MEND – Mind, Exercise, Nutrition…Do it! (a national perspective) Suzi Woolcock MEND Sustainable Outcomes Manager, MEND Central

Get involved – referral opportunity What do we do when we identify a child that is overweight or obese? National Child Measurement Programme Copyright © MEND Central 2

Agenda Overview of MEND The MEND 7-13s Evidence Programme outline Get involved Referral opportunity Delivery Follow up support Questionnaires 3

What is MEND? MEND is a child obesity organisation that provides: – Evidence-based, family-oriented programmes to prevent and treat child obesity – Training to frontline staff to build local capacity and skills MEND’s mission To enable a significant, measurable and sustained reduction in childhood overweight and obesity levels

Evidence-based age & stage-specific family weight management services MEND Teens Maternity MEND 0-1 MEND Lite MEND Resources Move It! MEND 2-4 MEND 5-7 MEND 7 - 13 Obese TREAT Over weight PREVENT Healthy weight Leader training One day child obesity awareness training TRAIN

MEND today: Scope £19 million project funding secured to 2010 to deliver 2,300 MEND Programmes at 310 sites with 150 lead partners: 29,000 families through MEND Programme (7-13) 1,000 families through Mini-MEND (2-4) 250,000 families exposed to Move It! (prevention) 7,000 healthcare professionals trained 8 Best Practice Conferences

Agenda Overview of MEND The MEND 7-13s Evidence Programme outline Get involved Referral opportunity Delivery Follow up support Questionnaires 8

The MEND Programme Designed for overweight and obese 7-13 year old children and their parents / carers Targeted prevention and treatment programme Intensive education and behaviour change: 10 weeks, 2 x 2 hr sessions / week, for both children and parents Not a diet Fun and interactive

MEND Programme evidence base UK Research team Dr Paul Chadwick Prof. Tim Cole Maria Kolotourou Dr Margaret Lawson Prof. Alan Lucas Paul Sacher Prof. Atul Singhal Research programme Feasibility 2002-3 (Sacher et al, 2005) Pilot 2004-5 (Sacher et al, 2006) Phase 1 UK RCT 2005-7 (Sacher et al, 2007) UK Roll-out (June 2007–June 2008) Phase 2 UK RCT (2008-2012) International RCTs (2009-2013) USA Australia 10

The MEND Programme Successful multi-site Randomised Controlled Trial (RCT) at Institute of Child Health, University College London and Great Ormond Street Hospital Results Very high attendance and retention RCT: 97% retention and 86% attendance Significant improvements in multiple health indicators No significant difference in outcomes across socio-economic indicators Intervention group: 9-week MEND programme Control group: delayed intervention (6 months) Measurements at 0, 6 and 12 months 5 sites (4 urban & 1 rural) – separate teams Sports centres & schools Teams: dietitians, nutritionists, physiotherapist, exercise trainers, PE teacher & social worker Copyright © MEND Central 11

Indicative RCT results UCL Institute of Child Health

12 month findings www.mendcentral.org Sacher, et al, Obesity, 2007:15,A92 Sacher PM, Chadwick P, Kolotourou M, Cole TJ, Lawson MS, Singhal A. The MEND Trial: Sustained Improvements on Health Outcomes in Obese Children at One Year. Obesity. 2007; 15:A92 www.mendcentral.org UCL Institute of Child Health

MEND 7-13s outline 20 x 2-hour sessions (10 weeks) Introduction Pre Measurement 8 Mind and 8 Nutrition theory sessions Post- Measurement Farewell 14

Land and water-based exercise 15

Supermarket tour 16

Who wants to be a Healthionaire?

Fruit & vegetable tasting 18

Agenda Overview of MEND The MEND 7-13s Evidence Programme outline Get involved Referral opportunity Delivery Follow up support Questionnaires 19

Get involved – referral opportunity What do we do when we identify a child that is overweight or obese?

Get involved – How to refer Health Professional referral Local care pathways for children’s weight management services Promotion for self-referral Flyers in school newsletters Flyers during consultation Media Letters to families

Refer online www.mend 22

Family registration Register families www.ommsonline.org/register.html Call  0800 230 0263  Local  registration  NB: MEND Programmes are not appropriate for children with serious medical, developmental, psychiatric or physical conditions

Delivery of Programme Theory leader Kit – includes: 2 day training Best practice conferences Online learning Kit – includes: Manuals Posters Programme handouts Children’s packs Copyright © MEND Central 24

Get involved - Post- Programme support Central Membership, password protected website and magazines, behaviour change tools Local Weekly exercise sessions Transition to community health and activity programmes Getting support Follow up measurements 6,9,12, 18 and 24 months BMI and waist circumference Target: overweight, obese & at risk children or families Multicomponent: play and physical activity, dietary modification and nutritional education, healthy habit development and behaviour change (NICE guidance, 2006, SIGN, 2003, AAP, 2007) Group based: face to face Group size: 8 to 16 children and families Delivery team: 2 to 3 members of staff Duration: 2 years (10 weeks treatment, transition and maintenance) Multi-site field trial: January 09 2nd phase field trial: April 09 Available nationally September 09 Copyright © MEND Central 25

MEND 5-7 years What do we do when we identify a child that is overweight or obese aged 5-7 years? MEND 5-7s

Setting up a MEND Programme Contact us www.mendcentral.org

Major partners NHS Direct CGOU Change4Life

Delivery partners

Thank you! www.mendprogramme.org