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In Uganda, prevalence of overweight children from 9 to 11 is 20% in 2018 [1]. Overweight children are likely to be obese adults and have higher possibility of being noncommunicable diseases (NCDs) such as diabetes, cardiovascular diseases, or cancers [2]. NCDs as Uganda’s cause of death, has increased double fold from 16%-35% during the last 20 years [3]. Nevertheless, obesity prevention program from childhood is limited [2] and the effective program development is needed in Uganda [4-6].

Authors have organized the schoolchild obesity prevention project team with many stakeholders such as schoolteachers, health center staff, child health specialists, public health specialists, and nutritionists since 2018. This project team had conducted the school child obesity survey in 2018, then held the program development workshop in 2019 (Figure 1). In this workshop, sometimes it was hard to collaborate with many stakeholders and the authors discussed the needs of the review and evaluation of the workshop. However, the evaluation of this workshop has not been conducted. To be a better fruitful program development workshop, the purpose of the study is to evaluate the process of the workshop on schoolchild obesity prevention program in urban Uganda.

Figure 1: Overview of the study “Evaluation of Collaborative Workshop for Child Obesity Prevention in Urban Uganda

Significance of the study is to develop the better effective program more effectively and Ugandan children to grow up in healthy weight by attending the better effective program in future.

Study design was a descriptive study using the framework of “Keep this Problem Try these (KPT)” [7] This KPT framework is widely used to reflect, review, and evaluate the event. Keep these (good points) means the succeeded things, things to be continued in the workshop. Problem (challenges) means the challenges in the workshop and the things to be improved. Based on Keep and Problem listed, Try these (way forward) discusses the future plan to be kept and improved.

Study target of the evaluation were the program development workshop itself. Evaluation was done by authors (principal investigators and co-researchers).

The study team started the study after the Institutional Review Board (IRB) approval at Japanese Red Cross College of Nursing (Study Approval Number: 2019-063). Written consent of study was obtained from participants. The data was stored in a locked cabinet of author’s office to protect data and confidentiality of participants.

The workshop was held one day in November 2019 in Kampala, Uganda. The program was developed based on the results of the schoolchild obesity survey in 2018. Seven participants, three faculty members (public health specialist, nutritionist, and health informatics specialist) and four Ph. D. students of Makerere University School of Public Health, and one physical education teacher attended the workshop. Health center staff, school principal, and schoolteachers were not able to join because of their urgent business such as emergency consultation or students’ examination. Participants were recruited by the principal investigator and the co-researchers. The workshop consisted of icebreaking, the dissemination of the past schoolchild obesity survey in 2018, program development, presentation, and wrap ups.

Keep these good points

Participants’ diversed background benefited this workshop. The quality of the program was improved by this workshop because the workshop accepted variety of opinions. Participants were from various kinds of professionals (physical education, nutrition, public health, and health informatics) and could discuss from many points of view. For example, the public health specialist adviced the cultural and gender consideration for the program. The physical education teacher added the characteristics and behaviors of schoolchildren. The nutritionist mentioned about excessive snacking behavior effects on child growth and the health informatics specialist commented about the effectiveness of raising awareness using radio and internet in urban Uganda. Participants from Japan contributed to introduce good school health practice and their system in Japan since 1872. Japanese schools had school nurses and school doctors to prevent diseases doing check-ups and follow ups. These exchanges of their experiences activated the discussion.

It was also a good point that the workshop was evidence based. Prior to the program development, the evidence from the 2018 survey was disseminated. The lifestyle factors significantly relating obesity status of the participant schoolchildren (<.001) were; (a) Financial access to snacks; (b) Screen time such as playing TV games; (c) Sleeping late; (d) Less sleep hours. Participants realized the Uganda’s health challenges as their own issue and developed the program for children reducing these associated behaviors based on the evidence.

Nice facilitation and good atmosphere in the workshop activated the discussion. The facilitator was nominated amongst the authors. The facilitator engaged all participants to talk freely. All the participants commented and concentrated on hearing other participants’ opinion and discussed lively. When someone talked at the same time, another one waited. Then the facilitator encouraged another one to talk accordingly.

Problems and challenges

Not all stakeholders from 2018 study attended the workshop this time, and the workshop could not gather all stakeholders at the same time. Therefore the authors needed to discuss and modify the program via internet conference with absent stakeholders.

Another challenge was keeping schedule on time. Some participants came late during discussion and the facilitator had to explain the topic several times. These participants are working students and came from other districts using night bus although authors thought they had come from neighboring cities.

The other challenge was that the participants ran off the track when they got too much engrossed in their discussion in the latter part of the workshop. Facilitator needed to get back to the subject from the digression in limited schedule.

Try these way forward

Involving the diversed stakeholders succeeded in developing the better program from participants’ professional contribution; therefore, the authors will keep inviting different kind of stakeholders to the implementation, evaluation of the program. To mobilize more participants, authors will remind the recruited participants more frequently, a month, a week, a day before the workshop so that they can manage their schedule in advance. Evidence based program development shared the common rationale for the contents of the program. The authors will keep disseminating the evidence for participants as much as possible.

To keep the workshop punctually, we need to check the participants’ address and mobilize resources of accommodation for the participants staying the hotel in advance. To avoid the digression from the main point, the principal investigator should clarify and confirm the objectives of the workshop and participants’ role not only at the recruitment and the beginning but many times such as at the recruitment, the beginning, after the tea break, and at the end of the workshop. Deviation can be talked during tea break and wrap ups.

The study showed the importance of the diversed participants and many stakeholders’ attendance. The participants from other professionals and nationalities enriched the workshop. Diversity leads the fruitful discussion and benefits the beneficiaries.

Sharing the evidence also contributed to develop the evidence based program. To make a consensus among these diversed participants, the evidence will be a series of thoughts which people generally understand. The study also showed the necessity to mobilize the resources for workshop to keep participants’ condition depending on the participants’ backgrounds. At least accommodations, foods, and transportation fee should be covered for those participants.

Reminding the objectives and roles was the way to avoid the digression in the workshop. The workshop can be enhanced when all participants discuss on the same track. However, we should remind these digressions bring us unexpected idea.

Other findings were the potential of the workshop as a campaign tool to raise awareness on the schoolchild obesity prevention in Uganda. The program of schoolchild obesity prevention was developed collaboratively. So the workshop might have succeeded in involving and motivating the participants to be realized as the member of the schoolchild obesity prevention team. The participants themselves will also be the leaders of obesity prevention in their own schools, universities, and communities.

Based on the evaluation of the workshop, better workshop will be held in future to develop a better program. These collaborative workshops could help developing feasible obesity prevention programs as well as development of human resources of school health in urban Uganda.

The study showed the importance of the diversed participants, the evidence based program development, coverage of the participants’ travel fee, reminding the objectives and roles to utilize the workshop.

This study was supported by the Japanese Red Cross Academy grant for research into nursing, caring and the Red Cross and JSPS (Japan Society for the Promotion of Science) KAKENHI (Grants in Aid for Scientific Research) Grant in Aid for Scientific Research (C) Grant Number.