Background
Methods
Schools intervention design
Activity | Description | Development/Preliminary feedback |
---|---|---|
Challenge Book | A simple diary distributed to students to monitor their daily physical activity and nutrition intake. A student shades in a check box relating to specific lifestyle behaviour choices (e.g. drink a sugary drink, eat vegetables, exercise, watch TV). | This helps the students to become more aware of their lifestyle choices and see progressive changes they have made. Some teachers have found this to be a particularly useful tool and have incorporated it into their curriculum planning. |
MPI Can You Dance? | A creative blending of hip hop and cultural dance with healthy lifestyle information. It incorporates street dance, contemporary style, cultural dance and current music to engage children and explore ideas surrounding healthy living. | By weaving in cultural dance, it creates a sense of individual, community and cultural pride, while educating children on the importance of healthy lifestyle choices. It was developed in partnership with a local community organisation working with MPI youth. |
MPI Eat Well | A classroom based nutrition education program based on the four key messages. Children learn nutrition and physical activity content through interactive games and fun activities. | This program is delivered during class time and the information presented is at a slightly more advanced level and students are supported to build a deeper understanding of health. Some schools have acknowledged the comprehensive nature of the information and include it as part of their health curriculum. |
MPI Got Talent | Students create a role play scenario that promotes healthy lifestyle behaviours. | The MHWs work with the students to prepare a short performance ensuring the content of messages is accurate. Role plays tend to use a variety of performance styles from cultural dance, singing, chanting and acting. |
MPI Junior Chef | The aim of this activity is to enable each child to develop basic cooking skills and build basic nutrition knowledge. The MPI Junior Chef utilises culturally tailored resources such as the ‘Healthy Taro Leaf’ and modified family recipes. MPI Junior Chef also incorporates the use of a ‘Kitchen Licence’ system. This system progressively builds the children’s skills as their cooking experience increases. | Kids enjoy a sense of achievement as they progress from a Basic Licence to an MPI Junior Chef. |
Power Up | Designed for high school students this structured one hour session is broken into two components: a nutrition segment and a physical activity segment. Each session is highly interactive with the use of many practical demonstrations, props, visual and audio media, personal stories and testimonies. | Within MPI communities it is these types of communication strategies that are most effective in conveying messages. This unique culture and environment has received positive comments from many of the school staff and principals. |
Power Up Leadership | This program was implemented with high school students for the purpose of training and developing future MPI Leaders to lead the way for change in their school, family and community. Students with potential leadership qualities (or those who might benefit from some additional structure and support) are identified by the school or selected by the MHWs. Weekly lunchtime meetings are delivered covering cultural leadership principles, group interactions and discussions with MPI guest speakers. | This program aims to build the capacity of students to take on responsibilities and lead change. |
