Background
Methods
Context and vision
Marketing, media and communications
Marketing and promotional strategy | Examples utilised |
---|---|
Website presence | PEACH™ QLD website |
Social media presence | PEACH™ QLD Facebook page |
Media Publicity | Media releases |
Print and online articles | |
Radio news reports and interviews | |
Television reports | |
Paid advertising | Paid advertisements e.g. parenting magazines |
Paid editorials e.g. newspapers | |
Commercial radio campaigns | |
Digital marketing campaigns | Facebook and Google Display Network |
Engagement with health community, health-related organisations e.g. peak bodies and health professionals e.g. General Practitioners, Dietitians, Practice Nurses | Information disseminated through newsletters, journals, website and social media posts and dissemination of flyers. |
Engagement with non-health community organisations e.g. Local Councils, Local Members of Parliament, schools, community organisations | Information disseminated through community expos, newsletters, website and social media posts, posters and dissemination of flyers. |
Key Message |
• PEACH™ stands for ‘Parenting, Eating and Activity for Child Health’ |
• It is a free program funded by the Queensland government and delivered by QUT. |
• The program promotes healthy growth in children. It is family-focussed and aims to help families lead healthier, happier lives by eating well and being more active. |
• The program offers a friendly and supportive environment where parents can share their stories while children enjoy active play with new friends. |
• It is evidence-based, internationally recognised and meets current guidelines and recommendations. |
• To be eligible to enrol into the PEACH™ Program families must reside in Queensland and have a primary school-aged child. |
• Parents/carers can register by calling the free call number or online at the program website. |
• The program runs weekly within a school term and after school hours in the local community.a |
An online version of the PEACH™ Program is also available called PEACH™ Online.b |
• It was introduced to offer an alternative to face-to-face sessions and to ensure the program is accessible to all Queenslanders. • PEACH™ Online features 10 interactive sessions, a parent forum and facilitated ‘live-chats’. • Families can opt to do PEACH™ in one of three ways – all face-to-face sessions, all online or a combination of the two. |
Program implementation plan
Recruitment and enrolment
The intervention
Implementation review phases
Analysis
Results
Implementation challenge | Strategies utilised to respond to implementation challenge | Resulting change | ||
---|---|---|---|---|
Interim Review Phase 1: Responding to contractual changes and preparing for pilot. | Interim Review Phase 2: Responding to up-scaling for retention and engagement and preparing for state-wide roll out. | Interim Review Phase 3: Responding to access and equity. | ||
Engagement of the health system and ownership of the health issue | • Stakeholder engagement to align with key health reform policies and strategies in Qld. • Mapped workforce. • Targeted service providers versus individual health professionals. • Designed flexible program delivery model. • Developed standardised Service Agreements. • Consulted Governance Committees to develop cost modelling for program delivery. • Kept abreast of political landscape. | • Issued EOI to engage service organisations to deliver the program. • Engaged early adopters in the primary health care sector to increase diversity of health care settings. • Lobbied for the project to continue with the change in government in 2014 and demise of Commonwealth prevention funds. • Kept abreast of political landscape. | • Issued EOI to engage service organisations to deliver the program. • Advocacy work at Departmental level to endorse the program. • Mobilised strategic advocacy for the program via stakeholder presentations. • Linked with other large scale community-based programs to leverage opportunities. • Promoted program adaptations to encourage uptake from the health sector. | • Requirement of Implementation Team to be flexible and adaptable. • Increased communications with Funding Body to leverage sustainability options. |
Recruitment of families and promotion | • Modified targets and milestone dates to align with implementation design. • Created PEACH™ QLD branding and marketing collateral. • Appointed dedicated marketing position. • Established enrolment processes and central intake functions to streamline enrolment. • Accessed demographic and prevalence data to map and profile Queensland to support likelihood of enrolments. • Devised geographical wave approach to implement the program state-wide. • Created database to capture program enquiries to inform future marketing. | • Deployed additional marketing strategies in regional and rural Queensland to reach the target audience and reduce stigma in small towns. • Modified marketing collateral to reflect changes in program design. • Strategically targeted rural areas to run the program to extend reach. • Monitored and adapted marketing and recruitment activities for different regions and holiday periods. • Initiated qualitative research looking at parents’ perspectives on factors influencing their decision to enrol [29] | • Trialled removal of weight criteria in four small communities. • Developed and launched PEACH™ Online to increase reach to families who could not access face-to-face groups. • Implemented online marketing strategy targeting regional and rural Queensland to promote PEACH™ Online. • Removed weight criteria. • Modified marketing collateral to reflect changes in eligibility criteria. | • Investment in marketing strategies which were driving enrolments. • Changes to eligibility criteria and enrolment milestone targets: ➢ Original eligibility criteria from 7 to 13 years to 5 to 11 years (aligning with typical ages of primary school in Qld), and from overweight only to overweight and obese from Wave 1. ➢ Removal of weight criteria and eligibility opened to all primary school-age children from Wave 5. ➢ Revised overall total enrolment target from 1400 to 1100. • Alternative models developed to launch in Wave 5, reported elsewhere. |
