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Professionals Home > Active living > Activity type > Structured programs > Programs > Fun 'n' Healthy in Moreland

Fun 'n' Healthy in Moreland

Fun 'n' healthy in Moreland is an exciting and unique project aiming to develop and implement a school-community based intervention promoting healthy eating choices, increased physical activity levels and improved social health and well-being for children and families in the City of Moreland.

The Moreland Community Health Service and Deakin University are working in partnership with the local community of the City of Moreland on this flagship community development project. The project will address the issue of child overweight and obesity by working closely with school communities to develop multi-level interventions guided by the limited evidence available. In contrast to many school-based projects, an extensive research component will be incorporated to evaluate the physical, environmental, social, behavioural and financial impacts and outcomes of the interventions. In doing so it aims to achieve sustainable, positive change for the Moreland community, work within national frameworks (Healthy Weight 2008) to improve the health of Australian children, and provide a unique and significant contribution to the limited international evidence-base for preventing childhood obesity.

Over the last decade the prevalence of overweight and obesity has risen dramatically across the entire age spectrum and currently almost a quarter of all Australian children are overweight or obese. Overweight and obesity in childhood and adolescence are associated with significant health complications, increased risk of adult obesity and higher adult morbidity and mortality. Due to both the social and economic costs associated with this epidemic it has become a major public health crisis.

If healthy dietary and physical activity environments and behavioural patterns can be established for young children it may help prevent the onset of overweight or obesity in adolescence and adulthood. Social changes, which have contributed to the increasing obesity epidemic, affect various aspects of our lifestyles and so single approaches to weight control are ineffective. Microenvironments such as school communities provide a means to influence many of the physical, economic, policy and socio-cultural factors impacting on food and physical activity choices. Therefore they provide an ideal setting for the multilevel interventionist approach necessary for obesity prevention. Schools also have a role as community leaders, are a source of support for parents and families, and can effect community change in environments, knowledge and behaviour.

City of Moreland social profile

The City of Moreland is a metropolitan area of inner Melbourne comprised of a population of 136,894 people, with 22,611 children aged 0-14 years. An estimated 13,286 residents are living in poverty in Moreland of which 29% are children. Residents in Moreland come from a range of culturally and linguistically diverse backgrounds. Just over one third of residents are born overseas, and a significantly lower proportion of residents speak English at home. The main languages other than English that are spoken at home are Italian, Greek, Arabic, Turkish and Mandarin. Low levels of proficiency in English among Moreland residents mean that Moreland has a high level of need for translation and interpreter services.

Project Objectives

Increase children’s physical activity levels and reduce sedentary behaviours.
Improve children’s dietary intake, indicated by increased consumption of fruit and vegetables and reduced inclusion of sweet drinks.
Improve child health, wellbeing, and educational outcomes.
Establish a sustainable intervention program and continued environment and behaviour change beyond the intervention.

Strategies

Recruitment of schools

Twenty-four primary schools in the Moreland district have been recruited to participate in the study. All enrolled students of the schools that agree to participate, will receive an invitation to participate in the study. Participating schools will be randomly allocated to intervention and control groups.

Recruitment of advisory committees and stakeholder support

This is a sustainable community-based health promotion and obesity prevention research study that will not only involve local primary schools, but also harness the enthusiasm and skills within local community groups such as the food retail sector, community cultural groups, the police, fire brigade, activity and sporting groups.

The design, implementation and evaluation of the study will also be guided by a research advisory committee consisting of a multidisciplinary team of Australian researchers specialising in key aspects of the study for example, physical activity, children’s body image and self esteem, food and nutrition, health inequalities, working with schools and communities.

Selection of intervention programs

Within the intervention schools, the school community will negotiate the exact content of the intervention strategies, but interventions that have demonstrated evidence of implementation or success in previous studies will be considered, or innovative programs which have a strong likelihood of success. The literature about randomised trials of overweight and obesity interventions in primary school children is very limited and therefore we would seek to include promising approaches that have been shown to be feasible. We will work with schools to ensure that the selection, design and implementation of strategies creates a supportive environment for the school community and covers dietary, physical activity and social and emotional wellbeing components.

