Community-based obesity prevention initiatives in aboriginal communities: The experience of the eat well be active community programs in South Australia

Annabelle Wilson, Michelle Jones, Janet Kelly, Anthea Magarey

Health Care Management, Flinders University of South Australia, Adelaide, Australia.
Nutrition and Dietetics, Flinders University of South Australia, Adelaide, Australia.
Obesity Prevention and Lifestyle, Health Promotion Branch, SA Health, Government of South Australia, Adelaide, Australia.

DOI: 10.4236/health.2012.412A215                

Abstract

Childhood obesity is a growing concern world-wide, and obesity rates are higher in certain groups in the developed world, including Australian Aboriginal people. Community-based obesity prevention interventions (CBOPI) can help to address obesity, however the approach of such programs to reach diverse groups, including Aboriginal people, must be considered. This paper considers one mainstream¹ CBOPI, the eat well be active (ewba) Community Programs in South Australia, which was delivered in two communities and sought to reach Aboriginal people as part of the overall program. This paper considers how well this approach was received by the Aboriginal people living and working in those communities. Semi-structured interviews were conducted with nine Aboriginal workers who had some connection to the ewba program, and seven ewba project staff. Qualitative data analysis was performed and factors found to affect how well the program was received by Aboriginal people include relationships, approach and project target group, including geographical area. A different response was observed in the two communities, with a more positive response being observed in the community where more relationships were developed between ewba and Aboriginal staff. For any CBOPI seeking to work with Aboriginal (or other Indigenous) communities, it is vital to consider and plan how the program will meet the needs and preferences of Aboriginal people in all stages of the project, in order to reach this group.

Keywords

Obesity Prevention; Aboriginal; Community-Based Intervention; Indigenous; Qualitative

