Are Kids Lazy? How the “Be a Player” campaign to increase physical activity in children fails to address social issues in childhood obesity –Rossana

The number of overweight children has increased significantly in the last few decades (1,2). During 1970 to 2003, the prevalence of childhood obesity among children 6 to 17 years increased from 4-4.5% to approximately 11% in 2003 (3,4). Childhood obesity can result in serious health consequences and can lead to such chronic diseases as cardiovascular disease and diabetes (4,5,6). Furthermore, obesity can have negative psychosocial effects among youth including low self-esteem and stigmatization (7). Risk factors identified as contributing to obesity include having a poor nutritional diet and physical inactivity (1). In the United States, physical activity has been shown to progressively decrease among children as they age, especially girls (7). Increases in sedentary behavior may account for part of this decreased trend in physical activity. One media study found that children spend approximately 5 and half hours per day using media such as television, computers, and video games (1,8). As a result, the United States Department of Health and Human Services has taken several initiatives to reduce childhood obesity by implementing programs and campaigns to increase physical activity among America’s youth.

The “Be a Player” campaign is a collaboration between the United States Department of Health and Human Services , the Ad Council, and the NFL and is a media campaign to encourage children to become more physically active (9). The campaign’s slogan, “Get up and Play an hour a day,” is simple and easy to remember as it is directed towards children (9). Prominent NFL players and characters from the popular children’s movie Shrek serve as role models and spokespersons for the campaign (9). Although the campaign’s commercial lasts only a few seconds, the commercial depicts sedentary behavior as negative by associating laziness with television viewing and computer use. During the commercial the spokesperson encourages the children to play outside. The children are then shown playing sports and engaging in other types of physical activity in a playground. Interestingly enough, the commercial ends by advertising the campaign’s website as a resource for ideas on how to play and directs children to obtain more information from their computer (9). Although increasing physical activity among children is important in reducing childhood obesity, the “Be a Player” campaign uses an ineffective method to change behavior. By focusing on individual responsibility, the campaign fails to address the social barriers that contribute to sedentary behavior among children in the first place.

Environmental Barriers to Physical Activity

Physical and environmental barriers prevent some children from participating in physical activity. The “Be a Player” campaign, however, ignores this fact. Neighborhood safety, for example, is an issue for many children, especially for those who live in inner-city neighborhoods where violence is prevalent (5,10,11). Furthermore, the availability of play space including parks and playgrounds are also factors that can serve as environmental barriers for outside play (5,11,12). The built environment can have an important impact on a child’s ability to engage in physical activity. Such factors include housing, transportation issues, and activity space (5,10,11,13). Low-income children are particularly vulnerable to their built environment, as they are less likely to have access to safe facilities or play areas (5,10,11). Furthermore, the physical appearance and aesthetic appeal of some neighborhoods and communities make it less appealing for parents and children to be active outdoors (10,11). Transportation issues, including distances from facilities and playgrounds can also have an impact on whether or not a child is able to engage in physical activity (10,13).

The Role of Parents and the Media

The campaign does not address parents and other peers as role models nor does it address the impact media has on a child’s behavior. In an effort to reduce childhood obesity, parents should be directly involved as they are far more likely to influence their children (14). For example, parents who are themselves physically inactive can negatively impact the physical activity of their own children (14). Children with obese parents have an 80% chance of becoming obese in their lifetime compared to only a 7% chance for children with parents who are physically fit (1,15). Similarly, children who only have one obese parent have a 40% chance of becoming obese during their lifetime (1,15).

Lack of parental supervision and monitoring of children’s television viewing and computer use also contributes to increased sedentary behavior among children (10,12). This is especially true for children who have parents who work full-time and are not available during the day. Furthermore, video games and internet blogs are becoming increasingly popular among youth further encouraging children to spend large amounts of time in front of a computer. Other factors that inhibit parents from supporting their children to be more active include lack of time, safety concerns, and lack of opportunities (1,10,12).

Self-Efficacy and Participation in Sports

The campaign fails to address economic barriers and the self-efficacy of children to participate in outside activity. Organized sports are expensive and are not accessible to children of low socioeconomic status. As a result, some children only have access to sports and other activities during recess and physical education classes during school. Periods of non-structured physical activity is highly recommended for children, however, such time is usually only offered during recess (1,16,17). Lack of funding and changes in school policies, however, can limit or eliminate time spent in recess and physical education classes (12).

Forcing children to engage in structured physical activity may actually have a negative impact on the child’s physical activity as an adult, as some children have low self-efficacy for engaging in sports and organized play (1,7,18). Organized sports can be highly competitive and requires a certain level of skill that some children believe they do not possess. For example, children who worry about not being selected for a sports team are more likely to avoid engaging in physical activity (18). Therefore, both structured and unstructured periods of physical activity are important factors in promoting physical activity among children.

