Promoting Adolescent
Health in the Community:
A Collaborative Approach
to Preventing Childhood
Obesity
A.S. Birnbaum, J. Davis-Manigualte,
E. Irish-Spencer, T. Miner, T.R. Nichols,
C. Parker-Duncanson, & C. Temlock-Teichman
Outdoor
Educ
CU
Cooperative
Ext @ NYC
CU
Public Health
WMC
Human Ecology
CU
Urban Semester
CU
Nutrition
CU
Healthy Adolescent Research Group
Good Fit Project
Funded by
National Cancer Institute
Background
Developed in response to an RFA on Mechanisms of Physical Activity
(PA) Behavior Change
Hypothesized mechanism for increasing afterschool PA in urban
multiethnic 11-14 year-olds:
 Motivating and training them to identify and engage in PAs that
are a good fit with their 1) environmental, 2) physiological, and 3)
psychosocial contexts and needs
Funding to develop materials and measures for a series of
afterschool skills-building workshops
 Strong youth involvement in materials design
 Conceptual and strategic guides
- Social ecological models of behavior
- Adolescent development
- Social marketing techniques
Objectives
 Develop tools for an innovative and scientifically sound PA promotion
intervention and measurement protocol
 Involve young adolescents in designing intervention messages and
materials for promoting PA behavior change.
 Use formative research to confirm and refine the model of person–PA
environmental, physiological, and psychosocial compatibility (“Good
Fit”).
 Create clear behavioral messages about safe, appealing, and realistic
PA practices for youth with physiological concerns such as asthma,
overweight, and low levels of baseline activity.
 Conduct instrument development activities to accurately assess the
proposed environmental, physiological, and psychosocial mediators
targeted by the intervention.
Phase I
Activities
 Focus Groups with Adolescents (N=7)
 Key Informant Interviews with Afterschool Program Leaders (N=10)
Image Bank Sub-Study
Preliminary Findings
 Program leaders perceived inner-city multiethnic youth are interested
in a limited scope of PAs, mostly basketball and dance
 Adolescents did not perceive themselves as overly constrained by
their environments
 Adolescents reported context as critical to enjoyment of PA
- Competition sometimes enhances enjoyment, sometimes
detracts from it
- Sometimes knowing how to do the PA and doing it well are
important, other times it is fun to do PA they don’t know how to
do well at all
Image bank sub-study (in progress) highlights unmet need for images
Positive Youth
Development &
Nutrition Through
Sports
Funded by Robert Wood Johnson
Foundation
Background
 Sports programs are major vehicles for incorporating messages related
to positive youth development and adoption of healthy lifestyle behaviors
Coaches, parents, & youth need adequate training to accept and
foster these ideas
 Participation in sports programs high
33.7 million 5-17 yr olds participate in extracurricular sports
75% of those in community-based programs
Objectives
1. Assess status of current programs for youth development/nutrition
& health training for coaches/leaders implementing recreational
youth sports programs
 Variety of settings: after school programs, community based
agencies, faith-based organizations, & individual leagues.
2. Document content of a select group of large scale, established
coach training programs
 Identify gaps in training initiatives for positive youth
development, nutrition & health.
Very Preliminary Findings
 Most coaches & directors have not had training in nutrition
 Half of coaches have not had training in positive youth development
•Receive “generic” child-work training instead
 Most parents “not sure” of hydration & nutrition education practices of
program
PAL Fit
Cornell Cooperative Extension @ NYC
&
Police Athletic League
Background
Cornell University Cooperative Extension – NYC (CUCE-NYC) and
the Police Athletic League (PAL) developed the PAL Fit pilot:
Introduce concepts of nutrition and fitness to youth at various PAL
Recreation Centers in NYC.
Attempt to decrease the growth of overweight and obesity rates
along with their resulting chronic diseases (i.e. diabetes,
hypertension, coronary heart disease, etc.) among youth.
3-Day Fitness Regimen plus 1-Day Hands-on Nutrition Workshop
Weekly basis for 8 weeks
Currently 2 Phases Delivered:
PAL Fit I
PAL Fit II
PAL Fit I
Activities
Findings
Manhattan (1)
Spring 2004 delivered in 5 PAL
Centers
Brooklyn (2)
Queens (1)
Bronx (1)
Positive impact on youth
participating in sessions
187 youth age 10-13
One-day orientation with PAL
Staff
USDA Nutrition Workshops
Power of Choice
FitnessGram
Challenges for staff to model
behaviors that PAL Fit promotes
Challenges exist in running a
structured program in traditionally
less structured environment.
Need to re-evaluate PAL center
environment to better understand
how staff & facilities can contribute
to PAL Fit message
Opportunities exist to increase
buy-in for PAL Fit
PAL Fit II
Activities
Planning Group Developed
Directors from PAL Centers
Nutrition & Health Community Educators
8 EFNEP Workshops to PAL Staff
Spring 2005 in 2 PAL Centers
Manhattan
Bronx
6-8 year olds
8 Weeks of Nutrition & Fitness workshops
EFNEP 4H youth curriculum
FitnessGram
10 Staff Members
45 youth
Evaluation currently underway
GoActive Girls
To be submitted
Background
Adolescence intensifies complex relationship girls’ have
with their bodies
Girls report more barriers to physical activity than boys
Social, Appearance & Access issues
Girls report less self-efficacy to overcome barriers
Sports beneficial to girls’ but does not appeal to all girls
Highly competitive
Access to nature bolsters children’s well-being
Objectives
Develop Girl-Specific Program
Conduct a Feasibility Trial
Outdoor Activities
 Rock climbing
 Hiking
 Canoeing
 Challenge course
Educational Activities
 Promote regular PA
 Goal-setting
 Environmental Ed
Group Building
Adult Female Role Models
Logistics
 Summer Program
 12 1/2 days
 12-20 girls (11-14 yrs old)
Outcomes
Participation &
engagement
Logistics
Knowledge & attitudes
Methods
Focus Groups
Pre-post PA & Health
Survey
Group Leader Journals
Mother/Daughter
Physical Activity
Promotion
To be submitted
Background
 Health promotion strategies should target women, both as individuals
and as agents of change within the family
 Understanding context of health behaviors within the female lifespan
& what behaviors mean for women & girls is crucial for developing
effective intervention strategies
 Need to examine how mothers and daughters interact over health
practices (PA) and how issues of control, conflict and closeness may
encourage or discourage participation in healthy behaviors
Critical to examine these processes both within and across
cultures
Objectives
1. Identify salient values, beliefs, resources, barriers, practices, and
behaviors around PA for urban women and adolescent girls;
2. Identify environmental (home & community) strengths &
challenges to PA for women & girls;
3. Develop intervention and measurement protocols for motherdaughter PA promotion;
4. Pilot-test intervention components and measures with urban
mother/daughter dyads.