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A randomized control trial intervention to combat childhood obesity in Negeri Sembilan, Malaysia

Siti Sabariah Buhari

Health promotion programs benefit from an accompanying process evaluation since it can provide insights to the strengths and weaknesses of a program. This paper reports on the process evaluation of a childhood obesity intervention program known as ‘The H.E.B.A.T! Program’, which aims to improve weight status, eating habits and physical activity of overweight children aged 10-11 years old in Negeri Sembilan, Malaysia. Process evaluation was assessed based on the reach, dose delivered, fidelity, dose received and context of the intervention. A total of 43 children (69.7% boys; 30.3% girls) participated in the H.E.B.A.T! Program. The intervention group underwent two series of 3-day camps and school-based fun activities to engage in healthy eating and active lifestyle. Parents of children in intervention group attended a half-day workshop to enable them to create supportive environments for their children at home. Process evaluation measures were obtained from researcher’s observation, participant interviews and records. Results indicated that the reach was high among
the children and their parents (>70%). Furthermore, the programme was delivered successfully as planned. Satisfaction score on ‘rate of excitement when participating in the program’ was 4.52±0.60 (1=most disliked; 5=most liked). The trainers reported that the intervention module was ‘user-friendly’. Facilitators and barriers faced by parents in adopting the recommendations were assessed through focus group discussions. A total of 18 parents were involved and they identified numerous barriers to adopting the recommendations, most notably child and family preferences and resistance to change, but also economic barriers. In conclusion, the program successfully reached the targeted population of overweight/obese children. The process evaluation performed during intervention provides information on the quality of program implementation and can guide the revision of intervention material and provide insights for future health promotion programmes and public health policy