2. ADULT OVERWEIGHT/OBESITY: THE
PROBLEM
• Adult Body Mass Index (BMI)-weight (kg)/height^2
(meters)
• BMI indicates high body fatness
• BMI<18.5= underweight
• BMI is 18.5 to 24.9= healthy weight
• BMI is 25.0 to 29.9= overweight
• BMI >30.0= obese
• Not always accurate
http://www.cdc.gov/obesity/adult/defining.html
3. ADULT OBESITY FACTS
• Common, serious and costly
• 22 states obesity rate 30% or higher (a)
• 40% U.S. adults ages 40-59 obese (a)
• Since 2002 Black obesity 8% and Latino 10% (a)
• Causes preventable death (b)
• More than 1/3 U.S. adults obese (b)
• U.S. medical cost in 2008= $147 billion (b)
• Obese cost $1,429 > normal weight cost (b)
(a) http://stateofobesity.org/fastfacts/
(c) http://www.cdc.gov/obesity/adult/defining.html
4. CAUSES & CONSEQUENCES OF
OBESITY
• Causes (a)
• Inactive lifestyle
• Environment (work schedule, gym affordability, no safe recreation
places)
• Unhealthy food
• Genetics
• Health conditions and medications (hyperthyroidism)
• Smoking
• Emotional factors (stress)
• Age
• Pregnancy
• Lack of sleep
• Consequences (b)
• Consequences heart disease, stroke, type 2 diabetes, cancer, (leading
causes of preventable death)
(a) http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes
(b) http://www.cdc.gov/obesity/adult/defining.html
8. Demographics Caroline County Virginia
Population 29,298 8,260,405
Below 18 years of age 23.4% 22.6%
65 and older 14.6% 13.4%
Non-Hispanic African American 27.9% 19.0%
American Indian and Alaskan Native 0.8% 0.5%
Asian 0.8% 6.1%
Native Hawaiian/Other Pacific Islander 0.1% 0.1%
Hispanic 4.0% 8.6%
Non-Hispanic white 63.8% 63.6%
Not proficient in English 0.3% 2.6%
Females 50.8% 50.8%
Rural 78.4% 24.5%
http://www.countyhealthrankings.org/app/virginia/2015/rankings/caroline/county/outcomes/1/additional
DEMOGRAPHICS
9. SOCIAL & ECONOMIC FACTORS
Social & Economic Factors Caroline Virginia
Median Household Income $55,760 $62,745
Children eligible for free lunch 51.9% 42%
High school graduations 77% 83%
Some college 49.4% 68.2%
Unemployment 6.7% 5.5%
Children in poverty 21% 16%
Income inequality 3.8 4.8
Children in single-parent
household
37% 30%
http://www.countyhealthrankings.org/app/virginia/2015/rankings/caroline/county/caroline/overall/snapshot
http://datacenter.kidscount.org/data/tables/3239-students-approved-for-free-or-reduced-price-school-lunch?loc=48&loct=5#detailed/5/6812-
11. OBJECTIVES
• Increase the proportion of adults who are at a healthy
weight
• Baseline: 30.8% aged 20+ years were healthy weight in
2005-08
• Target: 33.9% healthy weight by 2020
• Reduce the proportion of adults who are obese
• Baseline: 33.9% aged 20+ were obese in 2005-08
• Target: Only 30.5% obese by 2020
https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status/objectives
12. COMMUNITY GUIDE INTERVENTIONS
Provider-Oriented Intervention:
Provider Education
• Directed to health care providers
• Task Force Recommendation and Findings
• Insufficient evidence
• Systemic Review
• Various outcomes
• Not enough adequate information
• Conducted by team of specialist for obesity prevention and control
• Economic Evidence
• Not conducted because of limited information
http://www.thecommunityguide.org/obesity/ProviderEducation.html.
