fun ‘n healthy in Moreland!
We are building a strong understanding of how to work with schools to create healthy environments for children and families. One of the principals recently reported that, “Being involved with fun ‘n healthy in Moreland! has been invaluable for our school…When we started our involvement we had an idea of where we wanted to go, but the support and guidance we have received has been the driving force behind us actually making changes and making a positive difference to the children in our school. Parents are telling us stories: “My son now insists on having two apples after school while he is doing his homework.”; “…if schools introduce it then children will listen”; “My son now notices everything around him, is lively happy and relaxed and enjoys going to school.”
Project description
Fun ‘n healthy in Moreland! is a cluster randomised controlled trial of a child health promotion and obesity prevention intervention with 23 primary schools in a culturally diverse, inner urban area of Melbourne, Australia. It is a partnership study between Moreland Community Health Service and the University of Melbourne. The intervention strategies are driven and customis ed by the schools to ensure relevance and sustainability, informed by an exchange of information about the evidence-base in child health promotion and obesity prevention. Schools are thus supported in the implementation of a range of whole-of-school initiatives designed to address healthy eating, increased physical activity and self esteem targeting school policies, physical and social environment, and programs. Ethics approval for this research project was provided by University of Melbourne and Deakin University Human Research Ethics Committees, the Department of Education and Training and the Catholic Education Office.
Current status
The study is employing a comprehensive range of qualitative and quantitative methods and data to evaluate the program. Data was collected at baseline, mid-point andprogressively through the study. Preparation is currently underway for final data collection, to occur end 2009.
Differences in effectiveness of the intervention between intervention and control schools will be analysed at all timepoints to assess change in diet, physical activity, health and wellbeing at child level and sustainability of intervention programs at school level.
Data will be collected from:
- schools to assess the food and physical activity environment, including canteen policies and a scan of play activity levels and play equipment in the school grounds
- school staff to assess staff knowledge of healthy eating and physical activity guidelines
- children to assess BMI z-score, physical activity levels, dietary and physical activity knowledge and attitudes, and child health and wellbeing. A lunchbox survey will also be carried out to assess dietary intake.
- parents and carers to assess knowledge and attitudes, the home food and physical activity environment, and children’s eating and physical activity behaviours. Information will also be sought regarding financial expenditure and time use associated with child and household physical activity and food.
Additional data will be collected relating to school and staff perceptions of the usefulness, acceptability and efficiency of the interventions, child levels of participation, engagement and satisfaction with the program, and a detailed economic evaluation to compare the incremental costs and consequences of the intervention experienced by children, households and schools over the period of the research project.
Project funding
Elizabeth Waters acknowledges the support of a VicHealth Public Health Research Fellowship. Lisa Gibbs and Lisa Gold acknowledge NHMRC Capacity Building Grant for Child and Adolescent Obesity Prevention and we gratefully acknowledge the funding provided by the Victorian Government’s Community Support Fund as part of the ‘Go for your life’ Campaign.
We hypothesise that:
1. A four-year intervention comprising school-community action plans of comprehensive evidence-based strategies will:
a) reduce child age-adjusted BMI Z-scores
b) increase physical activity participation levels and reduce sedentary behaviours
c) increase fruit and vegetable intake, and reduce sweet drink consumption
d) improve child wellbeing and education outcomes
e) not increase child and family body-image dissatisfaction.
2. The intervention will be acceptable and feasible within the school and community setting, and cost effective
3. Active participation and involvement of key stakeholders will produce sustainable environmental and behavioural changes
The study findings are being disseminated to participating schools, funding bodies, community, government and academic networks.
Research publications to date include the following:
Gibbs L, St Leger L, Waters E, Green J, Gold L, Garrard J, Swinburn B. A settings-based theoretical framework for obesity prevention community interventions and research Health Education Research (submitted 3 Nov 08)
Ashbolt R, Gibbs L, Waters E, Walsh O, Gold L, Green J, Recruitment for school-based research with culturally and linguistically diverse families: issues and strategies. Health Education Research (submitted August 08)
Willenberg L, Ashbolt R, Gibbs L, Holland D, Waters E, Garrard J, Green J, MacDougall C. (submitted April 08) Exploring the relationship between playground environmental characteristics, children’s perceptions and playground activity levels. Journal of Science and Medicine in Sport.
