Progress 02/15/08 to 02/14/13
Outputs
Target Audience: Children 5-8 years old, their parents and primary care providers; Asian and Native Hawaiian, and Pacific Islander ethnic groups; children at risk for overweight and obesity; Hawaii. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? Caryn ES Oshiro, PhD, Biomedical Sciences-Epidemiology, University of Hawaii at Manoa, University of Hawaii. Dissertation:Birth Size, Infant Growth, and Child BMI at 5y in a Multiethnic Population.. Joanne Avila, MS Nutritional Science, University of Hawaii at Manoa. Thesis: Dietary Added Sugar and Overweight and Obesity in Multiethnic Children in Hawaii. Obesity. May 2013. Masako Matsunaga, PhD candidate in Biomedical Sciences-Epidemiology, University of Hawaii. Dissertation topic:Development, Application and Evaluation of a dietary index: the DASH index. How have the results been disseminated to communities of interest? Results have been disseminated to the scientific community and to Kaiser Permanente health care community. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
1. The PacDASH intervention program resulted in both intervention and attention control groups maintaining their BMI level, with no significant difference between the two groups. The PacDASH intervention group decreased diastolic blood pressure by 12.7 points more than the attention control group. The Pacific Tracker version 2 was developed, incorporating MyPyramid equivalent units and the Healthy Eating Index 2005. An Expert System for fruit and vegetable intake and physical activity tailored messages was developed based on stage of readiness and self efficacy by stage.The PacDASH intervention increased fruit and vegetable intake, but not physical activity intake. 2. Kaiser Permanente electronic medical data (n=4608) showed that mean overweight & obesity prevalence of 5-8 year old children was 326% (12.9% overweight and 19.7 % obese). Samoan, Native Hawaiian, Filipino, and those of mixed ethnic ancestry had higher levels of overweight and obesity compared to Asian and White children. Those with higher neighborhood education level, higher maternal education level, and older maternal age had generally lower risk for overweight and obesity, except for mothers who were 21 to 30 years old.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2013
Citation:
Novotny R, Oshiro CS, Wilkens LR. Prevalence of Childhood Obesity among Young Multiethnic Children from a Health Maintenance Organization In Hawaii. Childhood Obesity. Feb. 2013;9(1) DOI: 10.1089/chi.2012.0103.
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Progress 02/15/11 to 02/14/12
Outputs
OUTPUTS: The Pacific Tracker has been updated with physical activity assessment, children's physical activities, and local foods. A public online version of PacTrac2 is available on the Hawaii Foods website (www.hawaiifoods.hawaii.edu). A computerized "Expert System" for targeted child behavioral counseling was developed and is being tested in the Pacific Kids DASH for Health intervention study. The tools targets food and physical activity advice according to stage of readiness to change and self efficacy. PARTICIPANTS: Caryn Oshiro, Doctoral Student, University of Hawaii, Epidemiology; Kaiser Permanante Hawaii; University of Hawaii TARGET AUDIENCES: Children; 5-8 years old; Asians and Pacific Islanders; Overweight and Obese PROJECT MODIFICATIONS: none
Impacts
Kaiser Permanente electronic medical data (n=4608) showed mean overweight & obesity prevalence was 30%; however, sex- & age-adjusted Native Hawaiians, Samoans, & Hawaiian-Asians were more overweight & obese compared to White (p<0.0001). Randomized, controlled behavioral intervention (n=85) & cross-sectional study of 5-8yo showed baseline dietary intakes were high in saturated fat [19.9 +- 8.2, female & 24.2 +- 9.7, male, g/d vs. <9.3 g/d recommended] (n=85). The PacDASH intervention program will provide valuable information on integrating child, family & physician approaches to childhood obesity prevention.
Publications
- Novotny R, Nigg C, McGlone K, Renda G, Jung N, Matsunaga M, Karanja N. 2011. PacificTracker2 - Expert System (PacTrac2-ES) Behavioral Assessment & Intervention Tool for the Pacific Kids DASH for Health (PacDASH) study. 9th IFDC Conference, Norwich, UK Sept. abstract.
- Novotny R, Nigg C, McGlone K, Renda G, Jung N, Matsunaga M, Karanja N. 2012. PacificTracker2 - Expert System (PacTrac2-ES) Behavioral Assessment & Intervention Tool for the Pacific Kids DASH for Health (PacDASH) study. Food Chemistry. In Press.
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Progress 02/15/10 to 02/14/11
Outputs
OUTPUTS: The Pacific Tracker assessment tool has been made publically available on the Hawaii Foods website (www.hawaiifoods.hawaii.edu). PARTICIPANTS: This project partners the Kaiser Permanente Health system with the University of Hawaii. Caryn ES Oshiro has entered doctoral candidacy for the PhD in Epidemiology at the University of Hawaii, to use electronic medical record data on early child growth patterns that influence obesity at age five years, as part of this study. TARGET AUDIENCES: This study targets understudied Asian and Pacific Islander children, living in Hawaii. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The Pacific Tracker has been updated with physical activity assessment, children's physical activities, and local foods. This fill an important gap since Hawaii and the Pacific Region are not included in the National Nutrition Examination Survey (NHANES), and therefore Pacific foods are not identified for inclusion in national databases that are used for national program planning. A computerized "Expert System" for targetted child behavioral counseling was developed and is being tested in the Pacific Kids DASH for Health intervention study. The tools targets food and physical activity advice according to stage of readiness to change and self efficacy.
