Healthy Lifestyle Program Research Articles

An Overview of Health-Promoting Programs and Healthy Lifestyles for Adolescents and Young People: A Scoping Review.

The health of children, adolescents, and young adults is a primary global concern. In 2021, there were 2.1 million deaths among children and adolescents. Injuries, violence, communicable diseases, nutritional deficiencies, substance use, non-communicable diseases, and mental health disorders are among the leading causes of death in this age group. Background/objectives: This scoping review aims to identify and describe health promotion and healthy lifestyle programs developed worldwide targeting adolescents and young adults. Methods: A total of 106 programs were included, of which 8 were selected through scientific databases and 98 through other research methods (e.g., government websites and other online sources). Results: The results show that Europe, North America, New Zealand, and the United States of America are the continents and countries with the highest number of programs. Most programs originated before 2020 and are aimed at children, adolescents, and young adults. Mental health, substance and non-substance dependencies, and sexual and reproductive health were the most frequent areas among the available youth programs. Most programs do not mention evaluating or monitoring the services provided. Conclusions: This work allows for a deeper understanding of the programs available for adolescents and young adults, providing an overview of their characteristics. Moreover, it emphasizes the importance of increasing the number of available programs, especially in countries with higher morbidity and mortality rates among the young population. The programs must be based on population studies to better meet their needs. Lastly, programs should become sustainable and integrated into national public policies, accompanied by ongoing training, supervision, and intervision of professionals working in these contexts.

Comparing the Effects of Healthy Lifestyle Education Through Peer Group and mHealth App on Self-esteem in Patients with Diabetes Mellitus: A Randomized Controlled Trial

Background: The increasing prevalence of diabetes mellitus has become a global public health challenge in recent decades. However, disease-related complications can be minimized through innovative educational programs. Objectives: This study aimed to compare the effects of healthy lifestyle education delivered via peer group and the mHealth app on self-esteem in patients with type 2 diabetes mellitus (T2DM). Methods: This three-group randomized controlled trial was conducted in 2022. A total of 135 patients living with T2DM were recruited using purposive sampling from two hospitals in Kermanshah Province, Iran, and then divided into three groups: Peer education, virtual education, and control groups, via replacement randomization. Peer patients with T2DM, previously trained by the researchers, provided education to those in the peer education group in four 35-minute sessions over two days. Simultaneously, patients in the virtual education group were trained by the researchers using the mHealth app, specifically designed for this purpose, in three 1-hour sessions over three days. Data were collected using the Patient Profile Form and the self-reported Rosenberg’s Self-Esteem Scale. The data were analyzed using IBM SPSS Statistics software, employing paired-sample t-tests, chi-square tests, Fisher’s exact tests, and one-way analysis of variance (ANOVA) for comparisons. Results: Before the intervention, there were no significant differences in the self-esteem mean scores between the study groups (P = 0.665). However, post-intervention, the self-esteem scores differed significantly between all groups (P = 0.002). The self-esteem mean scores of patients in the peer education group (100.36 ± 15.9 vs. 106.87 ± 9.08, P = 0.011) and the virtual education group (100.80 ± 24.72 vs. 116.91 ± 10.67, P = 0.018) significantly increased after the intervention, while no significant difference was observed in the control group (106.87 ± 9.08 vs. 105.60 ± 10.84, P = 0.134). Virtual education via the mHealth app was more effective than peer education in improving self-esteem in patients with T2DM. Conclusions: The healthy lifestyle education program delivered through virtual education via the mHealth mobile app led to higher self-esteem among patients with T2DM compared to peer education. It is suggested that future studies investigate the impact of virtual education using mobile-based apps and artificial intelligence capabilities on self-esteem in other patient populations. These results can serve as guidelines for the optimal use of distance education and educational apps for patients with chronic diseases.

Improving Men’S Health Through A Tailored Healthy Lifestyle Program Powered By Sport Fandom

Improving Men’S Health Through A Tailored Healthy Lifestyle Program Powered By Sport Fandom

Reducing the incidence of overweight and obesity by a healthy lifestyle intervention program for schoolchildren in Hanoi, Vietnam: a randomized controlled trial

