Oral Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Two-year outcomes of Whānau Pakari: a novel home-based intervention for child and adolescent obesity. (#111)

Yvonne Anderson 1 2 , Lisa Wynter 1 , Cameron Grant 3 4 , Cervantée Wild 1 5 , Niamh O'Sullivan 1 5 , Tami Cave 1 5 , José Derraik 5 6 , Wayne Cutfield 2 6 7 , Paul Hofman 2 7
  1. Taranaki Base Hospital, New Plymouth, New Zealand
  2. Paediatric Endocrinology, Liggins Institute, the University of Auckland, Auckland, New Zealand
  3. Department of Paediatrics, The University of Auckland, Auckland, New Zealand
  4. General Paediatrics , Starship Children's Hospital, Auckland, New Zealand
  5. Liggins Institute, The University of Auckland, Auckland, New Zealand
  6. A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
  7. Paediatric Endocrinology, Starship Children's Hospital, Auckland, New Zealand

Introduction: Whānau Pakari is a community-based multi-disciplinary child obesity programme.1 Based in Taranaki (NZ), it targets high-risk groups (predominantly Māori and those from high deprivation). Both treatment arms in our RCT displayed a change in BMI SDS at 12 months from baseline (−0.12 low-intensity control, −0.10 high-intensity intervention).2 Two-year outcomes are reported here.

Methods:  Participants (recruited 2012-2014) were aged 5-16 years, with a BMI ≥98th centile or >91st centile with weight-related co-morbidities. Participants were randomised either to an intense intervention (12 months of weekly sessions) or a low-intensity control (6-monthly home-based assessments). At home visits, participants underwent clinical assessments, with physical and psychological wellbeing evaluated. Primary outcome was change in BMI SDS from baseline.

Results: 203 children were randomised (47% Māori, 43% NZ European), 53% female, 28% living in the most deprived quintile of households, mean age 10.7 years, mean BMI SDS 3.12 (range 1.52-5.34). 121 participants (60%) were assessed at 24 months (n=53 control, n=68 intervention). The reduction in BMI SDS at 12 months from baseline was lost in both groups at 24 months (-0.03 control [95% CI: -0.14 to 0.09] and -0.02 intervention [-0.12 to 0.08]). However, participants who attended ≥70% of intense intervention sessions had a reduction in BMI SDS of -0.22 compared to a return to baseline levels for those attending <70%  (p=0.002). Intervention participants were faster on the 550m walk/run test (-0.57mins, p<0.0001), and both groups reported improvements in quality of life (p<0.05), and reduction in sweet drink intake (p<0.001). 

Conclusion: High adherence to the intense intervention resulted in sustained reductions in BMI SDS at two years. Futher, even with home-based assessments only, improvements in quality of life and reduction in sweet drink intake were achieved.  Obesity programmes incorporating assessments and an intense intervention can result in improvements, with attendance being key to long-term outcome.

  1. Anderson YC, Wynter LE, Moller KR, Cave TL, Dolan GMS, Grant CC, Stewart JM, Cutfield WS, Hofman PL. (2015). The effect of a multi-disciplinary obesity intervention compared to usual practice in those ready to make lifestyle changes: design and rationale of Whanau Pakari. BMC Obesity, 2:41.
  2. Anderson YC, Wynter LE, Grant CC, Cave TL, Derraik JGB, Cutfield WS, Hofman PL. (2017). A novel home-based intervention for child and adolescent obesity: the results of Whānau Pakari randomised controlled trial. Obesity, 25(11):1965-1973.