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Be Active Eat Well (Colac) Final Reports

A series of six final reports of activity at the Barwon Sentinel Site for Obesity Prevention have been produced. The reports present the baseline and final measurements from the BAEW (Colac) project (Primary school age, 4-12 year olds) and information regarding the associated obesity prevention projects: ‘Romp & Chomp’ (Under 5 year olds) and ‘It’s Your Move!’ (Secondary school age, 12-18 year olds).

The series of reports also contain the findings/lessons learned from:

The methods and tools used;
Anthropometric measurements;
Dietary and physical activity patterns;
Obesogenic environments, and
The lessons learned from Colac’s ‘Be Active Eat Well’ project (2002-2006).

The Reports

Report 1 – Methods and Tools
This report focuses on the design and methods of the evaluation and tools used for each of the BAEW projects. In general, tools were used to measure:

Anthropometry
Behaviours, attitudes, and knowledge
Environments (eg schools, early childhood settings, homes)
Community capacity
Quality of life.

The strengths and limitations of each tool are discussed including the source of tool components and any quality assessment (eg validity, repeatability). Some recommendations are made on the design of program evaluation for obesity prevention and on the choice of tools.

The collection of baseline data for the three intervention studies provides detail on the patterns of eating, physical activity, body size, and environmental support in the region. Such information is valuable for monitoring trends over time, comparing the impacts of interventions in the demonstration projects, and providing information to other regions of Victoria and Australia where patterns are likely to be similar.

Report 1 – Methods and Tools (392kb, pdf)

Report 2 – Anthropometry
This report presents the findings from anthropometric data collected in the Barwon-South Western region of Victoria from three community-based demonstration projects encompassing children aged 2-18 years.

In this sample of over 6,000 children and adolescents, the prevalence of overweight and obesity combined was 24.5% (overweight: 18.2%, obesity: 6.3%) and by age group was 17% in preschool children, 26.7% in primary and 26% in secondary school students. The burden of overweight and obesity was higher in school-aged children and was also higher in girls (26% v 23%, for girls and boys respectively). The prevalence was also higher in children from disadvantaged families with socioeconomic status related to the prevalence of overweight and obesity (27.4% v 21.8%, for low and high SES respectively). Waist circumference and waist-to-height ratio also showed the same SES gradient in all three age groups.

The findings highlight the need for population and community-wide strategies, but also the need to ensure that prevention strategies are targeted towards, and are sensitive to, addressing the issues faced by disadvantaged families. It is also important to develop strategies that are embedded in policy to create environments that promote healthy eating and physical activity and ensure equity and sustainability across the range of settings in which children and adolescents spend significant amounts of time.

Report 2 – Anthropometry (374kb, pdf)

Report 3 – Dietary patterns
This report presents the baseline findings from the dietary intake components of the three studies in the Barwon-South Western region and highlights the implications these have for public health and health promotion efforts to improve healthy eating and prevent unhealthy healthy weight gain in Australian children. The methods related to the dietary patterns are outlined in this report but the details of the methods and tools can be found in the accompanying report (Report 1).

The results highlight several areas important for obesity prevention with the greatest areas of concern being the large amount of energy dense nutrient poor (EDNP) snacks and sweet drinks being regularly consumed by children and adolescents. In addition, the low vegetable consumption in all children is of concern. These dietary patterns are clearly drivers of increasing overweight and obesity in children and need to be included in population-wide interventions. Effective and sustainable strategies must be developed that are also targeted towards, and sensitive to, addressing the issues faced by children and adolescents from disadvantaged families.

Report 3 – Dietary patterns (628kb, pdf)

Report 4 – Physical activity patterns
This report provides a summary of physical activity including involvement in sport and organised activities, outdoor play after school time, and transport to/from school. The report also summarises information about sedentary behaviours such as watching TV, playing computer-based and electronic games, as well as total screen time by drawing on findings from three separate studies undertaken in the Geelong and Barwon-South Western region of Victoria.

The methods used to collect baseline data on physical activity patterns in the three projects are described briefly in this report. Further description is provided in the full report on Methods and Tools in the accompanying report (Report 1).