BackgroundThe increasing incidence and prevalence of childhood overweight (OW) and obesity (OB) are major global health challenges. This study aimed to evaluate the effectiveness of a 2-year healthy lifestyle intervention program in reducing the incidence of OW and OB among schoolchildren aged 11–12 years in Vietnam.MethodsStudy design: Randomized controlled trial.Participants and interventions: In total, 733 students participated in this study. Participants were included from four schools in Hanoi based on a random cluster sampling method. Students’ health outcomes were assessed at baseline and after 2 years.Main outcomes: The primary outcomes were the incidence of OW and OB, and the secondary outcomes were the prevalence and remission of OW and OB. Generalized estimating equations (GEEs) were used to determine the outcomes and risk factors.ResultsAfter the intervention, the prevalence of OW decreased by 9.24% in the intervention group and 3.01% in the control group.After adjustment for age and sex, the odds of overweight were 36.7% lower in the intervention group than in the control group (OR = 0.633; 95% CI: 0.434–0.925; P = 0.018). The incidence of OW was 1.31% in the intervention group compared with 5.33% in the control group. After adjustment for age and sex, the odds of incident overweight in the intervention group were 77.4% lower than in the control group (OR = 0.226; 95% CI: 0.063–0.813; P = 0.023). The proportion of patients who achieved OW remission was 41.22% in the intervention group and 28.68% in the control group. After adjustment for age and sex, the odds of OW remission of overweight were 2.219 times greater in the intervention group than in the control group (OR = 2.219; 95% CI: 1.220–4.036; P = 0.009). For most OB-related factors, there were no significant differences between the intervention and control groups.ConclusionA multicomponent healthy lifestyle intervention was effective in reducing the incidence of OW; however, it had no significant effect on OB among children aged 11–12 years in Hanoi, Vietnam.Trial registrationRetrospectively registered number: UMIN000014992, 20/08/2023.

Fostering health behaviour change in overweight male football fans through the European Fans in Training (EuroFIT) program: A Self-Determination Theory perspective

The European Fans in Training (EuroFIT) program integrated need-supportive motivational strategies from Self-Determination Theory (SDT) in the design of a healthy lifestyle program delivered to overweight or obese male football fans (n = 1113; mean age of 45.9 [SD = 9.0] years old and BMI of 33.2 kg/m2 [SD = 4.6]) in professional football club settings in the UK, Portugal, Norway and the Netherlands. With a critical realist approach, we developed a structured thematic framework analysis based on Self-Determination Theory (SDT) to investigate the process of change in men who participated in the EuroFIT randomized controlled trial (RCT). We examined whether men’s experiences of the social context of EuroFIT, and whether their engagement with the program’s motivational strategies supported or frustrated their basic psychological needs while attempting to change their lifestyle behaviours. We found that men in all countries perceived the social contexts of the EuroFIT program as mostly needs-supportive, and that they found engagement with most of the program components helpful in supporting their psychological needs when initiating health behaviour changes. However, some of the program elements in the EuroFIT program were perceived as needs-frustrating by some participants and need-supportive by others. Implications for the use of need-supportive motivational strategies in designing future lifestyle interventions in sport settings to promote health behaviour change among male football fans are discussed.

Risk factors of cardiovascular disease (CVD) in young adults: a community-based study of Iranian context

BackgroundCardiovascular disease (CVD) is the leading cause of death and disability worldwide, particularly in low- and middle-income countries. Young adults are susceptible to CVD risk factors, especially in developing countries. This study aimed to compare CVD risk factors between medical and non-medical students.MethodsThe present cross-sectional study was conducted on a sample of 302 students in Tehran, including 151 medical students and 151 non-medical students, in 2022. Data collection tools included four online questionnaires to collect demographic information, knowledge/attitudes, knowledge of risk factors, and risk factors. Data were analyzed using SPSS version 18 software at a 0.05 significance level.ResultsData analysis revealed that the mean age of medical and non-medical students was 22.06 ± 3.53 and 21.88 ± 4.20 years, respectively. The two groups were not significantly different in gender, age, marital status, and place of residence. Knowledge of CVD was significantly different between the two groups of students (P < 0.001), but attitudes were not significantly different (P = 0.208). A significant difference in the prognosis of diabetes and dyslipidemia was observed between the two groups (P < 0.001).ConclusionsAs a large group of young adults in society, students are at risk for CVD. Poor knowledge and inappropriate attitudes regarding CVD risk factors are among the contributing factors. Therefore, it is recommended to design and implement a healthy diet, physical activity, stress management, and healthy lifestyle programs for the young group along with screening programs to prevent complications and mortality caused by CVD.

