Health Promotion Program: Obesity Prevention Grant Application

This document is a comprehensive health promotion grant application, targeting the prevention of obesity in Aboriginal children aged 5-15 years residing in the Northern Territory, Australia. The application meticulously details the critical need for the program, highlighting the disproportionate rates of obesity and related health issues within the Aboriginal community, supported by national, state, and local data. It examines the socio-economic, cultural, and environmental determinants contributing to childhood obesity, emphasizing the importance of addressing these factors holistically. The program's solution is presented through a detailed outline, including the overarching goal to reduce childhood obesity, along with specific, measurable objectives. Evidence-based strategies are proposed, encompassing population and individual-level approaches such as nutrition supplements and community-based initiatives like cooking classes and food supply improvements. The application also provides a robust evaluation plan, ensuring the program's effectiveness and sustainability, referencing health promotion theories like the Ottawa Charter and planning frameworks. The budget requested is between $250,000 - $300,000. It aims to improve accessibility, impact and appropriateness of the health program among the children aged 5-15 years in aboriginal community, Northern Territories, Australia.

HEALTH PROMOTION
PROGRAM Grant
Application form 2019

PLEASE READ THE GRANTS GUIDELINESBEFORE PROCEEDING.
Please answer all of the questions in the application in full and submit this form. This is the only form you will
be submitting.
Application closing date is: Tuesday 1st October 2019 5.00pm
Please enter your application through the AT2 dropbox via TURNITIN.
For further information or assistance contact:
Teresa Capetola
Email: [e-mail]
APPLICATION SUMMARY
Program title
A short statement capturing the nature and intent of
the program.
Prevention of obesity in aboriginal children aged
5y -15yrs in Northern Territory, Belyuen,
Australia
Location
Where will the program take place? (local area)
Who is the lead agency?
Northern Territory, Belyuen, Australia
Duration
What is the start and finish date for the program?
January 2020 – September 2020
Amount of funding requested
This should be between $250, 000 – 300,000 and be
supported with a budget as an Appendix.
$ 271,200.00
CONTACT PERSON FOR DAY-TO-DAY ENQUIRIES

APPLICATION SUMMARY
Name
Organisational ID (Deakin):
Email address
Who will the program benefit? The children aged 5-15 years of the Aboriginal
community living in Belyuen, Northern Territories
How many people will attend, participate, or
benefit from the program?
Include an actual estimated number of people or
estimate of the minimum and maximum numbers.
The whole aboriginal community, children, parents,
family, school staff, community stores, will
participate. According to Australian Census 2016,
there are 164 people living in Belyuen of aboriginal
ancestry who will benefit from the program
holistically.
THE PROBLEM (NEED) - 1000 words
Health issue and community context
 Provide a clear description of the community and the need the program is responding to.
 What evidence is there that this is an issue? What is the data and literature saying (at an national, state and
local level)?
There exists a phenomenal disproportion of mortality and morbidity figures among Aboriginal Australians in

comparison to the non-indigenous population of Australia, which can be proved from the gap exceeding 10 years in
the average life expectancy. One of the main reasons, which contribute, to the widening gap is obesity, which is a
problems that needs to be tackled from childhood. As per Thurber et al, (2014) 2012-2013 figures show that more
than 1/3rd of the aboriginal children suffers from obesity between the age group 2-14 years. As the rate continues, by
the time the child reaches adulthood, the percentage increases to being 66%. This is a major factor contributing to
lower average life expectancies in comparison to their non-indigenous counterparts. Moreover, some other affects of
childhood obesity increases with rise in Type2-diabetes, among the aboriginal children, which decreases the average
life expectancy by 27 years. Moreover, the childhood obesity is another risk factor, which contributes to other
chronic diseases, cardiac problems, weakening muscular-skeletal systems etc. Being overweight since childhood has
other repercussions on the emotional, psychological and social parts of life that wholly contributes to economic
consequences, loss in productivity among individual and community level (Mihrshahi et al., 2018). Hence, reducing
obesity should be tackled from the grass-root level from childhood, as it is the right time for prevention of obesity
and over-eating; and to reduce morbidity in adulthood. Early intervention hence is seen as the right approach in
tackling risk of obesity and lessening the gap.
Figure: Prevalence of obesity among school-going children according to SES status
Source: (Mihrshahi et al., 2018)
The current interventions at reducing childhood obesity have found various interacting factors, which leads to
childhood obesity, namely behaviour, environment, genetics, culture metabolism rate and socio-economic factors.
However, the current intervention plans ignores the main factors involving environmental, socio-economic and
cultural factors, which leads to childhood obesity among the aboriginals (Thurber et al., 2014). The interventions
fail to include health behaviour and habits corresponding to poor nutrition and physical inactivity, due to lower
socio-economic status and environmental factors contributing to the disease. Even though diet pattern, genetics and
metabolism rate have a major effect in increasing obesity, socio-economic and cultural reason also do exist, that
raises risk of obesity and other risk behaviours. Among the disadvantaged group, there exist various barriers of
socio-economic and cultural patterns, which make it impossible for these SES communities to imbibe and modify
their habits and behaviours to reduce obesity. Such factors include low-income status, poor education levels,
cultural gap, insecure housing, low access to social needs and unemployment. The obesity figures among children
aged 2-17 among aboriginal communities in Australia is more among boys than among girls (Dawson et al., 2017).

