Obesity

Health Promotion in the Pacifi c Vol 14 No 2. Sep 2007

139

Pacifi c Health Institutions

The Pacifi c OPIC Project (Obesity

Prevention In Communities) -

Objectives and designs

Boyd Swinburn*, Jan Pryor**, Marita McCabe***, Robert Carter****, Maximilian de Courten*****,

David Schaaf******, Robert Scragg*******

*Professor, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria

3125, Australia. Email boyd.swinburn@deakin.edu.au ** Dr Fiji School of Medicine, Suva, Fiji. Ph +679 323 3401, email

j.pryor@fsm.ac.fj. ***Professor School of Psychology, Deakin University, 221 Burwood Highway, Melbourne, Australia

3125. Email marita.mccabe@deakin.edu.au. **** Associate Professor School of Population Health, 207 Bouverie St, The

University of Melbourne, Melbourne, Australia 3010. Email r.carter@unimelb.edu.au. ***** Associate Professor, Department

of Epidemiology, Monash University, Commercial Rd, Melbourne, Australia. Email max.decourten@med.monash.

edu.au. ******Email d.schaaf@auckland.ac.nz. *******Associate Professor School of Population Health, University of

Auckland, Private Bag 92019, Auckland, New Zealand. Email r.scragg@auckland.ac.nz

Abstract

Background: Evidence on how to reduce the increasing prevalence of youth obesity is urgently needed in many countries.

The Pacifi c OPIC Project (Obesity Prevention In Communities) is a series of linked studies in four countries (Fiji, Tonga,

New Zealand, Australia) which is designed to address this important problem.

Objectives: The studies aim to: 1) determine the overall impact of comprehensive, community-based intervention programs

on overweight/obesity prevalence in youth; 2) assess the feasibility of the specifi c intervention components and

their impacts on eating and physical activity patterns; 3) understand the socio-cultural factors that promote obesity and

how they can be infl uenced; 4) identify the effects of food-related policies in Fiji and Tonga and how they might be

changed; 5) estimate the overall burden of childhood obesity (including loss of quality of life); 6) estimate the costs (and

cost-effectiveness) of the intervention programs, and; 7) increase the capacity for obesity prevention research and action

in Pacifi c populations.

Design: The community studies use quasi-experimental designs with impact and outcome assessments being measured

in over 14,000 youth across the intervention and control communities in the four sites. The multi-strategy, multi-setting

interventions will run for 3 years before fi nal follow up data are collected in 2008. The interventions are being informed

by socio-cultural studies that will determine the family and societal infl uences on food intake, physical activity and body

size perception.

Progress and conclusions: Baseline studies have been completed and interventions are underway. Despite the many

challenges in implementing and evaluating community-based interventions, especially in the Pacifi c, the OPIC Project

will provide rich evidence about what works and what does not work for obesity prevention in youth from European and

Pacifi c backgrounds.

Background

The obesity epidemic is rapidly increasing in both developed

and developing countries1. Of particular concern is its hold

in Pacifi c populations. The Pacifi c region has the highest rates

of obesity in the world2, yet the capacity to respond to the

epidemic is very limited.

Prevalence rates for

overweight and obesity

(body mass index, BMI

>25kg/m2) are as high as

75% in Nauru, Samoa,

American Samoa, Cook

Islands, Tonga and French

Polynesia3. The Pacifi c

populations living in New

Zealand also have extremely high prevalence rates (~80%)

compared to the European population (~50%)4. The impact

of obesity on non-communicable diseases, especially

diabetes, is correspondingly enormous and increasing 1 with

overweight and obesity ranked as the 7th leading cause of

avoidable burden for 2010 and 20205.

Obesity prevention has, therefore, been recognised as a

high priority by the World Health Organization (WHO) in

the latest World Health Report5, successive Pacifi c Health

Forums and other Pacifi c Consultations6, 7, and Australian

and New Zealand health authorities8-11 for at least the last 10

years. However, it is only

recently that governments

have been seeking evidence

on what works and does not

work for obesity prevention

and unfortunately this is

very limited. Systematic

reviews