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Caron T, Bernard P, Gadais T. Clinical and school-based intervention strategies for youth obesity prevention: A systematic review. Front Sports Act Living 2022; 4:906857. [PMID: 36923584 PMCID: PMC10008876 DOI: 10.3389/fspor.2022.906857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/31/2022] [Indexed: 03/03/2023] Open
Abstract
Introduction In the last couple of decades, numerous intervention strategies (ISs) have been formulated in school/community or clinical sectors using physical activity (PA) in order to prevent youth obesity because they have been highly effective in addressing this issue. These two sectors have revealed some interesting information in terms of efficient results and best practice mechanisms, but comparisons between them to learn about their functioning have been rare. Methods Therefore, the aim of this systematic review was to analyze and synthesize PA ISs from school/community or clinical domains for the period 2013-2017, in French or English, targeting youths aged 5-19 years old through primary, secondary, and tertiary prevention. Results In total, 68 full articles were reserved for data extraction and synthesis and 617 were excluded because they did not meet eligibility criteria (61 of 68 were kept for the final analysis). The results identified a number of differences between the studies of the various IS sectors and also a third type of IS, mixed sector. Mixed ISs (clinical and school-community) have a special advantage because they can benefit from the strengths of both school/community-based and clinical-based ISs. Mixed ISs showed the most promising results. This review also highlighted the differences between sectors and their ISs in terms of intervention teams, prevention objectives, duration, materials, and efficiency. Conclusion Future studies should focus on establishing a prevention program in a given geographical area involving all stakeholders with their respective skills/knowledge, in the area of decision-making and in the development of ISs, to ensure that the program is the most efficient and best adapted to its environment.
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Affiliation(s)
- Théo Caron
- Faculté des Sports et de l'EP, Université D'Artois, Liévin, France
| | - Paquito Bernard
- Département des Sciences de l'activité physique, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center, University Institute of Mental Health at Montreal, Montréal, QC, Canada
| | - Tegwen Gadais
- Département des Sciences de l'activité physique, Université du Québec à Montréal, Montréal, QC, Canada.,UNESCO Chair in Curriculum Development (UCCD), Université du Québec à Montréal, Montréal, QC, Canada
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Goodman AC, Ouellette RR, D'Agostino EM, Hansen E, Lee T, Frazier SL. Promoting healthy trajectories for urban middle school youth through county-funded, parks-based after-school programming. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2795-2817. [PMID: 33914915 DOI: 10.1002/jcop.22587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.
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Affiliation(s)
- Allison C Goodman
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Rachel R Ouellette
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Emily M D'Agostino
- Department of Family Medicine and Community Health, and Department of Population Health Science, Duke University, Durham, North Carolina, USA
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Eric Hansen
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Theodore Lee
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Stacy L Frazier
- Department of Psychology, Florida International University, Miami, Florida, USA
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Messiah SE, D'Agostino EM, Patel HH, Hansen E, Mathew MS, Arheart KL. Changes in cardiovascular health and physical fitness in ethnic youth with intellectual disabilities participating in a park-based afterschool programme for two years. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1478-1489. [PMID: 31219677 DOI: 10.1111/jar.12642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/09/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Youth with intellectual disabilities are more likely to be an unhealthy weight and less physically active than youth without intellectual disability. OBJECTIVE The effects of Fit2Play, a park-based afterschool programme on cardiovascular/fitness health outcomes among youth with intellectual disability, were prospectively assessed. METHODS Youth ages 6 to 22 with intellectual disability who participated in Fit2Play for either one or two school years between 2010 and 2016 (N = 297, mean age 14.1 years, 70% Hispanic, 20% non-Hispanic black, 72% male) were examined via a fitness battery at the beginning/end of the school year(s). Effects of length of Fit2Play participation on body mass index (BMI) %ile, skinfold thicknesses, systolic/diastolic blood pressure (SBP/DBP) %iles, fitness tests, and health and wellness knowledge) were evaluated via two-level repeated measures analysis adjusted for child gender, age, ethnicity and area-level poverty. RESULTS Adjusted models showed that up to two years of Fit2Play participation was significantly associated with improved BMI %ile, skinfold thicknesses, SPB/DBP %iles and PACER scores (p < 0.05 for all). One and two years of programme participation was associated with a 6% [95% CI: 0.92, 0.96] and 10% [95% CI: 0.87, 0.93] reduction in SBP%ile, respectively (p < 0.001), and a 36% [95% CI: 1.28, 1.45] and 57% [95% CI: 1.44, 1.70] increase in PACER score laps, respectively, compared to baseline. CONCLUSIONS Results here suggest that park-based, structured afterschool programmes with a focus on health and wellness can be a rich resource for this nation by offering both exclusive and immersion programmes for children with intellectual disability to foster cardiovascular health in all youth.
