title: After the RCT: who comes to a family-based intervention for childhood overweight or obesity when it is implemented at scale in the community?
abstract: BACKGROUND
  When implemented at scale, the impact on health and health inequalities of public health interventions depends on who receives them in addition to intervention effectiveness.
  
  
  METHODS
  The MEND 7-13 (Mind, Exercise, Nutrition…Do it!) programme is a family-based weight management intervention for childhood overweight and obesity implemented at scale in the community. We compare the characteristics of children referred to the MEND programme (N=18 289 referred to 1940 programmes) with those of the population eligible for the intervention, and assess what predicts completion of the intervention.
  
  
  RESULTS
  Compared to the MEND-eligible population, proportionally more children who started MEND were: obese rather than overweight excluding obese; girls; Asian; from families with a lone parent; living in less favourable socioeconomic circumstances; and living in urban rather than rural or suburban areas. Having started the programme, children were relatively less likely to complete it if they: reported 'abnormal' compared to 'normal' levels of psychological distress; were boys; were from lone parent families; lived in less favourable socioeconomic circumstances; and had participated in a relatively large MEND programme group; or where managers had run more programmes.
  
  
  CONCLUSIONS
  The provision and/or uptake of MEND did not appear to compromise and, if anything, promoted participation of those from disadvantaged circumstances and ethnic minority groups. However, this tendency was diminished because programme completion was less likely for those living in less favourable socioeconomic circumstances. Further research should explore how completion rates of this intervention could be improved for particular groups.
authors.affiliation: Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Fagg
authors.affiliation: Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Cole
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Cummins
authors.affiliation: Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK Centre for Multilevel Modelling, University of Bristol, Bristol, UK.
authors.forename: Harvey
authors.initials: H
authors.lastname: Goldstein
authors.affiliation: Department of Applied Health Research, UCL, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
authors.affiliation: Carnegie Faculty, Leeds Metropolitan University, Leeds, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Radley
authors.affiliation: Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Sacher
authors.affiliation: Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Law
mesh_terms: D000293:Adolescent; D002648:Child; D004739:England; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000628:therapy*; D016012:Poisson Distribution; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D017678:Sex Distribution; D012923:Social Class; D061217:Weight Reduction Programs / Q000379:methods*
keywords: CHILD HEALTH; HEALTH BEHAVIOUR; INEQUALITIES; OBESITY; Outcome Research Evaluation