- Facts4Life is on a mission to redefine health education for children.
- The organisation’s directors, Dr Hugh van’t Hoff and John Davis, discuss Facts4Life’s innovative approach to improving child health literacy in the UK.
- To promote student health and wellbeing, the organisation trains teachers, educational practitioners, and family support workers to use their resources in schools and early years settings.
- Talking about the benefits of their research-backed approach, the directors reveal the obstacles they have overcome in this area of public health.
- Facts4Life is now looking to partner with researchers and organisations to expand the proven benefits of their unique health education curriculum.
Research Features was thrilled to speak with Facts4Life, an organisation addressing health inequality head-on through an innovative approach to health education for children. Improving health literacy is vital for successful long-term public health strategies, so Dr Hugh van’t Hoff and John Davis, co-directors of Facts4Life, discuss how we can put this into practice.
Facts4Life provides teachers, educational practitioners, and family support workers with the training and resources they need to deliver a robust and holistic health education curriculum in schools. It’s one of the few organisations educating children about their health in early years and primary settings. They’re keen to connect with other health and education organisations, as well as researchers, to expand their empowering impact. We find out more about the fascinating field of child health literacy, and what’s in the pipeline at Facts4Life.
You’ve taken very different and interesting educational journeys and careers. How have they inspired your work at Facts4Life – and why is it unique?
Hugh: As a practising GP, I realised that children’s health literacy is critically important to their overall and future wellbeing. But it was, and still is, a chronically overlooked aspect of their developmental needs. Unfortunately, too many of us are becoming deskilled in attending to our own physical and mental health needs; our health service cannot deal with the consequences – and people are suffering as a result. This is why we are redefining health education – and why I founded Facts4Life – to ensure every child has access to vital health education.
My medical training involved international public health. Here, I realised we have some control over our health, and I became fixed on translating medical ideas in an accessible way for children in areas of greatest socio-economic deprivation.
This prompted me to write widely to politicians and policymakers to promote teaching medical ideas in schools. I had few replies, but notably, one from Tony Benn, former cabinet minister of the UK government, suggesting I pilot the ideas in schools – and show they worked. This was the impetus to form Facts4Life – and we did.
John: My background, by contrast, began not in health but in the world of education. I worked in schools in Berlin and Paris, have taught modern foreign languages in large secondary schools in the UK, and have taken on various school leadership roles in the state system.
As a student, learning languages gave me insight into a new way of thinking and interpreting the world. In a related way, we help children and young people to learn a language to make sense of their experience of mental and physical health – and build strategies to manage life’s ups and downs. I’ve worked with many children whose own state of health and wellbeing has limited their capacity to learn. The self-understanding we are facilitating can remove some of these blocks.
We help educators and children accept the ubiquity of illness – to see illness as a challenge which, by and large, we can meet.
We are a unique partnership between medicine and education. Together with our expert teachers, Kelly Green and Pete Kirby, we have translated medical insights into a practical health curriculum that embraces the child’s experience of illness. We’re the first health education provider to acknowledge illness (physical and mental) as a normal part of life, which children have agency over.
How does Facts4Life improve children’s and young peoples’ lives?
Hugh: By giving children agency over their health, we shift the locus of control away from the medical profession to empower the individual.
John: In practical terms, we do this by training teachers, teaching assistants, early years practitioners, and family support workers to deliver our health resilience curriculum.
Our resources and training enable children of all ages to explore their thoughts and feelings about mental and physical illness in their own and their families’ lives. We help educators and children accept the ubiquity of illness – to see illness as a challenge which, by and large, we can meet. We call this the ‘Most Idea’ – most of the time, most of us get better from most illnesses on our own.
Hugh: Three main ideas underpin and thread through our resources. They are, essentially, a distillation of medical thinking and insights from practice ‘at the coal face’ to provide practical lessons that children can apply to understand and manage their health.