Gibbs L, Baxendale A, Webber L, Waters E. Methodological modifications required to conduct obesity prevention research in school settings for children with an intellectual disability. Journal of Intellectual and Developmental Disability, submitted Mar 08
Gibbs L, Baxendale A, Webber L, Waters E. Prevention of obesity in children with an intellectual disability- A qualitative study. Journal of Intellectual and Developmental Disability, submitted Mar 08
Swinburn B, Waters E, Nichols M, King L, Gibbs L, Magarey A, et al. The vital but vexed question of measuring children’s weights. Medical Journal of Australia. submitted Dec 07
Waters, E., Ashbolt, R., Gibbs, L., Booth, M., Magarey, A., Gold, L., et al. (in press 2008). Double disadvantage: the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children. International Journal of Pediatric Obesity.
Gibbs L, O'Connor T, Waters E, Booth M, Walsh O, Green J, Bartlett J, Swinburn B, (2008) Addressing the potential adverse effects of school-based BMI assessments on children’s wellbeing. International Journal of Pediatric Obesity 3(1):52-57
Conference presentations include the following:
Gibbs L, Waters E, Swinburn B, Honisett S. Innovative approaches to understanding community change. Community and Policy Based Obesity Prevention Interventions Symposium. Brisbane 2008
Willenberg L, Ashbolt R, Holland D, Gibbs L, Waters E. Can easily implementable strategies be employed within the school playground to increase physical activity? Population Health Congress. Brisbane 2008
Willenberg L, Ashbolt R, Holland D, Gibbs L, Waters E. Can easily implementable strategies be employed within the school playground to increase physical activity? UK Public Health Congress. Cardiff 2008
Gibbs L, Waters E, Honisett S, Swinburn B. Mapping and monitoring the implementation of community-based child obesity prevention interventions. UK Public Health Congress. Cardiff 2008.
Gibbs L, Waters E, Honisett S, Swinburn B. Mapping and monitoring the implementation of community-based child obesity prevention interventions. European Congress on Obesity. Geneva, May 2008.
Gibbs L, O'Connor T, Waters E, et al. Body Image Considerations in Child Obesity Prevention In: AUSTRALASIAN SOCIETY FOR THE STUDY OF OBESITY 15th Annual Scientific Meeting; 2007; Sydney, Australia
Gibbs L, Armstrong R, Daly J, et al. Reflecting on the Role of Evidence in Qualitative Public Health Research. In: 38th Public Health Association of Australia Annual Conference; (Accepted) Sep 2007
Gibbs L, Waters E, Leger LS, Swinburn B, Green J, Garrard J, Gold L & Booth M (2007) Underpinning obesity prevention research and intervention design with a theoretical framework. The 19th IUHPE World Conference on Health Promotion and Education.
Waters E, Ashbolt R, Gibbs L, Booth M, Magarey A, Gold L, Gibbons K, Lo SK & Swinburn B (2007) Child prevalence of overweight and obesity in an inner urban, culturally diverse community. The 19th IUHPE World Conference on Health Promotion and Education.
Waters E, Moore L, Gibbs L & Murphy S (2007) Maintaining research rigour in mixed method evaluations - workshop. The 19th IUHPE World Conference on Health Promotion and Education.
