Background
Children of Māori & Pacific Islander descent living in Australia have a greater prevalence of overweight/obesity, and consequently, an increased risk of adverse health outcomes. Despite this, childhood obesity prevention programs accessible within the community and tailored to the Māori & Pacific Islander population are lacking. Ultimately, the risk of chronic disease and the rates of health inequity continue to increase, placing a significant health and financial burden on the Australian health care system.
Methods
Program co-design involved a three-phase, iterative, participatory and experience-based process, guided by the Te Ara Tika: Guidelines for Māori Research Ethics, to promote respect and equity. Following traditional oratory customs of Māori & Pacific Islander cultures, “talanoa” facilitated the collaborative program design with consumers, cultural advisors and health professionals. Co-design empowered consumers to formulate program objectives, session plans, resources and evaluation tools. Implementation and research processes are ongoingly co-designed with consumers, ensuring cultural sustainability across all program aspects.
Results
Co-design developed an 8-week community-based childhood overweight/obesity prevention program providing culturally tailored education across nutrition, physical activity, positive parenting practices and culture. Child participants reported life-changing improvements to health behaviours, with 72% reducing their sugar sweetened beverage consumption and 60% increasing their vegetable consumption. As a reflection of improved health behaviour, 59% of children decreased their BMI z-score. Positive outcomes were observed across the life course, with 47% of parents decreasing their BMI, 67% decreasing discretionary drink consumption and 47% increasing vegetable consumption.
Conclusion
Co-design empowered consumers to successfully build on community strengths and tackle the complexities of obesity. A bottom-up approach holds high potential to be adapted to other priority populations, significantly improving culturally tailored health care delivery. A consumer-led approach is pivotal to sustaining engagement and improving health outcomes across generations, ultimately tackling childhood obesity and health inequity among Australia’s priority populations.