Background:

A Green Prescription (GRx) is written advice for physical activity given by a GP or practice nurse. This health initiative is managed by Sport and Recreation NZ (SPARC) with funding from Pharmac.

Nationwide since 1998, GRx has traditionally been prescribed for adults; however primary health care providers have been increasingly contacting the Green Prescription (GRx) Area Managers throughout NZ with inquiries about Green Prescriptions for children and families. A gap has been identified in the community for a collaborative approach in the treatment of children and youth who are at risk of suffering adverse health affects from being overweight or obese. In 2005 SPARC has funded programmes in Auckland Central, North Shore, Waikato, Hawkes Bay, Tasman and Canterbury.

The children and young people mentioned above, are not taking part in sports based activities and SPARC research shows that activity levels in this age group are declining. Sport programmes are neither suitable nor appropriate for children whose needs are greater and wider ranging in terms of improving their overall health status and lifestyle. The barriers to participation for the child or young person can range from being inaccessible, unaffordable, lack of parental support, lack of confidence and self-esteem.

Programme details:

The GRx Active Families programmes are community based health initiatives designed to address the issues of childhood obesity and related health problems for children and young people aged 5 – 18 years of age and their whanau/families, with a focus on children aged 5-12 years. It enables them to embrace, healthier and more active lifestyles that are sustainable, through encouragement and education, nutritional guidance and advice, realistic goal setting and ongoing support. Each programme provides support for a minimum of 35 children and young people and their families.

Referral Procedure:

Referrals are by dietitians, GP or practice nurses, Public Health nurses and paediatric specialists. Prescriptions require GP's sign off to obtain current health status and ensure their GP is kept informed of the families' involvement in the programme. Criteria is a BMI over 25 along with either weight or height over the 95^th percentile.

Support Process:

From the initial referral date it is expected that the child and family will be involved with the programme for at least a 6 -12 month period. Commitment by the family to make significant lifestyle changes is essential to the success of the programme.

Group Activity/Support Sessions:

Group Activity Sessions are held weekly at community Leisure Centres and include goal setting and review, nutritional advice, a physical activity session, working as a group on individual goals/achievements including circuits, modified games and aquatic activities.

Information and education about health, well-being and physical activity are provided.

Participants and their families are encouraged to join in the activities and to take ownership of the programme. They often form friendships and social interactions between families.

Ongoing Monitoring/Evaluation:

Long term goal for each participant is 60 minutes of moderate intensity activity most days. Regular monitoring and testing of each participant is conducted to measure the progress and effectiveness of the programme, in conjunction with Dietitians, to align with expected improvements in overall health status and reports to the referrer.

Exit Strategy:

Providing the long term goal of being moderately active for at least 60 minutes on most days has been achieved on a sustainable basis along with the expected improvement in health outcomes, an exit strategy addresses the "where to from here?" Linking the participant to other activities in the community – such as sports and outdoor pursuits can ensure the lifestyle change is maintained including daily physical activity by the whanau/family – new goals can be set for their maintenance phase – for life.