the mend programme: healthy lifestyles for the whole family dr. gordon macmillan
TRANSCRIPT
The MEND Programme: Healthy lifestyles for the whole
family
Dr. Gordon MacMillan
School-based policies have delivered limited results:
• Majority of primary school pupils bring crisps,
sweets or chocolate into school to eat during break.
• Decline in school meal take up.
• Primary 7 pupils display less healthy eating
behaviour than younger children.
Source: Glasgow Centre for Population Health 2007
Figure 17.2 Work place counselling – body mass index (BMI [kg/m2]) over time
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30.00
0 2 4 6 8 10
Time (years)
BM
I
Prevention
'Do nothing' model
Figure 17.4 Whole school approach – body mass index (BMI [kg/m2]) over time
Figure 17.3 Counselling by primary care staff – body mass index (BMI [kg/m2]) over time
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Time (years)
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Prevention
'Do nothing' model
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Time (years)
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Time (years)
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Prevention
'Do nothing' model
Figure 17.5 Family-based interventions, BMI over time
Effectiveness of different programme types
Only family-based interventions have a significant effect on BMI, which is sustained over time (NICE, Obesity, Full Guidance December 2006)
Rates of child obesity continue to rise
Parents have most influence over child health
• Socio-economic status.
• Breastfeeding.
• Patterns of sedentary / active behaviour.
• Structure of mealtimes.
• Attitudes towards foods.
Schools can engage with parents & help them to:
• Offer children healthy, balanced diets.
• Select and prepare food with children.
• Manage food in the home.
• Encourage and reward active lifestyles.
• Instill positive attitudes towards healthy foods.
And food service providers can support children to:
• Manage stimuli to eat.
• Withstand peer pressure.
• Distinguish between healthy and unhealthy diets.
• Understand food labeling.
• Get involved in the selection & preparation of food.
• Adopt healthy lifestyles.
Components of an effective response to child obesity:
• Involves parents and children.
• Informal, engaging and fun.
• Empowers parents and children.
• Community based.
• Founded on robust clinical evidence.
• Delivers measured health & social outcomes.
MEND Programme comprises
20 x 2-hour group sessions (10 weeks)
Introduction and farewell
8 Mind
8 Nutrition
18 Exercise
2 Measurement sessions (Pre & Post)
Content – Mind
Goal & rewards Role modeling Stimulus control - hunger vs. craving Problem solving Positive parenting e.g. bullying, sleep etc Self-esteem & confidence
(5 / 8 sessions – parents only)
Applying social learning theory & behaviour modification techniques:
Content - Exercise
Land & water based
Group play
Non-competitive
Graded activities
self-esteem (dance, voice & drama)
Fun
Content - Nutrition
Customised healthy eating
Not a diet
Educating & empowering families
No forbidden foods
Many convenience and ready-meals promoted
Organic products not promoted
(All sessions - parents & children)
Regional and national funding partners
Number of funded MEND Programme sites (free for participants)
Number of sites
0
50
100
150
200
250
300
350
Q12006
Q22006
Q32006
Q12007
Q22007
Q42007
Q12008
Q22008
Q42008
Cumulative funded children on MEND programmes (free for participants)
Cumulative number of children through MEND Programme
0
5,000
10,000
15,000
20,000
25,000
30,000
Jan '07 Apr '07 Jul '07 Sep '07 Jan '08 Apr '08 Jul '08 Sep '08 Jan '09 Apr '09 Jul '09 Sep '09
Cumulative frontline staff through One Day Training (free for participants)
Cumulative cumber of additional frontline staff in health, voluntary and education sectors trained in how to respond to childhood obesity- ODT
0
1,000
2,000
3,000
4,000
5,000
6,000
Jan '07 Apr '07 Jul '07 Sep '07 Jan '08 Apr '08 Jul '08 Sep '08
20 year research partnership
UCL Institute of Child Health
Evidence Base (Research)
Feasibility study 2002-3(Sacher et al, 2005)
Pilot 2004-5(Sacher et al, 2006)
RCT 2005-7(Sacher et al, 2007)
Research teamPaul Sacher
Dr Paul Chadwick
Prof. Tim Cole
Maria Kolotourou
Dr Margaret Lawson
Prof. Alan Lucas
Dr Atul Singhal
UCL Institute of Child Health
86% mean MEND Programme attendance
68% of children attended ≥ 16 / 18 sessions
97% MEND Programme retention rate
79% study retention rate (12 months)
Attendance and retention
