Reversing Childhood Obesity with a Novel Approach

Mar 8, 2016, 10:45 AM, Posted by Christina Economos

ChildObesity180 is bringing the best elements of private sector thinking and scientific research in order to improve the health of kids in America. Here's how.

Children playing outside in Claremont, CA. Photo courtesy Tufts University

In 2009 it became clear to me that if our nation were truly serious about reversing the childhood obesity epidemic, a novel approach was required. The numbers remain just too unacceptably high in all groups and troubling disparities persist.

Enter Peter Dolan, Chairman of Tufts University Board of Trustees and former Chief Executive Officer of Bristol-Myers Squibb with a long-time commitment to health.  His background made him a complement to our work at Tufts University Friedman School of Nutrition Science and Policy.  Along with Dr. Miriam Nelson, a professor of nutrition, we set out to develop a new method of addressing this complex problem, and co-founded ChildObesity180.

We created a collaborative model: bringing together nationally-renowned leaders from academia, nonprofits, business, and government (whom we refer to as Charter Members) to drive change on a national scale and substantially effect 5-to-12-year-olds across the country. We blend scientific rigor with insights from the private sector to develop, implement, evaluate and scale high-impact obesity prevention initiatives. 

Boy Scouts eating a healthy snack of fruits and vegetables. Photo courtesy Tufts University

What were the results? First we created a fertile environment for creative thinking and used innovations from the business world we might not typically have considered, much less tried.

ChildObesity180 was formed with core funding from Robert Wood Johnson Foundation, and is now marking its fifth anniversary. We’ve reached over 4 million children across all 50 states through four initiatives, involved more than 100 senior national leaders, formed 60 partnerships with public and private entities for implementation, funding, research and related activities, leveraged RWJF’s investment over two-fold, and produced 18 peer-reviewed publications, 48 presentations and 17 videos and multimedia communications. Importantly, along the way we’ve also trained dozens of future leaders, engaging and mentoring students, post-doctoral fellows, and early-career professionals.

To decide what initiatives to take on initially, we gathered data on what kids were thinking about obesity and went through a rigorous process, guided by the Institute of Medicine’s LEAD Framework, of analyzing evidence-based strategies that were working, always through the prism of such factors as reducing disparities, cost effectiveness, scalability and time to results. Those efforts led us to create four projects aimed at changing behavior through environmental and systems change—specifically, each focused on an aspect of a child’s typical daily routine. They include:

  • Active Schools Acceleration Project encourages kids to be more physically active during the school day. ChildObesity180 engaged in crowdsourcing, something typically used in the private sector, not academia or scientific research, via an innovation competition with cash rewards. In 2012 we invited schools across the country to submit promising programs that they had implemented to increase physical activity in their schools. We received about 500 applications representing 2500 schools. Programs ranged from in-class activity breaks to walking/running programs to before school activity sessions. We gave 1,000 schools $1,000 each to test out three of the promising programs. One of the three, a low-cost, easy to implement program to encourage walking and running called the 100 Mile Club®, is now being introduced to thousands of schools across the country through the New Balance Foundation Billion Mile Race. To date we have reached over 4500 schools in all 50 states.
  • Healthy Kids Out of School works with organizations such as the Boy Scouts of America and US Youth Soccer that provide short-term, volunteer-led out-of-school-time activities. In partnership with each organization, we customize ways that fit the group’s usual activities, not only to encourage kids to eat healthier snacks and move more, but also to integrate those activities as a regular part of operations. For example, in 2013, working with the Boy Scouts, we created the SCOUTStrong Healthy Unit Award; it’s now included in the organization’s national hand books and merit patches can be earned through the national store. Another example: customized training tools for youth sports coaches titled Coaching Healthy Habits.
  • The Restaurant Initiative aims to reduce kids’ calorie consumption while dining out by working on both the supply and demand side. We are in the throes of creating and testing a national campaign to debut in early 2017, leveraging the roll-out of calorie counts on menus and making that information relevant and accessible to parents. One particularly noteworthy element is work we’ve done with Silver Diner, a regional restaurant chain. Starting in 2012, the company introduced a new children’s menu making healthy choices more prevalent, more prominent and the default–strawberries as a side dish instead of French fries and no soda offered on the kids’ menu, for example. The effort was based in part on research about “default bias,” which shows that people respond more enthusiastically to automatic options. So, kids could still order fries or soda, but they had to ask for them.

The results have been encouraging. Not only did diners choose healthier meals, but restaurant revenues continued on an upward trend outpacing segment growth. There’s a clear lesson: What’s good for kids can be good for business.

Over the past three years, we’ve also collaborated with dozens of restaurant executives, and that’s resulted in another dividend:  access to large amounts of real-world data, a treasure trove of information most researchers can’t tap. Analyzing reams of proprietary data is a useful way for scientists to look more deeply into what’s happening in the real world.

  • The Breakfast Initiative, which concluded in 2014, evaluated the impact of an innovative program to deliver breakfast to kids in their classroom. We also produced a video series to highlight the research and resources to help schools adopt and expand school breakfast programs.

Collectively these initiatives work together as an integrated portfolio that can beneficially impact children’s energy balance. ChildObesity180 is utilizing real-world and theoretical methods to evaluate its collective impact, return on investment, and strategic collaborations. Through this process, we seek to measure the reach and effect of our initiatives, contribute to the evidence base in areas critical to advancing the field of obesity prevention, and understand how our unique approach can inform future efforts to address complex systemic problems.

Our overall approach—develop, pilot, scale—has been crucial to our success. It allows us to combine out-of-the-box thinking with rigorous analysis, careful experimentation and thoughtful expansion. We have a long way to go in the fight to reverse childhood obesity and to close the disparities gap. By mixing the best elements of private sector thinking and scientific research, we are making significant strides.

Dr. Christina D. Economos is director and vice chair of ChildObesity180, the New Balance Chair in Childhood Nutrition, and an Associate Professor at the Friedman School of Nutrition Science and Policy at Tufts University. Read her full bio.