Don’t Weight To Lose “Kids” Program Design Good looking logo. Should add kids somewhere in it. Make bottom writing come all in at once. Otherwise, too many animations… Overall Impression: I feel that you guys have done tons or research which is great. From this power point, I don’t feel that as much time was put into designing the program. I don’t know if there are things that you are adding during the presentation, but this is lacking a lot of specifics. You should be able to walk us through the program from 2 perspectives which makes your job much more difficult that DWTL. Make sure you specify KIDS with everything to make it unique. Talk to KC’s girlfriend and/or other teachers to figure out how kids learn, especially N.O kids. Don’t Weight To Lose “Kids” Program Design

Childhood Obesity Background The CDC findings: -80% of overweight children 10-15 y/o become obese adults by age 25 -Obesity in 6–11 y/o has climbed from 6.5% to 17.0% in past two decades; adolescent rate has tripled Good info, just break up into multiple slides. JC:where does Louisiana Stand? Ryan’s comments: Good, but details above are probably too much for the church meeting. KC’s comments: if at all possible, cite your facts at the bottom of the slide or with a footnote that is referenced on a “references” slide at the end of the presentation. Also, the chart is not very high yield in terms of the info presented. You can summarize in three bullet points the facts on the chart, though from the chart it looks like most schools actually DO teach the importance of decreasing sedentary activity, health-related fitness and benefits of physical activity. You could say, “over ¼ of schools do NOT teach these thing”. Additionally, it would help if you had stats from LA or New Orleans schools because I assure you the numbers are more grim.

Adolescent Obesity Background 65 % do not meet recommended level of physical activity 46% do not attend physical education classes 35% watched television 3 or more hrs/day -Only 18% of students could purchase fruits and vegetables -77% could purchase soda or fruit drinks that are not 100% juice Ryan’s: Add those mentioned and this is BIG!!! KC: make sure geographical context is referenced. Is this “in the USA”, “in LA”, “in the South”, “at Carlo’s mom’s house” or what? *2007 national Youth Risk Behavior Survey

Health Risks Associated with Childhood & Adolescent Obesity Type 2 diabetes mellitus Metabolic syndrome Polycystic ovarian syndrome Hypertension Neruological Advanced Maturation Cardiovascular Disease Dyslipidemia Pulmonary Gastrointestinal Orthopedic Psychosocial Renal Now are kids getting these diseases as kids, or are they at a higher risk when they get older? JC:Healthy People 2010 Recommendations should come after this slide. These recs are imperative to any health program as far as goals are concerned. Ryan’s: Good question, but the answer is probably not necessary for church meeting KC: I agree that the above question isn’t really relevant. Obesity (regardless of when you become obese) leads to these chronic conditions. This list of diseases is good and important. However, I think it needs to be stressed that by allowing our children to get obese we are giving them essentially NO CHANCE to avoid these chronic diseases and eventual debilitation.

Motivation for Change Economic Incentive Academic Performance School performance & test scores decrease in overweight children.* Inadequate consumption of nutrients affects cognitive function and has been linked to shortened attention span, irritability and fatigue. Daily physical activity can lead to increased test scores, particularly in math; enhances thinking ability and reduces disruptive behavior** Good News: Better food + More activity = Better grades! *Krukowski et al., Int J Pediatr Obese, 2009 ** Shephard, RJ, Pediatric Exercise Science, 2001 Economic Incentive Increased financial burden among obese population due to increased drug costs and outpatient visits. Good News: loose weight & cut costs! *Transande L et al., Obesity, 2009 Need to have Healthy People 2010 goals Good selling incentives Ryan’s: Try to make this into two slides. It’s relatable and again, BIG!!! KC: Guess what is more important than grades? TEST SCORES. Its all test scores to the schools anyway. So instead of better grades, say better test scores. I dunno about the Franklin Ave crew, but that will get the school admin salivating.

Environmental/Lifestyle Changes Less healthy diets High fat foods Take out & fast food High fat snacks Liquid Calories Non-citrus juice increased by 300% in young children More unhealthy foods “Super-Sized” Less physical activity Less PE in schools Less participation in afterschool sports 20% of US 8-16 yr, have 2 or fewer bouts of rigorous activity/wk More physical inactivity More television time 25% of US kids watch >4 hrs/day More computer time This should be in a table form. Ryan’s: Agree; but great points to emphasize KC: “non-citrus juice”? What does that mean. It aint like OJ with 300 cals is any diff than Cran juice with 300 cals.

