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National Prevention Summit:
Prevention, Preparedness, and Promotion

October 26 and 27, 2006
Hyatt Regency Washington on Capitol Hill
Washington, D.C.

Concurrent Workshop Session I—Healthier People
(A4) Families

Thursday, October 26, 11:00 a.m.-12:30 p.m.

Moderator

CAPT Laura A. McNally, M.P.H., R.D., FADA
Senior Advisor, Office of Commissioned Corps Affairs

Presentations

FLAIR: OPTIMIZING THE PRIMARY CARE PRACTICE FOR CHILDHOOD OBESITY PREVENTION

Darwin Deen, M.D., M.S.; M. Diane McKee, M.D., M.S.; Alice Fornari, Ph.D., R.D.; Arthur Blank, Ph.D.
Albert Einstein College of Medicine, Bronx, NY

The Family Lifestyle Assessment of Initial Risk (FLAIR) project targets families with young children to address lifestyle behaviors known to place children at risk for overweight and smoking-related illnesses (family meals, physical activity, fast food, juice, soda, low fat milk, sedentary behavior, and smoking exposure). In New York City, 43 percent of elementary public school children are overweight or at risk of overweight, making early intervention in problem behaviors a critical issue.

We trained clinicians in three practices to implement a family-focused lifestyle risk assessment during pediatric preventive care visits with 2- to 4-year-olds and then provided brief behavior change messages utilizing the choices and changes model (assessing conviction and confidence for the behaviors to be addressed). We also incorporated a "lifestyle counselor" into the practice to augment the clinicians' behavior change efforts. The lifestyle counselor's contacts have mostly been via telephone. In addition, we recommend a follow-up interval every 3 to 6 months rather than annual revisits.

While only half-way through the intervention, the presentation will cover what has been learned through the development of the screening tool, the training of the clinicians, implementation challenges, and the methodology used to assess baseline health behaviors and behavior change. FLAIR represents a reproducible model for changing the primary care practice environment to engage families in preventive health behavior change. This project is funded through the Robert Wood Johnson Foundation's Prescription for Health program.


WITH COMMUNITIES AND PARENTS, WE CAN! HELP CHILDREN MAINTAIN A HEALTHY WEIGHT

Susan G. Dambrauskas
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD

In September 2006, the National Heart, Lung, and Blood Institute (NHLBI) will complete a process and outcome evaluation of the first year of the National Institutes of Health's (NIH's) nationwide community-based childhood obesity prevention program, We Can! (Ways to Enhance Children's Activity & Nutrition). This presentation will highlight the evaluation methodology and findings and discuss the implications for community obesity prevention programs.

Using in-depth interviews and community event and partnership tracking measures from 14 selected sites, NHLBI is assessing the impact of We Can! on community obesity prevention programs. To determine outcomes, NHLBI also is quantifying changes in knowledge, attitudes, and behaviors among youth and adult participants of evidence-based curricula available through We Can! These include three youth curricula—CATCH, Media-Smart Youth, and SMART—and a new curriculum for parents and adult caregivers: We Can! Energize Our Family.

We Can! was developed by NHLBI to combat the public health problem of childhood overweight and obesity and is promoted in collaboration with three other NIH Institutes and national partners. The program provides resources and community-based programs for parents, caregivers, and youth to help children age 8 to 13 maintain a healthy weight through improved food choices, increased physical activity, and reduced screen time. We Can! offers a unique approach to stakeholders through its highly flexible program design. The initiative collaborates with national partners to expand outreach; fosters innovation and information-sharing among community sites to raise awareness and educate the public; and encourages local and national media to disseminate key messages.

Since its launch by Health and Human Services Secretary Leavitt and other public health officials in June 2005, We Can! has enrolled more than 85 sites across the United States. This diverse group includes park and recreation departments, schools, health departments, hospitals, and faith-based groups in a variety of geographic areas.


SNEAKS AND TREATS: A FUN FAMILY FITNESS PROGRAM

MaryBeth Knowlton, R.D., C.D.N.; Kristi R. Briones
Jefferson County Public Health Service, Watertown, NY

West Carthage Elementary (WCE) in Jefferson County, New York, receives funding and technical assistance from Steps to a HealthierNY to create sustainable programming and policies to improve the health of students and staff at that school. A Healthy School Team at West Carthage Elementary completed the Centers for Disease Control and Prevention School Health Index in the fall of 2005 and identified several areas in need of improvement. Three main areas of focus for the school were a need to increase physical activity for their students; a need to encourage healthier eating habits among students; and a need to get parents and the community more involved with the school.

The team designed a program called "Sneaks n' Treats" to address the three identified areas. "Sneaks" refers to organized physical activity, and "Treats" refers to healthy snacks, which were provided to all who attended the program. Snacks were centered on the idea of encouraging families to eat more fruits and vegetables everyday, and exposing children and parents to healthier food choices. Information also available to parents and children included easy healthy recipes and snack ideas, an emphasis on reducing TV time, and milk taste tests and handouts to encourage a switch from 2 percent or whole milk to 1 percent or skim milk. The family-oriented evening program was held at WCE and was open to the community. Overall, Sneaks n' Treats averaged about 80 adults and children on each of the 10 nights of the program. On the last night of the program, 32 adults completed a survey on the health impact of Sneaks n' Treats. The results indicated that the program had a positive impact on parent involvement with the school, fruit and vegetable intake, and TV viewing time.


PREVENTING HEALTH DISPARITIES BY PROMOTING BREASTFEEDING AMONG OKLAHOMA NATIVE AMERICANS

Karen K. Palumbo, M.Ed.; Piers R. Blackett, M.D.; Elisa T. Lee, Ph.D.; Dana S. Campbell-Sternlo; Heather D. Hoffhines, M.S.; Stephen R. Glore, Ph.D.
University of Oklahoma Health Sciences Center, Oklahoma City, OK

Statewide and national studies demonstrate the existence of obesity and diabetes mellitus in Native American adults and children. The state of Oklahoma has one of the highest obesity ratings in the Nation. The purpose of this study is to see if additional education on healthy feeding practices will prevent obesity in early childhood in order to help Native American children grow up as healthy adults with lower risks for diabetes and obesity.

Interviews were conducted to determine prevailing nutritional practices. A second group was recruited during pregnancy, and individuals in that group are being followed until the child's second birthday. Participants attend a baby-feeding education class during pregnancy promoting breastfeeding and healthy feeding practices.

The primary survey indicated a low initiation rate of breastfeeding, 52 percent, as the prevailing feeding practice in the target population. Barriers to breastfeeding, obtained by interviews, include lack of support from immediate and extended family, and education by healthcare providers. The cohort group consists of 186 mothers. To date, 125 babies have been born, which includes five sets of twins. The breastfeeding initiation rate of the cohort group is 88 percent. Additional data are currently under analysis.

Risk factors for childhood obesity that can be identified in the population include low socioeconomic status, high maternal body mass index, and absence or short duration of breastfeeding. The information collected is being used for establishing educational needs for Native American families. The increase in breastfeeding prevalence, continued support for breastfeeding mothers, and nutrition education can lead potentially to a reduction in diabetes and obesity. The study offers support and education during pregnancy and during the child's first 2 years, and feedback from participants has been positive.

For questions or more information, please contact summit@hhs.gov.

 

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