title: Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia.
abstract: Reducing the prevalence of obesity and chronic disease are important priorities. Maori and Pacific Islander communities living in Australia have higher rates of obesity and chronic disease than the wider Australian population. This study aims to assess the effectiveness of the Good Start program, which aims to improve knowledge, attitudes and practices related to healthy eating and physical activity amongst Maori and Pacific Islander communities living in Queensland.
  
  
  
  The intervention was delivered to children aged 6-19 years (N = 375) in schools by multicultural health workers. Class activities focused on one message each term related to healthy eating and physical activity using methods such as cooking sessions and cultural dance. The evaluation approach was a quantitative uncontrolled pre-post design. Data were collected each term pre- and post-intervention using a short questionnaire.
  
  
  
  There were significant increases in knowledge of correct servings of fruit and vegetables, knowledge of sugar and caffeine content of common sugar-sweetened drinks, recognition of the consequences of marketing and upsizing, and the importance of controlling portion size (all P < 0.05). There was also increases in knowledge of physical activity recommendations (P < 0.001), as well as the importance of physical activity for preventing heart disease (P < 0.001) and improving self-esteem (P < 0.001). In terms of attitudes, there were significant improvements in some attitudes to vegetables (P = 0.02), and sugar-sweetened drinks (P < 0.05). In terms of practices and behaviours, although the reported intake of vegetables increased significantly (P < 0.001), the proportion of children eating discretionary foods regularly did not change significantly, suggesting that modifying the program with an increased emphasis on reducing intake of junk food may be beneficial.
  
  
  
  The study has shown that the Good Start Program was effective in engaging children from Maori and Pacific Island backgrounds and in improving knowledge, and some attitudes and practices, related to healthy eating and physical activity. The evaluation contributes valuable information about components and impacts of this type of intervention, and considerations relevant to this population in order to successfully change behaviours and reduce the burden of chronic disease.
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland, Brisbane, 4006, Australia. seema.mihrshahi@sydney.edu.au.|Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney, The Charles Perkins Centre D17, Level 6, The Hub, Sydney, NSW, 2006, Australia. seema.mihrshahi@sydney.edu.au.
authors.forename: Seema
authors.identifier: 0000-0002-2394-5432
authors.initials: S
authors.lastname: Mihrshahi
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland, Brisbane, 4006, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Vaughan
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland, Brisbane, 4006, Australia.|SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fa'avale
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland, Brisbane, 4006, Australia.|Faculty of Medicine, Department of Community Medicine, University of Colombo, Colombo, Sri Lanka.
authors.forename: Shreenika
authors.initials: S
authors.lastname: De Silva Weliange
authors.affiliation: Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Spring Hill, Brisbane, 4006, Australia.|School of Professional Studies and Education, Griffith University, Mount Gravatt, Brisbane, 4122, Australia.
authors.forename: Inez
authors.initials: I
authors.lastname: Manu-Sione
authors.affiliation: Faculty of Medicine and Biomedical Sciences, School of Public Health, The University of Queensland, Brisbane, 4006, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schubert
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D010139:Pacific Islands; D011793:Queensland / Q000208:ethnology
keywords: Children; Evaluation; Healthy eating; Interventions to reduce obesity; Maori and Pacific Islander; Obesity; Physical activity