WSUV professor earns acclaim for childhood obesity research

Her efforts to help kids eat better, exercise more draw wide interest

By Jacques Von Lunen, Columbian staff writer

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Clark County's university campus lay still this week, with only a few final exams left in the summer term.

But Jane Lanigan is not expecting downtime real soon.

The Clark County researcher is involved in several national efforts to combat childhood obesity, and even made a splash in the international research community this spring. Her study on how to get kids to eat healthy and exercise produced an interview method that may soon be used to assess childhood-obesity programs nationwide.

Lanigan, who has taught at WSUV for 10 years, last year completed a three-year pilot project as its lead researcher. The project was called Encouraging Healthy Activity and Nutrition in Childcare Environments, or ENHANCE.

The project, which was a collaboration of several nonprofits, colleges and a K-12 agency, examined 43 child care and early-learning facilities in Clark County. It was paid for by the Northwest Health Foundation, a Portland nonprofit.

"We were aware that the obesity problem has become quite acute throughout Washington," Lanigan said.

A lot of the then-current research focused on kids already in school. About one-third of all middle- and high-school-aged children in Washington are overweight or obese, according to federal health data.

"But we were well aware that the problem starts before school," Lanigan said. "We wanted to work through the child care environment (to help) children and families understand healthy eating and exercise."

First, the researchers looked at what child care providers thought about the issue. It turned out the providers were misinformed about some aspects of childhood obesity.

Many providers thought their input on health-related topics didn't matter much to kids, that parents had more influence on children's healthy habits, Lanigan said. But research shows that children will model their behavior after all of the important adults in their lives, which include child care providers.

Another misconception was that children will get healthy exercise if you just let them go outside for an hour. But a child who is used to a sedentary lifestyle will just sit outside, Lanigan said. Children need structured play activities to get healthy exercise.

Many child care providers -- and parents, for that matter -- thought that kids dish up oversized portions if they're serving themselves. But the reality is that kids put less food on their plates when allowed to choose, Lanigan said.

ENHANCE provided materials on how best to get kids to eat healthier and exercise to all of the facilities it examined. Each facility -- in cooperation with parents -- then picked at least one aspect of its operation to change or expand. For example, one site added a gardening program for the children to teach them about food. Another bought reusable lunch boxes that were sent home with the children. Parents were asked to place the children's food into these generic-looking boxes, rather than send the food to school in its original packaging. This cuts out the influence of marketing on children, Lanigan said. Some children might want what another kid is eating because the packaging is designed to appeal, even if the contents are unhealthy.

All of the sites improved their healthy practices during the study, Lanigan said. But the facilities where providers' misconceptions changed the most made the biggest strides, she said.

Feeding dolls

The study didn't just examine child care operators' misconceptions, of course. It also sought to find out what the kids knew about healthy eating and exercise.

But you can't just pose complicated questions about health and nutrition to a 4-year-old. That's why Lanigan and her team developed an interview protocol for this study, which can be used as a template to ask preschoolers about other topics, as well.

The interview method included role play, during which young children were asked to take care of a doll, to feed it and to recommend healthy activities for it.

One finding was that children had a much better understanding of the health benefits of nutritious food than they did about those of an active lifestyle.

But even those kids who wanted their dolls to eat healthy foods at meals thought it was fine to enjoy unhealthy snacks and beverages. Half of all children said they got their information on healthy lifestyles from television. The other half didn't know where they'd gotten their information from.

Fewer than 25 percent of children said they would do anything physical when they got home from day care. Almost 85 percent told their dolls to watch TV as an activity.

Many of the kids used what Lanigan called "high-power methods" in telling their dolls what to eat. Those methods can include threats or rewards, either of which is equivalent to forcing a kid to do something and has negative effects on children's eating habits, Lanigan said.

Wide acclaim

The findings of the study and the methods used in it have gotten a fair amount of attention in the academic world of human-development studies and childhood obesity prevention.

The University of Georgia is developing a curriculum on how to teach feeding in child care settings that uses Lanigan's interview protocol. The report Lanigan wrote about her work with ENHANCE received an award for best research paper from the National Council for Family Relations. Lanigan will speak at the council's fall conference in Phoenix, Ariz.

A couple of months ago, she traveled a little farther than Arizona to present her work. Lanigan was invited to Rome, Italy, in May to speak at the United Nations International Congress on Diet and Activity Measurement.

"I submitted a proposal, but didn't truly expect to be accepted," she said with a smile.

She was accepted and introduced experts from all over the world to her interview method. Much of assessing obesity focuses on quantitative measurements, i.e. numbers. Researchers and advocates talk about body-mass index, waist sizes and pounds of weight.

That lacks the qualitative component, which is understanding the behavior that leads to the excessive pounds, Lanigan said. A lot of the attendees at the conference in Rome were interested in her work, she said.

Lanigan also is about to participate in two other national efforts. She is an investigator in an upcoming research project, together with professors from WSU Pullman and Baylor University in Texas. The project is paid for by a U.S. Department of Agriculture grant and targets feeding practices for black and Hispanic preschoolers, who have higher rates of obesity. That project in part builds on her work with ENHANCE. It involves pilots in Washington and Texas, and will eventually be rolled out nationwide.

Lanigan also may become involved with Let's Move, an initiative by the Centers for Disease Control and Prevention that focuses on childhood obesity. It was started by first lady Michelle Obama. Lanigan is the co-leader of an alliance for better child care, which is part of collaborative group of 70 U.S. universities. The alliance is in negotiations to provide technical assistance for child care facilities under Let's Move.

Making a dent in childhood obesity will require awareness and change in a lot of different systems, Lanigan said. These include child care, schools, health care, food vendors and, of course, families, Lanigan said.

The interview protocol can measure if these systems are changing effectively, she said.

The systems in Clark County, by the way, are doing pretty well, particularly when it comes to available play spaces and activities for children.

"We live in a good place," Lanigan said.

And she's working on getting the rest of the world caught up.

Jacques Von Lunen: 360-735-4515; jacques.vonlunen@columbian.com;http://www.twitter.com/col_schools.