Evidence-based intervention strategies offered to intervention schools will include, but not be limited to:

Engagement and participation of all stakeholders within the school community: grandparents, parents, children, school staff, local and extended community members.
Professional development and support for teachers.
Strategies to increase children’s amount of physical activity throughout the entire day, eg. active transport to and from school.
Ways to encourage children to reduce the hours they spend watching TV or video games.
Provision of a safe open area in which children can play before, during and after school.
Education programs for teachers, children, parents and extended families focusing on healthy food choices for all meals, eg supermarket visits, cooking classes.
Structural changes, eg healthy food choices in school canteens, food policies where incentives/school based activities are involved, content of vending machines, fundraising policies involving food.
Programs promoting participation in healthy activities within the community.
General parent and family strengthening strategies and improvement of parent-child interaction.

Implementation of interventions

Schools will be encouraged to form Project Management Teams with responsibility for the development and implementation of their customised intervention program. Teams may include teachers and non-teaching staff, children, parents, canteen workers, community nutritionists, community sporting organisations, and community cultural representatives. A Project Officer will assist each school to choose and monitor the strategies to be implemented. To develop sustainable programs, all intervention schools will be encouraged and helped to recruit and train volunteers to help with strategy implementation.

Evaluation

The study will employ qualitative and quantitative methods and data to evaluate the program.

To assess the sustainability of the interventions, baseline data at the child and school level will be collected at:

Timepoint 1- pre-intervention
Timepoint 2 - 2 years post the commencement of the school intervention programs
Timepoint 3 - approximately 4 years post commencement of the intervention

Data collection at T1, T2 and T3 will be completed in all schools over a 4-week period to minimise seasonal variation in food availability and environmental weather conditions. Differences in effectiveness of the intervention between intervention and control schools will be analysed at all timepoints to assess change in diet, physical activity, health and wellbeing at child level and sustainability of intervention programs at school level.

Data will be collected from:

Schools to assess the food and physical activity environment, including canteen policies and a scan of play activity levels and play equipment in the school grounds.
School staff to assess staff knowledge of healthy eating and physical activity guidelines.
Children to assess BMI z-score, physical activity levels, dietary and physical activity knowledge and attitudes, and child health and wellbeing. A lunch box survey will also be carried out to assess dietary intake.
Parents and carers to assess knowledge and attitudes, the home food and physical activity environment, and children’s eating and physical activity behaviours. Information will also be sought regarding financial expenditure and time use associated with child and household physical activity and food.

Additional data will be collected relating to school and staff perceptions of the usefulness, acceptability and efficiency of the interventions, parent and child levels of participation, engagement and satisfaction with the program, as well as assessments of relevant changes in the school and external environment, and a detailed economic evaluation to compare the incremental costs and consequences of the intervention experienced by children, households and schools over the period of the research project.

Performance Indicators

The school-community based intervention programs will be considered successful if they achieve:

Sustainable change in the school food and physical environments.
A significant increase in children’s healthy food choices.
A significant increase in children’s physical activity levels.
A significant increase in children’s health, wellbeing and educational outcomes.

Fun ‘n healthy in Moreland will be considered successful if it identifies the conditions that are needed for particular interventions to be successful and brings about change in these areas resulting in a stabilising of population weight and ideally, a decrease in the prevalence of overweight and obesity.

Residents in Moreland come from a range of culturally and linguistically diverse backgrounds. The project seeks to achieve its goals whilst being culturally sensitive to the diverse ethnic community among the City of Moreland as well as addressing the particular needs of these community groups. The intervention also aims to avoid such exacerbating factors as: body image dissatisfaction/unhealthy pre-occupation with weight, increasing the risk of developing eating disorders, negative stereotype of overweight people, and weight and shape related teasing.

Despite strong indicators for the promise of this approach, no study has previously been conducted, internationally, to evaluate either the impact or cost-effectiveness of such an intervention. This project will make a highly innovative intervention and significant contribution to the international evidence-base for preventing childhood obesity and improving the health of Australian children.

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Acknowledgement

This information has been sourced from The Department of Human Services.

Last updated: 10/22/2009

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