Daily Independent (Ashland, KY)

February 21, 2013

Taking a bite out of APPLE

Carrie Stambaugh
CNHI News Service

ASHLAND — A grant from a national pharmaceutical company will help 500 local children improve their cardiovascular health and set them on a path for lifelong health.

Today, officials from the Ashland-Boyd County Health Department will travel to Charleston, W.Va., where they will be awarded a $210,000 grant from AstraZeneca HealthCare Foundation’s Connections for Cardiovascular Health.

Officials will use the funds to launch the first phase of a three-phase public health campaign aimed at elementary school students and their families. The Appalachian Partnership for Positive Living and Eating, or APPLE, will provide year-long individual case-management services to help them make healthy eating and exercise choices.

APPLE is by invitation only and will provide students with an individualized health assessment, plans of action and services tailored to their nutritional needs, and provide fitness resources and suggestions. The grant will cover the first year of home-based services but officials are applying for second and third year funding through AstraZeneca. Latter phases of APPLE would take health education and physical fitness activities into schools where all children would have access to then go out into the greater community. It is a collaboration between local physicians, hospitals, health coalitions, fitness centers, and schools.

“This is something that I believe can make a huge difference in our community,” said Holly West, the Ashland-Boyd County Health Department’s public health service coordinator and the grant writer for the program. “We hope to serve as a model to other communities that are wanting to provide cardiovascular improvement to their communities.”

Case-management is not a new concept, but as far as West knows, the agency is the first to try it for treatment of pediatric obesity.

“We have an epidemic here, so it’s going to take some action,” she said. Appalachia has the highest rates of obesity and cardiovascular disease among adult and children in the nation, which is why AstraZeneca focused on this area for its grant program.  

Students in kindergarten through fifth-grade are now being invited via letters sent out by school nurses and enrolled into the program through the health department. The program is free and voluntary. Parents are encouraged to call the agency for additional information.

Candidates were identified based on measurements taken at the schools this winter. All students are measured for their height and weight each year. Using those measurements, health officials calculated body mass indexes or BMI for students. BMI is a fairly reliable measure of body fatness and is used to screen for weight categories that may lead to health problems.

According to officials, of 2,948 students measured, 41.4 percent had BMI’s in the 85th percentile, while 25 percent were in the 95th percentile, making them technically obese, said West. Students with BMIs at the 85th percentile or above were invited to participate. BMI’s in the 85th percentile generally indicate an individual is overweight while those in the 95th or above are obese.

APPLEā€ˆis a voluntary, completely confidential and complies with health privacy laws, said West.

Marlie White, a registered nurse and public health services coordinator at the health department, said to date she’s signed up 22 families. They all share concerns about their child’s health and or weight.

“Parent’s are wanting help,” said White. “Even though parents are very knowledgeable, I’m getting comments like ‘my child won’t listen to me’ or ‘My family won’t listen to me.’ We are kind of a backup for families, or reinforcement.

“Raising awareness is a huge factor — being mindful of what we eat and how we spend our energy. We’re hoping to focus on that and increase self-esteem.

White said she’s heard from many parents who are concerned their child’s health could open them up to bullying, or teasing. They want to help their child become healthier and build their self confidence at the same time.

“That is a common theme,” said White. “They want their child to have better self-esteem than they had growing up.”

Children that participate will be medically evaluated by pediatrician Dr. A.K. Khanna, and assigned a registered nurse as a case manager, who will meet with families monthly and track their progress, while providing nutrition information, suggestions, and even cooking classes. A physical fitness activity coordinator will help the entire family find activities and exercises that suit their schedule and interests.

Larger scale events, like family fun nights at the YMCA are also in the works, said West.

 “Our goal is to see them increase their diet to include five fruits and vegetables daily. Increase to up to an hour of daily activity,” said White. Other goals are decreasing participants sedentary T.V. time, intake of sweets while boosting consumption of drink water and skim milk over sugary drinks.

Families will have access to the agency’s nutritionist and plans could include personal training at Our Lady of Bellefonte’s Firm Fitness Center, said West.

“We’re trying to save lives here. This is not just an issue that is person by person, or family by family. This is a community issue. Cardiovascular disease is a big community concern. Reducing the body mass index and improving people’s lifestyles will have a profound impact on their future,” West said. “It could potentially save the lives of these children as they get older. The things that we are teaching them are things they can teach other people.”

CARRIE STAMBAUGH can be reached at cstambaugh@dailyindependent.com or (606) 326-2653.