Drumming to A Healthy Beat: An Innovative Health Management Program

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Drumming to A Healthy Beat An Innovative Health
Management Program

• Kimberlee Wyche-Etheridge, MD, MPH
• Lateesa Posey-Edwards, APRN, BC
• CityMatCH 2007

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Objectives

• To give an overview of why programs like this are
  beneficial
• To demonstrate a fun and innovative way to
  address obesity
• To point out successes and limitations
• To outline how lessons learned will be used to
  move the program forward

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The Epidemic

• This generation of youth will be the first in
  history that has the potential of living fewer
  years than their parents
• Federal government

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The Epidemic

• Since 1960 the prevalence of obesity in the US
  ages 12-19 has tripled
• In 2003 Nashville ranked 43rd in the Nation for
  overall health
• According to the 2003 Youth Risk Behavior Survey
• 13 of Nashville youth admit to being obese
• 16 at risk for overweight
• 21 of Nashvilles AA youth are overweight and
  18 are obese vs. 13 and 10 of Caucasian youth
• 68 of AA youth indicated watching over 3 hours
  of TV/day Vs. 34 of Caucasian youth
• According to Local elementary school data
• 28 of elementary students are overweight, and
  20 are at risk for overweight. This is up from
  22 and 16 3 years ago.
• We are super sizing our youth

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Obesity Trends Among U.S. AdultsBRFSS, 1990,
1995, 2005
(BMI ?30, or about 30 lbs overweight for 54
person)
1995
1990
2005
No Data lt10 1014
1519 2024 2529
30
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The Epidemic

• CDC notes
• An unhealthy diet and lack of physical activity
  can be contributing factors in many chronic
  diseases and conditions, including type 2
  diabetes, stroke, hypertension, heart disease,
  breast cancer, colon cancer, gall bladder
  disease, depression, and arthritis..

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The Epidemic

• Health and Education are linked
• Health goes hand in hand with educational
  attainment. Therefore, a student who is not
  healthy, is less likely to excel in school
• Children who are overweight in Kindergarten tend
  to score lower on math and reading tests

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The Epidemic

• African Americans (AA) suffer from conditions
  related to obesity at a higher rate than
  Caucasians
• In order to decrease this disparity, it is
  important to reduce the number of obese and
  overweight AA people, while improving the quality
  of life for the general population

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Barriers

• Strong interconnection between AA lifestyle and
  culture
• Not a strong relationship between cultural
  identity and health consciousness

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The Response

• Target AA female youth who are overweight, and at
  risk of becoming obese
• Provide daily physical exercise in the form of
  structured cultural dance
• Provide nutrition education through weekly
  interactive activities focusing on the
  psychosocial aspects that lead to poor dietary
  choices
• Participate in self esteem building through the
  use of drama and Rights of Passage program

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Drumming to a Healthy Beat

• Partners
• Village Cultural Arts Center
• Metro Public Health Department
• Family Empowerment Services
• Community Medical Providers
• TN State University Food Stamp Nutrition
  Education Program

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Drumming to a Healthy Beat

• Program Design
• Identify and recruit a cohort of AA girls ages
  10-13 who attend school in 3 target zip code
  areas identified as high risk

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Drumming to a Healthy Beat Goals

• Goal 1To decrease the age appropriate Body Mass
  index of each participant to a healthy level
• Objective 1 Increase physical activity of
  program participants to meet daily
  recommendations
• Objective 2 Monitor key health indicators
  monthly to include wt, bp, BMI

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Drumming to a Healthy Beat Goals

• Goal 2 To improve the self-esteem and academic
  performance of young girls through empowerment
• Objective 1 Facilitate group sessions to address
  some of the major psycho-social issues affecting
  unhealthy diets and other behaviors
• Objective 2 Provide monitored homework time to
  strengthen academic performance
• Objective 3 Engage participants parents in a
  series of sessions around adolescent development,
  health and nutrition

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Drumming to a Healthy Beat Goals

• Goal 3 To guide youth toward making smarter food
  choices for a healthier future
• Objective 1 Engage participants in topic related
  sessions around healthy eating and activity

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Drumming to a Healthy Beat Planned Activities

• Tween girls with BMIs gt95th identified by
  school nurse
• Each girl receives a physical exam, and monthly
  wt and bp checks
• Girls are transported to the Village after school
  each day
• Guided homework and healthy snack time while
  preparing for exercise
• 60 minute African dance or Afrocize class each
  day
• 60 minute weekly Rights of Passage class
• 60 minute 2X weekly interactive nutrition classes
  using the Power of Choice curriculum
• Monthly parents meeting
• Quarterly report card submission

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Drumming to a Healthy Beat Reality Activities

• Tween girls with BMIs gt95th identified by
  school nurse avg BMI at start was 32, a lot
  higher than anticipated
• Girls are transported to the Village after school
  each day there was interest at too many schools
  to pick up with limited van space
• Guided homework and healthy snack time while
  preparing for exercise girls could buy
  unhealthy snacks at school and would sneak them
  during the program
• 60 minute African dance or Afrocize class each
  day several girls complained to their mothers
  about having to exercise, and they were allowed
  to drop out of the program
• Monthly parents meeting parental commitment
  was lacking making it difficult to reinforce
  lessons at home

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Drumming to a Healthy Beat Results ?

• Education
• Avg GA changed from a 2.0 to a 2.8
• Self Esteem
• At beginning girls were self conscious and didnt
  participate in school activities. Now they are
  trying out for plays and dance programs
• Improved attitude and respectfulness towards each
  other and school
• By the end of the program girls were performing
  at village functions
• Nutrition
• Girls were knowledgeable about the new food
  pyramid and portion control/size (however they
  did not practice this at home)

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Drumming to a Healthy Beat Results ?

• BMI
• Average BMI 31.9 at start. At end, average BMI
  33.3 4 increase
• Girls noted that clothing fit better, and they
  could wear more cute styles

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Drumming to a Healthy Beat Conclusions

• BMI measures may not be the best measure of
  success for obesity programs
• Parental involvement is essential
• Creating a comfortable environment is important

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Drumming to a Healthy Beat Next Steps

• Identify additional sources of funding to
  continue program
• Target students from only a few schools
• Make parental involvement mandatory
• Maybe work to get PE credit for school

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