Empowering Youth Through Physical Activity: Using Bright Futures

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Empowering Youth Through Physical Activity
Using Bright Futures

• Bonnie A. Spear, PhD, RD
• Associate Professor Pediatrics
• University of Alabama at Birmingham

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Bright Futures Guidelines

• Guidelines for Health Supervision for Infants,
  Children and Adolescents

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Bright Futures Management
Web site www.ncemch.org
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Bright Futures in Practice Series

• Oral Health
• Nutrition
• Physical Activity
• Mental Health (forthcoming)
• Children with Special Health Care Needs
  (forthcoming)

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Surgeon Generals Report

• Nearly half of adolescent ages 12-21 did not
  participate regularly in vigorous physical
  activity
• About 14 percent of children and adolescents did
  not participate in light to moderate physical
  activity

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Physical Activity in Children and Adolescents

• Benefits of Physical Activity
• Increase bone mass/reduce risk osteoporosis
• Reduce obesity
• Lower blood pressure
• Improve blood lipids
• Reduce anxiety and stress

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Benefits of Physical Activity

• Increasing bone mass/reducing risk of
  osteoporosis
• PA helps build greater bone density
• Helps maintain peak bone mass into adulthood
• In order to increase greater bone mineralization
  children and adolescents need to participate in
  weight-bearing PA
• Jumping rope, walking, playing soccer, dancing

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Benefits of Physical Activity

• Reduces Obesity
• PA is crucial for obtaining and maintaining a
  healthy weight
• Increasing PA helps in reducing sedentary
  behaviors
• Reducing inactivity is a critical factor in
  reducing obesity
• Helps in controlling blood sugars in children
  with Type 2 diabetes

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Benefits of Physical Activity

• Lowers Blood Pressure
• In children with elevated blood pressure, PA can
  significantly lower both systolic and diastolic
  blood pressure

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Benefits of Physical Activity

• Improve Blood Lipids
• Regular PA in adults improves blood lipid
  levels, particularly by increasing HDL-C.. Which
  are associated with a reduction in
  arteriosclerosis
• Impact of PA on HDL-C in children is unclear, but
  higher HDL-C have been seen in children with
  regular PA

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Benefits of Physical Activity

• Reduces anxiety and stress
• Regular PA has the potential to promote
  psychological well being
• Improve self-esteem
• Reduce level of anxiety
• Reduce symptoms of depression

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But How Do You Get Kids More Active?
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(No Transcript)
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Families Matter!

• Families as partners
• Families as caregivers
• Families as teachers
• Families as resources

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Health Promotion Is Everybodys Business

• Health professionals
• Families
• Child care professionals
• Social service professionals
• Schools
• Local and state government
• Community groups
• Business/industry
• Faith communities
• Payers

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Vision and Goals Bright Futures in Practice
Physical Activity

• Improve the health and physical status of
  infants, children, and adolescents
• Establish health supervision guidelines focusing
  on physical activity

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How the Guide Can Be Used

• Clinical
• Community
• Policy
• Education and Training

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How the Guide Can Be Used Clinical

• Incorporate into each health supervision visit
• Develop and evaluate physical activity programs
• Implement standards of practice and protocol
• Educate children, adolescents, and their families

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How the Guide Can Be Used Community

• Provide anticipatory guidance to families on
  developmentally appropriate physical activity
• Develop physical activity programs
• Help schools incorporate physical activity
  education into health curricula
• Implement standards of practice and protocol
  

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How the Guide Can Be Used Policy

• Provide information to policymakers, program
  administrators, and community leaders on relevant
  physical activity issues and concerns
• Obtain support for physical activity policies and
  programs

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How the Guide Can Be Used Education and Training

• Educate and train health professionals and
  paraprofessionals
• Provide in-service education and training to
  staff
• Use as a textbook or reference

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Four Major Developmental Stages
Infancy 011 Months
Early Childhood 14 Years
Middle Childhood 510 Years
Adolescence 1121 Years
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Physical Activity Issues and Concerns Chapters

• Asthma
• Children and adolescents with special health care
  needs
• Eating Disorders
• Diabetes
• Girls and Female Adolescents in Physical Activity
• Ergogenic aids
• Heat-related illness
• Injury
• Obesity

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Motor Skills Development During Middle
Childhood-p.58
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Motor Skills Development During Middle
Childhood-p.58
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Motor Skills Development During Middle
Childhood-p.58
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Interview Questions (p55-56)

• Are there any physical activities you enjoy but
  dont participate in? If so, which ones? Why?
• Do you feel that you are good at physical
  activities you enjoy? If so, which ones? Why?
• Do you think you are in good shape?
• How much time each day do you spend each day
  watching TV?

