Application of the PRECEDE model to obesity prevention

Application of the PRECEDE model to obesity prevention Sally Black, RN, Ph. D & Cayley Warner, RD Saint Joseph’s University INTRODUCTION In the United States, childhood obesity is becoming the greatest challenge of this century. A goal of Healthy People 2010 is to reduce the proportion of children and adolescents who are overweight or obese to 5% (Baseline=11%). In Pennsylvania, an estimated 18. 2% of eighth grade students are overweight. 1 In 2003, the overall incidence of obesity was 24% with Hispanic (31%) and Black (23%) at highest risk compared to White children (16%) in New York City. 2 Frequencies of overweight and obese may be higher in inner city, minority youth. The purpose of this study was to plan and pilot a program to reduce childhood obesity in Philadelphia. Researchers and practitioners from Saint Joseph’s University investigated childhood obesity at environmental, educational, and policy levels and planned interventions. Major components of the project were a science based nutrition education program, critical media awareness, working with food manufacturers to influence marketing practices, and building a community playground to provide safe play opportunities for children. PRECEDE Phase 4: Educational and Organizational Diagnosis Phase 3: Behavioral and Environmental Diagnosis Phase 2: Epidemiological Diagnosis Phase 5: Administrative And Policy Diagnosis Health Promotion Educational ØProvide nutrition education (Cifelli & Reynolds) ØProvide critical media awareness (Lazar) Policy Regulation Organization Consumer reactions to obesity information (Simmers) ØInvestor reactions to obesity information influences stock prices (Ghani) ØEvaluation of current marketing practices to inform policy regulation (Childs) PROCEED Phase 6: Implementation Predisposing Factors ØBody image (size = power) ØPerceived risk ØPerceived susceptibility Series of health fairs (Black) Reinforcing Factors Ø Advice from health care providers ØCommunity ØMedia is taking a more positive role Investigation of food advertising aimed at children (Lord) Enabling Factors ØAccess ØSkills ØKnowledge Community playground (Brady & Black) Phase 7: Process Evaluation FIGURE: The PRECEDE-PROCEED model 3 applied to childhood obesity Research projects funded by Centers for Disease Control, Chronic Disease Prevention & Promotion Division printed by www. postersession. com Behaviors ØFood choices ØActivity levels Needs Assessment to identify current behaviors (Logio) Environment Access to healthy foods ØAccess to safe play areas ØMedia influence ØFamily influence ØCultural influence GIS Mapping to geographically identify areas of higher obesity (Jambulingam) Phase 8: Impact Evaluation 1 PA Health Problem 27% Overweight or at risk ØHeart disease ØHypertension ØType 2 diabetes ØCancer ØAsthma ØAltered glucose metabolism ØIncreased lipid levels ØLow self-esteem ØDepression ØSocial discrimination ØPremature sexual development ØHip and joint problems Phase 1: Social Diagnosis Quality of Life Physical and mental health and well being Literature review (Swartz) Phase 9: Outcome Evaluation Department of Health, (2002). “Pennsylvania Assessment of Overweight Children and Youth. ” 2 Thorpe, L. E. , List, D. G. , Marx, T. , May, L. , Helgerson, S. D. , and Frieden, T. R. (Sep 2004). Childhood Obesity in New York City Elementary School Students, Am J Public Health, 94: 1496 – 1500 3 Green, Kreuter, Deeds, & Partridge (1980). Health Education Planning: A Diagnostic Approach. Mountain View, CA: Mayfield.