Overweight & Obese Children in Harrison School District Two and El Paso County, a Needs Assessment Christa Hyson Meiler 2014 MPH Candidate University of Florida
Overweight & Obese Children in Harrison School District Two and El Paso County, a Needs Assessment
Christa Hyson Meiler2014 MPH Candidate
University of Florida
IntroductionInternship Site Meadows Park Community Center (MPCC)• Located in Colorado Springs, Colorado • In El Paso County, Harrison School District Two • Utilized by southeast Colorado Springs • 71% of participants in summer camp programs received a reduced
rate • MPCC is a result of available space in the community and a group
of concerned citizens about gangs and teenagers in the early 1980s
Source: Meadows Park Community Center 2014
Order of PresentationMeadows Park Community Center Profile
Background
Methods
Results
Discussion
Implications
Conclusion
Meadows Park Community Center Profile
Focus on•Early Childhood, Youth and Teens•Health and Wellness•Food Insecurity•Medical Services•Public Safety•Technology•Community Building
Services offered•Golden Circle Nutrition Program•After School Program•Before School Breakfast•Summer Camp•Grant-Funded Services
Background
• Childhood obesity is considered one of the major epidemics of the 21st century
• Decrease in life expectancy• Examine the physical and social environment• Connection between low socioeconomic status (SES) and obesity
Obesity and public health values• Right to healthcare• Health Education • Improve & Protect Life
Review of Critical Literature
Review of Critical Literature
Review of Critical Literature
About El Paso County
Population El Paso County ColoradoPopulation, 2012 estimate 645,439 5,189,458
Persons under 5 years, percent, 2012
7.0% 6.5%
Persons under 18 years, percent, 2012
25.3% 23.7%
Persons 65 years and over, percent, 2012
10.7% 11.8%
Female persons, percent, 2012 49.9% 49.8%
Population of El Paso County and Colorado by age in 2012
Source: U.S. Census Bureau: State and County QuickFacts, 2014
Educational Attainment Estimate Male Female
Population Over 25 393,192 190,547 202,645
Less than 9th grade 2.2% 2.3% 2.1%
9th-12th grade, no diploma
4.4% 4.2% 4.6%
High school graduate (includes
equivalency)
21.9% 21.0% 22.8%
Some college, no degree
26.0% 25.8% 26.1%
Associate’s degree 10.3% 9.6% 10.8%
Bachelor’s degree 21.7% 21.3% 22.1%
Graduate or professional degree
13.6% 15.9% 11.4%
In El Paso County, ages 25 and overSource: U.S. Census Bureau: American Community Survey, 2012
Small Area Income & Poverty Estimates
Source: United States Census Bureau: Small Area Income and Poverty Estimates, 2013
State of Colorado in 2012, Percent in Poverty, Ages 5-17 in Families
Percent of Children Engaging in Selected Eating &Recreational Behaviors, Colorado 2009 to 2010
A Five or more servings per day.B Food is paid for at a counter or drive thru, before being eaten.C 60 minutes of physical activity per day.D Unrelated to schooln/a: Measure unavailable for age group Source: El Paso County Public Health
Unhealthy Weight in El Paso County
The percent of population with an unhealthy weight in El Paso County and Colorado from 2008 to 2010
Source: El Paso County Public Health, 2014
Research Question & Specific Aims
Research Question• Is there a causal relationship present between low
socioeconomic status (SES) and obesity in children? Specific Aims
• Through interviews and secondary data gain a general understanding of the health status of the children in El Paso County.
• Find out how many children in El Paso County/ Harrison School District Two are overweight or obese.
Specific Aims
• Through interviews, identify disparities that prevent children in the Meadows Park Community from being a healthy weight.
• Assess the opportunities for physical activity available to children living in Harrison School District Two with a focus on the Meadows Park Community.
• Assess the availability of healthy food choices for children living in the Meadows Park Community.
