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Background

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physical activity in children and youth. Explore what can be done ... siblings, and peers is related to youth physical activity. Other approaches need further study: ... – PowerPoint PPT presentation

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Title: Background


1
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2

Background
  • In June 2007, an international conference
    was held in Toronto, ON, to examine issues
    related physical activity and obesity in
    children
  • The conference was attended by nearly 1000
    delegates from 35 countries

3

Overview of this Presentation
  • review the most current scientific evidence
    concerning the problems of obesity and physical
    activity in children and youth
  • Explore what can be done
  • Summarize Promising Practices for
    community-based interventions

4

Defining Obesity in Children
  • A weight to height ratio (kg/m2) known as the
    Body Mass Index (BMI) is most commonly used
  • Contrary to adults, BMI changes with sex and
    age in children
  • Sex- and age-specific values based on standard
    growth charts should be used
  • Insufficient evidence for use of waist
    circumference in children


5
Childhood Obesity in Canada
  • In Canada,
  • 25 of children and youth (2-17 y) are
    overweight /obese
  • 41 of Aboriginal children living off-reserve
    are overweight/obese
  • 55 of Aboriginal children living on reserve
    are overweight/obese

Data Sources CCHS 2004 First Nations Regional
Longitudinal Health Survey 2002/2003
6
HOW DID WE GET HERE? What are the causes of the
Obesity Epidemic in Children?
7

Many contributors to Childhood Obesity
  • genetics
  • maternal health
  • in utero growth
  • low birthweight
  • parent obesity
  • parenting styles
  • personality traits

and many more
8

Food Nutrition
  • Shifts in Food Practices? food availability, ?
    portion size, ? consumption of soft drinks, ?
    frequency of family meals
  • The Cost of Calories
  • Mass Marketing

9

10
Average Number of Steps Per Day
Source CFLRI
11
2007 Report Card Indicators
PHYSICAL ACTIVITY / INACTIVITY   Physical
Activity Levels Grade F (2006 Grade D) Screen
Time Grade D- (2006 Grade D-)   Sport
Participation Grade C (2006 Grade C-)
 
12
Number of students who participate in ?60 minutes
of moderate to vigorous Physical Activity on 5 or
more days per week
Courtesy of Dr. M. Tremblay
13

Changes in Time (min/week) Spent in Activities by
Children Ages 3-5 years in USA Change from
1981-1997
Strum R. Public Health Practice and Policy.
211-9, 2005 Data from University of
MichiganHofferth SL Sandberg JF. 2001
14
Recreation has gone from spontaneous to
organized and regimented activity parents
exercise at the gym while the young play soccer
and hockey in leagues with schedules rather than
in the backyard or the street in front. More time
is often spent preparing for and getting there
rather than on the activity itself.
Friedman. Room For Thought. 2005
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  • We must think about physical activity over
    the WHOLE DAY rather than just sports,
    exercise, or recreation.

17

Time spent in various types of activity
Moderate 18.1 min/day 2.2
Vigorous 5.6 min/day 0.7
Light 341.6 min/day 41
Sedentary 459.9 min/day 56
TAAG study, USA
18
HOW SHOULD WE APPROCH THE PROBLEM? What does the
evidence suggest?
19

There is No Single Cause
  • It is impossible to identify a single cause of
    the current obesity epidemic
  • It is likely explained by a broad range of
    changes that have occurred together throughout
    the past 20-30 years

Therefore, SOLUTIONS must also be multi-faceted!
20

To address the problem we will have to examine
both our biology and our environment.
21

Developed by Dr. William Haskell, 2007
22

Three Common Behavioral Settings for Youth
SCHOOL
HOME
COMMUNITY
23

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One-dimensional interventions may be ineffective
WHY?
Combined efforts can become multi-level
26

Individual
  • Young People have to
  • Want to
  • Think they can
  • Overcome barriers
  • Be reinforced

27

Families (Interpersonal)
  • Family interventions have not been greatly
    successful despite good evidence that support
    from parents, siblings, and peers is related to
    youth physical activity

28

Physical Social Environment
If you build it, they will come?
29

Policy
  • Policies have broad reach -
    housing, transportation, environment, economic

