Grant Proposal for Obesity Prevention and Control in South Australia

This grant proposal outlines an intervention plan for obesity prevention and control in South Australia, specifically in Northern Adelaide. The action plan is triple faceted; multi-sectorial, multi-component and whole of community. Behavioral change (active lifestyle and right dietary choices) is the anticipated outcome which is significant in achieving the objectives of the intervention plan.

Running head: OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA
Grant Proposal for Obesity Prevention and Control in South Australia
Name
Institution

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 2
Table of Contents
Executive Summary.........................................................................................................................3
Introduction......................................................................................................................................3
Background Information..................................................................................................................4
Needs Analysis................................................................................................................................5
Aims and Objectives........................................................................................................................6
Aim...............................................................................................................................................6
Objectives.....................................................................................................................................7
Proposed Action Plan......................................................................................................................9
Whole of Community Approach..................................................................................................9
Multi-Sectorial...........................................................................................................................10
Multi-Component Approach......................................................................................................10
Anticipated Outcomes and Significance........................................................................................11
Evaluation Plan..............................................................................................................................13
Conclusion.....................................................................................................................................17
References......................................................................................................................................18

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 3
Executive Summary
Obesity in Australia has been on the rise over the last few decades. According to the
latest national survey, the prevalence of obesity in the country is 63.7% indicating that about 2
thirds of the adult population is overweight. Approximately 70% of these obese adult people
suffer from one or the other weight related complication, diseases and conditions. The burden of
healthcare for these individuals is increased by more than 30 % due to the high rates of illnesses
such as cardiac problems, cardiovascular diseases, diabetes, hypertension, high blood pressure
and musculoskeletal diseases. Going by states, South Australia leads with a prevalence of 65.4%
which is slightly higher than the national average. The Heart Foundation estimates that 70 % of
residents of Northern Adelaide, South Australia are obese. The foundation submits that 72 % of
the population of Northern Metropolitan Adelaide does not engage in physical exercises. This
background has been used in the paper to present the needs analysis and rationale for creating an
intervention plan for prevention and control of obesity in the Northern Adelaide, South Australia.
The action plan is triple faceted; multi-sectorial, multi-component and whole of community.
Behavioral change (active lifestyle and right dietary choices) is the anticipated outcome which is
significant in achieving the objectives of the intervention plan. An evaluation of the intervention
is finally provided to help assess the performance of the initiative.
Introduction
Obesity is a medical condition where the body mass index of the person is greater than
30. Morbid obesity hampers the normal physiological functioning of the body and predisposes
one to other related illnesses and conditions. Obesity is a major public health concern in

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 4
Australia; over 60 % of the country’s adult population is obese (Hartmann-Boyce et al., 2015).
10 of these individuals are severely obese. More than half of the country’s general population is
overweight. The state of South Australia is the most affected. In 2018, 65.4% of adult South
Australians were reported as either overweight or obese. The Local Health Network estimates
that the Northern Adelaide accounts for most of the cases of obesity in South Australia with a
prevalence of 70.7% (ObeNghiem & Khanam 2016). There have been interventions and health
promotion initiatives in the state of South Australia such as OPAL which targets obesity control
and prevention but the success rate has been minimal. This paper intends to bridge the gap by
conducting a needs analysis leading to development of a health promotion proposal to curb
obesity in South Australia, specifically in Northern Adelaide. The objectives of the plan are
outlined in the paper alongside the action plan for realizing the set goals. An evaluation plan for
the intervention is the presented.
Background Information
Approximately 70% of Australia’s’ obese adult population is suffering from one or the
other weight related complication, diseases and conditions (Malakellis et al., 2017). As a result
the cost of healthcare for these individuals is increased by more than 30 % due to the high rates
of illnesses such as cardiac problems, cardiovascular diseases, diabetes, hypertension, high blood
pressure and musculoskeletal diseases (Sainsbury et al., 2018). The leading cause of death in
Australia is cardiovascular conditions; 22 % of Australians suffer from the condition. In effect,
obesity is a leading cause for morbidity in the country and claims more lives than any other

