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