1 / 29

Vonna Drayton, DrPH Gregory D. Benjamin, M.P.H. Hu An, M.S.

Environmental factors associated with reduction in overweight and obesity among Delaware children age 6-17 years. Vonna Drayton, DrPH Gregory D. Benjamin, M.P.H. Hu An, M.S. Acknowledgements. Likun Hou, MS Robert Colnes, PhD Michele Lempa, DrPH NHPS’ Policy, Evaluation, and Research Dept.

adonai
Download Presentation

Vonna Drayton, DrPH Gregory D. Benjamin, M.P.H. Hu An, M.S.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Environmental factors associated with reduction in overweight and obesity among Delaware children age 6-17 years Vonna Drayton, DrPH Gregory D. Benjamin, M.P.H. Hu An, M.S.

  2. Acknowledgements • Likun Hou, MS • Robert Colnes, PhD • Michele Lempa, DrPH • NHPS’ Policy, Evaluation, and Research Dept. • This evaluation has been made possible in part by a grant from the Robert Wood Johnson Foundation (RWJF ID: 62078)

  3. Presentation Objectives • Describe Nemours Health & Prevention Services’ (NHPS) multi-sector intervention to reduce overweight in Delaware’s children. • Identify factors associated with the reduction in overweight BMI (body mass index greater than the 85th percentile) in DE children, 6-17 years. • Explain the development and use of NHPS’ Healthy Eating and Physical Activity (HEPA) Index.

  4. NHPS’ Strategy Strategy based on the social ecological model Prevention-oriented child health system that includes the following components: Strategies in multiple sectors: Exposure to consistent healthy messages/environments for behavior change Strategic partnerships: Greatest potential impact, authority to make policy and practice changes, ability to leverage resources Social marketing: Creating and accelerating social policy and behavior changes

  5. A Day in the LifeMultiple Sources of Influence in a Child’s Day 12:00 AM 9:00 PM Sleep Community/ Family 6:00 PM 6:00 AM Time with parent Afterschool Primary Care Child Care/ School 8:00 AM 3:00 PM 9:00 AM 12:00 PM

  6. NHPS’ Healthy Eating and Physical Activity (HEPA) Initiative • Policy and practice changes in child-serving organizations • Office of Child Care Licensing and child care centers • Department of Education and Delaware school districts • Primary healthcare providers • Youth-serving organizations (YMCA, 4-H) and after-school programs • Built Environment (e.g., Delaware Greenways, Delaware Parks & Recreation, DNREC)

  7. NHPS’ 5-2-1-Almost None Message • 5: Five or more fruits and vegetables consumed each day • 2: Screen time is limited to less than 2 hours each day • 1: Children are physically active for at least 1 hour each day • Almost None: Sugar-sweetened beverages are limited to no more than 2 servings each week

  8. Award Winning Media

  9. Increasing Awareness of NHPS’ 5-2-1-Almost None Message • In 2006, 5% of parents heard of and could recall NHPS’ 5-2-1-Almost None campaign. • In 2008, 19% of parents heard of and could recall NHPS’ 5-2-1-Almost None campaign. • 15.5 % of respondents talked to someone about this message. • There was approximately a four-fold increase in awareness and recall between 2006 and 2008.

  10. HEPA behaviors of children whose parents were aware of NHPS’ 5-2-1-Almost None message: DSCH 2006 vs. 2008 2006 DSCH (N=164) & 2008 DSCH (N=528)

  11. Data Sources Population HEPA Awareness HEPA Behaviors BMI Systems Policy and Practice (Child Care and Schools) Delaware Survey of Children’s Health (DSCH), Electronic Medical Record (EMR) SHPPS, Wellness Policy Review, Provider Surveys, Document Reviews, and Legislation

  12. DSCH Design and Sampling • Random-digit-dialing (RDD) of DE households containing at least one child less than 18 yrs of age. • Statewide sample (n=3055, response rate=57%) allowed comparisons among: • Four specific locations: • City of Wilmington • New Castle County, excluding the City of Wilmington • Kent County • Sussex County • Children of various age and racial groups: • Birth through 5 yrs old • 6 through 11 yrs old • 12 through 17 yrs old • African-American versus all other children Blumberg SJ, Olson L, Frankel MR, Osborn L, Srinath KP, Giambo P. Design and operation of the National Survey of Children’s Health, 2003. National Center for Health Statistics. Vital Health Stat 1(43). 2005.

