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Social and mental health integration may help prevent, treat obesity in teens

Monday - 9/30/2013, 7:40am  ET

Research shows integrating cognitive-behavioral components into health curricula makes for happier and healthier teens. (Getty Images)

WASHINGTON - High school health education classes that focus exclusively on topics of physical activity and nutrition may be a thing of the past. It turns out, integrating cognitive-behavioral components into health curricula makes for happier and healthier teens.

The national research

A recent study conducted at The Ohio State University and published in the American Journal of Preventive Medicine shows that making mental health a part of students' health education lessons, compliments physical and nutritional components of a high school health education curriculum. And the results are showing on the teens' waistlines.

"Nutrition and physical activity-based interventions are often tested when it comes to preventing obesity, but mental and psychosocial health can also be contributing factors," says Dr. Patricia A. Grady in an official press statement. Grady is the director at the National Institute of Nursing Research, a supporter in the research conducted at The Ohio State University.

In the study's 2010-2012 randomized controlled trial, teens enrolled in a class that integrated goal setting, problem solving and healthy coping skills, in addition to small amounts of physical activity and healthy eating, had significantly higher levels of physical activity and had a significantly lower mean BMI, compared to the control group of teens who did not receive the program.

The program tested in the study, called the COPE/TEEN program, was developed by Bernadette Mazurek Melnyk, chief wellness officer and dean of the College of Nursing at The Ohio State University.

"Teens who are overweight or obese experience a higher prevalence of school, social and mental health problems," Melnyk tells WTOP. "The (COPE/TEEN) program builds their self-esteem, helps them to engage in positive self-talk, to cope in healthy ways with stress, to regulate their emotions in healthy ways and to communicate effectively."

What's happening locally

While Grady and Melnyk say the COPE/TEEN program needs to be evaluated on a wider scale with groups of high-risk teens before it can be recommended to schools, some local schools are already blending physical and mental health lessons in high school classes.

Liz Payne, coordinator for health, family life education and physical education for Fairfax County Public Schools, says this integrative approach to health education is already taking place in Fairfax County classrooms. And while it's not the COPE/TEEN program, it's a start.

Fairfax schools currently have a Carol M. White Physical Education Program (PEP) grant from the U.S. Department of Education to address subjects of fitness and nutrition in grades K-12. But Payne says the cognitive-behavioral topics are just as prominent as physical/nutrition topics in the schools' ninth-and 10th-grade curricula.

"In regards to mental, emotional and social health We do information on managing stress, we talk about healthy relationships, conflict resolution, we delve into depression and suicide and we talk about family relationships. We talk about connections between personal and community health and obesity And we talk about healthy relationships, as well," says Payne.

And while Payne does not have specific measurements related to BMI and increased physical activity with this integrative approach, she is receiving positive feedback from students, and predicts a mental health will continue to play an important role in teen's overall health.

Last year, Payne met with a group of teens from Oakton High School who expressed concern over stigmas associated with mental health. Now, Payne is using their input and their suggestions to make revisions to the eighth grade health education curriculum.

"We do recognize that emotional, social, mental health is extremely important with a lot of things We're really going down this road of the mental health piece."

The importance of teachers in health education

In addition to suggesting that combining health education with cognitive- behavioral skills-building may be an effective way to prevent and treat overweight and obesity in teens, the study also found that teacher-delivered information may be the ideal mode for dissemination.

"Adolescents spend a significant amount of time in school-settings and classrooms, and these learning environments are a logical place for providing teens with skills to improve their healthy lifestyle behaviors, mental health, social skills and academic performance," Melnyk says.

"Besides the practical cost-effectiveness of not having to hire health professionals, the ability of teachers to deliver this program and others like it is significant due to the fact that teachers are likely to reinforce the skills and behaviors taught by the program in the real world classroom setting on a daily basis. Routine reinforcement increases the promise of the students sustaining long-term positive outcomes, as was shown in this study," she adds.

Despite the encouraging results from the study, Grady and Melnyk know there may be challenges down the road with adapting this integrative approach.

"Public education is under pressure to improve academic performance of students. Any added content, including school based-health promotion programs, must be justified as not only efficacious, as measured by academic outcomes including standardized test scores, but also cost-effective," Grady says.

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