dc.contributor.advisor |
Hofman, P |
en |
dc.contributor.advisor |
Grant, C |
en |
dc.contributor.advisor |
Cutfield, W |
en |
dc.contributor.advisor |
Derraik, J |
en |
dc.contributor.author |
Anderson, Yvonne |
en |
dc.date.accessioned |
2018-07-10T02:17:23Z |
en |
dc.date.issued |
2018 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/37413 |
en |
dc.description.abstract |
Aim: Multi-disciplinary interventions remain the recommended management for children with obesity. The purpose of this research was to create and assess a multi-disciplinary intervention programme for children and adolescents with obesity in Taranaki, Aotearoa/New Zealand, using a mixed methods approach, incorporating a randomised clinical trial. Whānau Pakari means “healthy, self-assured families that are fully active”. The programme specifically targeted those over-represented in obesity statistics, namely Māori and those from most deprived households in the region, thereby addressing identified health inequities. Methods: Background audits informed the creation of Whānau Pakari. A randomised controlled clinical trial was embedded within the new service, offering home-based weight-related 6-monthly assessments and advice (control), or assessments and weekly group sessions for 12 months. Multi-source evaluation was undertaken to determine satisfaction, and an economic evaluation was performed, comparing Whānau Pakari with the previous conventional (hospital-based) model. Results: High rates of weight-related comorbidities, suboptimal eating behaviour, low physical activity, high screen time, and low health-related quality of life were found at baseline. Engagement with Whānau Pakari was associated with a significant decrease in body mass index standard deviation score in the low intensity control and high intensity intervention 12 months from baseline. Attendance ≥70% in the high intensity intervention doubled the effect. Improvements occurred in quality of life and cardiovascular fitness in both groups. Multi-source programme evaluation found high stakeholder, referrer and participant satisfaction. Economic evaluation demonstrated Whānau Pakari was cheaper and more effective compared with the previous conventional model of care. Conclusions: Whānau Pakari is an acceptable, appropriate intervention for children and adolescents with obesity. It is a mainstream service that achieved high levels of initial recruitment and engagement from at-risk groups, therefore improving health outcomes. Scalability and transferability appear possible. Whānau Pakari challenges the notion that a multi-disciplinary intervention programme only includes a group-based intervention with weekly sessions. Instead, it is a model where multi-disciplinary support from a team provides comprehensive assessment that identifies and manages weight-related comorbidities, which can assist in planning individualised interventions. This assessment and intervention model of service provision could be considered for New Zealand children and adolescents with obesity. |
en |
dc.publisher |
ResearchSpace@Auckland |
en |
dc.relation.ispartof |
PhD Thesis - University of Auckland |
en |
dc.relation.isreferencedby |
UoA99265067212602091 |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
http://creativecommons.org/licenses/by-nc-sa/3.0/nz/ |
en |
dc.title |
Whānau Pakari: a multi-disciplinary intervention for children and adolescents with weight issues |
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dc.type |
Thesis |
en |
thesis.degree.discipline |
Paediatric Endocrinology |
en |
thesis.degree.grantor |
The University of Auckland |
en |
thesis.degree.level |
Doctoral |
en |
thesis.degree.name |
PhD |
en |
dc.rights.holder |
Copyright: The author |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.elements-id |
747508 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Paediatrics Child & Youth Hlth |
en |
pubs.record-created-at-source-date |
2018-07-10 |
en |
dc.identifier.wikidata |
Q111963385 |
|