Island Flavour | The Island Flavour program is based on traditional MPI games. The games showcased are physically active and fun. Each week students “travel” to different islands using a passport in which they write down the key learning from each island, e.g. “60 min everyday, got to keep on moving” | The Island Flavour sessions were very well received by students and teachers. They provide an excellent opportunity to learn about health, physical activity and MPI cultural heritage. |
Intervention delivery
Evaluation planning and data collection
Questionnaires
Data analysis
Results
Characteristic |
N
| % | |
---|---|---|---|
Age | 5–11 years | 254 | 67.8 |
12–19 years | 114 | 30.4 | |
Missing | 7 | 1.9 | |
Gender | Male | 183 | 48.8 |
Female | 187 | 49.9 | |
Missing | 5 | 1.3 | |
Cultural Background | Samoan | 89 | 23.7 |
Maori | 79 | 21.1 | |
Cook Islander | 27 | 7.2 | |
Tongan | 16 | 4.3 | |
PNG | 13 | 3.5 | |
Fijian | 5 | 1.3 | |
Mixed background/other | 139 | 37.1 | |
Missing | 7 | 1.9 |
Fruit and Vegetable | Question/Statement | % with correct answer Pre-test (95% CI) N = 375 | % with correct answer Post-test (95% CI) N = 369 |
P value | AORa for change |
P value |
Knowledge | How many serves of vegetables should you eat every day | 50.5 (46.1–56.0) | 61.7 (56.5–66.8) | 0.002 | 1.58 (1.17–2.14) | 0.003 |
How many serves of fruit should you eat every day | 59.2 (54.2–64.7) | 68.1 (63.1–72.9) | 0.010 | 1.53 (1.12–2.08) | 0.007 | |
Sweet potato is which type of vegetable (starchy/non-starchy) | 75.6 (71.2–80.2) | 80.8 (76.4–84.8) | 0.090 | 1.43 (0.98–2.09) | 0.062 | |
Lettuce is which type of vegetable (starchy/non-starchy) | 68.6 (63.9–72.5) | 76.0 (71.3–80.4) | 0.030 | 1.49 (1.04–2.09) | 0.028 | |
% with strongly agree/agree Pre-test | % with strongly agree or agree Post-test | |||||
Attitudes | Eating vegetables makes me feel healthy | 89.1 (85.5–92.1) | 93.6 (90.6–95.7) | 0.030 | 1.64 (0.95–2.82) | 0.073 |
I like the taste of many vegetables | 65.0 (59.9–69.9) | 73.3 (68.4–77.8) | 0.020 | 1.45 (1.05–2.07) | 0.024 | |
It is easy to prepare vegetables to eat | 76.2 (71.5–80.4) | 82.5 (92.0–96.8) | 0.040 | 1.56 (1.07–2.27) | 0.020 | |
Eating fruit makes me feel healthy | 94.8 (92.0–96.8) | 96.1 (93.5–97.8) | 0.410 | 1.55 (0.719–3.33) | 0.264 | |
I like the taste of most fruits | 92.8 (89.7–95.3) | 94.7 (91.8–96.8) | 0.300 | 1.58 (0.82–3.00) | 0.165 | |
Fruit is an easy snack | 94.8 (92.0–96.9) | 94.7 (91.8–96.8) | 0.940 | 1.14 (0.56–2.30) | 0.719 | |
% with adequate intake Pre-test | % with adequate intake Post-test | |||||
Practices | How many serves of vegetables do you usually eat each day | 14.9 (11.4–18.9) | 26.8 (22.2–31.7) | <0.001 | 2.06 (1.41–3.02) | <0.001 |
How many serves of fruit do you usually eat each day | 88.4 (84.7–91.5) | 92.2 (88.9–94.8) | 0.080 | 1.51 (0.91–2.51) | 0.114 |
Soft drinks | Question/Statement | % with correct answer Pre-test
N = 421 | % with correct answer Post-test
N = 326 |
P value | AORa for change |
P value |
Knowledge | How many teaspoons of sugar are there in a 600 mL coke | 40.9% (36.0–45.4) | 84.0%(79.3–87.5) | <0.001 | 8.34 (5.73–12.15) | <0.001 |
Too much sugar in the diet can contribute to obesity | 64.0% (59.9–69.0) | 90.5%(86.9–93.4) | <0.001 | 5.36 (3.47–8.28) | <0.001 | |
Refined carbohydrates are a good source of vitamins and minerals (neg) | 15.5% (13.1–20.2) | 53.5%(48.7–59.5) | <0.001 | 5.79 (4.08–8.20) | <0.001 | |
Energy drinks have high caffeine and sugar content | 69.8% (66.1–74.8) | 87.3%(83.4–90.8) | <0.001 | 2.78 (1.86–4.16) | <0.001 | |
Being overweight or obese increases your risk of developing diabetes | 63.7%(60.0–69.2) | 86.5%(82.8–90.3) | <0.001 | 3.58 (2.42–5.30) | <0.001 | |
