CHANGE study
The CHANGE Study was a National Institute for Health Research Health Technology Assessment -funded study which aims to develop a children’s weight management programme that is culturally relevant to children and families from Pakistani and Bangladeshi communities, and is also suitable for delivery in a diverse community.
Project background
Overweight and obese children are at risk of poor health both in childhood and adulthood. As well as physical ill health, being overweight or obese can also affect a child's social and emotional wellbeing. Some South Asian children are at greater risk of becoming overweight or obese in childhood and South Asians are also more susceptible to some of the health consequences of obesity, such as heart disease and diabetes.
In Birmingham (a large ethnically diverse city), a weight management programme for children and their families is available for all overweight and obese children. It was found that Bangladeshi and Pakistani families were willing to start the programme but are less likely than other families to complete it, which suggested that this programme was not suited to the needs of these families. Therefore the main aim of this study was to develop a weight management programme for children aged 4-11 years and their families, tailored to be culturally relevant to Bangladeshi and Pakistani communities, but also suitable for delivery to an ethnically diverse population. Once developed, the team tested the feasibility of delivery of the programme and its acceptability to families.
The study has two phases:
- Phase 1: development phase
- Phase 2: feasibility and acceptability testing phase.
The study started in September 2014 and ran for two and a half years (ended February 2017).
Phase 1
Phase 1
In the first phase, the team explored the reasons why Bangladeshi and Pakistani families do not finish the existing children's weight management programme, and made changes to try and make sure that families feel more able to continue to the end of the programme.
First, the team looked at the results of previous research to identify what worked well in other children's weight management programmes.
Then researchers invited 40-60 Bangladeshi and Pakistani parents and carers who had been offered the local children's weight management programme to take part in interviews or focus groups with researchers from their own communities. The team then explored reasons why they did or did not attend or complete the programme, and their ideas on how it could be improved.
In order to explore a range of viewpoints, the team interviewed parents who accepted a place on the programme but then did not attend, parents who attended part of the programme, and parents who attended the entire programme. Interviews and focus groups were carried out in the participants’ preferred languages so that they were able to express their views fully.
Third, these previous experiences, together with what is already known about adapting health promotion services for minority ethnic groups, was combined to develop a modified children's weight management programme that was relevant to Bangladeshi and Pakistani communities, while also being suitable for a diverse population.
The development of the modified children’s weight management programme was completed in July 2015.
Phase 2
Phase 2
The second phase tested the modified programme's feasibility to deliver and acceptability to families, and the team also tested methods for use in a future study to find out the programme's effectiveness and its value for money.
As the existing programme was available to all overweight children, the new programme would be tested in children and families from all ethnic backgrounds. In this way the team could explore whether the new programme is acceptable to Bangladeshi and Pakistani families, and also to families from other ethnic backgrounds.
The study team recruited 120 families who were referred to the Birmingham children's weight management service (60% were Bangladeshi or Pakistani and 40% from other ethnic backgrounds). Families were randomly allocated to the modified or existing weight management programme. The team then calculated and compared the proportions of families completing the adapted programme and the existing programme. Measurements from children and parents before they start the programme were also taken immediately after the programme finished, and 6 months after the programme. Measurements include measures of weight and body fat, food intake, physical activity levels, psychological assessments and assessments of parental behaviours.
The second phase of the study was completed in February 2017.
Project team
Project team
Principal Investigator:
Professor Miranda Pallan
Email m.j.pallan@bham.ac.uk
Study Coordinator:
Tania Griffin
Research Assistant:
Dr Kiya Hurley
Email k.hurley@bham.ac.uk
Administrative Staff:
Laura Ocansey
Email: l.ocansey@bham.ac.uk
Related studies
Contact
Contact
Principal Investigator: Professor Miranda Pallan
Study Management team: Professor Peymane Adab