Strategies for Obesity Prevention Behavioral Family-Based Programs Epstein, et al: 10 year follow up data available Positive effects for Children & Young Adolescents Diet + Exercise more effective than exercise alone Parents as Exclusive Agents of Change Golan et al: “Parents as agents of change in childhood obesity” Non-Dieting Approach Improve self-esteem and attitude toward eating/food I’m not sure where this slide is going Ryan’s: Agree; probably could take out unless it’s presented better KCs: I actually disagree. You guys are presenting prevention/intervention models that have worked before right? That’s important to show that we aren’t just pulling things out of Carlo’s butt and trying to make it work. There are several precedents to what we are doing and we are using them.

Behavioral Strategies Exercise: “a family affair” Family walks, interactive games, activities Decrease Inactivity turn off TV, video games, computer games (<2hrs/day) Self monitoring Food records/activity log Modification of eating habits Not in front of TV, food exploration Reinforcement and rewards Enhance self-esteem Dealing with family/parenting communication Is eating in front of the TV bad for you? Can’t this be the time they watch TV since they are exercising earlier in the day? JC:I'm confused about this slide. You list the three strategies on the previous slide, but then expand only on the first point. What about Parents as Agents of Change and Non-Dieting Approach? Loss in fluidity here... I think it is a good idea to push Nintendo Wii for those who can afford it. This is a great way to continue playing video games and still exercise. Ryan’s: Minimizing TV is good for kids period, regardless of before or after exercising b/c it gives more rest and increases attention span during school hours……..I’ll find the article to give you guys to support it. KC: If I’m not mistaken, these are methods/interventions that have been used by other programs and other researchers have decided that they are key to an effective childhood obesity program right? Thus, I think its all good stuff. However, you need to cite your info and SAY that these are methods used by previous programs in other areas. Again, we need to look like we are using proven methods and applying them to our program; not pulling stuff out of our butts.

Overview of the Program Program is designed to be run for 6 weeks Will take place each Saturday 10:30a-Noon Targeted sessions for parents and children Parents: nutrition and exercise education for yourselves and your family. Children: nutritional and physical education. (your input is needed) JC: Is this definite? If so that would be great! Mention that this will be DWTL as usual. Adults can still be a part of this even if they don't have children. This will be important to stress, because I can see people saying "I don't have a kid, can I still come?" KC: We need an interactive approach. KC/Jacques (especially KC) just talking in front of ppl aint gonna cut it. So whether it be little cooking sessions, mix and match games with food cut-outs, “bring in your healthy recipe contests”, exercise days (I think this is a must/ with Jacques leading), or whatever it needs to be 75% interactive, 25% lecture/information.

Overall Goal of the Program Encourage children to think holistically about how lifestyle behaviors are directly related to health and wellness. Offer a long-term community/family based approach to learning about the importance of increased physical activity and proper nutrition in combating childhood obesity. + Put goals in simpler terms KC: For kids, short term goals are the best. Even superficial stuff like “look buff/run fast like Reggie Bush”, “be able to touch the rim on a basketball hoop”, “get stronger” are going to work better than overall health goals like reduce your likelyhood of cardiovascular events, improve glycemic control, and increase your basal metabolic rate. Kids hate big words.

DWTL Design Overview DWTL is community-based 6-week program designed to combat obesity in the New Orleans area through: Nutritional Education Physical Education Increasing Physical Activity Ryan’s: Mention how it will help the church and its involvement KC: To add to what Ryan said, I have personally heard from at least two participates about how their shared commitment to health with their husband/wife/son/daughter actually brought the family closer together in that they were united for a common goal.

DWTL Design Nutritional Education- comprehensive education and counseling for whole families in meal planning, healthy nutrition, and overall wellness. Ryan’s: Would re-word “whole families” KC: I don’t know if this chart helps your cause. It basically says that most schools provide nutrition and dietary behavior conseling one-on-one/small group at school but a small percentage do it outside of school. Are you saying that outside school is more effective, and thus here comes DWTL kids to fill that void? *School Health Policies and Programs Study CDC 2006

DWTL Design Health/Physical Education- education focused on understanding how healthy behaviors are interrelated and how to integrate physical activity into their lives . JC: I don't see the purpose of the chart. You made your point that there is no exercise in schools. I'm ready to hear about the program. KC: Good. But delete “education focused on”, and start from “understanding. . .” *SHPPS CDC 2006

DWTL Design Increasing weekly physical activity- limiting TV and other sedentary behaviors, providing a setting for exercise and physical activity, and giving practical take home assignments. JC: This is also obvious at this point. Tell me about DWTL Kids. Maybe give some examples, etc. Use these slides to spell out YOUR specific goals. You did the research, how is it now being made practical.

