Developing health messages: qualitative studies with children, parents, and teachers help identify communications opportunities for healthful lifestyles and the prevention of obesity – Perspectives in Practice
Susan T. Borra
Childhood overweight is at an all-time high in the United States, up 50% since 1991 (1,2). The problem of overweight is multifactorial and thought to be a convergence of factors favoring an imbalance between energy consumed and expended (3). Complex social and environmental factors contribute to this imbalance (4,5), including changing food habits, declining physical activity, and increasingly sedentary lifestyles (6). Children and adolescents spend more free time in sedentary activities (7-9) while the number of schools requiring daily physical education has declined (3).
Successful intervention programs, as well as Healthy People 2010, recommend using a population-based, multifaceted approach to address the problem (10,11). Promoting Better Health for Young People Through Physical Activity and Sports: A Report to the President also suggests an integrated approach, using an ongoing media campaign designed to increase awareness of the problem of inactivity and communicate practical solutions (12).
Decreasing the rates of childhood overweight in this country is of great importance, but perhaps even more critical is its prevention. Unfortunately, few research studies have examined the prevention aspect of overweight among children and data on the effectiveness of such programs are limited (13).
We initiated this consumer research to provide a basis for a future research-based communications and education campaign to help prevent (rather than treat) obesity and overweight in children. The consumer message development model (Figure 1) was used to develop meaningful and relevant messages to children and their families. Processes up to and including Step 3 are presented in this article.
OVERVIEW OF PLAN COMPONENTS AND PARTICIPANTS
The qualitative research described here consisted of three phases, with the results of each phase serving as the foundation for the next (see Figure 2). Open-ended questions were presented to gauge reactions to and attitudes about a variety of issues related to childhood overweight. The methodology for all three phases was designed to be exploratory and directional in nature, using a nonrandom sample of consumers.
Specifically, our research assessed issues children view as most relevant and important to their lives; examined attitudes, perceptions, and behaviors related to healthful lifestyles and overweight; examined perceived barriers to losing weight or staying at a healthful weight; and gauged reactions to strategies and solutions to help prevent children from becoming overweight that were developed using the data obtained during the earlier phases. For this article, we combined the methods and results discussions for each phase to illustrate the stepwise nature of our research.
Phase 1 included focus groups of children, parents, and teachers. Children were selected based on their weight status strictly as perceived by their parents, not actual weight or other anthropometric measurements. The definitions for weight status used were normal weight child, somewhat thin or within a normal range proportionate to height; somewhat overweight or overweight child, “a little chubby” or “somewhat heavy” (not significantly overweight) in proportion to height. Children were not selected for participation if their parents perceived them to be “significantly overweight.” The investigators judged this recruiting approach to be appropriate for exploring attitudes and perceptions related to weight issues.
The age group of the children selected was based on several factors. Phase 1 research focused on children aged 8 to l2 years (grades 3 through 7), parents of children in third, fourth, seventh, or eighth grades, and teachers of fourth- through seventh-grade students to help determine the most appropriate age for reaching children directly with overweight prevention messages. Phase 1 findings provided two primary reasons to select children in middle school (aged 11 and 12 years) and their parents as the target audience for the next two research phases. First, children of this age are increasingly concerned about physical appearance and performance. Second, they have more freedom of choice and begin to make more independent decisions away from the influence of parents, including those related to food selection and activity habits.
Study sites differed for each research phase. For Phase 1, Chicago, IL, and Baltimore, MD, were selected for logistical reasons. Also, both cities provide a snapshot of the typical position on many issues. For Phase 2, Atlanta, GA; Minneapolis, MN; and Los Angeles, CA, were selected to represent the East, Midwest, and West, respectively. For Phase 3, Chicago was again used as the study site, for logistical reasons.
Professional marketing research firms conducted the studies. The study coordinators audiotaped and videotaped all groups and used typed transcripts for data coding and interpretation. The coordinators also tabulated and grouped similar reactions into categories. Subjects received incentives for participation.
