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The development, feasibility and acceptability of a school-based obesity prevention programme: results from three phases of piloting
  1. Katrina M Wyatt1,
  2. Jennifer J Lloyd1,
  3. Siobhan Creanor2,
  4. Stuart Logan1
  1. 1Institute for Health Service Research, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
  2. 2Centre for Health and Environmental Statistics, University of Plymouth, Plymouth, UK
  1. Correspondence to Dr Jennifer J Lloyd; jennifer.lloyd{at}


Objectives To develop a school-based obesity prevention programme and evaluate the feasibility and acceptability of the intervention and the planned definitive cluster randomised trial.

Design This was a three stage pilot involving six schools (398 children) in South West England, including an exploratory randomised controlled trial and qualitative interviews and focus groups with teachers, parents and children.

Intervention The Healthy Lifestyle Programme uses a range of school-based activities including lessons, assemblies, parents' evenings, interactive drama workshops and goal setting to engage schools, children and their families.

Results Of the 398 eligible children in the three pilot phases, only four opted out and a further three withdrew from the exploratory trial. In the exploratory trial, baseline measurements (anthropometric and behavioural) were obtained for 202/204 eligible children in four schools and both 18- and 24-month outcome measurements for 193/204 and 187/204 participants, respectively. Qualitative data show that delivery of the intervention is feasible within schools and acceptable to teachers, children and families. In the exploratory trial, 18/80 children (24%) in the intervention schools and 31/122 (26%) in the control schools were overweight or obese at baseline, increasing, at 18-month follow-up, to 38/119 (32%) in the control schools compared with 18/74 (24%) in the intervention schools. At 24 months the proportion of overweight and obese children in the control schools remained at 32% (36/114), whereas the proportion in the intervention schools decreased slightly to 22% (16/73).

Conclusion The Healthy Lifestyle Programme is feasible to deliver and acceptable to schools, children and their families. We recruited, retained and obtained outcome measurements from 92% of eligible children in the exploratory trial, including measurements taken after transition to secondary school, suggesting that a definitive trial is likely to be deliverable.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • To cite: Wyatt KM, Lloyd JJ, Creanor S, et al. The development, feasibility and acceptability of a school-based obesity prevention programme: results from three phases of piloting. BMJ Open 2011;1:e000026. doi:10.1136/bmjopen-2010-000026

  • Funding Phases 1, 2 and 3 of development were funded by the Children's Research Fund (registered charity no. 226128) and the NIHR Research for Patient Benefit (RfPB) Programme. SL, KW and JL were partially supported by PenCLAHRC, the National Institute for Health Research (NIHR) CLAHRC for the Southwest Peninsula. This paper presents independent research commissioned by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None.

  • Ethics approval Ethics approval for each phase of the development and evaluation of the HeLP intervention was granted from the Peninsula College of Medicine and Dentistry Ethics Committee. This followed an approach to the NHS ethics committee who felt the study did not fall within their remit.

  • Contributors JL, KW and SC drafted the manuscript with SL providing critical revision. JL developed and supported the design and production of the intervention materials, coordinated the implementation of the intervention during pilot phases and conducted interviews with teachers and parents. JL and KW conducted the focus groups and SC performed the analyses on the anthropometric data. JL, KW and SL designed the study and obtained funding. KW will act as guarantor of the paper.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data is available.