Reclaiming & Nurturing the Health of our Youth!!Presenter: !Maxine Garvey, DPT!Oakwood University!!Summit on !Nurture & Retention.!General Conference of SDA Headquarters!Silver Springs, Maryland!November 19, 2013

The Research Team

Maxine Garvey, DPT, MHS George Ashley, PhD, MSW

Howard Shaw, PhD Eva Starner, PhD

Marta Sovyanhadi, DrPH, RD

Collaborating Departments: Allied Health; Social Work; Health & Physical Education; and Psychology.

Student Researchers

The following students were mentored in undergraduate research:

Cherelle Bailiff Wayne Gordon Ruth Guiness

Rashane Taylor Woody Victor

Ashlie Williams

Acknowledgement

Funding provided by Oakwood University Faculty Development

& Research Office

Why this Research Interest?

  Obesity - A worldwide epidemic (WHO, 2011)

  Predisposes to Type 2 DM, CVD, HTN, CVA, and CA’s

  All lifestyle diseases – All preventable   African Americans – Higher incidence of Type 2 DM

  Alabama - 2nd most obese state in nation(CDC, 2011)  

  30% of children & young adults overweight - obese (CDC, 2011)

  Minority obesity rates: Blacks 49.5%; Hispanics 39% (JAMA, 2012)   Compared to Caucasians 34% (JAMA, 2012)

  36% of adults obese - Projected 42% by 2030 (Finkelstein, et al., 2012)

  Oakwood University & Southern University students combined -

30% overweight to obese (Pawlack & Sovyanhadi, 2009)   Same as national average for children & young adults  

Health & Wellness Study I

Garvey et al, 2011:

Landmark Quantitative Study Funded  

Methodology

Three assessments conducted to determine

prevalence of overweight & obesity among Black college students:

Body Mass Index (BMI)

Body Fat Percentage (BF%) Waist to Hip Ratio (WHR)

 

Participant Criteria

N = 265 students

≥19 years

≥ 2nd semester Freshman – Senior year

Incentives: Audited drawing for 1 iPad, 1 Flash drive, 1 Walmart card

 

Instruments

Skin Fold Caliper

Digital Scale Meter Ruler

BMI Calculator Tape Measure

Emphasis on BF%: (Most accurate to determine lean to fat ratio)  

200 lb person with 40% body fat = 80 lbs of fat

VS 200 lb person with 10% body fat = 20 lbs of fat

Each weighs 200 lbs

BUT Different health risks!

 

Data Analysis

Statistical Package for the Social Sciences (SPSS)

 

Results: What do Oakwood students look like?

Demographics

  Age range of 19 to 26 yrs (Average 21 yrs)   128 Males (48.3%)   137 Females (51.7%)   Class Standings: FR: 19.6%

SO: 27.2% JR: 30.6% SR: 22.6%

BMI Ranges

  Normal (<25) = 56.6%   Overweight (25-30) = 26.8%   Obese (30-40) = 12.8%   Severely Obese (>40) = 3.8%

___________________________   Healthy: 56.6%   High Risk: 43.4%

Comparison to Previous Study

  Pawlak  and  Sovyanhadi  (2009)    31%  with  BMI  of  overweight  to  obese      (21%  overweight  and  10%  obese)    African   American   students   35.8%   overweight   to  obese  

  Caucasian  students  18.9%  overweight  to  obese

Body Fat %

Body Fat % by Gender

WHR

(Predictive of Risk for Cardiovascular Disease)    

Low  Risk  :  80.8%  Moderate  Risk:  9.1%  High  Risk:  10.2%  

 (Insignificant  finding  –  may  be  due  to  age  of  this  

populaPon  sample)    

Full Study Published 2013 in Peer Reviewed Journal  

 

“The prevalence of obesity among students at an African American university in the south”  

   http://jsumurc.org/ojs

How can we reclaim and nurture

the health of our youth?

