Evaluation of the Red Apple Program: a healthy lifestyle program for disadvantaged families & young people piloted in the Wide Bay Burnett Queensland, 2011-2012

Evaluation of the Red Apple Program: a healthy lifestyle program for disadvantaged families & young people piloted in the Wide Bay Burnett Queensland, 2011-2012

Poor nutrition and sedentary lifestyle contribute to the statistics of 7.4 million overweight Australian adults with over a third of those being obese(1). Middle age (45-64) Australians have the highest combined rates of overweight and obesity compared to other age groups. Data collected from 14,000 adults throughout Australia on National Blood Pressure Screening Day in June 2007 showed that around 35% of middle aged women and 50% of middle age men were overweight (defined as having a BMI in the 25-30 range) and it is estimated that over the next 20 years 700,000 hospital admissions and 123,000 deaths will be a direct consequence of overweight in middle aged Australians(2).

The central focus of the Red Apple Healthy Lifestyles Pilot Program was the delivery of practical activities around the topics of healthy eating, shopping, cooking, physical activities, promoting sustainable changes in health and shopping behaviours among low socio economic families and young people in regional/ rural communities by community service providers. The aims of the evaluation project were to answer the questions; how do the activities offered by the Red Apple program in the Wide Bay- Burnett (Fraser Coast & North Burnett) regions lead to;
a) increased knowledge and skills of participants to better adopt healthy eating behaviours, b) increased participants’ ability to better adopt healthy Physical Activity (PA) behaviours, and ;
c) increased parents’ ability to establish healthy eating and PA behaviours in their children?

The study also aimed to identify any barriers to healthy choices adoption by participants in relation to food choices or physical activity.

The pilot project was a Department of Health Queensland funded project. It encompassed support for people who live with social disadvantage. The intervention was piloted by engaging 176 participants across at least two locations in the Wide Bay Burnett Region. The program was facilitated by workers from existing service delivery agencies that currently provide a range of programs for this target group in partnership with the Hervey Bay Neighbourhood Centre and Uniting Care Community Fraser District.

These services already operate programs and services to the client group and the program was incorporated in their broader servicing of these client groups. This community development based arrangement provided the advantage that those delivering the program have an existing relationship with the clients. Intended benefits to participants included improvements to knowledge and skills to adopt healthy eating behaviours; improved ability to adopt healthy physical activity behaviours; and increased parents' ability to establish healthy eating and physical activity behaviours among children early in life.

Community Service Providers were very positive in their reception of the Red Apple Pilot Program and in implementing healthy lifestyles information as part of an holistic approach to supporting clients as were the program recipients. The main impact that emerged from the

both the qualitative and quantitative findings was that people are now more aware of healthy food choices for themselves and their children and that together with regular physical activity, this helps to maintain a healthy lifestyle. Participants now appear to better understand the benefits of participating in regular exercise, as well as the importance of selecting healthy fresh food, eating breakfast and cooking meals at home rather than eating fast food. More than half of the participants stated they were more confident in planning and shopping for healthy meals, finding ways to buy healthier food, cooking healthy meals, preparing healthy lunchboxes for children and knowing about the suitable food for babies. Around one quarter of participants stated they were a little more confident in these healthy eating processes. The confidence level of participants has been sustained in all 5 domains after the 3 month survey and even further increases in the area of children’s healthy lunchboxes increasing from 57% to 80%, and understanding suitable food for babies from 50% to 70%.

The self-reported benefits of participants involved in the program are summarized as follows:
a) improved knowledge and lifestyle skills
b) the adoption of healthy eating behaviours
c) improved ability to adopt healthy physical activity behaviour
d) increased parent ability to establish healthy eating and physical activity patterns among children early in life
e) increased self-reliance in relation to aspects of health food choices.

The key messages (behaviours) reinforced throughout the Manual, the program and its resources are based on then current (in 2011-2012 during program development) recommendations largely sourced from the Australian Guide to Healthy Eating (AGTHE), Food Plate as well as the Physical Activity Guidelines from the Department of Health and Ageing. Main recommendations for areas of improvement in program materials and the delivery focused on:
• More multi-cultural food samples and recipes would be good for some groups such as rice based meals-to improve delivery to diverse groups
• It would be good not to have such intensive evaluation paperwork in a future program but do keep some evaluation going
• Inclusion of specific content for older people
• The program would work better and be more interesting for some young people if they were able start with the cooking.
• Simplify facilitator materials as much as possible.

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