title: Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun®.
abstract: BACKGROUND
  Community-based obesity treatment programs for children that have a large program reach are a priority. To date, most programs have been small efficacy trials whose findings have yet to be up-scaled and translated into real-world settings. This paper reports on the process evaluation of a government-funded, translated obesity treatment program for children in Australia. It describes the characteristics and reach of children participating in the New South Wales (NSW) Ministry of Health Go4Fun® program.
  
  
  METHODS
  Delivered across the state of NSW (Australia) by Local Health Districts (LHDs), Go4Fun® is a community-based, multidisciplinary family obesity treatment program adapted from the United Kingdom Mind Exercise Nutrition Do it (MEND) program that targets weight-related behaviours. Children aged 7-13 years with a BMI ≥85th percentile and no co-morbidities were eligible at no cost. Parents/carers self-refer via a toll-free phone number, text messages, online registration or via secondary referrals. LHDs deliver a 16 to 20-session program based on length of school term, holidays and recruitment challenges. Both parent/carer and child attend bi-weekly after school sessions. Parent-reported socio-demographic and measured child weight characteristics are presented using descriptive statistics. Differences between completers (attended at least 75% of sessions) and non-completers were assessed using chi-square tests, independent sample t-tests and adjusted odds ratios. Analyses were adjusted for clustering of programs.
  
  
  RESULTS
  Between 2009 and 2012, a total of 2,499 children (54.8% girls; mean age [SD]: 10.2 [1.7 years]) participated in the Go4Fun® program. Children were mainly from low-middle socioeconomic status (76.5%), resided in major cities (63.3%), and 5.7% were Aboriginal. At baseline, 96.5% of children were overweight or obese. Mean BMI-z-score was 2.07 (0.41) and 94.5% had a waist-to-height ratio ≥0.5. More than half (57.9%) completed at least 75% of sessions. Amongst completers (N = 1,446), girls (56.8%; p = 0.02), non-Aboriginal children (95.9%; p < 0.01) and children residing in less socially disadvantaged areas (25.9%; p = 0.02) were significantly more likely to complete the program.
  
  
  CONCLUSIONS
  The Go4Fun® program successfully reached the targeted population of overweight/obese children at socioeconomic disadvantage and is a rare example of an up-scaled translational program.
authors: Debra
authors: D
authors: Welsby
authors: Binh
authors: B
authors: Nguyen
authors: Blythe J
authors: BJ
authors: O'Hara
authors: Christine
authors: C
authors: Innes-Hughes
authors: Adrian
authors: A
authors: Bauman
authors: Physical Activity Nutrition Obesity Research Group, Level 2, Medical Foundation Building K25, University of Sydney, Sydney, NSW 2006, Australia. louise.hardy@sydney.edu.au.
authors: Louise L
authors: LL
authors: Hardy
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003153:Community Health Services / Q000379:methods*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009517:New South Wales; D016017:Odds Ratio; D050177:Overweight / Q000628:therapy; D010290:Parents; D063766:Pediatric Obesity / Q000628:therapy*; D017064:Process Assessment, Health Care