Childhood Obesity in Texas: A Massive Public Health Issue (and what we can do to help) Shreela Sharma, PhD, RD, LD Assistant Professor, The University of Texas School of Public Health Michael & Susan Dell Center for Healthy Living Michael & Susan Dell Center for Healthy Living Mission: Healthy Children in a Healthy World Established in 2006 at the University of Texas School of Public Health with funding from MSDF. Director: Dr. Deanna Hoelscher; Co-director: Dr. Steve Kelder
19 faculty members located in Austin, Houston and Brownsville One of our goals: prevention and control of childhood obesity through healthy eating and physical activity, promotion of healthy living behaviors in youth, policy and environmental Source: Brownell, 1994 change Coordinated Approach to Child Health (CATCH) Classroom Curriculum Physical Education
School Food Service A Good Place to Start Family Research Phases of CATCH Pilot Trial 1987-91 8 schools 1991-94 96 schools Tracking Maintenance
Dissemination schools 1994-97 51 schools 1998-99 88 schools 1998-2006 Catch Kids Club 1999-2001 Homocysteine 2000-2001 1900 +
16 schools 25 schools Research Phases of CATCH EXPORT 2003-2007 LRGV Pass & CATCH 2004-2007 8 schools
RWJ Policy2005-2008 150 schools Harris County 2005-2007 430 schools CDC SIP 11,12,18 Dell CATCH 2005-2008 32 schools 2006-2010 97 schools CATCH UP 2008-2011 16 Head Start centers
CATCH is a TEA approved program Proven to increase healthy eating behaviors and physical activity in children. But.does CATCH have any effect on childhood obesity? El Paso CATCH replication. The Michael & Susan Dell Center for
Healthy Livings SPAN study found a significant decrease in the obesity rates for children in the El Paso region from 2000-2002 to 2004-2005, from 25.8% to 18.8%. CATCH initiative was ongoing in schools for 8 years. Hoelscher et al., Obesity 2009. Steps to a Healthier Houston/Harris County Consortium: Dissemination of CATCH in Harris County Public Elementary Schools (2007-2008) 22 Harris County Districts Invited 19 Districts 488 schools
20 Districts Agreed to Participate 39 Trainings Conducted March 06Nov. 07 Potential reach of >335,000 students 2,119 school staff trained in CATCH Evaluation Results (n=39 schools)
No increases in prevalence of obesity over study period. Increased physical activity (total minutes, number of PE classes, outdoor time) Improvements in dietary habits Travis County Dell CATCH community program 8.3% decrease in obesity prevalence from spring 2007 to spring 2008, compared to a 1.3% decrease in elementary school students enrolled in the CATCH BasicPlus program. Hoelscher DM et al., Obesity 2010. 18 suppl 1, S36-44.
CATCH Early Childhood for preschoolers CATCH UP CATCH in Underserved Populations Nutrition and garden-based classroom curriculum Age and developmentally appropriate physical activities Family component Implemented in Harris County Department of Education Head Start centers (1200+ children enrolled) Predominantly low-income Hispanic and AA families with >35% of the children overweight or obese; <5% of time at preschool spent in MVPA; low intake of vegetables and high prevalence of sedentary behaviors. Pilot evaluation of CEC showed: Significant increases in vegetable intake (p=0.002)
Increase in mean minutes of physical activity and MVPA (p<0.05) Sharma et al., American Journal of Health Education, 2011 Dissemination of CATCH in Texas >2,500 Texas elementary schools N o . E le m S c h o o ls in T e x a s Other Adopters: Dept of Def Florida California Illinois New York New Mexico
Maine Delaware Kansas Natl Parks & Rec Thousands nation and worldwide 950,800 children; 33% of Texas students 3000 2500 2000 1500 1000 500 0 1996-97
1997-98 1998-99 1999-00 2001-02 2002-03 2003-04 2004-05 2005-06 2009 School Year Why CATCH? Evidence-based Proved track record of success Cost-effective Teacher-led Available for purchase through Flaghouse
Inc. across U.S. and Canada ( www.catchinfo.org) Promoting physical activity through social reinforcement and goal setting: the effects of Marathon Kids on lowincome elementary school students in Texas Nonprofit organization established in 1996 in Austin, Texas. Austin, Dallas, Houston, Harlingen, Los Angeles, Baltimore, & Chicago:~150,000 Goals: To engage children (and families) in running/walking 26.2 miles over six month period. To promote childrens consumption of 5 fruit & vegetables a day/26 days per month. Evaluation Results 383 intervention vs. 128 controls (primarily
low-income, minority) Significant increases in: Running time (p=0.007) Fruit (p=0.01) and vegetable (p=0.03) intake Athletic identity, physical activity selfefficacy and outcome expectations (p<0.001) Springer et al., Journal of Physical Activity and Health, in press Promising Practices Simple model (Low-cost, high volunteer factor, easy to implement at school) Structured time for run/walk during school
day Social reinforcement: parents, teachers, public role models, public events, rewards Next Steps: How do we refine the model for greater impact? Sprouting Healthy Communities Sprouting Healthy Communities (SHC) is a comprehensive community-based project, developed by the Sustainable Food Center (SFC), a non-profit organization based in Austin, Texas. SHC targets community members of low-income communities through multiple interventions including a school-based program, community cooking classes,
community gardens, and local farmers markets. Currently they are measuring the impact of the middle school program and the farmers markets on fruit and vegetable intake of program participants. Evans A, Jennings R, Smiley A, Medina J, Sharma S, Rutledge R, Stigler M, Hoelscher D. Placement of farm stands in low-income communities increases fruit and vegetable consumption among community residents. Under review. SFC projects Sprouting Healthy Kids farm-to-school and food systems education project Local foods in the school cafeteria In-class lessons in core curriculum classes After-school program, including gardening and cooking activities and field trips
An Ecological Model Depicting the Multiple Influences on What Children & Adolescents Eat Source: Kolbe, L & Story M. Preventing childhood obesity. National Academies Press; 2005. p.84 What Can We Do? Strengthen work on evidence-based Coordinated School Health Programs (SB 19, 42, 530, 283, 892) Increase accountability
Provide resources (personnel, funding) and structure (e.g., require community members to serve on school committees) Require healthy eating and physical activity courses in high schools Support evidence-based community strategies Increase and improve availability of healthy foods in public places Create safe communities that support physical activity What Can We Do? Provide opportunities for increased access to PA and healthful eating Increase allocation of funds for Safe Routes
to School Provide guidelines for early childhood nutrition and physical activity (SB 395) Support expansion of farm to school programs and WIC/SNAP into farmers markets Support recess in schools Monitor BMI & nutrition/activity trends SPAN and Fitnessgram
