Directions in Childhood Obesity Prevention

In regard to childhood obesity prevention programs that I have spent the better of two weeks reviewing, I have chosen the CATCH one to promote to my community partners and community. To better help me wrap my mind around what I want to say, I will use you, my loyal blog readers, for a practice articulation. (I have found graduate school to be similar to emasculation – my ability to form cohesive thoughts and sentences is considerably weakened. As Sarah Palin might say WTF? Which, incidentally,  is the only time you will see THAT name in my blog)



Back to childhood obesity…


Though my review is far from complete or exhaustive, a concept or theme is developing. I see that the Coordinated Approach To Child Health, a revision of the Child and Adolescent Trial for Cardiovascular Health, is the program that is the most comprehensive, most studied and seemingly the most socio-ecological (it involves all areas of exposure – individual, school, home and community). CATCH has been involved in randomized controlled trials and evaluated for sustainability. After the initial transnational project, smaller studies on more diverse populations were completed. Though low-income schools with minority populations have been studied, the sole program that involved an adequate number of black children measured the changes in the school environment only. In other words, they did not look at knowledge, skill or behavior change on the individual level. In the larger trial, one district did have a 15% representation of black children, but during analyses it was noted that more black children were lost to follow up (left the schools) than the whites. According to our public health databases, black children have much higher rates of OW/OB than white children do, though all races have higher rates than expected/acceptable. It is this researcher’s assumption that individual subcultures are not the causal factor in our obesity epidemic. Instead, the overall culture or sociopolitical climate is obesogenic. Poverty, not race, promotes obesity as much as overconsumption. If we can deliver this comprehensive program in a majority black school and or majority low income school and allow these children the knowledge, skills and resources to eat well and exercise more– the positive outcomes will add to the research questions we ask and the policy decisions we make. This is not to say we do not to continue work with ALL children, but to make sure we do not leave out the group with the greatest risk. The studies already completed may have been nationally representative – meaning that they may have had the right proportion of race and gender to start the study, but they did not finish in parity. Even so, if most of our evidence for childhood obesity was on girls and not boys, wouldn’t that be a problem?


And that is where I am headed with my research these days – though I also have a proposal in for a worksite wellness program that would be Internet based. I will let you know if that one gets funded :)