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  • Published on: 14th September 2019
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Team Members: Bethanie Barber, Carlie Combs, Navarrus Hale, Jada Williams, Tristan Ferguson

Project Title: Prevention of Unhealthy Lifestyles for Children Using Interventions in Physical Activity and Dietary Guidance

General Project Overview:

Prevention of Unhealthy Lifestyles for Children Using Interventions in Physical Activity and Dietary Guidance is a project designed to ultimately lead children that may be at risk for unhealthy lifestyles to live healthier lives by demonstrating physical activity they can do anywhere and educating them on proper food choices. We want to provide 6-week course for children ages 8 to 12 that will include 2 hour sessions, 3 days a week with fun physical activity, an exciting place to create healthier lifestyles, a registered dietician to learn about nutrition, and guest appearances by trainers and a doctor. We believe that children are not only the best candidates for our program, but also make up the future of our community. We hope to teach children to be able to perform physical activity no matter where they are at or with, as well as make healthier food choices.

Project Description

Introduction

Obesity has been an increasing epidemic in the United and has been increasing exponentially within the past couple of years. The dangers of this issue are not just confined to adults and the elderly population, but can become dangerous within the childhood population as well. Children seem to prefer eating energy dense foods, processed foods and various types of sugary items. There has also been a decrease in physical activity, possibly due to the increasing use of technology devices such as cell phones, tablets and computers. According to research, 17% of children are overweight or obese, but those that do not participate in sports or physical activity are 44% more likely to experience weight issues, (Aryeetey, 2017).

Background:

Research suggests that there is a significant decrease in the amount of physical activity children engage in, but interventions like the one we hope to implement help break sedentary behaviors by up to 90 minutes and increased physical activity by 60 minutes, (Brittin J, 2017).  According to the Center for Disease Control, overweight and obese children are also at a greater risk at acquiring a multitude of health issues, including: cardiovascular disease, high blood pressure, Type 2 diabetes, and high cholesterol. Starting unhealthy habits young can affect the children later in life, resulting in far greater health issues. The CDC also reports that being overweight or obese as a child has been linked to bullying in school, low self-esteem and self-efficacy, and social exclusion from various groups at school or others non-school related social groups. The most surprising of all, according to a journal by the American Diabetes Association, some issues such as Type 2 Diabetes, have grown significantly in the younger population in recent years and with continue to grow unless intervened with.

Significance

    Our project is significant to the field, because children on our future and represent the health of our community. If we teach children the benefits of physical activity and educate families and children on how to choose foods that are more nutritious and eat unhealthy foods in moderation, we can create a healthier lifestyle and hopefully reduce the prevalence of health-related disease in children. It is estimated that overweight individuals spent roughly $1500 more in medical bills yearly than healthy individuals, (IN.gov). Reducing the amount of health-related physical and mental diseases in children will carry over into their adulthood, and will help our community by reducing community costs associated with treating such diseases, allowing that money to be put somewhere else.

Potential Impact of the Study:

    The impact of our study will depend mostly on if the children adhere to what they are being taught, and continue improving their fitness and choices beyond our program. Due to the positive research of other child intervention programs and because of the layout of ours, we expect the retention rate to be very high. The children that participate in the study will be able to experience the benefits of physical activity by an increase in stronger muscles and bones, a decrease in their likelihood to become overweight or obese, a decrease the risk of developing type 2 diabetes, high cholesterol, or high blood pressure, and hopefully an overall better outlook and understanding of health in their life. Our project will impact the future of not only the children involved but also the community of Indianapolis. Children that will participate will be less likely to become overweight when they start to reach adulthood, meaning that there is a greater possibility they will live happier lives and cause less of a financial burden on the community. Educating families and children on eating healthy foods will benefit the child by providing proper nutrients the body needs while it is still growing, giving children stronger minds and bodies, as well as proper brain development. Research suggests that although implementing healthy eating and proper amounts of daily physical activity was not suggested to decrease BMI, it will have a positive impact on the percentage of overweight and obese children, (Morano, 2012). This impact on diet and activity levels will provide healthier and happier lives for everyone as they age, and hopefully bring about a healthy environment that will be able to be passed down to multiple generations.