Children who are already obese are less likely to engage in physical activity, especially with their peers. This may be due to low self-esteem or anxiety and the stigma they may experience of being overweight. (7,18). Psychosocial factors that inhibit children, especially overweight children, from participating in physical activity also include peer victimization, depression, and parental distress. Children who feel victimized by their peers are more likely to feel self-conscious about being active and lack support to participate in outdoor sports and activities (18). Furthermore, children who are depressed are more likely to experience symptoms of fatigue and low self-esteem which can also contribute to decreased physical activity (18). Likewise, parental distress can effect the emotional and psychological functioning of a child and can impact their desire to be active (18).

The “Be a Player” campaign takes a negative approach to marketing behavior change by suggesting that children are lazy and are mainly responsible for their physical inactivity. The campaign takes this approach despite the fact that children are more likely to be motivated to engage in physical activity if the goals are to improve their appearance, or to increase social acceptance (7,14,16,18). Addressing such values is often the focus of most successful marketing campaigns, however this particular campaign fails to address these issues. Given that children and adolescents place more value on physical appearance and social acceptance, they will most likely be less inclined to engage in physical activity if the message is to improve health.

Conclusion

By not taking into consideration the social and environmental factors that prevent children from being physically active, the “Be a Player” campaign does more harm than good. Children alone are not to blame for the decrease in physical activity. Environmental and physical barriers can prevent many children from playing outdoors. Parents are also important role models and need to take responsibility in monitoring their children’s television viewing and computer use. Some parents are not able to support their children for such reasons as safety concerns and lack of time. This is especially true for low income parents who tend to live in poorer and unsafe communities and are less available to monitor their children during the day. Instead of encouraging children to be healthy, the campaign contributes to the stigma of being overweight or obese by directing responsibility to the individual. Future campaigns need to address both physical and social barriers that prevent children from playing outside. School policies on recess and the management of neighborhood parks should all be considered when creating an intervention to improve physical activity in children. Although the campaign makes good use of using popular athletes and characters to support the campaign’s message, without accounting for the social and environmental barriers that inhibit children from being active, the campaign will most likely do little to change behavior.

REFERENCES

1. Sothern MS. Obesity prevention in children: Physical activity and nutrition. Nutrition 2004;20:704708.
2. Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549-1555.
3. Schwartz MB, Puhl R. Chilhood obesity: A societal problem to solve. The International Association for the Study of Obesity. Obesity Reviews 2003:4:57-71.
4. Troiano RP, Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 1998:497-504.
5. Papas MA, Alberg AJ, Ewing R, Helzlsouer KJ, Gary TL, Klassen AC. The built environment and obesity. Epidemiology Review 2007:29:129-143.
6. Allison D, Fontaine K, Manson J, et al. Annual deaths attributable to obesity in the United States. JAMA 1999:282:1530-8.
7. Strauss RS, Rodzilsky D, Burack G, Colin M. Psychosocial correlates of physical activity in health children. Archives of Pediatric and Adolescent Medicine 2001:155:897-902
8. Roberts DF, Foeher UG, et a. Kids and media at the new millennium: a comprehensive national analysis of children’s media use. Menlo Park, CA: Henry J. Kaiser Family Foundation, 1999.
9. Ad Council: News Detail: U.S. Department of Health & Human Services and Ad Council Join NFL to Combat Childhood Obesity. Ad Council. http://www.adcouncil.org/newsDetail.aspx?id=207
10. Bedimo-Rung AL, Mown AJ, Cohen DA. The significance of parks to physical activity and public health. American Journal of Preventive Medicine 2005:28(2S2):159-168.
11. Lopez RP, Hynes HP. Obesity, physical activity, and the urban environment: Public health research needs. Environmental Health: A Global Access Science Sources 2006:5:25.
12. Standford Prevention Research Center. Building “Generation Play:” Addressing the crisis of inactivity among America’s children. Stanford, CA. Stanford University School of Medicine, 2007. http://www.playeveryday.org/Standford%20Report.pdf
13. Centers for Disease Control and Prevention. Barriers to children walking and biking to school, United States 1999. MMWR Weekly 2002; 51(32):701-704.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5132a1.htm

14. Ward-Begnoche W, Speaker S. Overweight youth: Changing behaviors that are barriers to health. Practical advice for dealing with the family, the child, and socioeconomic environment. Journal of Family Practice 2006; 55(11):957-963.
15. Whitaker RC, Wright JA, et al. Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine 1997;337:869.
16. Sothern M, Gordon S. Prevention of obesity in young children. Clinical Pediatrics 2003;42:101.
17. DiNubile NA. Youth fitness—problems and solutions. Preventive Medicine 1993;22:589.
18. Gray WN, Janicke DM, Ingerski LM, Silverstein JH. The impact of peer victimization, parent distress and child depression on barrier formation and physical activity in overweight youth. Journal of Developmental and Behavioral Pediatrics 2008;29:26-33.