No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Childhood Obesity in the Community: Treatment, Prevention, and Monitoring of Childhood Obesity in Leeds, U.K.
Abstract
Childhood obesity has essentially no consequences at the community level and therefore presents a dilemma. On the one hand, communities should be dealing with those health matters that place a real burden on their resources. On the other hand, childhood obesity places almost no immediate burden on resources. However, the burden of adult obesity is highly significant and is predicted by the prevalence of untreated childhood obesity. The medical complications for the vast majority of obese children occur beyond the childhood years. Emotional suffering, which is common, could take up resources, but mental health services are so inadequate across the country that the troubled child is infrequently seen. The community does have a great responsibility to address the problem of childhood obesity, and I propose to address its potential role across the three areas of prevention, treatment, and monitoring.
Childhood obesity has become a major concern of public health over the last decade. Obesity prevention programmes show limited success and the evidence base is weak. Experience with school-based obesity prevention research in Leeds highlighted the felt needs of children who were already obese, and a project was set up to attempt to meet those needs. WATCH IT has been running since 2003 and has involved 94 children. The quantitative data has been reported elsewhere, and this paper presents qualitative data from focus groups and interviews with participating children and their parents. These data show that WATCH IT has been successful in recruiting and retaining children, that children enjoy attending, and that it meets their emotional needs. Parents and children reported reduced self-harm, depression and better results at school for their children. The data also illustrate the effect of obesity on the family and that parents have a range of emotional and practical needs, which are partly being met by the programme. There needs to be a more systematic attempt to evaluate projects such as WATCH IT so that this can be added to the existing patchy evidence base. The data point to the importance of whole-family approaches.
The WATCH IT programme was developed to address the needs of obese children from disadvantaged communities in Leeds and has been running since January 2004. Results of the pilot phase, prior to a randomised controlled trial, are presented.
A process evaluation to assess success of implementation was conducted in December 2004. User views (parent and child) were obtained by semi-structured interviews and focus groups. Change in BMI SD score was calculated for children attending between January 2004 and November 2005.
A total of 94 children (49 girls, 45 boys), mean age (SD) 12.2 (2.0) years attended. They were moderately to severely obese (mean BMI SDS 3.09 (0.45), with low quality of life and self-image scores. There was a significant reduction in overweight at 6 months (DeltaBMI SD -0.07), especially for teenagers (DeltaBMI SD -0.13) and girls (DeltaBMI SD -0.07). The programme was successfully implemented. By December 2004 mean attendance was 2.1 (0.7) clinics per month, and sports sessions 3.3 (1.7) sessions per month. Fourteen children dropped out and non-attendance was low (only 7.5% sessions missed in 12 months). Qualitative research indicated significant appreciation of the service, with reported increase in self-confidence and friendships, and reduction in self-harm.
WATCH IT offers a model for a community based service for obese children. The programme suggests that effective care can be delivered by health trainers supervised by health professionals, and so potentially provides a cost effective programme within children's communities. These findings are encouraging, and need to be substantiated by extension to other locations and evaluation by randomised controlled trial.
HELP! A Healthy Eating and Lifestyle Programme: what, when, where and why overweight, working with adolescents with obesity
- D Christie
- R Viner