PHASE 1: FOCUS GROUPS
Methods
Separate focus groups composed of children, parents, or teachers examined eating and activity habits of preteen children and the influences on their behavior, attitudes and perceptions related to healthful lifestyles and overweight, and perceived barriers to maintaining a healthful weight.
Sixteen focus groups (N = 112) were conducted in January and February 2000 in Chicago, IL, and Baltimore, MD: 8 groups of children, 6 groups of parents, and 2 groups of teachers. The children were divided into “normal weight” and “somewhat overweight” groups, as perceived by parents. The parent groups included a mix of those with children described as “normal weight” and “somewhat overweight.” On a scale of 1 to 10, with 1 being not concerned and 10 being very concerned, parents were categorized as either “less” (1 to 5) or “more” (6 to 10) concerned with their children’s weight.
In the children’s groups, an appropriate variety of ethnic backgrounds was represented. A mix of children living in suburban vs urban neighborhoods and those attending private vs public schools was included. Activity levels were also screened to include children who were more or less physically active in each group.
For the parent groups, subjects represented a range of age, family size, marital status, spousal employment, income, and ethnicity. Efforts were made to ensure that a minimum number of subjects in each group lived in urban neighborhoods.
Recruiting quotas for teachers were designed to include a variety of teaching experience, classroom or physical education teachers, urban/suburban and public/private schools, and mix of ethnic majority in the school at which they taught. The teacher groups included a mix of gender, ethnic, and socioeconomic backgrounds.
Each group began with an investigation of general perspectives on children’s lives and then examined specific knowledge, behavior, and attitudes related to children’s health and weight.
Results
Issues children see as most relevant/important to their lives In general, children aged 8 to 12 years were concerned about their physical appearance and performance; this was more pronounced in the older children. Additional concerns included “fitting in” and not being seen as “different.” Friend and peer acceptance issues increased in importance as children aged. Important and admired people in their lives included parents, grandparents and other relatives, best friends, special teachers and coaches, and famous performers or athletes.
Attitudes and perceptions related to healthful lifestyles and overweight Although children believed having good health is desirable, most gave little thought to the subject, recognizing neither its immediate benefits nor long-term importance. They associated achieving “good health” with what they ate more so than with physical activity. For many, the term “healthy” had negative connotations, such as parents making them eat fruits or vegetables they did not like, or not being able to eat favorite foods.
Weight concerns usually arose as the result of failed athletic performance (more for boys) or dissatisfaction with physical appearance. Girls tended to experience more dissatisfaction and at a younger age. Most boys and girls indicated they were unable to sustain interest in healthful eating or staying physically active.
Parents stated a “healthy child” meant the absence of severe or ongoing medical problems. Weight was recognized as an issue only if it was extreme enough to prevent children from keeping up physically or socially with peers. The long-term effects of overweight-related problems did not appear to be a concern.
Teachers claimed a poor body image isolated overweight children, both socially and emotionally, from their normal-weight peers. Many overweight kids were less frequently involved in sports, less confident, less popular with peers, and often, more pessimistic about their lives compared to children of normal weight, the teachers said.
Awareness and barriers to action Most children aged 8 to 10 years, regardless of weight, did not think about food choices. Some older (11 to 12 years old) overweight children attempted to change eating behavior and lose weight by skipping meals, rather than building a healthful modified eating plan. For these children, changing eating habits was a more appealing means to controlling weight than increasing their level of physical activity because they believed changes in diet required less effort and had a greater influence on their weight.
The primary barriers to taking action for parents of overweight children included a belief–apparently supported by conversations with their children’s doctors–that children will outgrow the problem, a lack of knowledge about how to assist their children in controlling their weight, and a fear that they may cause unhealthful eating disorders in the other extreme (eg, anorexia).
Teachers considered it essential that parents support healthful lifestyles at home. However, they saw little continuity between lessons on healthful living at school and lifestyle outside of school. Further research examining this disconnect is warranted.
