CompletedPregnancy, Children & Inherited ConditionsPublic Health & Healthcare
Development and evaluation of interventions for the prevention of childhood obesity in a multi-ethnic population: the Born in Bradford NHS Research Programme.
A team in Bradford is tracking the growth of 10,000 babies—half of them from South Asian families—to find out why children from these communities are at higher risk of obesity and to design a prevention programme that actually works for them. The UK’s obesity epidemic begins in early childhood, and children of South Asian origin face a particularly high risk. Yet there is almost no evidence on how to prevent obesity in pre-school children from these communities. This programme fills that gap by combining routine growth monitoring with home visits by bilingual researchers, who collect detailed data on diet, exercise, and feeding practices. It also reviews existing interventions and tests new ones in small-scale action research cycles. If successful, the programme will produce a community- and family-based intervention that can be tested in a full-scale NHS trial. That could change how the NHS approaches childhood obesity in diverse populations—shifting from one-size-fits-all advice to tailored support that accounts for cultural differences in feeding, physical activity, and access to healthy food. The result would be a practical, evidence-based tool for preventing obesity before it becomes entrenched, particularly in the communities that need it most.
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Aims. To study the patterns and aetiology of childhood obesity in a multi-ethnic population and use this evidence to develop a tailored prevention intervention. Background. The obesity epidemic is one of the most daunting public health threats facing the UK. Contemporary data indicate that this epidemic begins in early childhood and that children from South Asian origin are at particular risk. Epidemiological evidence has highlighted the importance of a number of early life factors for the development of obesity but there are gaps in our knowledge about the impact of potentially important exposures in pregnancy and early life. Early childhood provides a unique and circumscribed opportunity to promote health and prevent obesity. However there is a disappointing lack of evidence for effective interventions in pre-school children and in children of South Asian origin. Research plan: Enrolment and data collection for the Born in Bradford cohort (10,000 babies ~ 5000 of South Asian origin) began in March 2007 with over 80% recruitment rates. Objective 1. Measuring child growth. This study will establish research-calibre routine data collection on growth monitoring in a deprived, biethnic population through strengthening routine surveillance and monitoring growth trajectories. A 10% sub-sample of the cohort (n=1080 with ~ 50% European and 50% South Asian origin) will be selected for more intensive follow-up to augment and validate data collection.Objective 2: Identifying modifiable risk factors for childhood obesity. The focus for this objective will be to identify modifiable behaviours and environmental risk factors that can be targeted in future interventions. Data will be collected in the 10% sub-sample through home visits by bilingual researchers who will administer survey instruments for behavioural measures and undertake anthropometry assessments. Objective 3. Reviewing the evidence of effectiveness of obesity prevention interventions in pregnant women and/or children up to the age of 5 years of South Asian origin.Objective 4: Determining appropriate intervention targets. Qualitative interviews, observational methods, geospatial mapping and nutritional audits will be undertaken to explore determinants of feeding practices; cultural and social differences in feeding practices; influence of key stakeholders; beliefs, attitudes and practices in relation to obesity, diet and exercise; perceptions in the South Asian community about childhood obesity; access to food retrailing; eating patterns.Objective 5: Field-testing implementation methods and potential intervention components. Evidence from current and previous implementation methods will be supplemented by a survey of nationally relevant work. Field testing of candidate components for an intervention strategy will be undertaken to test their feasibility and acceptability in small scale action research cycles.Objective 6.Feasibility of implementation and evaluation of intervention to prevent obesity. The ultimate aim of the programme is to design an innovative community/family-based intervention to improve modifiable behaviours in both parent and child. The exploratory trial will to inform a definitive (phase 3) cluster randomised trial which can be implemented within the NHS. Early evaluation will help to refine and optimise the interventions in partnership with families and professionals. We will describe the process of implementation and assess: the feasibility and acceptability of the interventions for different communities; eligibility, consent and recruitment rates; acceptability of randomisation process; follow up rates. The outcomes will inform the components and delivery of the interventions, estimate the effect size and test and validate outcome measures. Research team. The programme is built on a strong and established multidisciplinary NHS/academic partnership. The applicants have a proven track record in high quality applied NHS research, epidemiology, ethnic
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