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Background: Childhood obesity has significant impact on future health and economic consequences. Evidence of effectiveness of interventions is developing, although little is known about costs. Therefore, the direct costs to health care and other public sector agencies of a pilot community-based childhood obesity treatment programme were estimated. Methods: The present study comprised a retrospective review of resource use of an intervention drawing resources from local government and primary care sectors and delivered across multiple settings. Ninety-six children, aged 8-16 years old; body mass index (BMI) >98th centile; mean BMI SD 3.1 and low quality of life scores attended a 12-month programme delivered by nonhealth professionals. Direct costs to health care and other public sector agencies were assessed. Results: Total programme direct costs were £82 380 (€94 736, $123 569) in the base case or £120 474 (€138 546, $180 713) when venues were treated as real additional costs, and varied only slightly with the number of participants in the programme. Costs per participant were £858 (€987, $1287) in the base case or £1255 (€1443, $1883) when venues were treated as additional costs. Costs per participant were sensitive to the number of participants, varying between £691 (€795, $1037) and £2026 (€2330, $3039) when venue costs were zero and between £1009 (€1160, $1514) and £2978 (€3425, $4467) with venue costs added. Conclusions: It is possible to provide a community-based service at reasonable cost, and probably less than for health professional delivered services. Further work is required to assess the possible effects of the programme on wider service resource use, on users' costs and on programme effectiveness. [ABSTRACT FROM AUTHOR]

Background: One in four children in England is overweight/obese upon starting school. HENRY (Health Exercise Nutrition for the Really Young) offers a novel, preventive approach to this problem by training practitioners to work more effectively with the parents of preschool children around obesity and lifestyle issues. The programme is being delivered to all Sure Start Children's Centres (the UK government initiative providing family support and childcare in disadvantaged areas) in Leeds, UK. Methods: The evaluation covered the first 12 Centres to be trained (these had a reach of approximately 5000 families). A series of semi-structured interviews were conducted with Centre managers, and 'drop boxes' were provided for all staff to leave their comments. Interviews took place up to 11 months post-training, allowing a consideration of any long-term impact. Results: Data from 12 interviews and 106 comment slips indicated that HENRY training was associated with considerable changes to the Centre environment. Immediate effects included changes to Centre policy and practice, including the provision of age-appropriate portion sizes and the introduction of healthy snacks; a strengthening of team working and increased staff confidence around tackling lifestyle change; and enhanced skills when working with families. Training also induced changes within the staff's personal lives (e.g. increased physical activity and family mealtimes). Conclusions: The findings suggest that positive and lasting lifestyle effects can be achieved by brief training courses involving Children's Centre staff teams. Both staff and attendant families appear to benefit. The effect on levels of preschool obesity across the city once HENRY has extended to the remaining Centres is yet to be seen. [ABSTRACT FROM AUTHOR]

Background Despite epidemic numbers of obese and overweight pre-school children, professionals report a lack of confidence and self-efficacy in working with parents around lifestyle change. HENRY - Health Exercise Nutrition for the Really Young - trains health and community practitioners to work more sensitively and effectively with parents of babies and pre-school children around obesity and lifestyle concerns. Underpinned by the Family Partnership Model, reflective practice and solution-focused techniques, it offers face-to-face training and e-learning. This paper describes the development, pilot and evaluation of HENRY Sure Start Children's Centres. Methods Twelve Children's Centres in Oxfordshire took part in the pilot involving 137 staff. Questionnaires were administered at the end of training courses. Self-reported confidence ratings were obtained before and after training. Postal questionnaires were sent to Centre managers 2-6 months later to ascertain long-term effects. Nine managers participated in in-depth interviews. A further 535 learners completed the e-learning course and online feedback. Results One hundred and thirty-one staff (96%) completed the training course and valued it as a way of enhancing skills and knowledge. Mean (±SD) self-reported confidence ratings increased (4.1 ± 0.7 to 7.2 ± 0.7; P < 0.00001). An influence on personal as well as professional lives was apparent. Long-term follow-up indicated ongoing impact attributed to HENRY on both Centres and staff. All 535 e-learners successfully completed: 98% would recommend HENRY; 94% thought it enhanced their skills as well as knowledge. Conclusions HENRY is an innovative approach that offers some promise in tackling obesity through training community and health practitioners to work more effectively with parents of very young children. It appears to have an effect on participants' personal lives as well as professional work. A large-scale long-term study would be required to ascertain if there is the desired impact on young children's lifestyles and risk of obesity. [ABSTRACT FROM AUTHOR]