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 5
condition. The risk of developing obesity in Australian men is 14.5% higher than that of women
which stands at 56.3% (McNaughton 2015).
The rates of obesity among Australian children are appalling. Between the ages of 5 and
17, 1 in every 4 children is reported obese or overweight. The prevalence of obesity in South
Australia is worse than the national average. Over 63.7% of the state’s adult population is obese.
The metropolitan area of Northern Adelaide leads South Australia State with prevalence of
65.4% (Demaio 2018). The last two decades have seen the rise in the prevalence of obesity in
both the state of South Australia and the metropolitan Northern Adelaide as reported by the
Local Health Network. So what is the cause of this problem? According to the Heart Foundation,
72.5% of the residents of the Metropolitan Northern Adelaide do not exercise at all. Their access
to healthy foods is limited and more importantly, most people simply do not make healthy eating
decisions (Sturgiss et al., 2018). The foundation has called on the state and federal governments
to intervene in the inactivity of the state as it is causing unprecedented health risks.
This paper notes that there is sufficient scholarly work that has been undertaken with a
view to establishing the rates of obesity among Australians and Southern Australians in
particular. However, there is a gap of knowledge with regards to the health promotion
interventions to bring down the prevalence of obesity in this community (MacKay 2011). This
paper targets to bridge this gap by looking at existing literature on obesity control and prevention
so as to design an intervention that responds to the gaps. The paper also discusses a mechanism
for evaluating the effectiveness of the intervention in controlling obesity.

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 6
Needs Analysis
The needs analysis presents the need for this health promotion intervention. It derives
from the situation of obesity which then creates the need to control the condition. A few fast
facts about obesity in Australia are testament to the need for a health promotion intervention. The
starting point is the national average prevalence of the country which stands at 63% of the adult
population making Australia one of the countries with the highest obese populations (Lacy et al.,
2015). This represents about 11.2 million obese people. The proportion of obese adults has
increased with time. Children are not doing any better; about 1.2 million of them are obese too.
Recent studies show that among the OECD countries, Australia’s fast food consumption patterns
and trends are some of the highest. South Australia leads with the highest prevalence and some
of the most inactive people in the country reside in the metropolitan area of Northern Adelaide
(Phillipov 2013).
There have been a number of interventions in the state of South Australia just like most
parts of the country to bring down the rates of obesity. Examples like the Obesity Prevention and
Lifestyle program can be mentioned. It is noteworthy that despite the efforts of these
interventions, the prevalence of obesity continues to be high in the state of South Australia
(Sonntag et al., 2018). There is therefore need for coming up with an intervention that does not
merely respond to the problem, but puts in place proactive measures to prevent the development
of obesity in South Australia.

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 7
Aims and Objectives
Aim
The broad aim of this grant proposal for health promotion intervention is to reduce the
occurrence of obesity among South Australians living in Northern Adelaide and help individuals
who are already obese to control the condition.
Objectives
The specific objectives of the intervention are:
 Awareness Creation
The first objective that must be met by this intervention for obesity control is to create
awareness about the problem. Many people see obese people and probably know a number of
obese persons in their lives, or are obese themselves but in order to draw attention to the fact that
obesity is a matter of public health concern, awareness creation is imperative. As posited by
(Hendrie et al., (2015) creating awareness around the matter will involve crafting salient
messages which are informative in nature and that communicate the statistics on obesity
nationally and in the state with ease. The other component of this is communicating the health
risks that are posed by being overweight and obese as well as the benefits of maintaining a
healthy weight, this information will then be disseminated through the mainstream media
platform as well as the non-formal media.
 Physical Activity