The first is called ‘Riding the ups and downs’. Throughout life, we have periods when we are unwell. That’s quite normal. Most preschool children will have six mild viral infections a year, and most infections are milder in severity in childhood. We all experience mental health ups and downs too.
The second idea is ‘Keeping in balance’. That’s the idea that the systems in our bodies are usually great at keeping our health in balance: different systems (like the immune system) work together to keep us well most of the time. Only when multiple systems are compromised do we lose balance – or become seriously unwell and need the help of others.
The third is ‘Smoothing the path’. We can make our health journey smoother by doing things which support our health and help keep us balanced (like healthy eating, exercise, rest, mindfulness, and sleep hygiene).
John: Facts4Life is a truly preventative approach to health that all children can benefit from. We’re supported by the NHS, who have commissioned us to develop our approach, which was rolled out initially in primary schools in Gloucestershire. We’re now looking to expand across the UK and internationally.
Why is health education for children and young people so important?
Hugh: Health anxiety in children and young people is common, and we’ve seen rising levels since the pandemic. But as medicine has advanced, we’ve also slipped into unnecessary dependency: the idea that we always look outside ourselves to be ‘fixed’.
As a society, we must find ways to help people to help themselves. In my daily practice as a GP, I am very aware of the increases in mental health problems in children – and witness the ever-reducing age at which children are diagnosed with type 2 diabetes, a weathervane for our increasing inactivity.
John: We’ve shown, for example, that in an early years setting, we can teach children as young as three or four the language to identify their emotions and connect them to bodily sensations. With this mental health awareness, they can develop self-regulation skills to manage difficult emotions more effectively.
We’re conscious that our messages have more impact when shared with the whole family. As a result, we train family support workers who can provide direct support to families in greatest need.
Do you think your field is valued?
John: There is broad international acknowledgement that we have reached a tipping point in our management of health. Due to overdemand, UK medical services are stretched to breaking point. The causes are multifactorial and are connected closely with the social determinants of health, and, of course, the pandemic has had a significant impact.
In such a climate, we can neglect the long-term strategy while reaching for a short-term ‘sticking plaster’ approach. Unfortunately, the potential value of health literacy approaches for longer-term public health benefits has yet to be fully recognised.
Hugh: Health literacy is recognised as a way of building competencies in people to understand medical ideas. However, on a societal level we haven’t begun to value the need to help children understand ill health. This is partly because it’s easy to think medical information can’t be communicated to young minds. We’ve proved it can.
More broadly, there is widespread acknowledgement across the UK that prevention and lifestyle changes and choices are central to the medicine of the future. For example, the Royal College of General Practitioners endorses our approach as setting the agenda for future prevention strategies. The challenge is ensuring this is translated into clear policy.
Could you tell us about some of Facts4Life’s successes?
Hugh: Our major success is devising a holistic approach to health education that allows us to talk about how mental and physical health almost always overlap and that medical ideas can be made accessible to children and young people.
John: Yes, and teachers, early years practitioners and family support workers are providing fantastic feedback on the quality of our training and resources. A teacher recently commented at a mental health training event that ‘this has the potential to be life-changing.’ Teachers say we’re ‘transformative’ and ‘inspiring’, bringing something new and urgently needed. We’ve now trained more than 2,000 professionals to deliver our curriculum, and it’s been rolled out in more than 350 settings in England and Wales.
Hugh: We were impressed with the findings of independent research conducted by the University of the West of England (UWE). Pupils enjoyed our health education curriculum, which increased their health literacy. UWE’s evaluation identified a significant improvement in child resilience for older primary school pupils. Younger pupils also learned new strategies for promoting mental health, had a decreased need for unnecessary medication when feeling unwell, and found learning about illness useful. You can read the fantastic results here.
John: Importantly, we’ve shown we can sustain our impact over time by changing the philosophy about teaching health and illness – with an approach backed by independent research.