Follow-up Study: Health & Wellness II

Garvey et al, 2012:

Mixed Method Study Funded

Methodology

OMRON Body Fat Analyzer (Model HBF-36)

40 Item Questionnaire (Based on Eight Laws of Health)

 Demographics   Nutrition   Exercise   Water   Sunlight   Temperance   Air   Rest   Trust in God

Participant Criteria N = 36 students

≥19 years

≥ 2nd semester Freshman – Senior year

BMI >25 only

BF% = Overweight to Obese only

Incentives: Audited drawing

for 1 iPad, 1 Flash drive, 1 Walmart card  

Data Analysis

Quantitative: SPSS

Qualitative: Manual coding of common themes  

Demographics

  16 Males   20 Females   Class Standings: 14 FR; 7 SO; 11 JR; 3 SR   60% - Immediate family members overweight   90% SDA’s   Ethnicity: 90% Black; 10% Hispanic  

Nutrition

Common Themes

  80% non-vegetarian   90% eat in Cafeteria &/or Student’s Market   “I eat when I feel hungry”   “I eat when I am bored”   “I am a Stress Eater”

Exercise

50% Do no form of exercise

(Reduces stress levels)

Water

90% drink 1-2 glasses per day

(6-8 glasses per day is recommended)

Sunlight

Most participants got 30 or more minutes per day

(≥30 mins. are recommended)

Temperance

  “Not enough balance between school & social activities”

  “I feel overwhelmed”   Several stress factors:   “Relationships”   “School work”   “Procrastination”   “Finances”  

Air

50% spend 30 minutes or less outdoors

Rest

  “Not enough hours of sleep at nights”

  “Long study hours”

Trust in God

  90% have daily personal prayer

  40% have daily personal devotion

(Reduces anxiety and stress levels)

Discussion

  Multi-faceted & culturally relevant interventions needed

  Curricular education: Revision of Gen Eds- (Freshman Seminar, Health Principles, Nutrition courses)

  Ongoing health awareness campaigns (campus & community health fairs)

 

Discussion

  Immediate family education needed   Co-curricular activity and active transportation

(Encourage intra-mural sports, more biking vs. driving)

  Institutional policy changes  

Discussion

  Many students are living on their own for first time

  Early intervention programs essential when students arrive as freshmen

  Basics of NEWSTART to be constantly repeated during college experience to prepare students for healthy adult life

  Emphasize and encourage practice

Discussion

  Cafeteria and student’s market to support health initiatives

  Provide wide variety of live, raw fruits & vegetables, nuts, legumes, whole grains, and reduction in sugary drinks

  Physical activity-related behavior is complex   Influencing factors - Access to recreation

centers, t ime availabil i ty, gender, and motivation to exercise

Follow-Up Study: Health & Wellness III (Garvey et al, 2013)

Qualitative; Interventions; Evaluate Policy   Eat- Pray- Move (Funded & In Progress)   Deeper qualitative investigation to inform

development of age appropriate intervention   Develop computer interactive “App”   Explore faith factor and obesity   Explore Partnership with LLU Adventist Health

Study 2   Evaluate Health Ministries Policies: NAD down

References  

   •  American  College  Health  AssociaPon  NaPonal  College  Health  Assessment.  (2008,  Fall  N/A).    •  Reference  Group  Data  Report.  Retrieved  June  19,  2009,  from  American  College  Health  AssociaAon:  hCp://www.acha-­‐ncha.org/docs/

ACHA-­‐NCHA_Reference_Group_Report_Fall2008.pdf    •  Bopp,  W.,  Wilcox,  S.,  Laken,  M.,  Butler,  K.,  Carter,  R.,  McClorin,  L.,  &  Yancey,  A.  (2006).  Factors  associated  with  physical  acPvity  among  

African  American  men  and  women.  American  Journal  of  PrevenAve  Medicine,  30,  340-­‐346.    •  Centers  for  Disease  Control  and  PrevenPon.  (2012,  August  13).  Overweight  and  Obesity.  Retrieved  November  29,  2012,  from  Division  of  