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 8
As already noted in the background of the study, the reason for the increase in weight of most
Australians is the lack of physical activity. Most people live a lifestyle that is characterized by
less physical movement. In the Northern Adelaide metropolitan area for instance the Heart
Foundation reports that more than 72% of the population is inactive and do not take part in any
physical fitness activities of any form (Lacy et al., 2012). The initiative objectifies to get obese
persons to sign up for physical activities to reduce their weights. These could be in the form of
sporting activities such a bike riding, yoga or zumba classes, aerobic and strength training, gym
lifting any other games that the participants could be interested in.
 Access to Healthy Food Options
This paper has reported that among the OECD countries Australia leads with trends
indicating poor choices of food. The average Australian is likely to prefer fast foods loaded with
calories, fat and refined grain over a healthy meal with plenty of vegetables and fruits (MacKay
2011). One of the major goals of this intervention is to champion the access to healthy foods at
all places from schools to workplaces. Locating healthy food joints at strategic places in the
workplace and schools for example is an effective way of ensuring access. The intervention can
also work around getting the prices of healthy foods in the workplace and learning institutions to
be reduced in order to encourage obese as well as persons of normal weight to buy.
 Health Behavior and Attitude Change
All strategies aimed at controlling and reducing overweight and obesity can only be sustained
if the people are sufficiently sensitized and educated to change their attitude and behavior
towards their role in the quality of life that they want to live (Thomas et al., 2010). In order that

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 9
this is realized, the intervention will pursue individualized as well as group counseling for
persons so as to inspire change of behavior. This will involve teaching the participants how to set
goals in life and how to follow up on achieving those goals. The obesity prevention initiative will
employ professional support for guidance of behavior changes alongside the use of
individualized behavior change approaches.
Proposed Action Plan
This section of the proposal outlines the intended plan for intervention and how this will
be used in the achievement of the identified goals. The action plan summarizes the approaches
that will be employed in meeting the challenges of controlling obesity among residents of South
Australia living within the Northern Adelaide metropolitan area. The intervention has 3 action
plans which when implemented interactively will yield meaningful results for the obesity control
program; a multi-component approach, a multi-sectorial approach and a whole-of community
approach. They are discussed in detail as follows:
Whole of Community Approach
If the battle against the rising rates of obesity and overweight is to be won, obesity must
be perceived in a different manner. It must be perceived beyond just being a matter of the
wellbeing and health of the individual to the wellbeing and health of the whole community. The
import of this is that in order to successfully reduce the prevalence of obesity in the community,
all members of the community must be involved because it is a societal problem (Martin 2018).
Consequently, this intervention will seek the participation of all members of the Northern

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 10
Adelaide metropolitan community beginning from the home, to the learning institutions, the
workplaces, neighbors and community members in general. It is necessary that the members of
the family and friends are capacitated to be able to provide support for persons known to them to
regain normal weight. According to Obesity Hitting Crisis Point (2014The involvement of the
colleagues at learning institutions and the workplace is also crucial so that they can provide the
enabling environment for recovery to occur. According to the action plan these members of the
community must be sensitized in order that they may be aware how to handle those who are
overweight and obese among them and provide necessary support.
Multi-Sectorial
The efforts of one sector alone cannot successfully bring down the high prevalence of
obesity in Northern Adelaide, South Australia. Other interventions that have had meaningful
results in obesity control have had to pursue a multi-sectorial approach. Health practitioners will
of course be involved as the principal partners in the initiative. However in order to have an
approach that deals with all the facets of the problem, more partners from a variety of sectors
must be sought by a health promotion initiative (Newman et al.,2016). This intervention will
bring on board partners from the National Health Services as well as the Local Health Network
in Adelaide because they have a major role to play in improving the well-being of the resident s
of the area. Community health volunteers will work alongside the nutritionists, nurses and
clinicians in order to offer nutrition classes on better and healthier diet options for individuals
depending on their BMI. As posited by Montgomerie, Chittleborough & Taylor (2014) the
partnership of the social welfare services will also be sought; social workers will work with
communities in providing support; counseling and behavior change follow up programs at home.

