Cited by 270Obesity, Physical Activity, DietPhysical Activity and HealthSchool Health and Nursing Education

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Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well

Sanigorski, A M, Bell, A C, Kremer, P J, Cuttler, R, Swinburn, B A·2008·International Journal of Obesity

DOI 10.1038/ijo.2008.79

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Abstract

Background Be Active Eat Well (BAEW) was a multifaceted community capacity-building program promoting healthy eating and physical activity for children (aged 4-12 years) in the Australian town of Colac.Objective To evaluate the effects of BAEW on reducing children's unhealthy weight gain.Methods BAEW had a quasi-experimental, longitudinal design with anthropometric and demographic data collected on Colac children in four preschools and six primary schools at baseline (2003, n=1001, response rate: 58%) and follow-up (2006, n=839, follow-up rate: 84%). The comparison sample was a stratified random selection of preschools (n=4) and primary schools (n=12) from the rest of the Barwon South Western region of Victoria, with baseline assessment in 2003-2004 (n=1183, response rate: 44%) and follow-up in 2006 (n=979, follow-up rate: 83%).Results Colac children had significantly lower increases in body weight (mean: -0.92 kg, 95% CI: -1.74 to -0.11), waist (-3.14 cm, -5.07 to -1.22), waist/height (-0.02, -0.03 to -0.004), and body mass index z-score (-0.11, -0.21 to -0.01) than comparison children, adjusted for baseline variable, age, height, gender, duration between measurements and clustering by school. In Colac, the anthropometric changes were not related to four indicators of socioeconomic status (SES), whereas in the comparison group 19/20 such analyses showed significantly greater gains in anthropometry in children from lower SES families. Changes in underweight and attempted weight loss were no different between the groups.Conclusions Building community capacity to promote healthy eating and physical activity appears to be a safe and effective way to reduce unhealthy weight gain in children without increasing health inequalities.

