|
Following one and a half year’s research with family practitioners, paediatricians, specialists, nutritionists, policy makers, educators and parents, our research showed that little else existed and that most community centres, after-school programs, one-on-one fitness trainers and more recently kids’ gyms (dancing mats and video games) may work for the general youth population, but not for the overweight child. Availability of physical recreation may not be the problem in meeting the needs of inactive, overweight children.
Reversing the present trend
MobilizeYouth is a for-profit, 16-week, non-clinical program designed specifically for overweight and obese youth, 7-16 years, and their families. The program offers 90-minute sessions, of which 50 minutes is spent three times weekly on rigorous fitness – weight training, spinning, running track, cardio circuit and non-competitive sports and hiking. Sessions include guidance to parents through meal planning adapted to the individual family dynamic. Nutrition sessions for youth and teens provide the tools to make better eating choices, examining the barriers each youth faces, media awareness and self-esteem exchanges.
Typical participants are inactive, overweight bordering on obese, have low self-esteem and sleep issues, and, in all cases, have dismally poor eating habits. For most families, visits to the family doctor or dietician; enrolling at the local Y or engaging a personal trainer have proven futile. Parents are also grateful to place their child with ADD, ADHD, Autism and other health issues in the program. Surprisingly, these youth thrive because they are not treated as ‘special needs’, but because they are expected to perform along with everyone else. In cases of extreme emotional or psychological situations, the family usually seeks outside help.
MobilizeYouth is not clinical which is key to its success: participants are not sick, but lack self-confidence, experience bullying, have little stamina for physical activity and eat poorly. Not much else exists in communities closer to home where these kids could share this complex experience of support, fitness and dietary change with like peers.
Our experience tells us that the combination of peer group, high performance expectations, persistent motivation and a hard work ethic instilled by Phys Ed and Kinesiology coaches committed to the cause works exceedingly well. The effort is labour intensive. For instance, monthly assessments provide a guide to progress but because the focus is not on weight, but on healthy living, empowerment and change, it often happens that assessments may be delayed for individual reasons.
MobilizeYouth is located in Toronto at the Columbus Centre which operates under the umbrella of the Villa Charities organization which is a large network of services for families, seniors, and children. Following a year and a half in a private facility, the move to the Columbus Centre - a family-centred community centre with excellent facilities has helped the program to evolve to a level where there is now an advanced group of fit teens, a weekend maintenance program, nutrition on-on-one guidance for teens and high performance summer boot camp.
High Retention; Successful Outcomes
Recent studies (Pediatric Management of Child Obesity) have shown that the cornerstone to success for child obesity is the lifestyle modification of physical activity and dietary habits.
Upwards of 90 kids have come through MobilizeYouth during its after school/weekend and summer boot camp program over two and a half years. It is the program’s personal caring approach beyond fitness and diet that has led to repeat customers and solid retention.
Around 40% succeed, dropping waist inches, showing signs dietary change and greater self- confidence and a renewed willingness to try activities outside the program. MobilizeYouth teens have taken part in 10km. walk/runs in city-wide fundraising events, many have started biking overcoming balance and fear issues, joined school teams, kept up with a gym routine, renewed a family commitment to activity and lost weight. MobilizeYouth retention is high - most stay longer than the four months.
Success occurs when there is strong support from parents, particularly when moms attend the meal planning sessions; engage in fitness (parents whose children are in the program pay half the monthly membership gym fee in a special arrangement with the Columbus Centre), and, attendance is consistent.
Coaches
Most MobilizeYouth coaches remain with the program longer than a year and now assist in recruitment and training. Initially joining the staff as student placements, volunteers and assistant coaches, they come with the right mentality, athletic backgrounds, experience in coaching sports and swim instructor certifications from over four Ontario universities with physical education and kinesiology faculties. These coaches are part of a unique group who now have experience in coaching overweight and obese youth – vastly different from coaching kids in the general population.
The Collaborative Required to Combat Obesity
Parents
The commitment to driving, conflicting schedules and cost have prevented many parents from enrolling their child. Compounding their reluctance is the lack of a doctor referral, resistance to change within the family and often parents’ own need to lose weight.
It is often pointed out the program will give their child the self-confidence and the skills to prevent a lifetime of yo-yo dieting and that the cost of the program is a lot less than fast food, nutritionists’ fees, gym memberships, weight watchers and doctors’ costs related to weight illness.
Many parents insist they eat healthy and have no idea where their child’s weight gain comes from. The number of calls reaching out with a similar story is four times higher than enrolment in the program. Besides the more emotional and personal pressures the program may place on the family, we may see this as an important investment in a child’s health, but many parents are reluctant to absorb the cost and OHIP, (Ontario’s Health Insurance Plan), is nowhere in sight to help parents seeking help for their obese child.
