children (mainly Pakistani and Bangladeshi origin) with excess adiposity are at particular risk from the cardiovascular
consequences of obesity. Many community-based children’s weight management programmes have been
delivered in the UK, but none have been adapted for diverse cultural communities. The aim of the Child weigHt
mANaGement for Ethnically diverse communities (CHANGE) study, was to culturally adapt an existing children’s
weight management programme for children aged 4–11 years so that the programme was more able to meet the
needs of families from South Asian communities.
Methods: The adaptation process was applied to First Steps, an evidence informed programme being delivered in
Birmingham (a large, ethnically diverse city). A qualitative study was undertaken to obtain the views of South Asian
parents of children with excess weight, who had fully or partially attended, or who had initially agreed but then
declined to attend the First Steps programme. The resulting data were integrated with current research evidence and
local programme information as part of a cultural adaptation process that was guided by two theoretical frameworks.
Results: Interviews or focus groups with 31 parents in their preferred languages were undertaken. Themes arising from
the data included the need for convenient timing of a programme in a close familiar location, support for those who
do not speak English, the need to focus on health rather than weight, nutritional content that focuses on traditional
and Western diets, more physical activity content, and support with parenting skills. The data were mapped to the
Behaviour Change Wheel framework and Typology of Cultural Adaptation to develop an intervention programme
outline. The research evidence and local programme information was then used in the detailed planning of the
Conclusions: The process of cultural adaptation of an existing children’s weight management programme resulted in
a theoretically underpinned programme that is culturally adapted at both the surface and deep structural levels.
Trial registration: ISRCTN81798055, registered: 13/05/2014.
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- Weight management