Nebraska Center for Integrative Nutrition and Metabolic Processes CoBRE Retreat October 28, 2010 - Ashland, NE. “Eat This, Not That!”: Using Avatars and the Community Readiness Model to Teach Healthy Food Choices to Native American Children. Phyllis Nsiah-Kumi, MD, MPH - PowerPoint PPT Presentation
“ “ Eat This, Not That!”: Eat This, Not That!”: Using Avatars and the Using Avatars and the Community Readiness Model to Community Readiness Model to Teach Healthy Food Choices Teach Healthy Food Choices to Native American Children to Native American Children Phyllis Nsiah-Kumi, MD, MPH Department of Internal Medicine Internal Medicine-Pediatrics College of Medicine ~~ Health Promotion, Social and Behavioral Health College of Public Health (Courtesy) Nebraska Center for Integrative Nutrition and Metabolic Processes CoBRE Retreat October 28, 2010 - Ashland, NE
Transcript
““Eat This, Not That!”: Eat This, Not That!”: Using Avatars and the Community Using Avatars and the Community Readiness Model to Teach Healthy Readiness Model to Teach Healthy Food Choices to Native American Food Choices to Native American
Children Children
Phyllis Nsiah-Kumi, MD, MPHDepartment of Internal Medicine
Internal Medicine-PediatricsCollege of Medicine
~~
Health Promotion, Social and Behavioral HealthCollege of Public Health (Courtesy)
Nebraska Center for Integrative Nutrition and Metabolic Processes CoBRE Retreat
October 28, 2010 - Ashland, NE
Project Team
MentorsTerry T.K. Huang, PhD, MPH, UNMC College of Public Health
Jennifer L. Larsen, MD, UNMC College of Medicine, Associaate Vice Chancellor for Clinical Research
Co-InvestigatorsDeepak Khazanchi, PhD, UNO College of Information Science & Technology
Susan Raatz, PhD, MPH, MS, United States Department of Agriculture, Grand Forks Nutrition Center, ND
Ronald J. Shope, PhD, Educational Psychology, UNL
Obesity in Native American Children
•Two-fold risk of being
obese compared to
their white counterparts
•Increased risk of pre-diabetic states in childhood and adulthood.
•Increased risk of early death from cardiovascular and other causes.
Northern Plains Tribes
Eighteen tribal nations in
•Iowa
•Nebraska
•North Dakota
•South Dakota
Ponca Tribe Pilot Data
•Prevalence of obesity in children•Parental perceptions of children’s risk of diabetes and weight related problems
•Health literacy of parents
•Family Health Behavior data
Type 2 Diabetes Risk in Rosebud Sioux Children (n=161)
Age 5-18 5-11 12-18 P-valueFemale 55.3% 51.6% 60.3% 0.27
Dietary Guidelines for AmericansTranslating nutritional science to community settings is essential
to enhance healthy diets and weights.
University of Nebraska Medical Center
Community Readiness
Assessment
Development of Metaverse and
Training Scenarios
Train 8-10 yo children fr Northern Plains Tribes (n=25)
Evalute impact of metaverse training
program
Project Approach
Phase 1 Phase 2 Phase 3 Phase 4
Specific Aim 1
University of Nebraska Medical Center
Assess readiness of participating Native
American community to take action on
childhood obesity and type 2 diabetes
prevention using the six dimension
Community Readiness Model.
Phase 1: Community Readiness Assessment
•Identify community and youth leaders
•Train youth on obesity, citizenship, CRM
•Key Respondent interviews
•Determine community readiness
Dimensions of Community Readiness
1. Community Efforts (programs, activities, policies, etc.)
2.Community Knowledge of the Efforts
3.Leadership (formal and informal)
4.Community Climate
5.Community Knowledge About the Issue
6.Resources Related to the Issue (people,
time, money, space, etc.)
University of Nebraska Medical Center
Community Readiness Scoring
University of Nebraska Medical Center
Specific Aim 2
Develop a culturally-appropriate metaverse
environment including theory-driven
interactive activities and simulation(s)
designed to teach healthy food choices and
portion size selection (based on the
Dietary Guidelines for Americans) to Native
American children.