Goals of the Project:

In Indiana, 32.5% of the total population and 14.3% of the child population falls within the obesity category, (stateofobesity.org). The purpose of the community-based research project is to provide a summer program for children ages 8 to 12 within Indianapolis to engage in active learning of healthy eating styles and physical activity, while we grow in our understanding if healthy lifestyle interventions will create a positive impact on the youth of our community. Research suggests that unhealthy children tend to have worse sleeping patterns, are at risk for depression, and ultimately perform lower in school, (Stojek, 2017). Our specific aims are to provide the children an opportunity to learn amongst their peers, great educators, and within a fun environment. We plan to have five personal trainers, a registered dietician, and a doctor to guest speak at our clinic. We want the personal trainers to help lead the children in activities while cultivating a mindset that physical activity can be performed anywhere. We understand that children in Indianapolis might not always have access to parks, backyards, or even large schoolyards to play in. We want to show them that physical activity doesn’t require any of those things to be fun and healthy, and that even indoor activity can be an option. The registered dietician is going to come in to talk to the children about healthy eating choices, as well as what it means to eat some things in moderation. We want to provide children with confidence in their ability to make healthy food choices, as well as teach them about the benefits of eating well. The doctor that we will have guest speak is to teach children about some of the diseases that are correlated with an unhealthy lifestyle. We understand that the children will be at different cognitive abilities, but we hope to reach all of them in some way through the different types of speakers. We also will be sending home pamphlets with the children so that they can further their learning of that week’s objectives and activities, as well open up a dialogue with their parents about healthy lifestyles. Research suggests that there is a correlation between sedentary lifestyles in children with obese parents, with a 13 to 20% decrease in activity due to the inactivity of the parents, (Angoorani, 2017). We hope that by educating the parents as well through these pamphlets, we can encourage them to make better food choices and engage in more activity for their children but themselves as well. We hypothesize that we will have a high retention rate of activity and better ability to make good food choices among the children. Children often have high energy levels and love to play, but are possibly not in the environments that they understand how to do that.  We expect that by teaching them about activity that can be performed anywhere, we will see a decrease in their sedentary behavior. Although we expect to see an increase in ability to determine healthy foods from unhealthy ones, we know that it food consumption is not usually determined by the children. We do expect though, by creating education in children and hopefully reaching the parents through the pamphlets, we can empower children to make healthy choices when given the opportunity and parents to provide as many of those opportunities as they can. An increase in activity and healthy food choices will lead to healthier lives for these children, the children they influence around them, and ultimately a healthier community.

Innovation:

Our project is innovative, because we are attempting to fix the problem through the kids first, not through their parents, schools, or sports activities. We are bringing knowledge to the children, we are teaching the children about bettering themselves. We want them to understand that if they don’t take charge of their health, negative things can happen to their bodies that can be detrimental to the lifestyle they want to live. We are allowing them to take ownership of their own interventional experience by providing guest speakers that they can listen to and ask questions, activities they can work hard in, pamphlets to practice what they learned, and activity-based toys they earn by completing the program so that they can take them home and engage in the new activities they know. We are offering a summer program that will truly better them, and a learning experience that they have full control over.

Project Plan

Subjects/Population:

Our population is children between the ages of 8 to 12 years old. We will include any child within the age limit that wants to learn more about healthy eating choices and physical activity, with an emphasis on those that do not currently receive positive influences in those areas. Due to our inability to provide care to certain populations, we will exclude children that have known transient illnesses or are taking medicine for those illnesses at the time of camp, or have extreme allergies that are threatened by the outdoors. We would encourage children to sign up only if they are interested in performing physical activity outdoors and learning from professionals. We discourage children that are currently participating in physical activity and sports in the summertime from signing up due to space issues, and to allow those without that privilege to benefit from our program.

Intervention:

In week 1, the focus of the first day will be to gather information of our participant’s knowledge of healthy eating, as well as their physical activity abilities. In order to gather our information, the participants will be given a pre-assessment. The pre-assessment will assess their ability to tell the difference between healthy and unhealthy food choices. The participants will circle an image or word they believe is healthy and cross out the image or word they believe is unhealthy. The second part of the pre-assessment will contain a physical test on an obstacle course. The participants will run the course while someone records the time is takes for them to complete it, and then rate their exertion level using a modified RPE scale. Day two of week one will be the first of three appearance of a guest Registered Dietitian. The dietitian will have fun, interactive material for the participants to learn and answer questions about healthy eating. Day three of week one, the five personal trainers will each be assigned four participants. The personal trainers will give them an overview of the materials for the course of the program, and ask questions. At the end of the week, the participants will go home with the weekly newsletter with a recap of the week including helpful tips to practice what they learned during week one.

