Effectiveness of a multi-faceted,school-based health intervention program with 4th graders in Alabama

Childhood obesity is considered one of the most prevalent, chronic disorders in the U.S. with Alabama among the states with the highest incidence. Schools have the opportunity to play a vital role in educating children about healthy nutritional, physical, and psychological choices. The purpose of this multi-faceted, school-based health intervention was to educate children about healthy nutrition, promote physical activity, and use avatars as an educational and motivational tool for understanding and developing healthy bodies. Six fourth-grade classrooms in rural Alabama participated. The intervention group consisted of 25 males and 26 females (43% African-American, 57% European-American; 26% obese, 14% overweight) who received a 10-week nutrition education program that incorporated classroom physical activity and exposure to avatars. The control group consisted of 30 males and 24 females (41% African-American, 59% European-American; 28% obese, 15% overweight) who received no intervention or initial avatar exposure. Repeated Measures Analysis of Variance determined that only intervention children significantly improved their healthy food choice intentions, ability to identify fatty foods, and general nutrition knowledge at posttest. Additionally, most intervention students reported that manipulating their avatar's body size helped them think about healthy weight (86%-helpful, 12%-somewhat helpful) and their own best, healthy body size (76%-yes, 22%-maybe). Intervention children picked healthier avatars as their ideal/desired body size at posttest. This intervention improved nutrition knowledge and attitudes and provided preliminary evidence that avatars can be a useful tool in childhood health interventions to help elementary school students think about healthy weight and body size.     

Scaling up a community-led health promotion initiative: Lessons learned and promising practices from the Healthy Weights for Children Project

The increase in overweight and obesity among children has emerged as an important public health issue. This trend has highlighted the need for accessible and novel approaches to support healthy weights for children and their families to prevent childhood obesity. The purpose of this article is to describe the iterative development and scale-up of a community-led, national-level project to promote healthy weights among Canadian children and families who may be experiencing vulnerabilities. In this project, the Healthy Together program was designed to engage families in an interactive program to support healthy lifestyles. The program also provides a platform for creating supportive environments for healthful lifestyles through practice and policy change. Based on a process evaluation, we describe the iterative development of Healthy Together from Phase 1 through 3 to shed light on processes shaping implementation and scale-up of the program. Lessons learned during each phase were used to refine the program and further expansion. Indicators of successful scale-up include the Healthy Together program’s cross-jurisdictional reach and promising evaluation results in real-world conditions. The practice-based program scaling approach provides practical guidance for planning and implementing similar health promotion programs in diverse communities.     

Mexican American birthweight and child overweight: unraveling a possible early life course health transition

Mexican American children have a weight distribution that categorizes them as relatively healthy at birth but relatively unhealthy by age 3. This early life course transition in health based on weight raises the question of whether Mexican American children "outgrow" the epidemiologic paradox of favorable birth outcomes despite social disadvantage or whether their birthweight distribution places them on trajectory for overweight in childhood. We address this question using newly available 9-year follow-up data from the Fragile Families and Child Wellbeing birth cohort study linked to pre-natal medical records. We systematically investigate the roles of birthweight, pre-natal factors, and childhood factors in explaining racial/ethnic differences in childhood overweight. Our main finding is that Mexican American children do outgrow the paradox: Their rates of childhood overweight are higher than expected given their birthweight distribution. Observed pre-natal and childhood factors do not explain the elevated rates of overweight among Mexican American children.     

Australian Social Work Reviewers 2010

Abstract

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care.     

The Impact of Stigma on the Child with Obesity: Implications for Social Work Practice and Research

Childhood obesity has greatly increased in the past 20 years and is highly stigmatized in today’s society. The effectiveness of obesity prevention efforts is threatened by the systemic impact of stigma that surrounds obesity. As childhood obesity increases so to does the responsibility of social workers to implement multi level interventions that not only assist children who are experiencing stigmatization, but are aimed at reducing stigmatization. This article reviews the origins of overweight stigmatization and the psychosocial influences of such stigmatization. The implications for social work practice and research from a systemic approach are addressed.     

Evaluating a social marketing campaign on healthy nutrition and lifestyle among primary-school children: A mixed-method research design

Italy has one of the highest levels of childhood overweight and obesity in Europe. Therefore, preventing children from becoming overweight is a major public health challenge. Here, we used a mixed-method research approach – including a quasi-experimental design and three surveys – to create a formative evaluation of a social marketing campaign on healthy nutrition and lifestyle in Italian primary school children. The social marketing campaign was organized around the 4 Ps of the marketing mix (product: the educational activities; place: the involved schools and supermarkets; promotion: the in-person and technology-based communication; and price: hours spent by the targeted children in fulfilling the educational activities). The campaign involved primary-school children across four Italian cities. The findings suggest that social marketing education campaigns can be effective tools to improve children’s knowledge about healthy food and lifestyle, reduce their sedentary behavior, and increase their consumption of healthy food. Also, increasing children’s acceptance of healthful nourishment is a valuable tool to improve the dietary habits of the entire family. With relation to the educational program assessment method, this study can inform societal interventions especially those involving children through the integration of different qualitative and quantitative research methods, which collect data from different subjects and perspectives.     