Methods
• Interviews
• Active Neighborhood Checklist- Sidewalk Audit
• SOPARC: System for Observing Play and Recreation In Communities
• Secondary Data
Methods- Interviews
• Community Center Director
• El Paso County Public Health, Community Health Educator
• Single Parent with Four Children in Harrison Schools• Harrison School District Administrators
Why these individuals?• Proximity to Population• Knowledge of Population• Involved Community Members
Analysis of MethodsFour stages of the constant comparative method: Categorize data
Place data into proper homes or properties
Define possible theories
Write the theory
Analysis of Methods
Categories to assess the results of the Sidewalk Audit/SOPARC:Land use/ Public transportation/ Street characteristics/ Environmental quality/ Walkability/ Bike accessibility/ Park Conditions/ Activities/ Age/ Gender/ Ethnicity
Results- Sidewalk Audit
Results- Sidewalk Audit
• Premier use of land is mostly residential • Homes or apartments in the area had on street parking or a small
lot or 1-car garage• Large green space and playground present in the middle of the
community• Street characteristics are lacking • No pedestrian scale lighting present or benches outside of the bus
stop
Results- SOPARC
Source: SOPARC Park Observation, 2014
This is the average park use from June 10-July 10 2014, items are separated by target area, activity, and gender.
Conditions of Meadows Park
This chart shows the percentage of target areas observed.
Source: SOPARC Park Observation, 2014
Results- SOPARC
Source: SOPARC Park Observation, 2014
Average Number of Park Users by Age
Children 0-12Teens 13-17Adults 18-55Seniors 55+ Source: SOPARC Park Observation, 2014
Results- Interview
Food Insecurity Limited Physical Activity
Lack of Financial Resources
Lack of Knowledge
Cost Video Games Personal Transportation
Scratch Cooking
Convenience School Regulations WIC Diet Habits
Time Park Safety Competing Priorities
Picky Eaters
Distance Neighborhood Safety
Single Parent School Curriculum
Food Desert Time Need vs. Want Stigma
The table shows the most frequently mentioned observations on why childhood obesity occurs in the community, as perceived by the interviewees.
Results- Interview
Most Frequented Key Words:• Video Games• Cost (of healthy food)• Personal Transportation• Cooking from Scratch
Significant Quotes
Relationship to Research Question & AimsResearch Question: Is a causal relationship present between low socioeconomic status (SES) and obesity in children? •Interview statements and secondary data •2008, 13.9% of children were obese in El Paso County In 2010, this percentage was 21.0% •2008 59% of students received free/ reduced lunches, in 2012, 70% of students received free/ reduced lunches.
Specific Aims: Through interviews and secondary data gain a general understanding of the health status of the children in El Paso County.
•Varied•Divide of wealth•Transient area/ military •Increase in medication
Source: El Paso County Public Health, 2013 & Harrison School District Two, 2014
Relationship to Research Question & Aims
Through interviews, identify disparities that prevent children in the Meadows Park Community from being a healthy weight.
Food Insecurity Limited Physical Activity
Lack of Financial Resources
Lack of Knowledge
Cost Video Games Personal Transportation
Scratch Cooking
Convenience School Regulations WIC Diet Habits
Time Park Safety Competing Priorities Picky Eaters
Distance Neighborhood Safety
Single Parent School Curriculum
Food Desert Time Need vs. Want Stigma
Relationship to Research Question & Aims
Find out how many children in El Paso County/ Harrison School District Two are overweight or obese.•Harrison SD2, not tracked
•El Paso County Public Health 2013 Annual Report stated that 31.9% of children in 2010-2012 were overweight or obese
Assess the availability of healthy food choices for children living in the Meadows Park Community.
Store Walk (one way) Bus Ride (one way) Distance from Meadows Park
Albertsons 43 minutes 33 minutes 2.2 miles
Wal-Mart 57 minutes 35 minutes 2.8 miles
Safeway 20 minutes 18 minutes 1 mile
Relationship to Research Question & AimsAssess the opportunities for physical activity available to children living in Harrison School District Two with a focus on the Meadows Park Community.
