astphnd state teleconference healthy weight indicator report card june 1, 2010 this information is...

ASTPHND State TeleconferenceHealthy Weight Indicator Report Card

June 1, 2010

This information is distributed solely for the purpose of pre dissemination public comment under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention. It does not represent and should not be construed to represent any agency determination or policy.

Obesity Prevention and Control BranchDivision of Nutrition, Physical Activity & Obesity

NCCDPHP, CDC

State Indicator Report on Healthy Weight for Youth

United States, 2010

Contributors

Report Card

Steve Onufrak Kelly Pattillo

Beverly Kingsley Ashleigh May

Holly Wethington

Data Advisors

Liping Pan Sohyun Park

Karen Dalenius DASH

Advisory Members

Heidi Blanck Bettylou Sherry

Meredith Reynolds Terry O’Toole

Tina Lankford Marilyn Batan


•General overview

•Draft outcome indicators

•Draft environmental and policy indicators

•Next steps


Division of Nutrition, Physical Activity and Obesity

• Primary Target Areas– Physical Activity, Fruit & Vegetable,

Breastfeeding– Sugar Sweetened Beverages– Television Viewing – Energy Density

• Environment and Policy

• Draft Outcome Indicators– Children Healthy Weight Prevalence – Soft Drink Consumption – Television/Screen Time

• Draft Environmental and Policy Indicators


Comprehensive Approach for Preventing and Addressing Childhood Obesity

(IOM, 2007)

• Draft Environmental and Policy Indicators– School Environment and Policy– Home Environment– Childcare Environment and Policy


• School Environment and Policy– School Competitive Food Environment– School Neighborhood Retail Environment– School Physical Activity Availability and

Participation


• Home Environment– Television in Bedroom– Meals Eaten with Family


• Childcare Environment and Policy– Childcare Nutrition and Physical Activity

Regulations


• Other Reports– “F as in Fat 2009” Robert Wood Johnson Report

http://healthyamericans.org/reports/obesity2009/– “Child Obesity State Report Cards” - National Survey of

Children’s Healthhttp://nschdata.org/Content/07ObesityReportCards.aspx

– “State Fact Sheets” – Youth Risk Behavior Surveillance System and School Health Profileshttp://www.cdc.gov/HealthyYouth/obesity/facts.htm


http://healthyamericans.org/reports/obesity2009/

http://nschdata.org/Content/07ObesityReportCards.aspx

http://nschdata.org/Content/07ObesityReportCards.aspx

http://www.cdc.gov/HealthyYouth/obesity/facts.htm

• How is this report different?– More in-depth focus on youth: early

childhood through adolescence– Home environment– Soft drink consumption and availability in

schools/on campus– Retail food environment


• Healthy Weight Report indicators can be used to:– Monitor progress and celebrate state successes. – Identify opportunities for growth and improvement in

environmental and policy supports that make promoting healthy weight more feasible at the state level.

– Report to be released regularly


• Criteria for Inclusion:– Highlighted in multiple expert

recommendations and reports: e.g., IOM, DNPAO Guidance Documents

– Data measurable, available for most states– Data available from reputable

sources: .gov, .org, .edu; transparent methodology in obtaining information


Things to consider during today’s call:• Indicator

– Is it the right concept?

• Data source– Additional sources meeting inclusion criteria?

• Metric– Is this a helpful way to represent the data?

• Usefulness and feasibility in your state


Draft Outcome Indicators


Healthy WeightOutcome Indicators

Prevalence of Healthy Weight

Percent of children ages 2-5 with BMI percentile ≥5th and <85th

Pediatric Nutrition Surveillance System (PedNSS), 2009

State BMI percentile ≥5th

and <85th, 2009 PedNSS

Alabama 71.1%* (95% CI)

Alaska ┼

Arizona 69.4%* (95% CI)

Arkansas 70.2%* (95% CI)

California 66.7%* (95% CI)

Colorado 76.2%* (95% CI)

Connecticut 68.8%* (95% CI)

*Data shown are from 2008 PedNSS; estimates represent prevalence of underweight and healthy weight and are for illustration only

┼ Data not available



Percent of children ages 6-12 with BMI percentile ≥5th and <85th

National Survey of Children’s Health (NSCH), 2007

State BMI Percentile≥5th

and <85th, 2007 NSCH

Alabama 63.9%* (95% CI)