Parent adoption and implementation of obesity prevention practices through building children's asking skills at family child care homes

BackgroundEarly childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP’N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children’s asking skills for healthful home environmental change through curricular activities.ObjectiveTo evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH.MethodsFCCHs (n = 5 settings) and children (n = 25; aged 3−5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities.ResultsFCCH providers implemented 83%–100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06).ConclusionsIt is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.     

Humor Your Way to Good Health

ABSTRACT

Although humor has been used in many ways, humor practices have not been fully conceptualized or utilized as a means to impact major concerns on a societal level. In this intergenerational model demonstration, humor practices were re-conceptualized and used as an effective vehicle for communicating messages to impact a societal issue, overweight and obesity among children. This objective was operationalized through an intergenerational project of the Legacy Leadership Institute on Humor Communication and Health (LLIHCH). Legacy Leaders were trained to use humor practices to convey messages about healthy eating and physical activity to children. They participated in interactive instruction on key topics (nutrition, humor practices, intergenerational relationships, children and schools, leadership, and instructional methods. Legacy Leaders used this training to conduct the Humor Your Way to Good Health program in two public elementary schools. Assessments indicate the children benefit significantly from the Humor Your Way to Good Health intergenerational program in terms of the knowledge acquired and its application to making choices that support healthy behaviors. The unique humor approach captures the attention and imagination of children. The intergenerational approach unites children and adults in a joint quest for healthier lifestyles. Together, they are addressing the epidemic of overweight and obesity among children.     

The impact of child obesity on active parental consent in school-based survey research on healthy eating and physical activity

Previous studies have shown that active consent procedures result in sampling bias in surveys dealing with adolescent risk behaviors such as cigarette smoking and illicit drug use. To examine sampling bias from active consent procedures when the survey topic pertains to childhood obesity and associated health behaviors, the authors pair data obtained from both active and passive consent procedures. The authors find that parents of children who are overweight or at risk for being overweight are significantly less likely to give active consent. In addition, parents of children enrolled in lower grades are more reluctant to consent to participate.     

Parental Work Schedules and Child Overweight or Obesity: Does Family Structure Matter?

The authors used longitudinal data from the Fragile Families and Child Wellbeing Study (N = 5,482) to investigate whether maternal and paternal work schedules affect child overweight or obesity. They took the novel step of examining whether this effect is consistent for children living in different family structures. Findings from child fixed effects models suggest that the probability of child overweight or obesity was higher for children living with mothers who worked standard shifts at a primary job and nonstandard shifts at a secondary job compared to children living with mothers who worked a standard shift at a primary job only. Fathers' work schedules were not associated with child overweight or obesity. Unexpectedly, maternal standard shift work at a primary job and nonstandard shift work at a secondary job was associated with overweight or obesity only among children living with married biological parents.     

Healthy eating and physical activity among low-income Hispanic adolescents and a school-based intervention

Hispanic and low-income adolescents have significantly higher overweight and obesity rates than others. This study described the nutrition and physical activity habits of a sample of 122 low-income, Hispanic adolescents and assessed the impact of their environment on their nutrition and physical activity. The study also assessed the outcomes of a pilot of a Farm to Table Chef Demonstration and Blender Bike intervention among a subsample of 16 participants. Family members' influence had a stronger positive correlation to healthy eating while friends' influence had a stronger positive correlation to exercise. The intervention piloted was statistically significantly associated with an increase in vegetable consumption.     

Childhood Obesity: An Overview

This article reviews recent research evidence, largely from systematic reviews, on a number of aspects of childhood obesity: its definition and prevalence; consequences; causes and prevention. The basis of the body mass index (BMI) as a means of defining obesity in children and adolescents is discussed: a high BMI for age constitutes obesity. In recent years the prevalence of obesity has increased dramatically across most of the world, and in the UK obesity prevalence is high and continuing to increase. Despite a widespread perception that obesity in childhood or adolescence is a cosmetic issue, the research evidence shows that it does matter to physical and psychological health and that there are adverse health risks for both the obese child and the adult who was obese as a child. Few interventions aimed at preventing or treating childhood obesity have been successful. There is an urgent need for more research on better strategies that will enable children and adolescents to make long‐term changes to their dietary and physical activity behaviour in order to prevent obesity.     

