Report on lessons learned from Colac's - DRO - Deakin

15 downloads 48737 Views 561KB Size Report
Jan 16, 2003 - Social Marketing Plan. 25 .... Table 1 Initial action plan for Be Active Eat Well project . .... the media and other social marketing opportunities.
Deakin Research Online Deakin University’s institutional research repository

DDeakin Research Online Research Online This is the published version (version of record) of: Simmons, A., Sanigorski, A. M., Cuttler, R., Brennan, M., Kremer, P, Mathews, L and Swinburn, B. A. 2009, Nutrition and physical activity in children and adolescents : report 6 : lessons learned from Colac's be active eat well project (2002-6) Department of Human Services Victoria, Melbourne, Vic. Available from Deakin Research Online: http://hdl.handle.net/10536/DRO/DU:30021654 Reproduced with the kind permission of the copyright owner . Copyright : 2009, Department of Human Services (Victoria)

Nutrition and Physical Activity in Children and Adolescents Barwon-South Western Region Sentinel Site Series Report 6: Lessons learned from Colac’s Be Active Eat Well Project (2002-2006)

Report prepared for Department of Human Services (Victoria)

By the WHO Collaborating Centre for Obesity Prevention Deakin University

This page is deliberately blank

Copyright protects this publication. This report was produced for Department of Human Services (Victoria) ….

ISBN No XXXX

Simmons A., Sanigorski AM, Cuttler R, Brennan M, Kremer P, Mathews L, & Swinburn BA (2008) Nutrition and Physical Activity in Children and Adolescents. Barwon-South Western Region. Sentinel Site Series. Report 6: Lessons learned from Colac’s Be Active Eat Well project (2002-6): Department of Human Services (Victoria)

Acknowledgements The work contained in this report, and the others in this series, represents an enormous effort from many people across a number of organisations. All of their efforts and contributions are gratefully acknowledged. Funding: The implementation of the three projects (Romp & Chomp, Be Active Eat Well, It’s Your Move!) and the support and evaluation provided by Deakin University has been funded from many sources, including the Victorian Department of Human Services, Australian Government Department of Health and Ageing, National Health and Medical Research Council, Australian Research Council, VicHealth, City of Greater Geelong, Barwon Health, Alcoa, Barwon Primary Care Forum, and Deakin University. Program implementation: Several organisations and staff have contributed to the implementation of these projects. Romp & Chomp: Barwon Health, City of Greater Geelong, Geelong Kindergarten Association, and Leisure Networks with significant input from Mark Brennan, Maree Crellin, Lisa De Majo, Kathleen Doole, Debbie Elea, Frank Giggins, Janet Park, Susan Parker, Sharon Sharp, Michael Smith, Karen Stagnitti, Janet Torode, Louise Van Herwerden and others. Be Active Eat Well: Colac Area Health, Colac Otway Shire, the primary schools and kindergartens in Colac and the Barwon South-Western Region, Victorian Government Department of Human Services (including Barwon South-Western Regional Office), Leisure Networks, Neighbourhood Renewal with significant input from Simon Baker, Tracey Bayne, Mark Brennan, Tim Bryar, Brooke Connolly, Ruth Cuttler, Juli Farquhar, Greg Fletcher, Christine Gurrie, Steve Illingworth, Di Leverret, Pauline Maunsell, Jorja Millar, Margaret Scanlon, Jason Thompson, John Townsend, Megan Trigg, Rachel Wood and others. It’s Your Move!: the secondary schools in Geelong, Bellarine and the Barwon South-Western Region, and the City of Greater Geelong with significant input from Sue Blackett, Leanne Denny, Kerryn Fearnsides, Christine Green, Sonia Kinsey, Kirsty Licheni, Louise Mathews, Kate Meadows, Lauren Reading, Lyndal Taylor and others Kristina Basile, Kathy McConnell, Helen Walsh, Rowland Watson and others from the Victorian Government Department of Human Services, and Virginia Cherry from the Department of Education and Early Childhood Development significantly contributed to all projects. The contribution of the participating schools, early childhood settings, parents, and children in the Barwon-South Western Region is gratefully acknowledged. Support and evaluation: The research and evaluation team from Deakin University that contributed to the work in these reports consisted of Dr Colin Bell, Associate Professor Max de Courten, Dr Peter Kremer, Mary Malakellis, Louise Mathews, Dr Marj Moodie Dr Andrea Sanigorski, Annie Simmons, Professor Boyd Swinburn, with vital support from many research assistants including Leva Azadi, Anthony Bernardi, Lauren Carpenter, Kerri Cuttler, Phil Day, Caryn Kave, Lawrie Meade, Lily Meloni, Narelle Robertson and others. Students who have also contributed to the projects are gratefully acknowledged: Luke Atkin, Cheryl-Ann Bennett, Camilla Birkebaek, Floor de Groot. Abbey Harding, Diana Isgro, Melanie Nichols, Amelie Roullier, Deuwke Schokker, Moniek van Zutphen and many placement students.

