sustain healthier lifestyles. The intervention addresses diet and physical
activity through education, skills training and motivational enhancement.
Because of the importance of family involvement for behaviour change,
the intervention requires a parent or carer to attend all 20 sessions (over
10 weeks). The MEND 7–13 intervention was developed to be delivered in
community settings such as schools or leisure centres12 and delivered by a
wide range of health, physical activity and social care professionals.
Children are eligible if they are between 7 and 13 years old and overweight
or obese (hereafter referred to as overweight, defined as exceeding the
91st centile of the UK 1990 BMI reference). MEND 7–13 was demonstrated
in a randomised controlled trial (RCT) to be effective in reducing BMI of
obese children at 6 months from baseline.12
Between 2007 and 2010, the MEND 7–13 intervention was implemented
on a large scale, with MEND programmes (hereafter ‘programmes’) rolled
out across all regions of England. The intervention was delivered by local
community-based ‘delivery partner’ organisations. Intervention content
and training were provided to delivery partners by MEND Central, a social
enterprise.
Delivery partners recorded attendance of participants at each session,
and measured height and weight to the nearest 0.1 cm and 0.1 kg using
electronic scales following standardised procedures.
Self-esteem was reported by participants on a modified Rosenberg
Self-Esteem scale.13 Designed for adolescents, the 10 scale items13 were
modified to suit the younger age group (for example, wording such as
‘satisfied’ was clarified with ‘happy’ in brackets). Responses were on a