87 A co-creative healthy lifestyle program for social vulnerable community dwelling older adults

87 A co-creative healthy lifestyle program for social vulnerable community dwelling older adults

250 - Aboriginal community perspectives on adapting a healthy lifestyle program

250 - Aboriginal community perspectives on adapting a healthy lifestyle program

Sleep and health improvement programme (SHIP) for patients with prostate cancer and caregivers

AbstractObjectiveThe objective of this study is to determine whether a sleep and health improvement programme (SHIP) to promote healthy sleep, eating and physical activity would be feasible, acceptable and have a positive impact on lifestyle behaviours for prostate cancer survivors and caregivers.MethodsWe recruited 50 participants for a single group 3‐month pre‐post pilot study. The SHIP intervention included (1) website about sleep, nutrition and physical activity (≥1 view/week), (2) two email newsletters with goal‐setting exercises and resources and (3) midpoint health coach call. The primary outcome was changes in validated sleep scales; secondary outcomes included changes in diet, physical activity and concentration from baseline to 3 months.ResultsOf 50 participants enrolled, median age was 65, 30% were Black and 8% were Hispanic. Thirty‐four patients and 7 family caregivers completed the pilot study (82%). Following the intervention, we observed a statistically significant improvement in the Sleep Hygiene Index (pre: 15, post: 13, p &lt; 0.01), and a trend toward lower Insomnia Severity Index (pre: 12, post: 9, p = 0.07). There were no statistically significant improvements in sleep quality or physical activity, but there were improvements in healthy eating (e.g., increase in cruciferous vegetables and reduction in dairy) and in fatigue‐related problems and concentration. Exit interview feedback was positive.ConclusionsA web‐based sleep and healthy lifestyle programme for patients with prostate cancer and their caregivers is feasible and acceptable. A randomized controlled trial is planned to test whether a refined SHIP improves sleep and lifestyle in patients with prostate cancer and caregivers.

Lifestyle Empowerment for Alzheimer's Prevention Prescribed by Physicians: Methods and Adaptations to COVID-19.

The health care system is insufficiently capitalizing on the benefits of physical exercise in America's aging population. Few tools exist to help clinicians incorporate physical activity into their clinical care, while barriers limit older adults from initiating and maintaining exercise programs. The Lifestyle Empowerment for Alzheimer's Prevention (LEAP! Rx) Program has been designed to support providers and participants in lifestyle change. LEAP! Rx uses two forms of participant enrollment: physician referrals through electronic health records and self-referrals to test the efficacy of delivering a community-based exercise and healthy lifestyle program to older adults. After referral into the program, participants are randomized to receive the LEAP! Rx Program or are placed in a standard-of-care group to receive the program later. The LEAP! Rx program consists of a personalized and structured exercise program, lifestyle education, and mobile health monitoring. This includes a 12-week Empowerment phase with coaching and supervised exercise training, followed by a 40-week Lifestyle phase with intermittent supervised exercise and coaching. Lifestyle education includes monthly, evidence-based classes on optimal aging. The evaluation of LEAP! Rx focuses on 1) the assessment of implementation and scalability of the LEAP!Rx Program for clinicians and patients 2) the effect of the LEAP! Rx Program on cardiorespiratory fitness, 3) the impact of the LEAP! Rx Program on secondary intervention outcome measures of chronic disease risk factors, including insulin resistance, body composition, and lipids. If successful, this study's findings could advance future healthcare practices, providing a new and practical approach to aging and chronic disease prevention.

Scalable Telehealth Cancer Care: integrated healthy lifestyle program to live well after cancer treatment.

Northwestern University's Center for Scalable Telehealth Cancer Care (STELLAR) is 1 of 4 Cancer Moonshot Telehealth Research Centers of Excellence programs funded by the National Cancer Institute to establish an evidence base for telehealth in cancer care. STELLAR is grounded in the Institute of Medicine's vision that quality cancer care includes not only disease treatment but also promotion of long-term health and quality of life (QOL). Cigarette smoking, insufficient physical activity, and overweight and obesity often co-occur and are associated with poorer treatment response, heightened recurrence risk, decreased longevity, diminished QOL, and increased treatment cost for many cancers. These risk behaviors are prevalent in cancer survivors, but their treatment is not routinely integrated into oncology care. STELLAR aims to foster patients' long-term health and QOL by designing, implementing, and sustaining a novel telehealth treatment program for multiple risk behaviors to be integrated into standard cancer care. Telehealth delivery is evidence-based for health behavior change treatment and is well suited to overcome access and workflow barriers that can otherwise impede treatment receipt. This paper describes STELLAR's 2-arm randomized parallel group pragmatic clinical trial comparing telehealth-delivered, coach-facilitated multiple risk behavior treatment vs self-guided usual care for the outcomes of reach, effectiveness, and cost among 3000 cancer survivors who have completed curative intent treatment. This paper also discusses several challenges encountered by the STELLAR investigative team and the adaptations developed to move the research forward.

Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme: a single-arm pilot study

BackgroundThe growing obesity epidemic in Malaysia presents a public health challenge that requires innovative intervention strategies. In an effort to address this problem, an Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme, which is a web-based initiative designed for preschool child–parent dyads offers a novel approach. Nevertheless, the success of such a web-based intervention depends on several interrelated factors. This research aims to examine the feasibility of i-MaCHeL in the Malaysian context, its usability for preschool child–parent dyads, and the acceptability of the programme among these user groups.MethodsThis was a single-arm pilot study involving 46 child–parent dyads recruited from six government preschools in Terengganu, Malaysia. The preschools were selected using a cluster random sampling technique at the preschool level. The intervention feasibility was determined based on the retention rate of participants in the pilot study. The System Usability Scale (SUS) and intervention process evaluation were used to assess the usability and acceptability of the web-based i-MaCHeL programme.ResultsThe retention data demonstrated that 42 out of 46 participants completed the 13-week intervention programme, which showed that the overall retention rate was 91.3%. A mean (SD) SUS score of 84.70 (13.82) was obtained from parents, indicating that the web-based i-MaCHeL had an acceptable usability level. The mean scores of the process evaluation items ranged from 4.52 (0.63) to 4.83 (0.38), demonstrating that the web-based i-MaCHeL was highly accepted by the parents. The acceptability data also indicated that at least 92.9% (39/42) of the parents agreed/strongly agreed that the web content, programme duration, intervention dose, WhatsApp group, and delivery mode were appropriate.ConclusionsAccording to these findings, the i-MaCHeL intervention using a web-based approach was feasible, usable, and acceptable as part of a weight-related behaviour change intervention for preschool child–parent dyads. This pilot study demonstrated that the web-based i-MaCHeL was feasible and promising for delivering weight-related behavioural intervention to child–parent dyads.Trial registrationClinicalTrials.gov, NCT04711525. Registered on January 15, 2021.

Hierarchical Bayesian adaptive lasso methods on exponential random graph models

The analysis of network data has become an increasingly prominent and demanding field across multiple research fields including data science, health, and social sciences, requiring the development of robust models and efficient computational methods. One well-established and widely employed modeling approach for network data is the Exponential Random Graph Model (ERGM). Despite its popularity, there is a recognized necessity for further advancements to enhance its flexibility and variable selection capabilities. To address this need, we propose a novel hierarchical Bayesian adaptive lasso model (BALERGM), which builds upon the foundations of the ERGM. The BALERGM leverages the strengths of the ERGM and incorporates the flexible adaptive lasso technique, thereby facilitating effective variable selection and tackling the inherent challenges posed by high-dimensional network data. The model improvements have been assessed through the analysis of simulated data, as well as two authentic datasets. These datasets encompassed friendship networks and a respondent-driven sampling dataset on active and healthy lifestyle awareness programs.

Evaluation of the population-level impacts of the LiveLighter® obesity prevention campaign from 2012 to 2019 based on serial cross-sectional surveys

BackgroundHalting and reversing the upward trend in obesity requires sustained implementation of comprehensive, evidence-based strategies at the population-level. The LiveLighter® program targets adults using a range of public education strategies, including mass media campaigns, to support healthy lifestyle changes to attain or maintain a healthy weight and reduce the risk of chronic disease. LiveLighter® has been implemented in Western Australia (WA) since 2012 and, to our knowledge, includes the longest running adult-targeted mass media campaign for healthy weight and lifestyle promotion and education globally. This evaluation assessed the impact of LiveLighter® on WA adults’ knowledge, intentions and behaviours as they relate to healthy eating and body weight from 2012 to 2019.MethodsLiveLighter® mass media campaigns, which are TV-led and aired statewide, depict genuine, graphic imagery of visceral fat around internal organs to raise awareness about the link between excess body weight and chronic diseases; demonstrate how unhealthy food and drink consumption can contribute to unhealthy weight gain; and recommend healthy alternatives. Cross-sectional telephone surveys were conducted at baseline and following each campaign phase with an independent, randomly selected sample of WA adults aged 25 to 49 years (n = 501 to n = 1504 per survey) to assess their knowledge of the link between excess body weight and chronic diseases, and their intentions and behaviours related to healthy eating and weight. Multivariable logistic regression models were undertaken to assess differences in responses between baseline and each post-campaign survey.ResultsCompared to baseline, there were significant increases in the proportion of respondents reporting knowledge of excess body weight as a risk factor for certain cancers and type 2 diabetes, intentions to eat more fruit and vegetables and drink less sugar sweetened beverages (SSBs) in the next seven days, and the proportion of respondents who reported meeting guidelines for daily vegetable intake. Reported consumption of SSBs significantly decreased.ConclusionsLiveLighter® is associated with improvements in knowledge of the health risks associated with excess body mass, increased vegetable intake and reduced SSB consumption in WA adults. These findings support the use of sustained, well-designed healthy lifestyle promotion and education programs as part of a comprehensive obesity prevention strategy.

