The effectiveness of local child weight management

programmes: an audit study

Charlotte Taylor, Rosie Erol, Penney Upton & Dominic Upton 23rd October 2013

Context: Why commission an evaluation of CWM programmes?

Obesity in children and adolescents increasing in the UK;

Particular challenge in the West Midlands region (HSE, 2007; The Health and Social Care Information Centre, 2009)

Many different programmes for family based weight management are available; limited evidence of the long term effectiveness of these models.

Measures used in evaluation are inconsistent and make cross-programme comparison difficult.

Need for a standardised approach to evaluation.

Evaluation aims Benefits to participating (a) children and (b) families in terms of health improvement and behaviour change;Barriers to change for (a) children and (b) families undertaking treatment programmes; Short and longer term support available for programme participants;Cost effectiveness of each intervention.

‘Does the programme work and at what cost?’

Interventions

1. Carnegie Fun for Life: Walsall

2. Fitter Families: Stoke on Trent

3. Goals: Sandwell

4. MEND

5. One Body One Life: Coventry

6. Watch It!: Birmingham

7. YW8?: Telford and Wrekin

MethodsReview of programmes:

the target group;Theoretical rationalerecruitment and retention rates;method of programme delivery;structure (including routine practice for ongoing support for participants)

Assessment of physical and psychosocial benefits to programme participantsEconomic evaluation

Results: SEF auditNo programme collected all of the essential or desirable SEF criteria;

19 criteria collected by all interventions– Weight and height for BMI;

Physical activity and dietary measures were collected by the majority of programmes (N=6 and 5 respectively)

Range of measures used for physical activity and diet.

Results: Health Improvement - BMI

Results: Behaviour change

Results: Benefits to families

Health ImprovementLimited/no data for parents or other family membersAnecdotal data suggests some impact

Behaviour ChangeData is also limited

Results: Economic evaluation

What are the costs?

Costs calculated based on numbers recruited/retained during the evaluation period:

Highest cost per child: Watch IT! = £798-£2,424Lowest cost per child: OBOL = £321-408

ConclusionsAll programmes have some strengths;SEF criteria enabled comparison between different interventions BUT:Highlighted lack of consistency between programmes

types of data recordedevaluation methods used

Key data should be chosen based on what can be collected as well as what is desirable;Behaviour change, e.g. food intake and exercise should be measured in a systematic and standardised way

Impact on people, policy and practice?

Our impact…Enabled Primary Care Trusts to improve measurement, data collection and evaluation;

Reassured PCTs that they were commissioning effective programmes;

PCTs adopted the SEF to evaluate child weight measurement programmes when making future commissioning decisions;

One PCT specified that the SEF and the UoW evaluation tools and findings must be used by service providers.

Saunders, Baker & Davis (2011)

For more information…Upton, P., Taylor, C. E., Peters, D. M., Erol, R. and Upton, D. (2013). The effectiveness of local child weight management programmes: an audit study. Child: Care, Health and Development, 39(1), 125-133. DOI: 10.1111/j.1365-2214.2012.01378.x

Upton, P., Taylor, C., Beddows, S., & Upton, D. (2010). Weighing up the SEF: An assessment of the use of the NOO Standard Evaluation Framework across family-based weight management interventions in one region. Community Practitioner, 83(7), 34-35.

Upton, D., & Upton, P. (2009). Weight management programmes for children and families: A toolkit for measuring behaviour change, psychosocial wellbeing and participant satisfaction. Available at http://www.foodwm.org.uk/resources/CWM_-_Revised_toolkit_final_20_04_2010.pdf

Upton, P., & Upton, D. (2009). Recommendations for Commissioners of Weight Management Programmes for Children and Families. Available at: http://www.obesitywm.org.uk/resources/Recs_of_Commissioners_of_CWM_Progs.doc

Any questions?