Upload
vuthuan
View
216
Download
0
Embed Size (px)
Citation preview
Deborah Burnet, MD, MA; Lorri McClinton-Powell, BS;
Rebecca Lipton, PhD; Michael Quinn, PhD Kweku Embil, MA; Dawnavan Davis, PhD; Althera Steenes
Marla Solomon, RD, LD/N, CDE; Shahid Choudhry, MPH
and
Power-Up Afterschool Program to Prevent Obesity:
A Case Study from Chicago’s South Side
Woodlawn Community
School
Chicago’s South Side 1.1 million, Primarily AA Very high rates of obesity, diabetes and complications Practical, real-world solutions needed
The REACH-OUT Program: YMCA, Co-op Food Market
REACH-OUT Children’s Diabetes Prevention Program
14 week nutrition & exercise program Obese 9-12 yr old kids and their parents Lay health leaders – successfully engaged Realistic goal setting, group activities & skills Improved dietary and PA behaviors No significant changes in BMI, z-scores More sustainable partnerships needed After-school programs provide opportunity
CBPR Principles in Power-Up Woodlawn Community
School (CPS) Relationship grew out of
existing network of community partners
Developed partnership
over a year and a half, before research began
Dr. Davis with Principal Embil
*CBPR = Community-Based Participatory Research (Israel, Ann Rev Pub Health, 1998)
CBPR Approach Attended PTA meetings &
coffees to gain parents’ input
Collaborated with teachers on curriculum
Involved staff in program implementation
Iteratively refined program with teachers & parents
Shared grant $ with WCS Mr. Hubbard (WCS Security) and Dr. Burnet
Power-Up Program
Adapted from Reach-Out curriculum Collaborative iterations with WCS teachers Curricular expert as consultant
14 weekly interactive sessions for grades K-2, 3-4, 5-6 (later expanded to 20 sessions)
All after-school kids participated; some as subjects (if consented)
Lay Health Leaders
Lorri McClinton After School Coordinator
Renee Salahuddin After-School Teacher Lornee Love After-School Teacher
CPS after-school teachers Trained by behavioral psychologist and research staff Continued support throughout program
Data Collection Pre- and post- data collected
on-site, user-friendly Parent and child outcome
measures: BMI (z-scores for children) Blood pressure Self reported dietary
intake, physical activity, health knowledge, beliefs and attitudes
Power-Up Kids with Medical Students
Drs. Burnet & Daru with a Power-Up Parent
Power-Up Results 70 children in after-school
program; 40 enrolled 16 boys and 24 girls, all
African American Age range: 5 – 12 years
(mean=8) 28 parents - all women,
ages 24 – 62 years (mean=37)
Power-Up logo contest winner and Dietitian Marla
Power-Up Baseline BMI
These data mirror figures for CPS overall, and other urban areas
BMI Z-Score Change
-0.244
-0.372
-0.206
-0.068
-0.4
-0.35
-0.3
-0.25
-0.2
-0.15
-0.1
-0.05
01 2 3 4
Series1
Overall Normal wt Overweight Obese
p<0.005 p<0.005 p=0.01 p=0.166
(Paired t-tests)
Limitations & Challenges Small sample size, short term follow-up One school on Chicago’s South Side No control condition
Heaviest kids need referral for more intensive
management Hard for parents to participate after-school due
to competing commitments
Cell-phone Texting for Parents Cellphones ubiquitous (Pew Rsch Ctr, 2010) Promising interventions: Diabetes, weight control, sexual health, smoking, asthma Tailored to participant preferences, interactive UC experience with diabetes (Peek, Nundy): high satisfaction, improved self-management
Texting already embedded in WCS culture: CPS 2011 First Day Attendance Award! Adapted for Power-Up parents – messages twice a day
Sample Text Messages Awareness: ‘USDA Food & Activity Pyramid was discussed at Power-Up today’
Information: ‘5 servings of fruits or vegetables are recommended per day for children and adults’
Behavioral cues: ‘Include at least one fruit or veggie in each of your child’s meals today’
Questions: ‘What kind of exercise did you do with your child today?’
Texting Experience 10 families with 3rd-4th graders enrolled 9/10 had unlimited texting plans
All parents reported “complete comfort” texting 55% of texted questions answered by parents, within 5 minutes on average “Very easy to use…and educational” “Helped me change to healthier snacks”
Breaking Ground Power-Up collaboration led to sustainable impact at WCS: New playground equipment Greenhouse for growing veggies Healthy snack choices after-school School newsletter highlights “Veggie or Fruit of the Month”and healthy recipes Produce van comes weekly
Proud WCS students
Principal Embil digs a site for playground equipment
Next Steps Continuing relationship
between UC and WCS
Planning randomized trial across multiple CPS after-school programs
White Sox partnership & social marketing to promote healthy lifestyles!
Proud students after installation of the fun-hoop
White Sox mascot Southpaw at WCS
Lessons Learned Time & effort invested in relationships pay off in sustainability – Build on existing culture Creative use of technology (texting) can address time constraints, scalability Refer heaviest kids for more intensive care Partnerships can lead to policy changes (CPS Task Force on vending machines) Dovetail with policy, social trends – help partners succeed
Policy Alignment USDA “Healthy Schools Challenge” CPS Wellness Initiative “Go for the Gold” campaign CDPH “Healthy Chicago” initiative Increased need & opportunities for obesity research in schools
Acknowledgements Funded by NIH UChicago CTSA award: U1 RR024999 Power-Up Children and Parents! Woodlawn Community School
Principal/ Co-Investigator: Kweku Embil Lay Health Leaders: Lorri McClinton, Renee Salahuddin,
Lorne Love; Staff: Jackie Greere, Mr. Hubbard Power-Up staff & investigators:
Resident, Fellow: Alyson Myers, Amy Darukhanavala Medical Students: Kavitha Selvaraj & Katie Gliessen Marla Solomon, Mike Quinn, Shahid Choudhry Dawnavan Davis, Becky Lipton, Althera Steenes
Thank You
For further information contact :
Deborah Burnet [email protected] Althera Steenes [email protected]
Power-Up Session Topics
1) Kick Off-Power Up to a Healthy Life 11) Fats: Healthy Choices
2) Fruits & Vegetables: 5-a-Day, Part I 12) Project Week
3) Fruits & Vegetables: 5-a-Day, Part II 13) Let’s Start with a Good Breakfast
4) Project Week 14) Water, Water, Everywhere
5) Grains: The Get Going Group, Part I 15) Snacks for Healthy Eating
6) Grains: The Get Going Group, Part II 16) Project Week
7) Great Combo: Milk, Bones, Teeth 17) Physical Fitness/Muscle Mania
8) Project Week 18) Mix it Up-Cooking Healthy
9) Mighty Meat to Grow 19) Final Review
10) Being Heart Smart 20) Celebration-Welcome Home!
CTSAs - Resources for CEnR University of Chicago Institute for Translational
Medicine 60 CTSA awards nationally – mandate, training and
supports for community-engaged health research (CEnR)
C3 Collaboration (UChicago, Northwestern, UIC, Rush,
ACCESS)