Watch it: a community based programme for obese children and adolescents

Mary CJ Rudolf ^1*, Deborah Christie ², Sinead McElhone ³, Pinki Sahota ³, Rachael Dixey ³, Jenny Walker ⁴ and Carolyn Wellings ⁵

¹ Belmont House, United Kingdom
² UCL, United Kingdom
³ Leeds Metropolitan University, United Kingdom
⁴ Leeds Teaching Hospitals Trust, United Kingdom
⁵ East Leeds Primary Care Trust, United Kingdom

^* To whom correspondence should be addressed. E-mail: mary.rudolf{at}leedsth.nhs.uk.

Accepted 12 February 2006

Abstract

The evidence for effective interventions in childhood obesity is limited, and has largely come from academic centres outside the UK. The WATCH IT programme was developed to address the needs of obese children from disadvantaged communities in Leeds and has been running in its current form since January 2004. Results of the pilot phase, prior to a randomized controlled trial, are presented.

The programme: WATCH IT is run through the NHS by trainers chosen for their communication skills but with no health care qualifications, who are supervised by a professional team. Children and parents have individual appointments and weekly group activity sessions. The programme targets family eating behaviour, physical activity, healthy eating, emotional wellbeing and socio- psychological issues. It is underpinned by adapted motivational enhancement and solution focused approaches.

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 BMIsd score was calculated for children attending between January 2004 and November 2005.

Results: 94 children (49 girls, 45 boys), mean age (sd) 12.2(2.0) years attended. They were moderately to severely obese (mean BMIsds 3.09(0.45), with low quality of life and self image scores. There was a significant reduction in overweight at six months (deltaBMIsd -0.07;p<0.01) especially for teenagers (deltaBMIsd -0.13;p<0.01) and girls (deltaBMIsd - 0.07;p=0.02). The programme was successfully implemented. By Decmber 2004 mean attendance was 2.1 (0.7) clinics per month and sports sessions 3.3(1.7) sessions per month. 14 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: childhood obesity, community programme, health trainers, intervention, treatment

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