1. Implementing Childhood Obesity Prevention Research in a Rural Oregon County Using a Partnership Approach: The U.C. (Union County) Fit Kids Project Nancy Findholt, PhD, RN OHSU School of Nursing

2. Overview Introduction – Community-based participatory research –Childhood obesity in rural areas Steps taken to implement the project Strategies for building an effective community-university partnership

3. What is Community-Based Participatory Research? “a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community and has the aim of combining knowledge with action and achieving social change.” * * W.K Kellogg Foundation

4. Key Principles of CBPR Builds on community strengths It is collaborative It integrates knowledge with action The goal is to achieve social change in order to improve health & well-being

5. Childhood Obesity in Rural America Rural children are 25% more likely to be overweight or obese than their urban counterparts* The underlying cause of this disparity is believed to be environmental Our focus: to understand & address the environmental contributors to childhood obesity in our rural area * Lutfiyya et al., 2007

6. Impetus for the Project U.C. Fit Kids evolved out of a previous collaborative effort to develop a school health program Prompted by the growing evidence of childhood obesity Congress had just passed legislation mandating that schools develop wellness policies

7. Step 1: Assessing Readiness Key informant interviews were conducted using questions from the Community Readiness Model* Results: –Union County was at a low level of readiness, but school personnel were more aware & concerned –Several participants offered to participate *Plested et al., 2004

8. Step 2: Structuring Community Involvement Coalition partners –School districts- Comm. on Children & Families –Hospital- Public health –Extension Service- Parks & Recreation –Head Start- Other groups & individuals –EOU & OHSU Coalition launched at a full-day retreat –Established the infrastructure –Introduced participants to the idea of environmental influences

9. Step 3: Getting Started With the help of college students: –Conducted a countywide BMI screening –Collected baseline data on children’s physical activities & diets –Held a contest to design a logo Helped the schools to develop wellness policies Provided a nutrition class to school food service personnel

10. Step 4: Assessing Influences on Physical Activity & Diets Received 2 grants for assessment Collected data from community leaders, school administrators & food service personnel, teachers, parents, adolescents, and children The data revealed many barriers to physical activity & healthy eating, but also a few facilitators

11. Assessment Findings Barriers to physical activity –Limited recreational resources –Unsafe streets –Fear of strangers –Limited physical education Facilitators of physical activity –Popularity of youth sports –Proximity to the natural environment

12. Assessment Findings continued Barriers to healthy eating –Limited availability of healthy food in small communities –Convenience stores near schools –High fat entrees in school meals –School practices that encouraged unhealthy eating Facilitators of healthy eating –Popularity of gardening

13. Step 5: Developing an Action Plan Findings reviewed & discussion within coalition Public input was obtained This feedback was used to set priorities for intervention –Improve quality of school meals –Increase availability of healthy food in small communities –Provide more physical activity at school –Increase opportunities for life-long activities

14. Step 5 continued Coalition brainstormed about potential strategies to address the priorities Action plan created from ideas that were generated

15. Current Status We are in early stages of implementation Coalition partners have taken the lead to find funding & initiate projects –Farm-to-school –Walking school bus –Brought a large educational event to Union County Over $450,000 in grant funding has been brought to the County

16. Lessons Learned Building on an existing, positive relationship allowed us to start quickly School participation & endorsement helped us to advance our agenda The coalition chairwoman’s connections within the county helped to launch the project

17. Lessons Learned continued The passage of legislation on school wellness policies helped to secure the schools’ commitment Providing honorariums & stipends to coalition partners helped to sustain their involvement

18. Acknowledgements Thank you to: –The members of the U.C. Fit Kids coalition –My research partners Vicky Brogoitti, Union Co Comm on Children & Families Dr Yvonne Michael, Drexel University Dr Linda Jerofke, Eastern Oregon University –Our primary funding partners National Institute of Nursing Research Northwest Health Foundation