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Curtin University
Collaboration for Evidence, Research and Impact in Public Health

REFRESH - Reminder on Exercise, Food, Relaxation and enlisting Support to maintain a Healthy lifestyle (2009-2011)

Investigators:

Chief Investigators:

  • Professor Peter Howat (WACHPR and Centre for Behavioural Research in Cancer Control, Curtin University)
  • Dr Jonine Jancey (WACHPR, Curtin University)
  • Associate Professor Sharyn Burns (WACHPR, Curtin University)
  • Associate Professor Alexandra McManus (Curtin Health Innovation Research Institute, Curtin University)
  • Associate Professor Satvinder Dhaliwal (WACHPR, Curtin University)
  • Professor Annie Anderson (Centre for Public Health Nutrition Research, University of Dundee)
  • Professor Andrew Hills (School of Human Movement Studies, Queensland University of Technology)

Project Manager/PhD Candidate:

  • Ms Ginny Monteiro (WACHPR, Curtin University)

Collaborating Partners

  • Centre for Behavioural Research in Cancer Control, Curtin University
  • Cancer Council of WA
  • Playgroup WA Inc.
  • University of Dundee
  • Queensland University of Technology
  • Monash University
  • The National Heart Foundation

Funding

  • National Health and Medical Research Council (NHMRC) ($456,000)

Project Aim and Objectives

A community-based intervention to improve the nutrition and physical activity behaviours of mothers of young families participating in playgroups located in the Perth Metropolitan area.

The project’s objectives are:

  • To reduce the fat and sugar intake in the intervention group participants compared to the control group participants by 10%.
  • To increase the fibre, fruit and vegetable intake in the intervention group participants compared to the control group participants by 20%.
  • To improve the dietary self-efficacy in the intervention group participants compared to the control group participants by 20%.
  • To increase the minutes of moderate intensity physical activity in the intervention group participants compared to the control group participants by 20%.
  • To improve the physical activity self-efficacy in the intervention group participants compared to the control group participants by 20%.
  • To improve the perception of social support in the intervention group participants compared to the control group participants by 20%.
  • To improve the overall perception of physical health and mental health in the intervention group participants compared to the control group participants by 10%.

Background

Overweight and obesity are important public health issues and there is evidence that rates in women rise with age as well as with the first and subsequent pregnancies. Excessive weight gain during pregnancy and excessive postpartum weight retention are significant and identifiable predictors of long-term obesity. Lifestyle factors relating to poor nutrition and lack of physical activity have been implicated in interpregnancy weight gain and weight gain 12 months postpartum. A recent Cochrane review stated that methods to control overweight and obesity among women have not been adequately evaluated. Research to date indicates that strategies are more likely to be effective when they include both diet and exercise components.

Project Overview

The REFRESH study is a 12-month randomised control trial which aims to improve nutrition and physical activity behaviours in mothers with young children in playgroup settings.

Overweight and obesity are important public health issues and there is evidence that rates in women rise with age as well as with the first and subsequent pregnancies. Excessive weight gain during pregnancy and excessive postpartum weight retention are significant and identifiable predictors of long-term obesity. Lifestyle factors relating to poor nutrition and lack of physical activity have been implicated in interpregnancy weight gain and weight gain 12 months postpartum.

A recent Cochrane review stated that methods to control overweight and obesity among women have not been adequately evaluated. Research to date indicates that strategies are more likely to be effective when they include both diet and exercise components.

The study is informed by the Healthway funded pilot project: Mothers of Young Children – Reducing Overweight and Obesity in Mothers with Young Children carried out between 2008 and 2010. The REFRESH study involves a more complex intervention, much larger sample and more rigorous evaluation including quantitative non-self report measures in addition to self-report measures.

To date, nine hundred mothers registered in playgroups with Playgroup WA Inc. have been recruited and randomly assigned to the control and intervention group. The community-based intervention has been implemented over six months and is currently being evaluated on its effectiveness.

The intervention included monthly educational workshops conducted by nutritionists or dietitians combined with a number of specially designed resources and activities such as booklets, sms reminders, newsletters, session handouts and food label reading activities (e.g. meal and activity planners, walking challenges).

Qualitative and quantitative data was collected on the mothers’ (n=174) perceptions of the strategies and resources used in the program. The use of multiple strategies and resources can enhance the delivery of a health promotion program and increase the likelihood of behaviour change. Mothers reported that the REFRESH magazine, SMS reminders, face to face sessions, newsletters, nutrition and physical activities, family meal and physical activity planner, fridge magnet, shopping list and food label fridge magnet, recipe booklet, and flexibility and muscle strength exercise card were all very useful to support positive changes to their nutrition and physical activity behaviours. It appeared that different combinations of the intervention materials and activities appealed to difference participants. They indicated that this variety was a positive feature of the program that enhanced the likelihood of participants being engaged in some aspect of the program.

Publications

  • Monteiro, G., Jancey, J., Howat, P., Burns, S., McManus, A. & Jones, C. (2009) A healthy lifestyle program for mothers with young children. Western Australian Centre for Health Promotion Research & Centre for Behavioural Research in Cancer Control, Curtin Health Innovation Institute, Curtin University, Perth, 54pp, ISBN 978-0-9807998-0-4.

Conference Presentations

  • Monteiro, S., Jancey, J., Howat, P., Jones, C., Burns, S., McManus, A., Dhaliwal, S., Hills, A. & Anderson, A. (2010) Physical activity behaviours of mothers with children between 0-5 years. Asia Pacific Academic Consortium for Public Health, November 2010.
  • Monteiro, S., Jancey, J., Howat, P., Jones, C., Burns, S., McManus, A., Dhaliwal, S., Hills, A. & Anderson, A. (2010) Eating behaviours of mothers with children between 0-5 years. Western Australian Branch of Public Health Association of Australia, November 2010.
  • Monteiro, S., Howat, P., Jancey, J., Jones, C., Burns, S., McManus, A., Hills, A., Anderson, A. & Dhaliwal, S. (2010) Healthy lifestyle program for mothers with young children. 2010 International Union for Health Promotion and Education, Geneva, 13 July 2010.
  • Monteiro, S., Howat, P., Jancey, J., Jones, C., Burns, S., McManus, A., Dhaliwal, S. Hills, A. & Anderson, A. (2010) Development of the REFRESH program for mothers with young children. 2010 Australian Health Promotion Association National Conference, Melbourne, May 2010.
  • Jones, C., Monteiro, S., Howat, P., Jancey, J., Burns, S., McManus, A., Dhaliwal, S. et al. (2009) The effectiveness of a lifestyle intervention designed for mothers with young children. 2009 Annual Conference of the International Society for Behavioural Nutrition and Physical Activity. Canberra, 29 September 2009.