Mid North Coast - Paediatric Obesity Programme - Family Based Therapy
This project was undertaken because 20-25% of children are obese/overweight in Australia and this percentage is following global trends. Therefore, the Area Dietitians felt they needed to investigate an approach to deal with this problem. Traditional therapies focusing on the child as responsible for change have had a negative impact and have caused high rates of withdrawal of the family from therapy. There is increasing evidence that treatment of preadolescent obesity with the parents as the exclusive agents for change is superior to a child-centred approach.
The Dietitians at Taree piloted the Family Weight Management Program, which is a program the Area Health Service purchased from Children's Hospital Westmead. This is a family based program. In this program the overweight child together with their family attends an initial consultation with the dietitian who collects anthropometry and dietary data and informs the parents/carers of the program. After this consultation the parents/carers attend (without their children) nine group sessions with the dietitian and a child psychologist/social worker. These sessions cover:
- Healthy Eating
- Sharing Food Habits
- Physical Activity
- Family Food Habits
- Overeating vs Hunger
- Recipe Modification
- Self Image
The parents receive education and are encouraged that the dietary and behavioural changes that are encouraged for the overweight child are habits that all family members should be adopting.
This pilot was evaluated and the results in terms of a reduction in Child's Body Mass Index, reduction in TV viewing, increase in activity were positive and it was decided to seek funding to implement the program as a treatment for overweight/obese children in the Mid North Coast Area Health Service.
During the six months the part time Paediatric Obesity Project Officer was employed, Mid North Coast Area Health Service staff and community awareness of paediatric obesity was raised. The Project Officer educated the Mid North Coast Area Health Service Dietitians, Southern and Central Network Child and Family Teams and Generalist Care Nurses who conduct Before School Screening on the prevalence of paediatric obesity, its risks, consequences, epidemiology and treatments, in particular the Family Weight Management Program. The Project Officer was involved in the development of a Mid North Coast Area Health Service Before School Screening policy, incorporating measuring children's height and weight and calculating their Body Mass Index.
The parents/carers of children with a Body Mass index >85th percentile are offered a referral to the appropriate dietitian for a nutritional assessment. On assessment the dietitian would then assess the child for referral to the Family Weight Management Program. Thus the Nurses and Child and Family Team members who conduct the Before School Screening programs were educated on how to calculate a child's Body Mass Index and how to classify if the child is overweight or obese using age and gender specific Body mass Index percentile charts (developed by the National Centre for Health Statistics in collaboration with the National Centre for Chronic Disease Prevention and Health Promotion (2000)).
Within the allocated time frame and the project budget financial allocation the Project Officer was able to implement three Family Weight Management programs in three centres over the Mid North Coast Area Health Service.