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 11
Funding for this initiative will be sought from the state government of South Australia and the
federal government as well.
Multi-Component Approach
As has been canvassed in the background of this paper, there are many underlying issues
and facets of the problem of overweight and obesity. It follows therefore that for an initiative to
meet the challenge of mitigating obesity, it must address the various components of the problem.
As posited by Sartorius et al (2015) a multi component approach that incorporates nutrition
programs with a physical fitness and behavior change follow ups is effective in obesity control.
Borrowing from this, the intervention will prioritize the provisions of education to the
participants in need of making decisions of proper diet and will help them to come up with food
timetables to ensure they take healthy foods regularly.
Making healthy food choices alone is not enough in regaining healthy weight; an
effective weigh loss regime must involve physical exercises (Hendrie et al., 2015). Owing to this,
the initiative will engage the services of fitness program providers such as zumba and yoga. As
part of weight loss regime, aerobics and strength classes will also be involved. These are aimed
at helping participants to lose weight. After attaining the healthy weight and the medically
healthy BMI, the next essential part is maintaining it to avoid a relapse of obesity. This
component of the approach involves a lot of follow up and support by social welfare and
community health volunteers to help the participants to stick to healthy dietary habits and
maintain a healthy BMI.

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 12
Anticipated Outcomes and Significance
This portion of the proposal highlights the outcomes or results that are anticipated from
the health promotion and how they will be significant to the implementation of the health
promotion initiative. The outcomes are direct consequences of the objectives and the action plans
Healthy Food Choices
The anticipation of this health promotion proposal is that it helps the residents of
Northern Adelaide, South Australia to make better decisions when it comes to diet options. The
proposal hopes that it will alter the current inclination of most people towards refined grains,
high fat and high calorie foods to more healthy food choices with less fat and calories but more
vegetables and fruits. As submitted by Feng et al., (2017) the anticipation stems from the
objective which seeks to increase access to better, healthier food options at the workplace, home
and school. Increasing access to healthy food joints in workplaces and schools in particular will
be a major boost towards this outcome. The significance of this outcome is self-explanatory.
Statistically, Australians are top consumers of refined and fast foods among the OECD countries
(Atlantis et al., 2018). A shift in the taste and preferences from the fast foods to healthy foods
will mean that the first obstacle to a healthy weight and a normal BMI is eliminated.
A More Active Lifestyle
Any health promotion initiative targeting reduction of obesity would anticipate a more
active lifestyle as a first priority. From the literature, watching the normal weight and normal
BMI demands not only eating what the body needs, but also doing physical exercises to ensure
any excess calories and fat are combusted (Atlantis et al., 2012). The Heart Foundation estimated

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 13
in a recent study that 72% of residents of Adelaide South Australia do not engage in physical
exercise. This kind of sedentary lifestyle is to blame for the rising prevalence of obesity and the
weight related conditions, fact that underscores the significance of achieving this outcome. Most
people live life characterized by using cars to work and long sitting hours at work. Getting this
community to adapt a more active lifestyle through activities such as zumba and yoga would
help those who are overweight to burn the extra calories and fat. In the long run, the initiative
will have met its objectives.
Evaluation Plan
This segment of the paper is going to look at the development of a strategy to conduct the
monitoring and assessment of the activities that will be carried out as part of the initiative for
prevention and control of obesity among the Northern Adelaide residents of South Australia. To
set the pace for the evaluation of the intervention plan, the evaluation plan outlines the key
aspects of the evaluation as adopted from (Warin et al 2015).
 To determine the number of obese and overweight persons that enters and stays in the
prevention and control program to completion.
 To determine the rate of turnover of the persons signing up for intervention on a monthly
basis.
 To assess the level of satisfaction of participants in the intervention as a measure of
program reach and its impacts.
 To compare the achievements of the intervention initiative against key performance
indicators provided by the National Health Services on obesity prevention and control.

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 14
Besides that, the evaluation plan is also structured along a set of questions that will help the
program implementers to measure the effectiveness of the strategies employed in the
intervention. The questions are formulated to address various aspects of the health promotion
initiative from the design to process, implementation, impacts and outcomes as well as its
implications for the future and policy.
Figure 1: Summary of evaluation questions addressed by evaluation plan (Sokol et al 2017).

