National Childhood Obesity Awareness Month

The National Children's Study Greater Chicago Study Center supports National Childhood Obesity Awareness Month by encouraging Cook County families to take small steps to help each child to stay at a healthy weight.



Elissa Bassler, CEO of Illinois Public Health Institute (IPHI) and Executive Director of the Illinois Alliance to Prevent Obesity, discusses the importance of tackling the issue of childhood obesity, ways in which can parents help overweight or obese children and the role of beverages in the obesity epidemic.



CLOCC's 5-4-3-2-1 Go! message contains recommendations for children (2 and older) and families to promote a healthy lifestyle: 

• 5 servings of fruits and vegetables a day
• 4 servings of water a day 
• 3 servings of low-fat dairy a day 
• 2 or less hours of screen time a day 
• 1 or more hours of physical activity a day 

Visit the Consortium to Lower Obesity in Chicago Children (CLOCC) tor more information.

United by Our Interests

Three weeks ago, we released the Community Voices videos and have been really excited about your responses. Hundreds of people have watched our YouTube channel, “Liked” our Facebook page and visited this blog as a result of our campaign. In addition, we have been collecting feedback about our videos at community meetings and events. If you haven’t had a chance to tell us what you think about the videos, please do so here.

When we started reaching out to community agencies all across Cook County to inform them about the National Children’s Study, our goal was to start a two-way conversation. As members of the community, we are well aware how an unhealthy community affects everyone. If we can learn through a long-term study like the NCS how homes, schools, and neighborhoods influence the health and safety of our kids, we believe we could build the evidence that we need to address and potentially prevent many problems. Besides sharing our side of the story, we wanted to hear from community leaders, parents, teachers, healthcare providers, and others about protecting and improving the health of their communities.

In the past couple of weeks, we have talked about the importance of longitudinal studies and the role of participants. In this week’s outtake, one of our partners shares her story regarding her work in the community:




We wanted to find a common ground for the entire community to come together around the NCS. As people who live and work in Cook County, we all want our kids to grow up in a healthy environment. By this, we mean we want them to have access to high quality schools, clean water, stores with fresh produce, and safe parks where they can be active, among many other things. As NCS data become available, it will be used to analyze the effect on health of genetics, personal choice and the environment that could ultimately be used to develop programs and policies that protect the health of our families and communities for years to come.

Our Number One Priority: Study Participants

During the course of our interviews with people who live and work across Cook County, we asked women if they would consider participating in the National Children’s Study (NCS). All of the women with whom we spoke overwhelmingly said “yes” to volunteering for the NCS.  In this week’s post, you can see a sample of those responses:



Regardless of where they are in life (some of them are mothers, some do not have children, others are planning to have children), women throughout the region always ask, what does participation in the NCS entail?

During active recruitment, our main message to women who enrolled in the NCS was that they would be part of a pioneering group of women who would join a national effort to ultimately improve children’s health. We are very thankful to all of our participants who answered the call and continue to be involved in Study activities. All of us should be very proud of our participants because their contribution is invaluable to future generations. Besides the real possibility of helping improve children’s health, our participants joined the NCS because:

1.    They only have to give the Study a small amount of their time.
Participation occurs through periodic visits and phone calls with National Children’s Study staff before and during pregnancy, and as their children grow. Our colleagues at the Cumberland County Maine Study Center have written a series of blog posts detailing what happens at each study visit. Take a look here.

2.    The NCS does not interfere with their life.
The National Children’s Study is not a substitute for regular doctor visits for our moms or their children. Participants won’t be asked to take any medications or treatments.

3.    Participants can decide what information to share.
If they are ever uncomfortable answering a question or participating in any part of a Study visit, they can opt out. If life is too busy, they can take a break and rejoin the Study when it better fits their schedule.

4.    Participants can move to a new home or out of Cook County and still be a part of the Study.
Study participants needed to live in one of several randomly chosen communities in Cook County only when they enrolled. If they move out of town or across the country, they can still be involved in the NCS.

5.    They are part of a ground-breaking study.
As we discussed in last week’s post, no other study has looked at how a wide range of environmental exposures impact children’s health beginning with pregnancy over the long-term. Previous adult studies did not consider whether environmental factors might have a different impact on children.

6.    They receive a small amount of money for their time. 
We recognize the commitment participants are making to improve the health and well-being of children. We are providing compensation and thank-you gifts for participating in the Study.

7.    Participants can change the world!
Doctors, scientists, health agencies and community organizations that work with children could ultimately use information from the Study to improve how we prevent and treat children’s health problems. We can’t stress enough that participation in the National Children’s Study will make a difference for generations to come.