PHASE 2: IN-DEPTH OBSERVATIONAL STUDY OF TARGET AUDIENCE
Methods
Using findings from Phase 1, an in-depth observational study of children perceived to be above “normal” weight for their age was undertaken to more fully understand eating, activity, and lifestyle behaviors and to gain insight into the most credible communications and messages to deliver healthful lifestyle information to families.
The research included in-home observations, interviews, and food-activity diaries of six families (two families per city), from April 24 to May 2, 2000, in Atlanta, GA; Minneapolis, MN; and Los Angeles, CA. Children aged 11 to 12 years were selected as the audience because of their concern over physical appearance and performance and growing independence away from parents in making decisions abut food and activity. The children in this study were considered by their parents to be “a little chubby” or “somewhat heavy.” Parents, all of whom worked part time or full time, were concerned about their children’s weight. The families were from various cultural and socioeconomic backgrounds.
The interviewer spent 3 hours after school with each family, usually over a meal period. The children were asked to invite up to 4 friends to their homes. In preparation for the interview, the child was asked to keep a diary for 5 days before the session, recording meals, snacks, and activities. The interviewer examined the children’s lives, asking the children, their parents, and their friends about their free time, activity levels, eating habits, and the challenges and implications of “getting fit/in-shape.”
Results
Eating, activity, and lifestyle behaviors Children spent time with friends talking on the phone, hanging out, shopping, and playing outside. They also used computers, watched television and videos, played video games, listened to popular music, did homework, and practiced musical instruments. Even though both children and parents disavowed watching a great deal of television, nearly every child had a television in the bedroom.
Children and parents recognized that being physically active was important to being healthy. However, neither group had an understanding or definition of what constitutes a “fit” or “unfit” child.
The children said they were “active,” but according to their diaries, lifestyles appeared mainly sedentary. Whereas several children were involved in organized sports, others had dropped out when the sport became too challenging or the coach too critical.
The children knew it was important to eat healthfully because their parents stressed it at home and they learned about nutrition in school. However, nutrition teaching appeared to provide little useful nutrition information that the children put into practice. At home, dinnertime was often chaotic and few families had regular mealtimes during the week, Some parents also had inconsistent or permissive policies about eating and snacking and admitted that they found it hard to monitor and control their children’s eating habits.
Credible communications As with other studies investigating changing lifestyle habits, the main question we were interested in answering was, what is it that turns knowledge into behavior? Children expressed a desire to change their eating and activity habits, but indicated they needed help. At the same time, they craved independence from their parents. Many parents were reluctant to take on new “battles,” tending to downplay the problem with the hope that their child would outgrow his or her chubbiness.
Some children and parents recognized the problem of overweight but did not know how to tackle it. Others needed assistance in acknowledging and then addressing the problem. Parents knew they needed to set an example and be committed to the effort, but most had limited time available. Some parents were also overweight and did not feel they could be an example without practicing what they preached.
Children and their parents believed that they need help setting reasonable goals. For children, constant “small victories” would sustain interest and boost self-esteem, and incentives would help them resist overeating and inactivity. Fun and variety were cited as critical factors in maintaining children’s long-term involvement.
PHASE 3: SMALL QUALITATIVE INTERVIEWS TO ASSESS CONCEPTS REGARDING NOTIONS OF OVERWEIGHT
Methods
Utilizing the previous research, a series of concepts were created and presented to participants to determine how to best target and develop messages. The research focused on two aspects: understanding which concepts audiences preferred so that healthful lifestyle messages would be relevant to and motivational for “unfit” children and their parents, and eliciting initial reactions to strategies under consideration for a communications and education project aimed at preventing overweight among children.
Ten small qualitative interview sessions (N=46) were conducted in Chicago, IL, in July 2000. Phase 3 participants were new participants; none participated in Phase 1 of this research. Six of the groups were conducted among children aged 11 and 12 years whose parents perceived them as physically “unfit.” The other four groups were conducted among parents who believed their child was “unfit.” “Unfit” was defined by three questions: rating of activity level, rating of physical height in relation to other children the same age, and rating of the child’s weight in proportion to height. Additionally, parents considered their children to be “a little chubby” or “somewhat heavy.” Again, participants for both the children and parent groups were screened to provide a mix of ethnic, socioeconomic, and other demographic backgrounds.