In week 2, a guest Pediatrician will visit on the first day. He/she will teach the participants about the positives of a healthy life, as well as some of the serious issues that an unhealthy lifestyle will cause. On day two of the week, the participants will go through an outdoor obstacle course that was created by their personal trainers. Each trainer will set up their own course, however, to ensure everyone is getting the same amount of physical activity, all the courses will be made up of the same station just in different orders. The obstacle course will contain a 20 yard sprint, hopscotch with 4 hula hoops, 20 jump roping, 10 sit ups, and 10 push-ups. The obstacle course will be repeated twice with a two-minute break for recovery. Prior to the obstacle course, the personal trainers will lead the participants through a fun dynamic warm up. At the end of the obstacle course, the trainers will lead the participants through a cool down and stretch. The third day of the week will be an indoor activity. The personal trainers design a fun indoor activity that the participants can do inside their home. The activity will consist of the participants doing 20 side oblique bends, 10 chair squats, 10 chest squeezes, 10 leg extensions on each leg, and 20 knee pull ups. They will repeat the exercises twice with a 1 minute break in between. The cool down will consist of them slow jogging in place and as well as some stretching. All three days will consist of a fun activity or sport that the participants can engage in after they finish the required material for the day. The participants will receive the weekly pamphlet to continue their knowledge and hopefully engage the parents.

In week 3, the guest registered dietitian speaker will return for their second session. The dietitian will lead a visual lecture using sugar and salt amounts that are found in common food items that participants consume, as well as teach the participants what the levels of these things in their body can cause. On day two of the week, the personal trainers will teach how to do activities with just hula-hoops. The exercises including hula-hooping, jumping through the hula-hoops, jumping forward and backwards into the hoop, jumping laterally into the hoop, and around the world jumps into the hoop. On day three of the week, the trainers will use a chair for physical activity. The physical activity will include quadriceps, glutes, hamstring, and calf workout. The exercises will include standing side leg raises on each leg, standing calf raises, standing back kicks, and squats. These activities demonstrate things that the participant can do in any environment as long as they have a chair. Each exercise will be performed in three sets of ten with a minute rest in between each set. The participants will go home with the weekly newsletter of a recap of the week for the parents to overview.

In week 4, the pediatrician returns to talk to the participants. The physician will talk about the importance of sleep on energy levels and learning. The physician will create a scavenger hunt about facts and myths of sleeping. At end of the session, the group will come back together to talk about the things they learned. On day two of the week, the trainers will split the participants into teams to compete on an obstacle course. Teams will have to form three goals to make through the obstacle course the fastest. The trainers also challenged the groups by asking a member of the team to sing a song while moving through the course, or making the most vocal person compete silently. On day three of the week, the trainers will create a fun, indoor circuit using, chairs, cones, hula-hoops, jump ropes, and the dot sets to go through with another participant. A rest and water station will be included in the circuit. At the end, the trainers lead participants through a cool down and stretch. The participants will go home with the weekly newsletter of a recap of the week for the parents to overview

In week 5, the dietician will hold their final session using a word-search, scavenger hunt of the vocabulary words from the previous lectures. Participants will find healthy foods within the word search, and then go search for where a printed form of that word is. If they accidentally search for an unhealthy food, a small activity will be given. The purpose of the scavenger hunt is to teach participants that learning is fun and can also be a fun way to be physically activity. On day two of the week, the participants played fun outdoor games. The idea behind this activity was to teach the participants about outdoor games that are not sport oriented. On the third day of the week, the participants will play indoor activity-based games such as: Musical Chairs, Twister, and an active Simon Says. The participants also went home with the weekly newsletter of a recap of the week for the parents to overview.

In week 6, the final week of the program. The pediatrician will create an interactive game about what participants would tell someone about health if they were a doctor. The participants will work through different scenarios that requires them to talk about things that they learned throughout the program, and engage in activities that they would recommend the person in the scenario. On day two, the participants will vote on some of their favorite outdoor activities to engage in, and end by trying to create their own. On day three, the participants will perform the same pre-assessments again to see if individual changes were made, as well as an assessment to collect data on the program itself. The parents will also be given an assessment to test their satisfaction with their child’s participation.

Data Collection:

We will use pre-assessment and post-assessment tests to measure our participant’s growth in performance of physical activity and their ability to make healthy food choices. The same tests will be used for the pre-assessment and post-assessment to maintain consistency. The pre-assessment, will be given on the first day of our six-week program. The participants will complete an obstacle course as quickly as they can and to the best of their ability. Results from the time for completion as well as a modified RPE scale will be recorded for each participant. A simple dietary picture-based questionnaire will also be performed by the participants to assess their knowledge of healthy foods. Participants will be asked to circle healthy food options, and place an X through unhealthy ones. Results will be scored based on number of correct answers. The post assessment will be given on the last day of the program. The participant will perform the same obstacle course and take the same dietary questionnaire. Results from these tests will be compared to the beginning of the program to look for individual growth, as well as overall program results.

