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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

Dose response relationship between program attendance and children’s outcomes in a community based weight management program for children and their families

Authors: Santosh Khanal, Leah Choi, Christine Innes-Hughes, Chris Rissel

Published in: BMC Public Health | Issue 1/2019

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Abstract

Introduction

The Go4Fun program in New South Wales, Australia is a community based weight management program for overweight and obese children aged 7–13 years and their families. This study assessed the impact of the number and type of sessions attended on body mass index (BMI) z-score, fruit and vegetable intake and physical activity and sedentary behaviours to determine the number of sessions required to achieve optimal program outcomes.

Methods

Secondary analysis was conducted on pre and post participant program data collected over 3.5 years. Relationships between session attendance and program outcomes were assessed using Spearman’s correlation and multivariate analyses of variance and multivariate regression. Number of sessions required to achieve optimal program outcomes was determined using piecewise linear regression.

Results

For 3090 participants (48.5% of registrants) who attended at least five sessions, outcome measures improved significantly at post program compared with pre (p < 0.01). No relationships were seen between number and type of sessions attended and outcome measures.
Children of mothers without a post-school qualification (university degree or vocational qualification) were more likely to achieve lower levels of improvements in BMI z-score (p = 0.02) and vegetable intake (P < 0.01) than those children with post-school qualified mothers (F = 3.68, p = 0.03). Children of mothers without post-school education that attended seven sessions or more achieved significantly better BMI z-score outcomes (p < 0.01) than those who attended fewer sessions.

