A Community Partnership to Assess Growth and the Risk of Diabetes in Children in the Community

Abstract

Background: The prevalence of obesity and type 2 diabetes in children is increasing and disproportionately effects children from minority and low socioeconomic backgrounds. Multiple interventions have been ineffective, in part, because they were not culturally relevant, nor did they consider environmental barriers. Purpose: The purpose of this four year University and community collaboration was to form a partnership to 1) screen growth and diabetes risk factors in children in an inner-city community; 2) assess nutrition knowledge; 3) measure physical fitness; and 4) survey parents about barriers to healthy living. Methodology: Nurse practitioner students and high school students partnered to evaluate children in an after-school program. The team assessed height, weight, waist circumference (WC) and the presence of acanthosis nigricans (AN); administered a nutrition knowledge test; and, taught children to prepare a healthy snack. Professional dancers led a dance class and children's pre and post activity heart rates were obtained. Parents were surveyed about their children's diet, physical activity and barriers to healthy living. Findings: 233 children were evaluated (AA, 5-13yr, x=9yr, 39% M) 33% of children had at least one of three diabetes risk factors (43% BMI > 85th%; 18% WC > 95%; 17% AN); 13% had all three risk factors. The average nutrition pre-test score was 65% In only 13% of children, heart rates returned to normal after rest following a dance activity. Parents reported that the greatest barriers to eating healthy were children's refusal to eat healthy foods (62%); barriers to activity included lack of access to safe places to play (54%) and excessive screen time (31%). Summary Concluding Statement: Children in this population had poor nutrition knowledge, were not fit, and 1/3 were at risk for diabetes. The key to effective interventions that target diabetes risk factors are those that are developed and executed collaboratively with the community, are culturally relevant, and focus on the barriers to healthy living that impact inner city populations.