A pioneering healthy lifestyle programme for kids and teens with obesity called Whānau Pakari has led to physical and emotional health gains across a group tracked for 12 months, a new study shows.
Whānau Pakari means “Healthy self-assured families that are fully active” in Māori, the language of New Zealand’s indigenous people. The unique programme for 5-16 year olds, offered only in Taranaki, was designed to take healthcare out of hospitals and into people’s homes and communities.
“It was evident the best way to address weight issues in young people was to de-medicalise what is a very personal condition, and design a new kind of service that removes the stigma and judgement around obesity. It was important to us that the service involves the whole family/whānau,” says Dr Yvonne Anderson, Liggins Institute researcher, Taranaki DHB paediatrician and lead author of the study.
“While Whānau Pakari may not be a silver bullet, many participants that engage and stick with the programme do really well. It’s time to celebrate their success.”
Researchers from the Liggins Institute at the University of Auckland, New Zealand, tracked 203 five to 16 year olds who enrolled in the programme for 12 months. Results are published in the international journal, Obesity.
“The study participants were split into two groups: the ‘high intensity intervention’ and ‘low intensity’ group,” says Dr Yvonne Anderson, Liggins Institute researcher, Taranaki DHB paediatrician and lead author of the study. “Children in both groups received a home visit involving a comprehensive health assessment and personalised advice at the beginning, six and 12 month time points.
“Those in the ‘intensive group’ were also invited to weekly group sessions at community venues on topics including cooking, virtual supermarket tours, sports and physical activity, making persistent lifestyle changes and self-esteem.”
The main 12 month findings were:
- consistent improvements in cardiovascular fitness in both groups (the high intensity group were on average, half a minute, or 11 percent faster on a 550 metre walk/run test)
- important improvements in quality of life in both groups (the change in the high intensity group shifted them to within the range of peers who do not have weight issues)
- modest reductions in body mass index (BMI) adjusted for age and sex in both groups
- the one-fifth (22 percent) of participants who attended more than 70 percent of weekly sessions in the high intensity group had double the reduction in adjusted BMI, which moved some out of the “obese” BMI range into the “overweight” or “normal weight” ranges
“The kids and teens are, overall, emotionally healthier and happier – which is not always an outcome of these types of obesity interventions,” says Dr Anderson. “The improvement in quality of life was clinically meaningful – which means the effect of the intervention is likely to have a positive health benefit for the individual long-term.”
The study also showed that this approach to managing obesity reached sections of society who are most at risk and yet most likely to fall through the cracks in healthcare. Almost three in 10 of the children in the study came from households in the most deprived neighbourhoods of Taranaki. Māori made up 47 percent of the participants; New Zealand Europeans 43 percent, with the remaining 10 percent from other ethnic groups.
“These findings are really important,” says Dr Anderson. “If we are going to make a difference to those most affected by obesity, services that families feel comfortable with, and that fit in with their lives, are key.”
New Zealand has the third highest obesity rate in the OECD (30.7 percent of the population), after the United States and Mexico. About 11 percent of New Zealand children aged two to 14 years have obesity (an estimated 85,000 children), and children living in most deprived neighbourhoods are five times more likely to experience obesity than those from the least deprived areas.
Dr Anderson: “We want to keep improving the intensive model so that it inspires families/whānau from all backgrounds to persist with the programme, given our findings show attendance is key to success.”
The Whānau Pakari programme is a collaboration between the Taranaki District Health Board and Sport Taranaki.