Evaluation of a sustainable obesity prevention programme delivered at scale ‘HENRY’ (Health, Exercise, Nutrition for the Really Young): effectiveness, cost-effectiveness and its role in obesity prevention within the wider complex system
Prevention of obesity in children
Local authorities across the UK will be approached to take part. Each local authority will nominate six children's centres. Participating centres within each local authority will be randomised to HENRY or control in a 1:1 allocation ratio by the Leeds CTRU. Minimisation, incorporating a random element, will be used to ensure the treatment groups are well-balanced for the following characteristics: 1. Size of centre (≤8 / >8 permanent centre members of staff, not including staff using the centre such as Health Visitors, nursery workers etc., gathered from centre baseline environmental questionnaire). 2. Area level ethnicity (<80% / ≥80% White British using Census data based on centre postcode, gathered from local authority centre nomination form) 3. Area level deprivation (≤10% / >10% ranking within Index of Multiple Deprivation at the Lower Layer Super Output Area, gathered from local authority centre nomination form) The following information for each centre will also be required at randomisation: 1. Centre name and postcode 2. Manager contact details (gathered from local authority centre nomination form) 3. Confirmation of local authority and centre eligibility (gathered from local authority eligibility checklist) Each children's centre will recruit parents and their children to take part in the trial. Intervention: The HENRY 'Right from the Start' Programme is aimed at providing parents with practical skills in authoritative parenting skills, increasing self-esteem, adopting healthy family lifestyles, goal setting, oral health, active play, portion sizes, and learning about food labels. HENRY is widely commissioned by local authorities in the UK and is delivered in children's centres by health practitioners including health visitors, dietitians and children's centre staff. During the trial, each children's centre in the intervention arm delivers 2-3 ‘Right from the Start’ group programmes per year, each consisting of 8 x 2-hour sessions. Control: Children's
1. The target population for the intervention are parents of preschool children; mothers, fathers and other carers (e.g. with children living in stable/long-term foster care). Parents may not be registered more than once but they may be screened on more than one occasion if not registered following the first screening, as both eligibility and willingness to participate may change. 2. Parents must have at least one child aged 6 months to 5 years (18 months to 6 years at 12-month follow-up). If more than one child in the family fulfils eligibility criteria, the youngest child (by birth timing if twins) will be considered as the reference child (from which data will be collected). 3. Parents must be willing to attend the programme sessions (intervention centres) and willing to provide data in accordance with the data collection protocol. Parents will be provided with full details of the data collection requirements in advance so that they can make informed decisions as to whether to participate. 4. Parents must speak English unless they wish to bring their own interpreter with them (e.g. family member) (the intervention and data collection forms are currently only available in English).
1. Parents with severe learning difficulties that preclude them from taking part in group sessions in which they need to be able to read and write, judged on a case-by-case basis with consultation with the HENRY team where appropriate. 2. Parents whose reference child is tube fed (PEG or nasogastric) or with other known clinical conditions likely to affect growth over the period of the trial (e.g. cancer, coeliac disease, or renal or cardiac problems). A detailed list of excluded conditions will be provided at screening, with any uncertainties resolved via clinical input from the HENRY team. 3. Parents who have attended a HENRY group for a previous child