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“No included study evaluated structural interventions to increase physical activity at the community or system level (ie, expanding/improving the usability of playgrounds, traffic calming zones, bicycle paths, and pedestrian routes for students) if not as part of complex interventions.(47,48,51,54) The setting of these…”
Background
A systematic review of the effectiveness of whole‐of‐community interventions by socioeconomic position
Boelsen‐Robinson, T., Peeters, A., Beauchamp, A., Chung, A., Gearon, E., & Backholer, K. (2015) · Obesity Reviews · doi:10.1111/obr.12297 · Cited by 62
“The effect of the 3-year (2003–2006) ‘Be Active Eat Well’ campaign on weight gain was evaluated in children aged 4–12 years of age in Victoria, Australia (29).”
BackgroundMethodResultInfluential
Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project
Swinburn, B. A., Malakellis, M., Moodie, M., Waters, E. B., Gibbs, L. F., Millar, L., Herbert, J., Virgo‐Milton, M., Mavoa, H., Kremer, P. J., et al. (2013) · Pediatric Obesity · doi:10.1111/j.2047-6310.2013.00201.x · Cited by 59
Self-citation
School‐based systems change for obesity prevention in adolescents: outcomes of the Australian Capital Territory ‘It's Your Move!’
Malakellis, M., Hoare, E., Sanigorski, A., Crooks, N., Allender, S., Nichols, M., Swinburn, B., Chikwendu, C., Kelly, P. M., Petersen, S., et al. (2017) · Australian and New Zealand Journal of Public Health · doi:10.1111/1753-6405.12696 · Cited by 57
“19,39,40 intervention schools These previous studies shared common features with the ACT IYM in recognising complexity of obesity prevention and the implementation of multi-focused, multi-level interventions that targeted multiple behaviours.”
Self-citation
The Pacific Obesity Prevention in Communities project: project overview and methods
Swinburn, B. A., Millar, L., Utter, J., Kremer, P. J., Moodie, M., Mavoa, H., Snowdon, W., McCabe, M. P., Malakellis, M., de Courten, M., et al. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2011.00921.x · Cited by 57
“Recent whole-of-community interventions are more promising in the prevention of obesity in primary school aged children (24,25) but there are very few published studies that capture the critical period from 12 to 18 years.”
BackgroundSelf-citation
Cost-effectiveness of community-based childhood obesity prevention interventions in Australia
Ananthapavan, J., Nguyen, P. K., Bowe, S. J., Sacks, G., Herrera, A. M. M., Swinburn, B., Brown, V., Sweeney, R., Lal, A., Strugnell, C., et al. (2019) · International Journal of Obesity · doi:10.1038/s41366-019-0341-0 · Cited by 55
Self-citation
Increasing community capacity to prevent childhood obesity: challenges, lessons learned and results from the Romp & Chomp intervention
Martino, F. P., Robertson, N., Swinburn, B. A., & de Silva, A. M. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-522 · Cited by 54
“the New South Wales Health Capacity Building framework) [4] and this approach is now gaining ground in public health nutrition and obesity prevention [5,6].”
BackgroundSelf-citation
Childhood obesity in Australia remains a widespread health concern that warrants population‐wide prevention programs
Gill, T. P., Baur, L. A., Bauman, A. E., Steinbeck, K. S., Storlien, L. H., Singh, M. A. F., Brand-Miller, J. C., Colagiuri, S., & Caterson, I. D. (2009) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2009.tb02318.x · Cited by 53
The cost‐effectiveness of a successful community‐based obesity prevention program: The be active eat well program
Moodie, M., Herbert, J., de Silva, A. M., Mavoa, H., Keating, C. L., Carter, R., Waters, E., Gibbs, L. F., & Swinburn, B. A. (2013) · Obesity · doi:10.1002/oby.20472 · Cited by 52
“0116) Triangular Effectiveness study (25) Girls <5 years (n 5 88) 0.”
BackgroundMethodInfluentialSelf-citation
Multilevel analysis of the Be Active Eat Well intervention: environmental and behavioural influences on reductions in child obesity risk
Johnson, B. A., Kremer, P. J., Swinburn, B. A., & de Silva, A. M. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.23 · Cited by 54
Self-citation
Contribution of social marketing strategies to community-based obesity prevention programmes in children
Gracia‐Marco, L., Vicente‐Rodríguez, G., Borys, J. ‐., Bodo, Y. L., Pettigrew, S., & Moreno, L. A. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.221 · Cited by 52
Using the Community Readiness Model to select communities for a community-wide obesity prevention intervention.
Sliwa, S. A., Goldberg, J. P., Clark, V. A., Collins, J. J., Edwards, R. W., Hyatt, R. R., Junot, B., Nahar, E., Nelson, M. E., Tovar, A., et al. (2011) · Europe PMC (PubMed Central) · Cited by 52
Evaluation of complex community‐based childhood obesity prevention interventions
Karacabeyli, D., Allender, S. E., Pinkney, S., & Amed, S. (2018) · Obesity Reviews · doi:10.1111/obr.12689 · Cited by 52
Scaling up community-based obesity prevention in Australia: Background and evaluation design of the Health Promoting Communities: Being Active Eating Well initiative
de Silva, A. M., Bolton, K. A., Haby, M. M., Kremer, P. J., Gibbs, L. F., Waters, E. B., & Swinburn, B. A. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-65 · Cited by 51
Self-citation
Dietary Policies to Reduce Non‐Communicable Diseases
Afshin, A., Micha, R., Khatibzadeh, S., Schmidt, L. A., & Mozaffarian, D. (2014) · The Handbook of Global Health Policy · doi:10.1002/9781118509623.ch9 · Cited by 54
Engaging Coalitions in Community-Based Childhood Obesity Prevention Interventions: A Mixed Methods Assessment
