Birmingham healthy Eating and Active lifestyle for CHildren Study

Funded by: National Prevention Research Initiative http://www.npri.org.uk

Investigators: Peymané Adab (PI), Tim Barrett, Janet Cade, KK Cheng, Amanda Daley, Joan Duda, Ulf Ekelund, Paramjit Gill, Miranda Pallan, Jayne Parry

Collaborators: Raj Bhopal, Michelle Howard, Eleanor McGee, Sandra PassmoreResearch team: Victoria Brookes; Miriam Banting; Sheila Hirst

BEACHeS Study: Aims

• To develop a childhood obesity prevention intervention aimed at children aged 6 to 8, particularly focusing on South Asians– Using lay knowledge, evidence base

and expert input

• To pilot developed intervention in an exploratory trial– Primary and secondary outcomes

measured in school children

MRC framework for developing and evaluating complex interventions

Campbell, M. et al. BMJ 2000;321:694-696

BEACHeS Study Methodology• Setting

– 8 Primary schools & communities in Birmingham with >50% South Asian pupils (Indian, Pakistani or Bangladeshi)

• Phase I– Focus groups run with a range of local stakeholders– Views on childhood obesity and potential prevention

interventions explored– Resulting data used in development of intervention

package

BEACHeS Study Phase II

– Year 1 and 2 children undergo baseline measures:

• Height, weight, waist circ, skinfolds, BIA

• Blood pressure• Physical activity assessment• Dietary assessment• HRQoL, self concept and body

image• Demographic information

– Intervention delivered to 4 schools/communities

– Year 3 and 4 children undergo follow up measures

Progress so far: baseline measures

• 52 schools in Birmingham eligible, 8 recruited:– 81% pupils are

South Asian

• 1090 pupils eligible, 606 consented– 574 measured

Phase 1: Focus groups

• Identity groups convened:– Parents (groups run in English and Punjabi)– Teachers– Catering and school support staff– Local Authority, leisure and retail

representatives– Community representatives– Health representatives– Children

Focus groups: emerging findings

• Focus of interventions should shift to family and community settings

• Themes for interventions included:– Developing parenting skills– Activities for parents/families– Working on children’s self-esteem– Daily, non-competitive physical activity in

schools– Involving children in school changes– Improving provision of healthy food in schools

– Working with mosques, and other faith groups

Focus groups: barriers to successful interventions

• Many barriers identified

• Some are culturally specific– Many children spend evenings at mosque– Extended families in same household, grand

parents may have major influence over children

– Obesity may not be seen as a problem in some communities

Baseline measures: obesity prevalence

22.5% of study population overweight or obese

(males 20.3%, females 24.9%)

Weight category Males (%) Females (%) Total (%) Underweight

32 (10.8) 21 (7.7) 53 (9.3) Healthy weight

204 (68.9) 184 (67.4) 388 (68.2) Overweight

24 (8.1) 23 (8.4) 47 (8.3) Obese

36 (12.2) 45 (16.5) 81 (14.2) Total

296 (100) 273 (100) 569* (100)

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Obesity prevalence: comparison of BEACHeS and regional data

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BEACHeS population Regional data:reception

Regional data: year 6

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Next steps for BEACHeS• Detailed analysis of focus group data • Detailed analysis of baseline

measures• Development of the intervention

using:– focus group data – Evidence base – expert input

• Implementation of the developed intervention package