Examination of the association between a child’s health behavior and access to healthy living at home

and their HR, BMI, flexibility and strength measures in 2nd and 3rd graders
Stephanie Birkenstock, Adam Engel, Katie Lorenzi, Josh Merrick, Kalina Myszkowski, Grace Price, Julie Waldie, Ira Gorman
School of Physical Therapy, Regis University, Denver, CO

INTRODUCTION METHODS RESULTS DISCUSSION

• Cohort of overall healthy 2nd and 3rd graders with only 3 
 Over the past 20 years, the prevalence of children who  Subjects:  subjects falling into the at risk or overweight category 
are overweight has become an epidemic, increasing 
by 50% in the United States.1, 2  This trend has proven  Subjects included second and third grade students at  • Percent BMI decreased significantly but can be attributed 
to put children, with increased Body Mass Index (BMI),  The Odyssey School, a DPS charter school that uses  to maturation of the subjects
at serious risk for developing negative or adverse  dynamic expeditionary learning to foster each child's 
• Pre/post-test analysis of the subject’s attitudes 
health implications across the lifespan including: type  unique potential and spirit of adventure.   A total of 54 
students (32 males) from two separate classes,  demonstrated a statistically significant positive trend 
II diabetes, numerous cardiovascular complications,  towards increased physical activity and better eating habits
and early mortality rates. The three major levels that  participated in this study.
we believe contribute to this epidemic are the     • Small sample size and skewed distribution of the outcome 
individual factors, the physical environment (i.e.,  variables prevented the finding of significant regression 
* Indicates p <.05
school and home) and the social/cultural environment.  
Pre-Test EDUCATIONAL PIECE Post-
Test
models
Shuttle
Heart Health Education
This said, it has been noted that increased physical   
run

Nutritional Reflection
Shuttle
run
HR/HT/WT
activity cannot only reduce children’s BMI, but reduce  Pre-
Curl up Importance of Physical Activity
HR/HT/WT Post-

the numerous corollary health conditions associated 
Test
Survey Shoulder
Flex
Pro-section of human, cow and
Curl up

Shoulder
Test
Survey CLINICAL RELEVANCE
sheep hearts/lungs
with high BMI.  It is further evident that performance  Sit and
Reach
Flex
•Physical therapists have a role in health education 
Sit and
gains in the areas of strength, power, speed,  Vertical
reach
within the community
Jump Vertical
endurance, coordination, and agility have been  Jump

associated with increased physical activity in children.  October April •Beginning health and wellness education at a young 

2007 2008
age could have beneficial effects on subjects’ attitudes 
Procedures: towards a healthy lifestyle

• We worked in collaboration with the faculty  at Odyssey  •Future studies should consider…
to enrich the student’s learning experience on various  • Larger sample size, different age groups, more 
health-related topics diverse SES, longer period for follow-up, and/or 
more active intervention
• Distributed initial survey that was completed at home  • Analysis of covariates as stated above and 
with parents included validated questions regarding  control for other possible confounders
physical activity levels, attitudes about health, nutrition,  • Clustering of tests to more effectively determine 
and environment fitness level of subjects

• Performance tests and measures administered to the 
Purpose: children including:  shuttle run, vertical jump, curl-up, sit 
and reach, push ups, and shoulder flexion Percentile BMI

To examine the association between a child’s health  8

behavior and access to healthy living at home and their  • Educational segments included: 7

HR, BMI, flexibility, and strength measures.  Additionally,   • Small group discussions about nutrition and  6
5

to determine if an educational-based intervention for  physical activity 4

second and third graders would result in improved  • Pro-section observation of human, cow and sheep  3
2
attitudes towards exercise, physiological measures, and  hearts and lungs 1

physical performance.  As a result, we hope to further  • Instruction on self monitoring HR 0
>5 5--10 11--20 21-30 31-40 41-50 51-60 61-70 71-80 81-84 >85

Percentile BMI
identify appropriate interventions for battling the epidemic 
of childhood overweight as well as contribute to the  • Data analysis conducted: 2
Post Test Data Regression Analysis with r Values
• Descriptive statistics to define demographics   Acknowledgements :
evidence detailing the effectiveness of school-based  Percent BMI Shuttle Run Curl Ups Vertical Jump
We would like to thank the 2nd and 3rd graders of Mr. Andy and Ms. Kathi’s 
intervention programs. • Paired t-test to determine if significant differences  Performance Measures 0.131 0.454* 0.328* 0.311* classes, Amy Hammerich, PT, DPT, and Ira Gorman, PT, MSPH.
pre- post-test existed Nutrition 0.07 0.077 0.127 0.169 References :
• Linear Regression models to determine if certain  Multimedia Usage 0.193 0.016 0.107 0.079 • Snethen JA, Broome ME. Weight, exercise, and health: children's perceptions. Clin Nurs Res.
Health Attitudes 0.088 0.197* 0.144 0.137 May 2007;16(2):138-152.
behaviors or attitudes predicted the various  • Center for disease control and prevention: BMI. May 2007;
*significant to p<.05
outcome variables http://www.cdc.gov/nccdphp/dnpa/bmi/childrens_BMI/about_childrens_BMI.htm. Accessed
July 15, 2007.