Taxing sugar-sweetened beverages: Knowledge, beliefs and where should the money go?

BackgroundThe Sugar-Sweetened Beverage (SSB) industry consciously and subconsciously influences consumers to buy its products. Countering unhealthy messaging and behaviour could be tackled through the SSB levy and allocation of revenue toward healthy lifestyle programs. Given the limited information in the UAE on demographic and consumer knowledge and beliefs and allocation of SSB levy, we conducted a study to explore this further. The study objectives were to a) explore the association between demographic factors (nationality, income and education) with knowledge and beliefs for SSB and b) explore participants' views on allocating SSB levy toward healthy lifestyle programs. MethodsA cross-sectional study of adults in the United Arab Emirates. ResultsThe findings suggest knowledge was high for Sugar-Sweetened Beverages (SSB), obesity, and diabetes (1,231, 96.1%), and there was a high awareness of SSB tax (1,066, 83.2%). Knowledge and beliefs about Sugar-Sweetened Beverages were statistically significant for two demographic factors. There was support for the tax revenue to be spent on government programs and greater support for spending to be directed toward specific healthy lifestyle programs such as school health programmes (514, 39.8%), children's diet and nutrition programmes (497, 38.5%), physical activity programmes (480, 37.2%), among others. ConclusionsThe findings shed light on the influence demographic factors have on knowledge and beliefs, public health gaps and potential areas for SSB levy expenditure. Further research is needed to understand how best to implement healthy lifestyle programs within the community to optimise coverage, cost-effectiveness, and health outcomes.

Training Promotoras to Implement a Mindfulness-Based Healthy Lifestyle Program in Rural Communities

Partnering with promotoras to implement a healthy lifestyle intervention has proven efficacious in reaching community members whom they serve. However, there are no clearly defined guidelines for implementing promotora training, especially when it involves developing mindfulness skills in promotoras unfamiliar with this concept. This is a report about the facilitators and barriers to training promotoras to implement a mindfulness-enhanced healthy eating and physical activity intervention, ADAPT+, using the Train-the-Trainer model. Following this model, we laid the foundations for sustained implementation of ADAPT+ even after the training process. Future studies may examine how these guidelines help map promotora training in other mindfulness-related interventions.

Intake of foods high in saturated fats, vegetarian dietary pattern, and sociodemographic characteristics associated with body weight in Peruvian university students.

The prevalence of obesity continues to increase among university students and the general population. Consumption of a diet high in saturated fats could be one of the risk factors. The consumption of foods high in saturated fats, the vegetarian diet pattern, and sociodemographic characteristics associated with excess body weight (overweight/obesity) were evaluated in Peruvian university students. A cross-sectional study was carried out selecting 5,608 Peruvian university students through no probabilistic convenience sampling. The survey was carried out during the months of February and April 2022. The Chi-square test and binary logistic regression analysis were used to evaluate the association between diet (saturated fats intake and dietary pattern) and sociodemographic factors with excess body weight in a cross-sectional analysis. It was observed that students who reported high consumption of foods high in saturated fats (ORB = 1.14) and those who had a non-vegetarian dietary pattern (ORB = 2.76) were found to be more likely to have excess body weight. On the contrary, students who reported adherence to the vegetarian diet pattern for more than 5 years were less likely to be overweight or obese (ORB = 0.84). Being ≥26 years of age (ORB = 3.28), living in urban areas (ORB = 1.68) and coastal areas of the country (ORB = 1.17), and enrolled in the engineering faculty (ORB = 1.19), were significantly associated with excess body weight. The findings of the current study evidenced several factors associated with excess body weight in university students. Therefore, it is necessary to promote and implement healthy lifestyle programs, considering sociodemographic and dietary aspects such as age and dietary intake to control and prevent obesity in university students.

