Whānau Pakari: a multi-disciplinary intervention for children and adolescents with weight issues

Aim: Multi-disciplinary interventions remain the recommended management for children with obesity. The purpose of this research was to create and assess a multi-disciplinary intervention programme for children and adolescents with obesity in Taranaki, Aotearoa/New Zealand, using a mixed methods approach, incorporating a randomised clinical trial. Whānau Pakari means “healthy, self-assured families that are fully active”. The programme specifically targeted those over-represented in obesity statistics, namely Māori and those from most deprived households in the region, thereby addressing identified health inequities. Methods: Background audits informed the creation of Whānau Pakari. A randomised controlled clinical trial was embedded within the new service, offering home-based weight-related 6-monthly assessments and advice (control), or assessments and weekly group sessions for 12 months. Multi-source evaluation was undertaken to determine satisfaction, and an economic evaluation was performed, comparing Whānau Pakari with the previous conventional (hospital-based) model. Results: High rates of weight-related comorbidities, suboptimal eating behaviour, low physical activity, high screen time, and low health-related quality of life were found at baseline. Engagement with Whānau Pakari was associated with a significant decrease in body mass index standard deviation score in the low intensity control and high intensity intervention 12 months from baseline. Attendance ≥70% in the high intensity intervention doubled the effect. Improvements occurred in quality of life and cardiovascular fitness in both groups. Multi-source programme evaluation found high stakeholder, referrer and participant satisfaction. Economic evaluation demonstrated Whānau Pakari was cheaper and more effective compared with the previous conventional model of care. Conclusions: Whānau Pakari is an acceptable, appropriate intervention for children and adolescents with obesity. It is a mainstream service that achieved high levels of initial recruitment and engagement from at-risk groups, therefore improving health outcomes. Scalability and transferability appear possible. Whānau Pakari challenges the notion that a multi-disciplinary intervention programme only includes a group-based intervention with weekly sessions. Instead, it is a model where multi-disciplinary support from a team provides comprehensive assessment that identifies and manages weight-related comorbidities, which can assist in planning individualised interventions. This assessment and intervention model of service provision could be considered for New Zealand children and adolescents with obesity.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Paediatric Endocrinology

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2018

Author dc:creator

• Anderson, Yvonne

Advisors dc:contributor.advisor

• Hofman, P
• Grant, C
• Cutfield, W
• Derraik, J

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/37413

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/37413