1. Diane Whaley, PhD Associate Professor, Curry School of Education Amy Boitnott, DNP, FNP-BC Assistant Professor, School of Nursing Mark DeBoer, MD, MPH Assistant Professor, School of Medicine

2. Childhood Obesity: Epidemiology Incidence has increased 33% over the past 30 years. In 1980 only 6.5% of children in all age groups were overweight or obese. Children’s Age Percentage clinically defined as Obese in 2008 2 to 5 years11 6 to 11 years19.6 12 to 19 years18.1

3. * 25 th heaviest state in the nation * 23 rd heaviest children in the nation * 30% of Virginia’s youth are overweight or obese * 38% of children in Charlottesville are overweight or obese

4. OBESE CHILDREN AGES 6 TO 11 YEARS OBESE CHILDREN AGES 12- 19 YEARS

5. Organ SystemCondition Cardiovascular Hypertension Dyslipidemia Heart disease Endocrine Type 2 diabetes mellitus Metabolic syndrome Pulmonary Obstructive Sleep Apnea Syndrome Musculoskeletal Slipped capital-femoral epiphysis Blount’s Disease (tibia vara) Psychosocial Depression Relationship impairment Alterations in Quality of Life Body dissatisfaction Low self-esteem

6. Child’s Behaviors Child’s Expectancies for success Child’s Value for the behavior Parent’s perceptions of child’s competence Parent role modeling

7. SALUD study design Family Child Parent

8. Family Child Parent Physical activity curriculum Nutrition curriculum Parental counseling program Discussion forum Family dinner Nancy Kechner Quickstart Tennis SALUD study design Ellen Markowitz Angie Hasemann Amy Boitnott Gloria Rockhold Growing up Healthy

9. SALUD study design Hypotheses 1. A multi-faceted, community-based intervention targeting overweight/ obese children and their parents individually (SALUD) will result in improved competence and value: a) of parents, with respect to their ability to help their child be physically active and lose weight, and b) of children, with respect to their ability to exercise and make healthy food choices. 2. This community-based intervention will result in improved body-mass index and activity levels among the overweight/obese children. Overweight/ obese children Competence * Normal weight children Overweight/ obese children BMI z-score * Normal weight children 1. 2.

10. SALUD study design Southwood Southwood Mobile Home Park Owned by Habitat for Owned by Habitat for Humanity Humanity >50% Spanish Speaking >50% Spanish Speaking ~350 children <12 years old~350 children <12 years old >1/3 of children overweight/>1/3 of children overweight/ obese obese

11. SALUD study design Initial session Parents Children Family Data collection: Height, weight, BMI Family size Surveys: Competency eval Quality of life (child) Intervention: Parental counseling Data collection: DOB, grade Ht, wt, BMI %tile Surveys: Competency eval Quality of life Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy

12. SALUD study design Initial session Parents Children Family Data collection: Height, weight, BMI Family size Surveys: Competency eval Quality of life (child) Intervention: Parental counseling Data collection: DOB, grade Ht, wt, BMI %tile Surveys: Competency eval Quality of life Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy Data collection: Attendance Intervention: Parental counseling Data collection: Attendance Ht, wt, BMI %tile Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy Monthly sessions (x4)

13. SALUD study design Initial session Parents Children Family Data collection: Height, weight, BMI Family size Surveys: Competency eval Quality of life (child) Intervention: Parental counseling Data collection: DOB, grade Ht, wt, BMI %tile Surveys: Competency eval Quality of life Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy Data collection: Attendance Intervention: Parental counseling Data collection: Attendance Ht, wt, BMI %tile Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy Data collection: Height, weight, BMI Family size Intervention: Parental counseling Data collection: DOB, grade Ht, wt, BMI %tile Healthy meal Intervention: Quickstart Tennis Growing-Up-Healthy Surveys: Competency eval Quality of life Surveys: Competency eval Quality of life (child) Final sessionMonthly sessions (x4)

14.  Recruitment:  Community Leader  Setting:  Covenant School  Workforce:  Student volunteers

15. 5-6pm Families welcomed Non-participant siblings engaged in activity & games area Participant data collected 6-7pm Parent group intervention© Quickstart Tennis© Growing Up Healthy© 7-8pm Family dinner, together with volunteers

17.  Parent’s and children’s BMI decreased slightly  However, heaviest participants dropped out  Parent’s perceptions of their child’s sport competence and their modeling of healthy behaviors improved (p=.1)  Children’s sport & healthy eating competence did not improve, nor did children’s fruit & veggie consumption