Effect of participation in a park-based afterschool program on cardiovascular disease risk among severely obese youth

E M D'Agostino; H H Patel; E Hansen; M S Mathew; M I Nardi; S E Messiah

doi:10.1016/j.puhe.2018.02.025

Effect of participation in a park-based afterschool program on cardiovascular disease risk among severely obese youth

Public Health. 2018 Jun:159:137-143. doi: 10.1016/j.puhe.2018.02.025. Epub 2018 Mar 27.

Authors

E M D'Agostino¹, H H Patel¹, E Hansen¹, M S Mathew², M I Nardi¹, S E Messiah³

Affiliations

¹ Miami Dade County Department of Parks, Recreation and Open Spaces, University of Miami Miller School of Medicine, Miami, FL, USA.
² Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
³ Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: smessiah@med.miami.edu.

PMID: 29599055
DOI: 10.1016/j.puhe.2018.02.025

Abstract

Objectives: The prevalence of severe obesity in youth is rising, despite reports of obesity rates stabilizing overall. While reports on treatment outcomes for youth with severe obesity (bariatric surgery, behavioral and pharmacological treatments) exist, very few community-based programs have reported changes in health outcomes in this population. We assessed changes in cardiovascular health risk profiles among racial/ethnic minority youth with severe obesity who participated in Fit2Play™, a park-based afterschool health promotion program.

Study design: A longitudinal cohort study.

Methods: Children aged 6-14 years (N = 1546, 51% Hispanic, 44% non-Hispanic black) who participated in the Fit2Play™ in one of 34 urban park sites for one school year over five separate school years (2010-2015) had height, weight, four-site skinfold thicknesses, systolic blood pressure (SBP)/diastolic blood pressure (DBP), fitness tests, and a health/wellness knowledge test collected at the beginning and end of the school year. Two-level repeated measures mixed models examined changes in cardiovascular health outcomes (body mass index [BMI], skinfold thickness, systolic/diastolic blood pressure percentile [SBPP/DBPP], cardiorespiratory fitness [PACER]) in youth with severe obesity over 1- and 2-year follow-up.

Results: Compared with baseline, BMI decreased 13% (incidence rate ratio [IRR] 95% confidence interval [CI]: 0.83-0.90), sumof skinfold thicknesses decreased 5% (IRR 95% CI: 0.91-0.99), SBPP decreased 5% (IRR 95% CI: 0.90-0.99), DBPP decreased 19% (IRR 95% CI: 0.77-0.86), and PACER scores increased 12% (IRR 95% CI: 1.0-1.27) after two years of participation in the Fit2Play™ program.

Conclusions: Findings here support community/park-based youth programs as effective and accessible treatment options for reducing cardiovascular disease risk among youth with severe obesity.

Keywords: Cardiovascular risk; Community-based; Extreme obesity; Prevention; Severe obesity; Youth.

Publication types

Evaluation Study

MeSH terms

Adolescent
Cardiovascular Diseases / prevention & control*
Child
Female
Humans
Longitudinal Studies
Male
Parks, Recreational*
Pediatric Obesity / therapy*
Program Evaluation
Risk
School Health Services*
Severity of Illness Index