1 AOTA Sponsored Workshop Primary Care and Children with Obesity

AOTA Sponsored Workshop
Primary Care and Children with Obesity: A Call to Action
SC 105 April 16, 2015; 8:00-9:30 am
This handout complements the workshop’s slides available on the conference website
Conclusions Workshop
 Obesity has become one more indicator of health disparities.
• OTs need to partner with primary care professionals and other health professionals, educators,
community leaders, community health centers, and parents to address obesity.
• Advocacy at the institutional and systems level needs to continue.
• We need to include community-based programming and teach families how to navigate non-healthy
environments.
• More research in OT needs to be conducted—what are interventions that work? What is the prevalence
of obesity in OT clientele?
Factors to Consider when working with Children, Families and Communities
o Cultural and socio-economic influences
o Family Structure (single parent families, grandparent caregivers, and co-parent or blended
families
o Family and child stressors and health related challenges including eating disorders and risk
factors i.e., genetics and changes in the child’s life
o Family food situations, preferences, philosophies about food, meals and meal-times e.g., time
for eating, parents work schedules, parents attitudes and beliefs about food and eating.
o Family routines – parents work schedules, children’s extracurricular activities, sleep patterns,
physical activity patterns
o Availability of school choices inclusive of breakfast programs and “snacks”
o Family and children’s preparation experiences linking that to meals
o Community resources— available of open spaces, inexpensive opportunities for participation
in sports, community and school group i.e., “walking clubs”, safe outdoor areas for active play
o School resources e.g., counselor and health education
Messages and Interventions Therapists May Consider
a. Parent education
1. Meal preparation (include the children)
2. Healthy food decisions for the whole family
3. Exercise suggestions/creative play and movement ideas
4. It is important to focus not just on what you eat but how you eat.
 Focus not just on what is eaten but how food is eaten.
 Enjoy the family time and use it to talk and share
 Sit down
 Do not eat meals in front of the TV
 Recognize picky eaters is not always a behavior problem – children could be
experiencing sensory issues and certain foods may not feel “right” in their
mouths.
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
b.
c.
d.
e.
f.
g.
h.
i.
j.
Fast food “just so they will eat something” is not the best route to take, it can
develop unhealthy choices and habits that will last a life time.
5. Eating well does not have to cost more or take more time
 Make local famers markets a family outing: gets in walking and interactions with
making choices and food is often cheaper, use of coupons, Planning meals and
cooking ahead of time and freezing the meals for easier mealtimes
Assess readiness for change and address attitudes towards food and exercise
Identify and deal bullying
Identify and address health (physical and psychological) sequalae
Facilitate family and child’s sense of empowerment and control to make change for a health
lifestyle
Focus on healthy life style and behaviors and avoid weight loss being the significant outcome
indicator of an interventions success
Making this a family project allows for in home support for each other: Healthier choices and
collective problem-solving
Helping to create a support network that is available to each other (by phone or email)—
neighbors, church /faith members—ask first eat later
Help create “mantras” for healthy reminders before eating—change “one cookie won’t hurt
me” to “what can I do good for me?”
Teach that this is NOT about losing weight but changing a life style and that is a slow process
so learning to forgive yourself and keep on trying
Resources for Parents and Occupational Therapy Practitioners
The American Heart Association is a good place to start and they have a lot of suggestions on
their web page.
http://www.heart.org/HEARTORG/GettingHealthy/HealthierKids/ChildhoodObesity/Preventin
g-Childhood-Obesity-Tips-for-Parents-and-Caretakers_UCM_456118_Article.jsp
Nutritionists associated with most children’s hospitals and clinics
Bright Futures in Practice (American Academy of Pediatrics) http://brightfutures.aap.org/
CLOCC.org (Consortium to lower obesity in Chicago Children) http://www.clocc.net/
The State of Obesity 2014 Robert Wood Johnson Foundation
http://www.rwjf.org/en/library/research/2014/09/the-state-of-obesity.html
AOTA resources on Obesity
AOTA web area on Obesity
http://www.aota.org/Practice/Children-Youth/Emerging-Niche/Childhood-Obesity.aspx
AOTA information sheet on Obesity (part of the School Mental Health toolkit)
http://www.aota.org//media/Corporate/Files/Practice/Children/SchoolMHToolkit/Childhood%20Obesity.pdf
AOTA tip sheet for families on childhood obesity
http://www.aota.org/-/media/Corporate/Files/AboutOT/consumers/Youth/obesity.pdf
AOTA tip sheet for families on childhood obesity in Spanish
http://www.aota.org/-/media/Corporate/Files/AboutOT/consumers/Youth/Childhood-ObesitySpanish-Tip-Sheet.pdf
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With a special thank you to Susan N. Schriber Orloff, OTR/L FAOTA, Children’s Special
Services, LLC Atlanta, GA and Amelia Sanders MOTS, University of St. Augustine—
Health Sciences
References
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children and youth: A guiding framework for occupational therapy. (pp. 119-139) Bethesda: MA: AOTA
Blanchard, S.A. (2006). AOTA’s statement on obesity. American Journal of Occupational Therapy, 60, 680.
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Pizzi, M., Vroman, K., Lau, C., Gill, S., Bazyk, S., Suarez-Balcazar, Y., Orloff, S. (2014). Occupational therapy and
the childhood obesity epidemic: Research, theory and practice. Journal of Occupational Therapy, Schools, &
Early Intervention, 7(2), 87-105.
