West Maas en Waal Local Prevention Agreement

The collaboration among all parties is embodied in the West Maas en Waal Local Prevention Agreement (hereinafter: LPA). The focus is on a preventive approach to health issues (physical, mental, and social), because prevention is better than cure. 

In addition, we work together based on the principle that we’d rather do four things well than ten things halfway. That’s why we take note of the initiatives already underway and the partnerships that already exist. We incorporate the positive aspects into the foundation of the LPA. 

To implement the agreements reached, organizations in the social sector, entrepreneurs, and residents of WMW are working together. Health is not just the responsibility of healthcare professionals, but of all of us. In light of the COVID-19 pandemic, this is particularly relevant. The goal is therefore to involve even more organizations, businesses, associations, and others in the LPA in the future.

We use the concept of positive health. This approach focuses on fostering people’s ability to cope with physical, mental, and social challenges. In doing so, people take the lead as much as possible.

On the following pages, you can read about how we plan to achieve all of our goals and who will be involved.

In healthcare, there is a noticeable shift from treating symptoms (curative care) to addressing causes (preventive care). Fueled by the COVID-19 pandemic, prevention is receiving increasing attention. This includes developing and maintaining a healthy lifestyle.
In recent years, the municipality has been working with various parties on prevention. In this regard, the support, input, and commitment of our partners are crucial. We do this, for example, through roundtable discussions with senior citizens’ associations, contact with village platforms, initiatives to address substance use, and the “Samen Beter 2017-2022” policy. The LPA is a partnership through which we can exchange ideas and make agreements on these matters. 

In early 2021, 37 partners signed the West Maas en Waal Local Sports Agreement. The Local Sports Agreement and the Prevention Agreement have many points in common, including in the area of prevention. In 2022, we plan to merge the two agreements. The combined documents will serve as the foundation for a single, robust sports and prevention agreement— West Maas en Waal —that will be sustained over the long term. 

Prevention and achieving its associated goals take time. The National Prevention Agreement has established over 200 commitments with various partners. At the local level, we adapt these commitments to meet local needs. The national and local goals therefore require that the LPA be secured for the long term. We currently define the long term as 2040. The LPA is continuously monitored, evaluated, and adjusted to ensure the best possible policy is implemented for the long term. 

A core team of leaders has been formed to oversee the LPA. The core team meets regularly, reviews grant and project applications, discusses feedback from other participants and ongoing activities, and organizes meetings for all participants. The core team takes the initiative to keep other participants engaged and enthusiastic. 

The LPA is a living document. More organizations may join in the future. Other partners also have the opportunity to join the core team. In addition, we plan to establish working groups for each priority area in the future. This will allow organizations to discuss specific issues with other stakeholders. A representative from the core team will always be present. This allows the core team to maintain an overview of all initiatives within the LPA. 

The core teams of the Local Sports Agreement and the Local Prevention Agreement will be merged in 2022. We see significant overlap between the two agreements and want to make efficient use of it.

In the municipality of WMW, prevention is already a topic addressed in, among other things, the West Maas en Waal Local Sports Agreement West Maas en Waal the “Samen Beter 2017–2022” policy framework. We build on this in the LPA. The key features, drawn in part from the documents mentioned above, are outlined below. Furthermore, the implementation document is concrete and practical. 

During the open house afternoons at the town hall week 38, potential partners were invited to contribute their ideas to the local prevention agreement. These sessions took place in person, online, and by phone, and were consistently lively. The key points and frequently mentioned topics from these discussions are listed below.
 
Appendix 2 lists the invited and potential partners. These represent the opportunities the core team currently sees for growth.

We would also like to provide context for the LPA by referring to the following guidelines:
The West Maas en Waal Local Prevention Agreement:

1. Encourages and supports the adoption and maintenance of a healthy lifestyle among all age groups;
2. Focuses on the issues of smoking, substance use, and problematic alcohol use among young people;
3. Focuses on the themes of healthy weight and mental well-being across society;
4. Provides a comprehensive approach;
5. Is a collaboration between public and private partners;
6. Involves residents in the development and implementation of the agreement;
7. Is linked to the West Maas en Waal local sports agreement West Maas en Waal the local health policy;
8. Ensures that the efforts will have lasting effects by securing them beyond 2023;
9. It’s not just a “paper tiger”; it includes concrete actions, and we’d rather do four things well than ten half-heartedly;
10. Establishes connections between the various organizations and themes wherever possible.