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Affiliation(s)
- Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Emily M D'Agostino
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Hersila H Patel
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Eric Hansen
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Matthew Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Messiah SE, Kardys J, Forster L. Reducing Childhood Obesity Through Pediatrician and Park Partnerships. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 23:356-359. [PMID: 27902563 DOI: 10.1097/phh.0000000000000453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sarah E Messiah
- Departments of Pediatrics (Drs Messiah and Forster) and Public Health Sciences (Dr Messiah), University of Miami Miller School of Medicine, Miami, Florida; and Recreation and Open Spaces Department (Mr Kardys), Miami-Dade County Parks, Miami, Florida
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Knight KB, Devers SA, Maloney M, Bomba AK, Walker H, Tucker K, Knight SS. Physical activity in the Families in Transformation (FIT) weight management program for children. Health Promot Perspect 2018; 8:237-242. [PMID: 30087848 PMCID: PMC6064755 DOI: 10.15171/hpp.2018.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/26/2018] [Indexed: 01/22/2023] Open
Abstract
Background: The purpose was to determine if an 8-week nutrition education and exercise program for families could influence health and fitness parameters, and retention of nutrition knowledge. Methods: Eighteen children (mean age: 10.52 ± 1.26 year; 50% boys, 50% girls; 56% white, 25% black, 19% multiracial) participated in the Families in Transformation (FIT) program. Preand post-study anthropocentric, blood pressure, fitness, and nutrition knowledge data was collected. Results: Diastolic blood pressure decreased for the total group (66.63 ± 8.81 to 63.75 ± 11.81mm Hg). Significant (P < 0.05) increases were seen for the group for push-ups (14.31 ± 7.62 to 19.63 ± 6.62) and chair squats (30.50 ± 10.21 to 34.44 ± 7.39). The reinforcing physical activity group performed significantly better on nutrition knowledge quizzes. Conclusion: Although, body mass index (BMI) z-scores did not change, there was a decrease in diastolic blood pressure, increase in fitness parameters, and increased retention of nutrition knowledge.
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Affiliation(s)
- Kathy B Knight
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Sydney A Devers
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Meagan Maloney
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Anne K Bomba
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Heather Walker
- Department of Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Kathy Tucker
- Coordinator of Outreach and Innovation, Health Works! North Mississippi, North Mississippi Health Services, Tupelo, MS, USA
| | - Scott S Knight
- Director of University of Mississippi Field Station, University of Mississippi, University, MS, USA
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7
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Messiah SE, D'Agostino EM, Patel HH, Hansen E, Mathew MS, Arheart KL. Sex differences in fitness outcomes among minority youth after participation in a park-based after-school program. Ann Epidemiol 2018; 28:432-439. [PMID: 29703522 DOI: 10.1016/j.annepidem.2018.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/05/2018] [Accepted: 03/30/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to describe sex differences in fitness outcomes after participation in Fit2Play, a park-based after-school health and wellness program. METHODS Youth who participated in Fit2Play for either 1, 2, or 3 school years between 2010 and 2016 (n = 2129, mean age 9.1 years, 52% Hispanic, 48% non-Hispanic black, 54% male) were tested via a comprehensive fitness battery at the beginning/end of the school year(s). Effects of length of Fit2Play participation on fitness outcomes were assessed via three-level repeated measures analysis stratified by sex and adjusted for child sociodemographics, weight category, area poverty, and year. RESULTS Significant improvements for boys and girls were found in the Progressive Aerobic Cardiovascular Endurance Run (P < .01 for girls, P < .001 for boys), 400 meter run tests (P < .001 for girls, P < .01 for boys), and push-ups (P < .01 for both), with dose-response trends for girls after up to 3 years of Fit2Play participation. From baseline to 1, 2, and 3 years of participation, girls demonstrated 8%, 14%, and 23% mean improvement in 400 meter run times versus 9%, 9%, and 17% for boys, respectively (P < .001 for all). Dose-response improvements were also found in girls for PACER scores and sit-ups. CONCLUSIONS After-school physical activity programs can improve fitness in all youth, and particularly girls with increased years of participation. Further research should examine sex differences in the effects of park-/community-based programs to reduce sex disparities in fitness, particularly in light of the current youth obesity epidemic.