Conclusions

Maternal educational attainment influences program attendance and health and behavioural outcomes in a family based obesity treatment program.
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Literature
1.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42.
2.
go back to reference Batch JA, Baur LA. Management and prevention of obesity and its complications in children and adolescents. Med J Aust. 2005;182(3):130–5.PubMed Batch JA, Baur LA. Management and prevention of obesity and its complications in children and adolescents. Med J Aust. 2005;182(3):130–5.PubMed
3.
go back to reference Sung-Chan P, Sung Y, Zhao X, Brownson R. Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obes Rev. 2013;14(4):265–78.CrossRef Sung-Chan P, Sung Y, Zhao X, Brownson R. Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obes Rev. 2013;14(4):265–78.CrossRef
4.
go back to reference Kothandan SK. School based interventions versus family based interventions in the treatment of childhood obesity- a systematic review. Arch Public Health. 2014;72(1):3.CrossRef Kothandan SK. School based interventions versus family based interventions in the treatment of childhood obesity- a systematic review. Arch Public Health. 2014;72(1):3.CrossRef
5.
go back to reference Welsby D, Nguyen B, O'Hara BJ, Innes-Hughes C, Bauman A, Hardy LL. Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun(R). BMC Public Health. 2014;14:140.CrossRef Welsby D, Nguyen B, O'Hara BJ, Innes-Hughes C, Bauman A, Hardy LL. Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun(R). BMC Public Health. 2014;14:140.CrossRef
6.
go back to reference Hardy LL, Mihrshahi S, Gale J, Nguyen B, Baur LA, O'Hara BJ. Translational research: are community-based child obesity treatment programs scalable? BMC Public Health. 2015;15:652.CrossRef Hardy LL, Mihrshahi S, Gale J, Nguyen B, Baur LA, O'Hara BJ. Translational research: are community-based child obesity treatment programs scalable? BMC Public Health. 2015;15:652.CrossRef
7.
go back to reference Khanal S, Welsby D, Lloyd B, Innes-Hughes C, Lukeis S, Rissel C. Effectiveness of a once per week delivery of a family-based childhood obesity intervention: a cluster randomised controlled trial. Pediatr Obes. 2016;11(6):475–83.CrossRef Khanal S, Welsby D, Lloyd B, Innes-Hughes C, Lukeis S, Rissel C. Effectiveness of a once per week delivery of a family-based childhood obesity intervention: a cluster randomised controlled trial. Pediatr Obes. 2016;11(6):475–83.CrossRef
8.
go back to reference Sacher PM, Kolotourou M, Chadwick PM, et al. Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity. Obesity. 2010;18(Suppl 1):S62–8.CrossRef Sacher PM, Kolotourou M, Chadwick PM, et al. Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity. Obesity. 2010;18(Suppl 1):S62–8.CrossRef
9.
go back to reference Baruth M, Wilcox S, Wegley S, et al. Changes in physical functioning in the active living every day program of the active for life initiative®. Int J Behav Med. 2011;18(3):199–208.CrossRef Baruth M, Wilcox S, Wegley S, et al. Changes in physical functioning in the active living every day program of the active for life initiative®. Int J Behav Med. 2011;18(3):199–208.CrossRef
10.
go back to reference Evans WD, Christoffel KK, Necheles J, Becker AB, Snider J. Outcomes of the 5-4-3-2-1 go childhood obesity community trial. Am J Health Behav. 2011;35(2):189–98.CrossRef Evans WD, Christoffel KK, Necheles J, Becker AB, Snider J. Outcomes of the 5-4-3-2-1 go childhood obesity community trial. Am J Health Behav. 2011;35(2):189–98.CrossRef
11.
go back to reference Redfern J, Enright G, Raadsma S, et al. Effectiveness of a behavioral incentive scheme linked to goal achievement: study protocol for a randomized controlled trial. Trials. 2016;17(1):1.CrossRef Redfern J, Enright G, Raadsma S, et al. Effectiveness of a behavioral incentive scheme linked to goal achievement: study protocol for a randomized controlled trial. Trials. 2016;17(1):1.CrossRef
14.
go back to reference Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002;11(246):1-190. Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002;11(246):1-190.
15.
go back to reference MEND Australia Pty Ltd. The MEND 7-13 program: Theory Leaders' Manual. Melbourne: Better Health Company; 2017. MEND Australia Pty Ltd. The MEND 7-13 program: Theory Leaders' Manual. Melbourne: Better Health Company; 2017.
16.
go back to reference Flood VM, Wen LM, Hardy LL, Rissel C, Simpson JM, Baur LA. Reliability and validity of a short FFQ for assessing the dietary habits of 2-5-year-old children, Sydney, Australia. Public Health Nutr. 2014;17(3):498–509.CrossRef Flood VM, Wen LM, Hardy LL, Rissel C, Simpson JM, Baur LA. Reliability and validity of a short FFQ for assessing the dietary habits of 2-5-year-old children, Sydney, Australia. Public Health Nutr. 2014;17(3):498–509.CrossRef
17.
go back to reference Booth ML, Okely AD, Chey TN, Bauman A. The reliability and validity of the adolescent physical activity recall questionnaire. Med Sci Sports Exerc. 2002;34(12):1986–95.CrossRef Booth ML, Okely AD, Chey TN, Bauman A. The reliability and validity of the adolescent physical activity recall questionnaire. Med Sci Sports Exerc. 2002;34(12):1986–95.CrossRef
18.
go back to reference Hardy LL, Booth ML, Okely AD. The reliability of the adolescent sedentary activity questionnaire (ASAQ). Prev Med. 2007;45(1):71–4.CrossRef Hardy LL, Booth ML, Okely AD. The reliability of the adolescent sedentary activity questionnaire (ASAQ). Prev Med. 2007;45(1):71–4.CrossRef