Figure: obese children 2-17 years in indigenous communities
Source: (Dawson et al., 2017)
The people from low-SES communities, mostly children focus most on food, which is promoted through advertising
that appeals to taste and eyes, without understanding the health repercussions. Heavily marketed food, rich in trans-
fats, oil, high cholesterol, are least healthy and more uptake by these children. Moreover, in Australia the most
advertised food near primary schools are soft drinks and sweetened drinks, which rises diabetes and obesity
(Thurber et al., 2014). Cheap food, which is unhealthy, is more readily available and is bought by low-SES children,
thereby increasing their risk of obesity. Conducting obesity programs without invigorating the socio-economic and
cultural elements cannot provide heavy impact on prevention or reduction in obesity.
Hence, the need arises to generate a health program, which properly envisages imbibing socio-economic, cultural
and environmental factors while tackling obesity among the aboriginal children aged 5-15 years. In indigenous level
studies, health programs that include the broad socio-structural issues like education, poverty, and cultural gap are
more likely to be successful, as it brings a holistic approach to the health program, instead of changing only diet-
pattern. The main success is attributed to the holistic approach of dealing with the problem-areas, instead of just
focusing on the solution. Hence, the wider determinants of health and social determinants of health need to be
linked through this program to effectively improve the reduction of obesity in children of aboriginal Low-SES
communities (Mihrshahi et al., 2018). Moreover, along with including social factor, the context that brings in
change, namely availability of food, accessibility and affordability of food must also be addressed.

Figure: Influencing sectors of Childhood obesity prevention
Source: (Mihrshahi et al., 2018)
Determinants
 Explain the context by identifying potential determinants surrounding the issue.
 Are there any strengths or assets in this context?
 What are the key characteristics or important socio-economic demographics of your targetpopulation?
 Support explanation with appropriate diagrams, figures and/or tables
The people belonging from Low-SES aboriginal community experience disadvantages pertaining to social and
economic factors at a wider scale in comparison to non-indigenous population. The main reasons for rising health
gap in this community is socio-economic issues, contributing to half of the gap in life expectancy in the population.
One important measure to reduce obesity is to improve the diet pattern of the aboriginals, include more fruits,
vegetables, and reducing intake of processed, high-sugar, high-sodium calorific foods.

Figure: Health facts for Aboriginal children eating junk food
Source: (Browne et al., 2009)
Moreover, intake of 1 apple per day reduces the spending on cardio-vascular problems by $160 million each year,
among indigenous population (Browne et al., 2009). Diet changes are influenced by factors like income-level,
education, housing, sanitation, and food supply, in order to understand implication of fruits, vegetables in diet, on
storing or cooking meals, and accepting healthy food-options. Ironically, cases where food security is less there is
high chances of obesity. Healthy food is more expensive then unhealthy options, and if food supply is care,
consumption of unhealthy, calorie-rich food is more among people having low education and income levels
(Thurber et al., 2014).

Figure: Cost of healthy vs. unhealthy food available in community stores of aboriginal communities
Source: (Thurber et al., 2014)
Therefore, most children in aboriginal communities tend to consume food rich in energy density and low in energy
cost. High energy density foods are mostly hg in calorie, sugar, trans-fats and are unhealthy which increases weight
and leads to various morbid situations. Moreover, the unaffordability of healthy food options in disadvantaged
groups increases relative deprivation, and ultimately leads to food insecurity and scarcity. In remote areas, this food
insecurity is heightened to new levels than in urban areas, due to their low socio-economic status, unaffordability
and due to neighbourhood disadvantages (Pollard, 2013). Remoteness also promotes risky health behaviour,
wherein local stores mostly rely on supply from suburbs, which can be hampered due to natural, political or
transport problems. Moreover, there may not be proper infrastructure to store healthy perishable food-items. Food
basket in Northern Territory is 45% costlier than in capital cities like Darwin. In suburbs, poor accessibility and
low-income-level also construe to reduce eating healthy foods, interplaying with factors like transportation,
availability of fast-food eateries, culture, budget and busy lifestyles. These impacts are more prominent during the
childhood phases, which ultimately shape the child’s personality, attitude, which further increases need for
interventions during early childhood (Thurber et al., 2014).
THE SOLUTION (Program outline) – 1500 words
Provide a description of your program including:

