Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia

BMC Public Health, Jan 2017

Background Reducing the prevalence of obesity and chronic disease are important priorities. Maori and Pacific Islander communities living in Australia have higher rates of obesity and chronic disease than the wider Australian population. This study aims to assess the effectiveness of the Good Start program, which aims to improve knowledge, attitudes and practices related to healthy eating and physical activity amongst Maori and Pacific Islander communities living in Queensland. Methods The intervention was delivered to children aged 6–19 years (N = 375) in schools by multicultural health workers. Class activities focused on one message each term related to healthy eating and physical activity using methods such as cooking sessions and cultural dance. The evaluation approach was a quantitative uncontrolled pre-post design. Data were collected each term pre- and post-intervention using a short questionnaire. Results There were significant increases in knowledge of correct servings of fruit and vegetables, knowledge of sugar and caffeine content of common sugar-sweetened drinks, recognition of the consequences of marketing and upsizing, and the importance of controlling portion size (all P < 0.05). There was also increases in knowledge of physical activity recommendations (P < 0.001), as well as the importance of physical activity for preventing heart disease (P < 0.001) and improving self-esteem (P < 0.001). In terms of attitudes, there were significant improvements in some attitudes to vegetables (P = 0.02), and sugar-sweetened drinks (P < 0.05). In terms of practices and behaviours, although the reported intake of vegetables increased significantly (P < 0.001), the proportion of children eating discretionary foods regularly did not change significantly, suggesting that modifying the program with an increased emphasis on reducing intake of junk food may be beneficial. Conclusion The study has shown that the Good Start Program was effective in engaging children from Maori and Pacific Island backgrounds and in improving knowledge, and some attitudes and practices, related to healthy eating and physical activity. The evaluation contributes valuable information about components and impacts of this type of intervention, and considerations relevant to this population in order to successfully change behaviours and reduce the burden of chronic disease.

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Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia

Mihrshahi et al. BMC Public Health Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia Seema Mihrshahi 0 1 Lisa Vaughan 1 Nicola Fa'avale 1 Shreenika De Silva Weliange 1 Inez Manu-Sione Lisa Schubert 1 0 Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney , The Charles Perkins Centre D17, Level 6, The Hub, Sydney, NSW 2006 , Australia 1 Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland , Brisbane 4006 , Australia Background: Reducing the prevalence of obesity and chronic disease are important priorities. Maori and Pacific Islander communities living in Australia have higher rates of obesity and chronic disease than the wider Australian population. This study aims to assess the effectiveness of the Good Start program, which aims to improve knowledge, attitudes and practices related to healthy eating and physical activity amongst Maori and Pacific Islander communities living in Queensland. Methods: The intervention was delivered to children aged 6-19 years (N = 375) in schools by multicultural health workers. Class activities focused on one message each term related to healthy eating and physical activity using methods such as cooking sessions and cultural dance. The evaluation approach was a quantitative uncontrolled pre-post design. Data were collected each term pre- and post-intervention using a short questionnaire. Results: There were significant increases in knowledge of correct servings of fruit and vegetables, knowledge of sugar and caffeine content of common sugar-sweetened drinks, recognition of the consequences of marketing and upsizing, and the importance of controlling portion size (all P < 0.05). There was also increases in knowledge of physical activity recommendations (P < 0.001), as well as the importance of physical activity for preventing heart disease (P < 0.001) and improving self-esteem (P < 0.001). In terms of attitudes, there were significant improvements in some attitudes to vegetables (P = 0.02), and sugar-sweetened drinks (P < 0.05). In terms of practices and behaviours, although the reported intake of vegetables increased significantly (P < 0.001), the proportion of children eating discretionary foods regularly did not change significantly, suggesting that modifying the program with an increased emphasis on reducing intake of junk food may be beneficial. Conclusion: The study has shown that the Good Start Program was effective in engaging children from Maori and Pacific Island backgrounds and in improving knowledge, and some attitudes and practices, related to healthy eating and physical activity. The evaluation contributes valuable information about components and impacts of this type of intervention, and considerations relevant to this population in order to successfully change behaviours and reduce the burden of chronic disease. Evaluation; Maori and Pacific Islander; Interventions to reduce obesity; Obesity; Children; Healthy eating; Physical activity - Background Obesity, one of the most important risk factors of nutrition-related chronic disease, is a growing global pandemic. In Australia, around one in four children aged 5–17 are overweight or obese, comprised of 20.2% overweight and 7.4% obese [1]. Reducing this prevalence is at the core of most preventive health strategies for nutrition-related chronic disease in Australia. Amongst ethnic minority groups there are some, including Maori and Pacific Islander communities, that have a particularly high prevalence of chronic disease including obesity and Type 2 Diabetes and are at a higher risk of hospitalisation for these diseases [2]. There is also evidence that obesity is significantly more prevalent among children from Pacific Islander backgrounds [3]. In New Zealand for example, 15% of Maori and 30% of Pacific children aged 2–14 years were obese compared to the national average of 11% [4]. Maori and Pacific Islander people migrated to Australia from the island groups of Micronesia, Melanesia, Polynesia, with the majority migrating from New Zealand. They are referred to collectively as ‘Maori and Pacific Islander people’, and despite often being grouped together, the cultures are heterogeneous with diverse customs, languages and religions. While diversity exists, some of the cultural values and beliefs among Maori and Pacific Islander groups are similar. This includes a strong foundation on the family relationship and a strong religious affiliation. Food and feasting is of particular cultural importance and traditionally, in the Pacific Islands cultures, larger stature has been associated with beauty, social standing, health and wealth [5]. Maori and Pacific Islanders also have a high degree of cultural connection through music, songs and dance and have documented and disseminated their history and (...truncated)


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Seema Mihrshahi, Lisa Vaughan, Nicola Fa’avale, Shreenika De Silva Weliange, Inez Manu-Sione, Lisa Schubert. Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia, BMC Public Health, 2017, pp. 77, 17, DOI: 10.1186/s12889-016-3977-x