Soft drink marketing encourages people to drink more soft drinks | 55.7%(52.2–61.6) | 79.8%(75.5–84.3) | <0.001 | 3.00 (2.13–4.21) | <0.001 | |
Caffeine in energy drinks is good for children’s developing brain and heart (neg) | 70.6% (64.6–73.4) | 86.5%(79.7–87.8) | <0.001 | 3.35 (2.18–5.12) | <0.001 | |
Upsizing is one of the techniques used to get people to buy larger sizes | 43.1%(40.0–49.4) | 76.7%(72.6–81.8) | <0.001 | 4.17 (3.00–5.78) | <0.001 | |
% with strongly disagree/disagree Pre-test | % with strongly disagree/disagree Post-test | |||||
Attitudes | I enjoy drinking soft drinks (neg) | 29.1%(25.7–34.4) | 42.2%(37.3–48.1) | <0.001 | 1.49 (1.14–2.00) | 0.009 |
I drink soft drinks because my friends drink soft drinks (neg) | 15.0% (11.9–18.7) | 9.8%(7.0–13.5) | 0.060 | 0.53 (0.33–0.86) | 0.010 | |
I think water is boring (neg) | 17.1 (13.5–20.7) | 14.1 (10.3 = 17.9) | 0.270 | 0.79 (0.52–1.19) | 0.261 | |
I like to drink energy drinks (neg) | 51.9%(47.1–56.7) | 63.0% (57.6–68.2) | 0.002 | 1.60 (1.81–2.17) | 0.002 | |
Energy drinks give me energy to study in school or play sport (neg) | 51.6%(46.8–56.4) | 64.5%(59.1–69.6) | <0.001 | 1.65 (1.22–2.24) | 0.001 | |
I like to drink sports drinks because all the sports stars drink them (neg) | 62.7%(58.0–67.3) | 76.0%(71.1–80.5) | <0.001 | 1.95 (1.40–2.74) | <0.001 |
Snacks | Question/Statement | % with correct answer -pre-test N = 357 | % with correct answer post-test N = 305 |
P value | AORa for change |
P value |
Knowledge | The body’s preferred fuel is carbohydrate | 22.8% (18.5–27.6) | 53.7% (47.9–59.5) | <0.001 | 4.18 (2.95–5.92) | <0.001 |
Eating mindfully means I am paying attention to what and how much I am eating | 57.4% (52.1–62.6) | 83.1% (78.4–87.2) | <0.001 | 3.57 (2.43–5.23) | <0.001 | |
Processed snack foods are low in salt, sugar and fat (neg) | 45.8% (40.5–51.1) | 53.6% (47.8–59.4) | 0.050 | 1.00 (0.71–1.43) | 0.980 | |
Being obese means there is a higher chance of getting a chronic disease like diabetes | 82.6%(78.5–86.6) | 83.8% (79.1–87.7) | 0.830 | 1.05 (0.68–1.62) | 0.820 | |
Chips, lollies, chocolate or take away food are very fatty and give me too much energy | 60.8% (55.5–65.9) | 68.8% (63.2–74.0) | 0.030 | 1.40 (1.00–1.96) | 0.045 | |
Swapping a large portion size to a smaller one can help to manage your weight | 62.2% (56.9–67.2) | 79.1% (74.1–83.6) | 0.001 | 2.11(1.48–3.01) | <0.001 | |
Packing my own lunch box is a great way to control what you eat during the day | 75.9% (71.1–80.3) | 79.5% (74.5–83.9) | 0.300 | 1.17 (0.80 = 1.72) | 0.410 | |
% with strongly agree or agree – pre-test | % with strongly agree or agree – post-test | |||||
Attitudes | I eat more when I am tired or stressed out | 21.1% (16.9–25.7) | 27.3% (22.4–32.7) | 0.060 | 1.37 (0.95–1.98) | 0.096 |
I ask my parents to buy foods or drinks that I see advertised on television | 25.8% (21.3–30.6) | 24.0% (19.3–29.2) | 0.600 | 0.86 (0.60–1.24) | 0.424 | |
I usually get the largest portion of food on offer, when having take-away food (e.g. upsizing) | 21.1%(16.9–25.7) | 29.9%(24.8–35.4) | 0.009 | 1.70 (1.18–2.46) | 0.004 | |
I think fruit and vegetable sticks are an easy snack | 79.0% (74.5–82.9) | 80.9% (76.0–85.1) | 0.560 | 1.10 (0.74–1.63) | 0.630 | |
Buying snacks or lunch out can be very expensive when compared with taking a homemade meal. | 60.0% (54.7–65.1) | 71.9% (66.4–76.9) | 0.002 | 1.79 (1.27–2.52) | 0.001 | |
I like to snack between meals | 47.5% (42.2–52.8) | 51.3% (45.5–57.1) | 0.250 | 1.12 (0.82–1.53) | 0.490 | |
I like to eat similar snacks to my friends | 31.9% (27.1–37.0) | 27.6% (22.7–33.0) | 0.230 | 0.82 (0.58–1.15) | 0.254 | |