The Effects of Family Structure on Consumption and Exercise Patterns for Adolescent Youth

With over 22 million children considered overweight or obese, research needs to examine factors related to overweightness and obesity. Parents seem to have an influence on their children’s eating behaviors such as taste likes and dislikes and quality and quantity of food. Parents also seem to influence their children’s physical activity levels. A link between physical activity level and obesity exists, indicating that less active children have an increased risk for high BMIs, with children from single parent families having higher than normal BMIs compared to children from two-parent families. The purpose of this study is to examine whether family structure influences eating and exercise patterns of adolescent youth. The current study employed a secondary data analysis utilizing data from the HBSC (N = 6733). According to the data, participants engaged in approximately 3.76 healthy consumption behaviors per week and moderate levels of exercise (mean = 2.38). The linear regression analysis indicated a significant relationship between family structure and consumption patterns, as youth from single parent families, stepparent families, and multigenerational families have fewer healthy consumption patterns (?.256, ?.142, and ?.164, respectively) compared to youth from two-parent families. Healthy eating initiatives need to target both parents and children, as a relationship between consumption patterns and family structure exists. Additionally, future research needs to examine initiatives targeted at promoting physical activity, particularly among overweight and obese youth who are less likely to engage in physical activity.     

Problematic Eating and Food-related Behaviours and Excessive Weight Gain: Why Children in Out-of-home Care Are at Risk

Emerging evidence suggests that abuse and neglect in childhood may play a role in subsequent development of obesity. One population group particularly at risk is children and young people living in out-of-home care (OOHC). Given this population is already a vulnerable group, identifying potential mechanisms by which childhood abuse and neglect increases risk for obesity is essential. A possible explanation is that problematic eating and food-related behaviours (i.e., emotional eating, compulsive eating, overeating, binge eating, stealing or hoarding food) might mediate the association between adverse childhood experiences and obesity. Hence, the overall goal of this paper was to provide a narrative review of eating and food-related difficulties for children in care and their possible association with unhealthy and excessive weight gain. This review revealed a shortage of existing empirical papers and signalled particular need for further examination of the mediating effects of problematic eating.     

Emigration and Schooling among Second‐Generation Mexican‐American Children1

In this Research Note, we investigate the prevalence and patterns of second‐generation Mexican‐American children's migration to and return from Mexico during childhood and consider the consequences of this migration for their schooling. Around one in ten second‐generation Mexican‐American children live in Mexico for some of their childhood. Strong patterns of return to the U.S. through childhood argue for their being considered as part of the Mexican‐American second generation even when in Mexico. Their rates of school enrollment in Mexico are much lower than for second‐generation Mexican‐American children remaining in the U.S. and cannot be explained by their weakly negative selection into emigration. We conclude that country of residence is a far more important determinant of schooling outcome than is migrant status in that country.     

Reclaiming Futures: Using communication to drive community and systems change

Reclaiming Futures is a national juvenile justice reform initiative of the Robert Wood Johnson Foundation. During its 11 years of demonstration and expansion phases, Reclaiming Futures has used a variety of communications strategies, tools, and techniques to achieve its objectives. This paper describes the literature relevant to contemporary use of communications tools to achieve social change, and presents a brief history of how communications contributed to the development of Reclaiming Futures and how communications strategies were implemented at key points. A focus on communication principles and tools in practical terms is highlighted, including strategies for empowering project leaders to be effective messengers and for conducting outreach to community members, professional stakeholders, and elected officials, as well as examples of creative projects developed to advance program goals. Use of techniques such as branding, messaging, and integration of social media are also presented. Implications for other system change efforts are explored.     

Childhood body mass index gain during the summer versus during the school year

The nationwide increase in obesity affects all population sectors, but the impact on children is of special concern because overweight children are prone to becoming overweight adults. Contrary to the opinion of experts, research suggests that schools may be more part of the solution than the problem. Recent seasonal comparison research (comparing children's outcomes during the summer and during school year) reports that children gain body mass index (BMI) nearly twice as fast during the summer as during the school year. Whereas most children experience healthier BMI gain during the school year than the summer, this is especially the case for black and Hispanic children and for children already overweight.     

中国青少年健康发展情况及挑战

20年来,我国青少年在营养、体格发育、心理健康及生殖健康等方面均有不同程度的提升。但随着现代居住条件的改善、交通的发展,高脂、高蛋白、高热量等食物的过多摄入,学习负担的加重,体育锻炼的减少及电脑、网络的依赖加剧,青少年的身体机能和身体素质正在下降,超重肥胖、视力不良、心理健康、生殖健康问题等流行日趋严重,需要家庭、学校、社会、政府等各个层面给予高度关注与系统介入。     

The Impact of Religiosity on Health Behaviors and Obesity among African Americans

Religion has been associated with good physical health and may represent a protective factor against overweight and obesity. This study explored dimensions of religiosity associated with health behaviors—eating habits and physical activity—and obesity in the African American population. Data from the National Longitudinal Study of Adolescent Health were analyzed for 3,620 African American adults ages 28 to 34. A structural equation model (path model) revealed that high levels of church attendance combined with religious practice encouraged healthy eating habits. However, increasing time spent in prayer while making religion more important in life was associated with poor eating habits. More frequent church attendance and prayer were implicated in heightened levels of obesity, suggesting that various dimensions of religiosity were constructed differently with health behaviors and obesity.