To develop a school-based obesity prevention programme and evaluate the feasibility and acceptability of the intervention and the planned definitive cluster randomised trial.
This was a three stage pilot involving six schools (398 children) in South West England, including an exploratory randomised controlled trial and qualitative interviews and focus groups with teachers, parents and children.
The Healthy Lifestyle Programme uses a range of school-based activities including lessons, assemblies, parents' evenings, interactive drama workshops and goal setting to engage schools, children and their families.
Of the 398 eligible children in the three pilot phases, only four opted out and a further three withdrew from the exploratory trial. In the exploratory trial, baseline measurements (anthropometric and behavioural) were obtained for 202/204 eligible children in four schools and both 18- and 24-month outcome measurements for 193/204 and 187/204 participants, respectively. Qualitative data show that delivery of the intervention is feasible within schools and acceptable to teachers, children and families. In the exploratory trial, 18/80 children (24%) in the intervention schools and 31/122 (26%) in the control schools were overweight or obese at baseline, increasing, at 18-month follow-up, to 38/119 (32%) in the control schools compared with 18/74 (24%) in the intervention schools. At 24 months the proportion of overweight and obese children in the control schools remained at 32% (36/114), whereas the proportion in the intervention schools decreased slightly to 22% (16/73).
The Healthy Lifestyle Programme is feasible to deliver and acceptable to schools, children and their families. We recruited, retained and obtained outcome measurements from 92% of eligible children in the exploratory trial, including measurements taken after transition to secondary school, suggesting that a definitive trial is likely to be deliverable.
To show the development and evaluation of a novel school-based obesity prevention programme through three detailed stages of piloting.
To demonstrate the acceptability of the Healthy Lifestyle Programme (HeLP) to schools, children and their families.
To present evidence showing the feasibility of the trial design and outcome measurements through an exploratory trial involving four schools and 202 children.
HeLP has been systematically developed and uses drama-based activities to engage the school, children and their families in healthy lifestyle messages and activities.
The programme has been piloted in six schools involving 398 children and results suggest that it is acceptable and feasible for schools, children and their families.
Results from the pilot phases have provided sufficient evidence to support the evaluation of the HeLP intervention in a full scale trial.
Strengths and limitations of this study
The HeLP intervention has undergone a systematic development process using research evidence, behavioural theory, stakeholder consultation and piloting. This has enabled the researchers to gain a deeper understanding of the context in which the intervention is to be delivered in order to maximise engagement at all levels. Preliminary results suggest the programme may affect behaviours associated with overweight and obesity.
Interviews and focus groups were conducted by the lead researcher who had built up a relationship with the schools, children and their families. This may have affected responses as the participants might not have wanted to express negative opinions. However, the ongoing support and retention of the schools and children would suggest that if there was such an effect, it was very slight. Piloting has taken place in schools in varying socioeconomic areas, and although there is a limited ethnic mix of children in South West England, the drama framework has been specifically developed to allow flexibility and adaptation to ensure it is recognising and responding to the needs of the children receiving it.