Nurse Practitioner-Coordinated Childhood Obesity Early Intervention and Prevention Program
Elsie M. Stines, MS, CRNP, Saranne Perman, MD and Sangita Sudharshan, MD
University of Kentucky College of Medicine
Elsie Stines, MS, CRNP
220 Arch Street, 14th Floor
Baltimore, MD 21201
Childhood obesity has reached epidemic proportions, and the problem is disproportionately represented in low income, minority settings. In an attempt to intervene, an elementary school-based prevention program designed to educate children and their caregivers in healthy and active lifestyles was developed by a community-based coalition. The coalition was anchored by faculty, staff and students of a medical school. The design, launch, and operations of this program as a model which may be useful to other communities are described.
What do optimal car performance and optimal adult weight have in common? They both require early intervention in the form of preventive care. For cars, preventive care begins at 5,000 miles at the service station. And for adult weight, preventive care begins in childhood in the home, the school and the community. In line with this concept, the University of Kentucky College of Medicine (UKCOM) created a model after school program promoting healthy and active lifestyles by organizing a coalition of academic and community partners. This program was created to assist children who are at the highest risk of becoming obese better understand healthy eating habits and active lifestyle choices while having fun. Such a program could be replicated in the many high- risk communities throughout the nation. Preventing childhood obesity is challenging, yet, possible! The United States is experiencing an obesity epidemic, but what is most alarming is the number of children who are obese. The prevalence of childhood obesity has nearly tripled over the past two decades.1 Currently, almost one third of children and adolescents are either overweight or obese.2 Overweight adolescents have a 70 percent chance of becoming overweight or obese adults. This increases to 80 percent if one or more parent is overweight or obese.3,4 According to the Center for Disease Control(CDC), overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile, and obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex. Classification of overweight and obesity for children and adolescents are age and gender specific because children’s body composition differ both for age and gender. BMI is one way to screen children and adolescents for both overweight and obesity; however it is not a direct measure of body fatness.5 Factors contributing to childhood obesity are generally caused by a lack of physical activity, unhealthy eating patterns, or a combination of the two.4 Recent studies have shown that genetics can also play a role in determining a child’s weight, but the increasing numbers are not related to genetics alone.6 Unfortunately, children who are obese are at risk for developing conditions in childhood which used to be found mainly in adults. For example, the onset of hypertension, fatty liver, non-alcoholic steatohepatitis, obstructive sleep apnea, high cholesterol, and type 2 diabetes are now increasingly common in children.6,7 The most immediate consequence of being overweight, as perceived by children themselves, can be social discrimination which may result in poor self-esteem and lead to depression.4 What populations of children are at higher risk of becoming obese? Studies have shown that low-income and minority children are disproportionately affected by obesity- primarily...