Sacher, PM; (2013) Randomised controlled trial of the MEND programme: a family-based community intervention for childhood obesity. Doctoral thesis , UCL (University College London).

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Abstract

Background and aims Childhood obesity is a serious global public health issue. The number of children affected has increased dramatically in recent years, and despite extensive research in this field, no effective generalisable prevention or treatment interventions have been achieved as yet. The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of the Mind, Exercise, Nutrition, Do it (MEND) programme, a multicomponent communitybased childhood obesity intervention. Methods One hundred and seventeen obese children were randomly assigned to intervention or waiting list control (6-month delayed intervention) groups. Parents and children attended eighteen 2-hour group educational and physical activity sessions held twice weekly in sports centres and schools, followed by provision of a 12-week free family swimming pass. Waist circumference, BMI, body composition, physical activity level, sedentary activities, cardiovascular fitness and self-esteem were assessed at baseline, 3, 6, 9 and 12 months. Results Participants in the intervention group exhibited reduced waist circumference z-score (−0.37; p < 0.0001, n = 81) and BMI z-score (−0.24; p < 0.0001, n = 82) at 6 months, compared to the control subjects. Significant between-group differences were additionally observed in cardiovascular fitness, physical activity, sedentary behaviours, and self-esteem. Mean attendance for the MEND programme was 86%, with a drop-out rate of 4%. At 12 months waist and BMI z-scores of children in the intervention group were reduced by 0.47 (p < 0.0001) and 0.23 (p < 0.0001), respectively, along with sustained benefits in cardiovascular fitness, physical activity levels, and self-esteem. Conclusions The MEND programme had beneficial effects on physical and psychological outcomes (anthropometry, cardiovascular fitness, physical activity habits, self-esteem), which were sustained at 12 months from baseline. The high attendance and low drop-out rates suggest that families found this intensive community-based intervention acceptable. Further studies are currently underway to confirm the promising findings of this trial.

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