Evidence on Effective Interventions - Lightweight at Best!” by- Lesley King & Debra Hector

One of the fellow Prevention Centers with CPAH, the Center for Overweight and Obesity (COO) participated in the Collaborative Centre for Aboriginal Health Promotion (CCAHP) Forum - Physical Activity and Nutrition held March 20. The forum focuses on Aboriginal Health Promotion to assist the sector in developing a coordinated approach in a number of focus areas and on Nutrition and Physical Activity in Aboriginal Communities. The event attracted over 100 delegates from rural, remote and urban areas who represented research centers, Aboriginal Medical Services and Area Health Services. I find myself fascinated with Aboriginal issues as they seem to parallel the American Indian health concerns. The forum series is supported by the Cancer Council of NSW, the Cancer Institute and the National Heart Foundation of Australia (NSW).

The aim of the forum was to:

• develop a coordinated approach to nutrition and physical activity within Aboriginal communities across NSW
• showcase programs in these areas
• highlight best practice and evidence based research in the area.

.The forum aimed to:

• Promote existing healthy weight interventions, evidence and health promotion programs specific to Aboriginal communities
• Provide people working in Aboriginal health promotion with the opportunity to network and collaborate
• Develop a strategic approach to nutrition & physical activity for Aboriginal communities in NSW

A particular topic that captured my interest was a session titled “Evidence on Effective Interventions - Lightweight at Best!” by- Lesley King & Debra Hector (Centre for Overweight & Obesity (COO)). In brief, her presentation covered the following:

After reading over the presentation the following is the summary of evidence:

There is a lack of evaluated programs

Nearly all interventions are based on a “Healthy Lifestyle” approach

Most involved nutrition and PA interventions or messages

Interventions were based on community cultural events

Only 3 programs had weight as an outcome measure

Evidence based interventions must include:

Socially based activities and sports-PA if done solely for the benefit of the individual, is often seen as shameful or as disconnecting individuals from ties to their social world

Traditional Foods in Community Gardens

Reduce dependence on outsiders

Keep money within the community

Fit within relationship and obligation systems

Address issues of self-worth and pride

Interventions included-Our games, Our Health

Project driven by and targeted the whole community

Indigenous holistic approach to health

Initial focus was men’s and older people’s health –changed focus to school children

Revival of traditional games – from Choopadoo: Games from the Dreamtime

No comprehensive evaluation

Conclusion

Focus has been on programs in rural and remote Aboriginal communities – yet the majority of Aboriginal people live in urban regions where the prevalence of obesity is highest

Accessible, culturally appropriate and relevant programs need to be developed for indigenous people living in urban, rural and remote locations

More programs, more research and more evaluation!

Successful interventions occur when they are a response to the expressed needs of the Community rather than a response to the health agency’s agenda

Community involvement from the beginning creates empowerment

A flexible and relaxed approach is necessary

Community relevance, acceptance and accessibility is paramount

Community ownership and management of the programs is particularly important