The issue of childhood obesity is much discussed in the news today. As someone working on the frontlines, how do you feel about the progress New York is making on the issue?
I’m very hopeful about what’s happening in New York City, especially with respect to organizational synergy and shared vision. Across the board from government agencies to community based organizations and the private sector, there is a sense of urgency and commitment towards moving the needle in childhood obesity. Everyone is encouraged by the recent progress announced last year showing a decline in youth obesity levels, however there is still a very long way to go, and we all need to continue to work together to keep these statistics moving in the right direction.
Synergy and collaborations across sectors isn’t always easy. Even though we all want our kids to be healthier, aligning efforts and resources can be tricky, especially in a large urban environment like New York City with the largest school system in America—nearly 1,800 schools, 1.1 million kids and almost 8 and a half million New Yorkers. Coordinated initiatives across sectors need to target the many pieces of this complex, multifaceted puzzle. There isn’t one isolated reason for the childhood obesity epidemic, and there certainly isn’t only one specific approach to reverse it. Everyone needs to keep asking, “What can we do from our perspective? Who else can we partner with to maximize our resources and impact?” That’s critical.
I’m also encouraged by the continued commitment from the New York City Health and Education Departments to support NYC FITNESSGRAM, a web-based longitudinal tracking system of youth fitness and obesity levels. This work began as a pilot a decade ago, and now is a robust citywide assessment and surveillance program representing hundreds of thousands of young people. This investment allows ongoing opportunities for research and investigation, and it’s going to be interesting to see what else we can learn from this rich data.
What do you think are some of the successes and challenges of the work you all have been doing in New York and do have any advice for other states given the challenges you all have faced?
Increasing opportunities for youth to become more physically active in a safe and supportive environment is a challenge that many states and cities face. This is particularly important during out-of-school time hours, when young people tend to become more involved in risky behaviors. To help address this issue of access, New York City’s YMCA launched the Strong Kids Card in 2007, which offers NYC kids free access to the resources and facilities of their local Y to help them develop healthy habits—all in a safe, fun, supervised environment.
But access is not the only issue. We need to understand what motivates young people to stay active. We need to expose kids to a range of activities so that they can find out what they enjoy. Too often we think of team sport activities as the only option for youth. And not every kid is excited about team sports. I mean, we love basketball at the Y—we invented basketball! And at the same time, what’s exciting for one young person may be a dreadful experience for another. We need to look at youth physical activity through a more expansive lens that encompasses individual, team and nontraditional sports in addition to individual and group fitness activities. It could be taking a yoga class, working out on a treadmill, going out for a run or dancing. It’s not like someone’s going to wake up one day when they’re 18 years old and say, “I think I will try Pilates today,” or “I’m going to take a spinning class,” when they’ve never ever done that before, have no clue what those activities are, or where they can do them.
Another angle for motivation is related to exploring the use of technology in physical activity programs. Too often we hear about devices, gadgets and screens that are keeping kids on the couch for an average of 53 hours a week! How can we employ and test these very same strategies to actually get kids up and moving?
Inspired by the latest advances in the fields of fitness education, online learning and gamification, we launched Y-MVP earlier this year in six NYC YMCA branches. The program uses digital media to teach fitness concepts and to ultimately stimulate teens to increase their daily levels of Moderate to Vigorous Physical activity. The Y-MVP app is aligned to a fun fitness curriculum that prompts participants to take on weekly quests and missions, utilizes digital badges, tracking tools and tangible rewards to keep users engaged. Our plan is to expand this free program to eight more branches this fall, with all NYC YMCAs participating in 2015. We are wrapping up an evaluation currently being conducted by Dr. Nate McCaughtry, Assistant Dean and Professor, Division of Kinesiology, Health and Sport Studies at Wayne State University, and will be eager to share the results widely – we are encouraged by this blended learning approach and are hoping to make Y-MVP a nationwide model as well.
Our Senior Associate of Outreach and Communications, Maureena Thompson, recently wrote about the documentary Fed Up and how a lack of education around healthy choices negatively affects wellbeing. What changes would you make if you could influence the messaging and information that children get today around health?
You know, we talk about making the healthy choice the easy choice. That’s difficult for adults and it’s especially difficult when it comes to our kids because they aren’t necessarily the ones making their own food choices or decisions about their schedules and physical activity. While working directly with youth is key, it is equally important to also engage parents, guardians and older family members with simple and clear messaging. And it needs to focus on what families can do—not just on what not to do. Too often there’s a lot of negative advertising, “Don’t do this or this will happen, don’t eat that, it’s not good for you.” We need to flip this language: “Choose water, serve a vegetable at every meal, take a fitness break during TV commercials.”