Alaska 66.1%* (95% CI)

Arizona 69.4%* (95% CI)





*Data shown are from 2007 NSCH; estimates represent prevalence of underweight and healthy weight and are for illustration only



Percent of high school students with BMI percentile ≥5th and <85th

Youth Risk Behavior Surveillance System (YRBSS), 2009

State BMI Percentile ≥5th and <85th, 2009

YRBSS

Alabama 67.4%* (95% CI)

Alaska 72.7%* (95% CI)

Arizona 74.1%* (95% CI)


California ┼


Connecticut 74.4%* (95% CI)*Data shown are from 2005 or 2007 YRBSS; estimates are for illustration only and do not account for underweight prevalence


Sugar Sweetened BeverageOutcome Indicators

Soft Drink Consumption

Median soft drink consumption for high school students

Youth Risk Behavior Surveillance System (YRBSS)

State Median Soft Drink

Consumption, 2009 YRBSS

Alabama *

Alaska *

Arizona *

Arkansas *

California *

Colorado *

Connecticut *

*Data currently not available

TelevisionOutcome Indicators

Television Viewing

% of children ages 2-5 meeting American Academy of Pediatrics recommendations of ≤2 hours of

TV per day


State % Children Ages 2-5 Meeting AAP

Recommendations

Alabama 67.9% (95% CI)

Alaska 75.8% (95% CI)

Arizona 66.7% (95% CI)

Arkansas 67.4% (95% CI)

California 77.8% (95% CI)

Colorado 82.3% (95% CI)

Connecticut 70.9% (95% CI)


Television Viewing

% of children ages 6-10 meeting American Academy of Pediatrics recommendations of ≤2 hours of

TV per day


State % Children Ages 6-10 Meeting AAP Recommendations

Alabama 71.1%* (95% CI)

Alaska 79.6%* (95% CI)

Arizona 76.9%* (95% CI)





*Data shown are from 2007 NSCH; estimates indicate % of children 6-17 meeting AAP recommendations and are for illustration only


Television Viewing

% of middle school students meeting American Academy of Pediatrics recommendations of ≤2 hours of

TV per day


State % Middle School Students Meeting

AAP Recommendations

Alabama 61.6%* (95% CI)

Alaska 77.0%* (95% CI)

Arizona 71.8%* (95% CI)


California ┼



*Data shown are from 2005 or 2007 YRBS; estimates reflect % of middle and high school students watching 3 hours or less of television each day and are for illustration only



Television Viewing

% of high school students meeting American Academy of Pediatrics recommendations of ≤2 hours of

TV per day


State % High School Students Meeting

AAP Recommendations

Alabama 61.6%* (95% CI)

Alaska 77.0%* (95% CI)

Arizona 71.8%* (95% CI)


California ┼



*Data shown are from 2005 or 2007 YRBS; estimates reflect % of middle and high school students watching 3 hours or less of television each day and are for illustration only


Draft Environmental and Policy Indicators


School Environment and PolicySugar Sweetened Beverages

% middle and high schools in which sugar sweetened beverages

(including sports drinks and juice drinks that are not 100% juice) are

not available

School Health Profiles (Principal Questionnaire), 2008

State % Schools Where SSBs Were Not

Available

Alabama 68.3%* (95% CI)

Alaska 66.0%* (95% CI)

Arizona 81.0%* (95% CI)


California ┼

Colorado ┼


*Estimates reflect % of middle and high schools where soda and fruit drinks (not 100% juice) were not available and are for illustration only; sports drinks are not included in this calculation


School Environment and PolicyHigh Energy Density Snacks

% middle and high schools in which candy, salty snacks, ice cream, and

cookies/baked goods are not available


State % Schools Where High Energy

Density Snacks Were Not Available

Alabama 73.9%* (95% CI)

Alaska 63.6%* (95% CI)

Arizona 71.7%* (95% CI)


California ┼

Colorado ┼


*Estimates reflect % of middle and high schools where candy or salty snacks were not available, and are for illustration only


School Environment and Policy

Data compilation in process

Question

Is this a useful and meaningful indicator?