4 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

Contents Acknowledgements

4

LISTOFFIGURES

9

LISTOFTABLES

10

ExecutiveSummary

12

Methods

12

KeyFindings

12

Conclusions

12

1.

BACKGROUND Childhoodobesity Dietandphysicalactivitypatterns Childhoodobesityprevention SentinelSiteforObesityPrevention,BarwonSWregion Thisreport

14 14 14 14 14 14

2.

OVERVIEWOFBEACTIVEEATWELLPROJECT

15

3.

FORMATIVEEVALUATION

16

Introduction

16

ProjectBrief

16

Approachtaken Acomprehensiveapproachtoobesityprevention Communitycapacitybuilding Lessonslearned–Projectbrief

17 17 17 17

Choiceoflocation

18

ProjectSetupandOrganisationalRelationships Lessonslearned–Approachtaken

18 18

DevelopmentofanActionPlan Lessonslearned–Projectsetup

20 20

TheActionPlan

22

5 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

Lessonslearned–TheANGELOProcess TheCommunicationPlan SocialMarketingPlan CommunicationPlan Lessonslearned–TheActionPlan 4.

PROCESSEVALUATION

22 25 25 26 26 27

Introduction

27

Evaluationcomponents(inputs) Evolutionoftheactionplan Records(minutes,reports) ProjectCoordinatordiaries Resourcesproduced,policytemplates,mediacoverageetc

27 27 28 28 28

Projectimplementation TVPowerdown Summaryofresults LessonsLearnedTVPowerdown BeActiveEatWellSchoolsInitiative Summaryofresults LessonsLearned–BAEWSchoolsInitiative BeActiveLunchpack Summaryofresults Lessonslearned–BeactiveLunchpacks AfterSchoolActivityProgram Summaryofresults BeActiveArts Lessonslearned–AfterSchoolActivityProgram Summaryofresults ActiveTransport Summaryofresults Lessonslearned–BeActiveArts ChoiceChips Summaryofresults Lessonslearned–Activetransport HappyHealthyFamilies Lessonslearned–ChoiceChips Summaryofresults Lessonslearned–HappyHealthyFamiliesprogram Lessonslearned–Overallprojectimplementation

28 28 29 29 30 30 30 31 31 31 32 32 32 32 33 33 33 33 34 34 34 35 35 36 36 36

6 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

5.

OVERVIEWOFIMPACTANDOUTCOMEEVALUATION

37

Design

37

Participants

39

Measures ThedetailsofallthetoolsareincludedinthereportonMethodsandTools. PrimaryOutcomeMeasures(OutcomeEvaluation) SecondaryOutcomeMeasures(ImpactEvaluation) EnvironmentMeasures DemographicMeasures Ethicsapproval

40 40 40 40 40 40 40

Statisticalanalysis

41

Commentsonevaluationdesign Whatworkedwell Evaluationdifficulties Lessonslearned–Evaluationdesignandmeasures

41 41 41 43

6.

