February 2010

Grant Results

SUMMARY

From 2004 to 2008, researchers at the School of Public Health at University of Illinois, Chicago adapted a well-known rapid assessment tool for use in low-income communities working to reverse overweight and obesity in children.

Key Results

  • Food & Fitness for Children & Families: A Rapid Assessment Tool (RAP) uses direct observation, interviews and focus groups to capture what young people really think, feel and do in regard to eating and exercise. The manual and data collection forms are available online after registering.
  • The project team trained some 85 people in the use of the RAP tool in five workshops.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through two solicited grants totaling $340,394.

 See Grant Detail & Contact Information
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The Problem

Children in low-income and minority communities are more likely to be overweight or obese than children in other communities. Researchers have sought to understand why this is by studying the context in which children live, eat and move. But traditional research methods often stop short of asking the very people who are most affected what their perception of the health problem is.

Rapid Assessment Procedures for Nutrition and Primary Health Care, or RAP, is a tool that uses direct observation, interviews and focus groups to gather information directly from community members. Created in 1983, the tool has been adapted to address a number of health issues and has been implemented in communities around the world.

This project sought to adapt the RAP tool to capture what young people and their families really think, feel and do in regard to eating and exercise. The intent was to help communities create programs that address fitness and food in a way that is acceptable and practical to community members.

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RWJF Strategy

At the time of this project (spring 2004), RWJF's grantees had made considerable contributions to understanding how the environment affects physical activity and exercise in diverse populations, but research was only beginning to do the same for food consumption.

More about the Foundation's strategy concerning childhood obesity is on the Foundation's Web site.

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The Project

Researchers at the University of Illinois at Chicago School of Public Health adapted Rapid Assessment Procedures for Nutrition and Primary Health Care, or RAP, to address childhood obesity in diverse low-income communities. They also created a training program to teach people how to use the tool.

To educate themselves on the food and fitness issues, the project team conducted in-depth interviews with:

  • Key personnel from the department of physical therapy and the College of Nursing, both at the University of Illinois-Chicago.
  • Physicians from a satellite clinic of the Cook County Department of Health in Palatine, Ill., and staff members from Chicago public schools. The project team worked with the Consortium to Lower Obesity in Chicago Children (CLOCC) to identify interviewees. See Grant Results for more information on the CLOCC project.

The project team also conducted focus groups in the community with:

  • Some 20 health care professionals and teachers, in two different groups
  • Some 70 students at 10 elementary/middle and high schools

Student Perceptions Shape Assessment Tool

Focus groups with students yielded some key findings that helped inform the final product, including:

  • Students were unfamiliar with the concept of portion size.
  • They knew how to respond "correctly" when asked about healthy eating choices, but did not necessarily make correct choices in their daily lives.

The project team continued to nurture the relationship with students participating in focus groups by helping them create videos, posters and essay campaigns focusing on food and fitness for Public Health Week.

Communications

Project staff presented on the Food & Fitness RAP for several Chicago area organizations and at the 2007 RWJF Childhood Obesity Grantees Annual Conference in New Orleans.

Other Funding

The Otho S.A. Sprague Memorial Institute, a Chicago-based philanthropy, provided an additional $24,911 for the project.

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Results

  • The project team created Food & Fitness for Children & Families: A Rapid Assessment Tool (available online after registering). Chapters provide instruction on:
    • Using anthropological methods such as direct observation, interviews and focus groups to gather information from community members
    • Selecting, training and supervising field workers
    • Working well with youth and teen populations
    • Doing data analysis and using data analysis software
  • The project team created two Food & Fitness RAP Training Practicum manuals used in conjunction with the workshops and not available to the public:
    • A version for trainees with little or no research experience focuses on teaching the RAP skills (methods such as interviewing, observation, focus groups, etc.) to individuals who are interested in using the tool to assess, plan or evaluate a program related to the food or fitness environment.
    • A "train-the-trainer" version for individuals with research experience who want to learn how to teach the Food & Fitness RAP skills and techniques to others who will be conducting the research.

See the Bibliography for details about the RAP tool and training manuals.

  • The project team conducted a total of five training workshops at these venues:
    • The University of Kansas, September 2007, with 21 participants
    • The College of Nursing at the University of Illinois at Chicago, November and December 2007, with 15 AmeriCorps volunteers
    • The University of Arkansas, December 2008, with nine participants
    • The University of Minnesota, January 2008, with 25 participants
    • The University of Illinois at Chicago, November 2009, with 15 AmeriCorps volunteers
  • The project team created the Food & Fitness RAP Web site to disseminate the RAP tool and promote the training program. Created through a subcontract with the Center for the Advancement of Distance Education at the University of Illinois, the Web site provides links to the trainee manual, an overview of Food & Fitness RAP, a workshop schedule and other resources. For details, see the Bibliography.

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Lessons Learned

  1. If a product will be used by community members, be sure to get their perspective as you develop it. This includes getting input from children, if the product has a focus on children. For example, through focus groups, researchers learned that the term obesity was uncomfortable to many community members. They changed the original title of the manual to put a stronger emphasis on child and family health. They also learned that portion size was not a concept with which the children were familiar (Project Director/Janel Heinrich)

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Afterward

The project team is discussing with a trade publisher turning Food & Fitness for Children & Families: A Rapid Assessment Tool into a hard-copy book.

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GRANT DETAILS & CONTACT INFORMATION

Project

Rapid Anthropological Assessment Procedures for Preventing Childhood Obesity in Low-Income Minority Communities

Grantee

University of Illinois at Chicago School of Public Health (Chicago,  IL)

  • Rapid anthropological assessment procedures for preventing childhood obesity in low-income minority communities
    Amount: $ 51,945
    Dates: May 2004 to October 2005
    ID#:  050750

  • Training and technical assistance on the Rapid Assessment Procedures (RAP) manual used to evaluate children's eating and fitness environments
    Amount: $ 288,449
    Dates: September 2006 to November 2008
    ID#:  057596

Contact

Janel M. Heinrich, M.P.H., M.A.
(608) 243-0341
jheinrich@publichealthmdc.com
Susan C. Scrimshaw, Ph.D.
(518) 244-2313
scrims@sage.edu

Web Site

http://www.rapidassessmentprocedure.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Heinrich J, Scrimshaw SC, Chavez N and Sullivan M. Food & Fitness for Children & Families: A Rapid Assessment Tool (draft). Chicago: University of Illinois at Chicago, School of Public Health, 2007. (Available online after registering.)

Heinrich J, Wheatley R, Scrimshaw SC, Chavez N and Sullivan M. Food & Fitness Rapid Assessment Procedures (RAP): Trainee Edition. Unpublished.

Heinrich J, Wheatley R, Scrimshaw SC, Chavez N and Sullivan M. Food & Fitness Rapid Assessment Procedures (RAP): Trainer Edition. Unpublished.

World Wide Web Sites

www.rapidassessmentprocedure.org. Targeted primarily at trainees, the site offers links to the trainee manual, an overview of Food & Fitness RAP, a workshop schedule and other resources. Chicago: University of Illinois at Chicago, School of Public Health, 2008.

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Report prepared by: Robert Crum
Reviewed by: Kelsey Menehan
Program Officer: Laura C. Leviton

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