- Email: [email protected]
Building a culture of health through research: The role of the physical activity research center
Journal Pre-proof Building a culture of health through research: The role of the physical activity research center
Tina J. Kauh PII:
S0091-7435(19)30374-3
DOI:
https://doi.org/10.1016/j.ypmed.2019.105894
Reference:
YPMED 105894
To appear in:
Preventive Medicine
Received date:
31 October 2019
Accepted date:
8 November 2019
Please cite this article as: T.J. Kauh, Building a culture of health through research: The role of the physical activity research center, Preventive Medicine(2019), https://doi.org/ 10.1016/j.ypmed.2019.105894
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
© 2019 Published by Elsevier.
Journal Pre-proof Building a Culture of Health through Research: The Role of the Physical Activity Research Center Tina J. Kauh1
1
Robert Wood Johnson Foundation, Research-Evaluation-Learning Unit, 50 College Road East,
of
Princeton, NJ 08543
ro
Submitted to Preventive Medicine. September 2019
-p
Word count: 883
re
Corresponding Author:
Senior Program Officer
na
Research-Evaluation-Learning Unit
lP
Tina J. Kauh, PhD, MS
Robert Wood Johnson Foundation
Jo
Telephone: 609-627-6463
ur
50 College Road East, Princeton, NJ 08543
Email: [email protected]
Highlights
The movement to build a Culture of Health is fostered by cross-sector, equity-targeted research.
The Physical Activity Research Center is a model for cross-sector research collaboration.
Abstract This paper provides brief context for why the physical activity research center was created and how it supports the national movement to build a culture of health.
Journal Pre-proof The Robert Wood Johnson Foundation (RWJF) envisions a nation in which every individual in our diverse society leads healthy lives, now and for generations to come. To bring this vision to fruition, the nation must build a Culture of Health, fostering a movement to make health a national priority, where leaders across sectors and across disciplines work together to advance efforts to improve our population’s health and well-being. A continued threat to the health and well-being of this country is the overweight and obesity epidemic among children and adolescents. In the United States, more than one in three young
of
people is overweight or obese (Fryar, Carroll, & Ogden, 2018). These youth face a greater risk for type 2 diabetes, heart disease, and asthma (NHLBI, 2013), and are more likely to miss school (An, Yan, Shi, &
ro
Yang, 2017) and experience psychological stress (Isasi, Parrinello, Jung, Carnethon, & Birnbaum-
-p
Weitzman, 2016). In addition to the toll on personal health, the epidemic has placed great strain on both
re
the nation’s health care system and economic productivity (Cawley & Meyerhoefer, 2012; Finkelstein,
lP
Trogdon, Cohen, & Dietz, 2009).
Efforts to reverse this epidemic have yielded some indications of discrete progress in cities,
na
counties, and states across the country (https://www.rwjf.org/en/library/research/2016/06/decliningchildhood-obesity-rates.html). However, much more needs to be done as obesity rates remain high,
ur
particularly among children from African American, American Indian, Latinx, Southeast Asian
Jo
American, and Pacific Islander backgrounds (Taveras, Gillman, Kleinman, Rich-Edwards, & RifasShiman, 2013; Cook, Tseng, Bautista, & John, 2016); those living in rural communities (Johnson & Johnson, 2015); and those from lower income households (Ogden, Carroll, Fakhouri, et al., 2018). One factor that contributes to the ongoing challenges to eliminate childhood overweight and obesity is the lack of safe and high-quality opportunities for children to be physically active across the places where young people spend time -- where they live, learn, and play (Council on Sports Medicine and Fitness and Council on School Health, 2006). The National Academies of Science, Engineering, and Medicine (2012) has recommended environment and policy changes as essential components of obesity prevention because of their
Journal Pre-proof population-wide reach, long-term effectiveness, and promise for creating healthier, more equitable communities. For more than a decade, RWJF has supported efforts to change policies and systems in ways that promote greater physical activity and healthier eating among children through research, advocacy, and action-oriented programming. Through more than $33 million of funding over nearly 15 years, RWJF supported Active Living Research (ALR, https://activelivingresearch.org/), a program that aims to build, translate, and disseminate
of
the evidence around effective policies and aspects of the built environment that promote greater physical
ro
activity. The science supported through ALR and other research is clear: Children and families are more active when they live, learn, and play in environments that are guided by policies and designed to
-p
promote opportunities to be physically active. For instance, providing in-class activity breaks during the
re
school day can yield nearly one-third of the daily minutes of physical activity that are recommended for
lP
good health (Whitt-Glover, Porter, & Yancey, 2013). Improvements to sidewalks and crosswalks and the installation of bike facilities increase walking and biking in the community (Cain, Millstein, Sallis,
na
Conway, Gavand, et al., 2014; Parker, Rice, Gustat, Ruley, Spriggs, et al. 2013). The evidence has shown, however, how limited those opportunities are in lower-income communities, where the risk for childhood
ur
obesity is greatest (Taylor & Lou, 2011). With the closing of ALR as an RWJF national program at the
Jo
end of 2015, the Foundation launched the Physical Activity Research Center (PARC) in 2016, which produced a new generation of evidence on policy and the built environment to promote increased physical activity among children.