FINDINGS

44

Anthropometry

44

Doingnoharm

45

Behaviouralchanges Nutrition Foodsanddrinksconsumedathome(parentreport) Lessonslearned–Outcomeevaluation Foodsanddrinksbroughttoschool(SchoolFoodChecklist) Lessonslearned–Eatingpatterns Physicallyactiveandsedentarybehaviours Lessonslearned–PhysicalActivitypatterns

45 45 45 45 46 48 49 49

EnvironmentalAudits Thenutritionenvironment Thephysicalactivityenvironment

50 50 51

CommunityCapacityBuilding CommunityCapacityIndex Lessonslearned–NutritionandPhysicalActivitySchoolEnvironment CommunityReadinesstoChange Lessonslearned–communitycapacity

52 52 52 55 57

7 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

7.

CONCLUSIONS

58

8.

PUBLICATIONS

59

9.

REFERENCES

61

APPENDICES

63

8 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

List of Figures Figure 1: LogicModelforBeActiveEatWellProject........................................................................15 Figure 2: TheANGELOprocess..........................................................................................................21 Figure 3: FlowdiagramofparticipationinBeActiveEatWellevaluation........................................38 Figure 4: AnthropometricoutcomesoftheBAEWintervention.......................................................44 Figure 5: Differencesinnumberofservesconsumedbychildrenatfollowupbetween Intervention(I)andComparison(C)group........................................................................46 Figure 6: AdjustedmeanchangeinbeverageservesinBeActiveEatWell......................................47 Figure 7: AdjustedmeanchangeinservesofkeyfoodsinBeActiveEatWell.................................48 Figure 8: Summaryof(adjusted)changeinoutsideplay,watchingTVandplayingelectronic gamesforinterventionandcomparisonsamples..............................................................49 Figure 9: AchievedcapacityforthedomainofNetworkPartnershipsatbaselineandfollowup....53 Figure 10:AchievedcapacityforthedomainofKnowledgeTransferatbaselineandfollowup......53 Figure 11:AchievedcapacityforthedomainofProblemSolvingatbaselineandfollowup............54 Figure 12:AchievedcapacityforthedomainofInfrastructureatbaselineandfollowup................54

9 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

List of Tables

Table1InitialactionplanforBeActiveEatWellproject.....................................................................23 Table2Characteristicsofthestudypopulationsatbaselineandfollowup.......................................39

10 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

List of Appendices AppendixA:

BAEWProjectBrief.....................................................................................................63

AppendixB:

TermsofReference....................................................................................................64

AppendixC:

TheANGELOProcess..................................................................................................67

AppendixD:

ActionPlanBeActive,EatWell.................................................................................69

AppendixE:

CommunicationPlan..................................................................................................87

AppendixF:

ResultsfromtheSchoolEnvironmentalAudit.........................................................107

AppendixG:

BAEWCommunityCapacity.....................................................................................113

AppendixH:

CommunityReadinesstoChange............................................................................117

11 WHO Collaborating Centre for Obesity Prevention, Deakin University Report 6: Lessons learned from Colac’s Be Active Eat Well project

Executive Summary Introduction Whole-of-community intervention programs are an important strategy to reduce childhood obesity. This report covers the first such demonstration project in Australia which was conducted (2003-2006) in the rural Victorian town of Colac (pop 11,000). The Be Active Eat Well (BAEW) project aimed to increase the community’s capacity to promote healthy eating and physical activity and prevent unhealthy weight gain in children aged 4-12 years.

Methods BAEW had a quasi-experimental, longitudinal design with anthropometric data collected on Colac children in 4 preschools and 6 primary schools at baseline (2003, n=1001, response rate: 58.0%) and follow-up (2006, n= 844, follow-up rate: 84.0%). The comparison sample was a stratified random selection of preschools (n=4) and primary schools (n=12) from the rest of the Barwon South Western region of Victoria, with baseline assessment in 2004 (n=1183, response rate: 44.0%) and follow-up in 2006 (n=983, follow-up rate: 83%). Other data collection involved a computer assisted telephone interview of parents, a grade 5 and 6 survey, a lunchbox checklist survey, an environmental school audit, and an assessment of capacity building using the Community Capacity Index.

Key Findings Colac children had significantly (p