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Lobstein, T., Baur, L. and Uauy, R. (2004) Obesity in children and young people: A crisis in public health. Obesity Reviews, 5, 4-85. doi:10.1111/j.1467-789X.2004.00133.x
[2]	Australian Bureau of Statistics (2012) Australian health survey—First results 2011-2012. Australian Bureau of Statistics, Can-berra.
[3]	Monteiro, C., Conde, W.L., Lu, B. and Popkin, B.M. (2004) Obesity and inequalities in health in the developing world. International Journal of Obesity, 28, 1181-11866. doi:10.1038/sj.ijo.0802716
[4]	Australian Council of Social Services (1974) Poverty, the ACOSS evidence. Australian Government Publishing Service, Canberra.
[5]	Eckermann, A., Dowd, T., Chong, E., Nixon, L., Gray, R. and Johnson, S. (2006) Binan Goonj: Bridging cultures in aboriginal health. Churchill Livingstone, Sydney.
[6]	Australian Bureau of Statistics (2010) The health and welfare of Australia’s aboriginal and Torres Strait Is- lander peoples. Australian Bureau of Statistics, Canberra.
[7]	Australian Bureau of Statistics (2008) Overweight and obesity in adults, Australia, 2004-2005. Aus-tralian Bu- reau of Statistics, Canberra.
[8]	Spurrier, N.J., Volkmer, R.E., Abdallah, C.A. and Chong, A. (2012) South Australian four-year old Aboriginal chil- dren: Residence and socioeconomic status influence wei- ght. Australian & New Zealand Journal of Public Health, 36, 285-290. doi:10.1111/j.1753-6405.2012.00872.x
[9]	Cook, P., Rut-ishauser, I. and Seelig, M. (2001). Compa- rable data on food and nutrient intake and physical meas- urements from the 1983, 1985 and 1995 National Nutrition Surveys. Australian Food and Monitoring Unit, Bris-bane.
[10]	Dollman, J., Norton, K. and Norton, L. (2005) Evidence for secular trends in children’s physical activity behaviour. British Journal of Sports Medicine, 39, 892-897. doi:10.1136/bjsm.2004.016675
[11]	Swinburn, B., Egger, G. and Raza, F. (1999) Dissecting obesogenic environments: the development and applica- tion of a framework for identifying and prioritising envi- ronmental interventions for obesity. Pre-ventive Medicine, 29, 563-570. doi:10.1006/pmed.1999.0585
[12]	National Obesity Taskforce (2003) Healthy weight 2008 Australia’s future: The national action agenda for chil- dren and young people and their families. Commonwealth of Australia, Canberra.
[13]	Catford, J., (2003) Promoting healthy weight—The new environmental frontier. Health Promotion International, 18, 1-3. doi:10.1093/heapro/18.1.1
[14]	World Health Organization (2000) Obesity: Preventing and managing the global epidemic in WHO report tech- nical Series. World Health Organization, Geneva.
[15]	Kumanyika, S.S., Jeffery, R.W., Morabia, A.A., Ritenbaugh, C.C. and Antipatsis, V.J. (2002) Obesity prevention: The case for action. International Journal of Obesity, 26, 425-36. doi:10.1038/sj.ijo.0801938
[16]	Waters, E., de Silva-Sanigorski, A., Hall, B.J., Brown, T., Campbell, K., Gao, Y., Armstrong, R., Prosser, L. and Summerbell, C.D. (2011) Interventions for preventing obesity in children. Cochrane Da-tabase of Systematic Re- views, 12, Article No: CD001871. doi:10.1002/14651858.CD001871.pub3
[17]	Trindall, S., Allen, L., Bartel, L., Draws, R. and Trapmas, J. (2007) Report from the “Good for Kids. Good for Life”. Aboriginal Communities Consultation Project—Gaaying- gal Maaru Gidhaylaya, Good for Kids Good for Life.
[18]	Trindall, S. and Bell, C. (2008) Good for kids good for life—Equity-Focussed Health Impact Assessment. Good for Kids Good for Life.
[19]	Kelaher, M., Sanigorski, A., Ferdinand, A., Bolton, K. and Waller, C. (2011) Final evaluation report for “Go for your life” Health Promoting Communities: Being active and eating well initiative (HPC: BAEW) Wathaurong Aboriginal Co-operative. University of Melbourne, Melbourne.
[20]	Thompson, K. and Kebisu, R. (2008) Eat well, be Active, healthy kids for life—Badu island. National Nutrition Net- works Conference: Good Tucker, Good Health, Alice Springs, 11-14 March 2008.
[21]	Pettman, T., McAllister, M., Verity, F., Magarey, A., Doll- man, J., Triptree, M., Stanley, S., Wilson, A. and Mas- tersson, N. (2010) Eat well be active community pro- grams final report. SA Health, Adelaide.
[22]	Caballero, B., Clay, T., Davis, S.M., Ethelbah, B., Holy Rock, B., Lohman, T.G., Norman, J.E., Story, M., Stone, E.J., Stephenson, L. and Stevens, J. (2003) Pathways: A school-based, randomized controlled trial for the preven- tion of obesity in American Indian schoolchildren. Ame- rican Journal of Clinical Nutrition, 78, 1030-1038.
[23]	LaRowe, T.L., Wubben, D.P., Cronin, K.A., Vannatter, S.M. and Adams, A.K. (2007) Development of a culturally appropriate, hoe-based nutrition and physical activity curriculum for Wisconsin American Indian families. Preventing Chronic Disease—Public Health Research, Practice and Policy, 4, 1-8.
[24]	Rush, E., Reed, P., McClennan, S., Coppinger, T., Simmons, D. and Graham, D. (2012) A school-based obesity control program: Project energize. Two-year outcomes. British Journal of Nutrition, 107, 581-587. doi:10.1017/S0007114511003151
