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The behavioral risk factor that I selected from the Healthy People 2020 objectives is overweight and obesity among children and adolescents (ages 6 through 19), which has increased significantly over the last three decades (Knickman & Kovner, 2015). Currently, only 36% of Floridians are at healthy weight, and if we stay on our current trend, by 2030, almost 60% will be obese (Florida Health, 2017). Additionally, six out of ten children born today will be obese by the time they graduate from high school (Florida Health, 2017). Five areas in which reform is critically needed in order to prevent obesity are creating safe environments for physical activity, healthy food and beverage choices, message environments, and health care, work and school environments (Knickman & Kovner, 2015). The population-based intervention model describes downstream, midstream and upstream interventions for preventing overweight and obesity among children and adolescents (Knickman & Kovner, 2015).

A downstream health prevention program focuses on changing behaviors at an individual level, rather than preventing risk behaviors (Knickman & Kovner, 2015). Given parents’ influence and control over their children’s diet, physical activity, media use, and sleep, family interventions are a key strategy in the effort to eliminate childhood obesity (Ash, Agaronov, Young, Aftosmes-Tobio & Davison, 2017). An example of a downstream intervention that would be effective is to provide a hand-out for parents and children through the school with helpful tips on reducing screen time, suggestions for healthy food swaps (having an apple instead of chips after school) and suggestions for easy ways to incorporate exercise into your day, such as go for a walk as a family for 20-30 minutes after school each day.

A midstream health prevention program focuses on changing behaviors at a community level, with health promotion programs that are targeted at populations to change or prevent risk factors (Knickman & Kovner, 2015). An example of a midstream intervention that would be effective is to provide school-based sports and physical activity to children each day. Two main individual behavior determinants of health are diet and physical activity (ODPHP, 2018). The school would provide coaches and equipment for children to participate in sports who may not have the ability to otherwise in their home environment.