Dr. Roundtree practices Internal Medicine with the Department of Veterans Affairs, Greenville, SC. Dr. Roundtree received her medical degree from the Medical College of Georgia, School of Medicine in 1998, and she completed a residency in Internal Medicine at the University of South Carolina School of Medicine in 2001. In 2003, she received an M.P.H. from the Harvard School of Public Health as a CFHU Fellow. She is currently partnering with Clemson University faculty to develop a nutrition/ physical activity intervention for the families of newborns.
Sheila Roundtree, MD, MPH
Staff Physician, Department of Veteran’s Affairs, Greenville, SC
TV Turn-Off Week in Cambridge Pubic Schools: Program Evaluation and Implications for Future Initiatives
The obesity epidemic in the United Sates has emerged as one of the most important threats to the health of our citizens. Worldwide, a billion people are overweight or obese, and recently the World Health Organization (WHO) deemed obesity one of the top ten global health risks. Sadly, the most vulnerable sectors of our population bear a disproportionate share of the disease burden. Specifically, ethnic minorities are most likely to be affected. At least 35% of the African American population, 30.6% of the Asian American and 20.6% of the American Latino population are obese compared to 20.0% in the white population.
Particularly concerning is the impact of obesity in the minority pediatric population. The most recent National Health and Nutrition Examination Survey (NHANES) cites a 10% increase in the number of overweight non-Hispanic Black and Mexican-American adolescents. Obesity and overweight status lay the foundation for devastating health consequences including cardiovascular disease and diabetes. Aside from well-documented adverse health consequences, research repeatedly confirms that overweight adolescents fair poorly in comparison with their age appropriate counterparts in terms of socioeconomic achievements throughout their life cycle. Dietz et al demonstrated that overweight individuals complete fewer years of school, are less likely to be married, and have lower household incomes and higher rates of poverty. Unfortunately, 50-70% of overweight children become overweight adults. Although the etiology of obesity is complex, this phenomenon is associated with increased caloric intake relative to energy expenditure. Sedentary lifestyle is a key contributor to pediatric obesity; children engage in less physical activity and spend more time watching television and playing electronic games. Cambridge Public Schools (CPS), in conjunction with Cambridge Institute for Community Health, has initiated several innovative programs to promote wellness for students and their families. To this end, the annual TV Turn-Off Week (TVTO) program was evaluated. Further, teachers and school nurses were queried for their thoughts on nutrition/physical activity programs.
Students indicated the number of hours of television they viewed before, during and following TV Turn-Off week via show-of-hands survey. Statistical analysis was performed to determine whether or not the effect was significant. Teachers and school nurses completed surveys to determine their views on TVTO and the potential for future school-based, nutrition/physical activity initiatives.
There was no significant difference in the number of children who watched two or more hours of television before TVTO versus during TVTO. The majority of teachers and school nurses surveyed feel that TVTO is a worthwhile effort. Moreover, they are willing to participate in this and other nutrition/physical activity related programs in the future. They also expressed interest in receiving additional training in these areas. Therefore, the following are recommended:
- Continue annual TVTO
- Solicit more parent participation
- Increase in-school and community-wide promotional efforts
- Collaborate with local health workers, artists and others to create stimulating alternatives to watching television
- Consider integrating nutrition/physical activity initiatives into the curriculum
Virginia R. Chomitz, Phd., Senior Scientist, Institute for Community Health (ICH) and Lan Jenner, MPH, Manager of Education, ICH.