To get back to the original question 1st. 2 very good papers on obesity
in children and the evidence of interventions can be found at:
BMJ 2008; 337: a1824 and a1848. These are parts 1 and 2 and review the
evidence to date - the conclusion is not very positive I am afraid
largely because HP has relied too heavily on motivational and behaviour
change strategies. 

The failure of top-down programming has not been because of the issues
it chooses to address or the messages it chooses to communicate.  It has
been because of the way in which health programmes have been delivered.
Top-down programming has relied heavily on strategies that have not
engaged with those people suffering the worse inequalities, in for
example obesity and health, the poor and marginalised. Low participation
in top-down programming has hindered its progress to close the gap in
health status between different social and economic groups in society.
Some key authors have even suggested that it has contributed to
inequalities in health. What this means is that the predominant style of
HP programming, the style that most people reading this email will be
involved in, has been contributing to inequality rather than addressing
it!

Of course, from a HP perspective we as practitioners need to address
both lifestyle issues and structural issues within a global context.
What this means in practice, for example, is that a national agenda on
reducing obesity through an increase in physical activity (top-down)
will also have to address local problems such as an unsafe environment
in low socio-economic communities (bottom-up) through mobilisation
leading to policy change and legislation. In turn this will contribute
to a global agenda by a reduction in fossil fuel consumption because
more people are walking to the local shopping centre rather than using
their motor vehicles for personal safety.

Hope this helps. Glenn Laverack. Health Promoter.


----Original Message Follows----
From: Nicholson Ellen <[log in to unmask]>
Reply-To: Health Promotion on the Internet <[log in to unmask]>
To: [log in to unmask]
Subject: [CLICK4HP] Obesity Interventions
Date: Wed, 17 Dec 2008 12:29:51 -0000

Hello,



Just wondering if anyone knew of any research into the effectiveness of
"brief intervention" work to support weight loss, particularly with
children.



Many thanks,



Ellen Nicholson

Public Health Policy and Performance Officer

NHS Cambridgeshire

Ph 01223 884805

Email  <mailto:[log in to unmask]>
[log in to unmask]




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