  13. DSCH Sample Distribution

  14. Presentation Objective #2 Identify factors associated with the reduction in overweight and obese BMI (body mass index greater than or equal to the 85th percentile) in DE children, 6-17 years.

  15. Body Mass Index (BMI) • Body Mass Index (BMI) is derived from a child’s weight and height. • BMI categories for children ages 2 and over: • Underweight < 5th percentile • Healthy weight: 5th ≤ BMI <85thpercentile (Reference Category) • Overweight or obese: ≥ 85th percentile Expert Committee Recommendations, June 6, 2007

  16. Access to Fruits and Vegetables in the Community 26% of respondents indicated that it was very easy to walk or bike to the place that sells fruits and vegetables. 20% of respondents indicated that it was very easy to walk or bike to a fast food restaurant

  17. Screen Time: Television • 53% of children usually watch TV, watch video or play video games for 2 hours or less on an average weekday. • 50% of children are allowed to watch TV, watch video or play video games for 2 hours or less on an average weekday. • 24% of children are allowed to watch TV, watch video or play video games for 2 hours or less on an average weekend day.

  18. School Physical Activity • 20% of children ages 6-17 participate in physical education or gym classes five days per week. • 77% of school offer recess or a break where selected child can be physically active.

  19. Parent Support of Physical Activity • Parent or another adult engaged in PA with child 3 days per week on average. • 69% of respondents always encouraged child to be physically active. • 43% for at least 60 mins/day • 48% of respondents always made sure child was physically active. • 39% at least 60 mins/day

  20. Walkability of Community • 67% of respondents reported that their neighborhood was a very pleasant place to walk. • 43% of respondents definitely disagreed that traffic makes it dangerous to walk in their neighborhood. • 60% of respondents said yes to the presence of sidewalks. • 36% of respondents definitely agreed that their neighborhood is safe from crime.

  21. Primary Healthcare Provider Promotion of HEPA • 84% of primary healthcare providers have discussed healthy eating and physical activity with respondent/child. • 77% of primary healthcare providers have made recommendations about healthy eating and physical activity to respondent/child.

  22. Presentation Objective #3 Explain the development and use of NHPS’ Healthy Eating and Physical Activity (HEPA) Index.

  23. HEPA Index Algorithm Select the DSCH Questions and conduct Exploratory Factor Analyses for the HEPA Index based on the Social Ecological Model Factor 13: Access to fruits & vegetables in community Factor 3: Screen Time-TV Factor 6: Parental Support of Physical Activity Factor 9: School Physical Activity (6-17 yrs) Factor 10: Community Support Factor 11: Access to PA in Community Factor 12: Walkability of Community Factor 14: Societal promotion of HE/PA Use the dichotomization system to calculate items’ scores and construct factor scores for Ages 2-5 years and 6-17 years Sum the dichotomized factors’ scores to construct the HEPA Index Examine the predictive validity of the HEPA Index for BMI ≥ 85th percentile

  24. HEPA Index Factors

  25. HEPA Index Range

  26. Distribution of HEPA Index Factor Scores • 53% of DE children ages 6-11 scored 6 to 8 on the HI. • 41% of DE children ages 12-17 scored 6 to 8 on the HI.

  27. Strengths Large sample size Representative of the data for Delaware Consistent with other findings from the NSCH Contribution to the literature Limitations Some survey items did not lend themselves to factor analyses. A few factors contained less than three items. Some survey items proved not to be ‘good’ measures of NHPS’ 5-2-1-Almost None behaviors. Causal inferences cannot be made between environmental factors and overweight/obesity. Strengths and Limitations

  28. http://www.growuphealthy.org For more info, please contact: Gregory D. Benjamin, M.P.H. Evaluation Scientist (p) 302-444-9163 (e) gbenjami@nemours.org

More Related