Magarey A, Tarli O C, Gibbs L. The Consumption of Fruit, Vegetables & Noncore Foods by Primary School Children in Melbourne. In: Dietitian Conference; 2007; Hobart (Nutritiion & Dietetics 2007;64 (suppl 1) S30
Gibbs L, O’Connor T, Waters E, Booth M, Green J, Swinburn B. Body Image Considerations for School-Based Child and Adolescent Obesity Prevention Research. 10th International Congress on Obesity, Sydney 2006
Gibbs L, Baxendale A, Webber L, Waters E Methodological modifications required to conduct obesity prevention research in school settings for children with an intellectual disability. 10th International Congress on Obesity, Sydney 2006
Garrard J, Holland D, Waters E, Gibbs L. Integrating process and impact evaluation findings: a systematic approach to understanding variability in the effectiveness of health promotion interventions in different settings. Community-based Obesity Prevention ICO Satellite Conference, Geelong 2006
Waters E, Gibbs L, Lipscomb J, Walsh O, Ashbolt R, Swinburn B, Booth M, Lo K, Gold L, Gibbons K, Magarey A, Garrard J, Green J, O’Connor T. Child Overweight and Obesity Increasing at 1% Per Year: Population Data from an Inner Urban Metropolitan Cluster RCT. 10th International Congress on Obesity, Sydney 2006
Baxendale A, Gibbs L, Webber L, Waters E. Obesity prevention issues for children with an intellectual disability – A qualitative study. Community-based Obesity Prevention ICO Satellite Conference, Geelong 2006
Waters E, Gibbs L, Mathews C, Nakhuda S, Rachel S. Integrating knowledge translation and a community development model within the health promoting schools framework: a case study of working with schools in a school-community partnership. Community-based Obesity Prevention ICO Satellite Conference, Geelong 2006
Waters E, Gibbs L, Poljski C, et al. Increasing cultural competency in public health research. In: PHAA 2006; 25-27 September; Sydney; 2006.
Gibbs L, McConell K, Waters E, Raven E. Multilevel partnerships supporting a child obesity prevention study. In: Governments and Communities in Partnership; 25-27 September; Melbourne; 2006.
Gibbs L, Holland D, Waters E. Capturing the issues qualitatively in a mixed method environment. Cochrane Qualitative Research Methods Group Regional Symposium: Qualitative Research in Evidence-Based Healthcare - an exploration of scope and methods, Adelaide, 2006
Gibbs L, Waters E, Lipscomb J, Walsh O, Kulkens M, . 2006. What's happening in the schoolyard? Assessing physical activity opportunities in inner urban, culturally diverse school communities. Presented at 13th Commonwealth International Sport Conference, Melbourne
Gibbs L, Waters E, Moore L, Pradel V. 2005. Child obesity prevention community interventions: employing principles of knowledge transfer and decision making in the context of evidence and need for innovation. Presented at 4th Annual Meeting of the International Society of Behavioral Nutrition and Physical Activity, Amsterdam
Walsh O, Gibbs L, Waters E. 2005. Encouraging participation in baseline data collection of a childhood obesity intervention study. Poster presented at PHAA 37th Conference, Perth
Waters E, Love K, Williams J, Gibbs L (2004) School community consultation for a sustainable, school-community child health promotion and obesity prevention intervention. 18th World Conference on Health Promotion and Health Education, Melbourne
Project staff
Research team
Professor Elizabeth Waters, Principal Investigator, McCaughey Centre
Dr Lisa Gibbs, Project Manager, McCaughey Centre
Ms Rosie Ashbolt, Research Fellow, McCaughey Centre
Ms Coralie Mathews, Community Development Worker, Moreland Community Health Service
Ms Maryanne Tadic, Health Promotion in Schools Coordinator , Moreland Community Health Service
Steering Committee
Professor Elizabeth Waters, McCaughey Centre, University of Melbourne
Dr Lisa Gibbs, McCaughey Centre, University of Melbourne
Dr Christine Armit, Moreland Community Health Service
Toni Collins, Department of Human Services
Naomi Lind, Department of Education and Early Childhood Development
Mick Coyne, Department of Sport and Recreation
Scientific Advisory Committee
Professor Elizabeth Waters, McCaughey Centre, University of Melbourne
Professor Boyd Swinburn, Public Health Research Evaluation and Policy Cluster,Deakin University
Ms Lisa Gold, Public Health Research Evaluation and Policy Cluster, Deakin University
Dr Tony Okely, Faculty of Education, University of Wollongong
Ms Kay Gibbons, Department of Nutrition Services, Royal Children’s Hospital
Dr Lisa Gibbs, McCaughey Centre: University of Melbourne
Dr Anthea Magarey, Department of Nutrition & Dietetics, Flinders University
Ms Thea O’Connor, Body Image Consultant
Ms Julie Green, Royal Children’s Hospital Education Institute
Dr Jan Garrard, School of Health & Social Development, Deakin University
Dr Andrea Sanigorski, McCaughey Centre, University of Melbourne
Dr Obioha Ukoumunne, Murdoch Childrens Research Institute
For further information contact Dr Lisa Gibbs, lgibbs@unimelb.edu.au