1. Charlotte Taylor, Rosie Erol, Penney Upton & Dominic Upton
The effectiveness of local child weight management programmes: an audit study
Charlotte Taylor, Rosie Erol, Penney Upton & Dominic Upton
23rd October 2013

2. Context: Why commission an evaluation of CWM programmes?
Obesity in children and adolescents increasing in the UK;
Particular challenge in the West Midlands region (HSE, 2007; The Health and Social Care Information Centre, 2009)
Many different programmes for family based weight management are available; limited evidence of the long term effectiveness of these models.
Measures used in evaluation are inconsistent and make cross-programme comparison difficult.
Need for a standardised approach to evaluation.
Statistics correct a the time of the evaluation
The Health Survey for England (2007) identified that among boys aged 2 to 15, the proportion classed as obese increased from 14% in 1998 to 20% in A similar picture was found for girls, with 12% classed as obese in 1998 rising to 18% in 2007 (Office for National Statistics, 2008). Clearly these rates are above the national prevalence rates, suggesting urgent action is needed in the West Midlands
National Child Measurement Programme (NCMP) for England, identified the West Midlands as an area where the prevalence childhood obesity is significantly higher than the national average (The Health and Social Care Information Centre, 2009). Nearly one in four (23.3%) of the reception age children measured were either overweight or obese. In Year 6, this rate was more than one in three (34.3%). 

3. ‘Does the programme work and at what cost?’
Evaluation aims
Benefits to participating (a) children and (b) families in terms of health improvement and behaviour change;
Barriers to change for (a) children and (b) families undertaking treatment programmes;
Short and longer term support available for programme participants;
Cost effectiveness of each intervention.
‘Does the programme work and at what cost?’

4. Interventions Carnegie Fun for Life: Walsall
Fitter Families: Stoke on Trent
Goals: Sandwell
MEND
One Body One Life: Coventry
Watch It!: Birmingham
YW8?: Telford and Wrekin
Children and families who had participated in one of these programmes between 1st July 2007 and 1st July 2009.

5. An audit of 7 family-based intervention programmes currently in place in the West Midlands. Programmes were audited against the Standard Evaluation Framework.
An audit of this routine data was then carried out, using the SEF for weight management interventions. Each intervention programme was compared against the SEF essential and desirable criteria.

6. Methods Review of programmes:
the target group;
Theoretical rationale
recruitment and retention rates;
method of programme delivery;
structure (including routine practice for ongoing support for participants)
Assessment of physical and psychosocial benefits to programme participants
Economic evaluation
An audit of 7 family-based intervention programmes currently in place in the West Midlands. Programmes were audited against the Standard Evaluation Framework.
An audit of this routine data was then carried out, using the SEF for weight management interventions. Each intervention programme was compared against the SEF essential and desirable criteria.

7. Results: SEF audit
No programme collected all of the essential or desirable SEF criteria;
19 criteria collected by all interventions
Weight and height for BMI;
Physical activity and dietary measures were collected by the majority of programmes (N=6 and 5 respectively)
Range of measures used for physical activity and diet.

8. Results: Health Improvement - BMI

9. Results: Behaviour change

10. Results: Benefits to families
Health Improvement
Limited/no data for parents or other family members
Anecdotal data suggests some impact
Behaviour Change
Data is also limited

11. Results: Economic evaluation
What are the costs?
Costs calculated based on numbers recruited/retained during the evaluation period:
Highest cost per child: Watch IT! = £798-£2,424
Lowest cost per child: OBOL = £

12. Conclusions All programmes have some strengths;
SEF criteria enabled comparison between different interventions BUT:
Highlighted lack of consistency between programmes
types of data recorded
evaluation methods used
Key data should be chosen based on what can be collected as well as what is desirable;
Behaviour change, e.g. food intake and exercise should be measured in a systematic and standardised way

13. Impact on people, policy and practice?

14. Our impact…
Enabled Primary Care Trusts to improve measurement, data collection and evaluation;
Reassured PCTs that they were commissioning effective programmes;
PCTs adopted the SEF to evaluate child weight measurement programmes when making future commissioning decisions;
One PCT specified that the SEF and the UoW evaluation tools and findings must be used by service providers.
Saunders, Baker & Davis (2011)

15. For more information…
Upton, P., Taylor, C. E., Peters, D. M., Erol, R. and Upton, D. (2013). The effectiveness of local child weight management programmes: an audit study. Child: Care, Health and Development, 39(1), DOI:  /j x
Upton, P., Taylor, C., Beddows, S., & Upton, D. (2010). Weighing up the SEF: An assessment of the use of the NOO Standard Evaluation Framework across family-based weight management interventions in one region. Community Practitioner, 83(7),
Upton, D., & Upton, P. (2009). Weight management programmes for children and families: A toolkit for measuring behaviour change, psychosocial wellbeing and participant satisfaction. Available at
Upton, P., & Upton, D. (2009). Recommendations for Commissioners of Weight Management Programmes for Children and Families. Available at:

16. Any questions?