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Affiliation(s)
- Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
| | | | | | - Eric Hansen
- Department of Parks, Recreation and Open Spaces, Miami, FL
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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D'Agostino EM, Patel HH, Hansen E, Mathew MS, Nardi M, Messiah SE. Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA. J Epidemiol Community Health 2018; 72:193-201. [PMID: 29175865 DOI: 10.1136/jech-2017-209333] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/01/2017] [Accepted: 11/13/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND The WHO calls for affordable population-based prevention strategies for reducing the global burden of cardiovascular disease (CVD) on morbidity and mortality; however, effective, sustainable and accessible community-based approaches for CVD prevention in at-risk youth have yet to be identified. We examined the effects of implementing a daily park-based afterschool fitness programme on youth CVD risk profiles over 5 years and across area poverty subgroups. METHODS The study included 2264 youth (mean age 9.4 years, 54% male, 50% Hispanic, 47% non-Hispanic black, 70% high/very high area poverty) in Miami, Florida, USA. We used three-level repeated measures mixed models to determine the longitudinal effects of programme participation on modifiable CVD outcomes (2010-2016). RESULTS Duration of programme participation was significantly associated with CVD risk profile improvements, including body mass index (BMI) z-score, diastolic/systolic blood pressure, skinfold thicknesses, waist-hip ratio, sit-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER) score, 400 m run time, probability of developing systolic/diastolic hypertension and overweight/obesity in high/very high poverty neighbourhoods (P<0.001). Diastolic blood pressure decreased 3.4 percentile points (95% CI -5.85 to -0.85), 8.1 percentile points (95% CI -11.98 to -4.26), 6.1 percentile points (95% CI -11.49 to -0.66), 7.6 percentile points (95% CI -15.33 to -0.15) and 11.4 percentile points (95% CI -25.32 to 2.61) for 1-5 years, respectively, in high/very high poverty areas. In contrast, significant improvements were found only for PACER score and waist-hip ratio in low/mid poverty areas. CONCLUSION This analysis presents compelling evidence demonstrating that park-based afterschool programmes can successfully maintain or improve at-risk youth CVD profiles over multiple years.
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Affiliation(s)
- Emily M D'Agostino
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Hersila H Patel
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Eric Hansen
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria Nardi
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
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A Scoping Review of Inclusive Out-of-School Time Physical Activity Programs for Children and Youth With Physical Disabilities. Adapt Phys Activ Q 2018; 35:111-138. [PMID: 29338295 DOI: 10.1123/apaq.2017-0012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to comprehensively evaluate inclusive out-of-school time physical activity programs for children/youth with physical disabilities. A search of the published literature was conducted and augmented by international expertise. A quality appraisal was conducted; only studies with quality ratings ≥60% informed our best practice recommendations. Seventeen studies were included using qualitative (n = 9), quantitative (n = 5), or mixed (n = 3) designs. Programs had a diversity of age groups, group sizes, and durations. Most programs were recreational level, involving both genders. Rehabilitation staff were the most common leaders. Outcomes focused on social skills/relationships, physical skill development, and psychological well-being, with overall positive effects shown in these areas. The best practice recommendations are consistent with an abilities-based approach emphasizing common group goals and interests; cooperative activities; mastery-oriented, individualized instruction; and developmentally appropriate, challenging activities. Results indicate that inclusive out-of-school time physical activity programs are important for positive psychosocial and physical skill development of children/youth with physical disabilities.
