Progress in Preventing Childhood Obesity Focus on Communities - Brief Summary: Institute of Medicine Regional Symposium (2006) / Chapter Skim
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Summary Institute of Medicine Regional Symposium Progress in Preventing Childhood Obesity: Focus on Communities
Summary Institute of Medicine Regional Symposium Progress in Preventing Childhood Obesity: Focus on Communities
Pages 1-26
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The nation shares a collective responsibility in rectifying the childhood obesity trend, and a clear focus of prevention efforts should involve the communities that affect the daily lives of our children and youth. Moreover, a special focus must be placed on low-income, high-risk communities where obesity rates are highest due to factors such as lack 1
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, the IOM is building on its previous work by initiating a study to assess progress in childhood obesity prevention efforts. The IOM, through its Food and Nutrition Board, has appointed a 13-member multidisciplinary committee with expertise in child health, obesity, nutrition, physical activity, food industry, community-based evaluation, public health, and public policy to conduct the study.
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Approximately 90 individuals active in childhood obesity prevention efforts in the southeastern region of the United States who represented a range of stakeholder perspectives and innovative practices in local communities -- including students, community leaders, physicians, health educators, clergy, teachers, and state and federal government officials -- were invited to participate in the symposium. The contents of this summary reflect specific examples presented and discussed during the symposium, and unless otherwise noted, the general perspectives of the participants.
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ethnic populations that are at high risk for obesity. For this reason, many faith-based communities are currently adopting the challenge of obesity prevention within their places of worship by identifying factors either contributing to or deterring health promotion and childhood obesity prevention efforts in these communities.
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Several speakers noted that many low-income communities in the United States are unintentionally developed such that there is greater availability of and access to high-calorie and low-nutrient foods and beverages and limited access to opportunities for regular physical activity. If fresh produce is not available or affordable, most families and their children may choose less nutritious snacks from the food environment, such as the neighborhood convenience store on the way home from school.
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For example, by adding play space to neighborhoods, parks, and programs, or by encouraging corner convenience stores to stock healthier food and beverage options, children, youth, and their families may begin to utilize these services and purchase these products. Different types of interventions are used at the neighborhood, city, and state levels to provide venues for facilitating physical activity within communities.
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The center provides adolescents with a safe space to enhance well-being, informs them about risks that impact their health and the health of their families, demonstrates the importance of physical activity and nutrition in maintaining wellness and preventing disease, involves them in developing public health strategies, and promotes academic excellence. The center recently undertook a project where it reclaimed an abandoned city-owned lot and transformed it into a community garden.
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A statewide school-based nutrition and physical activity intervention in Mississippi found that the initial development of a health advisory council representing different stakeholder perspectives at each school greatly facilitated the negotiations, agreement, and implementation of the program. In addition, the partners in the intervention have served as a sounding board for suggestions regarding program implementation.
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Specifically, the group provides policy recommendations to the governor and legislators related to increasing physical activity, fruit and vegetable consumption, and the proportion of West Virginians who are at a healthy weight. Recent legislative efforts in the state have focused on mandating increased physical activity in schools, limiting the types of beverages sold in schools, performing regular measurements of students' body mass indexes (BMIs)
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The Council advises the state health department with regard to organizing efforts to achieve programmatic objectives, disseminating expert opinions and developing policies, and creating awareness among various state sectors. The Council has assisted in passing several state laws including requiring 30 minutes of physical activity per day in elementary schools, allowing only healthy food choices in elementary and middle school vending machines, and mandating that at least 50 percent of the vending machine choices in high schools are healthy options.
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Preventing childhood obesity requires the ongoing interactions among children, families, communities, and state and government officials. With many issues to be concerned about, many individuals may fail to recognize a problem unless they are directly informed about the matter.
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Because parents want their children to grow up to lead happy and healthy lives, they make ideal health advocates when provided with the information they need to make informed choices and opportunities to engage in healthy lifestyles. The success of preventing childhood obesity requires parental involvement.
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Moreover, culturally competent health information is more likely to reach and affect the targeted communities. Identify Leaders and Build on Cultural Assets Health behaviors and lifestyles are important contributors to the childhood obesity epidemic.
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Many faith-based organizations, given their influence on certain communities, are striving to promote health from a faith perspective to address childhood obesity. Ministers represent the most visible leaders
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Similarly, physicians who are at a healthy weight may speak more authoritatively about health and nutrition to their patients. Collect and Disseminate Local Data To facilitate the childhood obesity prevention movement, data should be collected on the prevalence of obesity, physical inactivity and sedentary behaviors, and dietary problems at a variety of geopolitical levels -- neighborhoods, cities, counties, states, and the nation.
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Similar to the BRFSS, the smaller Youth Risk Behavioral Surveillance System (YRBSS) is a population-based measure tracking tobacco use, drug use, physical activity, fruit and vegetable consumption, and the BMI of high school youth and selected middle-school youth over time.
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As recommended by the Work Group on Health Promotion and Community Development at the University of Kansas, key questions to ask during a community evaluation process include: (1) Is the intervention catalyzing community change to prevent childhood obesity?
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In these instances, inviting university collaboration to help evaluate an intervention may provide a viable option. The Work Group on Health Promotion and Community Development at the University of Kansas has created a community toolbox that includes practical guidance for implementing community health interventions.
