Ninos Obesos: "Moving On" Project Reduced Obesity in Hispanic and Non-Hispanic Children

Obesity is a pervasive public health problem in the US having the highest rates of obesity in the world with obesity overtaking smoking as the largest preventable cause of the loss of quality-adjusted life years. Aaron and Siegel (2016) advocate that soda consumption is vital in stemming obesity. Athough corporate sponsorship by tobacco and alcohol companies has been studied, only Aaron and Siegal investigated the nature, extent and implications of soda company sponsorship of US health and medical organizations, as well as corporate lobbying expenditures on soda-or-nutrition-related public health legislation from 2011-2015. Childhood obesity increases risk of obesity in adulthood, leading to type 2 Diabetes & Cardiovascular Disease (Chen et al, 2016, Evans et al, 2016; Bauer, 2015; Brown, Kuk & Lee, 2015). Treating obesity-related illness (25%) in Florida costs $6,675,940 annually. Latino children are at a greater risk of obesity with prevalence increasing over time. National Association Hispanic Nurses (NAHN) Miami Chapter was a site for Muevete USA™ Project (2012-2015) reducing Hispanic childhood obesity sponsored by Coca-Cola Foundation (Milan, 2011). In 2016-2017, the college collaborated with a university for the "Moving On" Project. The collegiate ASN/RN-BSN students conducted "Moving On" project at summer camps while the university BSN students conducted the "Let’s Move" project (www.letsmove.govt at elementary schools.

Purpose: To determine if an education program can increase the level of knowledge preventing childhood obesity focusing on 1) awareness/understanding of food labels; 2) daily portions of fruits, vegetables, grains, dairy, protein; 3) preferring drinking water and using half water with juices and drinking no sodas; 4) incorporating daily physical activity with exercises and dancing.

Methodology: A descriptive exploratory research design was conducted with children completing five pre/post tests of 15 questions - “My Plate”; “Food Label”; “Physical Activity and Exercise” “Healthy Snacks” and “Goal Setting”. Content validity was established. Community Health ASN & RN-BSN students (100) participated in Muevete projects at South campus (1^st-3rd) and Homestead (2^nd - 4^thyears). Seven university nursing students conducted a "Moving On" project in 2016 and will be conducting another "Moving On" project in 2017. Students received 10 community hours; orientation, designing posters, collecting data and attending "Moving On" events. Children (4-15), were divided into 12 groups (2 students/group); completing pretest, taking food cutouts, making plates with appropriate portions, discussing nutritional requirements focusing on sodas, reading labels and completing posttests.

Results: In 2013, ASN/BSN students taught over 130 children at the 1st site; ages 5-12; males 50%, females 50%; mostly Hispanics. All mean scores increased pre-to posttest 1^st test 3.13-4.67; 2^nd test 2.94-3.72 3^rd test 3.50-4.55 4^th test 3.50- 4.13; 5^th test 2.96-3.52; In 2014, ASN/BSN students taught 125 children ages ranged 4-15 mean= 8 years, kg-8th grade males-62%, females 38%; Hispanic 55%, White 30%; Black 9% Asian 6%; pretest-posttest scores increased 9.40--10.68, 13.62% change; In 2015, ASN/BSN students taught 128 children ages ranged 4-15 mean= 8.51 years, kg-8th grade males- 59%, females 41%; Hispanic 74%, White 20%; Black 5% Asian 1%; pretest-posttest scores increased 9.77-11.81, 42% change. In 2014, ASN/BSN students taught 102 children at the 2nd site ages ranged 4-15 mean= 9 years; males- 54% females 46%. Hispanic 41%, Black 38%, White 13%, Asian-8% pretest-posttest scores increasing 8.33-9.45, a 13% change. In 2015, ASN/BSN students taught 109 children ages ranged 5-12 mean=8.51 years; males- 65% females 41%. Hispanic 41%, Black 36%, White 22%, Asian-1% pretest-posttest scores increasing 9.77-11.81, a 21% change. In 2016, ASN/BSN students in Homestead taught 56 children ages ranged from 9-12; 57% males 43% females; Hispanic 42%, Black 36%, White 21%, Asian-1% with 34% change in scores while University BSN students taught 42 children at an elementary school ages 10-11, 54% female-46% male 93% Hispanic 5% Caucasian and 2% Asian with 23% change from pretest-posttest.

Discussion: Over four years with nursing students conducting "Moving On" projects, almost 700 children drew plates with food portions (www.choosemyplate.gov), ate healthy snacks, drank water with juice, exercised to Zumba and Utube exercises, did hand washing techniques, and loved “Moving-On” t-shirts. Parents received nutrition classes. Most missed question -“How much Sodium is in entire food product?” on a food label. Sodium is 440 mg but for 4 servings = 1760 mg so correct answer was reviewed and explained.

Conclusion: Children learned healthy food habits and the need to avoid sodas to overcome childhood obesity. This program increased the level of knowledge of obesity for Hispanic/non-Hispanic children while decreasing associated healthcare costs. Recommendation is to involve grandmothers since they may be the ones who are not adhering to "Moving On" priniciples and giving their grandchildren the "unforbidden fruits".