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Obesity in Schools: Ground Zero for Intervention. Good Evening State Senators, Superintendent, School Board Members, and Teachers. Obesity in Schools: Ground Zero for Intervention Amy B. Dreher RN, BSN, MPH student Walden University 6165-1 Dr. Shana Morrell Summer, 2009. Learning Objectives.
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Obesity in Schools: Ground Zero for Intervention Good Evening State Senators, Superintendent, School Board Members, and Teachers.
Obesity in Schools: Ground Zero for Intervention Amy B. Dreher RN, BSN, MPH student Walden University 6165-1 Dr. Shana Morrell Summer, 2009
Learning Objectives • History of Childhood Obesity in the U.S. • Effects of Childhood Obesity • Behavioral, Psychosocial, and Environmental Manifestations • Ground Zero Interventions for Childhood Obesity in the schools
Childhood Obesity Stats Children’s Age19802006 2-5 years: 5.0% 12.4% 6-11 years: 6.5 % 17.0% 12-19 years: 5.0% 17.6% Reference: Centers for Disease Control and Prevention (2008). Childhood Overweight and Obesity. Centers for Disease Control and Prevention. Retrieved June 23, 2009 from http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/index.htm Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118.
Co-morbidities • Hypertension • Cardiovascular Disease • High Cholesterol • Asthma • Sleep Apnea • Type-2 Diabetes • Multiple Cancers Reference: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Centers for Disease Control and Prevention (2008). Childhood Overweight and Obesity. Centers for Disease Control and Prevention. Retrieved June 23, 2009 from http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/index.htm Institute of Medicine (2005). Report on Childhood Obesity. Preventing Childhood Obesity: Health in the Balance. Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. Mayo Clinic (2008). Childhood Obesity. Mayo Clinic.com. Retrieved June 23, 2009 from http://www.mayoclinic.com/health/childhood-obesity/DS00698 Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435.
Obesity and School Performance • Increased Absenteeism • Lower School Performance • Increased Learning and Memory Retrieval Problems Reference: Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. National Institutes of Health (2002). Childhood Obesity on the Rise. Word on Health: consumer Health Information Based on Research from the National Institutes of Health. Retrieved June 23, 2009 from http://www.nih.gov/news/wordonhealth/jun2002/childhoodobesity.htm Swallen, K., Reither, E., Haas, S., and Meier, A. (2005). Overweight, obesity and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics, 15, 340-347. Taras, H. and Potts-Datema, W. (2005). Obesity and Student Performance at School. The Journal of School Health, 75, 291-295.
Behavioral Dimensions • Cost & Portion Size • Eating outside the home • Increased Snacking References: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298.
Psychosocial Dimensions • Stereotyping • Discrimination • Teasing • Bullying Reference: Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298.
Psychosocial Dimensions • Low Self-Esteem • Anxiety Disorders • Depression • Increased Absences and skipped classes References: Taras, H. and Potts-Datema, W. (2005). Obesity and Student Performance at School. The Journal of School Health, 75, 291-295. Vieweg, V., Johnston, C. H., Lanier, J. O., Fernandez, A., & Pandurangi, A. K. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. Southern Medical Journal, 100(1), 1–7.
Environmental Dimensions • Family Influences • Electronics • Advertisements • Social Economic Status References: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Dehghan, M., Akhtar-Danesh, N., and Merchant, A. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal. Retrieved June 23, 2009 from http://www.nutritionj.com/content/4/1/24 Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. National Institutes of Health (2002). Childhood Obesity on the Rise. Word on Health: consumer Health Information Based on Research from the National Institutes of Health. Retrieved June 23, 2009 from http://www.nih.gov/news/wordonhealth/jun2002/childhoodobesity.htm Styles, J., Meier, A., Sutherland, L., and Campbell, M. (2007). Parents’ and Caregivers’ Concerns About Obesity in Young Children: A Qualitative Study. Family and Community Health, 30 (4), 279-295. Utter, J., Neumark-Sztainer, D., Jeffery, R., and Story, M. (2003). Couch potatoes or French fries: are sedentary behaviors associated with body mass index, physical activity, and dietary behaviors among adolescents? Journal of the American Dietetic Association, 103(10), 1298-1305. Vieweg, V., Johnston, C. H., Lanier, J. O., Fernandez, A., & Pandurangi, A. K. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. Southern Medical Journal, 100(1), 1–7.
Environmental Dimensions at school • Unhealthy foods • Advertisements • Lack of PE classes References: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Carter, R, (2002). The Impact of Public Schools on Childhood Obesity. The Journal of the American Medical Association, 288, 2180. Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. Taras, H. and Potts-Datema, W. (2005). Obesity and Student Performance at School. The Journal of School Health, 75, 291-295. Vieweg, V., Johnston, C. H., Lanier, J. O., Fernandez, A., & Pandurangi, A. K. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. Southern Medical Journal, 100(1), 1–7.
Primary Intervention Image used with permission from the U.S. Dairy Council. References:: United States Department of Agriculture (2008). My Pyramid. Accessed June 23, 2009 at http://mypyramid.gov/ Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435.
Secondary Interventions BMI Report Cards Image used with permission from the Tri-County Health Department.. Reference: Dehghan, M., Akhtar-Danesh, N., and Merchant, A. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal. Retrieved June 23, 2009 from http://www.nutritionj.com/content/4/1/24 Johnson, A. and Ziolkowski (2006). School-Based Body Mass Index Screening Program. Nutrition Today, 41(6), 274-279.