The Relationship Between Fear of Death and Healthy Lifestyle Behaviors in Individuals Having Percutaneous Coronary Intervention

Objective: The study aims to investigate the relationship between fear of death and healthy lifestyle behaviors in individuals undergoing percutaneous coronary intervention.&#x0D; Materials and Methods: The sample number was determined to be 109. The study was carried out in the angiography unit and cardiology clinics of a hospital. Data were collected using the Thorson-Powell Death Anxiety and Healthy Lifestyle Behaviors II Scales.&#x0D; Results: The patients' death anxiety scale score was 55.17±11.52 and their healthy lifestyle behavior scale score was 123.51±14.56. A negative relationship (r = -0.683, p = 0.003) was found between death anxiety and healthy lifestyle behavior scales. As death anxiety increased, healthy lifestyle behaviors decreased. A negative correlation was found between death anxiety level and physical activity (r = -0.720, p=0.002). As physical activity decreased, death anxiety level increased.&#x0D; Conclusions: In order for patients to experience less death anxiety, the importance of a healthy lifestyle, such as diet, exercise, spiritual development, stress management, and a healthy social life, should be known. Healthy lifestyle education programs should be applied to patients. To ensure permanence, patients should be supported with visuals and brochures, and training should be repeated.

Changes in weight status of caregivers of children and adolescents enrolled in a community-based healthy lifestyle programme: Five-year follow-up

Whānau Pakari is a family-centred healthy lifestyle programme for children/adolescents with overweight/obesity in New Zealand. This secondary analysis from our randomised trial within the clinical service assessed 5-year BMI changes in accompanying caregivers (n = 23), mostly mothers. Overall, baseline and 5-year caregivers’ BMI were similar (32.50 vs 31.42 kg/m2, respectively; p = 0.31) but two-thirds (65%) experienced BMI reductions. Five-year BMI change was similar in High-intensity and Low-intensity randomisation groups [–1.37 kg/m2 (–4.95, 2.21); p = 0.44]. Caregiver’s BMI change was not associated with child’s BMI change. Despite no overall BMI reduction, our findings contrast with upward BMI trajectories predicted for NZ adults with overweight/obesity.

A Multisource Process Evaluation of a Community-Based Healthy Lifestyle Programme for Child and Adolescent Obesity.

Whānau Pakari is a healthy lifestyle assessment and intervention programme for children and adolescents with obesity in Taranaki (Aotearoa/New Zealand), which, in this region, replaced the nationally funded Green Prescription Active Families (GRxAF) programme. We compared national referral rates from the GRxAF programme (age 5-15 years) and the B4 School Check (B4SC, a national preschool health and development assessment) with referral rates in Taranaki from Whānau Pakari. We retrospectively analysed 5 years of clinical data (2010-2015), comparing referral rates before, during, and after the Whānau Pakari clinical trial, which was embedded within the programme. We also surveyed programme referrers and stakeholders about their experiences of Whānau Pakari, analysing their responses using a multiple-methods framework. After the Whānau Pakari trial commenced, Taranaki GRxAF referral rates increased markedly (2.3 pretrial to 7.2 per 1000 person-years), while NZ rates were largely unchanged (1.8-1.9 per 1000 person-years) (p < 0.0001 for differences during the trial). Post-trial, Taranaki GRxAF referral rates remained higher irrespective of ethnicity, being 1.8 to 3.2 times the national rates (p < 0.001). Taranaki B4SC referrals for obesity were nearly complete at 99% in the last trial year and 100% post-trial, compared with national rates threefold lower (31% and 32%, respectively; p < 0.0001), with Taranaki referral rates for extreme obesity sustained at 80% and exceeding national rates for both periods (58% and 62%, respectively; p < 0.01). Notably, a referral was 50% more likely for referrers who attended a Whānau Pakari training half-day (RR = 1.51; p = 0.009). Stakeholders credited the success of Whānau Pakari to its multidisciplinary team, family-centred approach, and home-based assessments. However, they highlighted challenges such as navigating multidisciplinary collaboration, engaging with families with complex needs, and shifting conventional healthcare practices. Given its favourable referral trends and stakeholder endorsement, Whānau Pakari appears to be a viable contemporary model for an accessible and culturally appropriate intervention on a national and potentially international scale.