For each session, concepts reflecting attitudes about achieving a healthful lifestyle were presented and potential strategies and solutions for each concept were introduced. (See Table 1 for details about the most relevant concepts and participant reactions.) For parents, the same children’s concepts were tested, as well as two others: “Lack of time” and “Not satisfied with the job the community is doing.”
All concepts were presented in written form, read aloud, and discussed individually in a rotated order to prevent order bias. Participants were asked to rate the concept on a scale from 1 to 10 to represent how closely the idea represented their feelings. Following the concepts, the strategies and solutions segment was presented, which included a partially developed communications program (Table 2).
Results
Two healthful lifestyle concepts were found to be most relevant and motivational for both children and their parents: “Need attainable goals” and “Self-esteem” (see Table 1).
“Need attainable goals” “Need attainable goals” fostered identification with the idea of making small rather than drastic changes in eating and exercise habits. Children believed the process of losing weight would be more achievable if tackled incrementally. Children were also receptive to having family and friends support their fitness goals, but parents, children said, would need to be positive rather than critical. Children wanted parents to participate in physical activities with them and help them make healthful food choices. At the same time, children did not want “everybody” to know they were making dietary changes or working to improve their fitness for fear of being teased by other kids or being perceived as receiving special attention from teachers and coaches.
Parents applauded the positive and realistic approach suggested by the “Need attainable goals” concept. Most agreed that children need ongoing encouragement and “small victories” to sustain their involvement in getting more fit. Parents said they would appreciate the support of teachers and coaches, but they ultimately felt it was the family’s own responsibility to solve the problem.
“Self-esteem” The “Self-esteem” concept was also very appealing to children. Most admitted they were sensitive about their appearance and did not like their parents nagging them about eating and exercise habits. However, they did want their parents to be more involved and provide better guidance about getting fit and staying fit. Parents agreed self-esteem was a critical issue for children and stated they were often reluctant to confront their children about health habits for fear of damaging that self-esteem.
Other concepts Although “Need attainable goals” and “Self-esteem” consistently emerged as the most important concepts for both children and parents, reactions to the other concepts highlighted important aspects of the communications challenge. For the “Where do I start?” concept, both children and parents said they welcomed more information about how to assess children’s fitness and why eating and exercise habits are important. Children recognized the need for good diet and exercise/physical activity, but said they frequently were stumped about how to get started and what to do.
Parents were defensive when they believed the concepts sounded critical of their parenting skill and priorities, as in the “Problem, what problem?” concept. This suggests that communications strategies should be designed to reassure parents they are doing a good job. The program can assist them with an issue they have already identified. The “question” format used in the “Where do I start?” concept was effective in raising issues for parents to consider without being critical of parenting skills.
Response to strategies/solutions Both parents and children were enthusiastic about the communications program designed to assess reactions to specific program elements, including Web sites for children and parents, a toll-free telephone number, and community support resources (see Table 2).
Children liked the idea of their own Web site that would not necessarily include parents. They also liked having access to information and communicating with other children facing similar challenges.
Children suggested the Web site include a chat room with other children, online support groups and counselors, games teaching healthful habits, nutrition information on kids’ favorite foods, and recommended exercise programs for children their age. Favorite features included questioning celebrities; engaging in minichat rooms with other children; and downloading “cool” music, games, and screensavers.
Most parents felt that a Web site would offer several advantages over a toll-free telephone number, but they were concerned about the reliability of information and protecting their children. Parents liked the idea of a separate section for children and for them.
To extend the reach of the Web site content, other delivery methods and community support resources could provide information through more traditional channels. Children liked the idea of being put in contact with support groups, gyms, and classes. Parents generally liked this approach, too. Fact sheets and referral services for local support groups and resources were of greatest interest.
