Intergenerational Practice to Address Childhood Obesity

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Intergenerational Practice to Address
Childhood Obesity
Dr. Gordon MacMillan
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Rates of child obesity continue to rise
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(No Transcript)
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Effectiveness of different programme types
Figure 17.4 Whole school approach body mass
index (BMI kg/m2) over time
Figure 17.3 Counselling by primary care staff
body mass index (BMI kg/m2) over time
Figure 17.2 Work place counselling body mass
index (BMI kg/m2) over time
Figure 17.5 Family-based interventions, BMI over
time
Only family-based interventions have a
significant effect on BMI, which is sustained
over time (NICE, Obesity, Full Guidance December
2006)
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School-based policies have delivered limited
results

• Majority of primary school pupils bring crisps,
  sweets or chocolate into school to eat during
  break.
• Decline in school meal take up.
• Primary 7 pupils display less healthy eating
  behaviour than younger children.

Source Glasgow Centre for Population Health 2007
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Parents have most influence over child health

• Socio-economic status.
• Breastfeeding.
• Patterns of sedentary / active behaviour.
• Structure of mealtimes.
• Attitudes towards foods.

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MEND engages parents children and helps them to

• Consume healthy, balanced diets.
• Select and prepare healthy food.
• Manage food in the home responsibly.
• Adopt and share active lifestyles.
• Acquire positive attitudes towards healthy foods.

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MEND supports parents and children to

• Manage stimuli to eat.
• Withstand peer pressure.
• Distinguish between healthy and unhealthy diets.
• Understand food labeling.
• Get involved in the selection preparation of
  food.
• Adopt healthy lifestyles.

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Components of an effective response to child
obesity

• Involves parents and children.
• Informal, engaging and fun.
• Empowers parents and children.
• Community based.
• Founded on robust clinical evidence.
• Delivers measured health social outcomes.

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MEND Programme comprises

• 20 x 2-hour group sessions (10 weeks)
• Introduction and farewell
• 8 Mind
• 8 Nutrition
• 18 Exercise
• 2 Measurement sessions (Pre Post)

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Content Mind
Applying social learning theory behaviour
modification techniques

• Goal rewards
• Role modeling
• Stimulus control - hunger vs. craving
• Problem solving
• Positive parenting e.g. bullying, sleep etc
• Self-esteem confidence
• (5 / 8 sessions parents only)

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Content - Exercise

• Land water based
• Group play
• Non-competitive
• Graded activities
• ? self-esteem (dance, voice drama)
• Fun

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Content - Nutrition

• Customised healthy eating
• Not a diet
• Educating empowering families
• No forbidden foods
• Many convenience and ready-meals promoted
• Organic products not promoted
• (All sessions - parents children)

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Regional and national funding partners
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Number of funded MEND Programme sites (free for
participants)
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Cumulative no. of households on MEND programmes
(free for participants)
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Cumulative frontline staff through One Day
Training (free for participants)
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20 year research partnership
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Evidence Base (Research)

• Feasibility study 2002-3
• (Sacher et al, 2005)
• Pilot 2004-5
• (Sacher et al, 2006)
• RCT 2005-7
• (Sacher et al, 2007)

• Research team
• Paul Sacher
• Dr Paul Chadwick
• Prof. Tim Cole
• Maria Kolotourou
• Dr Margaret Lawson
• Prof. Alan Lucas
• Dr Atul Singhal

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UCL Institute of Child Health
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Attendance and retention

• 86 mean MEND Programme attendance
• 68 of children attended 16 / 18 sessions
• 97 MEND Programme retention rate
• 79 study retention rate (12 months)

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About us

• We seek a significant, measured, reduction in
  global childhood overweight obesity levels.
• We deliver the Efficiency of Private Sector, with
  
• The Accountability of Public Sector, and
• The Compassion of the Voluntary Sector.
• Shortlisted as Social Enterprise of the Year 2007

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Delivering improvements in child health, globally

• Partnership with UCL, Institute of Child Health
  Great Ormond St. Hospital for Children NHS Trust
• 80 of activities are grant funded.
• Enter into Service Level Agreements with Local
  Authorities and PCTs.
• Manage the worlds largest community-based
  response to childhood obesity.

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Contact

• gordon.macmillan_at_mendprogramme.org
• www.mendprogramme.org