1. A Community Intervention on Obesity Funded by the Robert Wood Johnson Foundation 2009 to 2011 Elizabeth Yznaga, CNM, MSN, sDNP

2. Obesity is a national health issue

3. Watch and Walk Off Weight Funded by Robert Wood Johnson Foundation

4. Lay advisors, Promotoras, help create Avatars in Second Life. A community clinic based intervention to decrease Hispanic women’s weight. Sponsored walks for Mother Walking Groups.

5.  Join a walking group  Weight loss  Decreased need for insulin  Access to health information at Mira y Camina Island.

6. With the help of staff advisors, women learn to create and activate Avatars. These Avatars shop for virtual foods Avatars plan menus and prepare recipes Calculate calorie counts And nutritional value

7. Avatars can dance, exercise, eat, and gain or lose weight. Women can morph their Avatars to be morbidly obese or normal weight. Women can see the medical problems in their future, if they remain obese.

8. The women use the Avatars to access their electronic chart. With their Avatars the women can also visit other health education locations. They can track walking stats, weight loss, blood pressure, and medication.

10. IndicatorMeasure of Indicator Results Community Acceptance Number of walkersWalkers increasing, Member Lifestyle Change Weight lost per walkerAve. 2 lbs/mo, see chart below Diabetes ImprovementDecreased need for insulin Five women went to lower amounts Healthcare EducationContinued Avatar activity Over 100 Avatars at the Island

11. An average of 53 women a week walked in one of the 11 groups.

12.  The average weight lost over a year was 25 lbs. with an average of 3 group walks a week.

13. A weight loss of 40 lbs was typically enough weight loss to lower insulin needs. For some, oral diabetic medications could be used instead of injectables. For others, they needed less insulin.

14. “ We have a group feeling that we are together and we can help each other”. “Last month I gave my big, big clothes to Elena. We are sharing clothes, advice, recipes, and watching out for each other’s kids”. “The walking saved my life. I lost 40 lbs. I want to see my children grown”.

15. Chavez Elementary Adelita Elementary Westside Community Clinic Central Library Westview Library

16.  Toro Elementary  San Pedro Community Clinic  School Age Mothers Program  Calexico County Hospital Diabetes Program

17. Come take a walk with us. Mira y Camina Staff Thank You, Robert Wood Johnson Foundation