Participant profile and impacts of an Aboriginal healthy lifestyle and weight loss challenge over four years 2012–2015

Abstract

Objective: To explore participation, consistency of demographic and health profiles, and shortterm impacts across six Aboriginal Knockout Health Challenge (KHC) team-based weight loss competitions, 2012 to 2015.Methods: Data comprised one competition each from 2012 and 2013 and two per year in 2014 and 2015. We compared baseline and change (pre-to post-competition) in weight, fruit and vegetable consumption, physical activity and waist circumference (baseline only) across competitions using mixed models.Results: Numbers of teams and participants increased from 2012 to 2015 from 13 and 324 to 33 and 830, respectively. A total of 3,625 participants registered, representing 2,645 unique people (25.4% repeat participation). Participants were mainly female and >90% were classified obese at baseline. Baseline weight and weight lost (between 1.9% and 2.5%) were significantly lower in subsequent competitions compared with the first. Improvements in fruit and vegetable consumption and physical activity were comparable across competitions. Conclusion:The KHC has increasing and sustained appeal among Aboriginal communities, attracting those at risk from lifestyle-associated chronic disease and effectively reducing weight and promoting healthy lifestyles in the short term. Implications for public health:Community-led programs generated by, and responsive to, Aboriginal Australians' needs can demonstrate consistent community reach and sustained program-level lifestyle improvements.

Weight change among repeat participants of an Aboriginal community-based weight loss program

“…PA was categorised dichotomously as having (or not having) adequate PA (defined as three or more vigorous sessions/week; or five or more walking or moderate sessions/week; or 1-2 vigorous sessions/week and 3-4 walking or moderate sessions/week according to previous procedures) [39]. Associations between repeat participation and change in diet and PA (calculated by subtracting baseline from post-intervention scores for each contest) and percent change in weight during the first participation occasion were further adjusted for gender and age, as these variables have been shown previously to affect contest outcomes [15]. Crossed random effects Poisson models with random effects for person and team were used to account for the clustering of observations and were adjusted for the exposure to the KHC.…”

“…The KHC is a long-running program with increasing appeal [15]. While the most common participation pattern in the KHC was a single participation occasion, repeaters accounted for about one-third of the participants.…”

“…Outcomes from community-based weight loss programs can be difficult to establish due to the variety of program designs and reporting inconsistencies [10]; never-the-less, weight reduction and reduced risk of non-communicable disease have been demonstrated in other populations [11][12][13][14]. For Aboriginal Australians there is limited but positive evidence of effectiveness for community-based programs [15].…”

“…We recently evaluated a community-based team weight loss competition, the NSW Aboriginal Knockout Health Challenge (KHC) [15], a program open to Aboriginal Australians and Torres Strait Islander peoples aged 16 years or older. KHC contests have been held once each in 2012 and 2013, and twice per year since 2014.…”

“…The program capitalizes on Aboriginal Australians' values (e.g., community) and is structured for prize money to be directed to environmental and socioeconomic factors which disproportionally affect Aboriginal Australians and contribute to their poor health [6]. Our recent evaluation of the KHC found increased participation and significant average weight loss [15] but did not explore within-individual outcomes. Therefore, we analysed participation patterns, particularly repeat participation patterns, and participant weight change between contests over 7 years (2012-2018) of the KHC.…”