A great deal of input was provided during the brainstorming sessions held at the open house afternoons. In some cases, organizations were able to exchange ideas with one another; in others, the project leader brought initiatives together afterward. The input from stakeholders has been channeled into concrete agreements, abstract ambitions, and existing policies. We have compiled an overview of this for each priority area:

Priority 1. Healthy weight

• Ambition to become a JOGG municipality;
• We offer Bendefit@work to companies to help them focus on and promote employee well-being;
• We are merging the sports and prevention agreement;
• Encouraging more physical activity in schools through initiatives such as the community sports coach, "Gym je slim," or "Bewegen met Nijntje."

Priority 2. Reducing smoking

• We are making various areas smoke-free, such as playgrounds, public spaces, and sports facilities;
• We are making promotional materials available to help create a smoke-free generation;
• We are participating in the regional working group on reducing smoking among young people, together with the municipalities of Beuningen, Druten, and Wijchen;
• We raise awareness among young people about the consequences of smoking through the Helder op School program (run by Iriszorg, Pro Persona Connect, and secondary schools, among others).

Priority 3. Reducing alcohol and substance use

• In 2022, we will work with partners to develop a new policy on responsible alcohol service. We will involve organizations such as Iriszorg and community groups in this process;
• In each village, we are organizing an informational meeting on substance use for parents, volunteers at community organizations, and other interested parties;
• We raise awareness about the consequences of alcohol and substance use and encourage parents to help identify these issues. Depending on the choice of the parties involved, programs such as Get2KnowU can be implemented. The Helder op School program is already in use.

Priority 4. Mental well-being

• We are committed to fostering open dialogue about mental well-being and involving parents in identifying issues. Depending on the choice of the parties involved, programs such as Get2KnowU can be implemented;
• Youth workers are present at the high school during breaks and are available to teachers to assist with lesson plans, provide support during escalations, and hold office hours for students.

The core team meets regularly. We hold meetings with all participating partners at least twice a year to discuss the progress of agreed-upon actions. We also work together to ensure that the LPA remains up to date. We do this by discussing the results of studies, experiments, or other experiences and adjusting the LPA as needed. 

The following guidelines have been established for requesting project budgets and evaluating projects.

Grant applications are evaluated based on the following criteria:

• Overlap(s) with priority area(s)
• Collaboration (at least 3 parties)
• Budget
• Continuity
• Schedule

Projects are evaluated based on:

• Target audience reached
• Target audience experience (Effectiveness/satisfaction)
• Project results
• Learning from the process
• Participation of partners from the local prevention agreement
• New connections (cross-pollination, new partnerships)
• Effective use of the budget

The national government provides an annual operating budget of €10,000. The municipality West Maas en Waal an annual application for this funding to the Ministry of Health, Welfare, and Sport. The financial scope can be expanded by combining activities with those outlined in the local sports agreement West Maas en Waal Beweging” or by seeking and utilizing other sources of funding (such as the national support program “Support Package for Social and Mental Well-being and Lifestyle” or support from the business community). The LPA does not function as a grant office for individual activities of a single organization. Its purpose is to support activities that, in line with the LPA’s objectives, are developed and/or carried out by at least three collaborating organizations (private and public). As previously indicated, the core team determines whether a contribution from the implementation budget will be allocated to an activity. The core team is responsible for financial processing and bears ultimate responsibility.

Of course, we want the activities in the LPA to help and support the right residents. To ensure effectiveness, supply and demand must therefore be well aligned. This requires coordination between those who identify needs (schools, youth and parent workers, primary care physicians, etc.) and activity providers (the municipality, social organizations, businesses, etc.). To achieve this, the LPA supports, on the one hand, those who identify needs in assessing demand. On the other hand, it helps activity providers bundle their offerings. A thematic meeting (e.g., a prevention afternoon at the town hall) brings referrers and providers together to exchange information on supply and demand. This facilitates referrals from referrers to providers and vice versa.

