Other Important CBPR Aspects

• Recognize & highlight community assets & strengths – View community members as advisers & experts

• Provide real service to communities by addressing the community's needs

• Build & maintain respecting, trusting relationships within/across the community. – Develop relationships with opinion leaders in the

community

Agency for Healthcare Research and Quality, 2003

CBPR IN BROWNSVILLE, TEXAS

CULTURAL RESPONSES TO OBESITY CULTURAL RESPONSES TO OBESITY (WELLNESS)(WELLNESS)

Children BORN TODAY HAVE A LOWER LIFE EXPECTANCY THAN THEIR PARENTS

• 1 in 3 will develop diabetes

• 3/5 if African American

• ½ if Hispanic

• > ½ if Native American

Portrait of an Overweight Child

Toxic Environment• Availability & affordability of high fat/high

carbohydrate food (fast food, soft drinks)

• Large portion sizes

• Marketing to children

• Fewer family meals

• TV, computers, video games

• Safety issue

• Decrease in physical educationSchwartz MB & Brownell KD, 2007

Dollars spent on U.S. food advertising in 2005

• Food, beverages, candy $7,313,200,000

• Restaurants & fast food $5,061,000,000

Advertising Age, 2006

Mixed messages

Obesity is caused by long-term positive energy balance

FatStores

~ 600 calories per day

Obesity Interventions• Current strategies are not containing the “diabesity”

(sedentary) epidemic

• Need to shift away from clinical view of obesity as personal disorder requiring medical Rx

• Understanding, measuring, & altering the “obesogenic” environment is critical

• Society has a key role in sharing with individuals the high “costs” of a healthy lifestyle change (maintenance)

A framework for obesity prevention

The Truth About TV (True or False)

• The average child watches about one hour of TV a day.TRUE or FALSE

• By the age of eighteen, the average child has seen about two-thousand murders on TV.

TRUE or FALSE• Children who watch three or more hours of TV a day are

more likely to be overweight than children who watch less than two hours a day.

TRUE or FALSE• Children who have a TV in their bedrooms are more likely to

be overweight.TRUE or FALSE

What is Screen-Time?

• Time spent in front of a screen:– TV (videos or DVDs)

– Computer (surfing the Internet, emailing, playing games)

– Handheld (instant messaging, playing games)

American Academy of Pediatricians Guidelines for Children’s Media Use

• No TV viewing for children < 2 years old

• No more 2 hours/day for older children

• Monitor programming

Over Exposed

• Average of 5½ hours a day using media

• Preschoolers (< 6 years old)– Time with screen media

– Playing outside

The Role of Media in Childhood Obesity, 2004

TV Viewing & Behavior Problems

• Healthy Steps for Young Children

• Age 2.5 & 5.5– 20% watched 2+ hrs– Behavioral problems

• 41% kids had a TV in their bedroom– Poor sleep

Mistry et al., Pediatrics, 2007

TV Advertisements & Kids

• 40,000 ads a year on TV

• Elaborate advertising campaigns– Candy– Soda– Snacks

Illustration:: Cathy Wilcox

The Role of Media in Childhood Obesity, 2004

TV Watching & Over Eating

• 24 children 3-5 years old– High socioeconomic

status

• > 1.5 hours of TV daily ate more while watching TV

Francis & Birch, J Am Diet Assoc, 2006

Credit iStock

What To Do about the TV?

• Set family goal to reduce screen-time

• “No eating while watching TV” rule

• Remove the TV from child’s bedroom

• Reward family with fun - EXERCISE

Physical Activity• Reduces the risk for many

diseases

• Helps control weight

• Strengthens muscles, bones, & joints

• Reduces feelings of depression & anxiety

www.cdc.gov

Physical Activity & Academic Achievement

• Healthier students do better in school

• Students who do better on achievement tests tend to be more physically fit than peers

• Exercise alleviates stress & anxiety, improves asthma, boosts self-esteem – FACTORS that influence school attendance & performance

Vail, Am School Board J, 2006; Grissom, 2004