13. COMMUNITY GUIDE INTERVENTION CONT.
Intervention in Community Settings:
Worksite Programs
• Worksite activities and programs
• Task Force Recommendation and Findings
• Recommended (strong evidence for effectiveness)
• About the Intervention
• Informational, educational, behavioral, and social strategies
• Policy and environmental approaches
• Policy strategies and worksite weight control strategies
• Systemic Review
• Most common strategies: informational and behavioral skills components
• Involved white collar workforce
• Assessed focus (diet, exercise, or both) and cost-effectiveness
• Conducted by team of specialists on worksite programs to prevent and control
obesity
http://www.thecommunityguide.org/obesity/workprograms.html
14. WHAT WORKS FOR HEALTH
INTERVENTIONS
Creating Places for Physical Activity
• Evidence Rating: Scientifically Supported
• Expected Beneficial Outcomes
• Increased physical activity
• Improved physical fitness
• Potential Benefit: Reduced obesity rates
• Implementation
• Changes to local environments to create new opportunities for
physical activity
• Reduce cost of existing opportunities
• Multi-component strategy includes training & education for
participants
http://www.countyhealthrankings.org/policies/places-physical-activity
15. WHAT WORKS FOR HEALTH
INTERVENTIONS CONT.
• Examples
• Creating walking trails
• Building exercise facilities
• Rails to Trails (RTT)
• YMCAs
• The American Community Gardening Association (ACGA)
• The National Recreation and Park Association (NRPA)
• American Trails
• Other Possibilities
• Community fitness programs
• Extracurricular activities for physical activity
• Recreational sports leagues for adults
• Farmers' markets/stands
• Community-wide physical activity campaigns
http://www.countyhealthrankings.org/policies/places-physical-activity
16. Potential Partnership
YMCA
• Mission: “To put Christian principles practice through programs that
build a healthy spirit, mind and body for all”
• Variety of activities for every age
• Contact: Chief executive Officer, Bernard C. Reiley
• Phone: 540-371-9622
• Email: barneyreiley@family-ymca.org
• Promotes healthy living and social responsibility
• Desires lasting personal and social change
• Community centered
• Offers financial assistance
http://www.family-ymca.org/branches/Caroline/CarolineOverview1.html
17. Potential Partnership cont.
Caroline 4-H Youth Development
• Mission: “to develop youth and adults working with those youth to
realize their full potential in becoming effective, contributing citizens
through participation in research-based, non-formal, hands-on
educational experience.”
• Cooking club
• Teaches new recipes
• Opportunity for teaching healthy eating
• Contact: Beth Jimenez, FNP Adult/Youth Food, Nutrition & Health
• Phone: (804)-633-6550
• Email: majimene@vt.edu
http://offices.ext.vt.edu/caroline/programs/4h/
18. Potential Partnership cont.
Parks & Recreation
• Mission: “Our goal is to enhance the physical and mental well being of all
citizens of Caroline County.”
• Variety of activities for multiple ages (camps, fitness, club activates, etc..)
• Low cost options
• Community centered
• Contact: Donnell Howard, Director of Recreation
• Phone: 804-633-7277
• Email: dhoward@co.caroline.va.us
https://co.caroline.va.us/238/Parks-Recreation
19. Works Cited
• Centers for Disease Control and Prevention. (2012). Defining Adult
Overweight and Obesity Retrieved February 09, 2016, from
http://www.cdc.gov/obesity/adult/defining.html
• KIDS COUNT Data Center. Students approved for free or reduced
price school lunch. (n.d.). Retrieved April 11, 2016, from
http://datacenter.kidscount.org/data/tables/3239-students-approved-
for-free-or-reduced-price-school-
lunch?loc=48outcomes/1/snapshot#detailed/2/any/false/1380,1232,11
23,1031,923/any/12923,6682
• NHLBI, NIH. What Causes Overweight and Obesity? (n.d.).
Retrieved February 25, 2016, from
http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes
• Office of Disease Prevention and Promotion. Healthy People 2020.
