VCOM Carolinas Research Day 2023

Educational Reports

Pilot Study Assessing the Baseline Physical Activity and Knowledge of Cardiovascular System of Elementary-aged Children in Rural South Carolina and the Impact of an Interactive Educational Program Anna C. Deal*, OMS II, Maya Aboutanos*, OMS II, Madison Dudick*, OMS II, Nicholas Minner*, OMS II, Carsten Steinmetz*, OMS II, Harold Garner PhD, David Reddon, PhD, Alexis M. Stoner, PhD. Edward Via College of Osteopathic Medicine, Spartanburg, SC. *equal contribution Statisticia n- David Redden, PhD Abstract Results Results

Abstract # EDUC-6



Cardiovascular disease is one of the highest causes of morbidity and mortality in the United States. Cardiovascular disease has a plethora of risk factors, including obesity, inadequate nutrition and exercise, and type II diabetes.⁵ Primary prevention of cardiovascular disease is directed toward mitigating childhood obesity through nutrition and exercise education.⁷ The current body of research aims to either complete nutrition or exercise based programs, particularly in elementary-aged children in rural southern United States.³ These programs often were outside of the school system or after-school programs, making it difficult for long-term retention and continuity.² The prior research focused on improving physical activity during the school day, instead of measuring the change in physical activity after school and over the weekend.⁴ Our research combined a nutrition and exercise program that was incorporated into an existing program, Be Great Academy, in Abbeville, Saluda, and Greenwood counties in South Carolina to impact children’s activity and nutrition over three separate sessions.⁹ The objective of this research project is to determine if teaching children the importance of heart healthy habits and how to find activities they enjoy will improve their activity levels on the weekends. The project seeks to answer, “If provided with education on heart healthy habits, will the elementary school children in Abbeville, Greenwood, and Saluda counties retain and have the desire to implement healthy nutrition and increased exercise on the weekends?” The hypothesis is that teaching the children about the importance of heart healthy habits and helping them find activities they enjoy will not only increase their activity levels on the weekend, but also improve their desire to be active. given a pre-survey to evaluate their understanding of heart healthy habits in accordance with pediatric nutritional guidelines and fundamental concepts of heart health. After administering the survey, the children had a fifteen minute educational period where second year student doctors discussed components of heart health. Topics covered include: importance of hydration, benefits of whole grains and reduced sugar, and why fruits and vegetables are good for your body. After the education portion, there was an interactive program where the children learned about the importance of physical activity and different ways to be active including: yoga, dancing, playing games, etc. Students completed the same survey at each of the three sessions, one session in August, September, and October, to assess knowledge retention and implementation of heart healthy habits in their daily lives. The survey, Kids’ Activity and Nutrition Questionnaire (KAN -Q) was taken from a study at Arizona University and is a research validated instrument. KAN-Q gathers information on students activity levels and diet, as well as knowledge and attitudes towards heart health. Data was analyzed using the Chi-squared statistical test. Methods The research is a longitudinal survey group design that was approved by the IRB under the protocol number, 1937076-4. The children present at Be Great Academy were


p-value 0.0464 <0.0001 <0.0001 0.0027

Decreased amount of TV watched Increased whole grains eaten Decrease in sugary drinks consumed

Increased knowledge how many whole grains to eat per meal Increased knowledge of healthiest milk choice


Figure 1. Consumption of Whole Grains. Figure 1A shows statistically significant increase in the consumption of whole grains among the students. Figure 1B shows a statistically significant reduction in the amount of white grains consumed.

Table 1. Other Statistically Significant Data.



Conclusions The results supported the original hypothesis of the study that if provided with education on heart healthy habits, elementary school children in Abbeville, Greenwood, and Saluda counties retained and implemented healthy nutrition choices and increased exercise after school. Improved nutrition choices were shown in the children choosing a half plate of fruits and vegetables, a quarter plate of whole grains, one percent milk, and opting not to drink high sugar beverages in compliance with United States Department of Agriculture’s recommendations on MyPlate.⁸ The children’s understanding of appropriate exercise also increased over the three sessions, indicating a preference for sixty minutes of exercise per day based on American Heart Association’s guidelines.¹ As the data exemplified, both nutrition and exercise choices enhanced over the three sessions. To augment behavior, a dual approach of nutrition education and exercise encouragement correlated to improved nutrition choices and exercise habits for primary prevention of cardiovascular risk factors in elementary-aged children. For future studies, consistent sessions could be implemented each month over a year to continue to increase knowledge and healthy habits. Further, this study was limited to a previously published survey, KAN- Q.⁶ Therefore, future studies could create a survey with increased specificity to the research question.


Figure 2. Consumption of Fruits and Vegetables. Figure 2A shows statistically significant increase in number of vegetables eaten. Figure 2B shows statistically significant increase in the number of fruits eaten. Figure 2C shows improvement in children’s knowledge of the percentage of fruits and vegetables that should be on their plate as fifty percent according to MyPlate.⁸



We would like to thank the students and staff of Be Great Academy in Abbeville, Greenwood and Saluda Counties for their participation with this research study. We would also like to thank Dr. Stoner, Dr. Gardner, and Dr. Redden for their guidance and contributions. This research was submitted and approved by IRB on 07/28/2022 under protocol number: 1937076-4.

Figure 3. Children’s Knowledge of Appropriate Amount of Exercise Each Day. Over the three sessions, the children increased their knowledge of the ideal amount of exercise per day according to American Heart Association guidelines.¹


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