Friday, April 16, 2010

Worksite Programs to Control Overweight and Obesity

While working as a secretary for three years, I got sick of sitting down all the time and feeling like I wasn't doing anything. I walked the mile-plus to and from work as often as I could, but during the day I still felt like a slug. Not fun.

When I heard about these, I became really jealous and really wanted one for my office. It never happened.

Here's a short video explaining more:

The intervention that I looked at for obesity prevention is one for the workplace community.

This intervention uses "informational and educational strategies to increase knowledge about a healthy diet and physical activity," such as printed materials and lectures. Another aspect of the intervention is aimed to change behavior. They provide group counseling and skill-building opportunities. The last focus is on policy. The aim here is to make healthy foods more available and affordable in the cafeterias, as well as increase insurance benefits for healthy living, gym memberships, etc.

The interventions most commonly used included informational and behavioral components, with a few of them aiming for policy and environmental changes in the workplace.

All of the types of interventions showed positive results in behavior, weight, and BMI. It didn't seem to matter if the intervention focused on diet, exercise, or both, they were all effective.

Thinking back on my own experience while working, I always participated in the activity/dietary challenges that the organization provided for its workers, however I tended to stop as soon as (or shortly after) the required time was over. It seems that if we had had opportunities such as this one providing counseling and/or workshops to increase knowledge and influence behavior, I may have been more likely to actually make some lasting changes.

information about the intervention can be found here.

Interview with Lynda Blades

About a month ago I had the chance to talk to Lynda Blades, program manager for the Physical Activity, Nutrition and Obesity (PANO) program at the Utah Department of Health. She was very accommodating and we had a great conversation about the challenges and rewards of being in public health and health promotion.

She, herself, graduate from BYU and then attended the "school up north" to receive her MPH. Her career in public health has ranged from teaching healthy eating, aerobics and fitness classes at Hill Air Force Base to working against heart disease in clinical settings in Montana. Reflecting on her past experience working with individuals and small groups, she says her current position as the program director of a state, population-based program has challenges and benefits.

The challenges of working in a population-based program to prevent obesity is that it can be extremely political and slow-moving. Besides the slow pace of politics, the pace of change in population-based programs is also hindered by the rate of trickle down from structural changes to behavior change. According to Blades, it can take your whole career to see a significant change.

However, despite the challenges she enjoys knowing that her program can help create places not just attitudes. Population-based work also has the advantage of being not as didatic in approach: more encouraging than instructing.

PANO, with its motto "Making the Healthy Choice the Easy Choice", is mainly about creating partnerships between the health department and worksites, schools, healthcare organizations, and communities. Blades finds the progress they have made so far encouraging. Forming partnerships with local urban planning boards has been one of their recent accomplishments. She sees the program is becoming more widespread and mentioned the recent initiation of "worksite awards" as a victory. However, patience is required. She mentioned despite the changes it can sometimes feel difficult to feel that "you're making a dent." According to her, at those times it's important as a health educator to remember that what you're doing is going to make a difference.

Her advice to budding young health professionals? Get exposure to as many areas of public health as you can. Blades feels her work in a local health department, with an HMO, and now in a population-based effort has given her a good feeling for all things current in public health practice. She particularly mentioned the stark difference between working with a local health department and a state health department, and thinks students should try to get the benefit of both.

After talking to her I was impressed both by her professionalism and her commitment to her program, despite its challenges. PANO is in good hands.

PANO was on the brink of publication of the Utah Nutrition and Physical Activity Plan 2010-2020 when Lynda Blades and I had our conversation. I checked back the other day and saw it was out and online! Check it out at the PANO webiste! You may see changes coming to your Utah neighborhood soon.

CATCH Program to Reduce Child Obesity

For an obesity prevention class I reviewed the CATCH program to reduce child obesity in schools. It's program components are pretty neat and it's been shown to be effective in Texas in a little as four years. Read on to find out more about it!

CATCH (or the Coordinated Approach to Child Health) has as its main goal creating healthy children and healthy school environments. It does this through an integrated team of elementary school principals, elementary school teachers, PE teachers, food service supervisors, and (when implemented with an accompanying community-based initiative) community representatives.

The program includes family fun nights/events, teacher-led activity breaks in school, social marketing efforts, CATCH community "best practices" workshops, a host of other training and coordination meetings, and a menu of options which communities can choose to include as part of their personal CATCH implementation. Some of these activities include providing opportunities for students to have a taste healthful foods, implementation of school gardening programs, implementation of physical activity breaks during classroom hours and organization of after-school physical activity programs. Because each community gets to choose the options that are right for them, this allows the program to tailor itself to specific community needs.

This program can be compared to Shape Up America, Be Active Eat Well, and other school-based obesity prevention programs. CATCH relies heavily on the recommendations for school health programs from the Division of Adolescent and School Health.

CATCH has measured success by lowering BMI measures from student self-reported height and weight. CATCH schools also show improvements in dietary choices as measured by the CATCH SPAN questionnaire. These effects are much more prominent when the CATCH program is implemented with its community-based component. This program has been demonstrated effective mostly among low-income schools.

If I were a principal struggling with a burden of obesity, I might look to CATCH for some answers...