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Messiah SE, Jiang S, Kardys J, Hansen E, Nardi M, Forster L. Reducing childhood obesity through coordinated care: Development of a park prescription program. World J Clin Pediatr 2016; 5:234-43. [PMID: 27610338 PMCID: PMC4978615 DOI: 10.5409/wjcp.v5.i3.234] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/24/2016] [Accepted: 06/01/2016] [Indexed: 02/06/2023] Open
Abstract
Major hindrances to controlling the current childhood obesity epidemic include access to prevention and/or treatment programs that are affordable, provide minimal barriers for participation, and are available to the general public. Moreover, successful childhood obesity prevention efforts will require coordinated partnerships in multiple sectors such as government, health care, school/afterschool, and the community but very few documented sustainable programs currently exist. Effective, community-based health and wellness programs with a focus on maintaining healthy weight via physical activity and healthy eating have the potential to be a powerful referral resource for pediatricians and other healthcare professionals who have young patients who are overweight/obese. The Miami Dade County Department of Parks, Recreation and Open Spaces in partnership with the University of Miami UHealth Systems have created a "Park Prescription Program (Parks Rx 4Health(TM))" that formally coordinates pediatricians, families, parents, caregivers, and child/adolescents to provide daily obesity-prevention activities. This Parks Rx 4Health(TM) program that we describe here allows UHealth pediatricians to seamlessly refer their overweight and obese patients to Fit2Play(TM), an evidence-based, park-based afterschool health and wellness program. Measurable outcomes that include body mass index, blood pressure, fitness, and nutrition knowledge are being collected at baseline and at 3-and 6-mo after referral to document patient progress. Results are then shared with the referring physician so they can follow up with the patient if necessary. Identifying successful models that integrate primary care, public health, and community-based efforts is important to accelerating progress in preventing childhood obesity. Effective, community-based health and wellness programs with a focus on physical activity and nutrition education could be a powerful referral resource for pediatricians who have obese patients.
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Hatfield DP, Chomitz VR, Chui KKH, Sacheck JM, Brown AA, Economos CD. Impact of a Community-Based Physical Activity Program on Fitness and Adiposity Among Overweight and Obese Children. Health Promot Pract 2016; 18:75-83. [PMID: 27199149 DOI: 10.1177/1524839916642714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study tested whether overweight/obese children's attendance in a community-based physical activity (PA) program was associated with changes in cardiorespiratory fitness (CRF) and adiposity and whether in-program activity levels influenced those associations. Program sessions (offered twice/week, 2 hours/session, over 9 months) included structured exercise/sports. At baseline and follow-up, CRF was measured as Progressive Aerobic Cardiorespiratory Endurance Run (PACER) laps, height/weight were measured, and body mass index (BMI) was calculated. Attendance was recorded as sessions attended. Children wore pedometers in 10 representative sessions; in-program activity was calculated as mean steps/minute across sessions. Linear mixed models tested associations between attendance and changes in PACER score and BMI and the influence of in-program activity on those associations. A total of 101 participants (56% male, 93% Hispanic) completed baseline and one or two follow-up fitness/adiposity measurements. Attendance was associated with PACER change (β = .093, p = .01) but not BMI change (β = .00026, p = .97). There were significant interactions between attendance and in-program activity: Attendance more favorably affected PACER (p < .0001) and BMI (p = .03) as in-program activity levels increased. Attending community-based PA programs may improve CRF among overweight/obese children, particularly when participants are highly active during program time. Community practitioners should not only enroll overweight/obese children in PA programs but also promote adequate attendance/in-program activity levels.
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Affiliation(s)
| | | | | | | | - Allison A Brown
- 1 Tufts University, Boston, MA, USA.,2 East Boston Neighborhood Health Center, East Boston, MA, USA
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