The Home Stretch

As we work putting the final touches on the videos produced by the VideoVoice project participants, we continue to reflect on what we have accomplished through this process. One of the main things we have learned is that community leaders are very aware of the health concerns in their communities. At the same time, local parents and residents seem worried about the environment in which their children are growing up. Whether it is a school in proximity to a Brownfields, or a power plant in the neighborhood, or the safety of a well water source, all of these are real concerns that have been brought up in our conversations in the community. There are many unanswered questions regarding the relationship between the built environment and children’s health. Data gathered through the National Children’s Study could provide insight and guidance for developing strategies to reduce the environmental risk of disease in the future. Our VideoVoice Project Coordinator talks about the lessons from conducting research in a very neighborhood-oriented city:

 However, the NCS goes beyond the physical environment, as it will also pay attention to social and cultural factors. As an observational study, the NCS is taking into account child-rearing practices, family background and composition, maternal and infant nutrition, among many other factors that may affect a child’s growth and development.  Additionally, NCS encourages community involvement in places where the NCS is taking place, here in Cook County and around the country. Maria, one our neighborhood ambassador, talks about this issue in the clip below:

“Well, I learned a lot about how my community feels, what their fears are, what their strengths are, how they view life, what their motivations are, what is it that precisely keeps us living in the same community. All of that in terms of my community. I also learned to listen a little bit more, to take my time to understand the thought process that people have when they are conversing with you. [I also learned] to understand their motivations, to see from an even more human point of view those motivations that make you live in such a beautiful community like ours. I also learned to feel more secure when talking to people. When doing the interviews, each one gave me more strength, more security, more confidence in finding out what we are thinking, what is going on with us and how can we project that. It was really beautiful.”

Prenatal Care

In this week’s post, one of our neighborhood ambassadors brings up the important issue of prenatal care and how the National Children’s Study (NCS) is focusing on this significant stage of a woman’s pregnancy:

If you listened closely, however, Rose also mentions how the NCS is going to “make mothers more aware of things that they weren’t aware before.” As in any study, a possible research bias may occur if study participants change their behavior simply because they are being studied. This is called the “Hawthorne Effect,” which bears the name of the Hawthorne Works factory outside of Chicago.

Now let’s take a closer look at prenatal care:

In its most basic definition, prenatal care is the health care that a doctor or clinic gives to a pregnant woman. The American Academy ofFamily Physicians and the American College of Obstetricians and Gynecologists recommend prenatal care visits take place at least:

• Once every four weeks during the first six months of being pregnant
• Once every two weeks during the seventh and eight months of being pregnant
• Once every week during the last month of being pregnant
• Or more often as directed by the doctor

In the state of Illinois 86 percent of mothers begin prenatal care in the first trimester. However, that number varies widely by race/ethnicity where Black and Latina mothers have lower rates than White moms. Even though the proportion of mothers receiving early prenatal care is at a record high in our increasingly diverse society, disparities in care and outcomes remain among racial and ethnic groups, presenting a host of challenges for many families. In addition, there are differences in the women’s stage of pregnancy when seeking prenatal care, as well as dissimilarities in the type of providers sought at various stages of pregnancy. Some women may not seek care until very close to birth, and the provider may be a hospital. The National Children’s Study will take all of these characteristics into account to seek a better understanding of important questions such as:

• Can good nutrition help overcome potential risks from other environmental exposures that can affect the fetus?
• How does infection at various times over the course of pregnancy impact the fetus? 
• How are exposures to environmental toxicants, stress, prenatal nutrition, and other factors, such as genes, linked to a child’s risk of autism, ADHD, and other developmental disorders?

Results from this effort can help revise standards of care for prenatal screening, as well as inform guidelines for the management of certain conditions during pregnancy, such as diabetes. While Rose was right to point out how the NCS may make participants aware of certain things, it is highly unlikely that a Hawthorne-type effect might be at play in terms of prenatal care.

Environmental Factors

We started this project because we are “all committed to observe, listen carefully, evaluate the evidence, engage, and incorporate the voices of the communities and people interested and involved in the study.[1]”

The National Children’s Study has the potential to impact millions of children and families across the country to lead healthier, safer and happier lives in the future. The Study plans to accomplish this by focusing on environmental factors and their influence on the health and development of children. The NCS defines the “environment” very broadly. First of all, environment includes your physical surroundings, and as the interviews on this week’s post reveal, many community residents that we talk to do worry about the quality of the air, water and soil in their community and how that might affect their children’s health.

For us, environment does not only include geographic location and differences between neighborhoods, but also biological factors such as diet and family health history. The Study also plans to look at other factors such as family size and composition. There are also emotional factors such as behavioral inhibition, and social factors such as closeness to family and friends. As children get older, the Study will also observe their cognitive development, peer and cultural influences. In addition, the Study intends to examine chemicals in the environments where children live, learn, and play. As this video from HealthyChild.org  shows, there are more chemicals in the environments where children grow up today than ever before:

The NCS wants to find out how the interaction of all these environmental factors makes some children predisposed to certain diseases. In addition, the NCS also seeks to find which factors are actually helpful in preventing some children from developing illness. The goal of NCS is to provide policy makers with valuable data to improve prevention programs and the necessary tools to combat the negative environmental impacts on children’s health and development.

The issues raised by our neighborhood ambassadors in the following videos come out of their conversations with parents in the community. We know that some communities in Cook County disproportionately suffer from premature deaths, high rates of asthma and emergency room visits due to air pollution. In addition, lead poisoning is still major concern nationwide as there are 36.7 billion square feet of lead paint remaining in the United States, which is enough to coat the entire city of Chicago with four layers.[2] Expecting parents who are interested in increasing our understanding about these and many other environmental health issues are signing up for the National Children’s Study. Even if you are not planning to have more children, watch the videos below and then click the links on the left to find out other ways in which you can get involved:

---

[1] Hirschfeld S, Kramer B, Guttmacher A. Current Status of the National Children’s Study [commentary]. Epidemiology. 2010;21:605–606.

[2] Source: HUD National Survey of Lead and Allergens, 2000