CHANGE (child weight management for ethnically diverse communities) is 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.

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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 has been found that Bangladeshi and Pakistani families are willing to start the programme but are less likely than other families to complete it, which suggests that this programme is not suited to the needs of these families. Therefore the main aim of this study is 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, we will test the feasibility of delivery of the programme and its acceptability to families.

The study has two phases: a development phase and a feasibility and acceptability testing phase. In the first phase we will explore the reasons why Bangladeshi and Pakistani families do not finish the existing children's weight management programme, and make changes to try and make sure that families feel more able to continue to the end of the programme. First we will look at the results of previous research to identify what has worked well in other children's weight management programmes. Then we will find out from parents themselves what they think about the existing children’s weight management service. We are inviting 40-60 Bangladeshi and Pakistani parents and carers who have been offered the local children's weight management programme to take part in interviews or focus groups with researchers from their own communities. We will explore reasons why they did or did not attend or complete the programme, and their ideas on how it could be improved. Third we will use our previous experience, together with what is already known about adapting health promotion services for minority ethnic groups, to develop a modified children's weight management programme that is relevant to Bangladeshi and Pakistani communities, but also suitable for a diverse population.

In the second phase we will test the modified programme's feasibility to deliver and acceptability to families, and we will also test methods for use in a future study to find out the programme's effectiveness and its value for money. As the existing programme is available to all overweight children, the new programme will be tested in children and families from all ethnic backgrounds. In this way we can explore whether the new programme is acceptable to Bangladeshi and Pakistani families, and also to families from other ethnic backgrounds. We will recruit 120 families who have been referred to the Birmingham children's weight management service (60% will be Bangladeshi or Pakistani and 40% will be from other ethnic backgrounds). Families will be randomly allocated to the modified or existing weight management programme. We will calculate and compare the proportions of families completing the adapted programme and the existing programme. We will also take measurements from children and parents before they start the programme, immediately after the programme finishes, 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 study started in September 2014 and will run for two and a half years.