ORIGINAL ARTICLE

WATCH IT: a community based programme for obese children and adolescents

M Rudolf¹, D Christie², S McElhone³, P Sahota³, R Dixey⁴, J Walker⁵, C Wellings⁶

¹ University of Leeds and East Leeds PCT, Leeds, UK
² Dept of Child and Adolescent Psychological Services, University College London, London, UK
³ Dept of Nutrition and Dietetics, Leeds Metropolitan University, Leeds, UK
⁴ Department of Health Promotion, Leeds Metropolitan University, Leeds, UK
⁵ Yorkshire Regional Endocrinology Service, Leeds Teaching Hospitals Trust, Leeds, UK
⁶ East Leeds Primary Care Trust, Leeds, UK

Correspondence to:
Prof. M Rudolf
Community Paediatrics, Belmont House, 3–5 Belmont Grove, Leeds LS2 9DE, UK; mary.rudolf{at}leedsth.nhs.uk

Background: The WATCH IT programme was developed to address the needs of obese children from disadvantaged communities in Leeds and has been running since January 2004. Results of the pilot phase, prior to a randomised controlled trial, are presented.

Methods: A process evaluation to assess success of implementation was conducted in December 2004. User views (parent and child) were obtained by semi-structured interviews and focus groups. Change in BMI SD score was calculated for children attending between January 2004 and November 2005.

Results: A total of 94 children (49 girls, 45 boys), mean age (SD) 12.2 (2.0) years attended. They were moderately to severely obese (mean BMI SDS 3.09 (0.45), with low quality of life and self-image scores. There was a significant reduction in overweight at 6 months (BMI SD –0.07), especially for teenagers (BMI SD –0.13) and girls (BMI SD –0.07). The programme was successfully implemented. By December 2004 mean attendance was 2.1 (0.7) clinics per month, and sports sessions 3.3 (1.7) sessions per month. Fourteen children dropped out and non-attendance was low (only 7.5% sessions missed in 12 months). Qualitative research indicated significant appreciation of the service, with reported increase in self-confidence and friendships, and reduction in self-harm.

Conclusion: WATCH IT offers a model for a community based service for obese children. The programme suggests that effective care can be delivered by health trainers supervised by health professionals, and so potentially provides a cost effective programme within children’s communities. These findings are encouraging, and need to be substantiated by extension to other locations and evaluation by randomised controlled trial.

Keywords: obesity; community programme; health trainers; intervention; treatment

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