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Cultural adaptation of a children's weight management programme: Child weigHt mANaGement for Ethnically diverse
Miranda Pallan1, Tania Griffin2, Kiya Hurley1
1Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Insights
Childhood obesity is high in the UK, especially for South Asian children. The Child weigHt mANaGement for Ethnically diverse communities (CHANGE) study culturally adapted a weight management program to better serve these families.
Area of Science:
- Public Health
- Pediatric Obesity
- Health Disparities
Background:
- Childhood obesity remains a significant public health issue in the UK.
- South Asian children face elevated risks for cardiovascular complications due to excess adiposity.
- Existing community weight management programs lack cultural adaptation for diverse ethnic groups.
Purpose of the Study:
- To culturally adapt an existing children's weight management program for South Asian families.
- To enhance program accessibility and effectiveness for children aged 4-11 years from diverse ethnic backgrounds.
- To address the specific needs of South Asian communities in childhood obesity interventions.
Main Methods:
- Qualitative study involving interviews and focus groups with South Asian parents in Birmingham.
- Utilized theoretical frameworks, including the Behaviour Change Wheel, for cultural adaptation.
- Integrated parent feedback with existing research and local program data.
Main Results:
- Identified key themes: convenient timing, accessible locations, multilingual support, focus on health over weight, culturally relevant nutrition, physical activity, and parenting support.
- Developed an intervention program outline based on parent input and theoretical models.
- Detailed planning of program sessions incorporated research evidence and local context.
Conclusions:
- The cultural adaptation process resulted in a theoretically grounded program.
- The intervention is adapted at both superficial and deep structural levels for cultural relevance.
- This approach can improve the effectiveness of childhood weight management for ethnic minority groups.
Background:
Childhood obesity prevalence continues to be at high levels in the United Kingdom (UK). South Asian children (mainly Pakistani and Bangladeshi origin) with excess adiposity are at particular risk from the cardiovascular consequences of obesity. Many community-based children's weight management programmes have been delivered in the UK, but none have been adapted for diverse cultural communities. The aim of the Child weigHt mANaGement for Ethnically diverse communities (CHANGE) study, was to culturally adapt an existing children's weight management programme for children aged 4-11 years so that the programme was more able to meet the needs of families from South Asian communities.
Methods:
The adaptation process was applied to First Steps, an evidence informed programme being delivered in Birmingham (a large, ethnically diverse city). A qualitative study was undertaken to obtain the views of South Asian parents of children with excess weight, who had fully or partially attended, or who had initially agreed but then declined to attend the First Steps programme. The resulting data were integrated with current research evidence and local programme information as part of a cultural adaptation process that was guided by two theoretical frameworks.
Results:
Interviews or focus groups with 31 parents in their preferred languages were undertaken. Themes arising from the data included the need for convenient timing of a programme in a close familiar location, support for those who do not speak English, the need to focus on health rather than weight, nutritional content that focuses on traditional and Western diets, more physical activity content, and support with parenting skills. The data were mapped to the Behaviour Change Wheel framework and Typology of Cultural Adaptation to develop an intervention programme outline. The research evidence and local programme information was then used in the detailed planning of the programme sessions.
Conclusions:
The process of cultural adaptation of an existing children's weight management programme resulted in a theoretically underpinned programme that is culturally adapted at both the surface and deep structural levels.
Trial Registration:
ISRCTN81798055 , registered: 13/05/2014.
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