Evaluation of Fit for Kids/Cool2BFit
Fit for Kids was a 40-week programme built up around a combination of physical exercise, coaching and motivational work, information about a healthy lifestyle, dietary advice and cooking classes. The programme was designed for children who are severely overweight, are inactive, are in poor physical condition and/or have poor body awareness. The Rockwool Foundation evaluated the Fit for Kids programme in 2011-12 and, on the basis of the results of that evaluation, decided to continue developing the project under the new name Cool2BFit. The evaluation indicated that a better retention strategy was needed, and that the dietary advice and physical training were of great importance.
Cool2BFit targeted both children and their families, offering dietary advice in the home, physical exercise activities, communal cooking sessions, and group meetings addressing a variety of topics. Maintenance of a healthy lifestyle after the conclusion of the programme itself was also a crucial focal point. A Cool2BFit book was prepared, offering families specific tools to help them to lead healthy lives.
The evaluation included both qualitative and quantitative elements. The quantitative evaluation was conducted by the Centre of Inflammation and Metabolism at Rigshospitalet, which is headed by Prof. Dr. Bente Klarlund. This part of the evaluation focused on the short-term impact of the programme and on the risk of developing diabetes and cardiovascular diseases among children of early school age.
The qualitative evaluation was conducted by ALS Research and focused on (1) the content of the programme and the synergy between physical exercise, mental training and dietary advice; (2) the effects of the programme on the participating children – both with regard to their motivation for living healthier lives and in terms of increased self-esteem and improved quality of life and social skills; (3) the impact of the programme on the children’s families; and (4) project organisation and management.
The quantitative evaluation followed 40 children, tracking their physical development for the first half of the programme, i.e. 20 weeks. Of these children, half began the Fit for Kids programme in January 2012, while the remaining 20 started the programme in August of the same year. The children starting in August 2012 functioned as a control group in the research. The examinations took place at Rigshospitalet in Copenhagen and included blood tests, measurements of participants’ weight, height, waist circumference and blood pressure, vertical jump tests, tests of physical condition, and tests of concentration, memory and quality of life.
The qualitative evaluation was based on interviews with participating children and their parents, personnel from Fit for Kids, and project partners. This part of the evaluation also involved participant observation in connection with the exercise sessions, dietary advice sessions and coaching. The data were collected during the period January-December 2012. A questionnaire survey was conducted among parents in November-December 2012. The data collection was based on case studies; nine families were selected and followed throughout the evaluation process.
The results from the quantitative evaluation showed that after 20 weeks of the programme, the children had achieved significant reductions in their BMI, waist circumference and body fat percentage. The programme had thus reduced the risk of the children developing diabetes and cardiovascular disease. In addition, their level of fitness and their self-image (according to their own reports) had improved significantly. The conclusion was that children who participated in the programme became significantly more active, thus becoming less likely to develop the lifestyle illnesses from which they would otherwise be at risk.
The results of the qualitative evaluation indicated good synergy effects between the various elements of the programme. However, dietary advice and physical exercise were judged to be the foundation components of the scheme. The regular contact with the project personnel and follow-up where necessary to motivate participants were also important. Most of the participating families expressed the opinion that their children had experienced an increase in self-esteem as a result of their loss of weight and their improved physical fitness, and that these factors had also had a positive impact on the children’s relationships with, for example, their classmates.
However, it should be noted that the evaluation results were based on short-term assessments made during and immediately after the programme. It was not possible to come to any conclusion about whether the programme will have a long-lasting impact on the children’s general health and wellbeing. Moreover, the qualitative evaluation showed that during the school summer holiday, almost all the children put back a considerable amount of the weight lost earlier. This indicated the need for a strategy for ensuring that the positive effects of the programme are maintained after participation in the programme has ended.