from Target: Wellbeing has encouraged Groundwork to further identify the health and wellbeing outcomes achieved through our work and to start the process of developing consistent monitoring and evaluation tools that enable effective comparison judging of impact. and why”.
Building on the portfolio evaluation and a Social Return on Investment (SROI) assessment model developed for Groundwork by Sheffield Hallam University, the intention is to develop a “Wellbeing Return on Investment” model that takes the best from existing SROI methodology and quantitative and qualitative evaluation methods.
Quantity vs quality of intervention
Some of our projects have worked with the same group of people for long periods of time. While this points to a depth of intervention that may be very effective for those individuals, this increases the cost of each outcome significantly and demonstrates limited targeting of potential beneficiaries.
Some other projects have seen a churn of participants that suggests a lack of sustained behaviour change.
Changing policy and structures
Target: Wellbeing was conceived in a very different health and wellbeing landscape. The original portfolio was designed to be integrated with the objectives of local Primary Care Trusts (PCTs) and worked closely with the regional public health team.
The advent of the coalition government saw a complete restructure of this landscape with established networks and relationships dispersed. It has sometimes been challenging to recreate the strong partnerships that existed at the beginning of the portfolio.
Read the full Impact Report (PDF)