Cluster randomised controlled trial and economic and process evaluation to determine the effectiveness and cost effectiveness of a novel intervention [Healthy Lifestyles Programme (HeLP)] to prevent obesity in school children
Public Health Research
NIHR Health Technology Assessment Programme
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Childhood obesity is an important health issue. Working with teachers, families and children, we developed the Healthy Lifestyles Programme (HeLP), which aims to engage and support children and families to make healthy food and activity choices. We designed a study to understand whether or not HeLP can prevent children aged 9–10 years from becoming overweight or obese. The study involved 32 primary schools from Devon, half of which were randomly selected to receive the programme while the other half continued as usual. We measured children’s weight and height, waist circumference and percentage body fat; assessed how active they were; and used questionnaires to look at the types of food and drink they consumed. We also asked what they understood about a healthy lifestyle and how they felt about it. The study began when the children were 9–10 years old, in Year 5, and HeLP was delivered in the spring and summer terms of Year 5 and in the autumn term of Year 6. Children had their final set of measurements taken when they were at secondary school (aged 11–12 years). We were able to follow up 94% of children for their final set of measurements, an exceptionally high follow-up rate; we think that this is because schools, children and families helped us design the trial. Despite HeLP’s success in engaging children, families and teachers, there was no difference in weight status between children who had received the programme and those who had not. There was no difference in the amount of physical activity children did or in the amount of time they spent not being active. We saw a positive difference in some snacking behaviours, with children who had taken part in HeLP eating fewer unhealthy snacks and having less unhealthy foods generally. Given that the programme failed to achieve sufficient change in behaviour to prevent overweight or obesity, we think that new approaches are needed to support families and children in making healthy lifestyle choices.
This project was funded by the NIHR Public Health Research programme (project number 10/3010/01).
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Vol. 6 (1)