DISCUSSION
The results from all three phases of our research suggest parent/child cooperation is essential to address physical activity and nutrition concerns. Children appear to lack the parental guidance, role models, and emotional support they desire to help them prevent overweight. Program elements and delivery strategies should incorporate the concepts “Need attainable goals” and “Self-esteem” to maximize reach and impact. Self-esteem issues could be used to motivate children to improve eating and exercise habits. Children and parents also want help setting reasonable goals.
When discussing fitness, children and parents tend to focus more on eating behaviors than on exercise and physical activity. However, research has shown increasing physical activity is an important contributor to long-term weight management (11,14,15). These results suggest an opportunity to educate families about the importance of both halves of the energy-balance equation. To promote physical activity in children, “spontaneous physical activity which is well-integrated into daily life, rather than regimented exercise programs” is recommended (16). Our research corroborates the findings of these studies, suggesting that children do not sustain interest in healthful eating or staying physically active unless activities are varied and designed to be fun.
Children who are targets of weight criticism by family and peers tend to have negative attitudes toward sports and report reduced physical activity levels (17). Our study found that parents want tools for talking to children about improving fitness and providing positive reinforcement about healthful eating and exercise. Likewise, children need messages to motivate change in eating and exercise habits, as well as tips and methods for cooperating with parents to achieve fitness goals. In addition to family, complementary programs in schools and other environments could also help increase chances of success (14).
To be successful, overweight prevention programs must include the family and incorporate the information and support needed (18,19). Studies have shown that direct involvement of at least one parent improves short- and long-term weight regulation (10). The key is implementing programs in the home by both parents and children. Further testing of the family approach concept should be undertaken. In conclusion, many factors contribute to children’s overweight. Our findings suggest the need for parents and children to work together in addressing the overweight prevention issue and the need for effective tools to facilitate this cooperative effort.
LIMITATIONS AND RECOMMENDATIONS
Due to the qualitative nature of our studies, results cannot be generalized to the general population. However, qualitative research is useful because it provides an in-depth view of attitudes and perceptions, as well as possible solutions. In future studies, it will be useful to develop a survey tool to assess the strength and distribution of the attitudes and perceptions related to overweight and healthful weight using statistically valid quantitative techniques. Other socioeconomic and demographic factors may affect perceptions of overweight and furthermore, may influence actual overweight. These factors should be controlled for in future quantitative studies.
APPLICATIONS
Several important issues emerged from our research that provide applicability to communications with children and parents.
* Parents and children need to work together Children and parents must address the overweight prevention issue together and learn how to communicate effectively with each other. Parents need to learn how to talk about eating and exercise habits with their children, avoid arguments on this issue, and help sustain children’s involvement in eating healthfully and staying physically active. For their part, children need direct messages to motivate change in exercise and eating habits, as well as support in learning to cooperate with parents to achieve fitness goals,
* Attainable goals should be set Both children and parents said a positive and realistic approach to getting fit that seems achievable and accessible would assist in efforts. Ongoing encouragement by family and celebrating “small victories” on the road to fitness were seen as essential factors for success.
* Self-esteem issues should be addressed Self-esteem is a tricky issue for children and parents alike and generated strong emotional reactions in our research. Children are sensitive about their appearance, and when parents “nag” them about it, they feel badly. It is imperative that assistance be positive and encouraging, rather than negative and critical. Parents’ ambivalence over dealing with children’s fitness habits underscores the need to provide tools that enable parents to work constructively with children on these issues.
* Tools are needed for promoting fitness Children and parents are looking for support and customized information. The prospect of tapping into support groups, either online or locally, was especially attractive to frustrated parents and children. A Web site that permits children and parents access to information and other people facing the same challenges was thought to be of considerable help. A Web site could also provide dietitians with a tool to help facilitate child-family discussion on nutrition and lifestyle issues, and help dietitians motivate families to begin the process of behavior change.
Table 1
Phase 3 selected concepts tested and reactions by children and parents
Concept title Concept theme for children/parents
Need
attainable
goals
Children If I start watching what I eat and exercising
more to get in better shape, I’ll want to see a
difference right away.