Retail Food Environment Index in 1 Mile Radius Surrounding Schools

Derived from GIS Analysis of Homeland Security Retail Database


Physical Activity Opportunities

% middle and high schools in which intramural sports or physical activity

clubs are available to all students


State % Middle and High Schools Offering Intramural Sports

or PA Clubs

Alabama 57.4%

Alaska 83.3%

Arizona 71.2%

Arkansas 54.5%

California 79.7%

Colorado 72.3%

Connecticut 74.6%


Data compilation in process

Question

Is this a useful and meaningful indicator?

Sports Participation

% of children participating on a sport team or taking sports lessons during

the past 12 months


Home Environment

Family Meals Eaten Together

% of families that eat together as a family most (≥4) days of the

week


State % Families Sharing Meal Together Most Days of the Week

Alabama 44.2*%

Alaska 50.2*%

Arizona 50.0*%

Arkansas 46.7*%

California 49.7*%

Colorado 44.7*%

Connecticut 40.3*%

*Estimates indicate % of children 6-17 eating meals together every day during week preceding survey and are for illustration only

Home EnvironmentTelevision in Bedroom

% of children meeting American Academy of Pediatrics

recommendations of no TV in bedroom


State % Children Without TV in Bedroom

Alabama 32.3%

Alaska 67.0%

Arizona 52.7%

Arkansas 34.1%

California 53.6%

Colorado 63.4%

Connecticut 57.1%

Childcare Environment and PolicyRecommended* Childcare Nutrition Regulations

•Foods of low nutritional value served infrequently

•Sugar sweetened beverages not served

•Children older than two years served reduced fat milk

•Drinking water available for children to serve themselves throughout day

•Nutrition education offered to child care providers

•Juice limited to 4-6 ounces per day for children over age one

•Child care providers do not use food as a reward / punishment

•Nutrition education offered to children

•Child care provider sits with children at table and eats same meals and snacks

•Providers encourage, but do not force, children to eat *Report: Preventing Obesity In The Child Care Setting: Evaluating State Regulations

http://cfm.mc.duke.edu/modules/cfm_ehs_resrch/index.php?id=6


Childcare Environment and PolicyChildcare Nutrition Policy

# of recommended* nutrition regulations (out of 10 total) currently enacted in both home childcare and

childcare center settings

*Source: Preventing Obesity In The Child Care Setting: Evaluating State Regulations


State # of Recommended Childcare Nutrition

Policies Enacted

Alabama 1

Alaska 2

Arizona 2

Arkansas 2

California 2

Colorado 4

Connecticut 1

Childcare Environment and PolicyRecommended* Physical Activity Regulations

•Children are provided with 60 minutes of physical activity per day

•TV/video/computer time limited to once per week and ≤ 30 minutes each time

•Child care providers do not withhold active play time as punishment

•Special needs children provided active play opportunities while other children are physically active

•Children provided outdoor active play time at least two times per day

•Physical activity education offered to child care providers ≥ 1 time per year

•At least one provider joins children in active play at least one time per day

•Shaded area provided during outdoor play

•Children not seated for periods > 30 minutes except when sleeping or eating

•Physical activity education is offered to children at least three times per year *Report: Preventing Obesity In The Child Care Setting: Evaluating State Regulations


Childcare Environment and PolicyChildcare Physical Activity Policy

# of recommended* physical activity regulations (out of 10 total) currently enacted in both home childcare and

childcare center settings

*Source: Preventing Obesity In The Child Care Setting: Evaluating State Regulations


State # of Recommended Childcare PA

Policies Enacted

Alabama 3

Alaska 5

Arizona 3

Arkansas 2

California 0

Colorado 5

Connecticut 0

• MAPPS Focal Areas to Consider– Access (e.g., neighborhood retail environment)– Price (e.g., school competitive food environment)– Social support (e.g., family meals)– Media– Point of decision information


• Next Steps– Post-call feedback from you

• Additional Indicators?• Addressing Disparities?• Errors and Omissions?• General Comments?


Send comments to: [email protected]

by June 23rd

This information is distributed solely for the purpose of pre dissemination public comment under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention. It does not represent and should not be construed to represent any agency determination or policy.


astphnd state teleconference healthy weight indicator report card june 1, 2010 this information is...

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