Korn, A. R., Hennessy, E., Tovar, A., Finn, C., Hammond, R. A., & Economos, C. D. (2018) · Childhood Obesity · doi:10.1089/chi.2018.0032 · Cited by 50
Social marketing theory measurement precision: a theory of planned behaviour illustration
David, P., & Rundle-Thiele, S. R. (2018) · Journal of Social Marketing · doi:10.1108/jsocm-12-2016-0087 · Cited by 49
“Behaviour was measured using two food checklist items (Sanigorski et al., 2008) capturing the serves of fruits and vegetables packed into the child’s lunchbox, as reported by the parent.”
Method
Development and testing of a novel survey to assess Stakeholder-driven Community Diffusion of childhood obesity prevention efforts
Korn, A. R., Hennessy, E., Hammond, R. A., Allender, S. E., Gillman, M. W., Kasman, M., McGlashan, J., Millar, L., Owen, B., Pachucki, M. C., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5588-1 · Cited by 49
Self-citation
Seeing through a Glass Onion: broadening and deepening formative research in social marketing through a mixed methods approach
Carins, J., Rundle-Thiele, S. R., & Fidock, J. J. T. (2016) · Journal of Marketing Management · doi:10.1080/0267257x.2016.1217252 · Cited by 62
A Human Rights-Based Approach to the Social Good in Social Marketing
Szablewska, N., & Kubacki, K. (2017) · Journal of Business Ethics · doi:10.1007/s10551-017-3520-8 · Cited by 51
“…social marketing campaigns that aim to tackle the obesity epidemic have been launched in the United States (Huhman et al., 2008; Thackeray et al., 2002), the UK (Croker et al., 2012) and other European countries (Henley et al., 2011) and Australia (Atlantis et al., 2008; Sanigorski et al., 2008).”
Background
Public Health Messages: Why Are They Ineffective and What Can Be Done?
Gill, T. P., & Boylan, S. M. (2012) · Current Obesity Reports · doi:10.1007/s13679-011-0003-6 · Cited by 55
“Disclosure Conflicts of interest: T.P. Gill: has received grant support from the Australian Department of Health and Ageing; S. Boylan: none.”
Background
The involvement of young people in school- and community-based noncommunicable disease prevention interventions: a scoping review of designs and outcomes
Jourdan, D., Christensen, J. H., Darlington, E., Bonde, A. H., Bloch, P., Jensen, B. B., & Bentsen, P. (2016) · BMC Public Health · doi:10.1186/s12889-016-3779-1 · Cited by 47
“The same held true for the highly influential, multifaceted community capacity-building interventions Shape Up Somerville [51] and Be Active Eat Well [52].”
Background
Effectiveness of educational and lifestyle interventions to prevent paediatric obesity: systematic review and meta-analyses of randomized and non-randomized controlled trials
Gori, D., Guaraldi, F., Cinocca, S., Moser, G., Rucci, P., & Fantini, M. P. (2017) · Obesity Science & Practice · doi:10.1002/osp4.111 · Cited by 52
“For instance, in three out of seven non-randomized studies, a selection bias was introduced by selecting children with a BMI >75th percentile for inclusion in the intervention group (39,90,91).”
Background
The utility of childhood and adolescent obesity assessment in relation to adult health
Goldhaber-Fiebert, J., Rubinfeld, R. E., Bhattacharya, J., Robinson, T., & Wise, P. (2012) · Medical decision making · doi:10.1177/0272989x12447240 · Cited by 42
Project FIT: A school, community and social marketing intervention improves healthy eating among low-income elementary school children
Alaimo, K., Carlson, J. J., Pfeiffer, K. A., Eisenmann, J. C., Paek, H.-J., Betz, H. H., Thompson, T., Wen, Y., & Norman, G. J. (2015) · Journal of Community Health · doi:10.1007/s10900-015-0005-5 · Cited by 43
“Few health behavior initiatives for children, especially for minority children living in low-income neighborhoods, have been evaluated that simultaneously incorporated school, community, and social marketing elements [4, 14–17].”
BackgroundMethod
Evaluation of the childhood obesity prevention program Kids - 'Go for your life'
de Silva, A. M., Prosser, L., Carpenter, L. M., Honisett, S., Gibbs, L. F., Moodie, M., Sheppard, L., Swinburn, B. A., & Waters, E. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-288 · Cited by 43
Self-citation
The outcomes of health-promoting communities: being active eating well initiative—a community-based obesity prevention intervention in Victoria, Australia
Bolton, K. A., Kremer, P. J., Gibbs, L. F., Waters, E. B., Swinburn, B., & de Silva, A. M. (2017) · International Journal of Obesity · doi:10.1038/ijo.2017.73 · Cited by 43
Self-citation
Evidence base for primary prevention of obesity in children and adolescents
Hillier-Brown, F. C., Pedley, C., & Summerbell, C. (2011) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1227-4 · Cited by 44
Environmental components of childhood obesity prevention interventions: an overview of systematic reviews
Cauchi, D., Glonti, K., Petticrew, M. P., & Knai, C. (2016) · Obesity Reviews · doi:10.1111/obr.12441 · Cited by 44
“…juices 137 were available at school, and at home  Availability of school playgrounds for structured/unstructured PA after regular school hours 124,125,137,138  Provision of free/low cost water in school: either through installation of water fountains, provision of water bottles or through…”
Background
Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Eating Habits and Physical Activity among Danish Families with Young Children. Part 1: Intervention Development and Implementation
Toft, U., Bloch, P., Reinbach, H. C., Winkler, L. L., Buch‐Andersen, T., Aagaard‐Hansen, J., Mikkelsen, B. E., Jensen, B. B., & Glümer, C. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15061097 · Cited by 40