I need goals I can work toward to get in better
shape. Like little steps along the way to keep
me on the right track. And I need help from my
family, friends, teachers, and coaches to help
me change for the better. Otherwise, I’ll just
fall back into my old bad habits.
Parents Changing how much my child eats and exercises
isn’t going to happen ovemight. But kids need
instant gratification. If kids are going to stick
with it, they’re going to need incentives
along the way.
I need to learn how to manage my child’s
expectations about getting fit so they can
realistic about their progress. I need support
from teachers, coaches, and atter-school
programs to make sure my child is surrounded
by positive messages and opportunities for
exercising and eating right.
Self-esteem
Children I’m very sensitive about the way 1100k as it is,
and I don’t need my parents telling me I’m going
to get fat or out of shape if I don’t
exercise more or watch what I eat.
Bringing up the problem of being overweight or
out of shape does more harm than good. Instead
of nagging me about it, my parents just
need to show me what to do.
Parents My kids are at a rough stage in life. They’re
becoming more and more concerned about their
appearance, so they don’t need me telling
them they should watch their weight or get more
exercise, If I’m too hard on them, I worry
that I could trigger an eating disorder. And
with all of the pressure they get from school
and their peers, the last thing they need
is me messing with their fragile self-esteem.
My parents never told me I should change how much
I ate or exercised, and I tumed out all right.
I’m at a loss for how to help my kid.
I wish I knew the magic words that would help.
I keep hoping that as they grow older, they’ll
just figure it out for themselves.
Where do I start?
Children I’m used to grabbing whatever is in the fridge and
plopping down on the couch to watch TV. But
lately my parents have been nagging me about
eating better and getting more exercise.
But where do I start? And what are some small
things I can do to start eating healthier and
getting more exercise?
Parents Changing how much my child eats and exercises is
going to be tough. With so much on TV, being
a couch potato is all too easy. And if I
don’t let them sit around the house and eat the
snacks they crave, they’re just going to get
them somewhere else. It’s my responsibility to
make sure my children develop healthy habits.
But I don’t know where to begin. How can I
motivate them to want to eat right and be more
active?
Concept title Reactions by children/parents
Need
attainable
goals
Children “This one sounded more like, more realistic…like
something my mother would say.”–Boy
“Instead of taking one big, giant step, it makes
it easier, a whole bunch of little steps, but as
you get used to it, you can just make them
bigger and bigger and bigger.”–Boy
“I need support but I don’t want them bugging me
all the time.”–Girl
Parents “I think a lot of it does apply to me and I think
what I have to do is not give in to their begging
for chips or lets go here and eat this kind of
junk food. Sometimes I give in, which is wrong.
But I think that it does take time. It doesn’t
happen ovemight, and you just have to stick with
it.”
“Kids do need support. This is realistic.”
“I like the idea of little steps, but not
relying on others.”
Self-esteem
Children “I feel like I’m being watched whatever I do. It’s
not so much fun.”–Boy
“I don’t want them to nag me, but when I’m going
for the cookies or something and they see me,
say: ‘Oh, there is a bag of carrots over there.
Eat those.’ And then I’ll be reminded.”–Girl
“My mom’s fat, too. I tell her, ‘I got it from
you!’ Girl
Parents “This is right on the money with me. I was talking
about her self-esteem. This really says
everything that is how I feel.”
“It’s basically: This thing is really negative to
me because it is saying be hard on them and
everything else. It’s like somebody telling me
what to do.”
Where do I start?
Children “That’s all me. But I don’t know where to go.”
–Girl “I would like some ideas about what
exercises I should do.”–Boy
Parents “I do know where to begin, but I could use some
help motivating them.”
“They will get defensive. If you mention something
to her, she will jump on me and say, ‘I don’t
need this all the time.'”
