Jackie Hargreaves

A whole family approach to childhood obesity management (GOALS): Relationship between adult and child BMI change

Background: A growing body of evidence advocates a multidisciplinary, family-focused approach to childhood obesity management, but there is a need to explore familial factors associated with intervention success. Aim: This study explored the relationship between adult BMI change and child BMI SDS change following completion of a community-based, lifestyle change intervention for obese children and families (Getting Our Active Lifestyles Started (GOALS)). Method: Sixty of 121 families with overweight children completed the GOALS intervention between September 2006 and March 2009.Complete pre- and post-intervention (6 months) BMI data was available for 47 of these families, 26 of whom attended 12-month follow-up. Child BMI was converted to age- and sex-specific standard deviation scores (SDS) using the 1990 UK growth references. Results: There was a strong correlation between adult BMI change and child BMI SDS change from pre- to post-intervention (r = 0.53, p < 0.001) and from pre-intervention to 12-month follow up (r = 0.72, p < 0.001). Over both time periods, children with adults who reduced BMI were more likely to reduce BMI SDS (p < 0.01) and showed a greater reduction in BMI SDS (p < 0.01) than children with adults who maintained or increased BMI. Conclusion: The results showed a strong positive association between adult BMI change and child BMI SDS change, particularly during the post-intervention period where therapeutic contact was minimal. The findings suggest active involvement of adult family members in the weight loss process improves child treatment outcomes.

Reaching older people with PA delivered in football clubs: the reach, adoption and implementation characteristics of the Extra Time Programme

BackgroundOlder adults (OA) represent a core priority group for physical activity and Public Health policy. As a result, significant interest is placed on how to optimise adherence to interventions promoting these approaches. Extra Time (ET) is an example of a national programme of physical activity interventions delivered in professional football clubs for OA aged 55+ years. This paper aims to examine the outcomes from ET, and unpick the processes by which these outcomes were achieved.MethodsThis paper represents a secondary analysis of data collected during the evaluation of ET. From the 985 OA reached by ET, n=486 adopted the programme and completed post-intervention surveys (typically 12 weeks). We also draw on interview data with 18 ET participants, and 7 staff who delivered the programme. Data were subject to thematic analysis to generate overarching and sub themes.ResultsOf the 486 participants, the majority 95%, (n= 462) were White British and 59.7% (n=290) were female. Most adopters (65.4%/n=318) had not participated in previous interventions in the host clubs. Social interaction was the most frequently reported benefit of participation (77.2%, n=375). While the reach of the club badge was important in letting people know about the programme, further work enhanced adoption and satisfaction. These factors included (i) listening to participants, (ii) delivering a flexible age-appropriate programme of diverse physical and social activities, (iii) offering activities which satisfy energy drives and needs for learning and (iv) extensive opportunities for social engagement.ConclusionsFindings emerging from this study indicate that physical activity and health interventions delivered through professional football clubs can be effective for engaging OA.

Service evaluation of the GOALS family-based childhood obesity treatment intervention during the first 3 years of implementation

Objectives To evaluate the impact of the GOALS (Getting Our Active Lifestyles Started) family-based childhood obesity treatment intervention during the first 3 years of implementation. Design Single-group repeated measures with qualitative questionnaires. Setting Community venues in a socioeconomically deprived, urban location in the North-West of England. Participants 70 overweight or obese children (mean age 10.5 years, 46% boys) and their parents/carers who completed GOALS between September 2006 and March 2009. Interventions GOALS was a childhood obesity treatment intervention that drew on social cognitive theory to promote whole family lifestyle change. Sessions covered physical activity (PA), diet and behaviour change over 18 2 h weekly group sessions (lasting approximately 6 months). A Template for Intervention Description and Replication (TIDieR) checklist of intervention components is provided. Primary and secondary outcome measures The primary outcome measure was child body mass index (BMI) z-score, collected at baseline, post-intervention and 12 months. Secondary outcome measures were child self-perceptions, parent/carer BMI and qualitative changes in family diet and PA (parent/carer questionnaire). Results Child BMI z-score reduced by 0.07 from baseline to post-intervention (p<0.001) and was maintained at 12 months (p<0.05). There was no change in parent/carer BMI or child self-perceptions, other than an increase in perceived social acceptance from baseline to post-intervention (p<0.05). Parents/carers reported positive changes to family PA and dietary behaviours after completing GOALS. Conclusions GOALS completion was associated with small improvements in child BMI z-score and improved family PA and dietary behaviours. Several intervention modifications were necessary during the implementation period and it is suggested childhood obesity treatment interventions need time to embed before a definitive evaluation is conducted. Researchers are urged to use the TIDieR checklist to ensure transparent reporting of interventions and facilitate the translation of evidence to practice.

Tackling mental health: the role of professional football clubs

Abstract In the UK, professional football clubs are being used as settings for the delivery of interventions that promote mental health in a number of ways including (i) the delivery of physical activity interventions to improve the mental health of the general population, (ii) the delivery of physical activity interventions for people experiencing mental illness, and (iii) the delivery of community mental health services within the confines of the football club. This research note offers insights into mental health interventions delivered within, and by, professional football clubs and the available evidence concerning their reach, effectiveness and impact. The findings suggest that professional football clubs can help to facilitate access to mental health services, particularly among young people, for whom accessing such services may be highly stigmatized. Furthermore, the findings highlight that such interventions have a positive impact on health. However, in order to capitalize on this opportunity funding agencies and commissioners must provide appropriate resources (human and financial) for effective delivery and evaluation. Furthermore, a more strategic approach to working towards the mental health agenda must be adopted. It is argued that this change in practice would allow professional football clubs to offer those in need access to high-quality interventions.

Sustaining health improvement activities delivered in English professional football clubs using evaluation: a short communication

It has been suggested that football and communities are inextricably linked. Healthy lifestyles are an important component in maintaining the sustainability of local communities, not least, because a convincing evidence base supports the holistic benefits that can be derived from health-enhancing behaviours, such as regular physical activity. As such, efforts to promote health improvement through sport and physical activity include those interventions delivered in professional sporting settings. Johnman and colleagues (Johnman and Mackie, ‘The Beautiful Game’) have heralded sports clubs as important venues for the delivery of health improvement interventions for a range of groups across local communities. This includes health improvement activities delivered in professional football club community schemes. While exemplary practice shows how health improvement programmes can be implemented and evaluated, our experience and engagement with professional football club community schemes supports the notion that more needs to be undertaken to help clubs develop monitoring and evaluation strategies in order to assess the impact of their health improvement programmes. In our short communication, we share our plans for helping two professional football clubs develop their monitoring and evaluation strategies for their community health promotion programmes. Potential outcomes emerging from this process are twofold. (1) To help club community schemes in-build and sustain monitoring and evaluation practices within their future health improvement provision. (2) To use the impact and process outcomes emerging from programme evaluations, to successfully secure the necessary resources to sustain future health improvement activities for their local communities. Outcomes emerging from this study will be of interest to football clubs and evaluators alike, as they seek to develop evaluation strategies for their health improvement programmes.