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Although low-income and racial/ethnic minority populations have the highest rates, the surge in childhood obesity encompasses all economic and racial/ethnic groups and all geographic areas within the United States. It is a complicated multifactorial problem involving our food supply and distribution system; restrictions and opportunities for regular physical activity; public policies, individual and collective choices; and interactions among families, schools, communities, businesses, and worksites; and all levels of government -- federal, state, and local.
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20 PROGRESS IN PREVENTING CHILDHOOD OBESITY childhood obesity. Although there is a long road ahead of the nation to effectively address the growing childhood obesity rates, building healthy communities is an essential leverage point, as the health of each individual is closely linked to the health of the community.
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BRIEF SUMMARY: FOCUS ON COMMUNITIES 21 Program Agenda Institute of Medicine Symposium Progress in Preventing Childhood Obesity: Focus on Communities In collaboration with Healthcare Georgia Foundation Supported by The Robert Wood Johnson Foundation October 6-7, 2005 Georgia Tech Hotel and Conference Center Atlanta, Georgia October 6, 2005 Opening Session Welcome Martha Katz, Healthcare Georgia Foundation Overview of the IOM Report and Goals for the Meeting Jeffrey Koplan, IOM Committee on Progress in Preventing Childhood Obesity Youth Efforts in Preventing Childhood Obesity Ray Figueroa, Anthony George, Kenneth Alleyne, Artrese Reid, Eboni Bowman, TRUCE Fitness and Nutrition Center of the Harlem Children's Zone, New York City Setting the Context for Obesity Prevention in Communities James Marks, The Robert Wood Johnson Foundation Plenary Panel Presentations and Discussion Mobilizing Neighborhood and Community Grassroots Efforts Developing, implementing, and evaluating grassroots changes related to childhood obesity prevention: barriers and opportunities. Moderator: Antronette Yancey, UCLA School of Public Health Plenary Panel Presentations and Panel Discussion
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North Carolina Stewart Gordon, Chair of Louisiana Council on Obesity Prevention Joan Miller, Bexar County Community Health Collaborative, Texas Carol Johnson, Georgia Physical Activity Network Breakout Sessions What are the barriers to change? What is needed to implement and sustain these changes?
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BRIEF SUMMARY: FOCUS ON COMMUNITIES 23 Howard Frumkin, Centers for Disease Control and Prevention, Atlanta Ed McBrayer, PATH Foundation, Atlanta Andy Fisher, Community Food Security Coalition, Venice, California Duane Perry, The Food Trust, Philadelphia Majora Carter, Sustainable South Bronx, New York Breakout #2 Fostering Collaboration between the Public Health and Health Care Communities to Prevent Childhood Obesity Facilitators: Ann Bullock, Health and Medical Division, Eastern Band of Cherokee Indians; Susan Foerster, California Department of Health Services Veda Johnson, Whitefoord Community Program, Atlanta Donna Hardy, Washington Wilkes County/Medical College of Georgia Partnership Luke Beno, Operation Zero, Kaiser Permanente, Atlanta John Batson, Pediatrician, Columbia, South Carolina Breakout #3 Supporting and Evaluating Community Efforts to Prevent Childhood Obesity Facilitators: Marshall Kreuter, Georgia State University, Atlanta; Jennifer Greene, University of Illinois, Urbana-Champaign Steve Fawcett, University of Kansas, Lawrence Laura Kann, Centers for Disease Control and Prevention, Atlanta Greg Welk, FITNESSGRAM Scientific Advisory Board, Ames, Iowa Karen Schetzina, East Tennessee State University, Johnson City Reception Speaker: David Satcher, Morehouse School of Medicine, Atlanta Friday, October 7, 2005 Welcome Jeffrey Koplan, Emory University and Institute of Medicine (IOM) Committee on Progress in Preventing Childhood Obesity
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Moderator: Douglas Kamerow, RTI International, Washington, DC State Perspective Daniel Foster, West Virginia Senate Federal Perspective Janet Collins, Centers for Disease Control and Prevention Local Perspective Larry Johnson, DeKalb County Commission, Georgia Youth Perspective Leann Alexander and Chance Holder, Mississippi 4-H Summary and Next Steps Jeffrey Koplan, Emory University and Institute of Medicine (IOM) Committee on Progress in Preventing Childhood Obesity Group Discussion Closing Session
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Built Environment Local governments, private developers, and community groups should expand opportunities for physical activity including recreational facilities, parks, playgrounds, sidewalks, bike paths, routes for walking or bicycling to school, and safe streets and neighborhoods, especially for populations at high risk of childhood obesity. To implement this recommendation: Local governments, working with private developers and community groups, should: · Revise comprehensive plans, zoning and subdivision ordinances, and other planning practices to increase availability and accessibility of opportunities for physical activity in new developments · Prioritize capital improvement projects to increase opportunities for physical activity in existing areas · Improve the street, sidewalk, and street-crossing safety of routes to school, develop programs to encourage walking and bicycling to school, and build schools within walking and bicycling distance of the neighborhoods they serve.
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and the Department of Transportation should: · Fund community-based research to examine the impact of changes to the built environment on the levels of physical activity in the relevant communities and populations. Health Care Pediatricians, family physicians, nurses, and other clinicians should engage in the prevention of childhood obesity.
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