The Communities Preventing Childhood Obesity project Multi-state - - PDF document

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A Social-Ecological Approach to Exploring Rural Food Access and Active Living for Families with Preschoolers

Research Brief, J Nutr Ed Behav;47(6):548-554 Authors: Brandy Buro, Abby Gold, Dawn Contreras, Ann Keim, Amy Mobley, Paula Peters, Sandy Procter, and Carol Smathers

Learning Objectives

• 1. Describe the ecological model of predictors of childhood
• verweight.
• 2. Describe how the community portion of the ecological model affects

the barriers and facilitators for accessing healthy food and physical activity opportunities for rural preschool children.

• 3. Describe Communities Preventing Childhood Obesity Project
• 4. Describe a mixed method developmental approach with

complementary intent used in order to best understand the experiences of rural parents and their preschool-aged children access to healthy environments.

The Communities Preventing Childhood Obesity project

• Multi-state

– IN, KS, MI, ND, OH, SD, WI

• Multi-disciplinary team

– Nutrition – Physical activity – Community development – Family and youth development

• USDA Agriculture and Food Initiative (AFRI)

Start a community development intervention to prevent childhood

• besity.

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Innovative Aspects

• 7 states collaborating
• Community capacity development coaching

approach

• Ecological Model of Childhood Overweight

– Rural communities – Low-income families – Preschool-aged children

Ecological Model of Childhood Overweight

Weight Status Weight Status

Ethnicity School lunch program

Work demands Neighborhood safety Socioeconomic status

School PE program s

Accessibility of recreational facilities, convenience foods, and restaurants Foods available in home Nutritional knowledge

Parent’s dietary intake

Encouragement of activity Parent’s activity patterns Monitoring TV hours Parent’s weight status

Dietary intake Sedentary behaviors Physical activity

Ecological Model of Childhood Overweight

Ethnicity School lunch program Work demand s Neighborhood safety Socioeconomic status School PE program s Accessibility of recreational facilities, convenience foods, and restaurants

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y g p Factors

These factors are more complex and their relationship to obesity is less understood; however, they must be taken into consideration when implementing an intervention.8 Ethnicity School lunch program Work demand s Socioeconomic status School PE program s Local Environment Local Environment

Community and Demographic Factors

These factors are more complex and their relationship to obesity is less understood; however, they must be taken into consideration when implementing an intervention.8

Local Environment

• Neighborhood Safety
• Availability of convenience foods
• Accessibility to recreational

facilities and restaurants

Ecological Model of Childhood Overweight

Ethnicity Work demands

Neighborhood safety Socioeconomic

status

Accessibility of recreational facilities, convenience foods, and restaurants

School Environment School Environmen

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Community and Demographic Factors

These factors are more complex and their relationship to obesity is less understood; however, they must be taken into consideration when implementing an intervention.8

Local Environment School Environment

• Neighborhood Safety
• Availability of convenience foods
• Accessibility to recreational facilities and

restaurants

• Lunch programs
• Physical Education programs

Ecological Model of Childhood Overweight

School lunch program Work demand s Neighborhood safety School PE program s Accessibility of recreational facilities, convenience foods, and restaurants Population- based characteristics Population- based characteristics

Community and Demographic Factors

These factors are more complex and their relationship to obesity is less understood; however, they must be taken into consideration when implementing an intervention.8 Local Environment School Environment

Population- based characteristics

• Neighborhood safety
• Availability of convenience foods
• Accessibility to recreational facilities and restaurants
• Lunch programs
• Physical Education programs
• Ethnicity
• Race
• Socioeconomic status

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Community coalitions consist of public- and private-sector organizations that, together with individual citizens, work to achieve a shared goal through the coordinated use of resources, leadership, and action.10

Role of a Coalition

The vehicle for successful change at the community level!

Engage residents in the cause Create a sense of community

Success of a Coalition

Relies on capacity-building ability of the coalition

Barriers to Coalition Success

Lack common vision Lack formalization Lack clearly defined roles Failure to reevaluate Failure to act Failure to commit

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Community Coaching

An effective approach to support community development for sustained community change initiatives

What is Community Coaching?

• “A Community Coach is a

guide who supports communities and

• rganizations in identifying

and achieving their goals.”

(Emery, Hubbell, & Miles-Polka, 2011)

• Works as a process coach

with a group or coalition

– Ensures efforts follow community development principles of good practice

Planned Approaches to Community Intervention

Robinson &Green (2011)

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Methods

– 14 communities

• 2 in each state

(1 intervention, 1 control) – Comparable in size and demographics

• Rural community
• Exhibit community readiness
• Has an existing community

coalition

– All communities:

• Child Ecological Model

Assessment

• Receive menu of evidence-

based interventions

• Implement 1 physical activity

and 1 nutrition intervention

• Receive $5000/year for 4

years

– Intervention communities:

• Hire a Community Coach
• Receive Community Coach

training

Measuring Impact

• Child Ecological Model

Assessment toolkit:

– Community Healthy Living Index assessments (YMCA)

• Community-at-Large
• Neighborhood
• Early Childhood Program

– Active Where? Parent Survey – Coalition Self- Assessment

Active Where? Parent Survey

Active Where? Parent Survey

• Pre-test / Post-test
• Assesses “Community and Demographic” and

“Parenting / Family Characteristics” rings

– Considers home, neighborhood, park, and school environments related to physical activity and eating

• Low-income parents of preschool-aged

children

http://www.activelivingresearch.org/node/11951

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Research Brief Description

• Mixed Method Approach

Active Where? Pre-Surveys (N = 377)

• 11 sections total
• Three sections were included in this CPCO sub-

study: recreation places and sports facilities where your child plays ( = 0.81); barriers to activity in the local neighborhood ( = 0.88); and a brief food frequency ( = 0.7)

One-on-One Semi-Structured Interviews (N = 15)

Results – Active Where Survey

• Physical activity of children we determined

by proximity to parks.

• Playing outside was determined by

proximity to road

• No significant relationship between ease
• f walking to stores and how often fresh

fruit or vegetables were available in the home

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Results – Interview Themes

• Accessibility and

utilization of resources

• Neighborhood

safety

• Interpersonal

relationships

Accessibility and Utilization of Resources

Neighborhood safety

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Interpersonal Relationships

Conclusion and Recommendations

• Proximity and traffic

safety

– Active transport – Traffic calming

• Assessment of the

local consumer food environment

• Valuing social capital

CPCO Resources

CPCO Toolkit https://cph.osu.edu/sites/def ault/files/outreach/docs/cpco %20toolkit_FINAL_small.pdf CPCO Learning Module http://media.cph.ohio- state.edu/articulate/CPCOT

• olkit/story_html5.html