Interpretation of Findings• Policy development • Proposed bus routes changes• More than obesity• Effect of community
Discussion
Kamath et al. (2008) - Argued that the efficacy of lifestyle interventions is unclear
• Children were very receptive to the messages of 5210 programming and could answer questions
Patrick & Nicklas (2008)- Examined physical and social environments • Positive role models and examples are essential early on in life
Olshansky et al. (2005)- Continuing the status quo• The profound effect that environment has on eating/ activity habits, it is
imperative to fund programs that set healthy examples and keep places like Meadows Park Community Center running
Strengths
• Qualitative Data• Unique perspective and data from interviews • Community relationships• Able to understand situation in a local context • Easy to replicate• Attention to detail• Good listener
Limitations
• Lack of quantitative data • Amount of qualitative data• Short period of time • Bias during interview• Personal accounts are not as easy to be generalized• Data analysis (constant comparative method) is very time
consuming• Results reflect my personal biases when categorizing data
Generalization
• Needs assessment was designed to be easily replicated • Interview questions could be asked to any community member,
community health educator, or school administrator in any state or community
• Identified themes: lack of financial resources, lack of knowledge, food insecurity, and limited physical activity are all things that communities across the nation understand and experience
• The sidewalk audit and SOPARC system are both evidence based assessment tools that have over time provided reliable results
Implications
• Special project became the internship • Childhood obesity will continue to be a problem without
intervention and change • Disparities to healthcare/ chronic condition care• SES & Obesity • Health education, health administration, and observing the
environment were the largest parts of this project
MPH Core Competencies
Develop policies and plans that support individual and community health efforts - Policy implementation for the 5210 Let’s Go program
Link people to needed personal health services and assure the provision of health care when otherwise unavailable – Peak Vista Mobile Clinic
Conduct research for new insights and innovative solutions to health problems - SOPARC (System for Observing Play and Recreation in Communities) and Active Neighborhood Checklist, a sidewalk audit
MPH Core Competencies
Diagnose and investigate health problems and health hazards in the community using an ecological framework – Identifying barriers and problem solving
Monitor health status to identify and solve community health problems & Conduct research for new insights and innovative solutions to health problems – Food accessibility and bus routes
Inform, educate, and empower people about health issues - Nutrition education
Mobilize community partnerships and action to identify and solve health problems - Work with the Healthy Communities Collaboration and the Colorado Community Center Collaborative
Concentration Competencies
Demonstrate knowledge and skills needed to design and implement a public health information campaign - 5210 Let’s Go program implementation
Understand and apply the principles of community participation in public health interventions- Community and trust
Apply social and behavioral science theories and concepts to public health problems- Understanding the community
Specify approaches for assessing, preventing, and controlling environmental hazards that pose risks to human health and the environment – Sidewalk audit
Concentration Competencies
Describe genetic, physiological and psychosocial factors that affect susceptibility to adverse health outcomes following exposure to environmental hazards- Asthma in Colorado
Monitor and evaluate programs for their effectiveness and quality – Summer Camp evaluations at MPCC
Identify, retrieve, summarize, manage and communicate public health information- Sharing findings from methods of this needs assessment
Demonstrate communication skills key to public health workforce participation and advocacy – 5210 Let’s Go programming advocacy
Lessons Learned
• Childhood obesity is not a huge issue to some community members
• More concern that their children are safe and fed, not their weight status
• Without community centers many senior citizens may not have a meal everyday if not for the nutrition program offered by the community center
• Community center provides a snack and a safe place to go afterschool for children of all ages after school
• Trust must be earned in a community situation
Recommendations for Future Projects
• Geographic information system or GIS mapping of grocery stores/ shopping Markets, WIC offices, primary care/ treatment facilities, and hospitals
• Change bus routes to meet the needs of the community
• Longitudinal study that focuses on tracking the effects of community centers on health, safety, and education
Conclusions
• Building the trust of the community • Mission of organizations will continue to change as the health status of
children change
“It [Parks & Recreation] used to be about quality of life and leisure and fun experiences. Now it is very much public health. It is about food,
clothing and shelter, if it’s an exercise class it’s as much about reducing your medications and BMI as it is having something enjoyable, maybe a
distraction in life. Years ago this wasn’t even close to something we felt we had to take on. That’s what doctors do. Now it has come to a community
center. Until you have the health of your community squared away you don’t have the luxury to take on leisure.”
Thank you for listening!
Questions or Comments?