NEWS

Church-based obesity prevention program shows how ‘Girls Rule!’ at staying healthy

By MEGAN MILLER
UNC School of Public Health

CHAPEL HILL -- In a program led by faculty in the University of North Carolina at Chapel Hill schools of public health and medicine, young black girls and their caregivers are learning skills to keep body and mind healthy in the fight against obesity, a condition that is on the rise in this population.

The program, called "Girls Rule!", teaches girls ages 6 through 9 and the women who care for them how to use dietary choices, physical activity and a positive self-image to maintain a healthy weight. With the basic message of "Eat healthy, move more," the weekly sessions held at Union Baptist Church near downtown Durham have participants exercising together, trying nutritious foods and listening to lectures on the key ingredients of a healthy lifestyle. Home visits by program staff help participants make their environment conducive to eating well and staying active.

The program concludes Tuesday (Oct. 29) with a jubilee celebration for participants and their families.

Dr. Alice Ammerman, principal investigator and associate professor in the department of nutrition, which is jointly housed in the schools of public health and medicine, and Dr. Kristine Kelsey, research assistant professor in the department of nutrition and clinical scientist in the School of Medicine’s Clinical Center for the Study of Development and Learning, are leading the initiative, assisted by other faculty in both schools. They developed the program in response to national concerns over a growing obesity risk in black females and the lack of programs for obesity prevention in the younger members of this group.

"You see a lot more obesity among African-American women and also among African-American girls [than in other groups]," said Kelsey. "The girls at this age [6-9] are pretty active. It’s when they hit puberty that there’s this big drop-off; and when they hit middle school, they stop participating."

By working with young girls, the study leaders hope to instill healthy behaviors in this critical period to prevent obesity later in life. They hope that engaging their caregivers will help those women return to healthier, more active lifestyles.

The current phase of Girls Rule!, involving 15 pairs of girl-caregiver participants recruited from the congregations of three churches in Durham, has been in session since April, but is part of a larger program running since February of this year. From the earlier phase of the program, researchers learned about obstacles to exercising and eating a healthy diet – such as unsafe streets, fast food and reduced access to healthy foods. In this phase, they are teaching participants to overcome these barriers, through lessons that can be incorporated into a larger study in the future.

Many of the weekly sessions offer activities just for the girls, giving the program a "girls’ club" feel that boosts participants’ self-esteem, leaders said. The girls participate in activities such a dance workshop with the Berry and Nance Dance Project, field trips to a skating rink, hikes along the Eno River and athletic events featuring women and girls.

They also learn how to choose a healthy diet through eating a nutritious meal prepared at the church, discussing how these foods fit into a colorful food pyramid they’ve constructed and sharing artwork and poems about healthy foods they enjoy. Meanwhile, caregivers participate in discussions on nutrition, physical activity and self-esteem and other related programs. Lessons from the sessions are reinforced through four planned home visits with the family of each participant.

Researchers are collecting diet surveys and activity measures during the program from both the girls and their caregivers to help in designing future such programs. Researchers are observing early indications that the program could be effective at controlling weight, instilling healthy behavior and improving overall health, the ultimate goals of the program that may be tested by future studies.

The churches where the program has been held are showing an active interest in carrying on the mission of the program after the researchers have left, program leaders said. They added that the church was chosen as the program site for its central position in black communities and its success in supporting programs involving healthy behaviors.

"We’re trying to design it in such a way that there’s a certain level of institutionalization and sustainability," Ammerman said, adding that one drawback of this type of short-term program is how quickly activity drops off after the study is finished. "We’re trying hard to set things up so that we train people in the church, who we call on for advice and also as the people who would help perpetuate things after we’ve left."

The program is funded by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.

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(Miller, a recent doctoral graduate of the UNC department of nutrition, is from Franklin, Ohio.)

Note: Alice Ammerman can be reached at (919) 966-6082 or alice_ammerman@unc.edu. Kristine Kelsey can be reached at (919) 966-3933 or Kristine.Kelsey@cdl.unc.edu.

School of Public Health contact: Lisa Katz, (919) 966-7467 or lisa_katz@unc.edu

News Services contact: Deb Saine, (919) 962-8415