Building a Culture of Health requires action in four key areas – a shared value for health, cross sector collaboration, healthier and more equitable communities, and integration of health services and systems (https://www.rwjf.org/en/cultureofhealth.html). PARC was funded by RWJF because of the way in which it contributed to the Culture of Health movement through two of these four action areas – (1) cross-sector collaboration and (2) healthier and more equitable communities. The Center is made up of a collaborative team of researchers led by four institutions (University of California San Diego; Georgia
Journal Pre-proof Institute of Technology; Johns Hopkins University; and North Carolina State University) and included research partners at Baylor University and San Diego State University. The team represents both urban and rural settings across the country and have been trained in a diverse set of disciplines (e.g., health psychology, urban planning, public health, parks and recreation). This networked structure encouraged intellectual collaboration across institutions and across sectors that fostered an examination of issues related to physical activity policy and systems through different lenses, moving beyond the borders of
of
their individual siloed perspectives. In addition, the Center was led by experts on health disparities, and each of the four study topics pursued by PARC were selected, in large part, because of their potential to
ro
inform efforts to foster equitable opportunities for increased physical activity among children of color,
-p
particularly those residing in lower-income communities. Importantly, health equity, which inherently
re
involves building equitable opportunities for health among all in our diverse society, is an overarching theme in RWJF’s framework for achieving a Culture of Health. And through its research, PARC has
Jo
ur
na
lP
made a notable contribution to the Culture of Health movement.
Journal Pre-proof References An, R., Yan, H., Shi, X., & Yang, Y. (2017). Childhood obesity and school absenteeism: a systematic review and meta‐ analysis. Pediatric Obesity, 18(12), 1412-1424. Cain, K.L., Millstein, R.A., Sallis, J.F., Conway, T.L., Gavand. K.A., Frank, L.D., et al (2014). Contribution of streetscape audits to explanation of physical activity in four age groups based on the Microscale Audit of Pedestrian Streetscapes (MAPS). Social Science & Medicine, 116, 82–
of
92.
ro
Cawley J, & Meyerhoefer C. (2012). The medical care costs of obesity: an instrumental variables
-p
approach. Journal of Health Economics, 31, 219-30.
re
Cook, W.K., Tseng, W., Bautista, R., & John, I. (2016). Ethnicity, socioeconomic status, and overweight
lP
in Asian American adolescents. Preventive Medicine Reports, 233–237. Council on Sports Medicine and Fitness and Council on School Health (2006). Policy statement: Active
ur
117(5), 1834-1842.
na
healthy living: Prevention of childhood obesity through increased physical activity. Pediatrics,
Finkelstein, E., Trogdon, J., Cohen, J.W. and Dietz, W. (2009) Annual medical spending attributable to
Jo
obesity: Payer and service-specific estimates. Health Affairs, 28, 822-831. Institute of Medicine of the National Academies (2012). Accelerating progress in obesity prevention: Solving the weight of the nation. Washington, D.C.: National Academies Press. Isasi, C.R., Parrinello, C.M., Jung, M.M., Carnethon, M.R., Birnbaum-Weitzman, O., Espinoza, R.A., Penedo, F.J., Perreira, K.M., Schneiderman, N., Sotres-Alvarez, D.T., Van Horn, L.V., & Gallo, L.C. (2015). Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults. Annals of Epidemiology, 25(2), 84-9.