Our final project evaluation will be done with the help of our participants. On the completion of the program, we will give each participant a red, yellow, green card. A member from our team will read off various statements on how the participants a liked or disliked our project. If the participant liked or agreed with the statement, then they will hold up green. If they are in between they will hold the yellow card. If they absolutely did not like or do not agree with the statement that was read, they will hold up the red card. The parents will also take part in our evaluation process. The parents will be given a sheet of paper with similar questions (some varying from the participants) and will be asked to evaluate our project using dice. For example, if a parent strongly agreed with the statement then they will say they rolled a six. If the parent only agreed, they will say they rolled a five. If they did not agree nor disagree with the statement, they rolled a four. If they disagreed they will say they rolled a three. If they strongly disagreed with the statement, they will say they rolled a two. And lastly, if the statement is not applicable, they will say they rolled a one. The evaluation are meant to be a fun and creative way to interact with the participants, while receiving great feedback.

Anticipated Results & Future Implications:  This integrative intervention program will positively affect the health and wellbeing of children who are/have the possibility of becoming obese by involving both the children and guardians.  We anticipate an 80% completion rate of our six-week program.  We anticipate a high completion rate for the following reasons: entertaining guest speakers that are able to engage the children in their learning, demonstrating that physical activity can be challenging but also fun, the brevity of the program, parental education, and the grouping of children who are similar in health/wellness characteristics.  Based on the positive anticipated changes in the children who participate in this intervention, we foresee the children taking what they learned and sharing it with their peers.  For example, a child saying to a sibling, “Watch what I can do. Can you do it?”  We also expect increased self-awareness.  Our proper nutrition/wellbeing education will teach the children about what state of health they are in.

    The aim, after this intervention, is to then influence community parent/family programs that focus on fun physical activities, welcoming environments, and/or educating in order to help prevent the growing epidemic of childhood obesity and associated risks.   We anticipate seeing even more of these programs that are short in duration, community-based for both child exclusive as well as for the entire family.  

Proposed Timeline

Task Jan Feb Mar Apr May Jun Jul Aug Sep

Recruit participants X X X

Recruit Trainers X X

Recruit RD & MD X X

Pre-assessments X

Program X X

Post-assessment X

Proposed Budget

Item Cost

Marketing materials $400

Jump Ropes X 20 $75

Agility Cones $30

Hula-hoops X 20 $75

Dots 2 sets $50

Weekly 1 page color printed learning objectives X 20 Kids $356

Water bottles 24pkg. for 18 days $65

Daily healthy snacks $700

Five Personal trainer volunteers for 18 days $2,934  $16.30 an hour for two hours X 18 days

Guest Registered Dietitian speaker $90  $30 a session X 3 sessions

Guest Dr. speaker $225   $75 a session X 3 sessions

Total: $5000

References

“Indiana.” Indiana State Obesity Data, Rates and Trends - The State of Obesity, stateofobesity.org/states/in/.

Gregory N. Larkin. “Burden of Obesity in Indiana.” Indiana Government, Indiana State Department of Health, 2011, www.in.gov/isdh/files/Burden_of_Obesity_FINAL_11_18_2011.pdf.

“Overweight & Obesity.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Dec. 2016, www.cdc.gov/obesity/childhood/causes.html.

Aryeetey, R, et al. “Prevalence and predictors of overweight and obesity among school-Aged children in urban Ghana.” BMC obesity., U.S. National Library of Medicine, 4 Dec. 2017, www.ncbi.nlm.nih.gov/pubmed/29214030.

Brittin, J, et al. “Impacts of active school design on school-Time sedentary behavior and physical activity: A pilot natural experiment.” PloS one., U.S. National Library of Medicine, 7 Dec. 2017, www.ncbi.nlm.nih.gov/pubmed/29216300.

D'Adamo, Ebe, and Sonia Caprio. “Type 2 Diabetes in Youth: Epidemiology and Pathophysiology.” Diabetes Care, American Diabetes Association, 1 May 2011, care.diabetesjournals.org/content/34/Supplement_2/S161.

Morano, M., & Colella, D. (2012).  Physical Activities for the prevention of childhood obesity: An overview of key research challenges for physical education. Acta Facultatis Educationis Physicae Universitatis Comenianae, 52(2), 49-59.  

Stojek, M. M., Montoya, A. K., Drescher, C. F., Newberry, A., Sultan, Z., Williams, C. F., . . .   Davis, C. L. (2017). Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models. Public Health Reports,132(2_suppl). doi:10.1177/0033354917731308

Tasks

Assigned Task Person Assigned Due Date Date Completed If not completed, who finished task

Planning Project Ideas Everyone November 6 November 6

Everyone’s Assigned Writing Everyone had their own November 13 December 7 Carlie had to rewrite some sections due to questions not being addressed  and research not found or cited

Planning for project Everyone November 20 November 20 Jada, Carlie, and Bethanie stayed to plan video

Video shoot and editing video Everyone, Bethanie brought in extra supplies for the group to use November 25 November 25

Finishing video Jada November 26 November 26

Tasks and References Everyone November 25 December 7 Carlie

Edit project Carlie December 7 December 7

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