(n.d). Nutrition and Weight Status. Retrieved March 22, 2016, from
https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-
and-weight-status/objectives
• Parks & Recreation | Caroline County VA. (n.d.). Retrieved April 14,
2016, from https://co.caroline.va.us/238/Parks-Recreation
20. Works Cited Cont.
• Rappahannock YMCA. (n.d.). Retrieved April 14, 2016, from
http://www.family-
ymca.org/branches/Caroline/CarolineOverview1.html
• The Community Guide. Obesity Prevention and Control: Worksite
Programs. (n.d.). Retrieved April 13, 2016, from
http://www.thecommunityguide.org
• The State of Obesity. Fast Facts on the State of Obesity in America.
(n.d.). Retrieved February 25, 2016, from
http://stateofobesity.org/fastfacts/
• University of Wisconsin Population Health Institute. County Health
Rankings & Roadmaps. (2015). Retrieved March 3, 2016, from
www.countyhealthrankings.org
• VCE Caroline County - 4-H Youth Development. (n.d.). Retrieved
April 14, 2016, from http://offices.ext.vt.edu/caroline/programs/4h/
Editor's Notes
Slide 1, 2,3,4
Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters.
Ex: 5”9= weight range 169 to 202, BMI (25.0, 29.9) =OVERWEIGHT
BMI is not always accurate in diagnosing a person If they are obese or not because it only measure the persons weight, but it doesn’t directly shows if is mostly fat or muscle.
Non Hispanic African American= Population percentages in Caroline compare to virginia, higher risk of having health issues and obesity, therefore Caroline have a higher percentage of adult obesity compare to the overall state of virginia. (30%--28%)
Rural= locations is far apart, outside of towns and cities. More convenient to use cars instead of doing physical exercise such as walking or biking to a particular destination. Prevents the people in the County to have the opportunity to be physically active. Hence less exercising, more chances of health issues and obesity.
Physical Inactivity
Caroline= 23% Virginia= 22%
Access to exercise opportunities
Caroline= 59% Virginia= 81%
Educational interventions directed at healthcare providers are designed to increase their knowledge as well as change attitudes and practices in addressing overweight and obesity among clients.
The Community Preventive Services Task Force finds insufficient evidence to determine the effectiveness of provider education alone to prevent and control obesity among child, adolescent, or adult clients because too few studies of suitable quality were available.
Interventions for providers with adult patients:
The three studies that qualified for the review assessed various outcomes and did not provide adequate information to draw conclusions.
Interventions for providers with child and adolescent patients:
The one study that qualified for review found minimal effects on patients’ body mass index (BMI).
Informational and educational strategies aim to increase knowledge about a healthy diet and physical activity. Examples include:
Lectures
Written materials (provided in print or online)
Educational software
Behavioral and social strategies target the thoughts (e.g. awareness, self-efficacy) and social factors that effect behavior changes. Examples include:
Individual or group behavioral counseling
Skill-building activities such as cue control
Rewards or reinforcement
Inclusion of co-workers or family members to build support systems
Policy and environmental approaches aim to make healthy choices easier and target the entire workforce by changing physical or organizational structures. Examples of this include:
Improving access to healthy foods (e.g. changing cafeteria options, vending machine content)
Providing more opportunities to be physically active (e.g. providing on-site facilities for exercise)
Policy strategies may also change rules and procedures for employees such as health insurance benefits or costs or money for health club membership.
Worksite weight control strategies may occur separately or as part of a comprehensive worksite wellness program that addresses several health issues (e.g., smoking cessation, stress management, cholesterol reduction).
No one focus, diet or physical activity, or combination of both appeared to be better than others in terms of its effect on weight loss.
Most of the studies involved a white collar workforce that included some employees with overweight or other chronic disease risk conditions.
The range of cost-effectiveness estimates from three studies (two involving weight-loss competitions and one involving a physical fitness program) varied from $1.44 to $4.16 per pound of loss in body weight.
