Alexandra Woodruff, a first-grade student at Fall Hamilton Elementary School, is weighed by Vanderbilt School of Nursing student Danielle Levison.The nursing students are helping to collect the body mass index of elementary students at the school during their community health rotation.
photo by Dana Johnson
VUSN program takes on obesity in schools
Nurses at one of the Vanderbilt University School of Nursing's School-Based Health Centers are tackling a big problem in Tennessee — obesity in children.
Information from the National Health and Nutrition Exam Survey shows about 10 percent of children ages 2-5 and 15 percent of children ages 6-19 are obese, and the percentages have more than doubled in the last two decades. Experts at Vanderbilt say Tennessee's numbers match those national statistics.
Patti Scott, who has a master of science in Nursing, has been the nurse practitioner in VUSN's Jane McEvoy School-Based Health Center at Fall-Hamilton Elementary School for 10 years and has seen the problem first-hand. That's why she decided to start recording the body mass index or BMI of every student in the school. “Last year's numbers show 22 percent of the children were already overweight. Ten percent were at risk for becoming overweight, and 62 percent were normal weights for age and gender,” said Scott. “We do indeed have a serious problem here, and we look pretty much like the rest of Tennessee.”
Sandra Moorman, principal at Fall Hamilton Elementary School, said the school is committed to working with Scott and parents to help the children become healthier and turn things around. “Supporting students to lead physically active lifestyles and do at least 45 minutes of physical activity daily helps them grow up to become active, healthy adults,” said Moorman.
Community Health students at the Vanderbilt School of Nursing, Theresa Hook, a registered nurse at Fall Hamilton, and a Vanderbilt Ingram Scholar are working with Scott to collect this year's BMI figures for each student at the school during P.E. classes at Fall Hamilton. They calculate the BMI using height and weight measurements. Scott hopes their work will help teach children ways to fight obesity and maintain a healthier lifestyle. “We send home the results to parents and make recommendations based on those results. We suggest they make an appointment to see their primary care provider, get involved in a program to focus on fitness, and send home a booklet from the Centers for Disease Control and Prevention helping explain ways to work on the problem as a family,” said Scott. Hook and Vanderbilt nursing students also teach the American Heart Association's “Heart Power” program in every class in the school.
Tom Cook, Ph.D., R.N., professor of Nursing and Director of School Health at Vanderbilt Children's Hospital, is known for his work to target obesity in school children. He said Scott's work at Fall Hamilton is crucial. “It is so important to help parents have some sort of objective measure of whether their child is overweight,” said Cook. “Of course parents see their child, but they don't necessarily know what constitutes being overweight. Many parents think unless a child is being picked on they don't have a problem, or they will grow out of a weight problem.” But Cook says children who are heavy during early childhood, between the ages of 5 to 7, and during pre-teen years tend to keep their weight into adulthood. “The overweight child becomes the overweight adult.” He says parents can help break the cycle of obesity by increasing activity levels and decreasing the fat and sugar content of a child's diet. “You can do something small like this to make a big impact.”
It's a good place to start, but Cook said Tennessee has a lot of work to do. The volunteer state ranks ninth in the nation for the number of adults with type II diabetes, which can be directly linked to being overweight. “Though genetics is important, environment plays a key role in the development of overweight,” said Cook.
State Sen. Raymond Finney, from the eighth district, and also a physician, strongly supports Scott's work and the example the School of Nursing is setting in partnership with Fall Hamilton. He has proposed legislation which would require school children in Tennessee to have their BMI measured, with parental consent, and a health report card of sorts would be given to parents. “The health report card would be sent home by mail and include interpretations about the child's BMI, offer interventions, and would presumably try to mention the kinds of health problems that are a result of prolonged obesity,” said Finney. “I commend Vanderbilt's efforts and look forward to seeing some of these results. I think it's a worthwhile effort and service to our public schools and this ties into what we're trying to do on the state level.” The legislation is backed by the Tennessee Nurses' Association, the Tennessee Medical Association, and the Tennessee Association of School Nurses.
GirlForce, a health risk prevention program for adolescent and pre-adolescent girls offered by Vanderbilt Medical Center, is also working to target obesity and other health problems at Fall Hamilton. Program Director Susan McDonald says every Metro School Health Nurse has been trained to implement the curriculum. “One of the greatest benefits of GirlForce is that it requires the active participation of adults, parents, teachers and volunteers, who model the type of behavior they would like to see in kids,” said McDonald. “Teaching by example gives adults credibility and sends an important message, that physical activity is a lifelong pursuit.”
Scott said she hopes recording the BMI of each child, following up with their parents at home, and offering the school-based educational programs will increase community awareness that this is a significant problem for children in Tennessee, and more work is needed at school and at home. “The primary key is that we hope to promote healthy lifestyles to all children and families, not just those who are overweight or at risk for becoming overweight.”