Progress in Preventing Childhood Obesity How Do We Measure Up? (2007) / Chapter Skim
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. The central recommendation is that parents should promote healthful eating behaviors and regular physical activity for their children.
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. represents a setting that is particularly relevant to the prevention of childhood obesity.
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. Additionally, Oklahoma enacted legislation that requires each public school to establish a Healthy and Fit School Advisory Committee comprised of teachers, administrators, parents, health care professionals, and business community representatives to examine and make recommendations to the school principal regarding health education, physical education and physical activity, and nutrition and health services (NCSL, 2006)
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Teens who consume meals with their families more frequently or who assist with the preparation of dinner for their families report higher intakes of fruits, vegetables, grains, and essential nutrients and lower intakes of low-nutrient foods, such as sweetened soft drinks and dietary fat, and are at lower risk for developing eating disorders (Larson et al., 2006; Neumark-Sztainer, 2006; Neumark-Sztainer et al., 2003)
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These strategies include encouraging parents to refrain from placing a television in their child's bedroom, establishing family rules about television viewing when children are young and consistently enforcing the rules, limiting the amount of time that children can watch television and use other electronic media on school days, not placing a television in household eating areas, disconnecting television viewing with eating meals or snacks, being attentive to how much time children spend with electronic media during their leisure time, and role modeling by limiting parental television viewing (Hersey and Jordan, 2006)
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Health care providers face several challenges when they address childhood obesity (Chapter 6)
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For example, a 16-week controlled trial that involved 43 American-Indian mothers of preschool-aged children used peer educators to deliver a home-based childhood obesity prevention program that included encouraging parental
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Four state WIC programs (California, Kentucky, Vermont, Virginia) and the Inter-Tribal Council of Arizona were funded for a 3-year period to identify ways in which WIC could respond to the childhood obesity epidemic for program participants (USDA, 2005b)
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CURRENT EFFORTS Many different ongoing efforts are focused on improving dietary patterns, increasing physical activity, and preventing childhood obesity in the home environment. However, evaluations of the interventions are generally not performed; therefore there is limited evidence of whether and how these efforts may assist families, whether they have effects on family lifestyles, or even whether they produce unintended adverse effects and outcomes.
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In August 2002, Gerber Products Company launched the Start Healthy, Stay Healthy™ campaign that was designed to provide parents and consumers with educational materials on raising healthy infants and toddlers and preventing childhood obesity (Gerber Products Company, 2006)
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Parents can assist their children with engaging in more healthful eating and physical activity behaviors by modeling the behaviors themselves, providing a supportive environment that facilitates the selection of healthier choices by their children, emphasizing healthy lifestyles and behaviors rather than weight or BMI, and engaging in supportive communication with their children (Neumark-Sztainer, 2005b)
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Progress in preventing childhood obesity through family- and homebased interventions can be categorized as progress in providing environments that facilitate obesity prevention; progress in changing parental, familial, and caregiver behaviors and practices; and progress in research, evaluation, and surveillance. As noted earlier in this chapter, numerous external stresses, pressures, and challenges make it difficult for parents and caregivers to provide guidance and care for their children.
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. One of the challenges in assessing progress and evaluating the childhood obesity prevention initiatives implemented by families is the difficulty in collecting data at the individual parent-caregiver or family-household level.
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. As is the case for government, industry, communities, and schools, the efforts of families and caregivers at home to prevent childhood obesity involve all aspects of the evaluation framework.
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340 STRATEGIES & SECTORS RESOURCES & INPUTS OUTCOMES ACTIONS Health Leadership and Structural Cognitive, Education Outcomes Government Commitment • Parents and families Outcomes Social, and • Parents commit to are educated about Industry • Develop Behavioral Reduce BMI healthy eating at foods, beverages, household policies Communities Outcomes home. Levels in the meals, and snacks consistent with Schools • Increase • Parents plan to model that support a healthy eating and Population consumption of HOME healthy eating.
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and Capacity • Families plan for regular physical Development activity and play for • Establish a family budget their children and to assure funds to support adolescents. opportunities for enjoyable physical activity.
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Develop, Sustain, and Support Evaluation Capacity and Implementation Evaluation capacity refers to assisting families with developing or strengthening their ability to meet specific goals or objectives, as well as monitoring and evaluating their strategies and actions to promote healthier lifestyles in the home setting. Families need to recognize that even small incremental advances are valuable in improving dietary quality, decreasing sedentary time, and increasing physical activity.
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The Youth Risk Behavior Surveillance System assesses the physical activity levels, television viewing times, leisure-time computer use, and fruit and vegetable consumption of middle school and high school students. Disseminate and Use Evaluation Results Although families play a central role in childhood obesity prevention, parents and families have only a limited number of information sources on obesity prevention.
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Recommendation 2: Policy makers, program planners, program im plementers, and other interested stakeholders -- within and across rel evant sectors -- should evaluate all childhood obesity prevention efforts, strengthen the evaluation capacity, and develop quality interventions that take into account diverse perspectives, that use culturally relevant approaches, and that meet the needs of diverse populations and contexts.
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Recommendation 3: Government, industry, communities, and schools should expand or develop relevant surveillance and monitoring sys tems and, as applicable, should engage in research to examine the impact of childhood obesity prevention policies, interventions, and actions on relevant outcomes, paying particular attention to the unique needs of diverse groups and high-risk populations. Addition ally, parents and caregivers should monitor changes in their family's food, beverage, and physical activity choices and their progress to ward healthier lifestyles.
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Implementation Actions for Home Government (federal, state, and local) , communities, families, and the media should disseminate and widely promote the evaluation results of effective family- and home-based childhood obesity pre vention efforts.
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. CNWICRA (Child Nutrition and WIC Reauthorization Act)
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2005. Preventing Childhood Obesity: Health in the Balance.
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2005. Factors associated with parental readiness to make changes for overweight children.
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2006. A Guide to School Health Advisory Coun cils (SHACs)
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