Childhood obesity isn’t an issue that strikes only when adolescents explore their independence and start making their own food and lifestyle choices, it unfortunately also strikes children at a much younger age. According to the recent study “Prevalence of Obesity Among US Preschool Children in Different Racial and Ethic Groups” (Arch Pediatr Adolesc Me 2009; 163(4):344-348), the obesity prevalence of 4-year old children in the United States is a disturbing 18.4% (95% confidence interval [CI], 17.1%-19.8%), with the ethic/racial breakdowns as follows:

American Indian/Native Alaskan, 31.2% (95% CI, 24.6%-37.8%); Hispanic, 22.0% (95% CI, 19.5%-24.5%); non-Hispanic black, 20.8% (95% CI, 17.8%-23.7%); non-Hispanic white, 15.9% (95% CI, 14.3%-17.5%); and Asian, 12.8% (95% CI, 10.0%-15.6%)

Childhood obesity can lead to a myriad of physical and psychological health problems, among them diabetes, high blood pressure, heart disease, low self esteem, harassment and discrimination.

Ideally parents should lead the charge in reversing this disturbing trend of obesity in children, but sometimes themselves contribute to the problem due to ignorance or their own poor health practices. Fortunately there are number of concerted efforts being made to combat childhood obesity. A select list of programs/organizations includes:

Alliance for a Healthier Generation

The Alliance for a Healthier Generation is a partnership between the American Heart Association and the William J. Clinton Foundation.

It seeks to make a positive impact on children’s health via its four core initiatives — Healthy Schools Program, Industry Program (encouraging restaurants and snack companies to create healthier meals, snacks and drinks for children), Kids’ Movement, and Healthcare Program.

NUTRITION DETECTIVES® “Teaching Kids to Make Healthy Choices”

Nutrition Detectives in a nutrition education program for elementary school children where youngsters learn how to read food labels, how to identify healthy foods, and how to make wise nutritional choices.

It includes a manual/curriculum guide for teachers and a pre- and post food label quiz to measure students’ increased nutritional comprehension.

Food Dudes

The Food Dudes Healthy Eating Programme, which originated in the UK and is available in six languages, is geared towards children 2-11.

It claims a high success rate in getting participating children to eat more fruits and vegetables, with equal effectiveness for boys and girls and children of all socioeconomic backgrounds. The site provides a step-by-step guide to starting a Food Dudes program.

"More Kiwi" from Matt Linehan

“I have long believed that prevention and wellness are the keys to solving our health-care crisis. We must recreate America as a “wellness society” focused on fitness, good nutrition and disease prevention—ultimately, keeping people out of the hospital in the first place. You paved the way for a lot of people, and this is something I have been laboring on for a long time.  We don’t have a health-care system in America; we have a “sick care” system. The problem is that this current system is all about patching things up after the fact.” – recent statement by Sen. Tom Harkin

Fortunately, the importance of preventive health care is gaining traction among the medical community, government and business leaders, and the public at large. Increasingly more people are educating themselves about how to lead healthy lives, and are doing so at a time when there is an immense amount of legitimate and free information about health and illness prevention available online.

Nutritional know-how is a vital component of illness and disease prevention, and these days consumers have an unprecedented opportunity to take their nutritional health into their own hands and develop true nutritional intelligence. Learning the basics, let’s call it Nutrition 101, is a good starting point, and that means knowing what carbohydrates, fats and proteins, vitamins and dietary minerals are, and how they impact and interact within the human body. Making wise choices regarding what foods to eat is another important component of nutritional intelligence. But although most consumers know that there are healthier and less healthy foods to chose from, and are becoming literate in reading food labels, comparing one food item against another can seem daunting.

While not a substitute for trying to keep up with the latest studies and findings in the nutrition field, comparing foods will likely become easier with the newly-launched NuVal Nutritional Scoring System. Although there are several other food labeling systems in place (for a good historical overview of American food and nutrition labeling, see Fooducate’s post), NuVal™ gets points for being easy to use – with a scoring system of 1 to 100 (100 being the highest), consumers can now compare items both within and across categories.

The scoring system takes into account more than 30 different nutrients and nutrition factors.  Nutrients with generally favorable effects are placed in the numerator (fiber, folate, Vitamin A, Vitamin C, Vitamin D, Vitamin E, Vitamin B12, Vitamin B6, potassium, calcium, zinc, omega-3 fatty acids, total bioflavanoids, total carotenoids, magnesium and iron), while nutrients with generally unfavorable effects on health are placed in the denominator (saturated fat, trans fat, sodium, sugar and cholesterol). Another positive aspect of NuVal™ is that, while its goal is to provide a nutritional score for every one of the more than 50,000 products found in the average grocery store, its Overall Nutritional Quality Index (ONQI™) algorithm underlying the scoring system was created independent of manufacturers and other similarly interested parties.

