The Arkansas Center for Health Improvement published the results of statewide surveys that suggest that the increase in obesity among its public school children has been slowed, if not stopped, over the past three years. Statewide participation rates for students having their Body Mass Index (BMI) measured with a standard protocol ranged between 90-95% over the past three years. Students who met the CDC criteria for overweight remained relatively stable over the 3-year period, declining slightly from 20.9% in the 2003-4 school year to 20.4% in 2005-6. As participation rates were uniformly high and showed no apparent sampling bias, the conclusion of the investigators is that a comprehensive statewide policy initiative is being successful at halting the rise in prevalence of obesity among children and adolescents.
The report offers little information for those interested in what was responsible for achieving these results. For that you will need to go to the article in this month's Health Affairs [abstract; full article with subscription only]. Here the authors document the process that went into forging the state's policy initiatives and collaborations, including the creation of a Child Health Advisory Committee (CHAC) to manage implementation of legislation targeting the school environment and to work with the Department of Education in developing and implementing standardized nutrition and physical activity requirements for all public schools - including the monitoring of children's BMIs.
Lessons learned from the Arkansas experience include:
- Identify and coordinate existing related activities to develop and implement policy.
- Provide clear intentions in legislation but leave the details to an independent body - such as the CHAC. [Note: the authors don't say this, but the CHAC provided an independent venue for reconciling health and education priorities rather than leaving it to the two agencies - Health and Education - to work out.]
- Provide tools and technical assistance to schools in order to minimize costs and efforts to them for implementation.
- Address privacy concerns when dealing with BMI assessments and reporting [an issue that generated substantial local and national media attention when it was being considered].
- Collect and tailor data at the district and school level to document the obesity problem and sustain program viability in the first years of implementation.
No conclusions can be drawn about what are the most important features of the Arkansas approach. Yet, the experience does offer a road map for other states and policy makers who need to gain the involvement of many different sectors of society to create a comprehensive effort for slowing, if not halting, the rising prevalence of childhood obesity. If you have such aspirations, you may also want to read this Issue Brief from the National Governor's Association on Building Healthy Schools.
Technorati Tags: Arkansas, Childhood Obesity, Policy Intervention
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