Healthy together Victoria and childhood obesity-a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial.

Claudia Strugnell,Lynne Millar,Mary Malakellis,Felice Jacka,Boyd Swinburn,Steve Allender,Andrew Churchill,Colin Bell

doi:10.1186/s13690-016-0127-y

Abstract

BackgroundHealthy Together Victoria (HTV) - a complex ‘whole of system’ intervention, including an embedded cluster randomized control trial, to reduce chronic disease by addressing risk factors (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in selected communities in Victoria, Australia (Healthy Together Communities).ObjectivesTo describe the methodology for: 1) assessing changes in the prevalence of measured childhood obesity and associated risks between primary and secondary school students in HTV communities, compared with comparison communities; and 2) assessing community-level system changes that influence childhood obesity in HTC and comparison communities.MethodsTwenty-four geographically bounded areas were randomized to either prevention or comparison (2012). A repeat cross-sectional study utilising opt-out consent will collect objectively measured height, weight, waist and self-reported behavioral data among primary [Grade 4 (aged 9-10y) and Grade 6 (aged 11-12y)] and secondary [Grade 8 (aged 13-14y) and Grade 10 (aged 15-16y)] school students (2014 to 2018). Relationships between measured childhood obesity and system causes, as defined in the Foresight obesity systems map, will be assessed using a range of routine and customised data.ConclusionThis research methodology describes the beginnings of a state-wide childhood obesity monitoring system that can evolve to regularly inform progress on reducing obesity, and situate these changes in the context of broader community-level system change.

Highlights

Healthy Together Victoria (HTV) - a complex ‘whole of system’ intervention, including an embedded cluster randomized control trial, to reduce chronic disease by addressing risk factors among children and adults in selected communities in Victoria, Australia (Healthy Together Communities)
Support is growing for population level efforts to prevent childhood obesity to apply systems thinking [15] in the expectation that systems thinking may improve intervention implementation, effectiveness and sustainability of changes
Due to the broad scope and the adaptive nature of HTV, detailed methods are beyond the remit of this article but can be found at http://www.healthytogether.vic.gov.au/ resources/index

Summary

Introduction

Healthy Together Victoria (HTV) - a complex ‘whole of system’ intervention, including an embedded cluster randomized control trial, to reduce chronic disease by addressing risk factors (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in selected communities in Victoria, Australia (Healthy Together Communities). Support is growing for population level efforts to prevent childhood obesity to apply systems thinking [15] in the expectation that systems thinking may improve intervention implementation, effectiveness and sustainability of changes. Taking a population-level approach to reducing chronic disease and obesity through improving associated determinants (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in the specific communities where they “live, learn, work and play” [17]. Due to the broad scope and the adaptive nature of HTV, detailed methods are beyond the remit of this article but can be found at http://www.healthytogether.vic.gov.au/ resources/index

Objectives

Methods

Findings

Conclusion