A Rationale for the Development of Nutrition-IQ Summer Camp for Little Brothers and Sisters of Pinellas County
The Problem
Nearly 1 in 5 children and teens in the United States are obese. Behaviors contributing to the problem include the consumption of high calorie and low nutrient foods, a deficit of physical activity and poor sleeping habits (CDC 2016). Obesity rates increase with age, with 13.9% of 2-5 year olds being obese, 18.4% of 6-11 year olds and 20.6% of those aged 12-19 (NCHS 2018). Alarmingly, kids with obesity are 80% more likely to become obese adults (Gordon-Larsen, et al 2010; Guo & Chumlea, 1999). Recent reports show obesity in the United States has reached epidemic proportions, with 40% of adults now in this category (NCHS 2018), and rates more than tripling for adolescents since 1980 (Ogden, et al 2002).
When economic costs are considered on a global scale, obesity costs the planet $2 trillion annually. This is comparable to the cost associated with armed violence or smoking in terms of effects on gross domestic product (McKinsey Global Institute 2014). In the US, the cost of obesity adds $190 billion annually to the healthcare price tag (Reuters 2012), and childhood obesity accounts for $14 billion of this (RWJF 2019).
From the socio-economic perspective, prevalence of obesity is highest in children and adolescents from lower and middle income groups (18.8%; 19.9%), and lowest in the upper income group (10.9%) (CDC 2019). In terms of race, Hispanic and non-Hispanic black children have overall obesity rates of 25.8% and 22%, as compared with non-Hispanic white children (14.1%) (Hales, et al 2017). To put these numbers in perspective, the Healthy People 2020 goal is to reduce the rate of childhood obesity to ≤ 14.5% (US DHHS 2020).
In the midst of the growing problem of childhood obesity, public school education for culinary skills has diminished over the past 20+ years (Lavelle, 2016). Also, assisted in part by the affordability and convenience of fast food, Americans are eating more meals prepared away from home than ever before (USDA 2019). 
These two facts create a gap for children in learning how to cook as a life skill (Lavelle, 2016), whether taught at school and/or at home. This gap presents a determinant for obesity risk, given meals prepared at home contain less total and fat calories, and more fiber, calcium and iron per calorie (Guthrie, et al 2002).
The Priority Population
Informed by the above data, the Nutrition-IQ (N-IQ) Summer Camp program focuses on adolescents from families with lower levels of socio-economic status in Pinellas County Florida. The Big Brothers Big Sisters (BBBS) organization in the county supports NIQ program eligible kids (Littles), and their respective adult volunteers (Bigs) matched for compatibility. The majority of Littles are ages 10-14, and there is a growing concern with childhood obesity recognized by BBBS leadership. The top barriers identified for Littles (and their parents/caregivers) to consume a more nutrient dense diet are described as: limited income, reduced access, and limited knowledge, skills and equipment to prepare good tasting nutrient-rich economical food at home. In terms of demographics, the Littles are represented by the following racial groups: 47% African American, 24% Caucasian, 15% Hispanic, 10% Multi-racial and 4% other.
As described, Pinellas Littles are at higher risk for the development or worsening of childhood obesity, and in the short-term this threatens higher rates of hypertension, high cholesterol, impaired glucose tolerance and breathing problems, as well as having weight associated psychological and social issues (CDC 2016). In the longer-term, it means more obese adults with a much higher probability of developing heart disease, type 2 diabetes and cancer (Jensen et al 2013).
The Opportunity
The N-IQ Summer Camp program is proposed with the purpose of increasing the knowledge Little’s have for good tasting healthy foods, while increasing their skills and confidence with preparing these foods themselves.
In order to achieve this, Big/Little pairs (Matches) will draw from an N-IQ website repository of materials to support three joint activities over the course of one summer month. These include a local produce store tour to build awareness of fruits and vegetables providing rich sources of nutrients lacking in youth diets, followed by preparation of a recipe incorporating such.
The second activity involves the Match taking an inventory of basic equipment on hand in the Big’s kitchen and sourcing items together in relationship to needs for the third activity. This process is designed over time to carry-over into identifying equipment the Little may be missing in their home environment. The third activity has the Match shopping for and preparing a main dish recipe. Additional skills in comparing cost of ingredients and adjusting recipes using kitchen math are also part of the curriculum. In sum, N-IQ summer camp will facilitate more home cooking of healthy food by targeting both educational and environmental influences.
The Promise
The primary gains for the Littles are to acquire knowledge, skills and confidence from N-IQ Summer Camp, such that their frequency of preparing healthy food at home increases. Before and after measurements of knowledge, ability and self-efficacy will provide an important means of evaluating outcomes.
Other stakeholders in the program also have exciting gains to make based on their area of involvement. Bigs will have the joy of cooking with their Littles, and with this comes the satisfaction they seek to make a difference. Parents/caregivers of Littles stand to benefit from enjoyment, health and economic perspectives by supporting their children. They may also take a larger role in home prepared meals in the future.
BBBS of Pinellas can utilize the N-IQ website as part of a valuable social and conventional media campaign to support Match recruitment. These communications also support additional donations from current and new sponsors wanting to be associated with this important work. By donating gift cards for grocery shopping, Wal-Mart secures more dollars spent on future food purchases, a healthier community from which to draw employees and increased brand loyalty.
All these gains contribute to the ability of the N-IQ Summer Camp to benefit more BBBS Littles in Pinellas County and beyond.
Reason to Believe
It is very encouraging to see cooking skills interventions from the research literature (Jarpe-Ratner, et al 2016; Oakley, et al 2017), and the real world (USDA 2020) find programs similar to N-IQ improving knowledge, attitude, self-efficacy and family communication around good tasting healthy food and preparation thereof.
In addition, the BBBS organization brings a unique strength to N-IQ’s probability of success. This lies in their support for the parents, the Littles and the Bigs volunteers. Bigs provide another coach to motivate, another teacher to share knowledge and skills, and a healthy example for the kids to model. Further, Matches are already in the habit of setting a health goal on an annual basis. This practice will go far to seeing that a benefit endures from a summer camp intervention.
References
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