JOGG and EPODE

EPODE (‘Ensemble Prévenons l’Obésité De Enfants’ or ‘Together let’s Prevent Childhood Obesity’) is a large-scale, centrally co-ordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity.

From 2004 to 2012, EPODE has been implemented in over 500 communities in six countries¹.

The EPODE is an international network that has been successfully implementing community-based projects since 2011.

Since 2012, the EPODE has expanded to 25 community-based programs. By 2023, this global initiative has been joined by 21 countries with the aim to tackle childhood obesity.

The EPODE logic model¹

The Dutch JOGG is a movement which encourages young people (0-19) to eat healthily and be active, and makes these lifestyle choices easy and attractive for them. The approach focuses on children, adolescents, their parents and the environment in which they live. The JOGG approach includes not only parents and health professionals but also shopkeepers, companies, schools and local authorities.

JOGG is based on 5 pillars:

• Local political commitment
• Cooperation between the private and public sector (public-private partnerships)
• Social marketing
• Monitoring and evaluation
• Linking prevention and healthcare

Currently 212 municipalities in the Netherlands use the JOGG approach to promote a healthy weight among their youth. The number of municipalities participating in the programme is continuously growing. In neighbourhoods where the JOGG approach has already been operating for four years, the measured percentage of overweight children and adolescents was 9% lower than in neighbourhoods without this approach. 

In 2018 JOGG has joined the National Prevention Agreement, with the ambition to reduce overweight and obesity levels to statistics from 1995 by the year 2040. JOGG wants to achieve this goal by continue their effort in creating better health environment with attention to healthy food, sufficient exercise and quality sleep. 

You can learn more about JOGG approach here: https://jogg.nl/

How does it work?

At the national level, JOGG is coordinated by the foundation based in The Hague. The central office of JOGG facilitates work at the local level but leaves municipalities plenty of autonomy to decide what needs to be done.

Municipalities that wish to join the programme need to pay between 5 and 10 thousand euros a year to participate². The JOGG programme runs for 6 to 9 years and has 2-3 phases. During the first three years, a participating municipality focuses on implementation of the programmes. Then, for the following three years, it maintains the activities and makes sure they continue after JOGG’s involvement finishes. An optional final 3 years involve a much lower fee and focus on sharing experience and learning with other JOGG municipalities.

Political commitment is vital for JOGG approach.

The work at the local level is coordinated by a project manager. Each participating municipality needs to commit to supporting 16 hours a week of the local manager’s work and 4 hours a week of local government / political work.

Local managers work with schools, sports clubs, religious groups, local healthcare centres and others. They need to be aware of the local context and activities. A key part of their work is making sure the existing resources are fully utilised by linking and co-ordinating them.

The success of JOGG initiatives is dependent on both network/influence of the local managers and the will and engagement at the local level. Examples of activities supported by JOGG include promotion of drinking tap water, designing healthier playgrounds, supporting schools and sports clubs to provide healthy food, promoting physical activity, promotion of eating vegetables. 
Social marketing focuses on positive messages that encourage and praise healthy choices, rather than condemn less healthy ones. There are five main social marketing messages:

Public-private partnerships are a part of how JOGG operates. Municipalities taking part in the programme receive guidance on how to operate such partnership and it was stressed that private partners do not influence JOGG’s policies. Public-private partnerships are a source of funding for activities that support healthy eating and lifestyle, especially for children. 

Monitoring progress is crucial to the JOGG approach – it is done regularly and progress is discussed at frequent meetings of managers, local politicians and policy makers to make sure the changes and initiatives are sustainable.

More information: https://jongerenopgezondgewicht.nl/

We visited s-Hertogenbosch which is one of the JOGG municipalities and were greeted by Mark Blankwater who works as an Adviser in the main JOGG office. He works with and supports many local managers and provided the majority of the information above, including the graphics.

Mark introduced us to one of the local co-ordinators, Miriam. She invited us to one of the secondary schools she works with. This was a vocational secondary school. There we had the opportunity to speak to the home economics teacher and some students. The school has excellent kitchen facilities, so they not only provide lunches for the children but also run obligatory cooking classes. Students gain experience of working in the kitchen by participating in food preparation, serving and cleaning. These skills are likely to last for a lifetime and students reported they had started to cook some meals at home too.

The school, through an EU grant, provides free fresh fruit and dairy smoothies for the students every day. Free school meals are not provided for children in the Netherlands, so such an initiative is quite unusual in the Netherlands; it highlights what local efforts can achieve. 

de Rijzert, the secondary vocational school we visited

A typical lunch in de Rijzert school

The school provides free fresh fruit and dairy smoothies but soups, sandwiches and hot meals are priced at 1 Euro each. The menu uses traffic light labelling indicating how healthy the options are.

We also visited a playground near one of the local primary schools. The playground is open to children from the area after school hours and was full of children of various ages running, rollerblading, playing ping-pong and football. Physical activity teachers who make school sports equipment accessible for play time, also organise activities and supervise.

Miriam said that the next step for the programme in s-Hertogenbosch is to work with social services to make sure the families are ready to be approached about weight (for example that they are secure and have housing).

We thank Mark Blankwater for telling us about the work of JOGG.

More information: 
http://www.ephestory.eu/ 
EPODE video https://youtu.be/dQw0DiKbmyI 
EPODE programmes in Europe https://epha.org/epode-together-lets-prevent-childhood-obesity/ 

References:

1 T. M. Van Koperen, S. A. Jebb, C. D. Summerbell, T. L. S. Visscher, M. Romon, J. M. Borys and J. C. Seidell. Characterizing the EPODE logic model: unravelling the past and informing the future. Obesity reviews (2013) 14, 162–170. doi: 10.1111/j.1467-789X.2012.01057.x

2 Committee D (Environment and Social). Report in Childhood Obesity for the British-Irish Parliamentary Assembly. July 2017.