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 15
Beyond the formulation of the questions to be addressed by the evaluation plan, there is
the actual evaluation of the design, process, impacts and outcomes as well as the implications of
the initiative on future programs and policy. In assessing the effectiveness of the design and
process of the intervention, policy guidelines provided by the National Health Services on the
prevention and control of obesity will be instrumental. In assessing the reach of the impacts and
outcomes, the key performance indicators provided by the Local Health Network as well as other
policy papers will be handy. As posited by Kwan Chiu Wong et al (2011) the evaluation will also
make use of qualitative date collection methods. Qualitative data analysis methods are usually
applied in research to establish trends and patterns in phenomenon or behavior. By use of
qualitative data collection methods such as in depth interviews and questionnaires, vital
information regarding the success of the initiative can be gathered (Lee & Cassell 2013). In this
respect, the evaluation will through program persons conduct interviews with key stakeholders of
the initiative so as to collect their assessment of the intervention.
Participants in the initiative will be provided with structured questionnaires that they
would be required to fill out and return to program officers. As contained in Fotu et al (2011) the
questionnaires would contain structured questions framed to elicit responses that grade the
quality of services that were offered to the participants by the personnel working in the initiative.
Overall, the program reach will remain a major yardstick for measuring the success of the
intervention. Program reach here makes reference to the number of persons that will have
participated in the program activities to the end (Backholer et al., 2014).

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 16
Figure 2: Major Outcomes and Indictors of Program Reach Used in Evaluation (Sokol et al
2017).
Figure 3: Continuation of Outcomes and Indicators of Program Reach (Sokol et al 2017).

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 17
Conclusion
As covered in the report, the prevalence of obesity in South Australia is a fundamental
public health issue. Approximately 70% of South Australia’s obese adult population is suffering
from one or the other weight related complication. The rates of obesity related morbidity and
mortality is high raising the cost of healthcare by more than 30 % due to the high rates of
illnesses related to obesity and overweight. This paper has presented a need analysis for this
health promotion intervention. It derives from the situation of obesity which then creates the
need to control the condition. The facts about obesity in Australia are testament to the need for a
health promotion intervention. Coupled with this is the fact that most initiatives to control and

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 18
prevent obesity have recorded low success. This paper has presented a new action plan with three
approaches; multi sectorial, multi-component and whole of community approach which when
integrated into the intervention will lead to the realization of the aims and objectives of the
initiative. The aim of the intervention is to achieve a reduction in the incidence of obesity among
South Australians. The expected outcome of the health promotion initiative is to influence a
behavior change from refined foods to healthier choices and a more active lifestyle in place of
the sedentary one. The evaluation plan to gauge the effectiveness of the initiative in the
achievement of set goals makes this intervention practicable and actionable.
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Appendices
Appendix 1: Proposed Timeline
Activity Start date Completion date Duration
Literature review and
collecting secondary
data
5th Nov 2018 19th Nov 2018 2 weeks
Selecting the sample
size for participants
and choosing the
participants
20th Nov 2018 4th Dec 2018 2 weeks
Designing
intervention plan
5rd Dec 2018 19th Dec 2018 2 weeks
Selecting and
mobilizing partner
organizations,
sponsors and other
stakeholders
3rd Jan 2019 3rd Feb 2019 1 month
Resource mobilization 4th Feb 2019 4th May 2018 3 months
Workshops and
trainings for program
personnel and staff
5th May 2019 5th June 2019 1month
Intervention activities 6th June 2019 7th June 2020 12 months

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 25
Program report
writing
10th June 2020 11th Aug 2020 2 months
Evaluation of program 12th Aug 2020 13th Sept 2020 1 month
Appendix 2: Proposed Budget
Year Activity Cost
2018 Literature review and
collecting secondary data
10
Selecting the sample size for
participants and choosing the
participants
10
Designing intervention plan 20
2019 Selecting and mobilizing
partner organizations,
sponsors and other
stakeholders
10
Resource mobilization 15
Workshops and trainings for
program persons and staff
20
2019/20 Intervention activities 85
2020 Program report writing 15

OBESITY PREVENTION AND CONTROL IN SOUTH AUSTRALIA 26
Evaluation of program 15