Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun®

BMC Public Health

Louise L Hardy¹  Adrian Bauman²  Christine Innes-Hughes²  Blythe J O’Hara¹  Binh Nguyen¹  Debra Welsby² 

[1] Physical Activity Nutrition Obesity Research Group, Level 2, Medical Foundation Building K25, University of Sydney, Sydney, NSW 2006, Australia;NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia

关键词: Process evaluation;    Up-scaling;    Child obesity;    Translational research;   

Others  :  1145377
DOI  :  10.1186/1471-2458-14-140

 received in 2013-11-06, accepted in 2014-02-07,  发布年份 2014

【 摘 要 】

Background

Community-based obesity treatment programs for children that have a large program reach are a priority. To date, most programs have been small efficacy trials whose findings have yet to be up-scaled and translated into real-world settings. This paper reports on the process evaluation of a government-funded, translated obesity treatment program for children in Australia. It describes the characteristics and reach of children participating in the New South Wales (NSW) Ministry of Health Go4Fun® program.

Methods

Delivered across the state of NSW (Australia) by Local Health Districts (LHDs), Go4Fun® is a community-based, multidisciplinary family obesity treatment program adapted from the United Kingdom Mind Exercise Nutrition Do it (MEND) program that targets weight-related behaviours. Children aged 7-13 years with a BMI ≥85^th percentile and no co-morbidities were eligible at no cost. Parents/carers self-refer via a toll-free phone number, text messages, online registration or via secondary referrals. LHDs deliver a 16 to 20-session program based on length of school term, holidays and recruitment challenges. Both parent/carer and child attend bi-weekly after school sessions. Parent-reported socio-demographic and measured child weight characteristics are presented using descriptive statistics. Differences between completers (attended at least 75% of sessions) and non-completers were assessed using chi-square tests, independent sample t-tests and adjusted odds ratios. Analyses were adjusted for clustering of programs.

Results

Between 2009 and 2012, a total of 2,499 children (54.8% girls; mean age [SD]: 10.2 [1.7 years]) participated in the Go4Fun® program. Children were mainly from low-middle socioeconomic status (76.5%), resided in major cities (63.3%), and 5.7% were Aboriginal. At baseline, 96.5% of children were overweight or obese. Mean BMI-z-score was 2.07 (0.41) and 94.5% had a waist-to-height ratio ≥0.5. More than half (57.9%) completed at least 75% of sessions. Amongst completers (N = 1,446), girls (56.8%; p = 0.02), non-Aboriginal children (95.9%; p < 0.01) and children residing in less socially disadvantaged areas (25.9%; p = 0.02) were significantly more likely to complete the program.

Conclusions

The Go4Fun® program successfully reached the targeted population of overweight/obese children at socioeconomic disadvantage and is a rare example of an up-scaled translational program.

【 授权许可】

   
2014 Welsby et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Hardy LL, Cosgrove C, King L, Venugopal K, Baur LA, Gill T: Shifting curves? Trends in thinness and obesity among Australian youth, 1985 to 2010. Pediatr Obes 2012, 7:92-100.
• [2]Australian Bureau of Statistics: Population by age and sex, regions of Australia. In Population by Age and Sex, Regions of Australia. Edited by Australian Bureau of Statistics. Canberra; 2011. 3235.0. 2012
• [3]Hardy LL, King L, Espinel P, Cosgrove C, Bauman A: NSW Schools Physical Activity and Nutrition Survey (SPANS) 2010: full report. Sydney: NSW Ministry of Health; 2011.
• [4]Spilchak PJ, Denney-Wilson E, King L, et al.: Tertiary paediatric obesity services in Australia. J Paediatr Child Health 2008, 44(5):243-247.
• [5]Denney-Wilson E, Campbell K, Hesketh K, de Silva-Sanigorski A: Funding for child obesity prevention in Australia. Aust N Z J Public Health 2011, 35:85-86.
• [6]Glasgow RE, Lichtenstein E, Marcus AC: Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health 2003, 93:1261-1267.
• [7]Glasgow RE, Emmons KM: How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health 2007, 28:413-433.
• [8]Sacher PM, Chadwick P, Wells JC, Williams JE, Cole TJ, Lawson MS: Assessing the acceptability and feasibility of the MEND Programme in a small group of obese 7-11-year-old children. J Hum Nutr Diet 2005, 18:3-5.
• [9]Sacher PM, Kolotourou M, Chadwick PM, Cole TJ, Lawson MS, Lucas A, et al.: Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity. Obesity 2010, 18:S62-S68.
• [10]Smith LR, Chadwick P, Radley D, Kolotourou M, Gammon CS, Rosborough J, et al.: Assessing the short-term outcomes of a community-based intervention for overweight and obese children: The MEND 5-7 programme. BMJ Open 2013., 3(5)
• [11]Bauman A, Nutbeam D: Evaluation in a Nutshell. 2nd edition. North Ryde: McGraw-Hill Australia Pty Ltd; 2013.
• [12]Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia - Data only, 2006. Cat no 2033 0 55 001 - [ 2008 [cited 2010 Feb. 22]Available from: URL:http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2033.0.55.0012006?OpenDocument webcite
• [13]Department of Health and Aged Care, Information and Research Branch: Measuring remoteness. Accessibility/Remoteness Index of Australia (ARIA). Revised edition. Canberra: Dept. of Health and Aged Care; 2001. Occasional Paper New Series: Number 14
• [14]Kuczmarski RJ, Ogden CL, Guo SS, et al.: 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11 2002, (246):1-190.
• [15]Browning LM, Hsieh SD, Ashwell M: A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev 2010, 23:247-269.
• [16]Wakerman J, Humphreys J, Wells R, Kuipers P, Entwistle P, Jones J: Primary health care delivery models in rural and remote Australia - a systematic review. BMC Health Services Res 2008, 8:276. BioMed Central Full Text
• [17]AIHW: Australia's health 2012. Australia's health no. 13. [Cat. no. AUS 156]. Canberra: Australian Institute of Health & Welfare; 2012.
• [18]Dixon J, Welch N: Researching the rural-metropolitan health differential using the 'Social Determinants of Health'. Austr J Rural Health 2000, 8:254-260.
• [19]Wolfenden L, Hardy LL, Wiggers J, Milat A, Bell AC, Sutherland R: Prevalence and socio-demographic associations of overweight and obesity among children attending child-care services in rural and regional Australia. Nutr Dietetics 2011, 68:15-20.
• [20]NSW Commission for Children and Young People, UNSW Social Policy Research Centre: A picture of NSW children. NSW Office of Communities, Commission for Children and Young People [serial online] 2013. Available from: NSW Office of Communities, Commission for Children and Young People. Accessed April 26, 2013
• [21]Rychetnik L, Bauman A, Laws R, King L, Rissel C, Nutbeam D, et al.: Translating research for evidence-based public health: key concepts and future directions. J Epidemiol Community Health 2012, 66:1187-1192.
• [22]Milat AJ, King L, Rissel C, Bauman A, Redman S: The case for funding more intervention research in public health - policy maker and researcher perspectives. Aust N Z J Public Health 2012, 36:582-583.