- Goal
- Objectives
- Program strategies (evidenced-based), and
- Evaluation plan
The health program plan includes the goals, objectives, evidence-based strategies, along with proper evaluation
plan, using health promotion theories like Ottawa Charter, and planning frameworks following Central Sydney Area
Health Services plan, partnership organizations, in developing the program.
Vision
The goal of the health program “Action Plan to Tackle Childhood Obesity among Low-SES and Aboriginal
Communities” is to provide an equity based health approach to provide effective, appropriate health services to
address the problem of childhood obesity among Aboriginal population in Northern Territories, Australia.
Goal
To reduce the childhood obesity, utilizing wider determinants of health approach and improving impact through
evidence-based actions among 5-15 year old children in Aboriginal community of Northern Territories, Australia.
Objectives
 To improve accessibility, impact and appropriateness of the health program among the children aged 5-15
years in aboriginal community, Northern Territories, Australia.
 To improve community-based participation in improving the social determinants of health factors among
the community and educate children to reduce obesity
 To engage various stakeholders and family participation to reduce the childhood obesity through creation of
proper environmental feasible to reduce obesity from grass-root level
 To enable accessibility of proper health-services, through partnerships and interactions through dissolving
transportation issues and issue of remote living
 To create a policy based on socio-economic, cultural and environmental factors for reducing relative
deprivation in order to develop personal skills in tackling childhood obesity
Strategies:
Population and individual level approaches
Nutrition supplements and Food fortification through supplementing folic acid requirements to improve
haemoglobin concentration are to be provided. Vitamin B12 supplements, along with iodine fortification to reduce
thyroid and goitre are other measures (Pollard, 2013). To address anaemia among children micronutrient sprinkles
are to be done, addressing the issues in inadequate food supply.
Income management action plans for improving the income status and wellbeing among aboriginals of Northern
Territories, along with taking measures to reduce alcohol dependency and wasting income on drug addiction. This
will enhance social security and increased spending on groceries, nutritious food, and reduce spending on tobacco,
drugs, alcohol and gambling. Improving responsibility of females in family is vital.
Community-based programs
Multi-strategy community projects through activities and interventions like holding cooking classes, courses on
reducing stress, diabetes, obesity, store tours, sorts, walking tours, informal education regarding childhood obesity
and diabetes are to be featured (Browne et al., 2013). Cross subsidisation, programs with linking government are to
be followed to reduce price of fresh foods, along with development of sports infrastructure to increase physical
activities in life. Trainings on nutrition, dietary requirements, physical activities through participation of family,
schools, and seniors in community are essential.
Food supply improvement drives features increasing food supply, accessibility and affordability through
improving local food production techniques, community gardening, home gardens, school gardens and improving
the food retail outlets. Removing sugary drinks counter, placing calorific value in each package, asking local

