Aoife Prendergast

“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.

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My own UK Experience

NHS: Primary Care Trust

Public Health

Community Health and Weight Management

Leeds Metropolitan University

Great Ormond Street

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.

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.

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

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.

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.

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.

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

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 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

GP’s, SNT, Public Health, Healthy Schools, Sports Teams , Dietitians, Paediatricians, Child Health Teams, HVT, Children centre's

Key Partnership Boards

Media & Communications

Businesses Community

STAKEHOLDERS

SELF REFERRALS

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

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

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

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

Change 4 Life

Health Trainers

Let’s Get Moving

Breakfast Clubs

Social media

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.