In Alachua County, teenage obesity rates have gradually risen since 2008, with nearly 80% of the teenage populace reporting low physical activity levels (University of Florida & Conduent Healthy Communities Institute, 2022). The response to this concern can be straightforward; encourage teens to get up, get outside, and get active. As simple as this may be, Alachua County teens are confronted with another grim reality about their community: community violence. Because Alachua County has one of the highest crime rates in Florida (University of Florida & Florida Department of Law Enforcement, 2020), it becomes increasingly difficult for teens to engage in physical activities outside their homes and even more difficult for their caregivers to disregard the impact of community violence on their child’s physical health. Due to the clear need for trauma-informed intervention, this program aims to promote health literacy and offer community-based support to parents and Alachua County high school students to ensure healthy dietary and physical behaviors in their communities sustainably.
This project will empower youth through peer mentorship and cultivating relationships between protective community organizations, school systems, and families. The program also hopes to instill resiliency in caregivers through trauma counseling and coaching to bolster sustainable healthy practices. Outcomes will be measured using pretest-posttest and qualitative methods to gauge comprehension and behavior changes. Project goals will continually be monitored as the program progresses and may be adjusted to accommodate participating families better.
Trauma-Informed Principles
The program will use the Substance Abuse and Mental Health Services Administration's (2014) six principles and ten implementation domains to ensure that a comprehensive effort has been made to ensure solidified trauma-informed approaches. Additional guidance by Philanthropy Network Greater Philadelphia (2016) will also be employed. To ensure the physical safety of all participants, program staff will conduct extensive research in collaboration with spatial epidemiology experts at the University of Florida to identify safe community locations where mentors and students can perform physical activities. For additional safety, cross-sector partnerships with public safety organizations will also be considered, although precedence will be given to secure physical locations.
Considering the sensitive nature and stigma associated with obesity, there is a significant concern about ensuring emotional and psychosocial safety. Emotional and psychological safety for participants will be provided through oversight by LCSWs. Additional program staff will be trained in crisis intervention and trauma-informed practice, with other program training modules developed by social and behavioral scientists at the University of Florida concentrating on understanding and preventing stigma. Similarly, to avoid compassion fatigue and burnout in peer mentors and program staff, training and resources will be developed to address vicarious trauma.
Alachua County has one of the largest populations of Black-/African American-identifying individuals in North Florida (University of Florida Health, n.d.). These individuals report having the lowest average household income in the County compared to other racial and ethnic groups (University of Florida Health, n.d.). With this racial and socioeconomic disparity in mind, the program will train staff on culturally sensitive practices (e.g., motivational interviewing) when empowering individuals who identify as Black, especially those who come from disadvantaged socioeconomic households. When evaluating program outcomes, community-based participatory strategies will be implemented to assess cultural relevance and effectiveness for future cohorts.
Social Ecological Model
Using the CDC's social-ecological model (Dahlberg & Krug, 2002), this program aims to promote and educate youth on healthy practices at the individual, relationship, community, and, to some degree, societal levels:
- Individual Level. Program specialists aim to understand how community violence has impacted mindsets and knowledge of healthy practices and frequency of physical activity in students and caregivers. Specialists will also identify other ACE-related occurrences, personal attitudes and beliefs, and other individual factors that impact decreased physical activity aside from community violence and develop strategies to address them.
- Relationship Level. Program specialists will help participants understand how caregivers and their teen influence each other's health behavior and contribute to each other's experience. Additionally, the program will foster improved caregiver-child communication through guided activities facilitated by LCSWs and nutrition experts.
- Community and Societal Level. The program will utilize community assets (i.e., Alachua County Public Schools District) to improve outcomes for decreased physical activity and increased teenage obesity. Through program evaluation and participant assessments, program staff will coherently classify how community violence prevents physical activity and influences teenage obesity and which areas in the community are safe for teens to engage in. Although it is beyond the scope of this program, researchers and policymakers can use outcomes from this intervention in the distant future to develop and enforce protective and preventive measures against community violence.
Public Health Framework
This program will utilize a cross-sector public health approach to address teenage obesity at the primary and secondary prevention levels to effectively address trauma- and ACE-related risk factors (Philanthropy Network Greater Philadelphia, 2016). Considering that the target population works with youth and families at a high risk of developing consequential effects of teenage obesity, the program chiefly addresses the second level of public health intervention to prevent further exacerbation of teenage obesity impacted by community violence and ACEs. However, the program takes system-level approaches to promote prevention among caregivers. Public health sectors that will be central to this program’s success include:
- Mental Health. The mental health sector will be instrumental in screening the psychosocial burden of ACEs and community violence. Likewise, peer mentorship is another secondary interventional strategy under the supervision of the mental health sector that aims to provide interpersonal mental health support to youth.
- Welfare and Social Services. LCSWs representing social agencies will ensure caregivers have adequate tools and resources to contest the impediments of community violence on teenage physical activity and well-being. Professionals will offer caregivers information on proximate neighborhood facilities and addressing food security concerns to address concerns at a primary intervention level.
- The education sector will be a critical liaison between families and program coordinators. School administrators and educators will be reliable for disseminating preventative information to families, offering guidance on effective screening methods, establishing rapport among participating families, and building relationships with other community stakeholders that may be an asset in future endeavors.
References
Dahlberg, L.L., & Krug, E.G. (2002). Violence: a global public health problem. In Krug, E., Dahlberg, L.L., Mercy, J.A., Zwi, A.B., Lozano, R. World report on violence and health (pp. 1-21). World Health Organization. https://www.cdc.gov/violencepr...ecologicalmodel.html.
Philanthropy Network Greater Philadelphia (2016). Trauma-Informed Philanthropy: A Funder's Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley (Vol. 1-2). https://philanthropynetwork.or...raumaGUIDE_Final.pdf.
Substance Abuse and Mental Health Services Administration (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884.
University of Florida Health. (n.d.). Demographics: Black/African American Population. https://ufhealth.org/community-health.
University of Florida Health, & Conduent Healthy Communities Institute. (2022). Teens who are obese: High school students. https://ufhealth.org/community...cnembedredirect_%3D1.
University of Florida Health, & Conduent Healthy Communities Institute. (2022). Teens without sufficient physical activity. https://ufhealth.org/community...cnembedredirect_%3D1.
University of Florida Health, & Florida Department of Law Enforcement. (2020). Violent crime rate. https://ufhealth.org/community...cnembedredirect_%3D1.
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