Publications
- Cuthrell KW, Yuen S, Murphy S, Novotny R, Au DA. Hawaii Foods Website: A Locally Based Online Nutrition and Food-Composition Resource for Healthcare Professionals and the Public. Hawaii Medical Journal 2010;69:300-301.
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Progress 02/15/09 to 02/14/10
Outputs
OUTPUTS: The Pacific Tracker version 2 (PacTRAC2) and Expert System (ES) dietary and physical activity analysis system for children has been developed and tested to provide targeted behavioral recommendations for fruit and vegetable and physical activity according to stage of readiness to change and self efficacy.Training of health center staff in 3 Kaiser Permanente clinics is complete, where the selected children will receive the guidance from their physican, based on the PacTRAC-ES assessment and output. Recruitment and assessment of the first 27 children for the Pacific Kids Dash for Health (PacDASH) intervention study has been completed, and recruitment is ongoing. Data have been extracted from the Kaiser Permanente Medical Records for children ages 5 to 8 years old, and data cleaning has begun, to examine ethnic, socio-demographic and biologic factors influencing overweight and obesity of these young children. PARTICIPANTS: Partnership between Kaiser Permanente and the University of Hawaii. Project is providing PhD training for 1 student in epidemiology. TARGET AUDIENCES: Target audience is young children at risk for obesity. The population is multiethnic. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
none yet
Publications
- No publications reported this period
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Progress 02/15/08 to 02/14/09
Outputs
OUTPUTS: Phase 1 of the project (2008 - 2009) focused on participatory work to design and develop study tools and materials for the planned randomized-controlled intervention trial. We plan to recruit 360 children(180 intervention, 180 control), 5 -8 years old, who are overweight(85-98th BMI-for-age percentile), with the goal of BMI-for-age maintenance or loss. Meetings with pediatricians, nurse practitioners, dietitians, medical assistants, have been conducted. Tools Developed: The Pacific Tracker 2 (PacTrac2) diet and physical activity (PA) assessment and education tool has been upgraded to include MyPyramid reference data. In addition, a quick survey was conducted with children to gather child/local specific physical activity information to guide selection of activities for the Physical Activity database. An Expert System (ES) has been added to the PacTrac2 tool, consisting of questions and algorithms that assess stage of readiness for change, and self efficacy. The new PacTrac2-ES provides fruit and vegetable and PA reports for child, parent and physician according to stage of readiness for change and self-efficacy. Web-based questionnaires: Web-based versions of Child and Parent socio-demographic questionnaires, early life questionnaire, anthropometry and DXA data sheets have been created to capture and enter data. Intervention activity development: Intervention and Usual Care mailers were developed to be sent during the main intervention. These mailers contain activities and support behavior information to reinforce intervention or usual care messages. 1) Stage-based Activity Mailers (Intervention) Fun and educational activities to support target behavioral messages of the intervention for the child based on the stage of readiness for change. 2) Support Behavior Mailers (for Intervention Group) are fun and educational activities to support target behavioral messages of the intervention for the child; this mailer is not based on stage of readiness to change; it provides health messages for supporting behaviors that are being reinforced. Health messages target DASH eating behavior- such as 1% dairy or less, whole grain, and less sedentary time. A recipe activity supports 1% dairy or less and whole grain eating and promotes child and parent interaction. These recipes were derived from the DASH of Aloha Cuisine and Lifestyle Book. 3) Usual Care (control) group mailers (non-intervention): These mailers provide health information aligned with those provided at well child (medical) visits. Health messages focus on hand washing tips, healthy mouth tips, and sun screen tips. Phase 2 of the project (2009)focused on development of protocol and preparations to conduct a pilot. The pilot study was conducted in August - October 2009 in a Kaiser Permanente Clinic. The objective was to test the acceptability of the flow and recruitment processes within clinic settings and test study materials. Three children/parents participated and provided evaluation of the process and materials (such as the mailers). Phase 3,the main intervention for this project, will begin in early March 2010. PARTICIPANTS: Partners Organizations: University of Hawaii at Manoa (Cancer Research Center, John A Burns School of Medicine, College of Tropical Agriculture and Human Resources) and Kapiolani Community College (Culinary Program), and Kaiser Permanente Center for Health Research (Oregon). Training: 1. Caryn Oshiro, Doctoral Student, University of Hawaii, Epidemiology Program. 2. Masako Matsunaga, MPH student, University of Hawaii, Program in Public Health Sciences. Professional Development: Training in behavioral counseling for physicians and nurse practitioners at Kaiser Permanente. TARGET AUDIENCES: Overweight children, 5-8y of Asian and Pacific Islander ethnic ancestry PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Pilot data was used to update tools, materials, protocol, and study flow- to prepare for the intervention. Formative data guided the development of protocols in coordination with clinic logistics and medical practice. Our program provides targeting behavioral counseling for diet and physical activity, fitting withing practice guidelines.
Publications
- No publications reported this period
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