It’s also important that we are mindful about the environment that our young people are in, not just when they’re in school, but what they encounter on the way to and from school. Or in the places they spend their time afterschool and on weekends. It’s one thing to have healthier vending machine options available for young people during the school day, but what happens when the ice cream truck is waiting right outside the door upon dismissal? What about when kids go to an afterschool program at a local sports center or community based organization and there are vending machines rows filled with candy? Our kids are bombarded with a lot of conflicting information. We need to make some of these choices much easier.
You recently attended Hope Street Group’s 2014 Annual Colloquium, where a major thread of discussion was working across sectors to create a Culture of Health. What examples of this do you see in your work or your state and how would you further like to see public, private, and nonprofit institutions collaborate to increase these efforts?
I’m really excited about answering this question! Here’s one example of how we’ve been working across sectors to support youth physical activity. When the First Lady announced the Let’s Move Initiative with the Partnership for a Healthier America, YMCAs all around the country made a commitment to implement new Healthy Eating and Physical Activity Standards in after school programs by 2015. In New York City, the core of our work has always focused on youth development, social responsibility and healthy living and we were inspired to take this to a new level. While we annually run about 75 afterschool programs in elementary and middle schools, most of these programs are primarily focused on academics, so we made a new commitment to incorporate 30 minutes of daily physical activity into all of these programs. And since these programs are based in classrooms, we looked to our partners at the NYCDOE to implement the Move To Improve curriculum, which was specifically created and designed to implement fitness breaks in classrooms and small spaces. We are also excited about building future capacity for this program via Move to Improve “training of trainer” sessions. Moving forward, we will have the ability to train new Y afterschool staff, and we can also be a resource for the NYCDOE if they are in need of more trainers.
Another example of working across sectors relates to our vending machine contracts. In 2010, the NYC Health Department created new vending machine standards and nutritional guidelines for school snacks and beverages for public schools, and incorporated it into the district’s wellness policy. We benefitted from the work that the City had done in this area without having to do this research on our own. To show our commitment to promoting an environment with healthier choices and vending options, NYC YMCA’s also adopted the same snack guidelines and standards. We want to make sure that the culture of health within the walls of the Y also reinforces the same messaging that exists within our communities.
Before joining the YMCA, you made tremendous progress in the NYC Department of Education to increase the measurement and utilization of fitness and health data, as you mentioned earlier. What future do you see for the use of “big data” to increase health and wellbeing in the country?
What’s so interesting about the use of big data is that the very same data can be meaningful to different stakeholders in many different ways. Let me give you a few examples:
From the physical education perspective, when the Office of School Wellness Programs first began to implement the NYC FTINESSGRAM assessment it was originally introduced to complement the introduction of a health-related fitness education curriculum, Physical Best. The data generated from the NYC FITNESSGRAM assessment isn’t solely about BMI, but also measures progress along cardiovascular fitness, strength, and flexibility. This individualized fitness data helps physical educators to differentiate instruction in P.E. programs—just like a teacher would use student assessments in other subject areas to drive instruction (like math or science or social studies).
From an advocacy perspective, the massive data set helped to shape an important conversation. Since NYC FITNESSGRAM was also integrated into the student information system, we were able to look at the correlation of levels of fitness and obesity and compare it to student academic achievement. As a result, in 2009 the Department of Education and the Department of Health were able to publish a really interesting report detailing the level of childhood overweight and obesity in addition to a striking connection betweenhigher levels of student fitness and higher levels of academic achievement. Now, it’s hard to know if this relationship is causal, but the connection is very powerful. It tells us an interesting story especially in a time when principals and school administrators are struggling with figuring out how to keep physical education programs when there are so many other requirements to fit into the school day. When advocates are concerned about not losing physical activity in the school day, having this data available can be incredibly helpful to drive the discussion about why physical activity and P.E. is so important to a young person’s health and academic achievement.
From the public health perspective, the NYC FITNESSGRAM dataset serves as a wonderful surveillance tool. It’s not just a one-time commissioned data set, but an annual web-based program that builds from year to year. As the data set grows larger with more and more schools participating, the potential for longitudinal analysis is so exciting! As long as a student is enrolled in public school, their data will follow them from kindergarten through high school graduation. In addition, with such a robust data set, researchers may be able to see interesting trends with such a large sample that would not be revealed with a significantly smaller sample.
It certainly will be interesting to see how big data in health continues to evolve, especially with our seemingly ever-changing technology platforms and the increased use of apps and social media outlets.