At the 2018 American Public Health Association’s (APHA) Annual Meeting and Expo in San Diego, CA, Dr. Rebekka Lee will present on LIH and OSNAP, and Jennifer Reiner will present CHOICES research. Details are below.
Date: Sunday, November 11, 2018
Time: 4:30pm-5:30pm
Session: 2098.0 FN Section Poster Session 5
Program: Food and Nutrition
Board 1: Strategies to promote water consumption in schools: Impacts on population health, health equity, and cost-effectiveness
Introduction: School-based strategies promoting water consumption hold promise for reducing youth sugary drink intake and obesity prevalence, improving hydration, and narrowing health disparities. However, their relative cost-effectiveness and population impact are unknown. Our objectives were to estimate the costs and health impacts of four school-based water promotion strategies overall and by race/ethnicity and socioeconomic status.
Methods: The Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation model estimated the cost-effectiveness of nationwide installation of chilled water dispensers on school lunch lines as well as the cost, number of children reached, and impact on water consumption of three separate additional strategies elsewhere in the cafeteria: installing cup dispensers and cups near existing water fountains, distributing bottle-less water coolers, and using portable water dispensers.
Results: Installing chilled dispensers on lunch lines was estimated to reach 56.0 million children (95% uncertainty interval (UI): 55.5 million, 56.5 million) over 10 years, prevent 180,000 cases of childhood obesity in 2025 (95% UI: 102,000, 258,000) and save $0.31 in healthcare costs per dollar invested (95% UI: $0.15, $0.55). Although installing cup dispensers next to existing water fountains was the least costly intervention, it also reached fewer children and had less impact. Preliminary results indicate all these strategies also reduce disparities in obesity prevalence and water consumption.
Discussion: Interventions to promote drinking water in schools should be considered as effective, relatively inexpensive strategies for addressing childhood obesity, improving water intake, and reducing health disparities.
Learning Areas
- Public health or related public policy Social and behavioral sciences
Learning Objectives
- Explain how cost-effectiveness analysis can be used to understand the potential public health impact of different school-based water interventions. Compare the costs, population reach, and impact on drinking water consumption of four evidence-based school water promotion strategies. Describe the estimated impact of a hypothetical nationwide implementation of a school water strategy on disparities in childhood obesity.
Keyword(s)
- Water & Health
- School-Based Health
Presenter
Authors
Erica L. Kenney, ScD
Harvard T.H. Chan School of Public Health
Angie L. Cradock, ScD, MPE
Harvard T.H. Chan School of Public Health
Michael Long, ScD
George Washington University
Jessica L. Barrett, MPH
Harvard T.H. Chan School of Public Health
Catherine M. Giles, MPH
Harvard T.H. Chan School of Public Health
Zachary J. Ward, MPH
Harvard T.H. Chan School of Public Health
Jennifer Reiner, MPH
Harvard T.H. Chan School of Public Health
Steven L. Gortmaker, PhD
Harvard School of Public Health, Prevention Research Center
Date: Tuesday, November 13, 2018
Time: 8:35am-8:50am
Session: 4068.0 Spirit of 1848 / Making Hope Practical: Progressive Pedagogy That Enhances Capacity for Civic Engagement in the Collective Struggle for Health Equity
Program: Spirit of 1848 Caucus
Leaders in Health Community Training Program: Building Capacity for Health Equity
Building the capacity of community members is essential for promoting health equity. The 8-week Leaders in Health program at the Harvard T.H. Chan School of Public Health aims to strengthen existing community health initiatives and empower individuals through an introductory training in public health. In alignment with this session’s theme of “making hope practical”, Leaders in Health aims to build the concrete skills of community activists, local health department employees, and practitioners from community-based organizations through discussion-based activities. Content of the training includes the basics of community-based participatory research, program planning, and evaluation. Participants use a change tool throughout the course to directly apply the course content to their current work. The training culminates with each participant presenting a project that they plan to implement using course content. The training, co-sponsored by the Office of Diversity and Inclusion and the Prevention Research Center on Nutrition and Physical Activity, has trained 45 community practitioners across five cohorts. In 2017, a student independent study component, which emphasizes co-learning between current masters students and training participants, was added. This presentation will describe how the program is carried out, including details on recruitment and an application process that ensures diverse participants, lesson plans implemented, and examples of power and privilege discussions. It will also feature the firsthand account from a past community participant on how the course content was used to successfully challenge health inequities within greater Boston.
Presenter
Date: Wednesday, November 14, 2018
Time: 9:10am-9:30am
Session: 5048.0 Dissemination and Implementation Research
Program: Public Health Education and Health Promotion
Training Models for Implementation of Nutrition and Physical Activity Promotion Afterschool
Introduction: While research on the effectiveness of health promotion initiatives grows steadily, there remains little investigation of how evidence-based public health prevention programs can be translated into practice. The Out-of-School Nutrition and Physical Activity intervention (OSNAP) has evidence for improvements in nutrition and physical activity outcomes from a group-randomized trial and is poised to be implemented in afterschool settings. This study aims to assess online and in-person train-the-trainer models for scale up within the YMCA.
Methods: A mixed methods design was used to compare the effectiveness of two training models and explore factors that influenced implementation. Fifty-one afterschool sites from three YMCA Associations completed baseline and follow-up nutrition and physical activity observations. One-third of sites were randomized to train-the-trainer, one-third to online, and one-third served as controls. In the train-the-trainer, local trainers conducted three learning collaborative meetings. The facilitated online model consisted of monthly self-paced modules, videos, quizzes, and discussion boards. Multivariable regression models, accounting for clustering of observations, assessed intervention effects on an aggregate healthy practice primary outcome. Implementation factors were assessed with an online survey and one-on-one interviews.
Results/Discussion: The intervention group achieved 0.44 additional healthy practices compared to controls (p=0.02). In-person sites achieved 0.51 additional goals (p=0.02), while online sites showed positive trends but did not have significantly different effects from controls (+0.34, p=0.16). Turnover and self-efficacy were identified as factors that influenced intervention effectiveness (p<0.05). Qualitative data explain how staff experienced these factors. This study fills the gap between effectiveness research and implementation, investigating training models for scale up.
Learning Areas
- Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related education Public health or related research
Learning Objectives
- Discuss how different training models can be assessed and utilized for scaling up evidence-based interventions. Describe how dissemination and implementation science methods, measures, and theory can be used to accelerate the process of putting program that work (i.e. evidence-based interventions) into practice.
Keyword(s)
- Child Health
- Evidence-Based Practice