Informational presentation to Church : Presentation to take place after Church service 2-3 weeks before kickoff date. Promote purpose and the goals of the program Family recruitment Distribute Parish family needs assessment Explain how healthy activity increases test scores, less hospital bills. JC: I don't think that a presentation is necessary. You will probably be able to give all this information out in a brochure/handout. The last thing people want to do after church is sit through another presentation. Set up a booth in the lobby and pass out info and talk to people. Stuff handout in church bulletin.A presentation will be difficult/impossible to pull off, and attendance will be slim. There are two services and Sunday school is after the first service. Ryan’s: LOL….this was our idea for DWTL too but again, Pastor Luter will make announcement and we should have needs assessments ready to fill out and then brochures with as much info as possible similar to those for DWTL.

Week 1 Upon arrival, after parents and children separate: Parents will begin orientation and baseline measurements including body compositions. Children will begin orientation and then baseline assessments will be made. Resource handouts will be provided for the participants. There should be a quick introduction when parents and children are sitting together to find out what the days plans are. Then they should split up. Orientation can definitely be combined, then they break up for more age specific orientation Ryan’s: Just curious on how we will make this baseline and future assessments in the kids.

Week 1 Children 1st Half (45min.): Program orientation The design of the program explaining exactly what will be done and what is expected of the participants will be presented. Surveys Retrieving information from the participants in order to better understand the effect of the program. Have kids track amount of time spent on screen, and then GIVE them a replacement for that. (tv viewing, hours spent outside, educational assessment, reported physical activity) Waist-to-Hip measurements and initial body comp readings Private screenings with the aid of professional medical personnel. Dr. Dise - training for medical measurements of the participants What does the research say is the best way to analyze kids body fat? Why does this kid have such a big A** HEAD???!!! This is realistically a lot to do in 45 min. maybe use "kids" instead of participants. how will this info be presented? You can't sit down and talk to kids. Got to get their attention an get them excited! should these survey be given to the parents instead of the kids? Ryan’s: Nice pic !!! KC: Remember to ask Dise/Heber about what they think in regards to kids body comps. I actually just read something about how triceps skinfold thickness as a reliable measure of subcutaneous fat in children (but not adults)—I will forward it to you. I also read something about a short 8 minute exercise test as a reliable predictor of cardiovascular fitness (measured most accurately as vO2 max in a research setting)—I will also forward that to you. Our other options: waist/hip ratio (good), BMI (a little more troublesome in kids), trunk fat fold thickness. Remember to consider privacy as a huge consideration for the kids (vulnerable self esteems). Curtains around every kids body comp station. Discourage any poking fun.

Week 1 Children 2nd Half (45min.): Fun Physical Activity of the Week (your input is needed!) What have other programs done? Create activities that reinforce the days lesson. With kids they probably need to be put together. Please present us with YOUR ideas of fun physical activity. All 12 of us can go on for days with this Ryan’s: Competitive games with rewards especially to keep them interested and wanting to come back. Must be very organized. We can also have sessions broken up b/w boys and girls with influential speakers, how to tie a tie, fill out job/college applications, etc. KC: While those would be fun, I think we need to focus on health related games. This will be a challenge for nutrition. For exercise, it will be easy: just have competitions on push ups, resistance band reps, etc.