Journal Pre-proof Johnson, J.A., & Johnson, A.M. (2015). Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Childhood Obesity, 11(3), 233-41. National Heart, Lung, and Blood Institute (2013). Managing overweight and obesity in adults: Systematic evidence review from the obesity expert panel. Washington, D.C.: U.S. Department of Human Services. Ogden, C.L., Carroll, M.D., Fakhouri, T.H., Hales, C.M., Fryar, C.D., Li, X., & Freedman, D.S. (2018).
of
Prevalence of obesity among youths by household income and education level of head of
ro
household — United States 2011–2014. MMWR Morbidity & Mortality Weekly Report, 67, 186–
-p
189. DOI: http://dx.doi.org/10.15585/mmwr.mm6706a3
re
Parker, K. M., Rice, J., Gustat, J., Ruley, J., Spriggs, A., & Johnson, C. (2013). Effect of bike lane infrastructure improvements on ridership in one New Orleans neighborhood. Annals of
lP
Behavioral Medicine, 45(Suppl 1), S101-S107.
na
Taveras, E.M., Gillman, M.W., Kleinman, K.P., Rich-Edwards, J.W., & Rifas-Shiman, S.L. (2013). Reducing racial/ethnic disparities in childhood obesity: The role of early life risk factors. JAMA
ur
Pediatrics, 167(8).
Jo
Taylor, W., & D. Lou (November 2011). Do all children have places to be active? Disparities in access to physical activity environments in racial and ethnic minority and lower-income communities. A Research Synthesis. Princeton, NJ: Active Living Research. Whitt-Glover, M., Porter, A., & Yancey, T. (February 2013). Do short physical activity breaks in classrooms work? A research brief. Princeton, NJ: Active Living Research.
Tina J. Kauh PII:
S0091-7435(19)30374-3
DOI:
https://doi.org/10.1016/j.ypmed.2019.105894
Reference:
YPMED 105894
To appear in:
Preventive Medicine
Received date:
31 October 2019
Accepted date:
8 November 2019
Please cite this article as: T.J. Kauh, Building a culture of health through research: The role of the physical activity research center, Preventive Medicine(2019), https://doi.org/ 10.1016/j.ypmed.2019.105894
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
© 2019 Published by Elsevier.
Journal Pre-proof Building a Culture of Health through Research: The Role of the Physical Activity Research Center Tina J. Kauh1
1
Robert Wood Johnson Foundation, Research-Evaluation-Learning Unit, 50 College Road East,
of
Princeton, NJ 08543
ro
Submitted to Preventive Medicine. September 2019
-p
Word count: 883
re
Corresponding Author:
Senior Program Officer
na
Research-Evaluation-Learning Unit
lP
Tina J. Kauh, PhD, MS
Robert Wood Johnson Foundation
Jo
Telephone: 609-627-6463
ur
50 College Road East, Princeton, NJ 08543
Email: [email protected]
Highlights
The movement to build a Culture of Health is fostered by cross-sector, equity-targeted research.
The Physical Activity Research Center is a model for cross-sector research collaboration.
Abstract This paper provides brief context for why the physical activity research center was created and how it supports the national movement to build a culture of health.
