LAUSD Hunger Study: A Cross Section Survey. In 1998, Dr. Wendy Slusser and UCLA colleagues undertook a landmark study to establish the prevalence and severity of nutrition problems among low-income elementary-school-age children in the LAUSD. Although the impetus for the study was a report of hunger in school-age children, more than 35% of the sample was found to be at-risk for becoming overweight or overweight according to BMI, with the highest prevalence found in the Latino and African-American children (Slusser, Cumberland, Winham et al, 2005). As a result, the Nutrition Network Project was launched in LAUSD, attracting more than $50 million to the district to promote education about nutrition and physical activity.
LAUSD Salad Bar Program and Evaluation: Research Stimulating Action. In response to the findings of the 1998 Hunger Study, LAUSD placed salad bars in three elementary schools as a pilot program to increase consumption of fruits and vegetables (FV) and combat obesity. Evaluating the results, Dr. Slusser and UCLA colleagues found FV consumption increased from a frequency of three to more than four FV. (Slusser, Neumann, Lange, & Cumberland, 2007). As a result, there are 60 salad bars in LAUSD schools. In addition, Dr. Slusser has worked closely with the Director of LAUSD new construction to ensure that the schools have the design plans to support salad bars as part of the school lunch program. The results of the study have attracted much media attention including feature stories on NPR Morning edition and the Jim Lehrer NewsHour.
Nutrition Friendly Schools and Communities (NFSC) Development. The aim of this study is to develop a comprehensive environmental model to address the health needs of LAUSD elementary school children by improving their nutritional status. The pilot study has demonstrated success in involving school and community stakeholders, including local parks and recreation staff, community health providers, parents and farmer's markets to improve the school environment and support healthy eating and physical activity (Slusser, et al, 2004; Vecchiarelli, et al, 2005). Major outcomes include a tool kit and extension of the work in LAUSD to conduct a worksite wellness study in LAUSD.
Quality Care Improvement of Nutrition and Physical Activity in Primary Care. The research team has also been working in a primary-care setting - the Venice Family Clinic (VFC) - to address problems of poor nutrition and physical underactivity in predominantly Latino families living in low-income households. Systems are currently being established to improve overweight pediatric tracking; through advocacy, Dr. Slusser has ensured that VFC patients had affordable access to a high-quality weight-management program. (NICHQ presentation in March, 2008, Slusser, Cameron, Rosales, 2008). Through this work, a clinical tool has been developed that is demonstrating at the largest free clinic in the U.S. to be effective in helping to reverse the trends of overweight.
Nutrition Network Evaluation. Dr. Slusser and UCLA colleagues have been evaluating the nutrition-network program for LAUSD since its inception in 2001 (Prelip et al, 2006). With a grant from the United States Department of Agriculture (USDA) through the California Department of Health Services, and in-kind district contributions through staff time, the LAUSD established the LAUSD Nutrition Network in October 2000. The Nutrition Network goal is for children to eat the recommended amount of fruits and vegetables, and participate in 60 minutes of physical activity, each day. As a result of this work, LAUSD is focusing more efforts on outreach and education of parents.
Pediatric Overweight Prevention Through Parent Training. Dr. Slusser conceived this program with UCLA colleagues to develop an innovative intervention to prevent overweight in Latino children ages 2-4 years old, combining evidence-based prevention programs with evidence-based parent-management skills instruction. The parent-training program involves 1.5-hour classes held once a week for seven weeks, and is designed to integrate nutrition and physical-fitness education. It is taught at the Venice Family Clinic and it has recently expanded to community sites. The intervention was presented at the 0-3 Conference in December 2007.
Increasing Children's Fruit and Vegetable Consumption in Title 1 Elementary Schools: A Pilot Program. Only 21% of California children ages 9-11 eat five or more servings of fruit and vegetables per day, with daily servings averaging 2.7. Diets high in a variety of fruits and vegetables not only help in weight management but also help reduce the risk of some cancers, cardiovascular diseases, stroke and Type 2 diabetes. This project increased the availability and accessibility to fruits and vegetables during the lunch period of four elementary Title I schools in Los Angeles. 24-hour food recalls, weight and height measurements and knowledge, attitude and behavior questions were asked to more than 600 fourth and fifth graders before and after the introduction of the fruit-and-vegetable bars. The intervention was presented at the NICHQ Conference in March 2008.
Quality of Life of Overweight Youth: Multicultural View (R01-DK071101). Dr. Leo Morales, M.D., Ph.D., is an associate professor of medicine and public health at UCLA and the UCLA principal investigator of a NIH-funded multi-site study to develop a multicultural quality of life (QoL) instrument specific to overweight adolescents (ages 11 to 18 years) for use in evaluating weight-management interventions in clinical research. The study sites include: University of Washington, UCLA and the Mexican Institute for Social Security (IMSS), located in Cuernavaca, Mexico. As of April 1, 2008 the new QoL instrument will be available to investigators for use in clinical research. To make inquires or for more information about the study, please contact Dr. Donald Patrick at donald@u.washington.edu or Dr. Morales at lsmorales@mednet.ucla.edu.
UCLA Study of Obesity Among Mexican-American Children. With support from the Diana, Princess of Wales Memorial Fund, James McCracken, M.D. (principal investigator) and Amanda Drews, Ph.D.(Co-PI), have undertaken a study of the genetic, familial, psychological and social factors implicated in the high rates of childhood obesity and its co-morbid conditions among Mexican-American youth, ages 6-11, in the East Los Angeles area. Drs. McCracken and Drews continue to actively recruit overweight and normal weight participants through a UCLA satellite office in Huntington Park, CA. For more information about the study, please contact Patricia Reyes at 323-586-1102 or patreyes@mednet.ucla.edu.
