A Community-Based Childhood Obesity Initiative: Family, Food, Fitness and Fun

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A Community-Based Childhood Obesity Initiative: Family, Food, Fitness and Fun A Proposal Submitted by A Consortium of 1890 Land-Grant Institutions Acting to Prevent Childhood Obesity through the Promotion of Healthy Lifestyle and Increase Physical Activity in Underserved and Vulnerable Communities

Proposal Project Title: Reducing Childhood Obesity for Generation Next: From 4-H to 4-F Implementation Date: March 1, 2008 Ending Date: January 31, 2011

Key Objectives To determine the impact of: school meals program on health, behavioral attitudes, and academic performance of school children in specific targeted and vulnerable areas. after-school program activities on academic performance and wellness of school children using the 4-H model of engagement.

Key Objectives Cont. To conduct behavioral surveillance and monitoring school and community-based population on relations between and among social, economic, and cultural habits on eating behaviors. To design an educational Nutrition and Health promotion curricula for school children to be used in targeted rural and inner city vulnerable communities. To implement nutrition and physical fitness programs that provide fun and involves family members in response to findings from 1a and 1b using selected best practices of 4- H and after-school models. To identify, collaborate, and strengthen existing appropriate community organizations and programs that target or may impact the reduction and prevention of childhood obesity

Introduction Minority audiences have not overwhelmingly participated in the very successful 4-H program, which has had significant impact on improving life skills, lifestyles, behavior, academic performance, positive assertiveness, and self confidence of participants. The rising obesity epidemic continues to impact our healthcare system and those most affected are the vulnerable populations least able to cope. The 1890 land-grant universities have had a long history of working with these populations which tend to be located in states where these universities are located. The 1890 land-grant universities propose the introduction of a 4-F program to conduct adaptive research and design and promote solution-based intervention activities in Food, Families, Fitness, and Fun.

Introduction Cont. Moving from 4-H to 4-F will be a community based program designed to engage communities and link university researchers and extension faculty with school teachers and school system officials, healthcare providers, nutrition educators and vulnerable parents and children. Food 4-H to A Healthy Generation Next Families Fitness 4-F Fun

Rationale The evidence is overwhelming; childhood obesity rates in the United States have reached alarming proportions. A report of the Institute of Medicine (IOM) of the National Academies, entitled, Preventing Childhood Obesity: Health in the Balance (2005) noted that obesity rates have more than doubled for children aged 2-5 years and adolescents aged 12-19 years and more than tripled for children aged 6-11 within the past 30 years. Approximately nine million children over 6 years of age are considered obese according to the IOM. Moreover, the U.S. Department of Health and Human Services in a mid-course review of progress toward Healthy People 2010 objectives, indicate that weight trends are worsening for both children and adults.

Rationale Cont. The obesity problems is more pronounced in certain ethnic groups. According to the Center for Disease Control and Prevention, the proportion of Mexican American children and adolescents who were overweight in 1999-2000 was 24 percent; for black children and adolescents, 22 percent. These statistics are dramatic since less than five percent of children and adolescents, male and female, were overweight in 1966-1970. For the first time in history, a course has been set that will lead to a decrease in life expectancy for the next generation. The lack of progress in recent years to stabilize and/or reduce obesity rates in childhood calls for dynamic and innovative solutions that include all sectors of society. Since the early 1960s, the 1890 land-grant institutions have worked with limited income populations to address health and nutrition needs. So it is appropriate that the 1890 institutions embark upon an initiative to confront the challenges of childhood obesity by developing and evaluation potential solutions based on rigorous outcome assessments.

Statement of Intent This proposal describes a collaborative initiative among a number of 1890 land-grant colleges and universities to develop, implement, and evaluate nutrition and physical activity strategies to address the growing childhood obesity epidemic, notably in the southern United States. This education and research initiative will target children of African American or Hispanic ethnicity between the ages of 2 and 11 years of age (a population in which obesity rates are rapidly increasing) in a variety of settings. The primary outcome of this project will be a compilation of evidence-based best practices to reverse current trends in childhood obesity in the target populations.

Project Goal The major goal of this initiative is to foster collaboration among the 1890 land-grant colleges and universities to develop, implement, and evaluate education and research projects which identify effective obesity prevent practices, policies and intervention strategies for children of African American or Hispanic ethnicity between the ages of 2-11 years who reside in limited-resource families located in the southern region of the United States. The collaborating institutions will form partnerships in vulnerable communities to address at least two of the following focus areas and one or more of the key objectives.

Focus Areas Individuals and Families (Family) Pre-school and Elementary schools (Fun) Communities and Local Governments (Fitness) Marketplace and Media (Food)

Individuals and Families To conduct behavioral surveillance and monitoring school and community-based population on relationships between and among social, economic, and cultural habits on eating behaviors. To expand and evaluate individual and family programs that promote adoption of healthy eating habits and increased physical activity. Determine relationships between socioeconomic and cultural issues and obesity. Teach behavior change strategies that enable adoption of healthy lifestyle. To implement nutrition and physical fitness program curricula that provide fun and involve family.

Pre-schools and Elementary Schools To determine the impact of school and meal programs on health, behavioral attitudes, and academic performance of school children in specific targeted areas. To work with school breakfast and lunch personnel on healthy meal planning, preparation and portion sizing. To determine the impact of after-school program activities on the wellness and fitness of school children using the 4-H model of engagement. To design an educational Nutrition and Health promotion curricula for school children to be used in targeted rural and inner city vulnerable communities.

Communities and Local Governments Develop programs that: To collaborate with local officials and identify and strengthen existing appropriate community organizations and programs that target or may impact the reduction and prevention of childhood obesity. To collaborate with local government and nongovernment organizations in the community on providing a safe and active built environment that promotes exercise and weight loss. To expand prevention research, experiential behavior research and community based population research that supports and strengthens surveillance, monitoring and evaluation efforts. To foster government and business policies to promote healthy eating and increased physical activity.

Marketplace and Media Develop programs that: Create media strategies that promote healthy eating and increased physical activity in targeted population. Collaborate with segments of the food industry to enhance consumption of high quality nutritious food products that are acceptable to children and families. Improve nutrition and health promotion education curricula. Provide access to fresh fruits and vegetables through the collaborations with direct marketing from farmers.

Evaluation The project will contract with an evaluator to conduct an ongoing and annual evaluation based on a series of questions posed by the National Institutes of Health/Institute of Medicine. Institute of Medicine Questions to Guide Childhood Obesity Prevention Policies and Interventions 1. How does the action contribute to preventing childhood obesity? What are the rational and supporting evidence for this particular action as a viable obesity prevention strategy, particularly in a specific context? How well is the planned action or intervention matched to the specific setting or population being served? 2. What is the quality and reach or power of the action as designed? 3. How well is the action carried out? What is the quality and the reach or power of the action as implemented? 4. What difference did the action make in terms of increasing the availability of foods and beverages that contribute to a healthful diet, opportunities for physical activity, other indicators of a healthful diet, opportunities for physical activity, other indicators of a healthful diet and physical activity, and improving health outcomes for children and youth?