Why is child obesity a problem?
Taranaki is the most affected region in Aotearoa/New Zealand in terms of childhood obesity prevalence, with over 4,500 children affected. Given 99,000 children are affected with obesity, evidence-based strategies for intervention in this population group are desperately needed. Whānau Pakari was first established in 2012 after Dr Yvonne Anderson, a local paediatrician, recognised the need to provide a different kind of service to the conventional medical model. Results of an initial audit into Green Prescription Active Families in Taranaki identified gaps in the model in terms of health equity and, accessibility and appropriateness of the service for māori.
What is Whānau Pakari?
Whānau Pakari is a family-based healthy lifestyle programme that supports children and adolescents (aged 4-16) who are struggling with weight issues in the Taranaki region. It means healthy, self-assured whānau/families in every sense of the word.
- incorporates a home-based assessment and intervention within the one programme
- removes the need for medical visits, improving access for all
- is whānau-centred, rather than focussing on the child.
Whānau Pakari has been successful due to improved accessibility and appropriateness of the service, including a holistic health check within a home-visit, undertaken by a trained Healthy Lifestyles Coordinator (HLC). This model improves access as transport costs are not an issue, and the service is region-wide. Whānau Pakari is a research-based model of care, which originally had a randomised clinical trial (RCT) embedded within the service. The programme has continued to be modified based on the findings of the clinical research.
How does it work?
The programme is run by a multi-disciplinary team comprised of a HLC, Paediatrician, Dietitian, Physical Activity Advisor and a Psychologist. It offers a home-based medical assessment and weekly activity session in the same programme. The programme has evolved to offer a suite of age-appropriate interventions and different levels of support, decided upon through initial consultation with the whānau and their needs.
What did the research show?
The RCT demonstrated that:
- even the low intensity intervention of 6-monthly health checks and advice from the HLC was successful in reducing weight status
- attendance at the weekly programme for more than 70% of the sessions doubled the reductions in weight status, highlighting that attendance is key to outcome. Link to the research here.
Some families choose to have 6-monthly health checks for up to one year or engage with the programme more intensively and attend weekly sessions for six months, run from two locations in Taranaki during school term.
How does Whānau Pakari engage with the community?
The nature of Whānau Pakari is collaboration on many levels: between Taranaki District Health Board (TDHB) and Sport Taranaki, within the clinical team, between the clinical team and research team and between the entire Whānau Pakari team and the Taranaki community. The research is also supported by the Liggins Institute, University of Auckland. The team meet biweekly for a multi-disciplinary meeting to discuss the participants on the programme holistically, and to identify their individual needs. Regular face-to-face meetings are a key aspect of optimal multi-disciplinary working and collaboration.
The team also engage and promote the service together through attending workshops in the community and speaking at professional development days. Co-delivering weekly sessions is another great way of using the expertise in the group to its best advantage. Whānau Pakari weekly sessions often see one team member take the children on their own for half a session with the adults with another team member, finishing with both coming together for a group activity and reinforcing of messages.
Although the Whānau Pakari team is a small team of health care professionals, the programme has been a community-wide project with support given from local businesses to promote a healthy, active lifestyle. Buy -in from the community has been a core part of the success of Whānau Pakari, and the team would encourage anyone building their own service for children with weight issues to consider a community-based model.
Engaging with physical activity providers in the region to give a variety of activity options throughout the terms can result in friendships and great collaboration and new ideas to develop. The collaboration between the TDHB and Sport Taranaki has allowed the programme to be more than just a clinical service – Sport Taranaki offers excellent community linkages and opportunities for the whānau engaged, including their ‘Tough Kids Challenge’ activity course and ‘Rainbow Run’. We also have close links with local schools, who support Whānau Pakari with providing cooking rooms for the much-anticipated cooking sessions during the term.Read more about the community involvement on page 20 of this link.
We are currently developing our pilot for an early childhood programme for 4-5 year olds and have already established an adolescent workshop model for participants over 11 years.
We are motivated by and learn from all the whānau that we cross paths with and it is a privilege to watch the journey that unfolds as these whānau work together to make persistent healthy lifestyle changes.
For more information
Visit the Whānau Pakari page on the Sport Taranaki website
Contact for referrals, email Lisa Wynter (healthy lifestyles co-ordinator) on email@example.com or phone on: (06) 753 6139 Extn 8729, mobile: 027 910 7253.
Whānau Pakari kids enjoying the vegetables they grew thanks to Return 2 Earth
Whānau Pakari kids with Sam Rapira at Boxfit in New Plymouth
Families getting active in the Sport Taranaki Rainbow Run
Bouncing up a storm at Air Zone Trampoline Park in New Plymouth
Article written for ANA by Dr Yvonne Anderson, August 2018