Participant Engagement - attendance and retention | • Designed and introduced 15 min healthy lifestyle component to child sessions. • Blitzed marketing campaigns 2 months in advance of sessions commencing. | • Referred to Cochrane review [5] to compare attendance data to that of similar national programs. • Reviewed pilot attendance data. • Consultations to gain feedback on content matter, delivery format, frequency of sessions, suite of resources, order of parent sessions and general feedback. • Consulted enrolled families of eight Wave 2 groups to explore how family resources were being used and could be improved. • Reviewed program design and content to better align with families concerns and reasons for enrolment. • Reviewed facilitator training encouraged proactive approach in managing attendance. • Focussed on using community venues such as schools to reduce stigma. • Initiated value-add work on ‘why families enrol in PEACH™ QLD’ to assess motivation to enrol in the program. • Added PEACH™ QLD website functionality for facilitators to record attendance data in real time. • Reviewed child sessions for appropriateness and enhancement for adherence with current Physical Activity Guidelines [37]. • Reviewed content of 10 parent sessions and modified order. | • Initiated value-add work on ‘why enrolled families do not attend’ to further inform implementation. | • Changes to program design: ➢ Frequency: sessions 1–9 delivered weekly and within a school term (initially delivered fortnightly with no alignment to school term); ➢ Motivational content SMS messages sent to families between session 9 and 10; ➢ Three support phone calls more spaced out between sessions 9 and 10 (initially fortnightly); and ➢ Introduction of SMS reminders to enrolled families 24 h prior to session (Wave 3 only). • Parent sessions reordered. • New edition of Parent Handbook released: language simplified, paper quality lowered, images updated for cultural inclusiveness. • Value-add resources for families sourced. • Goal setting tool introduced. • Child sessions enhanced to address child satisfaction, benefit diversity in child facilitator experience and style, guide delivery of sessions for varying group sizes, levels of complexity, venues and age appropriateness. |
Engagement of the health system and ownership of the health issue
Provider Type | Unique Providers n (%) | Groups delivered n (%) | Summary of enrolled families | Summary of enrolled children | |||||
---|---|---|---|---|---|---|---|---|---|
Number enrolled n (%) | Number attended ≥1 session n (%) | Session attendancea (median (IQR)) | Number enrolled n (%) | Number attended ≥1 session n (%) | Session attendancea (median (IQR)) | ||||
Health Service Providers (HSP) | Hospital & Health Services (HHS) | 5 (28) | 24 (22) | 252 (27) | 179 (26) | 6 (3–9) | 294 (26) | 214 (25) | 6 (3–9) |
Medicare Locals (ML) | 3 (17) | 6 (6) | 43 (5) | 35 (5) | 5 (2–7) | 45 (4) | 35 (4) | 5 (2–7) | |
Hospitals (H) | 1 (5) | 2 (2) | 18 (2) | 17 (2) | 5 (3–9) | 21 (2) | 20 (3) | 8 (3–9) | |
Sub-total
|
9 (50)
|
32 (30)
| 313 (34) |
231 (33)
|
6 (2–9)
|
360 (32)
|
269 (32)
|
6 (2–9)
| |
Non-Health Service Provider (non-HSP) | Other Providers | 8 (45) | 23 (22) | 187 (20) | 146 (21) | 7 (4–9) | 224 (20) | 178 (21) | 7 (4–9) |
QUT-Provided | 1 (5) | 50 (48) | 419 (46) | 316 (46) | 7 (3–9) | 538 (48) | 402 (47) | 7 (4–9) | |
Total | 18 | 105 | 919 | 693 | 7 (3–9) | 1122 | 849 | 7 (3–9) |
Recruitment of families and promotion
Participant engagement – Attendance and retention
Discussion
Engagement of the health system and ownership of the health issue
Implementation at scale
Recruitment of families and promotion of the program
Participant engagement (attendance and retention) of families
Conclusions
1. Health system | Recommendation 1.1: Governments should continue to invest in community based healthy lifestyle programs for families as part of a universal service delivery model for the treatment of overweight and obese primary school aged children. This investment should be embedded in the policy and strategic context for community and primary care. Recommendation 1.4: Primary health care services are well positioned for ongoing service provision of childhood overweight and obesity management services. Recommendation 1.2: Government investment in programs should include routine performance monitoring for participating health services and program monitoring to ensure health gains continue to be achieved. Programs should include a quality improvement cycle to improve outcomes. Recommendation 1.3: The establishment and monitoring of local level performance targets for program delivery are needed to ensure childhood obesity management services are prioritised by providers. |
2. Implementation at scale | Recommendation 2.1: A Model of Care and implementation plan should be closely aligned with and informed by national Clinical Practice Guidelines and the WHO Commission on Ending Childhood Obesity Report. Recommendation 2.2: A consistent and coordinated approach to paediatric weight management services across the State including eligibility, availability and type of service with the ability to deliver services to families at the point in which people engage with the health care system. Clinical Practice Guidelines should be extended to describe care pathways with the approach involving all National, State and Private health service providers involved in the management of childhood overweight and obesity across the continuum of care in clinical, community and primary health care settings across a complexity of cases. A shared vision by all, referral pathways and communication between providers is needed, as services to families of children who are already overweight or obese do not sit in only one part of the health care continuum. Recommendation 2.3: Upscaling of programs requires a deep understanding of administrative enablers and barriers to embedding childhood obesity management into the core business of the health service, including links to internal funding structures and medical record charting of occasions of service. |
3. Recruitment of families and promotion of the program | Recommendation 3.1: Programs should market directly to families as it is unlikely that the families who would benefit from the program are all interacting with the health care system. Health professional referrals alone are not adequate. Recommendation 3.2: Children impacted on parent’s interest in taking action on their weight status. Marketing directly to children is likely to be complex but warrants further investigation. Recommendation 3.3: Care should be taken to not further sensationalise childhood obesity in the media, and therefore it is critical to ensure that marketing is solution focussed and not problem focussed. |
4. Engagement of families | Recommendation 4.1: Future investment and expansion of PEACH™ must apply a quality improvement framework to ensure modifications and changes which led to an improvement can conclusively demonstrate they are worthwhile. Recommendation 4.2: The evaluation of up-scaled programs should focus on reducing the burden on participant families whilst maintaining the integrity of evaluation datasets for ongoing monitoring and surveillance. |