Research News: The Whole Child

From the Department of Epidemiology and the Center for Molecular and Clinical Epidemiology of Infectious Diseases (MAC-EPID)

From the Department of Health Behavior and Health Education

From the Department of Health Management and Policy

Childhood Obesity Update from UM SPH

25 million children in the United States are overweight or obese—triple the number 40 years ago. The American Heart Association estimates that of those 25 million, 70 percent will become overweight or obese adults, many of whom will develop chronic (and costly) conditions like diabetes and cardiovascular disease. Today’s kids, in fact, may be the first generation of Americans to live shorter lives than their parents. Here’s how UM SPH faculty, students, and alumni are working to stem the tide:

> SPH student Noam Kimelman has launched the Ypsilanti Health Initiative, an alliance involving UM students and members of the Ypsilanti community. The initiative aims to make healthy foods more accessible and affordable to lower-income families by providing health-education workshops, subsidized grocery-shopping trips, and exercise classes. In its first year, the initiative organized 15 workshops, and disbursed $3,000 in healthy groceries.
> SPH Professor Noreen Clark and colleagues in the UM Center for Managing Chronic Disease serve as the evaluation team for the W.K. Kellogg Foundation’s Food and Fitness/Food and Community project, a nationwide initiative aimed at providing children and families in vulnerable communities with improved access to affordable, healthy, locally grown food, as well as opportu-nities for physical activity and play.
> Stacy Goldberg, MPH, RN, BSN, has created A Weigh of Life/What’s in Your Cart?™, LLC, a family-centered approach to preventing childhood obesity. Offered exclusively by the Detroit-based Plum Market, What’s in Your Cart?™ provides interactive nutrition education in a real-life grocery-store setting. Goldberg is also the nutritionist for Danialle Karmanos’ Work It Out, a holistic, yoga-based, not-for-profit program that helps kids and families in Detroit make healthy choices.
> Karen Peterson, director of the SPH Human Nutrition Program, is leading the evaluation of the Healthy Choices Initiative, a multi-program intervention designed to improve diet and activity behaviors and weight status in 20,000 adolescents in 46 Mas-sachusetts middle schools over a three-year period.
> SPH faculty members Alison Miller and Karen Peterson are collaborating with UM pediatrician Julie Lumeng on a new study that’s looking at eating behavior, stress, cortisol production, and obesity in low-income preschoolers attending Head Start. The researchers hope to learn whether young children who are overweight show aberrations in their stress physiology, and whether such aberrations relate to their eating behaviors—specifically the consumption of “comfort foods” high in fat and sugar.
> Through a statewide coalition called Healthy Kids, Healthy Michigan, SPH Associate Professor Amy Schulz and colleagues in the Department of Health Behavior and Health Education are working to identify a slate of statewide policies to reduce childhood obesity. The coalition was initiated with the support of the state’s Surgeon General, SPH alumna Kimberlydawn Wisdom, MS ’91.
> Through its “Building Healthy Communities” grant program, Blue Cross Blue Shield of Michigan is investing in a school-based preventive intervention strategy in 17 elementary schools across the state. SPH Associate Research Scientist Tom Reischl is evaluating the impact of the strategy, which provides grants to help schools complete school- and community-based assessments, implement physical-activity and nutrition curricula for both students and families, and initiate running/walking programs. <

Last year in a speech at UM, Marian Wright Edelman of the Children’s Defense Fund called on the public health community to invest in “the whole child, and not just our piece of a child.” SPH researchers are doing just that. Through a vast body of work aimed at making kids everywhere healthy, faculty, students, staff, and alumni are reducing—and in some cases eliminating—the dangers that threaten the young, and restoring the magic and hope we associate with that strange, miraculous, all-too-fleeting place called childhood.

From the Office of Public Health Practice:

Moms, Kids, and Care: Are there enough public health workers to provide the maternal and child health care services Detroit residents need? Thanks to a $300,000 grant from the Kresge Foundation, the SPH Center of Excellence in Public Health Workforce Studies is about to find out. Over the next two years, the center will survey the city’s community-based organizations to determine their contribution to the delivery of maternal and child health services in Detroit. The results will characterize the composition of this important segment of the public health workforce, which plays a critical role in ensuring that mothers and children get such vital services as pre- and postnatal care, nutrition counseling, and childhood immunizations. Established in 2009 with the aim of assessing public health workforce capacity, Michigan’s Center of Excellence is one of only two such centers in the nation.

The Challenges of Children's Health Research: Both the CDC and NIH recognize the need for community engagement if health research is to lead to real-life practice. But when clinical or community-based research involves children and adolescents, there are additional challenges:

>Parents may be concerned about--or fear--the nature, purpose, and potential impact of research.
>Children and adolescents need to be guaranteed confidentiality, especially when a research study involves sensitive issues such as sexual identity or sexual behavior.
>Researchers need both assent from children (who are not legally able to give their consent) and consent from parents.
>Research studies must be sensitive to the complexities of childhood development.
>One of the most effective ways for researchers to reach both children and their parents is through the school system, and yet for safety reasons, school policies and regulations restrict access to students.
>It can be difficult to track children over long periods of time, especially with low-income or disadvantaged populations.

In collaboration with the UM SPH Office of Public Health Practice, the Michigan Institute for Clinical and Health Research (MICHR) addressed these and other issues during a workshop, “Improving Children’s Health through Community-Engaged Research,” in April. Workshop presentations are available online. Funded by a National Institutes of Health Clinical and Translational Science Award and based in Ann Arbor, MICHR is a community resource aimed at accelerating the translation of research into practice by providing infrastructure and other support services.