Up to one third of the MobilizeYouth program cost can be put through most insurance plans. Yet, only two families in two and a half years have put half the program cost through workplace nutrition counselling benefits.
The American Medical Association has also identified a lack of payment by most health insurance and managed care plans for obesity-related treatment programs as a barrier to obesity management. There is less coverage for the treatment of obesity than for the care of other chronic medical conditions.
Insurance companies have no employee coverage for weight loss treatment for child obesity. Yet, there is a prevalence within the overweight adult population of obesity related illnesses and treatment expenditures, depression and counselling which will significantly increase as this demographic reaches adulthood.
The Canadian Children’s Fitness Tax Credit
In 2006, the federal budget proposed the creation of a Children’s Fitness Tax Credit to cover eligible fees up to $500 for enrolment in a physical activity program, effective January 2007. The purpose of this credit is to facilitate access by children and youth to physical activity and recreation programs, as a means of helping them maintain a healthy active lifestyle. Many families who come to us cannot afford the initial program outlay over four, six or eight months that may be required for lifestyle change, and so not even a small rebate is seen as beneficial.
Doctors
Paediatricians, frustrated at years of failure in improving the situation for their young overweight patients, have hesitated to make referrals to MobilizeYouth in the absence of proven track record and because of the cost.
Physicians
In the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children, we learn that only about 40% of obese people receive recommendations from their physicians regarding weight loss and weight loss maintenance even if they have comobidities (e.g. diabetes and hypertension). In addition, the medical profession is failing to counsel young, disease-free adults and those in lower socioeconomic groups.
During the last decade, eight studies revealed a lack of knowledge about nutrition were major barriers preventing American primary care physicians from providing nutrition counselling to patients. Only 4.5% of family practitioners and 36.4% of endocrinologists reported ‘any specialty training related to obesity. It is no wonder that generations of overweight children have been overlooked.
Schools
Some effort has been made in the schools on the part of teachers, organizations and government promotion towards healthy eating and getting kids active. But, most of the same conditions still exist: Sports and gym programs are uneven or often elitist and, despite calls to the contrary, cafeterias have done little to remove junk food. Some schools may offer healthier choices right alongside pizza, hamburgers and fries, but, after huge cost and fanfare, studies in over 50 U.S. schools in 2007 concluded that availability of healthy foods in school cafeterias has failed as an experiment because the option to eat fast food has remained. Where fast food is not served in the schools, a Harvey’s or McDonald’s or Wendy’s can be seen a block away.
Ministry of Health
We maintain that the lack of available, accessible, affordable programs makes lifestyle change for thousands of overweight and obese youth impossible. Ministry of Health funds are directed to obesity prevention programs and promotion of active healthy eating targeting mainstream youth - bypassing the neediest. The Ministry’s online promotion and access to a dietician is a step, but it cannot match the insurmountable effort it really takes to address this issue.
MobilizeYouth doesn’t fall within the Ministry funding guidelines of primary prevention or not for profit status. Yet the program spends an inordinate amount of skill and effort stopping the weight gain, making accessible peer fitness and family nutrition which actually prevents obesity in many participants who are marginally overweight.
MobilizeYouth: Accessible, Affordable and Available throughout communities
The vision is for an industry-wide collaborative effort allowing for the implementation of MobilizeYouth in community centers across Ontario through a special Obesity Fund and Licensing Arrangement underwritten by private-public partnerships.
There would be the Ministry of Health Obesity Matching Dollar Fund for families unable to afford the cost along with a Licensing Arrangement underwritten by private sector. MobilizeYouth team would implement the program in community or private membership centres willing to commit. Through the Operations & Program Manual providing day to day guidance, MobilizeYouth would also make available all coach training and information as to staff sources, marketing, media and print materials; design, grant and sponsorship packages and much more. The MobilizeYouth team would continue to guide the program for up to a designated and agreed upon time.
MobilizeYouth is proven, scalable and transportable. Surely, the severity of child obesity warrants some consideration of options beyond conventional thinking. For practitioners interested in hearing our kids’ voices and seeing how the program works, a visual presentation of media clips is available along with along with a package of print materials.
Compared to the future toll on healthcare, families, workplace and individual lives, the MobilizeYouth licensing package would be way less costly: community centres buying in to the Program would ensure access to a multi-disciplinary fitness & nutrition program for the greatest number of families needing special support for their child.
Health Practitioners and community centre managers are welcome to visit the program. Dina Lieberman Founder MobilizeYouth
|
button (top left)