Local Prevention Agreement West Maas en Waal

The collaboration of all parties comes to life in the local prevention agreement West Maas en Waal Vitaal (hereinafter: LPA). The preventive approach to health problems (physical, mental, and social) is central, 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. 

Early in 2021, 37 partners signed the local sports agreement West Maas en Waal. The local sports agreement and the prevention agreement have many commonalities, including in the area of prevention. In 2022, we aim to intertwine the two agreements. The merged documents will form the basis for one powerful sports and prevention agreement, West Maas en Waal Vitaal, which will be continued in 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 in, among others, the local sports agreement West Maas en Waal and the policy framework 'Samen Beter 2017-2022'. We will build on this in the LPA. The key characteristics, partly derived from the aforementioned documents, are listed below. Furthermore, the implementation document is concrete and practical. 

During the open house sessions at City Hall in week 38, potential partners were invited to contribute their ideas regarding 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 are the opportunities the core team currently sees for growth.

Furthermore, we would like to frame the LPA with the following established rules.
The local prevention agreement West Maas en Waal Vitaal:

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 local sports agreement West Maas en Waal and 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 implementation budget of € 10,000. The Municipality of West Maas en Waal submits the annual application for this to the Ministry of Health, Welfare and Sport (VWS). Financial reach can be extended by combining activities with those from the local sports agreement West Maas en Waal in Beweging, or by utilizing and seeking other subsidy sources (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 subsidy desk for individual activities of a solitary organization. It concerns supporting activities that, fitting within the LPA, are developed and/or implemented by at least three collaborating organizations (private and public). As previously indicated, the core team decides whether a contribution from the implementation budget is allocated to an activity. The financial processing and ultimate responsibility lie with the core team.

Of course, we want the activities offered through 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/parent workers, general practitioners, etc.) and activity providers (municipality, social organizations, entrepreneurs, etc.). To achieve this, the LPA supports, on the one hand, those who identify needs in mapping out the demand. On the other hand, it supports activity providers in bundling their offerings. A thematic meeting (e.g., a prevention afternoon at city 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 Vitaal was established in a very short time, despite time and corona restrictions, through various physical meetings, many phone calls, and digital consultations. We are proud of the ambitions set, agreements made, and planned new collaborations. This makes it possible to apply for the 2021 implementation budget for the local prevention agreement Maas en Waal Vitaal via VNG and VWS and to start implementation immediately. In the coming months, the core team will ensure further elaboration and deepening. 

The goal is broader support, more partners, and more activities. Additionally, there is a significant overlap with the local prevention agreement West Maas en Waal. We seize the opportunity to intertwine both agreements, in consultation with all partners. It is expected that the local sports and prevention agreement Maas en Waal Vitaal will be merged in the first quarter of 2022. This is to strongly push for a more vital 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