manufacturers to voluntarily stop resorting to trans-fat and sugar during food processing, and asking store managers
of outlets to improve food supply are some necessary steps (Lee and Ride, 2018).
Education programs run through schools, for educating children from grass-root level, in workplace and
institutions to educate the family members are some serious drives. Education can be provided by the trained
aboriginal workforce on need of proper diet, physical exercise an removing intangible factors like deprivation and
psycho-social factors are some effective steps.
Nutrition and Budgeting programs helps in enabling families in cooking healthy meals along with saving money
while purchasing grocery to inculcate nutrition knowledge, confidence and proper dietary behavior. This education
programs are targeted at the adults so that they emphasize the learning on the diet pattern of the children.
FOODcents had already done such a program till 2016 (Pettigrew et al., 2018).
Life-style modification programs include addressing socio-economic, cultural and environmental factors of the
aboriginals and envisaging creating modifying activities to imprint better health behavior, and healthy lifestyle. The
activities helps in increasing need for physical exercises, nutrition diets, opting healthy options, reducing spending
on addiction, improving effort of females in families, and workshops to promote good nutrition, healthy weight and
physical activities among children.
Evaluation plan
Process based evaluation- the process-based evaluation is to take place using quantitative primary data collection
using surveys, which are based on proper health behaviors, and changing dietary patterns. The main stakeholder
participants includes parents of children, primary school heads, directors of schools, care-centers, youth aged 13-15
years. Moreover, the process-based evaluation is based on the strategies followed according to the plan, through
surveys, and interviews (Lee and Ride, 2018). These measures will enable understanding reach of the program and
interviewing the target audience and their families will enable understanding the effectiveness of the process of the
health plan.
Impact-based evaluation- the impact-based evaluation is evaluated based on two major outcomes, 1) changes in
health behavior of children, communities, families, organizations, and environment to impact obesity, 2) changes in
total number of children from being obese to having healthy weight and better quality in life. The evaluation is to be
done based on three sectors, within early childhood population, schools, community stakeholders, and among
children aged between 5 to 15 years. The communities pertain to the low-SES communities, and aboriginals who
are the target population of this program. The impact-based evaluation is to be carried out among the target
audience and the report will be based on impact of program strategies and interventions upon healthy weight
management and decreasing child obesity among aboriginal community in Northern Territories (Schultz, 2012).
 Explain why your approach is the best way to engage the target population and help them get to the
intended results. Justify using health promotion theory.
 Describe how the overall program and individual program strategies are evidence-based and informed by
best practice and/or incorporates innovative practices.
 Provide information about the groups and/or organizations you will partner with for the delivery of the
program and how your program will adopt a collaborative, cross-sectoral approach to the issue/s it is
seeking to address.
 Demonstrate your understanding of how planning tools (such as planning frameworks and agency planning
documents) and health promotion theory and frameworks are used to assist in developing the program and
evaluation plan.
Applying Ottawa Charter for reducing childhood Obesity
As per the Ottawa Charter the five main areas for improving childhood obesity among children aged 5-15 years in
Northern Territories, includes building healthy public policy in relation to childhood obesity, generating supportive
environment for seamless implementation, strengthening community programs, re-orienting existing health
services, and developing personal skills to reduce childhood obesity. Within the ambit of reducing childhood
obesity, improving personal skills towards reducing obesity among aboriginal children includes, providing healthy
diet for children aged 5 to 15 years. A guide to regulate proper energy intake requires proper dietary requirements,

including vitamins and minerals through vegetables and fruits, reducing intake of spicy, preserved and sweetened
products, equal proportion sizes 3 times a day, and regular physical exercises (Flynn, 2015). Reduction of
carbohydrate intake and increasing protein within diet is another individual level development.
For re-orientation of health services, is to reduce obesity and co-morbidities like Type2 Diabetes among the
aboriginal children. Improving cultural, socio-economic factor through inter-governmental efforts along with
interaction with obesity-related organizations and groups will help in re-orientation of health services assimilating
obesity and diabetes among aboriginal children. Reducing the barriers o communication, cultural gap is essential for
reorientation, which can be supported through community-based programs, and roping in role models to increase
awareness. To strengthen community actions, community-based interventions and prevention plans are to be
undertaken, to increase participation of families, schools, education and society as a whole to improve their
awareness about problems for obese children in future. Surveillance of weights of children in schools, and using
evaluation strategies through data on the BMI, growth-rate and body proportions will enable to understand the effect
of the intervention (Zivkovic et al., 2010).
Generating proper supportive environment can be done through calorie menu labels for each food item, improving
government policies on health and obesity, implementing fat-tax and sugar-drinks levies. In addition, restriction on
junk-food ads, making certain food products available, issuing statements on food merchants to reduce trans-fat
during production, and creating an environment, feasible to reduce obesity in aboriginal children (Valery et al.,
2009). Proper public-health policy can be built through fortification programs, Health-star rating Calculator,
imbibing socio-economic, cultural and environmental factors in policies, regular monitoring and enforcement of
policies.
Partnership organizations
The plan adopts a collaborative and cross-sectional approach among partners and stakeholders to implement the
plan. Various partners include National Aboriginal Community Controlled Health Organization NACCHO,
Aboriginal Health and Medical Research Council AH&MRC, Aboriginal Medical Services Alliances Northern
Territory AMSANT, Healthy Food Partnership, Australian Institute of Health and Welfare (Hayman et al., 2014).
The other stakeholders and partners of implementing the health plan are the stakeholders involved, namely the
aboriginal community of Northern Territories, the children suffering from obesity, the family members, community,
school and social groups.
PROGRAM MANAGEMENT AND OUTCOMES: 500 words
• Briefly outline the proposed short or medium-term impacts of the program.
• Outline how the program benefits will be sustained once funding has ceased.
• Provide a basic logic model which includes: inputs, outputs (activities and participation), outcomes (short,
mid and long term)*
• Provide a basic budget including details and costings for staffing and program operations. *
• Provide a Gannt Chart or similar for a program implementation timeline. *
*Not included in the word count
Programme management and outcomes
Impacts
Short-term
impacts
 Engaging community stakeholders and target population within the
program capacity including the families, guardians, schools,
healthcare workers, store managers of community stores, from the