30

Marrying Research and Practice
Research Promising Practices
Public Health Promising Practices
EVALUATION
BEST PRACTICES
Researchers and Practitioners need each other!!
31
PROMISING PRACTICES Who or What Should We Target?
32

Who and What Should We Target?
WHO?
  • Active Play
  • Active Transport
  • Organized Activities
  • Physical Education
  • Sedentary Behaviours
  • Girls ( boys?)
  • Mothers Infants
  • Pre-school children

33

The Home Environment
  • Changing home environments to increase PA is
    challenging
  • Children should be encouraged to
  • go outdoors
  • use active transport
  • reduce screen time

34

The School Environment
  • Offers Several Opportunities for PA
  • School grounds
  • After-school sports and activities
  • Physical education programs, facilities
  • Travel to and from

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Challenges to Active Commuting
  • Crime (stranger danger, gangs, bullying)
  • Too much traffic (school, neighbourhood)
  • Cars drive too fast through neighborhood
  • Inadequate sidewalks/bikeways on the route to
    school
  • School is too far away
  • Not enough time
  • Child would be walking/biking alone to school
  • Easier to drop off child on the way to work
  • Child does not want to/like to walk or bicycle
    to school

37

The Community Environment
  • Youth PA is influenced by urban design,
    especially proximity to destinations
  • More PA if youth live close to recreational
    facilities and school
  • Venues and physical features of a location
    matter in determining
  • What activity occurs
  • Intensity of activity
  • Novelties (e.g. markings, equipment, signs) can
    increase PA

38

Social Factors are Potential Multipliers
  • Social factors determine when and whether people
    will be exposed to specific physical environments
  • e.g. Public spaces (parks, schoolyards) are used
    more when organized activities are available
  • Creating activity-friendly environments may not
    be enough,
  • But, more activity-friendly environments
    should make individual programs more effective!

39

Support Healthier Choices
  • Create home and community environments that
    make healthful choices easy.
  • And motivate and educate people to make those
    choices.

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Make Healthy Choices The Easy Choice
Create Optimal Defaults
  • Consider
  • Abundance lots of opportunities
  • Convenience cost, proximity, etc.
  • Choice appealing to target group

42

VS.
43

VS.
44

Many Potential Allies
  • Health
  • Emphasising benefits
  • Addressing costs
  • Economic
  • Appraisal of health impacts
  • Industry
  • Alignment with product design, architecture,
    etc.
  • Transport / Planning
  • Alignment with targets e.g. road safety,
    congestion

Climate Change
45

Community Capacity Building
  • Community capacity to promote PA
  • Leadership
  • Organizational structures
  • Partnerships
  • Skilled workforce
  • Resources
  • Creates ownership
  • Improves sustainability
  • Helps decrease inequalities

46

Keys to Success
  • Need many targets for intervention
  • e.g. increasing physical activity and decreasing
    sedentary time are both recommended
  • Need multiple, complimentary approaches
  • The complex interactions between social and
    built environments provide strong support for
    multi-level action
  • Need to aim for sustainability
  • Involve many partners


47

What Impact Can You Expect?
Certainty of Effectiveness
Population Impact
Low Moderate High
High Moderate Low


least promising most promising
Swinburn et al. Obesity Reviews 2005
48

Evaluate!
  • Evaluate Process
  • Evaluate Outcome
  • Why was it successful/unsuccessful?
  • Appropriate outcome measures?
  • What are other implications of intervention?
  • Were there unintended consequences?
  • How can future interventions be improved?

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SUMMARY
  • Look for opportunities to be active throughout
    the ENTIRE day
  • Make HEALTHY choices the EASY choices
    identifying the barriers to physical activity
    in your community
  • Consider ways to target multiple levels of
    influence
  • Improving physical structures alone may not
    change physical activity
  • Social structures need to be in tune with
    physical changes

51
  • Dont be discouraged by obstacles
  • Small changes are good
  • Lighthouse interventions can be valuable
  • Develop future programs based on best
    available evidence

52

Physical Activity is about having fun
53

this should not be lost!!
54
ADDITIONAL RESOURCES
55
more info available at www.phe.queensu.ca/epi/ob
esity/index.htm
56

Thanks to
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