Implementing Childhood Obesity Prevention Research in a Rural

Nancy Findholt, PhD, RN
OHSU School of Nursing
Implementing Childhood Obesity Prevention
Research in a Rural Oregon County Using a
Partnership Approach:
The U.C. (Union County) Fit Kids Project
• 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
• “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
• 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
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 &
– Several participants offered to participate
*Plested et al., 2004
Step 2: Structuring Community Involvement
• Coalition partners
School districts
Extension Service
Head Start
- Comm. on Children & Families
- Public health
- Parks & Recreation
- Other groups & individuals
• Coalition launched at a full-day retreat
– Established the infrastructure
– Introduced participants to the idea of environmental
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
• 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
– Convenience stores near schools
– High fat entrees in school meals
– School practices that encouraged unhealthy
• Facilitators of healthy eating
– Popularity of gardening
Step 5: Developing an Action Plan
• Findings reviewed & discussion within
• Public input was obtained
• This feedback was used to set priorities for
– Improve quality of school meals
– Increase availability of healthy food in small
– 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
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
• 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
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
• Thank you to:
– The members of the U.C. Fit Kids coalition
– My research partners
• Vicky Brogoitti, Union Co Comm on Children &
• Dr Yvonne Michael, Drexel University
• Dr Linda Jerofke, Eastern Oregon University
– Our primary funding partners
• National Institute of Nursing Research
• Northwest Health Foundation

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