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Best Practices in Public Health Interventions regarding Adolescent Obesity Pat Stewart, PhD, RD LEAH Nutrition Discipline Coordinator Bionutrition Manager.

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Presentation on theme: "Best Practices in Public Health Interventions regarding Adolescent Obesity Pat Stewart, PhD, RD LEAH Nutrition Discipline Coordinator Bionutrition Manager."— Presentation transcript:

1 Best Practices in Public Health Interventions regarding Adolescent Obesity Pat Stewart, PhD, RD LEAH Nutrition Discipline Coordinator Bionutrition Manager CRC URMC 11/15/07

2 Objectives Review public health strategies and approaches to address child and adolescent obesity Review outcomes of adolescent school based interventions Highlight specific state legislation and innovative approaches that address childhood and adolescent obesity

3 Percent of 10 to 17 year olds who are overweight or obese

4 Percent of 10 to 17 year olds Overweight by Race/Ethnicity

5 Percent of 10 to 17 year olds Overweight by Income Level

6 “It is hard to envision an environment more effective than ours (in the USA) for producing obesity” Battle + Brownell

7 Med Clin N Amer (2) Best Practices Prevention should be the primary focus when considering a best practice approach to deal with the problem of childhood obesity Changes in the environment must be the crux of any public health attempts to address the epidemic

8 Preventing Childhood obesity Health in Balance IOM 2005 Dr Kaplan, chair of IOM Report on Preventing Childhood Obesity “changes are needed in our schools and communities, as well as at the national level. Just as it was imperative to make changes across society to protect youth from the hazards of tobacco smoking, it is now critical to alter social norms and attitudes so that healthy eating behaviors and regular PA become a daily part of life for our children and youth.”

9 Obesity Reviews (3): Public Health Strategies to Combat Childhood Obesity Breast Feeding Limiting TV/screen time Encouraging physical activity Increasing fruit and vegetable intake Controlling portion size Limiting soft drink consumption

10 /06_0082.htm Successful Health Policy Existence of sufficient evidence base Development of effective coalition Commitment of policy makers

11 Target Areas for Childhood Obesity Interventions: Primary health care Family based interventions School based interventions

12 Med Clin N Amer (2) School based interventions Are attractive because: Large contact time Existing organizational structures Reach a large number of children at low cost Natural lab for exploring impact of environmental change on eating and activity habits Life science, health and PE classes offer built in opportunity

13 Obesity Reviews (3), School Based Programs for Adolescents PATH – (Physical Activity and Teenage Health) - Fardy Planet Health - Gortmaker Frenn New Moves – Neumark-Sztainer

14 NIH Strategic Plan for Obesity Research TAAG – Trial of Activity in Adolescent Girls GEMS – Girls Health Enrichment Multi Site Studies HEALTHY – - A Middle School-Based Study to Reduce Risk Factors for Type 2 Diabetes in Children

15 Obesity Reviews (3), Summary of Interventions In general interventions have resulted in modest changes in behaviors and mixed results with indicators of obesity. TV watching seems to be most modifiable behavior, followed by PA and nutrition behaviors.

16 Obesity Reviews (3), Environmental studies 200 – 300% increase in purchases of healthy foods when prices were reduced by 50% Suggest the potential to influence behaviors related to obesity by changing environmental exposures

17 Am J PrevMed 2004;27(3S): Interventions targeted at children and adolescents: Eliminate soda vending machines at school Implement nutrition guidelines for foods sold anywhere in school Increase availability of fruit + vegetables in schools Regulate food advertising + marketing efforts targeting kids Ban advertising in school

18 Federal Initiatives to Support School Based Approaches Coordinated School Health Program School Health Index Physical Education Curriculum Analysis Tool School Health Policies and Programs Study School Health Profiles Division of Adolescent and School Health (DASH) Steps to a Healthier US

19 /06_0082.htm States Rule! Much of the authority for public health policy lies at the state level States may tie compliance to state funding

20 Topic Areas of State Legislative Initiatives Improving the quality of food sold in schools Limiting sale of less nutritious foods Improving PE + health education Encouraging PA in + out of school BMI reporting

21 Existing Legislation 17 states set nutritional standards for lunch, breakfast + snacks stricter than USDA 22 states have nutrition standards for competitive foods 26 states limit when + where competitive foods maybe sold Only 2 states do not require schools to provide health ed – (CO + OK) 12 states passed legislation to test BMI (most including provisions for communicating to parents)

22 Additional State Legislative Activity – 2006 Develop local wellness policies – 8 states Establish committees, councils, and task forces – 10 states Increase access to fresh produce – 8 states Promoting school nutrition – 7 states

23 sity/ Obesity Report Cards A - CA, NY + TN B – 19 states C – 19 states D – 6 states F - ID UT WY

24 sity/ Childhood Obesity Report Card

25 ty_final_with_correct_appendix_C. pdf States With Innovative Approaches AK + TX – worksite wellness at schools CA – state standards for beverage snacks and side dishes – school gardens ME – vending machine policy initiative MI – milk vending, requirements for recess + PE/policy for healthy options outside school lunch MT – healthy vending options/recess before lunch NC – Sybershop/vending machine restrictions/focus groups with families MA – provides grants for Healthy Choice Program RI – works with school based health centers awards mini grants to lead policy + environmental change WA – awards for school districts who have made policy changes

26 Innovative Approaches –Legislative and Non legislative 2006 CT - financial incentive for schools to offer healthy foods DE – physical fitness assessment to parents VA – superintendents educated on childhood obesity NV – constitutional amendment for daily PE MA – Every Body Move! MN – Governor certificate of recognition OH – Best Buckeye Healthy School WV – website showcases success stories throughout state

27 “Healthy America Initiative: wellness where we live, work, and play,” NGA Encourage + assist state governors in developing + implementing wellness initiatives Bring together public + private sectors Raise awareness of need for healthier lifestyles Bring together experts for solutions Seek out best practices + innovative programs Hold workshops and provide tools Improve state programs Urge governors to implement state employee health initiatives

28 Healthy Kids, Healthy America $110,000 grants for 10 states focusing on preventing childhood obesity through policy + environmental change

29 State Programs Funded by CDC to Prevent Obesity and Other Chronic Diseases

30 Alliance for a Healthier Generation Healthy Schools Program Let’s Just Play Go Healthy Challenge Beverage Guidelines for US Schools Guidelines for Snack Foods in Schools

31 Websites State differences in rates of overweight or obese youth tm tm State level summaries for school health programs University of Baltimore state report cards based on efforts to pass state measures How healthy is your state? Balance| State Action to Promote Nutrition, Increase Physical Activity and Prevent Obesity

32 sity/ Websites con’t State by state grantee information Childhood Obesity – 2005 Update and Overview of Policy Options _C.pdf State Approaches to Childhood Obesity/National Academy of State Health Policy _us.htm _us.htm CDC state funded grants to address overweight and obesity School success stories by state


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