B irmingham healthy E ating and A ctive lifestyle for CH ildren S tudy

1. BEACHeS Birmingham healthy Eating and Active lifestyle for CHildren Study Investigators: Peymané Adab (PI), Tim Barrett, Janet Cade, KK Cheng, Amanda Daley, Joan Duda, Ulf Ekelund, Paramjit Gill, Miranda Pallan, Jayne Parry Collaborators: Raj Bhopal, Michelle Howard, Eleanor McGee, Sandra Passmore Research team: Victoria Brookes; Miriam Banting; Sheila Hirst Funded by: National Prevention Research Initiative http://www.npri.org.uk

2. BEACHeS Study: Aims • To develop a childhood obesity prevention intervention aimed at children aged 6 to 8, particularly focusing on South Asians • Using lay knowledge, evidence base and expert input • To pilot developed intervention in an exploratory trial • Primary and secondary outcomes measured in school children

3. MRC framework for developing and evaluating complex interventions BEACHeS Campbell, M. et al. BMJ 2000;321:694-696

4. BEACHeS Study Methodology • Setting • 8 Primary schools & communities in Birmingham with >50% South Asian pupils (Indian, Pakistani or Bangladeshi) • Phase I • Focus groups run with a range of local stakeholders • Views on childhood obesity and potential prevention interventions explored • Resulting data used in development of intervention package

5. BEACHeS Study Phase II • Year 1 and 2 children undergo baseline measures: • Height, weight, waist circ, skinfolds, BIA • Blood pressure • Physical activity assessment • Dietary assessment • HRQoL, self concept and body image • Demographic information • Intervention delivered to 4 schools/communities • Year 3 and 4 children undergo follow up measures

6. Progress so far: baseline measures • 52 schools in Birmingham eligible, 8 recruited: • 81% pupils are South Asian • 1090 pupils eligible, 606 consented • 574 measured

7. Phase 1: Focus groups • Identity groups convened: • Parents (groups run in English and Punjabi) • Teachers • Catering and school support staff • Local Authority, leisure and retail representatives • Community representatives • Health representatives • Children

8. Focus groups: emerging findings • Focus of interventions should shift to family and community settings • Themes for interventions included: • Developing parenting skills • Activities for parents/families • Working on children’s self-esteem • Daily, non-competitive physical activity in schools • Involving children in school changes • Improving provision of healthy food in schools • Working with mosques, and other faith groups

9. Focus groups: barriers to successful interventions • Many barriers identified • Some are culturally specific • Many children spend evenings at mosque • Extended families in same household, grand parents may have major influence over children • Obesity may not be seen as a problem in some communities

10. Baseline measures: obesity prevalence 22.5% of study population overweight or obese (males 20.3%, females 24.9%)

11. Overweight, obesity and age Males Females

12. Overweight, obesity and ethnicity Males Females

13. Obesity prevalence: comparison of BEACHeS and regional data

14. Next steps for BEACHeS • Detailed analysis of focus group data • Detailed analysis of baseline measures • Development of the intervention using: • focus group data • Evidence base • expert input • Implementation of the developed intervention package