NutriAon,  Physical  AcAvity,  and  Obesity,  NaAonal  Center  for  Chronic  Disease  PrevenAon  and  Health  PromoAon:  hCp://www.cdc.gov/obesity/data/adult.html    

•  Centers  for  Disease  Control  and  PrevenPon.  (2013,  March  19).  Behavioral  risk  factor  surveillance  system.    •  Retrieved  June  2013,  from:  h]p://www.cdc.gov/brfss/about/about_brfss.htm    •  Epstein,  J.  (2001,  December  1).  Stopping  short  of  no  more  fries.  Retrieved  September  7,  2012,  from  Inside  Higher  EducaAon:  hCp://

www.insidehighered.com/news/2009/12/01/obesity    •  Gary,  T.,  Gross,  S.,  Browne,  D.,  &  LaVeist,  T.  (2006).  The  college  health  and  wellness  study:  baseline  correlates  of  overweight  among  

African  Americans.  Journal  of  Urban  Health,  83,  253-­‐265.    •  Gyursicsic,  N.,  Bray,  S.,  &  Bri]ain,  D.  (2004).  Coping  with  barriers  to  vigorous  physical  acPvity  during  transiPon  to  university.  Family  and  

Community  Health,  27,  130-­‐142.    •  Hasse,  K.,  Steptoe,  A.,  Sallis,  J.,  &  Wardle,  J.  (2004).  Leisure  Pme  physical  acPvity  in  university  students  from  23  countries:  AssociaPons  

with  health  beliefs,  risk  awareness,  and  naPonal  economic  development.  PrevenAve  Medicine,  39,  182-­‐190.    •  Healthy  people.gov.  (2011,  December  17).  About  healthy  people.  Retrieved  December  2011,  from  US  Department  of  health  and  human  

services:  hCp://www.healthypeople.gov/2020/about/default.aspx    •  Johns  Hopkins  School  of  Public  Health  (2011)  Research  in  health  dispariPes.  The  college  health    •  and  wellness  study.  Retrieved  December  2011  from:  hCp://www.jhsph.edu/research/centers-­‐and-­‐insAtutes/johns-­‐hopkins-­‐center-­‐for-­‐

health-­‐dispariAes-­‐soluAons/Research/college_health_and_wellness.html    •  Kahng,  S.  (2010).  Can  racial  disparity  in  health  between  black  and  white  Americans  be  a]ributed    •  to  racial  dispariPes  in  body  weight  and  social  economic  status?  Health  and  Social  Work,  35,  257-­‐266.    •  KeaPng,  S.,  Guan,  J.,  Pinero,  J.,  &  Bridges,  D.  (2005).  A  meta-­‐analysis  of  college  students  physical  acPvity  behaviors.  Journal  of  American  

College  Health,  54,  116-­‐125.    

•  Kimm,  S.,  Glynn,  N.,  Kriska,  A.,  Barton,  B.,  Kronsberg,  S.,  Daniels,  S.,  Liu,  K.  (2002).  Decline  in  physical  acPvity  among  black  girls  and  white  girls  during  adolescence.  The  New  England  Journal  of  Medicine,  347,  709-­‐715.    

•  Krisberg,  K.  (2008,  fall  N/A).  American  Public  Health  AssociaAon.  Retrieved  October  6,  2011,  from  The  NaAon's  Health:  hCp://www.acha-­‐ncha.org/docs/ACHA-­‐NCHA_Reference_Group_Report_Fall2008.pdf.    

•  Krisberg,  K.  (2009).  Healthy  People  2010  Tackling  social  determinants  of  health:  Input  sought  from  workforce.  The  NaAon's  Health,  38,  1-­‐25.  Retrieved  from  The  American  Public  Health  AssociaAon.    

