Prepared by Jodie Peace On Behalf of the PAKMAN Team, Tamworth Child, Youth & Family Health Team

1. Parents and Kids Movement and Nutrition (PAKMAN) Program:A Model for Allied Health Team Collaboration Prepared by Jodie Peace On Behalf of the PAKMAN Team, Tamworth Child, Youth & Family Health Team 4th NSW Rural Allied Health Conference 2009

2. Introduction • Hunter New England: children 2-15 years • 23% overweight or obese • 70% spending > 2hrs watching T.V (sedentary) • 58% not consuming vegetable recommendations • Gap in services reflective of best practice • High turn over multidisciplinary staff • Tamworth Child, Youth & Family Health Team • Pilot Long Term Allied Health Program collaboration

3. Background Best Practice Vs. PAKMAN Dietetic, Occupational Therapy, Physiotherapy, Psychology Professionals Community Health Based Setting Children BMI > 85th Percentile 8-12 years Parents and Children < 8 years Parents only • Multidisciplinary team approach= comprehensive approach • Target Risk Factors • Children BMI > 85th Percentile • Children 8-12 years • Involve parents=better outcomes

4. Referrals Initial Assessment Week 1 Week 2 Week 3 Week 4 3-Month F/U 12-Month F/U Background Team Functioning Champion Discipline • Team communication • Administrative tasks • Project communication • Electronic Program Storage • Each week own folder • Universal team access • Retention of program materials • Comprehensive resource package • Program overview • Client brochures • Referral forms and processes Functioning

5. Background • North West Slopes Division General Practice • Program Awareness • Resource package • Education

6. Aim • Assess the effectiveness of the PAKMAN Allied Health partnership • Team functioning • Group education delivery model • Impact on services • Sustainability • Assess the effectiveness of Division General Practice, Practice Nurse Partnership • Support Resources • Communication

7. Methods Allied Health • Survey Development and Dissemination to Past and Present PAKMAN Team members • 13 Questions, Closed and Open • Electronic Dissemination Practice Nurse • Survey Development and Dissemination to large Practices • 9 Questions, Closed and Open • Manual Dissemination

8. Outcomes: Allied Health

9. Outcomes: Allied Health • Dietetics Professionals Responded Yes • Low Priority

10. Outcomes: Allied Health Group Education Delivery Model • 100% effective Comments “ Families benefited from hearing about the experiences of others and feeling supported....parents were less intimidated by having others with similar issues” “Separate sessions for parents and kids allowed parents to talk freely” “Participants provided examples to support the presenters content”

11. Outcomes: Allied Health • ‘Champion’ Professional team • 100% Effective • 100% Minimal Time burden Comments “Generally only 1 ½ hr to implement session” “Due to Dietitians as leaders to direct this program there was minimal time burden...without a leader to take control it may have been in-completed” “ It enabled our department to be involved” • 100%

12. Outcomes: Allied Health • Electronic Folders • 100% Practical for large team to access program resources Comments “One central location meant no doubling of copies/changes” “Made access quick and easy” “Very useful tool that assists with team communication”

13. Outcomes: Allied Health • Strategy to support new practitioners • 100% agree involvement in established program is supportive in rural areas

14. Outcomes: Allied Health • Continuing Involvement • 100% enjoyed Allied Health Collaboration Comments “Great to share achievements together” “ It provides positive workplace moral and workforce building” “You learn so much about other professions, where new knowledge could be used in daily practice” • 100% committed to future implementation or encouragement of peer participation

15. Outcomes: Practice Nurse • 100% find availability Family weight management program a a useful referral point • No availability of other local programs for childhood obesity • 100% believe Division-PAKMAN partnership effective

16. Outcomes: Practice Nurse • 100% find PAKMAN resource package useful Comments “Easy to refer” “Would be great to extend the package to include waiting room resources such as posters....” • 100% commitment to continued involvement and encouragement of peers

17. Take home messages • No Program = No Multidisciplinary Services • Decrease reach • Lack expert information • Program ‘Champion’ • Short and Long sustainability • Minimise time commitment • Supportive for new rural staff • Skills and satisfaction • Engaging Practice Nurses increase referrals • Clear processes and materials • Electronic Folders • Retention Information

18. Further Applications • Any Behavioural Change Program • Allied Health Approach • Rural settings/minimal human resources • Broaden referrals • ‘Champion’ • Lack administrative support/organisation • Programs for new staff

19. Acknowledgements • PAKMAN Team (Past & Present) • Tamworth Child, Youth and Family Health Team members: Katrina Wakely, Marisa Barnes, Luke Wakely, Rachel Thornton, Kelly Ancuk, Nicola Wade • Tamworth/Nundle Community Health Service • North West Slopes Division General Practice • Deanne Harris, Northern Dietetic Advisor • Leanne Brown, Tamworth University Department of Rural Health

20. References • (1) NSW Department of Health. Facts about childhood obesity [homepage on internet]. No date [cited 2009 April 4]. Available from: http://www.health.nsw.gov.au/publichealth/healthpromotion/obesity/background.asp. • (2) NSW Department of Health. New stats to help fight childhood obesity, John Della Bosca, media release, 22 October [cited 2009 October 22]. Available from: http://www.health.nsw.gov.au/news/2008/pdf/20081022_00.pdf • (3) National Health and Medical Research Council (NHMRC). Clinical Practice Guidelines for the Management of Overweight and Obesity in Children and Adolescents. Commonwealth of Australia; September 2003.