William gave examples of how serial dramas are able to significantly raise awareness about family planning options, HIV prevention, arranged marriages (in reality abductions and violations of young girls) and exploitative child labor and child slavery. He also showed where this awareness resulted in changed behavior. For example, he told one moving story where the family of a 14-year old abducted girl was reluctant to let their other daughter attend school for fear that she too would be attacked on the way to class. However, after hearing a serial radio drama discussing "arranged marriages," they and the other villagers decided that they would band together to prevent further abductions. 

Esta explained that the success of serial dramas, one of several types of entertainment-education vehicles (others include telenovelas, series, sit coms and docu dramas), lies in the identification of the audience with the characters, and in helping audience members believe that if a character can improve his or her life, perhaps they can too. Esta also provided an overview of the steps involved in using serial dramas to bring about change: Audience, analysis, access, articulation, artistry, auxiliaries, advocacy, advertising, assessment, and adjustment.

Katie Paine, who writes KDPaine’s PR Measurement Blog and will be presenting at the conference this afternoon, also enjoyed the session.

The students, representing all four years of medical school, offer a Dose of Reality, namely "what it’s really like at the University of Michigan Medical School. [They] give you an intimate look at their med school lives—their insights, ‘ah-ha’ moments, frustrations and excitement."

According to American Medical News (online subscription required; quote from April 17, 2006 article, Med school’s Web site adds student blogs): 

"Plenty of medical students have independent blogs, but 12 students…have blogs on the medical school web site, an event the university says is a first among medical schools…

The blogs are part of an overall strategy to use the Internet as a recruitment too. Officials hope that an unfiltered picture of life at the school will increase the applicants….

Dan Remick, MD, assistant dean for admissions and director of the blog project, said prospective medical students want information that hasn’t been run through administration filters or censored in any way."

The article also states that the medical school offers monthly Internet chats for applicants and those who have been accepted but haven’t decided whether to attend. The combined efforts resulted in an increase of 20% admissions acceptances for the 2005-06 class.

The Dose of Reality site currently hosts these students’ blogs:

• M1 Amanda Elliott
• M1 Andrea Knittel
• M1 Karen Lo
• M1 Jon Streit
• M2 Ben Bryner
• M2 Janani Krishnaswami
• M2 Jason Cheng
• M2 Tim Bodnar
• M2 Shelby Stewart
• M3 Tanyaporn Wansom
• M3 Elliott Gozansky
• M4 Okeoma Mmeje

The blogs’ greatest appeal is that the students don’t gloss over their medical school experiences. For example, in a May 3rd post, first-year student Andrea Knittel writes:

"As the bearer and compulsive checker of a fibroadenoma (a benign fibrous lump of breast tissue identified only a week after I learned what the word meant in our first pathology sequence), I know what waiting for a diagnosis is like.  It’s a time filled with worry, what-ifs, and pre-emptive decision making.  It’s hard, and even harder to describe.  At the same time, I can only imagine that the pain of waiting for a diagnosis and wondering what was going is nothing compared with the pain of breast cancer treatment both emotionally and physically.  It’s the kind of pain that you probably can’t treat with medicines…" 

Meanwhile, fourth-year student Okeoma Mmeje writes this on March 24 (warning: post covers the topics of abortion and rape) :

"My team always takes call on Thursday and my second day on service we were on call. I worked with the intern and resident assigned to gynecology emergency and there were so many interesting cases, particulary ectopic pregnancies and incomplete abortions. The first case was of a 24 year old woman that presented in a semi-conscious state with peritoneal signs. An ultrasound done at an outside hospital revelaed that she had an ectopic pregnancy. We did a lapartomy and took out her right fallopian tube. She lost 2300 mL of blood during the case. I don’t think she had much time left before the outcome of the case would have been fatal…. Next, we evaluated a 12 year old girl that came with her grandmother after being raped. She said she was raped the day before by a man who forced her to go with him to the beach. The resident completed the police reprt and took samples. On physical exam, there were signs suggesting that she had a forced sexual encounter. The hymen was rugged in appearance and lacerations were also present. Now, it’s left in the hands of the police to prosecute the offender. According to the girl, her friends knew the guy so they would be able to find him. What’s really sad about this case is that the girl has some type of developmental delay, which I thought was due to cerebral palsy.

