Evaluating a comprehensive child health initiative: Results from Nemours Health & Prevention Services

Early results show that Delaware's comprehensive obesity initiative has stemmed the increase in prevalence of childhood overweight and obesity with findings that prevalence is statistically unchanged for children since 2006. Nemours' initiative has also spurred increased knowledge of healthy eating and increased physical activity in school and care settings, resulting in policy and practice changes. This model, of focusing on population health and changing policies and practices in multiple settings through strategic partnerships, knowledge mobilization and social marketing, can effectively address obesity and other complex problems facing children today is the focus of a comprehensive evaluation. Results from the 2008 Delaware survey suggest that the prevalence of overweight and obesity for Delaware children ages 2-17 years has not changed significantly since measured in 2006. Furthermore, no statistically significant changes in prevalence of overweight and obesity were observed within geographic and demographic categories between 2006 and 2008. There was a four-fold increase in Delaware households' awareness of the 5-2-1-Almost None message. When there was parental message awareness, significantly more children age birth through 17 years engaged in one hour of physical activity per day (10% vs. 26%) and moderate to vigorous physical activity for more than 20 minutes (21% vs. 33%) between 2006 and 2008. The data indicate that changes are being implemented in systems – schools, childcare, primary care – with associated changes in healthy eating and physical activity behaviors, and ultimately health outcomes. The results of this initial evaluation provide evidence for the efficacy of a comprehensive prevention-oriented model.