Journal Pre-proof The Robert Wood Johnson Foundation (RWJF) envisions a nation in which every individual in our diverse society leads healthy lives, now and for generations to come. To bring this vision to fruition, the nation must build a Culture of Health, fostering a movement to make health a national priority, where leaders across sectors and across disciplines work together to advance efforts to improve our population’s health and well-being. A continued threat to the health and well-being of this country is the overweight and obesity epidemic among children and adolescents. In the United States, more than one in three young
of
people is overweight or obese (Fryar, Carroll, & Ogden, 2018). These youth face a greater risk for type 2 diabetes, heart disease, and asthma (NHLBI, 2013), and are more likely to miss school (An, Yan, Shi, &
ro
Yang, 2017) and experience psychological stress (Isasi, Parrinello, Jung, Carnethon, & Birnbaum-
-p
Weitzman, 2016). In addition to the toll on personal health, the epidemic has placed great strain on both
re
the nation’s health care system and economic productivity (Cawley & Meyerhoefer, 2012; Finkelstein,
lP
Trogdon, Cohen, & Dietz, 2009).
Efforts to reverse this epidemic have yielded some indications of discrete progress in cities,
na
counties, and states across the country (https://www.rwjf.org/en/library/research/2016/06/decliningchildhood-obesity-rates.html). However, much more needs to be done as obesity rates remain high,
ur
particularly among children from African American, American Indian, Latinx, Southeast Asian
Jo
American, and Pacific Islander backgrounds (Taveras, Gillman, Kleinman, Rich-Edwards, & RifasShiman, 2013; Cook, Tseng, Bautista, & John, 2016); those living in rural communities (Johnson & Johnson, 2015); and those from lower income households (Ogden, Carroll, Fakhouri, et al., 2018). One factor that contributes to the ongoing challenges to eliminate childhood overweight and obesity is the lack of safe and high-quality opportunities for children to be physically active across the places where young people spend time -- where they live, learn, and play (Council on Sports Medicine and Fitness and Council on School Health, 2006). The National Academies of Science, Engineering, and Medicine (2012) has recommended environment and policy changes as essential components of obesity prevention because of their
Journal Pre-proof population-wide reach, long-term effectiveness, and promise for creating healthier, more equitable communities. For more than a decade, RWJF has supported efforts to change policies and systems in ways that promote greater physical activity and healthier eating among children through research, advocacy, and action-oriented programming. Through more than $33 million of funding over nearly 15 years, RWJF supported Active Living Research (ALR, https://activelivingresearch.org/), a program that aims to build, translate, and disseminate
of
the evidence around effective policies and aspects of the built environment that promote greater physical
ro
activity. The science supported through ALR and other research is clear: Children and families are more active when they live, learn, and play in environments that are guided by policies and designed to
-p
promote opportunities to be physically active. For instance, providing in-class activity breaks during the
re
school day can yield nearly one-third of the daily minutes of physical activity that are recommended for
lP
good health (Whitt-Glover, Porter, & Yancey, 2013). Improvements to sidewalks and crosswalks and the installation of bike facilities increase walking and biking in the community (Cain, Millstein, Sallis,
na
Conway, Gavand, et al., 2014; Parker, Rice, Gustat, Ruley, Spriggs, et al. 2013). The evidence has shown, however, how limited those opportunities are in lower-income communities, where the risk for childhood
ur
obesity is greatest (Taylor & Lou, 2011). With the closing of ALR as an RWJF national program at the
Jo
end of 2015, the Foundation launched the Physical Activity Research Center (PARC) in 2016, which produced a new generation of evidence on policy and the built environment to promote increased physical activity among children.
Building a Culture of Health requires action in four key areas – a shared value for health, cross sector collaboration, healthier and more equitable communities, and integration of health services and systems (https://www.rwjf.org/en/cultureofhealth.html). PARC was funded by RWJF because of the way in which it contributed to the Culture of Health movement through two of these four action areas – (1) cross-sector collaboration and (2) healthier and more equitable communities. The Center is made up of a collaborative team of researchers led by four institutions (University of California San Diego; Georgia
Journal Pre-proof Institute of Technology; Johns Hopkins University; and North Carolina State University) and included research partners at Baylor University and San Diego State University. The team represents both urban and rural settings across the country and have been trained in a diverse set of disciplines (e.g., health psychology, urban planning, public health, parks and recreation). This networked structure encouraged intellectual collaboration across institutions and across sectors that fostered an examination of issues related to physical activity policy and systems through different lenses, moving beyond the borders of
of
their individual siloed perspectives. In addition, the Center was led by experts on health disparities, and each of the four study topics pursued by PARC were selected, in large part, because of their potential to
ro
inform efforts to foster equitable opportunities for increased physical activity among children of color,
-p
particularly those residing in lower-income communities. Importantly, health equity, which inherently
re
involves building equitable opportunities for health among all in our diverse society, is an overarching theme in RWJF’s framework for achieving a Culture of Health. And through its research, PARC has
Jo
ur
na
lP
made a notable contribution to the Culture of Health movement.
