Children’s Healthy Living (CHL)
In the U.S., obesity in children is occurring at younger ages than previously observed and is impacting children as early as age two. Being obese or overweight carries substantial health consequences. Children are at risk for serious chronic diseases including type 2 diabetes, heart disease and certain types of cancer. The estimated rate of overweight/obesity prevalence in the U.S. for children ages 2 to 19 years is approximately 32%; however, a recent study suggests that the rate of obesity and overweight for children of those same ages on Guam is significantly higher than their US counterparts at approximately 39%.
The Children’s Healthy Living Program for Remote Underserved Minority Populations in the Pacific Region (CHL) Program is a collaboration of land grant institutions in Alaska, American Samoa, the Commonwealth of the Northern Mariana Islands(CNMI), Guam, the Federated States of Micronesia (FSM), Hawai‘i, the Republic of the Marshall Islands (RMI), and the Republic of Palau (RP). The overall goal of the CHL program is to prevent early childhood obesity and improve the health of young children; and one of the specific objectives used to accomplish this was to design and test a community-based, environmentally-focused intervention program.
Before the CHL environmentally-focused intervention program was launched, an extensive amount of baseline data was collected from approximately 1,000 young children, ages 2 to 8 years, from 5 different villages on Guam. This was done to determine the effectiveness of the intervention program efforts, and to learn more about the health and food consumption behaviors of young children living in Guam. Results from the baseline data collection have been entered and analyzed, and the following are some preliminary results collected on the physical activity in a sample of activity logs and Actical accelerometer data from Guam.
How physically active are children on Guam?
Of the 367 children with accelerometer data, 179 (48.8%) children met the U.S. national recommendations for achieving at least 60 minutes of moderate or vigorous activity daily, which is also a CHL behavioral intervention target or goal. There was no significant difference in activity level by village. Parents were asked, “On usual weekdays (Monday to Friday), how many hours a day does your child spend watching television and/or videos/DVDs?” Parents were then asked how many hours their child spent playing active and inactive video games on weekdays. They were asked the same questions about the weekend days. The national recommendation is that young children should spent 2 hours or less on screen time per day. Only 13.5% of the children from the various villages met this recommendation. Baseline data indicate that the levels of physical activity of young children on Guam have a lot of room for improvement.
The Guam CHL Program is now working with local partners to ensure the long-term sustainability of their efforts. Over the past 5 years, the Guam CHL Program has developed long-term partnerships with the New and Veteran Farmer’s Program, SNAP-ed, EFNEP, 4H, the Department of Public Health and Social Service’s Non-Communicable Disease (NCD) consortium, Guam Department of Education, and the Mayor’s Council of Guam, and many other community partners and sponsors. Through these partnerships we tested many community-based interventions to increase physical activity. Community/University partnered approaches have proven successful in the implementation and long-term sustainability of our efforts.
Through the “Getting Guam Healthy Incentives Program” (P.L. 32-179), $700,000 was appropriated to the NCD to promote health, wellness, physical activity, and the effective use of social and healthcare services for medicaid-eligible recipients and other disadvantaged populations on Guam through individual, family, and community programs. The NCD Physical Activity Team received funding to implement both the Walk to Wellness Program ($200,000) and the Early Start, Fit for Life Initiative ($300,000), which builds upon earlier CHL activities. The Walk to Wellness Program focuses on increasing daily physical activity throughout the island by improving availability and accessibility in each village. Efforts include short-term solutions such as implementing physical activity, conducting health screening and education, and longer-term environmental changes in identified villages in order to increase overall physical activity levels for all in the community.
The Early Start, Fit for Life Initiative’s goal is to reduce and/or eliminate non-communicable diseases, including common and modifiable risk factors, such as obesity in children, and to promote health, wellness, and physical activity during and after school at Guam Department of Education (GDOE) in order to provide students with the minimum of 25 minutes of instructional physical education. Key objectives of the program include: a School Program Consultant to ensure program sustainability and build GDOE’s capacity to support physical activity in the elementary curriculum; to standardize and enhance the monitoring of the health, wellness, and physical activity of students at the elementary school level through BMI screenings; to provide SPARK training/SPARK curriculum and kits, coordinators and support; and the School Health Intervention Program to create avenues for teachers and local organizations to implement physical fitness and wellness activities both during and after school.
Additional funding has been awarded to Dr. Bob Barber ($126,709) and Dr. Clare Camacho ($71,674 and $144,110) through the Guam Cancer Trust Fund (P.L. 30-80) to conduct cancer preventative interventions in the community. These activities will expand the efforts and reach of both the Walk to Wellness Program and the Early Start Fit for Life Initiative.
With the knowledge of healthier lifestyle choices, obesity can be prevented at an early age. The CHL program has adopted “The Food Friends, Get Movin with Mighty Moves” curriculum for the GDOE pre-k classrooms. This program takes a two-pronged approach to health with both a physical and nutritional component.
The program promotes healthy eating behaviors and enhances motor skills. Guam DOE pre-k classrooms have already implemented the physical component, “Get Movin’ with Mighty Moves” and will introduce the nutritional component “Fun with New Foods” in January 2017.
To date, the CHL program has made a significant impact on health-related issues in Guam villages and schools through the efforts highlighted above. Their successful affiliation with various agencies, schools and community partners ensures the longevity of their work and will do much to inform their research.
Funded by USDA NIFA AFRI and USDA NIFA Hatch ACCN#1011461