[25]	Ruben, A. (2009) Un-dernutrition and obesity in indigenous children: Epidemiology, prevention, and treatment. Pediatric Clinics of North America, 56, 1285-1302. doi:10.1016/j.pcl.2009.09.008
[26]	Australian Bureau of Statistics (2006) Population distribution, aboriginal and Torres Strait Islander Australians, 2006. Australian Bureau of Statistics, Canberra.
[27]	Australian Bureau of Statistics (2008) Census of population and housing: Socio-economic indexes for areas. Aus- tralian Bureau of Statistics, Canberra.
[28]	Wilson, A., Magarey, A. and Mastersson, N. (2008) Reliability and relative validity of a child nutrition question- naire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, atti- tudes, knowledge and environments associated with heal- thy eating. International Journal of Behavioural Nutrition and Physical Activity, 5. doi:10.1186/1479-5868-5-5
[29]	Wilson, A., Magarey, A., Dollman, J., Jones, M. and Mastersson, N. (2009) The challenges of quantitative eva- luation of a multi-setting, multi-strategy community ba- sed childhood obesity prevention program: Lessons learnt from the eat well be active Community Programs in South Australia. Public Health Nutrition, 13, 1262-1270. doi:10.1017/S1368980009991807
[30]	Swinburn, B., Gill, T. and Kumanyika, S. (2005) Obesity prevention: A proposed framework for translating evidence into action. Obesity Reviews, 6, 23-33. doi:10.1111/j.1467-789X.2005.00184.x
[31]	Denzin, N. and Lincoln, Y. (1994) Handbook of qualitative research. Sage Publications, Thousand Oaks.
[32]	Crotty, M. (1998) The Foundations of Social Research: Meaning and perspective in the research process. Allen & Unwin, St Leonards.
[33]	Neuman, W.L. (2000) Social research methods qualitative and quantitative approaches. 4th Edition, Allyn & Bacon, Needham Heights.
[34]	Haralambos, M. and Holborn, M. (2004) Sociology themes and perspectives. Sixth Edition, Collins, London.
[35]	Etherington, K. (2004) Becoming a reflexive researcher: Using our selves in research. Jessica Kingsley Publishers, London.
[36]	Harvey, L. (1990) Critical Social Research. Unwin Hyman Ltd., Sydney.
[37]	National Health & Medical Research Council (2003) Values and ethics: Guidelines for ethical conduct in aborigi- nal and Torres Strait Islander health research. Common-wealth of Australia, Canberra.
[38]	Pyett, P., Waples-Crowe, P. and van der Sterren, A. (2008) Challenging our own practices in indigenous health pro- motion and research. Health Promotion Journal of Australia, 19, 179-183.
[39]	Sherwood, J. and Edwards, T. (2006) De-colonisation: A critical step for improving aboriginal health. Contempo- rary Nurse, 22, 177-190. doi:10.5172/conu.2006.22.2.178
[40]	Paradis, G., Levesque, L., Maucaulay, A.C., Cargo, M., McComber, A., Kirby, R., Receveur, O., Kishchuk, N. and Potvin, L. (2005). Impact of a diabetes prevention program on body size physical activity, and diet among kanien’keha:ka (Mohawk) children 6 to 11 years old: 8- year results from the Kahnawake Schools Diabetes Prevention Project. Pediatrics, 115, 333-339. doi:10.1542/peds.2004-0745
[41]	Smith, L. (1999) Decolo-nizing methodologies—Research and indigenous peoples. Zed Books Ltd., London.
[42]	Watts, E. and Carlson, G. (2002) Practical strategies for working with indigenous people living in Queensland, Australia. Occupational Therapy International, 9, 277- 293. doi:10.1002/oti.169
[43]	Read, C., (2006) Working with an aboriginal commu- nity liaison worker. Rural and Remote Health, 6, 1-9.
[44]	Blackman, R., (2009) Knowledge for practice: Challenges in culturally safe nursing practice. Contemporary Nurse, 32, 211-214.
[45]	Macaulay, A.C., (2009) Improving aboriginal health. Ca- nadian Family Physician, 55, 334-336.
[46]	Smith, D., (2010) Rethinking nursing best practices with aboriginal communities: Informing dialogue and action. Nursing Leadership, 22, 24-39.
[47]	Bennett, B., Zubrzycki, J. and Bacon, V. (2011) What do we know? The experiences of social workers working alongside aboriginal people. Australian Social Work, 64, 20-37. doi:10.1080/0312407X.2010.511677
[48]	Stedman, A. and Thomas, Y. (2011) Reflecting on our effectiveness: Occupa-tional therapy interventions with Indigenous clients. Australian Occupational Therapy Journal, 58, 43-49. doi:10.1111/j.1440-1630.2010.00916.x
[49]	Daniel, M., Green, L.W., Marion, S.A., Gamble, D., Herbert, C.P., Hertzman, C. and Sheps, S.B. (1999) Effectiveness of community-directed diabetes prevention and control in a rural aboriginal population in British Columbia, Canada. Social Science and Medicine, 48, 815-832. doi:10.1016/S0277-9536(98)00403-1
[50]	Saksvig, B., Gittel-sohn, J., Harris, S.B., Hanley, A.J.G., Valente, T.W. and Zin-man, B. (2005) A pilot school-ba- sed healthy eating and physical activity intervention im- proved diet, food knowledge and self-efficacy for Native Canadian children. The Journal of Nutrition, 135, 2392- 2398.
[51]	Smylie, J. (2000) A guide for health professionals work- ing with Aboriginal peoples—Cross cultural understand- ings. Journal of the Society of Obstetricians and Gynae- cologists of Canada, 23, 157-167.
[52]	Braveman, P. and Gruskin, S. (2003) Defining equity in health. Journal of Epidemiology and Community Health, 57, 254-258. doi:10.1136/jech.57.4.254