“The Australian studies focused especially on local capacity building, awareness, and changing policies [49,50].”
Background
The Public Health 12 framework: interpreting the ‘Meadows 12 places to act in a system’ for use in public health
Bolton, K. A., Whelan, J., Fraser, P., Bell, C., Allender, S. E., & Brown, A. D. (2022) · Archives of Public Health · doi:10.1186/s13690-022-00835-0 · Cited by 40
“Context Building on previously reported community-based approaches to obesity prevention [9, 11], the Global Obesity Centre (GLOBE) at Deakin University has been trialling CBSD to empower communities for childhood obesity prevention since 2014 [21].”
Method
Interventions for increasing fruit and vegetable consumption in children aged five years and under
Hodder, R. K., Stacey, F. G., Wyse, R., O’Brien, K. M., Clinton‐McHarg, T., Tzelepis, F., Nathan, N., James, E. L., Bartlem, K. M., Sutherland, R., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008552.pub3 · Cited by 42
Lifetime cost effectiveness of a through-school nutrition and physical programme: Project Energize
Rush, E. C., Obolonkin, V., McLennan, S., Graham, D., Harris, J., Mernagh, P., & Weston, A. R. (2013) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2013.03.005 · Cited by 46
Evaluation Overview for the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project
Davison, K. K., Falbe, J., Taveras, E. M., Gortmaker, S. L., Kulldorff, M., Perkins, M. E., Blaine, R. E., Franckle, R. L., Ganter, C., Baidal, J. W., et al. (2015) · Childhood Obesity · doi:10.1089/chi.2014.0059 · Cited by 39
“Complex community interventions for childhood obesity prevention are commonly evaluated using quasiexperimental designs with outcomes measured for consented individuals, often a select subset of the target population.(2,3,6) Less common is the use of existing electronic data.”
Background
Systematic review of the effectiveness and cost-effectiveness of weight management schemes for the under fives: a short report
Bond, M., Wyatt, K. M., Lloyd, J., Welch, K., & Taylor, R. S. (2009) · Health Technology Assessment · doi:10.3310/hta13610 · Cited by 39
Connected Community and Household Food-Based Strategy (CCH-FBS): Its Importance for Health, Food Safety, Sustainability and Security in Diverse Localities
Wahlqvist, M. L. (2009) · Ecology of Food and Nutrition · doi:10.1080/03670240903308596 · Cited by 38
Incorporating Systems Science Principles into the Development of Obesity Prevention Interventions: Principles, Benefits, and Challenges
Gittelsohn, J., Mui, Y., Adam, A., Lin, S., Kharmats, A. Y., Igusa, T., & Lee, B. Y. (2015) · Current Obesity Reports · doi:10.1007/s13679-015-0147-x · Cited by 38
Interventions for increasing fruit and vegetable consumption in children aged five years and under
Hodder, R. K., Stacey, F. G., O’Brien, K. M., Wyse, R., Clinton‐McHarg, T., Tzelepis, F., James, E. L., Bartlem, K. M., Nathan, N., Sutherland, R., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008552.pub4 · Cited by 42
Creating a collective impact on childhood obesity: Lessons from the SCOPE initiative
Amed, S., Naylor, P., Pinkney, S., Shea, S., Mâsse, L. C., Berg, S., Collet, J., & Higgins, J. (2015) · Canadian Journal of Public Health · doi:10.17269/cjph.106.5114 · Cited by 38
The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials
Taghizadeh, S., & Farhangi, M. A. (2020) · Journal of Translational Medicine · doi:10.1186/s12967-020-02640-1 · Cited by 43
“Study quality [17, 18] was evaluated as “weak” for 15 studies [22, 24, 27–31, 34, 42, 43, 48, 52, 54–56], “moderate” for 10 studies [25, 26, 36, 37, 40, 44, 45, 47, 50, 51], and “strong” for 13 studies [23, 32, 33, 35, 38, 39, 41, 46, 49, 53, 57–59].”
Background
Behavioral changes associated with economic development in the South Pacific: Health transition in Vanuatu
Dancause, K. N., DeHuff, C., Soloway, L. E., Vilar, M. G., Chan, C. W., Wilson, M., Tarivonda, L., Regenvanu, R., Kaneko, A., Garruto, R. M., et al. (2011) · American Journal of Human Biology · doi:10.1002/ajhb.21146 · Cited by 38
Capacity building through cross-sector partnerships: a multiple case study of a sport program in disadvantaged communities in Belgium
Marlier, M., Lucidarme, S., Cardon, G., Bourdeaudhuij, I. D., Babiak, K. M., & Willem, A. (2015) · BMC Public Health · doi:10.1186/s12889-015-2605-5 · Cited by 35
“ling health inequalities in physical activity and sport participation is capacity building [12, 13].”
Background
A Theory of Change for Community-Based Systems Interventions to Prevent Obesity
Brown, A. D., Whelan, J., Bolton, K. A., Nagorcka-Smith, P., Hayward, J., Fraser, P., Strugnell, C., Felmingham, T., Nichols, M. S., Bell, C., et al. (2021) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2021.10.006 · Cited by 34
A participatory and capacity-building approach to healthy eating and physical activity – SCIP-school: a 2-year controlled trial
Elinder, L. S., Heinemans, N., Hagberg, J., Quetel, A.-K., & Hagströmer, M. (2012) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-9-145 · Cited by 32
“The Be Active Eat Well programme from Australia [48], a quasi-experimental study, was effective in slowing the rate of weight and waist gain in children by 0.1 units in BMIsds over 3 years.”
BackgroundInfluential
Healthy together Victoria and childhood obesity—a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial
Strugnell, C., Millar, L., Churchill, A. C., Jacka, F. N., Bell, C., Malakellis, M., Swinburn, B. A., & Allender, S. E. (2016) · Archives of Public Health · doi:10.1186/s13690-016-0127-y · Cited by 32
“on previous school-based research [22–24].”
Self-citation

