1. Delaware Survey of Children’s Health 2011 - March 7, 2013 Zhongcui Gao, Co InvestigatorJia Zhao, Co Investigator Judith Johnson, Team MemberMonica Burnett, Team Member Tiho Enev, Principal Investigator

2.  The Delaware Survey of Children’s Health (DSCH), funded by Nemours, is one of the most comprehensive surveillance instruments in the field of public health for Delaware children;  The survey data is used to guide NHPS and it’s partners programmatic work and to monitor children’s health outcomes at the state level;  DSCH contain s a broad range of information about health domains including healthy eating, physical activity, screen time, and emotional behavioral health. Introduction 2

3. Sampling Design  The DSCH features a two-stage cluster sample using random-digit-dialing (RDD).  The sample represents all Delaware households with one or more children younger than 18 years of age.  Sample size: 2006: N=3,055 2008: N=3,081 2011: N=3,207  The statewide sample allows comparisons among the following demographic categories: – Geographic locations : Kent County New Castle County Sussex County City of Wilmington 3

4. – Age groups:  birth through 5  6 through 11  12 through 17 – Race and Ethnicity:  Hispanic*  African American  White  Other * In the 2011 administration the Delaware Hispanic population was oversampled to increase the power of the analyses. Sampling Design 4

5. Section20062008-092011-12 1.Introduction & Screening 2.General Health 3.Schools and Child Care 4.Nutrition 5.Physical Activity 6.Screen Time 7.Neighborhood Characteristics 8.Family Functioning Family Functioning (Parent-child relationship) 9.Emotional &Behavioral Health- Emotional & Behavioral Health (age-specific scales) 10.Medical Care 11.5-2-1-AN AwarenessSocial Marketing5-2-1-AN Awareness 12.Demographics 13.Provider Information Survey Topics 5 NOT FOR DISSEMINATION

6. Demographic Characteristics: 2011 DSCH 6 Age Race / Ethnicity

7. Weight Status of Delaware Children Ages 2-17 (Based on BMI Percentile): 2006 - 2011 Body Weight 7

8. Weight Status of Delaware Children Ages 2-17 (Based on BMI Percentile): 2006 - 2011 8

9. Percentage of Overweight and Obese Children by Age Group: 2006-2011 Body Weight 9

10. Percentage of Overweight and Obese Children Ages 2-17 by Race and Ethnicity: 2006 -2011 10

11. Percentage of Overweight and Obese Children Ages 2-17 by Geographic Location: 2006-2011 Body Weight 11

12. Percentage of Overweight and Obese Children Ages 2-17 by Gender: 2006-2011 Body Weight 12

13. Percentage of Overweight and Obese Children Ages 2- 17 by Type of Insurance: 2011 Body Weight 13

14. Fruit and Vegetable Consumption  NHPS recommendation for children ages 2-17: –Children should have five or more servings of fruits and vegetables each day.  Measures of fruit/vegetable consumption in the 2006, 2008, and 2011 DSCH: –Thinking about yesterday, how many servings of fruit did your child have? –Thinking about yesterday, how many servings of vegetables did your child have? –Thinking about yesterday, how many cups of 100% fruit or vegetable juices did your child drink? (* Note : if the number of cups reported by parents is greater than 1, only 1 cup will be counted in the total daily fruit/vegetable consumption ) Healthy Eating 14

15. Percentage of Children Ages 2 – 17 who Eat 5 or More Servings of Fruits and Vegetables per Day: 2006 - 2011 Healthy Eating 15

16. Percentage of Children who Eat 5 or More Servings of Fruits and Vegetables per Day by Age Group: 2006 - 2011 Healthy Eating 16

17. Percentage of Children Ages 2-17 who Eat 5 or More Servings of Fruits and Vegetables per Day by Race and Ethnicity: 2006 - 2011 Healthy Eating 17

18. Percentage of Children Ages 2-17 who Eat 5 or More Servings of Fruits and Vegetables per Day by Gender: 2006 - 2011 Healthy Eating 18 NOT FOR DISSEMINATION

19. Average Number of Servings of Fruits and Vegetables per Day by Age Group: 2006 -2011 Healthy Eating 19

20. Physical Activity  2008 Physical Activity Guidelines for Americans: –Children and adolescents ages 6-17 should have 60 minutes (1 hour) or more of physical activity each day.  Measure of physical activity in the 2008 and 2011 DSCH: –“During the past seven days, on how many days was {selected child} physically active for a total of at least 60 minutes per day? (Add up all the time he/she spends in any kind of physical activity that increases his/her heart rate and makes him/her breathe hard some of the time.)” 20 Physical Activity NOT FOR DISSEMINATION

