LHI Webinar: Nutrition, Physical Activity, and Obesity (Part 4 of 5)

CARTER BLAKEY: Some of you were very busy during the webinar. We already have a pile
of questions here for folks to answer. So I’m going to send the first one toward Dr.
Hoelscher. The question is do you customize the CATCH program for communities with different
demographics or is the CATCH program a one size fits all? And if you do customize, how
do you determine which program works for certain populations?
DR. DEANNA HOELSCHER: First of all I’d like to you let you know that I have two other
people joining me to answer questions, Dr. Steve Kelder and Peter Cribb, and so I’ll
start out on this one and then I’ll hand it over to Dr. Kelder. But when we developed
CATCH, CATCH was developed for the school setting, so within the school setting there’s
a lot of room to customize is for the population. For example, in Brownsville and El Paso we
have the Mighty Amigos, so that is one way that they have adapted the CATCH characters
to the specific population. Steve, would you like to expand on that?
DR. STEVE KELDER: ...We hope that each school district will customize it on their own because
they know best what their target population is, and so we provide activities across many,
many different cultural scenarios and tastes and values.
CARTER BLAKEY: Great, thank you. And here’s another one for CATCH. This actually came
in over Twitter. It’s the first time we’ve tried this so I’m glad it’s working. How
has standardized testing impacted implementation of CATCH? In other words, have principals
at schools been receptive to the CATCH program?
DR. DEANNA HOELSCHER: Dr. Kelder, do you want to answer that one?
DR. STEVE KELDER: Sure, you know, standardized testing makes it more challenging to implement
programs like CATCH to a certain extent, but usually that falls into place at the classroom
curriculum. Most schools in the U.S. have a P.E. program, physical education. Most schools
have a food service, so those components of CATCH usually take off and take route easily.
However, you know, finding classroom time for the implementation of the classroom curriculum
by teacher sometimes is challenging, so we’ve done a variety of things likely have a kick
off week at the beginning of the school year or at various times throughout the year.
So those are the main ways we do it, but, you know, mostly schools are beginning to
recognize that the relationship that was outlined in the I believe it was 2010 CDC report that
relates physical activity and physical fitness to academic achievement, when superintendents
and school personnel and principals read that and understand it they’re more like to implement
a program like CATCH.
CARTER BLAKEY: Great, thank you. And here’s a question for Dr. Koh. Dr. Koh, on one of
your slides you listed several administration or Department of Health and Human Services
that are targeting obesity and overweight and nutrition and physical activity. Can you
explain how these tie in? For example, what is the Affordable Care Act doing to help combat
obesity?
DR. HOWARD KOH: Okay, we’ve had so much transformation under this administration’s
leadership on areas of prevention and public health in general and obesity in particular.
We have on the prevention front a National Prevention Strategy that I mentioned, a new
National Prevention Council, a dedicated prevention fund. Obesity related issues, physical activity
and nutrition issues are all tied into those efforts.
On a individual level, health plans are asked to cover screening for body mass index without
adding cost to the beneficiary, so that’s a big advance because we don’t want cost
to be a barrier. We have the tremendous leadership of the First Lady as I mentioned, and we have
a coordinating meeting every month across the department that I chair that helps on
Let’s Move! initiatives and coordinates with the White House. I was delighted to see
that the CATCH themes actually align with the Let’s Move! themes very, very nicely.
And then we have as I mentioned not only the dietary guidelines and the physical activity
guidelines that are constantly re-updated, but the President’s council that’s really
putting forward the message on physical activity has really been revitalized under this administration
as well.
CARTER BLAKEY: Great, thank you very much. Now for Dr. Hoelscher. Can you talk about
the importance of evaluation of your programs that aim to change health behaviors? I think
that’s one of the biggest challenges we face is evaluating changes in health behavior,
so can you tell us a little bit about what you’ve done and the importance of it?
DR. DEANNA HOELSCHER: Yes. I think evaluation is always important for programs like this
to demonstrate impact for funders and for other stakeholders in the community. So we’ve
done evaluation in many different ways; from the original randomized control trial in which
we collected blood for cholesterol levels and did heights and weights, and blood pressure
to the way that we normally evaluate now. So usually what we do when we’re in schools,
we have a series of questionnaires that we can ask students about their dietary habits.
And then we usually do measure their height and weight as part of that as well. We also
have some parent surveys that we’ve used at times. These parent surveys will ask about
access to healthy foods at home and how safe the parents perceive their environment to
be. We also have a series of measures that are done at the school level, and often that’s
not done, but we found it’s extremely helpful. We have a series of tools that schools can
use.
One is a questionnaire that says how do we know it’s working, so it’s a list of criteria
that you can evaluate how well the program is being evaluated or how well the program
is being implemented in the school level.
CARTER BLAKEY: Great, thank you. And here’s another question for you. Can you provide
more details on how you bring the appropriate stakeholders together to work toward reinforcing
each other’s messages and combating obesity?
DR. DEANNA HOELSCHER: I think I’d like to direct that question to Peter Cribb. Peter,
would you like to answer that one?
PETER CRIBB: Yes, I might just defer to Steve for this one.
DR. STEVE KELDER: Sure, what we do is during training we ask ... when we conduct trainings
at schools or school districts we will ask for a member at the school campus from the
school’s administration, a lead classroom teacher, the physical education teacher and
usually the food service director of the campus. If we’re training a school district, we’ll
ask for each of those people from all the schools that we’re training as well as district
personnel. So what we do is we offer what we call a CATCH coordination kit.
Deanna mentioned that, but when you train all those different individuals that have
supervisory responsibility for classroom, P.E. and food service, we break it into six
week objective cycles, so during training they plan together on how they’re going
to implement the various components of CATCH and we find that, you know, the training part
and having those different people with different responsibility makes all the difference.