The development and implementation of a family and home-based pilot programme for preventing child obesity in Pacific families in Dunedin, New Zealand

Obesity in childhood has physical, psychological and social consequences that impact on health and quality of life. While there is a need for obesity prevention and treatment programmes amongst all New Zealanders, the need is greatest for Pacific children and their families. Over one in five Pacific children (23%) and three in five Pacific adults (62%) are obese, rates which are at least 2.5 times higher than the rates for non-Pacific children and adults, respectively. Consequently, the rates of obesity-related complications and diseases are also increasing among Pacific children in New Zealand. Programmes for child obesity prevention in New Zealand, largely school-based, have not proved effective for the Pacific population, nor have they focused specifically on the home environment. It is unlikely child obesity can be treated or prevented without addressing the child's influential family and home environment. However, the research to support such a programme in Pacific communities is lacking, particularly collaborative research that works with Pacific families to develop and evaluate a health promotion programme that will prevent child obesity, improve family health, and benefit Pacific communities. This thesis describes the development, implementation, and qualitative evaluation of a home-based pilot programme for preventing child obesity by promoting healthy lifestyle behaviours in 'at-risk' Pacific families in Dunedin, New Zealand. The focus of the programme was small changes in lifestyle behaviours tailored to the self-identified priorities, challenges, and strengths of each family with the aim of improving nutrition and physical activity habits. The programme was delivered in the home over 12 weeks and involved the whole family. This qualitative research was guided by Pacific models including Talanoa (Samoan) methodology and the Kakala (Tongan) research framework. Families were interviewed after participating in the programme and interview transcripts were qualitatively analysed for themes in the experiences and opinions of participating families using a general inductive approach. The results of this pilot suggest home-based programmes that focus on attainable goals, provide clear information, and involve the whole family are a positive and enjoyable method for prevention of child obesity in Pacific families. Families like the fun and family focused programme with simple and clear messages that were tailored to their unique situation and health goals within a flexible structure. Delivery in the home setting was viewed as a way to enhance the understanding of family context, thereby setting achievable goals, something considered highly important by participating families. There is value in considering a complementary community-based programme alongside home-based child obesity prevention because Pacific families were strongly influenced by their community and church environments. Recommendations for future research include formal evaluation of a family and home-based obesity prevention programme based on this pilot programme and development of a complementary community-based component, preferably through the church setting