title: The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention.
abstract: OBJECTIVE
  The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds.
  
  
  METHODS
  Non-randomised controlled evaluation of a complex public health intervention.
  
  
  METHODS
  527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control).
  
  
  METHODS
  Training SSCC staff in behaviour change skills that would empower women to change their health behaviours.
  
  
  RESULTS
  Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control.
  
  
  RESULTS
  1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)).
  
  
  CONCLUSIONS
  While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the intervention might improve health behaviour. Further evaluation in a more controlled setting is justified.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Janis
authors.initials: J
authors.lastname: Baird
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK.
authors.forename: Megan
authors.initials: M
authors.lastname: Jarman
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK.
authors.forename: Wendy
authors.initials: W
authors.lastname: Lawrence
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Black
authors.affiliation: Public Health Team, NHS Southampton City, Civic Centre, Southampton, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Davies
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Tannaze
authors.initials: T
authors.lastname: Tinati
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK.
authors.forename: Rufia
authors.initials: R
authors.lastname: Begum
authors.affiliation: Public Health Team, NHS Southampton City, Civic Centre, Southampton, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mortimore
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Robinson
authors.affiliation: Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Barrie
authors.initials: B
authors.lastname: Margetts
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Barker
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Hazel
authors.initials: H
authors.lastname: Inskip
mesh_terms: D000328:Adult; D065187:Controlled Before-After Studies; D004032:Diet; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D009043:Motor Activity; D011634:Public Health; D020377:Self Efficacy; D000068356:Self-Control
keywords: behavour change; complex public health intervention; diet; physical activity; self efficacy; sense of control