Background The UK Department of Health for England and Wales has issued guidance to all local Primary Care Trusts (PCTs), who have responsibility for school nursing services, for the annual weighing and measuring of all children on entry to primary school and in Year 6 (age 5 and 11 years respectively), known as the National Child Measurement Programme. The guidance places the responsibility for implementation and funding of this scheme onto the PCTs. Method This paper describes the conduct and evaluation of the 2006 monitoring exercise in a 10% sample of Leeds primary schools. Results The evaluation showed that the exercise can be carried out with little disruption in schools and minimal distress for children. Conclusions Recommendations include: adequate staff training in measuring children, along with anticipation of the issues and problems they may encounter and best practice for dealing with them. A good working relationship must be established between the team and school before the measuring day. Schools need to ensure the availability of suitable accommodation and a screen to maintain privacy. Lightweight but robust and accurate scales conforming to the European Union standard should be used and routinely checked for accuracy. Where possible, children should not be lined up, but seen individually. This is considered essential for the older Year 6 children. [ABSTRACT FROM AUTHOR]

Objective: To develop and evaluate "Families for Health", a new community based family intervention for childhood obesity. Design: Programme development, pilot study and evaluation using intention-to-treat analysis. Setting: Coventry, England. Participants: 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. Intervention: Families for Health is a 12-week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social and emotional development. Main outcome measures: Change in baseline BMI z score at the end of the programme (3 months) and 9-month follow-up. Attendance, drop-out, parents' perception of the programme, child's quality of life and self-esteem, parental mental health, parent-child relationships and lifestyle changes were also measured. Results: Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including four who dropped out), BMI z score was reduced by -0.18 (95% CI -0.30 to -0.05) at 3 months and -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and used with confidence by most parents. Conclusions: Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required. [ABSTRACT FROM AUTHOR]

Aims: The government has set a target to halt the rise in childhood obesity in those aged under 11 by 2010, but no system is in place to ascertain if this has been achieved. We aimed to develop a simple and reproducible methodology to monitor trends in childhood obesity. Methods: A purposive sample of 10 primary schools and three secondary schools was selected. Children were measured with parental ‘opt out’ consent in reception class, year 4, and year 8 (ages 5, 9, and 13 years, respectively). Measurements were compared with those obtained locally in 1996–2001. Calculations were then performed to ascertain the sample size required to confidently identify a halt in the rise in obesity using three growth measures. Results: A total of 999 children were measured with ascertainment of 95% in primary and 85% in secondary schools. The proportion of overweight and obese children aged 9 and 13 years had increased since 1996–2001, although only 9 year olds showed a significant rise. A general trend of an increase in obesity was observed with increasing age. Calculations showed that 1900–2400 children per age group are needed to detect a halt in the rise in obesity based on mean body mass index (BMI) standard deviation scores (SDS) by 2010 with 90% power, whereas 4200–10 500 children are needed for other measures. Conclusion: We have developed a simple, cost effective methodology for accurately measuring the epidemic and recommend the use of mean BMI SDS for demonstrating if a halt has been achieved. [ABSTRACT FROM AUTHOR]

Summary Background: The UK Government has set a target of halting the rise in childhood obesity by 2010. However, at the time the target was set, no monitoring process existed. The English Department of Health has now issued guidelines to primary care trusts for the annual weighing and measuring of all children on entry to primary school and in year 6. Aim: Development of an inexpensive school-based monitoring scheme for trends in childhood obesity suitable for national implementation. Method: The methodology was developed in 10 pilot schools in 2004 and implemented in 25 primary schools and three secondary schools in 2005. Specially trained heatthcare support workers (HCSWs) recorded height and weight measurements of primary school children in reception and year 4, and secondary school children in year 8 (aged 5, 8 and 13 years, respectively, on average). The ethnic and socio-economic profile of the sample was compared with census data, and the levels of obesity were calculated using standard age cut-offs. Results: While monitoring in primary schools was achieved with no evidence of disruption to the schools or distress to the subjects, monitoring in secondary schools was deemed to be impractical. Cost analysis indicated an estimated cost of less than £1.50 per primary school child measured. Conclusions: The model provides a viable means of monitoring childhood obesity trends. Monitoring should be confined to primary schools and should be conducted by specially trained Chews rather than school nurses. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the reliability of the routine surveillance of the height and weight of children as a method of monitoring obesity epidemic in Great Britain. Under the study, the data collected by the local school nursing service was compared with those by specially trained teams on a class-by-class basis on the same group of schoolchildren. It adds that the specially trained teams collected data in the context of the TRENDS project. It cites the advantages of the TRENDS model over routine surveillance which include a defined aim.