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Overweight Screening Procedure (171)
BMI
At risk for overweight BMI gt85th lt 95th
Not at risk for overweight BMI lt85th
Overweight BMI gt 95th
In-depth medical assessment
Screening
Return next yr.
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Treatment- p.172

• Treat uncomplicated obesity with
• Achieving healthy eating behaviors
• Participating in regular physical activity
• Achieve psychological well being

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Physical Activity Counseling (page 173)

• Begin intervention early
• Recommend that parents focus on gradually
  changing the entire familys eating and physical
  activity behaviors
• Encourage children and adolescents to participate
  in physical activities they enjoy
• Encourage children and adolescent to reduce
  sedentary behaviors (e.g., watching TV, playing
  computer games)

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Frequently Asked Questions (175)

• How can I encourage my son to be more physically
  active?
• Encourage spur-of-the-moment physical activity
• Participate in physical activity together-
  biking, hiking, skating
• Involve child in family chores- raking, walking
  the dog

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Appropriate Physical Activity for Children (187)

• Guidelines- Elementary
• 30-60 minutes of age and developmentally
  appropriate physical activity from a variety of
  physical activities on all, or most days.
• Some of the childs activity each day should be
  in periods lasting 10-15 minutes

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The Stages of Change ( pg 182-186)

• Precomptemplation - unaware
• Contemplation good intentions
• Preparation getting ready
• Action is involved in PA
• Maintenance PA gt 6 months

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PrecontemplationKey Concepts

• Identify the benefits of physical activity
• Explain the benefits relevant to your patient
• Recommend that your patient consider starting
  some type of activity

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Counseling Statements for the Precomptemplator 

• Jane, being more physically active is one of the
  most important things you can do to stay healthy,
  both physically and mentally.
• Jane by starting something as easy as walking
  with your friends, it could help you maintain a
  healthier weight and feel more energetic.

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Contemplator and Preparation PhasesKey Concepts

• Identify benefits of physical activity
• Help your patient chose appropriate physical
  activities
• Identify barriers to physical activity
• Evaluate your patients confidence in their
  ability to make the change

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Identify benefits of physical activity

• What do you hope to gain?
• If active before, what did you like or enjoy?
  Why did you stop?

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Help your patient choose appropriate physical
activities

• Jane, what types of physical activities do you
  enjoy?
• Are there any activities you have enjoyed in the
  past?
• Do you participate in physical activities at
  school? With your family?

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Identify barriers to physical activity

• If you were active before, why did you quit?
• Do you feel that you are good at physical
  activities?
• Is your neighborhood safe for walking/ jogging?

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Evaluate your patients confidence

• Jane, on a scale of 1 to 5 how confident are you
  that youwill start this physical activity
  plan? 
• If low, ask why, problem solve and revise plan
  if needed

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Action and Maintenance Phases  

• Key Concepts
• Praise the adolescent for being physically
  active
• Help the adolescent remain physically active
• Help the adolescent identify social support
• Help the adolescent assess confidence in
  remaining active

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Praise the Adolescents Successful Activity

• Jane, I am really pleased that you have started
  walking to school. I bet you feel more energetic
  and you have lost 3 pounds since your last
  visit.

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Help the adolescent remain physically active

• Jane, I think walking to school is a great
  start. Have you thought about what you could do
  on the weekends that is fun and physically
  active?
• What activity have you thought about doing this
  summer since you will not be walking to school
  each day?

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Help the adolescent identify social support 

• Jane, do you have a friend that can walk or do
  other physical activities with you. It is always
  easier and more fun to do things with your
  friends
• Are other family members supportive of your
  choice to be more active? What do your parents do
  that is physically active?

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Assess adolescents confidence

• Jane, on a scale of 1 to 5 how confident are you
  that you will continue regular physical activity
  over the next three months? If low, ask why
  and problem solve with the child/adolescent

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Counseling Parents

• Review the child/adolescents plan for increasing
  her physical activity
• Provide positive reinforcement for any small
  improvement
• Be a positive role model
• Participate in physical activity with your
  daughter
• Provide healthy choices for snacks

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Features of excellent coaching (pg 196) 

• Makes the sport/activity fun
• Improves existing skills teaches new ones
• Helps the adolescent feel successful
• Uses a positive style of interaction
• Recognizes avoids competitive stress
• Avoids overemphasis on competitions outcome

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Physical Activity Resources- p. 198

• For health providers there are over 100 web sites
  in different areas of physical activity. Such as
• American College of Sports Medicine
• National Association for Health and Fitness
• YMCA
• Rails to Trails Conservancy
• Shape Up America!
• Presidents Council on Physical Fitness and Sports

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In Summary

• Health professionals are one part of our
  countrys efforts to encourage children and
  adolescents to adopt a physically active
  lifestyle.
• Bright Futures in Practice Physical Activity,
  can enhance health professionals ability to
  deliver this important message in a more
  knowledgeable, effective and developmentally
  appropriate fashion.

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Bright Futures In Practice Physical Activity

• Disease specific recommendations for activity
• Strategies for effective behavioral change
  counseling
• Advocating for the promotion of physical activity
  in clinics, schools, and within communities.

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Bright Futures In Practice Physical Activity

• A user-friendly source of practical information
  for the promotion of physical activity covering
• Benefits of Physical Activity
• Assessment of Physical Activity
• Developmentally Appropriate Activity
  Recommendations
• Common problems/ issues related to physical
  activity

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To order additional materials and to find out
more about Bright Futures, contact

• Bright Futures Project
• National Center for Education in
• Maternal and Child Health
• Georgetown University
• 2000 15th Street, North, Suite 701
• Arlington, VA 22201-2617
• Tel [phone]
• Fax [phone]
• E-mail BrightFutures_at_ncemch.org
• Bright Futures Web site www.brightfutures.org

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• Permission must be requested in writing from the
  National Center for Education in Maternal and
  Child Health before using any slides contained in
  this presentation