The remaining cases we saw were all incomplete abortions… Many young girls and women can’t afford to go to a private clinic and get an abortion so they start the process at home…, then when they start bleeding and cramping they come to the hospital to complete the abortion. When the patients present with an incomplete abortion, a MVA (manual vacuum aspiration) is done to remove the remaining uterine contents. This was quite painful to watch because it’s done with no anesthesia. They offered  me an opportunity to do one of the MVAs, but I couldn’t do it knowing that the patient wasn’t anesthetized. The patients already go through enough pain.."

Does the use of this type of recruiting mean that traditional/professional-led PR is becoming less relevant? Not necessarily. But it does represent the growing influence and appeal that insiders — in this case actual students sharing in their own words their real-life experiences — continue to have with particular audiences. The fact that the University of Michigan recognizes this reflects its true understanding of public relations and marketing.   

However, the article on organizations, Survival of the Adaptive by Nitin Nohria, the Richard P. Chapman Professor of Business Administration at Harvard Business School, is particularly enlightening for PR and and other related professionals counseling clients on crisis management. Nohria writes:

"In the complex and uncertain environment of a sustained, evolving crisis, the most robust organizations will not be those that simply have plans in place but those that have continuous sensing and response capabilities…

We know from complexity theory that following a few basic crisis-response principles is more effective than having a detailed a priori plan in place….

The goal is not to create specific rules for responding to specific threats but to practice new ways of problem solving in an unpredictable and fast-changing environment."

Nohria recommends that organizations have a global network of people in place that can help out as needed if internal communications systems break down, or as either human or physical resources are compromised.

He also compares the characteristics of organizations that will be less, and those that will be more, successful in surviving an outbreak:

• Hierarchical vs. networked
• Centralized leadership vs. distributed leadership
• Tightly coupled (greater interdependence among parts) vs. loosely coupled (less interdependence)
• Concentrated workforce vs. dispersed workforce
• Specialists vs. cross-trained generalists
• Policy and procedure driven vs. guided by simple yet flexible rules

(Photo source is Max xx)

Much work still needs to be done before local municipalities and state governments are ready to handle an outbreak. But opportunistic marketers have already moved into overdrive to make sure they are ready when a panicked and ignorant public searches for a quick H5N1 protection fix.

There’s LG Electronics air conditioners that allegedly prevent avian influenza with a special filter coated with a substance extracted from a fermented kimchi (via Boing Boing and Envisioning 2.0).   

And there’s the Plan for Flu: Better Safe Than Sorry! site that offers a water purifier, masks, a radio and a crank flashlight for sale, warning readers:

"Please be aware that there is no guarantee that these items will  be available if ‘things get worse’. Genuine 3M Masks have already become harder to obtain. We highly recommend that you and your loved ones finish getting prepared as soon as possible."

While the site provides an "Avian Flu News" page, it only posts articles that serve its sales purpose, and doesn’t provide a single link to reputable public health information sources such as PandemicFlu.gov, Centers for Disease Control and Prevention, World Health Organization or the World Organization for Animal Health. Why? Probably because it wouldn’t help stress the urgency to buy now before it’s too late:

The least hype-driven sales site I’ve come across is Flu Armour: Pandemic Influenza Defense Systems. Although it too warns of a product shortage, it does so in a less panic-inducing way than the site mentioned previously:

"Please be aware that a Bird Flu Pandemic or heightened threat may create an excessive demand for Flu Armour products. We encourage concerned parties to be mindful of possible present and/or future shortages when ordering. If an item is sold out, it will not be listed in our product menu."

And to its credit, it links to all the major avian flu information sites.

Guess who I would buy from?

A Roanoke Times editorial reported that the Virginia House of Delegates passed a bill last week, HB 1531 Healing arts; unprofessional conduct in practice thereof, that sought to prevent physicians from discussing gun safety with patients:

Establishes as unprofessional conduct by a practitioner of the healing arts the oral or written inquiry to a patient concerning the possession, ownership, or storage of firearms, where the inquiry is unrelated to the patient’s condition and is for the purpose of gathering statistics or to justify patient counseling.

This would have had a particularly chilling effect on pediatricians, who would have been prevented from inquiring about the safe handling and storage of guns in homes where children are present.

Not surprisingly, according to the Roanoke Times, the National Rifle Association supported the bill, while the Virginia Chapter of the American Academy of Pediatricians and the Medical Society of Virginia opposed it. 

HB 1531 was fortunately defeated February 23 by the Senate’s Committee on Education and Health  with 6 yeas and 9 nays.