A resiliency based intervention for diet management By: Megan Govindan MPH candidate

Outline The obesity epidemic Weight management Dietary habits Resiliency Resiliency intervention Outside-in and inside-out prevention Health realization model Target population Intervention outline

Obesity Obesity stems from a combination of factors including genetics, environment, physical inactivity and dietary intake. Obesity develops when a chronic, quantitative imbalance exists between energy intake and energy expenditure.

Obesity trends Children from obese parents are 5x more likely to be obese in adulthood Currently 1/3 of America’s youth are either obese or at risk of becoming obese. In the past 30 years the obesity rate has:  5% to 14% for children 2-5y  4% to 19% for children 6-11y  5% to 17% for children 12-19y

Prevalence of overweight high school students Source: CDC Division of Adolescent & School Health Percentage of high school students who were overweight* — selected U.S. states, Youth Risk Behavior Survey, 2003 & 2005 * Students who were ≥ 95th percentile for body mass index, by age and sex, on the basis of reference data.

Benefits of increased resiliency in dietary management Many people understand the relationship between physical activity, diet and lifestyle choices but do not make a conscious effort to change their behavior. Why do we continue to make poor decisions when we know the outcome?? Our thoughts

Benefits of increased resiliency in dietary management If we understand these principles we can understand that we are naturally resilient Understanding the principles will help access our own internal health We are the only ones who can access our natural resiliency

Target population High school & college students Beliefs can be changed at any age Challenge students to identify barriers to health and ways to sustain healthy behaviors.

Intervention 1. Outside-in & inside-out prevention model 2. Health realization model 3. 3 principles & understanding how thought works 4. Innate resiliency

Internal health & Strength

Model Health realization model Living the feeling/living the understanding Creating the feeling/creating the climate Deep listening Conveying or drawing out understanding/teaching

Living the feeling & understanding Instructor Must have understanding and meaning of the 3 Principles Generally living their life in well-being Respond to adversity, and to others without getting reactive or “brought down”

Creating the feeling/creating the best climate Sessions 1-3 Seeing people’s health and how it gets obscured Having fun with people Building rapport Building hope

Conveying/drawing out the understanding Sessions 4-7 will start out with a question to help introduce resiliency principles Listening to our bodies It takes an average of 15 minutes for our brain to receive the signal from our stomach’s that our bodies are full. Eating for hunger vs. eating for solace

Intervention Session 1: Introduction and overview. Build rapport by having meet & greet session. Have participants play people bingo where they go around the room and meet people that match the descriptions on the card. Examples of these categories could be “has a dog”, “is an athlete”, “is from another state/county”, “has blue eyes” etc. Session 2: Discuss what resiliency is and its relationship to diet management. Session 3: Discuss outside-in and inside-out prevention model. Talk about similarities and differences between the two.

Intervention Session 4: Have people work in groups and define what the 3 principles mean to them and how it applies to diet and other lifestyle choices. Sessions 5-6: Discuss health belief model and role of 3 principles. Session 7: Have participants talk about what they like to eat, and why they eat these types of foods. Session 8: Discuss health problems associated with being overweight. Discuss how diet plays a role in health.

Intervention Session 9: Discus barriers to eating healthy such as cost, meal preparation, time constraints etc. Discuss how it is possible to overcome these barriers. Session 10: Discuss mindful eating and managing our thoughts instead of letting them dictate our eating behaviors and what foods we eat. Session 11: Reiterate main concepts.

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