Yale-Griffin Prevention Research Center Tackles Childhood Obesity

May 14, 2018 | Ioana Ungureanu, Beth Comerford, Kim Doughty

State health leadership can play a key role in the prevention of childhood obesity by partnering with educational systems, community stakeholders, and the private sector to implement cross-cutting programs. The Yale University Yale-Griffin Prevention Research Center (PRC) is tackling this issue through Community Health Opportunities Organized with Schools at the Epicenter (CHOOSE), a multi-partner and multi-level intervention for communities in Connecticut. CHOOSE is a five-year Community Based Participatory Research (CBPR) intervention, funded by CDC, designed to improve nutrition, physical activity, cooking skills, academic performance, and body measurements in school-aged children and ultimately all members of target Lower Naugatuck Valley communities.

Yale-Griffin PRC is part of a network of 26 funded CDC academic research centers that partner with communities to translate research into effective public health programs. As Beth Comerford, deputy director of the Yale-Griffin PRC explained, the “infrastructure of the PRC network is ideal” for translating and disseminating research into practice.

Partnerships to Prevent Childhood Obesity 

The partnership essential to the implementation of CHOOSE started in 2011 when Yale-Griffin PRC and five Lower Naugatuck Valley school districts convened a community meeting to address childhood obesity in Connecticut communities. Comerford recalls “one of the assistant superintendents commenting that he thought it was striking that school districts who normally see themselves as adversaries on the football field were coming together with the common interest to address childhood obesity and advance health promotion in schools.” The meeting, coordinated by the Yale-Griffin PRC, addressed available resources and best practices for preventing childhood obesity at the local, state, and national levels. However, “ownership within the community” dictated how they would work with partners to address the issue at the local level.

The partnership for the CHOOSE project, coordinated by the Yale-Griffin PRC and championed by local school districts, has since developed into a community advisory board comprised of representatives from various stakeholders, including: Yale-Griffin PRC, Griffin Hospital, Naugatuck Valley Health District, Valley YMCA, Naugatuck Valley Council of Governments, Massaro Community Farm, Shop Rite Supermarket, and Naugatuck, Ansonia, Derby, Seymour, and the Shelton Public Schools school districts. The Yale-Griffin PRC serves as a “gate-keeper for potential partners” ensuring that the mission of each potential partner fits with the mission of participating school districts to advance health promotion and prevent childhood obesity.

The local Naugatuck Valley Health District and school superintendents were key in championing implementation of cross-cutting community and school interventions. Through the Community Based Participatory Research (CBPR) approach, all community stakeholders work collaboratively to determine which evidence-based or promising interventions will be implemented in their communities.  

Implementing CHOOSE

The Yale-Griffin CHOOSE core research delivers health messaging programming in five school districts through a multi-pronged collaborative approach by delivering a variety of programing within schools and the community. The school districts work with the community advisory board to deliver a variety of programming, which can include: evidence-based programs, school gardens, cooking classes, kinesthetic classroom equipment such as standing desks, farm-to-table education, and fitness competitions.

The Yale-Griffin PRC offers training on evidence-based programs to serve as a “foundation for schools to build on.” Educators within communities are trained to deliver ABC for Fitness and Nutrition Detectives programing. Nutrition Detectives, developed by the Yale-Griffin PRC in 2002, is designed to improve nutrition knowledge. ABC for Fitness, developed in 2006, aims to add short activity bursts during the educational day. Previous studies completed by the Yale-Griffin PRC have demonstrated that ABC for Fitness improves measures of physical fitness and medication use for asthma, while Nutrition Detectives improves food label literacy.

Although training and resources are provided to school districts, Kim Doughty, a research associate at Yale-Griffin PRC, indicated that flexibility and a multi-pronged approach are keys to successful implementation: “We’ve let them decide what their priorities are, and we just help them achieve their own goals, as long as it falls under our mission of improving nutrition and physical activity." The PRC is evaluating the effectiveness of the CHOOSE intervention by tracking student BMI, physical fitness scores, classroom behavior, attendance, as well as physical activity and food preferences.

Impact and Translation of Yale-Griffin PRC Research

What differentiates CHOOSE from other health promotion programs is that it is a multi-pronged approach that engages the community, allowing for greater flexibility when it comes to replication. CHOOSE builds on the multisite translational community trial model in which a standard intervention is adapted to multiple diverse community sites, increasing uptake and impact. The CHOOSE intervention is designed to work with existing community infrastructure, building on community partnerships to increase capacity and sustainability within communities. The model also emphasizes reinforcing health promotion messaging through various interventions while allowing flexibility for schools to pick interventions.  

Comerford and Doughty ultimately hope that CHOOSE will improve the health of target communities. “By improving diet and increasing physical activity, risk of many chronic diseases should be reduced,” they explained. “We hope that other schools will choose to replicate the specific components of CHOOSE that are relevant to them and that community health organizations will consider developing similar multi-pronged, collaborative approaches to prevent obesity and chronic disease.”

State health leadership can learn from the Yale-Griffin PRC, particularly as it relates to support for the development of community-based partnerships and multi-pronged interventions to reduce childhood obesity. Involving communities in the process—and having educational leadership champion the interventions—can lead to successful implementation.

Additional information about the Yale-Griffin PRC programming can be found on the Connecticut State Department of Education website and the Yale-Griffin PRC resources page. Read more about the Yale-Griffin PRC’s prevention research and visit CDC’s Prevention Research Centers website for more tools, resources, and success stories.