Facts4Life is a way of bringing health and education together to address the social determinants of health.
What barriers and challenges have you encountered when leading Facts4Life’s efforts?
John: We are well aware of how challenging it is for teachers and early years practitioners to manage day-to-day pressures inherent in their work and to meet the academic performance indicators they are held to account for. It requires commitment to take on longer-term preventative support for children, and the need for this work is clear – the NHS Mental Health of Children and Young People in England Survey found that 17.4 % of children aged six to sixteen had a probable mental disorder in 2021.
What’s more, we don’t have a history of teaching medical ideas in schools. However, we’ve shown that medical insights can easily be incorporated in a cross-curricular way in the primary setting. Initially, there may have been a concern that in addressing illness we would cause distress. Our approach doesn’t generate more health anxiety – quite the opposite.
Children described Facts4Life’s positive impact in the UWE research, saying our projects are empowering and teach important life skills. In fact, children enjoyed learning about their health: ‘we all really looked forward to those lessons each week.’
Hugh: Yes – and their teachers echoed this feedback on our beneficial impact. For example, one teacher in the UWE evaluation said that ‘the children I spoke to afterwards could give me strategies that they could use if things were getting on top of them. They talked really confidently compared to other classes who hadn’t done Facts4Life lessons – and that made me want to have a go with all the classes.’
So, we feel we’ve come a long way in winning over hearts and minds and overcoming barriers, allowing us to implement vital health literacy outreach for children.
John: On a practical and organisational level, the medical and educational sectors are siloed when they could be working in harmony. Facts4Life represents a way of bringing health and education together to address the social determinants of health. We can’t change children’s housing and parental income, but we can help give them agency and meaningful responsibility.
How can academics and funders support efforts to improve health education for children?
John: We launched our charitable branch of Facts4Life this year. Our non-profit CIC delivers our outreach at cost to help the most vulnerable and socioeconomically disadvantaged children. We’re looking to partner with charitable trusts and organisations committed to health and education. On a regional level, we are looking to connect with NHS Integrated Care Boards.
Hugh: We are also committed to building dialogue with interested academics and exploring research projects together. For example, we are currently in discussion with some of the leading thinkers in health literacy in the UK to set up a research project for early years in an area of social deprivation. We’re exploring this with Professor Jo Protheroe, Director of General Practice Education and Clinical Academic Training at Keele University and NHS Clinical Adviser for Health Literacy, and Gill Rowlands, Professor of Primary Care at Newcastle University in the UK. We’d strongly encourage any researchers interested in our approach to contact us here. We’d love to hear from you!
We’ve successfully devised a holistic approach to health education that makes medical ideas accessible to children and young people.
What’s in the ‘pipeline’ at Facts4Life?
John: It’s an exciting time for us as we look to bring our ideas to a wider audience while continuing to provide new materials in response to changing needs. We also aim to extend our online presence and take advantage of digital possibilities. For example, we’re adding digital gamification elements and launching online training courses for teachers. We’ve also had a fantastic reception to our children’s books, such as This is Fin Bear. Building on this success, we’re looking to publish new stories and make these (and all our resources) available for Kindles and e-readers.
Hugh: And talking of pipelines, Facts4Life is a classic example of upstream, preventative medicine. We tend to focus on ‘end of pipe’ solutions for public health problems – but we need to address these further upstream. Preventative approaches to health, such as ours in the UK, address the real problems we see all around us, both on an individual level and within the health system, and more broadly in schools.
We are strongly committed to addressing the social determinants of health inequality – so that Facts4Life helps the most socially and economically disadvantaged children and their families. Giving children agency and understanding from a young age will empower the next generation and drive down demand on our already overstretched healthcare systems. When all children benefit from Facts4Life education, we will have truly realised our vision: redefining health education to support children to be happier and healthier.
Interview conducted by Luna Dewey, a UK-based feature writer covering the latest research and groundbreaking thought leaders.
