In 2002, health educators at the Trenton Central High School
approached the Women’s Heart Foundation with a request to create
a wellness environment for teen girls. In addition to the high
rate of obesity at the school, teachers observed poor health
choices being made with skipped meals and poor overall performance.
Youth need accurate information and guidance to help them make
conscious, well-informed choices regarding health habits.
They also need substantial encouragement to actively seek health
Health Science - Cardiovascular disease (CVD) is the leading cause of death
and disability among American women (American Heart Association,
2001). Many of the risk factors for CVD such as obesity, sedentary
lifestyle, and poor nutrition have their origins in childhood
and adolescence. The United States is the world leader in
childhood and adolescent obesity with 37% of children and
adolescents categorized as overweight or obese (Dwyer al, 2000).
Childhood obesity contributes to adult obesity, one of the risk
factors for cardiovascular disease, diabetes and other chronic
diseases. Obesity has been linked to problematic asthma,
hypertension, hyperlipidemia, social discrimination,
orthopedic problems, early maturation, hepatic steatosis,
cholelithiasis, sleep apnea, obesity hypoventilation syndrome,
and skin integrity problems. Studies indicate that both
environmental and genetic factors contribute to overweight
and obese children and adolescents (Trolano et al, 1995).
Poor nutritional and physical activity behaviors among adults
have been demonstrated to begin in childhood (Mechanic, 1979;
The relationship among CVD, diabetes, and hypertension is becoming
clearer and is now recognized as an important factor in women's
higher morbidity and mortality from CVD (American Heart
Association, 2001). Research has shown that prevention
of cardiovascular disease is successfully begun in childhood
and adolescence (Meininger, Hayman, Coates, & Gallagher, 1998).
The adolescent transition is seen as a critical period for the
formation of health-promoting behaviors that can greatly
influence adult lifestyles (Pittman & Hayman, 1997).
Researchers have found manifestations of unhealthy behaviors
such as decreased participation in physical activity programs,
skipping meals, smoking to control weight, and lack of fruit and
vegetable consumption in girls as young as preadolescents
(Santucci & Dowdell, 1996). It is much easier to prevent the
continuation of metabolic syndrome (early diabetes) into adulthood, addressing
factors in adolescence, then to treat adults with manifestations of diabetes later in life.
Justification - Prior to the program introduction October 2004
students were not participating in gym class,
accepting a failing grade rather
than exercising in
the co-ed gym environment. The school reported as high as 60 percent drop-out rate.
A New Beginning . Over
one hundred and twenty
10th-grade students voluntarily signed up for the program and the girls are changing into their gym clothes and participating. They enjoy a customized
work-out routine in a same-sex environment. Certified fitness trainers work collaboratively
with the head teacher, who is also fitness-certified. There
are dedicated nutrition days with hands-on food preparation
in the Teen Esteem
kitchen, led by a registered dietitian. There are standard
curriculum days for health class and a field trip to the grocery store. The girls
exercise while listening to their favorite
music and having fun. They learn about the importance of taking
care of themselves. A research team from the Rutgers University-Camden Department of Nursing is gathering data. Now in its
second year, the Teen Esteem Health and Fitness Program© TM;
is beginning to shine as a program that offers a gender-specific approach to teen girls' health and wellness.
At the end of the first year (June 2005),
improvement in their health choices. At the end of the second year (June 2006),
LDL levels decreased by 2 points -- a statistically significant finding as an indicator
for metabolic syndrome. The program has been extremely well received by the girls and the staff and, in fact,
helps keep students connected. The Teen Esteem drop-out rate is zero.
Start-up costs for the Teen Esteem Health and Fitness Program were provided by the New Jersey
Department of Health & Senior Services Office on Women's Health and
by the New Jersey Department of Human Services. The Horizon Foundation
of New Jersey and the state of New Jersey provided
funding for the 2005-2006 school year. WHF would like to continue
the program and offer it to other schools.
Interested sponsors please contact email@example.com