Weeks 2-6 (Kids) 1st Half: Nutrition (45min) Education & Group Activity 2nd Half: Exercise (45min) Group Physical Activity Week 2: “Nutrients & My Pyramid” Pyramid construction *Week 3: “Whole vs. Processed” Food Organization Week 4: “Dietary Guidelines” Creating balanced meals Week 5: “Healthy Choices” Food label dissection *Week 6: “Advertising & Eating Healthy” Magazine cut-out Week 2: Energy In vs Energy Out Food consumed compared to exercise needed Week 3: “Get Off Your Tail!” Eliminating Screen Time Week 4: Types of Exercise Cardio vs Resistance Week 5: Benefits of Exercise Creating a balanced playtime schedule Week 6: “You Can Do It!” Pending Famous Guest Speaker What are the most important things for kids to learn about health? Many of these topics are applicable to the adult that is making most of these decisions. A kid doesn’t necessarily need to know if something is whole or processed. It is also imperative that you keep time as a strong consideration, especially on body comp weeks. We should be teaching kids fun things to do, so they won’t stay in all day and watch TV. How are these topics going to be made interesting to kids? This seems great for adults. They are good lessons for kids, maybe too complex, but if it can be done in a fun and interesting way then be sure to note how you plan on doing that. Ryan’s: Agree but I can see the need to educate good vs bad b/c not every decision will be made for them and plus they need to begin to think for themselves at an early age of what/why they are good vs bad. It all needs to be age appropriate though. KC: I think we definitely need to educate the kids on things like whole vs processed. They are sponges for info. They can tell their parents what to buy or complain at school when the food isnt healthy. They need to become advocates for their own health. Knowledge is power. I like the “My Pyramid” idea, but lets not focus on the USDA My Pyramid. Too much damn dairy for one. Instead lets use the “new american plate” that I got from Leigh. Where it shows a plate with rearranged proportions of foods ¼ meat, ¼ whole grain, ½ veggies. That is easy enough to remember. Then we can substitute where nuts, legumes, fruits, come in. Beware though, we are going to have some serious convincing to do, and we will DEFINITELY need to bring food in for the kids to try. Coleen’s kids wouldn’t even eat apples that she brought in for them because they rarely eat any fruit at home, so we are going to need to be creative in getting them to try some of these foods. Kids don’t have adventurous palates. Also, since people seem to like the “Building a better Gumbo” talk, perhaps I could do a modified version of it to parents and we could require them to use the methods presented and bring in their own recipes for field day. Just a thought. I could bring in some flour that I had browned, maybe make the gumbo for field day if I have time and a lil financial support for the ingredients. *Body Comps will be measured during 1st Half

Example of Prizes for Interactive Learning Prizes will be age appropriate Toys Games Sports equipment Music Prizes for what? Are they randomly given out? What specific prizes? What is your budget request for this? Ryan’s: For the competitive games/exercises. Hey maybe we should ask C.P.3, Reggie, etc. for donations/special guest appearances for this stuff (random thought)

Adult Classes DWTL adult classes will be run in accordance with previous sessions stressing family efforts. Each class will be uniquely focused to address all topics with relation to the family unit and active health planning for all members Body composition assessment weeks will take place on the 1st, 3rd, and 6th session. On weeks with body comp and speaker, who will go first? There should be an outlined schedule as you did for the kids Ryan’s: Make sure these “topics” are mentioned in the initial needs assessment so that people will be attentive and they will be more tailored to what they want to hear.

Intended Lecturers Dr. Harlan – week 2 Dr. Hebert – week 4 Dr. Dise – week 6 No exercise? What activities are adults going to do? Will there be power circuits? KC: I don’t know if there is the same benefit in having the guest speakers in this setting since it will be a mostly interactive program. People aren’t going to want to sit through an hour and a half of Harlan talking about Yo-play.

Final Note At the end of the program, we will have a Family Field Day. Family Field Day will be a day of fun filled family activities such as Father-Son 3-Legged Race, Tug-of-War, and the Sack Race. Prizes will be provided for All Participants. (input needed. Promote dwtl) Good idea. This can be mentioned in the orientation as a goal. They essentially are training for this field day. You can set it up where you get “a head start” for attendance, most weight loss etc. Do Parent/child don't want to leave out single parents, etc. How is data being managed? Do you have examples of recording logs? KC: Good idea. Maybe it can also be self-catered, with participants bringing in their own modified healthy recipes?

walk-a-thon (for prizes.) Appendix A Aerobic Activities jump rope, jumping jacks, squat-thrusts, running in place, stretching, running, hopping, skipping, walking, jumping rope, swimming, dancing are all examples of aerobic activities) basketball, kickball, dodgeball capture the flag, and soccer(or other team sports) walk-a-thon (for prizes.) What are these for?

Appendix B Muscle/Bone Training: push-ups, sit-ups, pull-ups, and stretching (or other pre-existing muscle training activities.) (Muscle-strengthening activities can be unstructured and part of play, such as playing on playground equipment, climbing trees, and playing tug-of-war. Bone strengthening activities are acts that produce a force on the bones that promotes bone growth and strength. This force is commonly produced by impact with the ground.) Students will also be encouraged to walk to school if possible and safe. (this was mentioned Healthy People 2010)