19.
go back to reference Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001;9:171–8.CrossRef Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001;9:171–8.CrossRef
22.
go back to reference Fagg J, Cole TJ, Cummins S, et al. After the RCT: who comes to a family-based intervention for childhood overweight or obesity when it is implemented at scale in the community? J Epidemiol Community Health. 2015;69(2):142–8.CrossRef Fagg J, Cole TJ, Cummins S, et al. After the RCT: who comes to a family-based intervention for childhood overweight or obesity when it is implemented at scale in the community? J Epidemiol Community Health. 2015;69(2):142–8.CrossRef
23.
go back to reference Law C, Cole T, Cummins S, Fagg J, Morris S, Roberts H. A pragmatic evaluation of a family-based intervention for childhood overweight and obesity; 2014.CrossRef Law C, Cole T, Cummins S, Fagg J, Morris S, Roberts H. A pragmatic evaluation of a family-based intervention for childhood overweight and obesity; 2014.CrossRef
24.
go back to reference Kolotourou M, Radley D, Gammon C, Smith L, Chadwick P, Sacher PM. Long-term outcomes following the MEND 7–13 child weight management program. Child Obes. 2015;11(3):325–30.CrossRef Kolotourou M, Radley D, Gammon C, Smith L, Chadwick P, Sacher PM. Long-term outcomes following the MEND 7–13 child weight management program. Child Obes. 2015;11(3):325–30.CrossRef
25.
go back to reference Fagg J, Chadwick P, Cole T, et al. From trial to population: a study of a family-based community intervention for childhood overweight implemented at scale. Int J Obes. 2014;38(10):1343–9.CrossRef Fagg J, Chadwick P, Cole T, et al. From trial to population: a study of a family-based community intervention for childhood overweight implemented at scale. Int J Obes. 2014;38(10):1343–9.CrossRef
26.
go back to reference Upton P, Taylor C, Erol R, Upton D. Family-based childhood obesity interventions in the UK: a systematic review of published studies. Community Practitioner. 2014;87(5):25–9.PubMed Upton P, Taylor C, Erol R, Upton D. Family-based childhood obesity interventions in the UK: a systematic review of published studies. Community Practitioner. 2014;87(5):25–9.PubMed
27.
go back to reference Spinks AB, Macpherson AK, Bain C, McClure RJ. Compliance with the Australian national physical activity guidelines for children: relationship to overweight status. J Sci Med Sport. 2007;10(3):156–63.CrossRef Spinks AB, Macpherson AK, Bain C, McClure RJ. Compliance with the Australian national physical activity guidelines for children: relationship to overweight status. J Sci Med Sport. 2007;10(3):156–63.CrossRef
28.
go back to reference Butcher K, Sallis JF, Mayer JA, Woodruff S. Correlates of Physical Activity Guideline Compliance for Adolescents in 100 U.S. Cities. J Adolesc Health. 2008;42(4):360–8.CrossRef Butcher K, Sallis JF, Mayer JA, Woodruff S. Correlates of Physical Activity Guideline Compliance for Adolescents in 100 U.S. Cities. J Adolesc Health. 2008;42(4):360–8.CrossRef
29.
go back to reference Miller E, Lee JY, DeWalt DA, Vann WF. Impact of caregiver literacy on children's oral health outcomes. Pediatrics. 2010;126(1):107–14.CrossRef Miller E, Lee JY, DeWalt DA, Vann WF. Impact of caregiver literacy on children's oral health outcomes. Pediatrics. 2010;126(1):107–14.CrossRef
30.
go back to reference Berkman ND, DeWalt DA, Pignone MP, et al. Literacy and health outcomes: summary. 2004. Berkman ND, DeWalt DA, Pignone MP, et al. Literacy and health outcomes: summary. 2004.
31.
go back to reference Sanders LM, Federico S, Klass P, Abrams M, Dreyer B. Literacy and child health: a systematic review. Arch Pediatr Adolesc Med. 2009;163(2):131–40.CrossRef Sanders LM, Federico S, Klass P, Abrams M, Dreyer B. Literacy and child health: a systematic review. Arch Pediatr Adolesc Med. 2009;163(2):131–40.CrossRef
32.
go back to reference Kitscha CE, Brunet K, Farmer A, Mager DR. Reasons for non-return to a pediatric weight management program. Can J Diet Pract Res. 2009;70(2):89–94.CrossRef Kitscha CE, Brunet K, Farmer A, Mager DR. Reasons for non-return to a pediatric weight management program. Can J Diet Pract Res. 2009;70(2):89–94.CrossRef
33.
go back to reference Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12(5):e273–81.CrossRef Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12(5):e273–81.CrossRef
34.
go back to reference Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50.CrossRef Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50.CrossRef
35.
go back to reference Stomfai S, Ahrens W, Bammann K, et al. Intra-and inter-observer reliability in anthropometric measurements in children. Int J Obes. 2011;35(1):S45.CrossRef Stomfai S, Ahrens W, Bammann K, et al. Intra-and inter-observer reliability in anthropometric measurements in children. Int J Obes. 2011;35(1):S45.CrossRef
36.
go back to reference Onis M. Reliability of anthropometric measurements in the WHO multicentre growth reference study. Acta Paediatr. 2006;95(S450):38–46. Onis M. Reliability of anthropometric measurements in the WHO multicentre growth reference study. Acta Paediatr. 2006;95(S450):38–46.
Metadata
Title
Dose response relationship between program attendance and children’s outcomes in a community based weight management program for children and their families
Authors
Santosh Khanal
Leah Choi
Christine Innes-Hughes
Chris Rissel
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7094-5

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