University of Nebraska Medical Center
Phase 2: Development of Second Life Training
•Avatar Development
•Environment Development
•Scenario Development with feedback
incorporated
•Scoring System Development
Decision-Making Training for Behavior Change
• Teaching guidelines alone is not enough.
• Curricula have been developed for delivery of content
in classroom settings.
• Decision-making skills are crucial for adoption of
healthy dietary habits.
University of Nebraska Medical Center
Metaverses
• Metaverses are immersive 3D virtual worlds (VWs)
in which people interact as avatars with each other
and with software agents, using the metaphor of
the real world but without its physical limitations.
• Second Life is among the most common.
Virtual Worlds
Computer based
Available via internet
3 dimensional recreation of “reality”
Visual
Static
Motion
Audio
University of Nebraska Medical Center
UNO/CON Pilot ResultsPresence Questionnaire
Mean total score: 134.67 + 15.62 (max – 224)
Min/Max: 121/157
Mean item score: 4.27 out of 7Summary of identified themes
Realistic scenario
For right now “good as it gets”
Gives sense of home visit
Inconsistencies (in environment)
• Modern house – too many broken windows
• Furniture too nice for run down neighborhood
• Clutter in real homes is much worse
• Too many homes with water damage
Benefits of avatars for skills training
• Nearly unlimited freedom. Highly adapatable.
• Can design and integrate content with engaged
learning.
• Experiment with decision-making safely in the virtual
world.
• Health related information exchange and teaching can
occur with this type of educational delivery.
• Successful transfer to the real world of skills practiced
in a virtual environment.
My Second Life Avatar – Pink Lapis
Phase 3: Second Life Training Program Implementation
8-10 year olds from Northern Plains Tribes
(n=25) will complete Second Life training.
Training scenarios will include food choices in:
•Home
•School
•Community event
•Restaurant
Conceptual Model for Metaverse Research
Source: Davis, A., Owens, D., Murphy, J., Khazanchi, D. and Zigurs, I. (2009, February). "Avatars, People, and Virtual Worlds: Foundations for Research in Metaverses." Journal of the Association for Information Systems, Volume 10, Issue 2 , Article 2, pp. 90-117.
Specific Aim 3
Evaluate the impact of metaverse-based
decision-making training on:
1. Knowledge of Dietary Guidelines for Americans
2. Metaverse-based food choices and real-world
choices
3. Anthropometric and biomarkers related to
childhood obesity and cardiovascular disease risk
over time
University of Nebraska Medical Center
Targeted Behavior(s)/Guideline Recommendations:
a.) increasing water consumption
b.) decreasing SSB consumption
c.) decreasing intake of fatty foods
d.) increasing fruit and vegetable consumption,
e.) decreasing portion size.
University of Nebraska Medical Center
Phase 4: Evaluation of Decision-Making Skills and Second Life Experience
•Second Life Test Scenarios
•Food and Beverage Logs
•Pre-post DGA knowledge testing
•Focus Groups
Anthropometric and biomarker dataPre-post-6mos-12mos
• Height, weight, BMI percentile, waist
circumference, blood pressure
• hsCRP
• Glucose
• Insulin
• Lipids
University of Nebraska Medical Center
Innovation
•Use of Second Life, as a platform for learning simulations through role plays with the intent to improve the development of decision-making.
•No web-based, metaverse-based trainings focused on teaching this type of decision-making currently exist.
•The impact of using 3D environments such as virtual worlds that integrate theory-driven pedagogy to teach effective decision-making to younger children is not very well studied.
University of Nebraska Medical Center
Percentage of Overweight or Obese Children: 2003*
Source: The National Survey of Children's Health.
Percentage of Overweight or Obese Children: 2005*
Source: The National Survey of Children's Health.
Percentage of Overweight or Obese Children: 2007*
Source: The National Survey of Children's Health.
Source: The National Survey of Children's Health.
Percentage of Overweight or Obese Children: 2003, 2005, and 2007
2003 2005
2007
Dietary Guidelines for Americans
GRAINSVEGETABLE
SFRUITS OILS MILK
MEAT & BEANS
Translating nutritional science to community settings is essential to enhance healthy diets and weights.
