Whānau Pakari is a family-based, multidisciplinary obesity intervention programme for children and adolescents. It has achieved engagement with Māori and those from socioeconomically deprived households. The objective of this study was to assess the impact of rurality and family structure on outcome.
Recruitment was from January 2012 – August 2016 in Taranaki, New Zealand. Eligible participants were 4-16 years old, with a body mass index (BMI) of ≥98th percentile (obese) or >91st centile (overweight) with weight related comorbidities. Primary outcome in the trial was BMI standard deviation score (SDS). Secondary analysis of BMI SDS, dietary behaviours, physical activity, and psychological outcomes was performed, as they pertained to rurality and family structure.
There were no differences in primary or secondary outcomes between urban and rural participants at baseline or 12 months. However, rural participants in a comparison group of children who did not proceed with Whānau Pakari displayed an increase in BMI SDS at 12 months from baseline. While there were low numbers of rural Māori in the cohort, background rates of rural Māori children and adolescents with obesity in Taranaki are not known. There were no differences in outcome in relation to family structure.
Whānau Pakari appears to be acceptable for both urban and rural participants, and has overcome the challenges of varying family structures. Rural obese children who do not engage in Whānau Pakari are at risk of increased BMI SDS. Further research should focus on how to improve engagement with rural communities, especially Māori. Consideration of the optimal location for delivery of programmes for groups most at risk of child obesity is warranted.