obesity prevention and nutrition communication for young
TRANSCRIPT
The University of Sydney
Obesity prevention and
nutrition communication for
young people
Dr Stephanie PartridgeNHMRC/National Heart Foundation Early Career Fellow
Accredited Practising Dietitian
School of Health Sciences
Faculty of Medicine and Health
@DrStephaniePart
Page 2The University of Sydney
CEE. NSW School Students Health Behaviours Survey. In: NSW MoH, ed. Sydney, 2005-2017; ABS. NHS. 2017-18; Killedar A et al. Int J Obes 2020; Epub ahead
of print; Hayes A, et al. Int J Obes 2017; 41: 178-185
Adolescent overweight and obesity
0
5
10
15
20
25
2005 2008 2011 2014 2017
Ove
rweig
ht o
r ob
esi
ty (
%)
Year
12-15 years (%) AllNSW
16-17 years (%) AllNSW
12-17 years (%) AllNSW
57% increase in the
incidence of obesity
among older
adolescents from
2014 to 2017
• In 2017–18, 41% of
young people aged 15–
24 years had overweight
or obesity
• Obesity impacts
negatively on quality of
life
• Effects are greater in
adolescence than at any
other time during
childhood
Page 3The University of Sydney
Obesity influences
Mihrshahi S, Gow ML, Baur LA. Med J Aust 2018; 209 (60)
It is the environment (in
utero and throughout life)
which determines
whether an individual’s
genetic predisposition
to obesity is manifest or
not
Page 4The University of Sydney
Our digital environment
• Physical development
• Neurodevelopmental
changes
• Psychological and social
changes
Our cultural e-wallpaper
Page 5The University of Sydney
Best practice domains for obesity prevention and
management
Adolescents are
supported to
optimise their
health
Accessible health
services
Health system
responds to needs
of adolescents
Supportive
environments
Monitoring and
evaluationHealth equity
Partridge SR et al., under review
Page 6The University of Sydney
Gaps in practise and policy in NSW for adolescents
Adolescents are
supported to
optimise their
health
Partridge SR et al., under review
No targeted public
education
campaigns on
physical activity
and nutrition
No online access
to youth-specific
and trustworthy
health information
Limited evidence
adolescents at risk are
directed to opportunities
for health promotion and
early intervention
Access to care is
mostly provided
after comorbidities
are established
Page 7The University of Sydney
Gaps in practise and policy in NSW for adolescents
Partridge SR et al., under review
Limited secondary/ tertiary
obesity prevention services
for adolescents aged 16-17
years and those living in
rural and remote areas
Limited access to
GP telehealth,
specialist, and
counselling
services
No promotion to increase
uptake of programs for
adolescents
Accessible health
services
Page 8The University of Sydney
Gaps in practise and policy in NSW for adolescents
Partridge SR et al., under review
Limited consumer
participation and community
engagement
Limited holistic support to optimise
quality of life (e.g., community
gardens, school programs and
parenting skills programs)
Health system
responds to needs
of adolescents
Page 9The University of Sydney
Gaps in practise and policy in NSW for adolescents
Partridge SR et al., under review
Limited evidence of long-
term follow-up (≥12
months) of strategies to
determine sustainability of
changes and long-term
benefits
Lack of focus on priority
populations
Supportive
environments
Monitoring and
evaluationHealth equity
Limited evidence of physical
education and nutrition
education interventions in
schools
The University of Sydney
> 90%OWN PHONE
FIFTYTEXTSPER DAY
TEXTSCHRONIC
DISEASE4
Roy Morgan Research. 2016; Lenhart A et al. (2015), PEW Research Centre; Chow CK et al (2015). TEXTME. JAMA;
314:1255-63.
SIMPLE
SCALE
Most phones
can receive
Flexib le
de l ivery
No internet
connection
TEXTBITES No $ to
r ece ive
The University of Sydney Page 11
NUTRITION BEHAVIOURS
PHYSICAL ACTIVITY BEHAVIOURS
GENERAL BEHAVIOURS
MENTAL WELLBEING
& SLEEP
Co-designed with 40
consumers
107
TEXT
MESSAGES
YOUNG PERSON RESEARCHER
Partridge et al. IJERPH. 2019, 16(24), 4887.
The University of Sydney Page 12
Final message
bank
• 107 text messages
• 26 nutrition
• 18 physical activity
• 34 general behaviours
• 21 mental wellbeing
• 6 health counsellor
• 25% encourage two-way
communication
• quizzes or short questions
• 22 differ based on age
• 13-16 or 17-18 years
How is everything
going, [pref_name]?
Text back if you would
like to chat with our
health counsellor
about all things food,
exercise and wellbeing
and we will get back
to you soon
Pilot tested on
commercial
platform, no
issues reported
Partridge et al. IJERPH. 2019, 16(24), 4887.
The University of Sydney Page 13
Next steps: TEXTBITES RCT (now recruiting)
NO TEXTBITES PROGRAM NO TEXT MESSAGE PROGRAM
TEXTBITES PROGRAM NO TEXT MESSAGE PROGRAM
INTERVENTION PHASE MAINTENANCE PHASE
RANDOMISATION 6 MONTH OUTCOMES 12 MONTH OUTCOMES
N=150
Primary outcome: BMI-z score
Secondary outcomes: waist-to-height ratio; diet; physical activity and sedentary behaviours; sleep quality;
quality of life; self-esteem; self-efficacy; social support; depression; eating disorders
n=38
to date
Partridge et al. JMIR Res Protoc 2020;9(2):e16481
The University of Sydney Page 14
How to refer
Refer young people:
• 13-18 years
• Above a heathy weight BMI>85-95th
• Access to active mobile phone
• Living in Australia
• Screened for ED/depression
• ALL ONLINE – NO IN-PERSON VISITS
→ EOI form: www.tinyurl.com/textbites
→ Email: [email protected]
The University of Sydney Page 15
ACKNOWLEDGEMENTSThank you to all the young people who co-designed the text messages! 👏🏼
Investigators
• Prof Julie Redfern
• Prof Clara Chow
• Prof Kate Steinbeck
• Dr Karice Hyun
• Alicia Grunseit
• Anna Singleton
• Rebecca Raeside
• Zoe Latham
Health and research professionals who contributed to text message reviews and workshop or database development
Funding• NHMRC/National Heart Foundation Early
Career Fellowship
• Sydney Medical School Kickstarter Grant
TEXTBITES RCT Sites • The Research and Education Network, Westmead
Hospital
• Weight Management Service, Department of Nutrition and Dietetics, The Children’s Hospital Westmead
sydney.edu.au/research/centres/westmead-applied-research-centre
•Dr Karen Spielman
•Dr Christopher Ganora
•Caitlin McMaster
•Pola Cohen
•Prof Adrian Bauman
•Prof Margaret Allman-Farinelli
•A/Prof Philayrath Phongsavan
•A/Prof Maree Hackett
•Dr Cindy Kok
•Dr Josephine Chau
•Dr Seema Mihrshahi
•Dr Talia Palacios
•Daniel McIntyre
•Bridget Foley
•Caroline Wu