21. Percentage of Children Meeting the 1-hour Physical Activity Guideline by Age, Race/Ethnicity, Gender, and Weight Status: 2011 21 Physical Activity

22. Comparing Physical Activity Levels: 2008 vs. 2011  The percentage of children who meet the physical activity recommendation increased significantly from 38.9% in 2008 to 44.8% in 2011.  Significant increase occurred among : –Ages 2-5 (53.2% to 62.6%) –Ages 12-17 (26.9% to 33.3%) –Non-Hispanic White (38.8% to 49.5%) –Males (41.8% to 48.4%) – Females (36.3% to 41.1%) –Children living in Sussex County (43.7% to 51.7%) –Children living in Kent County (39.7% to 46.6%) 22 Physical Activity

23. Average Number of Days with 60+ minutes of Physical Activity per Week by Age, Race/Ethnicity, Gender and Location: 2008 & 2011 20082011 Sig. Mean Age groups Age 2-55.315.84<.05 Age 6-114.825.07 Age 12-174.074.44<.05 Race/ethnicity Hispanic4.365.06 NH-White4.745.26<.01 NH-Black4.654.58 Other4.585.12 Gender Male4.895.31<.05 Female4.464.82<.05 Location Wilmington4.684.78 New Castle4.604.99 Sussex4.805.28<.05 Kent4.745.21<.05 23 Physical Activity

24. Screen Time  NHPS recommendation for children : Children should have two hours or less of screen time a day.  Measures of screen time in the 2006, 2008, and 2011 DSCH : - On an average weekday, about how many hours does your child usually watch TV, watch videos, or play video games? - On an average school day/weekday, about how many hours does your child use a computer for purposes other than school work? Healthy Use of Media 24

25. Average TV Time by Age Group 2006 - 2011 Healthy Use of Media 25

26. Average Computer Time by Age Group 2006 -2011 Healthy Use of Media 26

27. Average TV Time for Children Ages 2-17 by Race and Ethnicity: 2006 - 2011 Healthy Use of Media 27

28. Average Computer Time for Children Ages 2-17 by Race and Ethnicity: 2006 -2011 Healthy Use of Media 28

29. Average TV Time per Day by Level of Physical Activity and Age Group : 2011 29 Healthy Use of Media

30. Sugar-Sweetened Beverage Consumption  NHPS Recommendation: –Children and youth should not consume more than two servings of sugar-sweetened beverages (SSB), specifically soft drinks, fruit drinks, and sports drinks per week.  DSCH measure of SSB consumption (2006, 2008, 2011) –Thinking about the last 7 days, how many cups of regular soda or other drinks containing sugar such as fruit-flavored drinks did [your child] drink? 30 SSB Consumption

31. Percentage of Children who Drank Less than Two Cups of Sugar-Sweetened Beverages per Week: 2011 31 SSB Consumption

32. Percentage of Children who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Age Group: 2006 - 2011 32 SSB Consumption NOT FOR DISSEMINATION

33. Percentage of Children Ages 2-17 who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Gender: 2006 - 2011 33 SSB Consumption

34. Percentage of Children Ages 2-17 who Drank Less than 2 Cups of Sugar- Sweetened Beverages per Week by Race and Ethnicity: 2006 - 2011 34 SSB Consumption NOT FOR DISSEMINATION

35. Parental Perception of Child’s Weight Status  Consistently, across all DSCH administrations, close to 80 percent of the parents consider their overweight children (between the 85 th and the 95 th BMI percentile) to be in the normal weight zone…  … and over 55 percent of the parents consider their obese children (above the 95 th BMI percentile) to be in the normal weight category. 35 Perception of Body Weight

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37. Perception of Body Weight 37

38. Dissemination  Press releases  Publications  Presentations  Electronic access – Nemours website  Availability of data for analysis to external parties 38

39. Electronic Access  To create an interactive data website, connected to and aligned in a seamless manner to the Nemours website, that will provide the opportunity for the community at-large to view and interact with the data and obtain information.  The website would provide access to measures of various health-related behaviors and domains and help inform a broad audience: –Partners –Communities –Researchers –Policy and Decision Makers –Providers and Caregivers 39

40.  Questions?  Contact Information: Tiho Enev tenev@nemours.org (302) 444-9246 40