Authors: Sanigorski, A. M., Bell, A. C., Kremer, P. J., Cuttler, R., & Swinburn, B. A.
Affiliations: Deakin University (AU)
ORCID: Kremer, P J
Swinburn, B A
Venue: International Journal of Obesity
Publisher: Springer Science and Business Media LLC
Published: 2008-06-10
Volume: 32
Issue: 7
Pages: 1060-1067
ISSN: 0307-0565 (ISSN-L)
1476-5497
DOI: 10.1038/ijo.2008.79
OpenAlex: W2052103732
Cited by: 270
References: 25
Citations by year: 2026: 4 · 2025: 6 · 2024: 10 · 2023: 6 · 2022: 6 · 2021: 14 · 2020: 10 · 2019: 18 · 2018: 19 · 2017: 11 · 2016: 14 · 2015: 27 · 2014: 17 · 2013: 25 · 2012: 23
FWCI: 19.87
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: International Journal of Obesity (publishedVersion)
PubMed (publishedVersion)
ResearchSpace (University of Auckland) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
Keywords: childhood obesity, community capacity building, healthy eating promotion, physical activity promotion, preschool children, elementary school students, body mass index, waist circumference, socioeconomic status, health disparities
MeSH terms: Anthropometry, Child, Child, Preschool, Community Health Services, Female, Health Promotion, Humans, Longitudinal Studies, Male, Obesity, Patient Acceptance of Health Care, Rural Population, Social Class, Victoria, Program Evaluation, Exercise, Case-Control Studies, Treatment Outcome

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Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well

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