Table 2
Strategy/solution components and children’s and parents’ reactions to a
communications program focused on food/nutrition and physical activity
issues
Component Reaction
A communications program
Focused on food/nutrition and physical Children say, “I think it is
activity issues that has an a good idea because people
informational network with several can get a lot of support …
components (toll-free number, Web site, It is something to help you,”
community support resources) –Girl
People interested in learning more “Cool! It would fit your
about healthful lifestyle habits have personal needs,”–Boy
access to specific information Parents say, “At last. Thank
customized to fit personal needs. you!…I’d want a support
group for me and one for the
kids”
“Sounds good, there’s a
variety of ways to reach them
and it’s customized to fit an
individual’s needs.”
Toll-free telephone number
Fact sheets (brochures) on how to Parents say, “It’s nice. You
identify one’s healthful weight and just call and they send you
personalized tips for increasing stuff,” and “I like the fact
physical activity and making healthful sheet … referral to a
food choices dietitian is good.”
Self-assessments of body-image, food,
and physical activity habits
Surveys and polls on the most popular
ways families are incorporating good
nutrition and activity into their lives
Community expert referrals to
dietitians, doctors, and recreation
experts
Clearinghouse of national data/
information on weight management
issues that points users to credible
resources
Web site for children
Current news from popular magazines and Children say, “I would check
shows on health trends it out while waiting for a
download,”–Boy
Ongoing polls on what’s hot and what’s “I would go on that. I would
not in food and physical activities want to go on the Internet
right away and try this out…
it sounds great and it sounds
like fun,”–Girl
Fun postcards to send and share with “I might play on it but I
friends don’t know how to go on the
Internet,”–Girl
Downloads of music and games “Downloads, man, downloads!
Cool! That is so sweet! All
right!”–Boy
Opportunities to question favorite Parents say, “Make it very
celebrities and get tips from their interactive. You could use
workout and eating habits the assessments and then the
Web site produces a
personalized plan for you,”
Q&A on “looking good” health information
Screensavers “I want to know who is there
with the kids.”
Special minichats with other kids on
health and lifestyle topics
Community and recreational programs
Web site for parents
Ask the experts, including Parents say, “This seems
pediatricians, trainers, dietitians, useful … it covers it …
nutrition Q&A on how to tell if your it’s better to have separate
family is at a healthful weight and/or areas for kids and parents.”
fit
Moderated chat rooms with health experts
and other concerned parents
Polls on trends in health
Hot links to health professional sites
and other parent groups (eg, the Parent-
Teacher Association)
Current news and media coverage related
to health issues regarding food and
phyical activity
Testimonials from parents and kids who
are dealing with these same issues
Community support resources for kids
Network of organizations to help you Children say, “Yeah, I would
find the food and fitness programs in go … that’s a nice thing …
your community that are right for you it would offer activities for
and your friends kids,”–Girl
“Like maybe there should be
kid bike tours or swim a mile
or something, just for kids.
Lots of kids would go and you
would make friends,”–Girl
“A gym in our town … or
someplace you could talk to
counselors or meet with other
people who have the same
problems … a library to
check things out,”–Boy
Community support resources for parents
Network of organizations/groups in your Parents say, “You can do it
community that offers the health and together and use it as a
fitness information and programs that bonding experience with your
are right for you child”
“My boy wouldn’t go if he
thought it had something to do
with his weight. It’s a
stereotype, you know, the fat
kids’ camp.”
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S. T. Borra is senior vice president and L. Kelly is director, public health, of the International Food Information Council Foundation in Washington, DC. M. B. Shirreffs is director, Self-care and Health Program at ILSI North America in Washington, DC. K Neville is principal of KLMN Communications, Inc, Chicago, IL. C. J. Geiger is research associate professor, Division of Foods and Nutrition, the University of Utah, Salt Lake City.
Address correspondence to: Susan T. Borra, RD, Senior Vice President, International Food Information Council Foundation, 1100 Connecticut Ave, NW, Suite 430, Washington, DC 20036. E-mail: borra@iftc.org
Copyright (c) 2003 by the American Dietetic Association.
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doi: 10.1053/jada.2003.50140
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