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The Eat, Breathe, Move (EBM) program delivered throughout 2023 in the Bundaberg region, aimed to promote physical activity by recognising the connection between metabolism, breathing and movement. The program addressed a critical gap in health literacy – understanding that the food we eat becomes the carbon dioxide we exhale (carbon in, carbon out), as well as providing opportunities for various groups to be physically active within our community.

The program delivered a number of targeted initiatives:

• EBM public lectures and professional development – with Ruben Meerman, Surfing Scientist
• Eat, Breathe, Move Walk – walking group utilising our 10,000 Steps pathways
• Skills and Drills – school holiday activity engaging students with local sports.

Background and context

The EBM program was supported through ActiveKIT funding, a joint initiative of the Department of Transport, Innovation and Sport, and Health and Wellbeing Queensland. This initiative provided Bundaberg Regional Council (BRC) with $100,000 for the delivery of the program to improve health literacy and support physical activity in Bundaberg. The program’s development was informed by the work of the Building a Healthier Bundaberg Alliance and the Do Your Thing, Behaviour Science Strategy.

This report highlighted key health issues including high rates of overweight and obesity, low rates of meeting nutritional guidelines and opportunities to increase engagement in sport and physical activity.

It also built on the previous work developed by Ruben Meerman around the carbon in, carbon out concept; that there was generally poor community understanding around the science of atoms and how this relates to health but there was opportunity to embed these concepts early into education in a fun and accessible way. 

‘Bundaberg is the first place on Earth where people are learning what actually happens to food after you swallow it. Food is made of atoms and almost all the atoms in your macronutrients turn into carbon dioxide and water. Amazing. I’ve noticed that this simple fact makes people think about food differently. We’ve been told to eat more fruit and vegetables and get more exercise for decades. Now people are starting to understand why. I’m very proud of this.’

Ruben Meerman, Surfing Scientist

A multi-strategy approach was taken with the project.

1. Improve health literacy of the Bundaberg community from the ground up using the carbon in, carbon out approach by:
   • Delivering a series of professional development workshops to teachers and resourcing them to continue this education within the curriculum.
   • Delivering professional development workshops to health professionals, active industry and workplace leaders.
   • Engage the broader community through demonstrations at community events (e.g. Move it Expo, Taste Festival) and a public lecture series.
   • Engaging students (and teachers) by demonstrating these concepts within a classroom environment across P-12 schooling.
2. Provide opportunities for young people (primary school age) to be physically active through a series of school holiday Skills and Drills events featuring local sporting clubs; with an aim to increase long-term engagement in sporting activities:
   • Engage local sporting clubs through our existing database to deliver activities in rotation as part of half-day event at Bundaberg, Gin Gin and Childers over the 3 mid-year holiday periods.
3. Provide opportunities for older demographics and the broader community to be active through establishing walking groups. (NB. While it was hoped that this would be the implementation of the established Walk with a Doc program, barriers that arose during implementation meant that this was modified to a 10,000 Steps activity included in BRC’s established Be Active Be Alive program).

Target audience

This project was implemented within the BRC area. There were a number of key target groups including:

• Primary and secondary school students
• Primary and secondary school teachers (particularly within science and HPE streams)
• Health professionals, active industry and sporting clubs
• General public.

Program implementation

Ruben Meerman was engaged as a specialist supplier to deliver the health literacy components of the project. He was a key member of the project team.

Engagement was sought from the community and stakeholders in various ways:

• A project page was developed through the established Our Bundaberg Region webpage. Community members, clubs, schools and organisations could submit expressions of interest through this page.
• The project was showcased at the Move it Expo early in the year to increase engagement.
• Databases and mailing lists were used throughout the project to communicate with specific groups on project elements.
• A marketing strategy was implemented to inform the community about upcoming events relating to the project.

Various stakeholders including BBRC, Primary and Secondary Schools within the Bundaberg Schools District, Bundaberg district sporting associations and Wide Bay Hospital and Health Services were engaged at key points in the planning of individual project events – e.g. sporting clubs for skills & drills; health professionals for EBM professional development activities.

Monitoring, evaluation and learning

Various evaluation methods were used, particularly post-event surveys which collected both quantitative and qualitative data around the impact of the events. Key data include:

• 21 schools received student workshops and/or teacher PD with Ruben reaching over 3,500 students
• Approximately 1,000 members of the public attended specific EBM public lectures with many more being exposed to the health literacy concepts at expos and public events. 75% of survey respondents stated they intended to make health changes due to the information they learnt. 100% of survey respondents believed these concepts should be taught within primary schools.
• 379 children participated across 9 Skills & Drills events throughout the year. 67% of survey respondents stated they intended to participate further in one or more of the sports they tried at these events. Qualitative feedback suggested that families enjoyed having active opportunities over the school holidays and that it was great to be able to try sports for free before committing to memberships.
• Eight 10,000 Steps walking groups were run with an average of 9 participants per week.

Learnings/findings

• Utilising existing council resources such as established events; web and media platforms; stakeholder databases as well as the partnership with Ruben were key enablers in getting the program off the ground and successfully delivered.
• Initially, establishing connections with schools posed a challenge. Although the primary focus was on teacher professional development, incorporating student workshops proved crucial for initiating interest and offered a platform to showcase concepts within a classroom setting, leading to increased school engagement.  
• The Walk with a Doc program faced challenges in engaging general practitioners (GPs) and health professionals, mainly due to concerns regarding liability. Consequently, a decision was made to modify this aspect of the program in response to these concerns.
• The public’s enthusiast response to the program’s scientifically framed message, right down to atoms and chemistry, was notable. Ruben’s approach in making these concepts accessible was highly effective. This success reinforced how powerful health literacy can be as change motivator.

Unexpected/additional outcomes:

The Gin Gin Community has shown exceptional engagement with Ruben. He has visited Gin Gin State High School along with all of its feeder primary schools and the homeschooling community. Potentially, every child in this area has been exposed to the concepts he is teaching. Ruben expresses a desire to persist in working with this community, aiming to foster long-term educational outcomes.

As a result of attending a homeschool workshop and public lecture, a nine-year-old boy with Avoidant Restrictive Food Intake Disorder (ARFID), reliant on PEG nutrition, increased his confidence in trying new foods and expanding his choice of ‘safe foods’ from 3 to 15.

Next steps/outcomes for others

Ruben will continue to deliver the EBM concepts, particularly within schools as an independent provider. His aim is that the carbon in, carbon out concept will be embedded throughout the P-12 curriculum and that these will have long-term impact of health. He is working on building relationships with key stakeholders in this area.

‘This is just the beginning. I want Bundaberg to be the healthiest city, with the highest levels of health literacy in the world. You don’t have to be rich to lead a healthy lifestyle, you just need to know how your body works and what food is made of. Atoms. Knowledge is power. Understanding your body puts you in control over your own health. We can all do this!’

Ruben Meerman, Surfing Scientist

Skills & Drills events will be included as an ongoing activity within BRC’s Sport & Recreation department although not in the same capacity. It is aimed that at least 1 event will be held in different regions throughout each calendar year.

Walking groups will be an activity option within the existing Be Active, Be Alive program as programming allows. These will showcase our local pathway resources.

For Further Information

Andrew Beckenhauer
Bundaberg Regional Council

Ruben Meerman
Surfing Scientist

Website: www.ourbundabergregion.com.au/eat-breathe-move