THAO Programme and its specifities
Rafael Casas, Scientific Coordinator of THAO Programme speaks about its specificities, achievements and expectations.
Rafael Casas is a medical doctor specialized in Psychiatry and Psychosomatic. He has a thirty years experience of qualitative research in the health care area, especially on food and physical activity habits. In 2005 he has been involved in the implementation of the EPODE methodology in Spain with the THAO Programme, officially launched in 2007 in 5 pilot towns.
The genesis of the THAO Programme and its implementation
In the beginning of the 21st century, there was almost no awareness about obesity as a huge public health issue that had to be tackled quickly. In 2005, the network of healthcare and public health professionals begun to alarm the population about the incredible increase of the childhood obesity prevalence in Spain. At this time, the International Obesity Task Force confirmed that the Southern European Countries had the highest rate of children with weight excess. From these catastrophic data, the Ministry of Health and Consumers Affairs, together with the Ministries of Sport and Education and scientific experts developed a national plan called “NAOS” (Strategy for Nutrition, Physical Activity and the Prevention of Obesity) recognized by the WHO as a global and cross-sectoral strategy. The THAO Programme, inspired by the EPODE methodology, came as a model of integration between national coordination and municipal leadership aimed at promoting healthier lifestyle and preventing childhood obesity through the development of a long-term community-based intervention. From 5 pilots towns in 2006, 96 towns are implementing THAO programme nowadays (see also the interview of the Prof. Varela from the Spanish Nutritionist Foundation).
The specificities of THAO Programme
One asset of the EPODE methodology is its transferability. As the programme was growing, it was important to adapt it step by step to the Spanish and Mediterranean context. Since the beginning, there has been a will of the THAO central coordination to adopt an emotional approach and actions using fun, pleasure and culturally specific communication towards the children and their families, supported by adapted tools and messages.
To sum up, the THAO programme is based on three key dimensions: Action, Evaluation and Communication. As regards the impact evaluation, to date the central coordination, under the guidance of its expert committee, is trying to complement BMI measurements by the analysis of the waist circumference (20000 children), and the monitoring of the food and physical activity habits. It is also important to develop other indicators e.g. in the environment of families such as urban planning parameters informing on the opportunities in favor of active transport in the community. In order to benefit from a good and global evaluation of the programme, the central coordination team is working on the development of a Thao evaluation protocol with a committee, made up of experts and members of the Computense University and the San Pablo CEU University from Madrid and the University of Santiago de Compostela (see also the interview of a THAO expert, Gemma Carreras).
The evaluation is always in progress and there is a lot to learn from the field. For that reason, in the framework of our process monitoring, the central coordination team is leading a qualitative research in several cities with key local stakeholders to know their perception and satisfaction about the programme (see also EEN Committee on Scientific Evaluation and Dissemination and interview of the SED Committee Research leader).
Achievements of the programme and further expectations
One important achievement is the acknowledgment and the notoriety of the programme among the scientific community, the institutions and the political representatives. In this respect THAO programme received last year the price for Health Culture 2010 from the Association of Health Education.
Another important signal is the continuous deployment of the THAO cities’ network: from 5 pilot towns, there are now 96 towns implementing the programme.
Beside that, the coordination team is working on the development of new technologies and the use of social networks to serve the programme’s objectives. As a result, three tools have been designed: one is a resource centre gathering a description of all the “best in class” actions implemented locally so that they can be shared among all the project managers through the THAO website; the second one is a web application to collect BMI and data from other evaluation questionnaires and finally the third one is a interactive web platform dedicated to children in order to involve them in the THAO activities. This last aspect is in line with our next challenge, which is the development of a specific obesity prevention programme (THAO-infancy) dedicated to children aged 0 to 3 years (see also the interview of Rafael Casas).