5 WAYS TO SOLVE THE CHILDHOOD OBESITY PROBLEM Aoife Prendergast - PowerPoint PPT Presentation

5 WAYS TO SOLVE THE CHILDHOOD OBESITY PROBLEM Aoife Prendergast Lecturer :Institute of Technology Blanchardstown

Introduction: Obesity • “Global Epidemic” • Recognized internationally as a major public health challenge. • The' "Growing Up in Ireland Study “(2009 ) found one in four 9- year olds overweight or obese • Unfortunately, there are no exemplar populations abroad to learn from as no country has been successful in turning the tide on obesity. .

Lessons Learned • My own UK Experience • NHS: Primary Care Trust • Public Health • Community Health and Weight Management • Leeds Metropolitan University • Great Ormond Street

5 WAYS 1. UK Experience: Lessons Learned 2. Community Health and Weight Management must remain a key focus 3. Evidence Based Settings Approach 4. Stakeholder Engagement 5. Comprehensive Follow on Support

UK Interventions: Lessons Learned • However there is an ever increasing and improving body of evidence and some promising interventions such as the Carnegie Weight Management (CWM) Programme which is currently being delivered in Peterborough in the UK.

CWM Peterborough • Settings Approach • Community • Only targeted programme

• CWM is a UK national programme led by Leeds Metropolitan University • Delivered locally by health promotion specialist staff at NHS Peterborough. • The programme aims to improve the health of children between two and 17 years of age who are overweight or obese. • It also provides families with the relevant support and information to help them make healthy, informed choices to maintain a healthy weight.

Type of Programme Club programme It runs as a 12 week programme For 3 ½ hours each week Young people are to attend with a parent or carer. Parents are key to the programme and they help to implement back in the home what has been learnt on club. After the 12 weeks there is 3 month follow on support programme

NHS Peterborough: Primary Care Trust • The commissioning process for the programme started in October 2009 and delivery began in May 2010. • The city currently has one of the highest childhood obesity rates for Year 6 children. • Results from the 2008/2009 school year show that one in seven (13.8%) reception age children are overweight and almost one in ten (9.2%) are obese.

• Three age specific 12 week programmes were delivered • 2-4 years, the first of it’s kind in the UK • 4-10 years • 11-17 years • Delivered in settings across Peterborough for children and their parents or carers. • There has been a high proportion of referrals for the programme. • It is the first time that the pioneering programme has been extended to include children between the age of two and four.

Community Health Focus of Programme • The programme focuses on a number of elements that directly influence and affect a child’s weight. • These include diet and nutrition, physical activity, anthropometric measurements, behavioural change to the sustainability of change. • It is delivered as a 12-week intervention with a six month and 12-month follow-up period.

Results and Conclusions • Continual evaluation concludes that there has been: • Reduction in body fat composition, • Reduction in waist circumference and weight • As well as improved self image and self esteem for children undertaking the programme.

Sustainability: Follow on Support • To further support children undertaking the programme, a post-Carnegie programme, Movers and Shakers is currently being delivered by health promotion specialist staff in partnership with Vivacity. • The programme is delivered over a six week period and introduces participants to locally available to further encourage sustained behaviour change. • Two age groups are targeted throughout the Movers and Shakers programme, 5-10 years and 11-17 years

Carnegie Club outcomes Change Children Parents Body mass (kg) 0.7 + 2.3 -1.1 + 2.5 BMI (kg.m -2 ) -0.19 + 1 -0.31 + 0.8 BMI SDS -0.11 + 0.23 NA Waist (cm) -8.7 + 4.2 -5.9 + 4.2 % Body fat -1.75 + 2.6 -1.2 + 5.3 Fitness (l.min -1 ) 0.2 + 0.4 0.3 + 0.3

Stakeholder Engagement • Stakeholder engagement is a key success criterion in order to reach those at risk who will benefit most from the programme and ensure equality of access. • More than 800 stakeholders have been informed of the programmes including clinicians and non-clinical practitioners. • A successful outcome of the programme was the number of referrals received through all the potential routes and particularly those that are able to access Peterborough’s six priority areas

Stakeholder Engagement Plan STAKEHOLDERS GP’s, SNT, Public Health, Healthy Schools, Sports Teams Key Partnership Media & Community Businesses , Dietitians, Boards Communications Paediatricians, Child Health Teams, HVT, Children centre's SELF REFERRALS

To Replicate in Ireland…… • Using lessons learned • Utilising the settings approach addressing the contexts in which people live, work and play, including: • – the needs and capacities of people in the setting • – make the setting itself more healthy

What can we learn from the UK experience? • Settings Approach • Stakeholder Engagement • Prevention and treatment has to occur at the same time • Family Centred Approach • Goal Setting • Monitoring and Surveillance • Commitment and Motivation • Addressing the problem • Follow – Up • Peer Support • Developing programmes suited to a family’s needs: targeted programme • Physical Activity

Observations • Many challenges exist • Hardest part is that professionals are not equipped with the right language and skills to talk sensitively and helpfully with children and families about overweight and obesity. • Referral Procedures • Sustainable behaviour change

• Multi – disciplinary approach – includes physical activity, dietary and lifestyle education and a cognitive behavioural approach • Adheres to the NICE guidance for safe weight loss

What we need in Ireland: Solutions • Behaviour Change and Motivation is key • Urgent need to address this problem and come up with realistic solutions • Targeted programmes • Social Media: Change 4 Life • Key Stakeholders on board

Other Interventions • Change 4 Life • Health Trainers • Let’s Get Moving • Breakfast Clubs • Social media

Conclusions • Overall, there has been a marked increase in the efforts to prevent obesity over the past 5 – 10 years; however, we are still virtually at the starting line. • Let us hope that the next 10 years will see a much greater policy (and research) response to making the food and physical activity environments less obesogenic so that the health promotion efforts to encourage healthier choices have some chance of working.