The core team provides updates via email newsletters and the municipality’s communication channels. This information can, of course, also be shared through the communication channels of all participating parties (both digital and print). 

West Maas en Waal was established in a very short period of time, despite time constraints and COVID-19 restrictions, through various in-person meetings, numerous phone calls, and digital consultations. We are proud of the ambitions we have set, the agreements we have made, and the planned new collaborations. As a result, the Maas en Waal Vitaal local prevention agreement allows us to apply for the 2021 implementation budget through the Association of Netherlands Municipalities (VNG) and the Ministry of Health, Welfare and Sport (VWS) and to begin implementation immediately. In the coming months, the core team will work on further developing and refining the initiative. 

The goal is to build broader support, attract more partners, and expand activities. In addition, there is significant overlap with the West Maas en Waal local prevention agreement. We are seizing the opportunity to integrate both agreements, in consultation with all partners. The local sports and prevention agreement, Maas en Waal Vitaal, is expected to be merged in the first quarter of 2022. Let’s keep pushing forward to build a healthier society!

Specifically: youth

The GGD Youth Health Monitor has provided insights into the health, well-being, and lifestyle of secondary school students in WMW. The survey is conducted every four years among students in grades 2 and 4 of secondary education. Students complete a digital questionnaire about their health, mental well-being, lifestyle (such as diet, exercise, alcohol, and smoking), enjoyment of school and absenteeism, and sexuality.
In summary, the key findings of the WMW monitor are:

• A very high percentage of young people drink alcohol (43%), and there is a high level of parental acceptance of alcohol consumption (34%). In the Gelderland-Zuid region, there has been a downward trend in alcohol consumption among young people over the years, but this decline has stalled in the municipality of WMW.
• The survey does not indicate that smoking or the use of soft and hard drugs is a cause for concern; rather, these figures are average compared to the Gelderland-Zuid region. What is striking is that 0% of young people report having used hard drugs in the past four weeks, and 1% report having used drugs at some point.
• Attention is needed regarding the slow rise in psychosocial problems among young people;
• Stress and pressure to perform among young people are evident in the figures. 38% report feeling stressed (very) often. While this is lower than the average for the Gelderland-Zuid region (41%), it is still a fairly high percentage. The vast majority of these young people feel stressed by “school or homework.” Stress related to the home situation affects a small percentage, but it is often more severe and combined with psychosocial problems.
• (Many) more young people in WMW say they don’t like school or find it awful (15%); this is a significant difference compared to the region (10%).
• Resilience is a major protective factor in preventing problems. 13% of young people in WMW report feeling that they lack resilience. 

The coronavirus is affecting the health and resilience of young people. That is why this group needs extra attention right now. Activities in the LPA help mitigate the effects of the coronavirus and enable a smooth transition back to normal life after the pandemic. 

Specifically: older adults and neighborhoods

According to the GGD Health Monitor 2020-2021, adults in WMW are doing quite well. There has been a decline in unhealthy lifestyle habits such as alcohol consumption and smoking. And physical activity is on the rise among those aged 65 and older. Fruit consumption among those aged 18–65 is also increasing. Fewer people report having difficulty making ends meet. They indicate having €1,000 available for unforeseen expenses. The social environment is also viewed positively. The sense of safety is increasing. In addition, the LGBTQ+ group reports experiencing less discrimination. Mental well-being among those aged 65 and older is also developing positively. Anxiety and depression symptoms show a downward trend.

However, there are also areas of concern: obesity among 18- to 65-year-olds has been on the rise for years, and this trend shows no signs of abating. Physical activity among 18- to 65-year-olds is also on the decline. Vegetable consumption among those aged 65 and older is also decreasing. Another worrying trend is that an increasing number of people report feeling lonely.

• Municipality of West Maas en Waal
• Sociom
• GGD Gelderland-South
• Trivium
• The Maas and Waal Rivers in Motion
• Active Maas and Waal
• Pro Persona Connect
• Stronger / VraagWijzer West Maas en Waal
• IrisZorg
• KoppieOp Children's Coaching