Obesity is a complex health problem that results from a combination of factors including genetics, physical inactivity, dietary patterns, and use of medications, among others (CDC, n.d.). It is a growing epidemic and has been recognized as a serious public health concern worldwide. In fact, according to the World Health Organization, worldwide obesity almost tripled between 1975 and 2016 (WHO, 2020). More specifically, more than 1.9 billion adults were overweight in 2016 and, of these, 650 million were considered obese (WHO, 2020). It is important to address this public health issue as obesity is a major risk factor for many leading causes of death including cardiovascular disease, stroke, diabetes, and cancer (CDC, n.d.).
Data from the National Health and Nutrition Examination Survey revealed that the prevalence of obesity among adults aged 20 and over in the U.S. was 42.4% in 2017-2018 (Hales et al., 2020). Furthermore, in 2016, 27% of adults aged 20 and over in Orange County, Florida self-reported having a BMI greater than 30 (CDC, 2017). These statistics are alarming and reflect the need for immediate action. Evidence has shown that adolescents who have experienced an adverse childhood experience (ACE) are “1.2, 1.4, and 1.5 times as likely to have overweight, obesity, and severe obesity, respectively, compared with their peers with no ACEs” (Davis et al., 2019). Since ACEs are known to increase the risk of obesity, obesity prevention programs should be designed using a trauma-informed approach (Felitti, 2002).
This intervention aims to use a trauma-informed approach to prevent obesity in individuals aged 18 and over who are overweight, have experienced at least one adverse childhood experience (ACE) and currently live in Orange County, Florida. This will be accomplished through a multidisciplinary approach, providing services pertaining to health care, nutrition, physical activity, and mental health. In addition, this intervention will utilize a public health framework as it will aim to prevent obesity in high risk individuals, thereby reducing the incidence and prevalence of obesity in the United States (Philanthropy Network Greater Philadelphia, 2016). Since individuals in the target audience are already overweight and have a history of adverse childhood experiences, they are at high risk of developing obesity. For this reason, this program has been designed as a secondary prevention program (Philanthropy Network Greater Philadelphia, 2016). As such, program activities will aim to improve participants’ dietary habits, physical activity levels, and self-monitoring skills to promote healthy weight loss and prevent obesity.
Our project will also utilize the CDC’s social ecological model as a framework for the prevention of obesity in high risk individuals. This four-level model allows us to understand the complex interaction between a range of factors and how they can put individuals at risk for obesity or protect them from it (CDC, n.d.). Project activities will focus on addressing the individual and relationship levels of the CDC’s social ecological model and will aim to have an impact on participants’ skills, knowledge, attitudes, self-efficacy, and behaviors in order to promote healthy weight loss and lifestyle changes.
Since our intervention will utilize a trauma-informed approach, we will incorporate various trauma-informed principles into our program. The key principles that will be built into our program are safety, trustworthiness and transparency, peer support, and collaboration and mutuality (SAMHSA, 2014). Safety will be addressed by providing staff trauma-informed training and by ensuring that program staff and participants feel physically and psychologically safe (SAMHSA, 2014). In addition, safety will be built into our program by ensuring that the physical environment where project activities take place is safe and welcoming and avoids re-traumatization of participants. Trustworthiness and transparency will be incorporated into our program by ensuring that program participants are properly informed about the program and its goals. Staff will work diligently to seek feedback from participants regarding project activities. The principle of peer support will be addressed in our program through visits to community parks and farmer’s markets where program participants will have the opportunity to develop social ties among themselves. Lastly, collaboration and mutuality will be built into our program by encouraging participants to take leadership roles and assist program staff with project activities. This principle will also be addressed by allowing participants to provide feedback to staff and by ensuring that program staff and target audience members who volunteer to form part of the leadership team undergo trauma-informed training.
References
Centers for Disease Control and Prevention (n.d.). Adult Obesity Causes & Consequences. Retrieved from https://www.cdc.gov/obesity/adult/causes.html
Centers for Disease Control and Prevention (2017) National Center for Chronic Disease Prevention and Health Promotion. Source geography: County. Retrieved from https://sparkmap.org/
Centers for Disease Control and Prevention (n.d.). The Social-Ecological Model: A Framework for Prevention. Retrieved from https://www.cdc.gov/violencepr...ecologicalmodel.html
Davis L, Barnes AJ, Gross AC, Ryder JR, Shlafer RJ. Adverse Childhood Experiences and Weight Status among Adolescents. J Pediatr. 2019 Jan;204:71-76.e1
Felitti V. J. (2002). The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead. The Permanente journal, 6(1), 44–47
Hales CM, Carroll MD, Fryar CD, Ogden CL. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db360-h.pdf
Philanthropy Network Greater Philadelphia. (2016). Trauma-Informed Philanthropy: A Funder's Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley. Retrieved from https://www.unitedphilforum.or...ma-informed-practice
Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, 2014. Retrieved from https://ncsacw.samhsa.gov/user...es/SAMHSA_Trauma.pdf
World Health Organization (2020). Obesity and overweight. Retrieved from https://www.who.int/news-room/...esity-and-overweight
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