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Moderate-to-Vigorous Physical Activity (MVPA), 2003-2005. HP 2010 Goal. En Vivo Lessons. Lesson 1: What’s Wrong with Screen-Time? Lesson 2: Less Screen-Time, More Fun Lesson 3: Planning Screen-Time Lesson 4: Screen-Time and Snacking Lesson 5: Live Life En Vivo Lesson 6: Booster Session.
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Moderate-to-Vigorous Physical Activity (MVPA), 2003-2005 HP 2010 Goal
En Vivo Lessons • Lesson 1: What’s Wrong with Screen-Time? • Lesson 2: Less Screen-Time, More Fun • Lesson 3: Planning Screen-Time • Lesson 4: Screen-Time and Snacking • Lesson 5: Live Life En Vivo • Lesson 6: Booster Session
Comic Books – Time Twisters • Comic 1: Screen-Time definition and consequences • Comic 2: Benefits of reducing Screen-Time and Alternatives • Comic 3: Skills and Strategies to reduce Screen-Time • Comic 4: TV Commercials and Snacking
Motivation • The probability that a person will enter into, continue, and comply with a change-directed behavior • Motivation can be influenced
Motivational Enhanced Interview • A client centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence Create cognitive dissonance between where one is & where one wants to be
Ambivalence Feeling two ways about something
Parental Self-Report of TV in Child’s Bedroom (2nd grader) Pre- & Post- MEI Intervention OR=0.25 (0.08-0.82); p=0.02
Proportion of Parents in Contemplation or Greater Stage Post-MEI Intervention to Remove TV from Child’s Bedroom (2nd grader) OR=3.55; p=0.04
En Vivo - Community Setting • 69 families • 25 female tweens • 22 male tweens • 20 mothers • 2 fathers
Behavioral Outcomes • Reduce screen-time • Remove TV from bedroom • Increase physical activity • Reduce intake of sugared beverages • Increase intake of fruit and vegetables • Restrict snacking while watching TV
Physiological Outcomes • BMI (overweight & obesity) • C-reactive protein • Insulin resistance (HOMA-IR) • HbA1c
Participant Recruitment • Diabetes Cohort • Local clinics • Faith-based settings • Community partners
Physical Activity Among Mexican-American Tweens • To se a socio-ecological framework to obtain physical activity levels • To identify facilitators & barriers to physical activity
Physical Activity Among Mexican-American Tweens • Two local churches • 100 tweens • Focus groups
Specific Messages: Physical Activity • Children - 60 minutes of MVPA/day • Adults - 30 minutes of MVPA/day • Encourage everyone to walk or bike (when reasonable) • Be active as a family (park, walk, hike, bike, soccer, frisbee, etc.)
Specific Messages: Sedentary Behaviors • Remove television from child's bedroom (& parents’) • Limit “screen time” - no more than 2 hours/day • Replace screen time with physical or family activities
Specific Messages: Diet • Eat 5-9 fruits & vegetables per day (not including juice) • Fast food < 1 time per week • Limit foods of minimal nutritional value (candy, processed snacks, etc.) • Replace sugar sweetened & caffeinated beverages with water • Pack a healthy lunch
Specific Messages: Other • 8 hours of sleep per night • Wear bike/sport helmets • Wash hands 3-5 times per day • Join schools health advisory board or PTA • Implementation of school health education
Key Conclusions – Childhood Obesity • Population-based prevention approach • Energy balance – healthy eating and active living to achieve a healthy weight while protecting health, normal growth, & development • Collective responsibility – multiple sectors & stakeholders must be involved in societal changes at all levels
Summary – Childhood Obesity • Causes (and solutions) are multi-factorial • Both societal level solutions (policy) and individual level solutions (prevention and treatment programs) are necessary • In the Rio Grande Valley, we are implementing a combination of policies, programs, & community-based initiatives • These efforts need to be maintained!
Acknowledgments • Steven H. Kelder, PhD, MPH • Deanna M. Hoelscher, PhD, RD, LD, CNS • Diamond Freeberg, PhD • Christopher Ledingham, PhD • Andrew E. Springer, DrPH • Kelli Drenner, PhD • Carolyn Agurcia-Parker, DrPH • Susan Hart, PhD • Lizbette Hernandez • Lidiana Ramirez • Rosa Sauceda • Dianeth Rodriguez • Nancy Gonzalez • Alda Rivas • Margarita Ramirez • Alejandro Bernal