No abstract

Background: The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5 th grade students. This (S)partnership is intended to augment and improve the existing 5 th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit.

This paper describes FitKids360, a stage 2 pediatric weight management program. FitKids360 is a physician-referred, multicomponent, low-cost healthy lifestyle program for overweight and obese youth 5–16 years of age and their families. FitKids360 provides an evidence-based approach to the treatment of pediatric overweight by targeting patients' physical activity, screen time, and dietary behaviors using a family-centered approach. The intervention begins with a two-hour orientation and assessment period followed by six weekly sessions. Assessments include lifestyle behaviors, anthropometry, and the Family Nutrition and Physical Activity (FNPA) survey, which screens for obesogenic risk factors in the home environment. Outcomes are presented from 258 patients who completed one of 33 FitKids360 classes. After completing FitKids360, patients increased moderate to vigorous physical activity by 14 minutes (P = 0.019), reduced screen time by 44 minutes (P < 0.001), and improved key dietary behaviors. Overall, FNPA scores increased by 9% (P < 0.001) and 69% of patients with “high risk” FNPA scores at baseline dropped below the “high risk” range by followup. Patients also lowered BMIs (P = 0.011) and age- and sex-adjusted BMI z-scores (P < 0.001) after completing the 7-week program. We hope this report will be useful to medical and public health professionals seeking to develop stage 2 pediatric obesity programs.

<p><strong>Objective: </strong>To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with weight status, percent body fat, and acanthosis nigricans (AN) in 6- to 13-year-old children from a low socioeconomic, urban community.</p><p><strong>Methods: </strong>Children (<em>N</em>=415) from four elementary schools located around Flint, Michigan were assessed for body mass index, percent body fat, and AN. The FNPA screening tool was completed by parents. Mann-Whitney U tests were used to assess differences in FNPA score by sex and pres­ence of AN. Logistic regression was used to evaluate the association of the FNPA (tertiles) with weight status and AN.</p><p><strong>Results: </strong>Children with AN (13.7%) had a significantly lower FNPA score (56.3 <span style="text-decoration: underline;">+ </span>7.1) compared with children without AN (61.0 <span style="text-decoration: underline;">+ </span>7.1; <em>P</em>&lt;.05). Children with FNPA scores in the lowest tertile (high-risk) had odds ratios of 1.74 (95% CI =1.05 – 2.91) and 2.77 (95% CI =1.22 – 6.27) compared with children with FNPA scores in the highest tertile (low-risk) for being overfat and having AN, respectively.</p><p><strong>Conclusion: </strong>Although the FNPA screening tool did not predict risk for being over­weight or obese, it was significantly associ­ated with an increased odds of children at risk for being overfat or having AN. <em>Ethn Dis. </em>2015;25(4):399-404; doi:10.18865/ ed.25.4.399</p>

Children from a high-risk, obesogenic family environment (determined using the FNPA) have a higher level of adiposity and CVD risk factor profile than children from a low-risk family environment. The FNPA screening tool can help identify children that may be at risk for overweight and adverse CVD risk factor development.