•  LaFountaine,  J.,  Neisen,  M.,  &  Parsons,  R.  (2006).  Wellness  factors  in  first-­‐year  college  students.  American  Journal  of  Health  Studies,  21,  214-­‐18.    •  Lapsley,  D.  K.,  Power,  F.  C.,  (1988).  Self,  ego,  and  idenPty:  IntegraPve  approaches.  New  York.    •  (Josselson,  R.  Book  chapter:  The  embedded  self:  I  and  thou  revisited),  91.    •  Lavie,  C.,  Milani,  R.,  &  Ventura,  H.  (2009).  Obesity  and  cardio  vascular  disease:  risk  factor,  paradox,  and  impact  of  weight  loss.  Journal  of  the  American  

College  of  Cardiology,  53,  1925-­‐1932.    •  Lawrence,  S.  (2010).  The  impact  of  sPgma  on  the  child  with  obesity:  implicaPons  for  social  work  pracPce  and  research.  Child  and  Adolescent  Social  

Work  Journal,  27,  309-­‐3  and  21.    •  Leenders,  N.,  Sherman,  M.,  &  Ward,  P.  (2003).  College  physical  acPvity  courses:  why  do  students  enroll,  and  what  are  their  health  behaviors?  

Research  Quarterly  for  Exercise  and  Health,  74,  313-­‐318.    •  Loma  Linda  University  (2013)  AdvenPst  Health  Studies.  Retrieved  May  2013,  from  Loma  Linda    •  school  of  public  health:  h]p://www.llu.edu/public-­‐health/health/index.page    •  Loma  Linda  University  (2013)  AdvenPst  Health  Study-­‐2.  Retrieved  May  2013,  from  Loma    •  Linda  school  of  public  health:  h]p://www.llu.edu/public-­‐health/health/about.page?    •  Novaki,  M.,  Ahlgren,  C.,  &  Hammarstrom,  A.  (2005).  A  life  course  approach  in  explaining  social  inequity  in  obesity  among  young  adult  men  and  

women.  InternaAonal  Journal  of  Obesity,  30,  191-­‐200.    •  Ogden,  C.,  M,  C.,  CurPn,  L.,  McDowell,  L.,  &  Tabak,  C.  F.  (2006).  Prevalence  of  overweight  and  obesity  in  the  United  States,  1999-­‐2000.  Journal  of  the  

American  Medical  AssociaAon,  13,  1549-­‐1555.    •  Pawlak,  R.,  &  Sovyanhadi,  M.  (2009).  Prevalence  of  overweight  and  obesity  among  Seventh-­‐day  AdvenPst  African-­‐American  and  Caucasian  college  

students.  Ethnicity  and  Disease,  19,  111-­‐114.    •  Pi-­‐Sunyer,  F.  (1990).  Obesity  and  diabetes  in  blacks.  Diabetes  Care,  13,  1144-­‐1149.    •  Suminski,  R.,  Petosa,  R.,  U]er,  A.,  &  Zhang,  J.  (2007).  physical  acPvity  among  ethnically  diverse  college  students.  Journal  of  American  college  health,  

55,  195-­‐206.    •  Tro]er,  L.,  Bowen,  D.,  &  Beresford,  S.  (2010).  TesPng  for  racial/ethnic  differences  in  the  associaPon  between  childhood  social  economic  posiPon  and  

adult  adiposity.  American  Journal  of  Public  Health,  100,  1088-­‐1094.    •  Wang,  M.,  &  Beydoun,  M.  (2007).  The  obesity  epidemic  in  the  United  States-­‐gender,  age,  socioeconomic,  racial/ethnic,  and  geographic  

characterisPcs:  A  systemaPc  review  and  meta-­‐regression  analysis.  Epidemiology  Reviews,  29,  6-­‐28.    •  World  Health  OrganizaPon.  (2008,  December  8-­‐11).  Controlling  the  world  obesity  epidemic.  Retrieved  November  2011,  from  Programs  and  Projects-­‐

NutriAon:  hCp://www.who.int/nutriAon/topics/obesity/en/    

Thank You!