Podlasek, S. (2010). Best practice in obesity: advocate for the best equipment possible. Advance for Occupational
Therapy Practitioners, 26(17), 17.
Reilly, J.J., McDowell, Z.C. (2003). Physical activity interventions in the prevention and treatment of pediatric obesity:
systematic review and critical appraisal. Proceedings of the Nutrition Society, 62(3), 611-619.
Rimmer, J.H., Vanderborn, K. A., Bandini, L.G., Drum, C.E., Luken, K., Suarez-Balcazar, Y., Graham, I. D. (2014).
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Workshop Presenters
Simone Gill, PhD, OTR/L is an Assistant Professor of Occupational Therapy at Boston University. In
her research, she investigates how individuals’ bodies and task demands influence motor
functioning across the lifespan. She uses a variety of methods to examine how children and adults
modify their walking patterns to navigate safely through the environment. Simone’s research
goals are to create new methods to detect fall risks linked with obesity and to design innovative
interventions that minimize fall risks associated with obesity. She directs the Motor Development
Laboratory, and her work is currently being supported by the American Occupational
Therapy Foundation, the National Institutes of Health, and the Comprehensive Opportunities in
Rehabilitation Research Training Grant.
Fengyi Kuo is Visiting Professor at Indiana University/IU School of Health and Rehabilitation
Sciences in Indianapolis, Indiana, USA. Additional affiliations in the past include University of
Indianapolis in Indiana, Gannon University in Pennsylvania, and MetroHealth Medical Center in
Cleveland, Ohio, USA. She is an experienced educator and a creative clinician, passionate in
community based program development and evaluation. She is the 2013 Occupational Therapy
Foundation (AOTF)'s Community Service and Volunteerism Award recipient to recognize her
advocacy and leadership in promoting healthcare access among refugee communities in
Indianapolis. Since her family’s relocation to Suzhou China in January 2015, she has started a new
journey of promoting occupational therapy development in Mainland China.
Cynthia Lau, OTR/L, PhD, is an Associate Professor in the School of Occupational Therapy at Touro
University and holds a Board Certification in Pediatrics.
Dr. Lau leads a health promotion/obesity prevention program in low social economic schools in
collaboration with the city’s recreation department and school district. Her research involves
intervention efficacy, inter-professional collaboration, and service learning.
Michael A. Pizzi PhD, OTR/L, FAOTA developed the Pizzi Healthy Weight Management Assessment
(PHWMA), child/youth and guardian/parent versions as well as a recent adult version. Several
studies utilizing the assessments have been completed and reliability and validity has been
established. He has also developed the Pizzi Health and Wellness Assessment (PHWA) which is
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being utilized in several studies and presented at AOTA 2015. Besides writing and research, in
2014, Dr. Pizzi was selected for the Leaders and Legacies Society (LLS) Steering Committee of the
American Occupational Therapy Foundation with induction of the first recipients in 2015. He can
be reached at mpizzi58@gmail.com.
Susan N. Schriber Orloff, OTR/L, FAOTA is a Clinical Associate Professor in occupational therapy at
GA State University and a national columnist and author of the book, “Learning Re-enabled: a
guide for parents, teachers and therapists,” (Elsevier/Mosby Books). It is endorsed by the
International Learning Disabilities Assoc., the National Education Association, is a resource at the
US Dept. of Education. Susan is the founder and the Exec. Director, and CEO of Children’s Special
Services, LLC, Atlanta, GA. CSS.LLC serves learning and developmentally disabled children ages
toddler through teen. She has been working with children since 1968. Among her awards are:
Fellow of the American OT Association, Outstanding Service Award/Bobbi Grant Award for
Contributions to Occupational Therapy 2008, Georgia OT of the Year 2006-2007,Georgia Woman
of Distinction 2006, the “Outstanding Educator Award” and many others.
Yolanda Suarez-Balcazar, PhD, is Professor and Head of the Department of Occupational Therapy
at the University of Illinois at Chicago (UIC). Dr. Suarez-Balcazar’s research examines the nexus
between race, culture and disparities developing models and tools. She and her colleagues
developed evidence-based materials to train health professionals on how to provide culturally
competent care. She also studies the development, implementation and evaluation of obesity
prevention programs for African American and Latino children and youth with disabilities. She is
the Principal Investigator on a grant, funded by the Chicago Community Trust, on promoting
healthy lifestyles among Latino youth with disabilities and their families. She is also an
investigator collaborating on a national study adapting the CDC obesity prevention strategies to
youth and young adults with disabilities. She is a co-author of the book titled “Race, Culture and
Disability: Rehabilitation Science and Practice” and the author of over 70 peer-reviewed
publications on the above topics.
Kerryellen Vroman, PhD, OTR/L is an associate professor in occupational therapy at the University
of New Hampshire. Her education in occupational therapy and doctoral degree in health
psychology has informed her mixed methods research, which involves the use of personal
projects analysis and the investigation of psychosocial factors that influence health, adaptation to
illness, and therapy outcomes. Her research in relation to childhood obesity focuses on factors
influencing behavioral change, the stigmatizing perceptions of adults and children who are obese
by professionals and peers and its effect on social participation. Currently, her work is focusing on
clients’ experiences of discrimination in therapy and the psychosocial correlates associated with
growing up obese. Contact address is kgn3@unh.edu
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