Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Longitudinal follow-up of caregivers of children enrolled in a community-based healthy lifestyle programme (95755)

Thomas Hadley 1 , Cervantée E. K. Wild 2 3 , Sarah E Maessen 2 , Paul L Hofman 4 , José G. B. Derraik 2 , Yvonne C Anderson 2 5 6 7
  1. Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
  2. Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
  3. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
  4. Liggins Institute, University of Auckland, Auckland, New Zealand
  5. Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
  6. Telethon Kids Institute, Perth Children's Hospital, Nedlands,, WA, Australia
  7. Community Health, Child and Adolescent Health Service, Perth, WA, Australia

Background: Whānau Pakari is a multi-disciplinary, family-centred assessment and intervention programme in Taranaki (Aotearoa New Zealand) for children and young people with weight issues, with an embedded randomised clinical trial. We examined accompanying caregiver BMI patterns at one-, two-, and five-year follow-up, to determine whether there was an indirect benefit to caregivers.

Methods: At baseline, participants were caregivers of children/adolescents aged 4.8–16.8 years with BMI ≥98th percentile or >91st with weight-related comorbidities. Each participant had height and weight measured in their home at one, two, and five years from baseline (n=107, n=86, n=24, respectively).

Results: Caregivers (88% mothers) had a median BMI of 32.6kg/m2 (Q1=28.32;Q3=35.67) at baseline. There was no overall change in BMI for caregivers at one-year [Δ=0.04kg/m2 (-0.47, 0.56); p=0.88], two-year [Δ=0.47 kg/m2 (-0.21, 1.14); p=0.17], or five-year follow-up [Δ=-0.83kg/m2; (-2.94, 1.29); p=0.43]. However, for participants identifying as Māori, children whose caregivers' BMI decreased at one year had greater BMI SDS reductions at one year [-0.30 (-0.49, -0.10); p = 0.004] and 2 years [-0.39 (-0.61, -0.16); p = 0.001] than children of caregivers with increased/unchanged BMI. Whilst analysis by ethnicity was not possible at five years due to small sample size, nearly two-thirds (63%) of caregivers had decreased BMI at five years from baseline [n=15; median reduction -2.01kg/m2 (Q1=-4.71;Q3=-0.72)] overall.                                                                                

Conclusion: On average, caregivers of children/adolescents in the Whānau Pakari programme had no change in BMI over the five-year study. However, reductions in caregivers' BMI were key to BMI SDS reductions among Māori participants at 12 and 24 months. These findings may indicate a positive outcome for caregivers compared to population trends of increasing BMI with age, particularly for those with higher weight status initially. Our findings highlight the importance of culturally relevant, family-focused programmes to achieve clinically meaningful improvements in weight status across the family.