The findings provide insight into physical activity and sedentary behaviour patterns and contributes to the evidence needed to develop health promotion efforts for reducing unhealthy weight gain in Victorian children.

Report 4 – Physical activities patterns (734kb, pdf)

Report 5 – Obesogenic environments
This report presents the baseline findings from the examination of the nutrition and physical activity related aspects of children’s settings in the three studies in the Barwon-South Western region. The report describes the home, settings and neighbourhood environments for early childhood, primary school and secondary school students in relation to nutrition and physical activity. The results demonstrate that different environments play a critical role in influencing the nutritional and physical activity choices made by children.

Each of the projects assessed potential obesogenic environments and in particular, focused on the home, neighbourhood, early childhood settings (long day care, family day care and kindergarten) and schools (primary and secondary). This report contains the information collected from the Early Childhood Settings Audit and the Primary/Secondary School Environmental Audits (contained in report 6). These audits examined the environment in relation to nutrition and physical activity policies and were completed by directors, carers, teachers, canteen managers and principals. Additional information examining the home and neighbourhood environment was collected from the Parent Computer Assisted Telephone Interview (primary school) and Knowledge, Attitude and Behavioural Survey (secondary school).

The findings suggest that a child can be exposed to a number of obesogenic environments during their life that represent major challenges to maintaining a healthy weight for life.

Report 5 – Obesogenic environments (563kb, pdf)

Report 6 – Lessons learned from Colac’s ‘Be Active Eat Well’ project (2002-2006)
This report presents the findings from the Colac BAEW project and highlights the lessons learned from community efforts to improve healthy eating and physical activity patterns and prevent unhealthy weight gain in children. The findings apply to the Colac initiative as specific outcomes from the ‘Romp and Chomp’ and ‘It’s Your Move’ initiatives are currently being analysed by Deakin University and are to be submitted to DHS in mid 2010.

The Colac ‘Be Active Eat Well’ (BAEW) project¹ was the initial project within the Sentinel Site. The project was funded for 4 years (1 planning year, 3 intervention years) and aimed to promote healthy eating and physical activity behaviours and reduce unhealthy weight gain in children aged 4-12 years in the rural Australian town of Colac. It used a multi-setting, multi-strategy approach and was based on community capacity building principles.

The Colac project was successful in reducing unhealthy increases in children’s weight and waist measurement. It clearly improved community capacity to promote healthy eating and physical activity and demonstrated that the interventions can reduce unhealthy weight gain, slowing down the obesity epidemic.

The Colac initiative provided ‘proof-of-principle’ that the whole-of-community approach to obesity prevention increases community health promotion capacity and has a significant impact on reducing unhealthy increases in children’s weight and waist. This was the first such evidence that whole-of-community programs in Australia can have an impact on unhealthy weight gain in primary school children. Importantly, there was no evidence of harm and very strong evidence that the program reduced inequalities by reducing the SES gradient with body weight. Changes were found in some, but not all, of the expected mediators (awareness of key messages and changes in attitudes, knowledge and behaviour).

Report 6 – Lessons learned from Colac’s ‘Be Active Eat Well’ project (2002-2006) (1.2mb, pdf)

Additional report - Combined appendices from reports 1-6
This report provides details of the appendices mentioned in reports 1-6 of the BAEW (Colac) project:

A Protocols for measuring height and weight of adolescents
B Eating and Physical Activity Questionnaire (EPAQ)
C How many servings of…? Pictures
D Parent Computer Assisted Telephone Interview (CATI) Survey
E Primary School Children’s Questionnaire (Grade 5 & 6)
F School Food Checklist
G Adolescent Behaviours, Attitudes and Knowledge Questionnaire (ABAKQ)
H Kindergarten Audit Tool
I Long Day Care Audit Tool
J Family Day Care Audit Tool
K Primary School Environmental Audit
L Secondary School Environmental Audit
M Community Capacity Index
N Community Readiness Interview
O ANGELO work sheets

Combined appendices reports 1-6 (3.8mb, pdf)

¹ Using excerpts from a paper written in August 2006 by Professor Boyd Swinburn, Deakin University, ‘Colac Be Active Eat Well’ project: Briefing on background, processes, preliminary results’.