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An Overview of Current NPHS Activity on Obesity

An Overview of Current NPHS Activity on Obesity. Aim. To provide an overview of current NPHS activity related to obesity To highlight specific initiatives To signpost NPHS staff to key individuals working in this area for follow up. Childhood Heights and Weights. Nathan Lester.

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An Overview of Current NPHS Activity on Obesity

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  1. An Overview of Current NPHS Activity on Obesity

  2. Aim • To provide an overview of current NPHS activity related to obesity • To highlight specific initiatives • To signpost NPHS staff to key individuals working in this area for follow up

  3. Childhood Heights and Weights Nathan Lester

  4. Child Heights & Weights feasibility study: brief overview • Current processes not standardised • Coverage appears to vary greatly between Trusts • England: National Childhood Measurement Programme established 2005 • WAG has asked NPHS to lead a feasibility study to monitor child heights and weights in Wales • Whole population approach among primary school children

  5. STAGE I • Retrospective analysis of NCCHD • Literature reviews • Questionnaire of Trusts STAGE II To undertake a feasibility study to inform the creation of a standardised national measurement programme of children’s height and weight. Any such programme would be used to: • monitor trends in childhood growth (including obesity) in order to inform strategies and service development; • assess the effectiveness of population based interventions; • provide the basis for population based epidemiological research.

  6. Who’s included? • Trusts: NE, N Glam, Pembs, Powys, Swansea • Schools: all state primary, special needs (where already included by Trusts) • Children: reception and year 4 • Most of the fieldwork to be undertaken by school nurses Data storage • Trust CCH2000 for data capture • National Community Child Health Database – pseudonymised data for surveillance • Year 4 data to be shared with WHO Timetable Measurement to be completed by end of March 2009 Report to WAG in May 2009

  7. Inequalities in Childhood Obesity Huw Brunt

  8. Childhood overweight and obesity: is the gap closing the wrong way? • Study to investigate relationship between overweight/obesity prevalence and socioeconomic status (SES) • Most research in area to date has been adult-focused • Study population: 21,301 children aged 3 years from Swansea, Neath and Port Talbot areas (1995 to 2005) • Data obtained from NCCHD • Overall, an estimated 80% of 3-yr old population accounted for (annual range 63% to 87%) • Estimates of adiposity: BMI using IOTF cut-offs • SES: Townsend material deprivation scores

  9. Results • 5.2% (1,115) obese, 15.0% (3,202) overweight • Overweight/obese proportion increased over study period: combined overweight/obese: 18% vs. 22% overweight: 13.9% vs. 16.8% obese: 4.1% vs. 5.1% • Variation in annual trends in overweight/obese observed in most and least deprived fifths • No statistically significant associations found between SES and proportions of boys or girls overweight or obese • Obese propn. decreased in least deprived fifth (5.6% to 4.3%) increased in most deprived fifth (3.7% to 6.3%) • Overweight propn. increased in least deprived fifth (14.6% to 16.0%) increased in most deprived fifth (12.8% to 18.3%)

  10. F-test analysis: Least deprived F = 0.188, d.f. = 9, P = 0.68 Most deprived F = 3.335, d.f. = 9, P = 0.10

  11. Conclusions • Some study limitations • Dynamic overweight/obesity and SES relationship observed • Prevalence greater amongst least deprived children at start of study (1995), but greater in most deprived children by end (2005) • Trends suggestive of some degree of association but results not statistically significant • Important range of public health implications: - data quality and surveillance - potential influence of socioeconomic factors - directing and targeting lifestyle-changing messages and interventions to maximise impact • Has led to, and informed, wider public health action e.g. Child Heights and Weights Feasibility Pilot Project Reference: Brunt H, Lester N, Davies G, Williams R. Childhood overweight and obesity: is the gap closing the wrong way? Journal of Public Health, 2008; 30(2): pp. 145-152.

  12. The Flintshire MEND Pilot Kim Burkhill

  13. Background • 15% of children aged 4-10 years old in Flintshire are classified as obese (National Heart Forum 2006) • NICE Guidance and other current evidence recommends a ‘Family Therapy Approach’ • Funding provided by Flintshire Local Health Board

  14. Things that worked well! • A Multi – Disciplinary Approach - team interaction and support – RELATIONSHIP • Pre prepared materials/resources –easy to understand handouts • Using leisure centre as a venue • Children and families meeting others with similar problems – time/facility for social interaction • Participants desire and willingness to change • Opportunistic contact for identification of health and social needs

  15. What didn’t work so well! • Trying to balance ‘normal’ workload with running MEND sessions • Using inappropriate areas for exercise element • Limited opportunities for local interpretation – must ‘stick to the script’! • Lack of team ‘back up’ • No formal follow-up agreed for graduates

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