By Keith Russell, Ph.D.
Associate Professor, University of Minnesota
T. Grant Lewis
Graduate Research Assistant, University of Minnesota
Moira Petit, Ph.D.
Associate Professor, University of Minnesota
Executive Summary
The increasing prevalence of childhood overweight and obesity is a public health concern, one that warrants improved attention in public and private sectors. Obesity results in numerous chronic diseases and has a direct impact on the health care industry. The reality is that children and adolescents who are overweight or obese are experiencing these diseases during their formative years of growth and development, with negative medical and psychosocial consequences that may endure into adulthood. A multitude of causes are leading to this rise in frequency of childhood obesity, including unhealthy choices and behaviors in dietary patterns and physical activity.
Study Objectives
A partnership between Recreation faculty at the University of Minnesota, the Säjai® Foundation, the City of St. Paul Parks and Recreation, and the National Recreation and Park Association (NRPA) was formed to investigate the premise that a structured integrative health and wellness program in an out-of-school setting can play a significant role in helping young people adopt healthy eating and physical activity habits and behaviors. The partnership resulted in the design, implementation, and evaluation of an innovative health, wellness and physical activity program that was implemented in four after-school recreation programs throughout the City of St. Paul, Minnesota. This study focused on the evaluation of the program to better understand the effects that may result from intentional after-school programming with this focus area. The Wise Kids® program was designed to be fun, experiential, and educational in promoting nutritional awareness and increased physical activity in youth ages 7 to 12.
Methodology
The research design used to evaluate the program’s effects is best described as a multi-site case study design using pre-, post-, and follow-up assessment with a non-randomized control group. The purpose of this study was to assess the process implementation and impact of the Wise Kids program as implemented at four recreation centers in the City of St. Paul. A total of 96 youth ages 7 to 12 participated in the program, coming from diverse socio-economic and cultural backgrounds. Multiple sources of evdience were used, including surveys, observation, focus groups with staff, and unstructured interviews with participants and families. An additional recreation center was selected as the control group, where the program was delivered after data collection was complete.
The evaluation of program impacts specifically focused on physical and attitudinal changes that resulted from participation in the eight-week program. These included: (1) attitudes towards healthy eating and physical activity before and after the implementation of the program; (2) social norms, which are operationalized as being attitudinally and behaviorally influenced by parents, guardians, and peer groups; (3) perceived behavioral control over specific desired outcomes associated with healthy eating and physical activity; (4) behavior intentions during a specified time period around eating and physical activity; (5) actual eating and activity behaviors over a specified time period; and (6) physical body composition changes to determine if changes in attitudes and subsequent behaviors translated into changes in their physical fitness measures.
The Theory of Planned Behavior was applied to the evaluation of the program because it provides a grounded empirical explanation for why individuals engage in certain behaviors. This is based on the notion that individuals are more likely to intend to participate in physical activity and to adopt healthy eating habits if they are positively disposed toward it, if they perceive social pressure to do so, and if they believe they will be successful. Because intention plays such a critical role in understanding behavior in the TPB model it serves as a mediator between attitudes, values, norms and perceived behavioral control. The correlation between intentions and behaviors is critical as this relationship should be strong to support the proposed relationships.
Conclusions
Several conclusions were developed based on the results generated from this pilot. It should first be noted that this study demonstrated that it is feasible to implement programs of this nature in after-school environments that serve youth, like recreation centers, and that recreation programs seem welcome to the idea of more structured and purposeful programs targeting youth development. In addition, it is worth mentioning that the program was well received by recreation center staff, youth, and parents at each of the participating centers. This was uncovered through systematic observation and focus groups conducted with implementing center staff, as well as through formal and informal interviews and discussions with the youth and center staff at each participating recreation center.
Results of the design, implementation and evaluation of the Wise Kids program suggests that the program has positive and significant impacts on attitudes and behaviors in areas that will lead youth to have better attitudes toward eating more healthy foods and engaging in physical activity. Ultimately, this should result in their being less at-risk of gaining weight and having associated health problems associated with weight gain. In addition, results suggest that the Wise Kids program positively impacted children's BMI trends and has the potential to stem continued BMI increases in participating youth.
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