implementing childhood obesity prevention research in a rural oregon county using a partnership...
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Implementing Childhood Obesity Prevention Research in a Rural Oregon County Using a Partnership Approach:
The U.C. (Union County) Fit Kids Project
Nancy Findholt, PhD, RNOHSU School of Nursing
Overview
• Introduction– Community-based participatory research – Childhood obesity in rural areas
• Steps taken to implement the project
• Strategies for building an effective community-university partnership
What is Community-Based Participatory Research?
• “a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community and has the aim of combining knowledge with action and achieving social change.” *
* W.K Kellogg Foundation
Key Principles of CBPR
• Builds on community strengths
• It is collaborative
• It integrates knowledge with action
• The goal is to achieve social change in order to improve health & well-being
Childhood Obesity in Rural America
• Rural children are 25% more likely to be overweight or obese than their urban counterparts*
• The underlying cause of this disparity is believed to be environmental
• Our focus: to understand & address the environmental contributors to childhood obesity in our rural area
* Lutfiyya et al., 2007
Impetus for the Project
• U.C. Fit Kids evolved out of a previous collaborative effort to develop a school health program
• Prompted by the growing evidence of childhood obesity
• Congress had just passed legislation mandating that schools develop wellness policies
Step 1: Assessing Readiness
• Key informant interviews were conducted using questions from the Community Readiness Model*
• Results:– Union County was at a low level of readiness,
but school personnel were more aware & concerned
– Several participants offered to participate
*Plested et al., 2004
Step 2: Structuring Community Involvement
• Coalition partners– School districts - Comm. on Children & Families– Hospital - Public health– Extension Service - Parks & Recreation– Head Start - Other groups & individuals– EOU & OHSU
• Coalition launched at a full-day retreat– Established the infrastructure– Introduced participants to the idea of environmental
influences
Step 3: Getting Started
• With the help of college students:– Conducted a countywide BMI screening– Collected baseline data on children’s physical
activities & diets– Held a contest to design a logo
• Helped the schools to develop wellness policies
• Provided a nutrition class to school food service personnel
Step 4: Assessing Influences on Physical Activity & Diets
• Received 2 grants for assessment
• Collected data from community leaders, school administrators & food service personnel, teachers, parents, adolescents, and children
• The data revealed many barriers to physical activity & healthy eating, but also a few facilitators
Assessment Findings
• Barriers to physical activity– Limited recreational resources– Unsafe streets– Fear of strangers– Limited physical education
• Facilitators of physical activity– Popularity of youth sports– Proximity to the natural environment
Assessment Findings continued
• Barriers to healthy eating– Limited availability of healthy food in small
communities– Convenience stores near schools– High fat entrees in school meals– School practices that encouraged unhealthy
eating
• Facilitators of healthy eating– Popularity of gardening
Step 5: Developing an Action Plan
• Findings reviewed & discussion within coalition
• Public input was obtained • This feedback was used to set priorities for
intervention – Improve quality of school meals– Increase availability of healthy food in small
communities– Provide more physical activity at school– Increase opportunities for life-long activities
Step 5 continued
• Coalition brainstormed about potential strategies to address the priorities
• Action plan created from ideas that were generated
Current Status
• We are in early stages of implementation• Coalition partners have taken the lead to
find funding & initiate projects– Farm-to-school– Walking school bus– Brought a large educational event to Union
County
• Over $450,000 in grant funding has been brought to the County
Lessons Learned
• Building on an existing, positive relationship allowed us to start quickly
• School participation & endorsement helped us to advance our agenda
• The coalition chairwoman’s connections within the county helped to launch the project
Lessons Learned continued
• The passage of legislation on school wellness policies helped to secure the schools’ commitment
• Providing honorariums & stipends to coalition partners helped to sustain their involvement
Acknowledgements
• Thank you to:– The members of the U.C. Fit Kids coalition– My research partners
• Vicky Brogoitti, Union Co Comm on Children & Families
• Dr Yvonne Michael, Drexel University• Dr Linda Jerofke, Eastern Oregon University
– Our primary funding partners• National Institute of Nursing Research• Northwest Health Foundation