Secondary Interventions No Soda Healthier Milk Reference: Johnson, A. and Ziolkowski (2006). School-Based Body Mass Index Screening Program. Nutrition Today, 41(6), 274-279. Millimet, D., Tchernis, R., and Husain, M. (2008). School Nutrition Programs and the Incidence of Childhood Obesity. Retrieved June 23, 2009 from http://ideas.repec.org/cgi-bin/htsearch?q=school+nutrition+programs&ul=%2Fiza%2Fizadps Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435.
Tertiary Intervention Reference: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Vieweg, V., Johnston, C. H., Lanier, J. O., Fernandez, A., & Pandurangi, A. K. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. Southern Medical Journal, 100(1), 1–7. JAM (2008). JAM: Just-a-minute School Program. Retrieved from June 23, 2009 http://www.jamschoolprogram.com/
Public Health Policy Implications for Schools • School lunches held to USDA standards • Nutrition standards in schools • Wellness policy implemented • PE reinstated to acceptable norms • Ban on advertisement of foods in school setting • Zoning of food establishments • Price watch • Safe playgrounds and parks References: Budd, G., and Hayman, L. (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435.
Summary • Weight loss is easier to obtain in childhood • Schools provide an ideal environment for this intervention Reference: Dehghan, M., Akhtar-Danesh, N., and Merchant, A. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal. Retrieved June 23, 2009 from http://www.nutritionj.com/content/4/1/24 Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435.
References Budd, G., and Hayman, L., (2008). Addressing the Childhood Obesity Crisis: A Call to Action. The American Journal of Maternal/Child Nursing, 33 (2), 111-118. Carter, R. (2002). The Impact of Public Schools on Childhood Obesity. The Journal of the American Medical Association, 288, 2180. Centers for Disease Control and Prevention (2008). Childhood Overweight and Obesity. Centers for Disease Control and Prevention. Retrieved June 23, 2009 from http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/index.htm Dehghan, M., Akhtar-Danesh, N., and Merchant, A. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal. Retrieved June 23, 2009 from http://www.nutritionj.com/content/4/1/24 Harper, M. (2006). Childhood Obesity: Strategies for Prevention. Family and community Health, 29(4), 288-298. JAM (2008). JAM: Just-a-minute School Program. Retrieved from June 23, 2009 http://www.jamschoolprogram.com/ Johnson, A. and Ziolkowski (2006). School-Based Body Mass Index Screening Program. Nutrition Today, 41(6), 274-279. Institute of Medicine (2005). Report on Childhood Obesity. Preventing Childhood Obesity: Health in the Balance. Mayo Clinic (2008). Childhood Obesity. Mayo Clinic.com. Retrieved June 23, 2009 from http://www.mayoclinic.com/health/childhood-obesity/DS00698 Millimet, D., Tchernis, R., and Husain, M. (2008). School Nutrition Programs and the Incidence of Childhood Obesity. Retrieved June 23, 2009 from http://ideas.repec.org/cgi-bin/htsearch?q=school+nutrition+programs&ul=%2Fiza%2Fizadps National Institutes of Health (2002). Childhood Obesity on the Rise. Word on Health: consumer Health Information Based on Research from the National Institutes of Health. Retrieved June 23, 2009 from http://www.nih.gov/news/wordonhealth/jun2002/childhoodobesity.htm Styles, J., Meier, A., Sutherland, L., and Campbell, M. (2007). Parents’ and Caregivers’ Concerns About Obesity in Young Children: A Qualitative Study. Family and Community Health, 30 (4), 279-295. Swallen, K., Reither, E., Haas, S., and Meier, A. (2005). Overweight, obesity and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics, 15, 340-347. Taras, H. and Potts-Datema, W. (2005). Obesity and Student Performance at School. The Journal of School Health, 75, 291-295. United States Department of Agriculture (2008). My Pyramid. Accessed June 23, 2009 at http://mypyramid.gov/ Utter, J., Neumark-Sztainer, D., Jeffery, R., and Story, M. (2003). Couch potatoes or French fries: are sedentary behaviors associated with body mass index, physical activity, and dietary behaviors among adolescents? Journal of the American Dietetic Association, 103(10), 1298-1305. Veugelers, P. J. and Fitzgerald, A.L. (2005). Effectiveness of School Programs in Preventing Childhood Obesity: A Multilevel Comparison. American Journal of Public Health, 95(3), 432-435. Vieweg, V., Johnston, C. H., Lanier, J. O., Fernandez, A., & Pandurangi, A. K. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. Southern Medical Journal, 100(1), 1–7.
Sources for Further Reading Ebbeling, C., Pawlak, D., and Ludwig, D. (2002). Childhood obesity: public-health crisis, common sense cure. The Lancet, 360(9331), p. 473-482. Koplan, J., Liverman, C., and Kraak, V. (2005). Preventing childhood obesity: Health in the balance: Executive summary. Journal of the American Dietetic Association, 105(1), p. 131-138. Mead Johnson Nutritionals (2007). Consensus in Pediatrics: Childhood Obesity. In Feld, L. and Hyams, J. (Eds.). Evansville, IN: Mead Johnson & Company. National Association of School Nurses (2008). S.C.O.P.E.: School Nurse Childhood Obesity Prevention Education. In Eliason, S., Dietz, W., Kimmes, S., Barry, C., and Mosca, N. (Eds.). Silver Spring, MD: NASN. Robinson, T. and Sirard, J. (2005). Preventing childhood obesity: A solution-oriented research paradigm. American Journal of Preventive Medicine, 28(2), p. 194-201.