In March 2009, a research team from newly formed STRIDE at California Polytechnic State University was contracted to review and evaluate Lillian Larsen Elementary Schools’ eating and physical activity environments with the intent to create baseline and outcome measures for school wellness improvement and sustainability. You have already received a September 2009 mid-cycle report summarizing STRIDE’s studies, observations and recommendations.

This final report evaluates Lillian Larsen’s accomplishments against those mid-cycle recommendations and presents results and take-home messages. It also delineates any significant obstacles to progress and makes recommendations for the school’s path forward for improvement and sustainability. First, a brief overview of the childhood obesity issue and a discussion of prevention through school intervention might be helpful.

In March 2009, a research team from the newly formed STRIDE at California Polytechnic State University was contracted to review and evaluate Oceano Elementary Schools’ eating and physical activity environments with the intent to create baseline and outcome measures for school wellness improvement and sustainability. You have already received a September 2009 mid-cycle report summarizing STRIDE’s studies, observations and recommendations.

This final report evaluates Oceano’s accomplishments against mid-cycle recommendations previously made and presents results and take-home messages. It also delineates any significant obstacles to progress and makes recommendations for the school’s path forward for improvement and sustainability. First, a brief overview of the childhood obesity issue and a discussion of prevention through school intervention might be helpful.

In March 2009, a research team from the newly formed STRIDE Institute at California Polytechnic State University was contracted to review and evaluate the Oceano Elementary School eating and physical activity environments with the intent to create baseline measures for school wellness improvement. This report summarizes STRIDE’s studies, observations and recommendations. Before diving into the results of this study, an overview of the childhood obesity issue and previous federal, state and school efforts undertaken to address this issue might be helpful.

On behalf of Cal Poly’s emerging Center for Obesity Prevention and Education (COPE), I would like to begin by expressing my gratitude to Dr. Steve McDowell and Ms. Judy Taggart for inviting our research team to partner with your community in this exciting project. It is clear to our research team that the community health agencies have invested a tremendous amount of time, energy and money in planning and implementing changes designed to improve the health of children and families in Lompoc.

By actively seeking input from the recipients of the Lompoc region medical and educational services and by conducting focus groups on the topic of food, physical activity and current family practices, we have a better understanding of the fundamental beliefs and perceptions of your clients. Unlike questionnaires, the qualitative data generated by focus groups provides information not only on what they do, but why they do it. Also, participating in the focus group sessions, it was clear that your clients felt a sense of value, pride and investment in helping their community. It was a very empowering and enlightening experience for all of us.

The following report includes a summary of our procedures, questionnaires and forms, and participants. Data generated from the transcripts have been carefully reviewed and analyzed by four researchers, then synthesized into this final report. Over one hundred sixty-five hours were required for the analysis and report phases alone.

We encourage you to examine the information contained in this report with a positive perspective. For example, we are aware that many changes in Lompoc were already in the works (such as park improvements), but weak communication lines left the community members unaware of the level of commitment by the city and health agencies and of the forward progress that was occurring. Language posed a problem for non-English speakers. And participants reported not reading the newspaper, but relying on the TV. Recognizing this cluster of facts then enables your agencies to develop an effective communication campaign to resolve the issue. Later, when unveiling new programs or playgrounds, you now have an opportunity to give credit to the community members who invested their time and expressed their concerns/wishes, thereby empowering and rewarding those clients.

Utilizing the information contained in this report will enable your Healthy Kids Initiative members to better understand perceived barriers. More importantly, you will be able to identify opportunities and strategies that address these perceptions in terms that are meaningful to your clients. Targeting your audience members through specific messages, approaches, and services will allow you to increase the likelihood of success.

We hope that your actions will set precedence for the central coast region and inspire other agencies to become familiar with qualitative research methods when problem solving. If we can be of further assistance in addressing the solutions, please do not hesitate to call. At Cal Poly, besides further developing our qualitative research team, we are strengthening our educational program capabilities for developing targeted nutrition and physical activity interventions, and have hired a new education technology specialist for film, media, and public service announcement campaigns and outreach.

On behalf of our entire research team, we wish you continued success on your quest for improved and responsive health for the Lompoc community. And in the future, we hope opportunities to collaborate continue on a regular basis.

Should you have any questions after reading the report, or wish to further discuss a topic, please do not hesitate to contact me. Also, I would be happy to present a PowerPoint presentation of the report findings to your staff or community members.

Sincerely,

Ann Yelmokas McDermott, PhD, MS, LDN

Director, the emerging Center for Obesity Prevention and Education
Associate Professor, Kinesiology
Cal Poly
San Luis Obispo, CA 93407
Office: 805-756-6447
Cell: 617-869-3878
amcdermo@calpoly.edu

To identify environmental antecedents, this study collapsed 10 existing ecological models of obesity prevention and divided resultant antecedents (n=94) into five ecological categories (social norms/national policies, community factors, school factors, family/peer or interpersonal factors, and individual or intrapersonal factors). A proposed ecological framework was then devised, defined, and constructed. Codebook reliability tests were conducted resulting in intra-rater reliability of 91.4% and inter-rater reliability of 89.4%. Utilizing a grounded emergent process of content analysis, 874 studies were identified in twenty-five journals across five disciplines and coded for ecological antecedents. Five hundred forty five articles (62.4%) of the sample were identified as empirical articles and three hundred twenty nine theoretical articles (37.6%). Social norms/national policies had the largest contribution to the model with 345 antecedents (39.5% of the sample); followed by individual/intrapersonal antecedents (n = 314; 35.9%); family/interpersonal antecedents (n = 291; 33.3%); community (n =140; 16.0%) and school antecedents (n = 122; 14.0%). Ecological antecedents with the greatest contribution to the model were: (1) social norm/national policy "cultural inactivity/eating poorly" 148 (16.9%), followed by; (2) individual domain "low levels of physical activity -television viewing" 137 (15.7%); (3) individual domain "genetic predisposition towards obesity" 110 (12.6%); (4) family domain "family social economic status" 95 (10.9%); and (5) social norm domain "modern technology - labor saving devices" 80 (9.2%).

Study findings suggest key beliefs about critical environmental antecedents are being placed on environmental factors (external to child) providing increased opportunities for overeating and sedentary lifestyle. Results suggest: 1) there is a lack of research addressing childhood obesity in an ecological framework; 2) there is a lack of obesity research addressing community and school antecedents collectively; and 3) published articles on childhood obesity have steadily increased over the past decade, however it is still uncertain if stakeholders will support the proposed ecological initiatives that have been identified as critical to reverse obesity prevalence.