% consuming at least 4 times/week pre-test | % consuming at least 4 times/week post-test | |||||
Practices | Packet of chips/snacks (e.g. potato or corn chips twisties) | 23.6% (19.3–28.4) | 16.1%(12.2–20.7) | 0.010 | 0.58 (0.38–0.87) | 0.009 |
Chocolate/chocolate bars | 9.0% (6.2–12.4) | 9.5% (6.5–13.4) | 0.890 | 1.13 (0.65–1.94) | 0.663 | |
Lollies | 12.6% (9.4–16.5) | 10.9% (7.6–14.9) | 0.480 | 0.87 (0.53–1.41) | 0.570 | |
Muesli bar/ fruit bar/LCM’s | 28.7% (24.0–33.7) | 29.2% (24.2–34.6) | 0.930 | 0.97 (0.69–1.38) | 0.890 | |
Yoghurt/ custard/chocolate custard | 20.0% (16.0–24.5) | 20.0% (15.7–24.9) | 0.070 | 0.98 (0.66–1.45) | 0.900 | |
Savoury biscuits/crackers | 14.6% (11.1–18.8) | 13.8% (10.1–18.2) | 0.820 | 0.94 (0.60–1.47) | 0.780 | |
Sweet biscuits/cake/muffin/doughnut | 17.4% (13.6–21.7) | 10.9% (7.6–15.0) | 0.020 | 0.59 (0.37–0.94) | 0.026 | |
Ice-cream / ice blocks | 24.4% (20.0–29.2) | 20.7% (16.3–25.6) | 0.260 | 0.83 (0.57–1.21) | 0.342 | |
Vegetables or salad | 65.3% (60.1–70.2) | 72.0% (66.6–77.0) | 0.060 | 1.35 (0.96–1.90) | 0.085 | |
Fruit (fresh or canned) | 78.6% (74.0–82.7) | 74.8% (69.5–79.5) | 0.540 | 0.79 (0.54 –1.15) | 0.218 | |
Dried fruit (e.g. sultanas) | 13.4% (10.1–17.4) | 15.6%(11.7–20.2) | 0.440 | 1.28 (0.82–1.99) | 0.277 | |
Hot chips/French fries/wedges | 15.5% (11.9–19.7) | 17.5%(13.4–22.2) | 0.530 | 1.09 (0.71–1.68) | 0.700 | |
Pies/pasties/sausage rolls | 18.2% (14.3–22.6) | 15.4% (11.5–20.0) | 0.350 | 0.82 (0.53–1.27) | 0.380 | |
Hot dogs | 9.2% (6.4–12.7) | 9.5%(6.5–13.4) | 1.000 | 0.97 (0.56–1.70) | 0.930 | |
Pizza | 12.0% (8.9–15.9) | 11.3% (8.0–15.5) | 0.810 | 0.95 (0.58–1.58) | 0.850 | |
Sandwich/roll | 63.3% (58.1–68.3) | 60.1% (54.3–65.6) | 0.420 | 0.88 (0.63–1.22) | 0.440 | |
Bread/toast | 62.4% (56.9–67.2) | 58.2% (52.5–63.8) | 0.300 | 0.82 (0.59–1.13) | 0.220 | |
Spaghetti/pasta/noodles/rice | 40.3% (35.2–45.6) | 39.6% (34.1–45.4) | 0.850 | 0.99 (0.72–1.36) | 0.940 | |
Soup | 18.8% (14.9–23.2) | 22.3% (17.7–27.5) | 0.290 | 1.29 (0.87–1.91) | 0.210 |
Physical activity | Question/Statement | % with correct answer Pre-test N = 361 | % with correct answer Post-test N = 323 |
P value | AORa for change |
P value |
Knowledge | PA recommendations (1 h/day) | 13.3 (9.7–17.1) | 57.6 (52.0–62.7) | <0.001 | 9.23 (6.31–13.68) | <0.001 |
PA prevents heart disease | 48.8 (43.5–54.0) | 71.8 (66.6–76.7) | <0.001 | 2.31 (1.66–3.22) | <0.001 | |
PA prevents dental disease | 52.9(47.6–58.2) | 61.6 (56.1–66.9) | 0.025 | 1.35 (0.98–1.85) | 0.062 | |
PA improves self esteem | 55.7 (50.4–60.9) | 72.4 (67.2–77.2) | <0.001 | 1.94 (1.39–2.70) | <0.001 | |
% with strongly agree or agree pre-test | % with strongly agree or agree post-test | |||||
Attitudes | I’m just not into sport | 10.1 (6.8–13.2) | 8.0 (5.1–11.2) | 0.416 | 0.85 (0.49–1.48) | 0.572 |
Playing sport costs too much | 23.5 (18.2–27.1) | 24.4 (19.3–28.9) | 0.855 | 1.13 (0.78–1.63) | 0.529 | |
I’m too unfit to play sport | 13.9 (10.0–17.2) | 8.0 (5.2–11.6) | 0.018 | 0.54 (0.32–0.90) | 0.019 | |
There is no time to do sport | 42.7 (36.4–46.8) | 35.7(30.4–41.3) | 0.067 | 0.73 (0.53–1.00) | 0.060 | |
% performing the activity regularly pre-test | % performing the activity regularly post-test | |||||
Practices | Running | 14.1(10.7–18.2) | 17.6 (13.6–22.3) | 0.210 | 1.33 (0.87–2.05) | 0.190 |
Walking | 48.2 (42.9–53.5) | 57.3 (51.7–62.7) | 0.021 | 1.34 (0.97–1.83) | 0.070 | |
Organised sport | 72.9 (68.0–77.4) | 74.3 (70.0–79.0) | 0.728 | 1.01 (0.71–1.43) | 0.950 | |
Non-organised sport | 73.7 (68.8–78.2) | 79.3 (75.3–83.6) | 0.105 | 1.25 (0.86–1.82) | 0.230 | |
Some activity | 91.4 (88.0–94.1) | 93.2 (90.5–95.5) | 0.395 | 1.00 (0.55–1.83) | 0.980 |