Journal Pre-proof References An, R., Yan, H., Shi, X., & Yang, Y. (2017). Childhood obesity and school absenteeism: a systematic review and meta‐ analysis. Pediatric Obesity, 18(12), 1412-1424. Cain, K.L., Millstein, R.A., Sallis, J.F., Conway, T.L., Gavand. K.A., Frank, L.D., et al (2014). Contribution of streetscape audits to explanation of physical activity in four age groups based on the Microscale Audit of Pedestrian Streetscapes (MAPS). Social Science & Medicine, 116, 82–
of
92.
ro
Cawley J, & Meyerhoefer C. (2012). The medical care costs of obesity: an instrumental variables
-p
approach. Journal of Health Economics, 31, 219-30.
re
Cook, W.K., Tseng, W., Bautista, R., & John, I. (2016). Ethnicity, socioeconomic status, and overweight
lP
in Asian American adolescents. Preventive Medicine Reports, 233–237. Council on Sports Medicine and Fitness and Council on School Health (2006). Policy statement: Active
ur
117(5), 1834-1842.
na
healthy living: Prevention of childhood obesity through increased physical activity. Pediatrics,
Finkelstein, E., Trogdon, J., Cohen, J.W. and Dietz, W. (2009) Annual medical spending attributable to
Jo
obesity: Payer and service-specific estimates. Health Affairs, 28, 822-831. Institute of Medicine of the National Academies (2012). Accelerating progress in obesity prevention: Solving the weight of the nation. Washington, D.C.: National Academies Press. Isasi, C.R., Parrinello, C.M., Jung, M.M., Carnethon, M.R., Birnbaum-Weitzman, O., Espinoza, R.A., Penedo, F.J., Perreira, K.M., Schneiderman, N., Sotres-Alvarez, D.T., Van Horn, L.V., & Gallo, L.C. (2015). Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults. Annals of Epidemiology, 25(2), 84-9.
Journal Pre-proof Johnson, J.A., & Johnson, A.M. (2015). Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Childhood Obesity, 11(3), 233-41. National Heart, Lung, and Blood Institute (2013). Managing overweight and obesity in adults: Systematic evidence review from the obesity expert panel. Washington, D.C.: U.S. Department of Human Services. Ogden, C.L., Carroll, M.D., Fakhouri, T.H., Hales, C.M., Fryar, C.D., Li, X., & Freedman, D.S. (2018).
of
Prevalence of obesity among youths by household income and education level of head of
ro
household — United States 2011–2014. MMWR Morbidity & Mortality Weekly Report, 67, 186–
-p
189. DOI: http://dx.doi.org/10.15585/mmwr.mm6706a3
re
Parker, K. M., Rice, J., Gustat, J., Ruley, J., Spriggs, A., & Johnson, C. (2013). Effect of bike lane infrastructure improvements on ridership in one New Orleans neighborhood. Annals of
lP
Behavioral Medicine, 45(Suppl 1), S101-S107.
na
Taveras, E.M., Gillman, M.W., Kleinman, K.P., Rich-Edwards, J.W., & Rifas-Shiman, S.L. (2013). Reducing racial/ethnic disparities in childhood obesity: The role of early life risk factors. JAMA
ur
Pediatrics, 167(8).
Jo
Taylor, W., & D. Lou (November 2011). Do all children have places to be active? Disparities in access to physical activity environments in racial and ethnic minority and lower-income communities. A Research Synthesis. Princeton, NJ: Active Living Research. Whitt-Glover, M., Porter, A., & Yancey, T. (February 2013). Do short physical activity breaks in classrooms work? A research brief. Princeton, NJ: Active Living Research.