The program keeping Portland children healthy.
A joint project between Deakin researchers and community members from the regional Victorian town of Portland is tackling the complex problem of childhood obesity.
Using a systems-based approach, visual mapping software, and working with community stakeholders like schools and sports clubs, the program has seen an improvement in the dietary behaviours of local children and an increase in the consumption of healthy foods.
Obesity is a risk factor for chronic and life-shortening diseases such as type 2 diabetes, heart disease and cancer, so tackling rising rates of obesity is a global health priority.
When more than one quarter of Australian children are overweight or obese, the case for prevention in our own backyards is compelling.
In a joint project between researchers from the Global Obesity Centre in Deakin University’s Institute for Health Transformation and the community of Portland, the causes of obesity in children are being addressed through systems thinking.
Specialists in systems thinking, health economics and implementation are empowering community leaders and members with the necessary skills to develop strategies and interventions to improve childhood health in their region.
The project, Sustainable Eating and Activity Change Portland (SEA Change Portland) is a long-term community-led initiative that seeks to identify and address the causes of unhealthy weight, develop sustainable local solutions and ‘make the healthy choice the easy choice’ in the regional Victorian town of Portland.
SEA Change was established through a 2014 Western Alliance Grants in Aid award and recurrent funding from then Department of Health and Human Services Victoria to Portland District Health and the Southern Grampians Glenelg Primary Care Partnership.
This initial funding led to the award of a larger NHMRC Partnership Project titled ‘Whole of Systems Trial of Prevention Strategies for childhood obesity: WHO STOPS childhood obesity’.
Developed by the community, for the community
Overcoming the complex problem of obesity in communities requires a new approach to that of short-term programs that rely on funding with an end date.
SEA Change Portland is a systems-based approach that mobilises local community resources and connects stakeholders, with the aim of delivering sustained change in the weight status of children aged 7 – 12 years by implementing changes to their environments, led by the community.
Using Systems Thinking in Knowledge Exchange (STICKE) – a visual mapping software developed by intelligent systems researchers at Deakin – the community was able to define the problem, identify the drivers of the problem in their community, and then co-design actions to make the local environment healthier for everyone, especially children.
“This unique intervention empowers the community to make lasting changes to health and wellbeing, taking into account the wider economic, commercial and social influences and barriers to healthy eating and active living specific to each community,” says Mayor Cr. Anita Rank, Glenelg Shire Council.
“It’s already resulted in hundreds of community‐led actions focused on changing norms and environments, and the insights gleaned may be useful to support other communities in translating systems theory into systems practice.”
Obesity – a complex problem
“In Australia, obesity costs the health system more than $21 billion annually,” says Cr. Rank.
“Childhood obesity is a great public health concern, with 27% of Australian children classified as overweight or obese and at increased risk of developing cardiovascular disease, type 2 diabetes, musculoskeletal disorders and some cancers.
“The high adult burden and developmental profile of adult obesity reinforces the need for prevention during childhood, and particularly in early childhood.”
Monitoring data from the region, which included Portland, revealed higher than expected rates of overweight or obese children compared to the national average.
As key modifiable determinants of childhood obesity include diet and physical activity, related data showing only 13% of children were meeting guidelines for eating vegetables and that 31.6% didn’t meet guidelines for physical activity were concerning.
However, reducing rates of obesity is a complex problem.
Research from Deakin’s public health experts has shown that residents of remote and regional towns in Victoria face difficulties in accessing affordable, healthy food.
Widespread access to junk food, barriers to physical activity and efforts to promote health predominantly through programmatic approaches have all been identified as potential root causes of obesity in regional areas.
Making the healthy choice the easy choice
SEA Change Portland has seen almost 300 community-led actions from promotion of drinking water to school canteen menu changes, resulting in a decrease in local children’s BMI.
The systems thinking methods used in SEA Change Portland have improved the community’s ability to measure what impacts childhood obesity in the area, to map and understand these systems, and to use systems data and models to improve the environments where children live, learn and play.
Community members with the ability to change environments to improve health led the project, and included representatives from local health services, the primary care partnership, the education sector, members of government and business owners.
This approach built new relationships and strengthened existing ones.
A willingness to take risks, change existing practices, and redesign health promotion work to have a community development focus were levers for great change.
As a result, this intervention has seen significant benefits for health-related quality of life, with a reduction in takeaway and packaged snack consumption in boy participants and an increased water consumption in girls.
SEA Change Portland won the Victorian Public Healthcare Award for Supporting Healthy Populations in 2018.
SEA Change Portland, and more broadly WHO STOPS, led to the application of the community-led approach across 12 local government areas in North-East Victoria through Reflexive Evidence and Systems interventions to Prevent Obesity and Non-Communicable Disease (RESPOND), an Institute for Health Transformation project.