What is TAT?
Taking Action Together (TAT) is a YMCA-based program designed to reduce type 2 diabetes risk among low-income overweight African American children, 9-11 years of age. This multi-disciplinary project was developed in collaboration with experts in nutrition, exercise physiology, public health, psychology, medicine, education, and cultural sensitivity. It involved academics and practitioners from numerous universities and community organizations.
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Why was TAT developed?
For the first time in modern history, children born today are not expected to live as long as their parents due to diabetes and other chronic diseases related to escalating rates of obesity. Obesity and diabetes risk may be reduced through early intervention and sustained improvements in diet and physical activity. For interventions to be most effective and sustainable, however, they must be integrally connected with existing programs that are accessible to children. After-school programs are just one example of such a setting.
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Has TAT been evaluated?
Evaluations after 1 year of 2 hours of weekly programming show that TAT: is well-received, viewed as being sustainable, and likely to be transferable to other ethnic groups; reduces risk of diabetes by reducing insulin resistance, and improves self-esteem, social skills and communication.
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Where can TAT lessons be used?
The curriculum was designed to be administered outside of school hours, such as at after-school programs, in a group setting to up 16 students (ages 9-11) by one adult leader and a minimum of one assistant. However, lessons can be adapted to accommodate different numbers of children by altering the numbers of leaders, assistants and supplies. Further, lessons can be utilized in a variety of settings with minimal facility requirements.
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How are TAT lessons organized?
Lesson goals include:
Healthy eating: increase intake of low-fat dairy, fruits, vegetables and whole grains; decrease intake of sweetened beverages and other calorie-rich but nutrient-poor foods
Promotion of physical activity: increase participation in inclusive and fun moderate-to-vigorous activity; improve physical fitness; reduce sedentary activity
Improvement of self-esteem and self-efficacy with respect to healthy eating and physical activity
Lesson plans include: Behavioral goals, Learning objectives, Activity and preparation time requirements, Supplies and materials needed, Background information for activity leader, Activity directions, Evaluation grid for activity leader and Pre/post evaluation questions for child participants.
Conceptual elements include: Knowledge and skill building, Modeling, Goal setting, Self-assessment, Practice, and Reinforcement.
Educational strategies include: Individual practice, Cooperative learning, Individual and group discussions, and Experiential activities.
Educational components are organized into 6 modules, each to be delivered over a 5-week period with lessons offered for 2 hours a day, 4 days per week. Modules were designed so that each week, children receive a total of 2 hr of nutrition and 2 hr of self-esteem. Reinforcement lessons (half hr each) follow core lessons (1 hr each) in order to provide greater opportunity for goal setting, self-assessment and self-efficacy building. A 1-hr physical activity session is provided daily for a total of 4 hr of physical activity weekly. However, because of the modular format, TAT lessons can be administered flexibly to accommodate a variety of different schedules.
Weekly Lesson Schedule
Lesson Type |
Nutrition |
Physical Activity |
Self-Esteem |
Core |
1 lesson (1 hour) |
4 lessons (1 hour each) |
1 lesson (1 hour) |
Reinforcement |
2 lessons (1/2 hour each) |
-- |
2 lessons (1/2 hour each) |
Total |
2 hours |
4 hours |
2 hours |
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Module |
Nutrition |
Physical Activity |
Self-Esteem |
I |
Making low-fat choices |
Flexibility |
Self awareness |
II |
Increasing fruits & vegetables |
Strengthening |
Positive interaction, effective communication |
III |
Reducing sugar & portion size |
Endurance |
Body Positive, Health at every size & respect of self and others |
IV |
Replacing refined with whole grains |
Balance & coordination |
Cultural expression of self |
V |
Healthy snacks & hunger cues |
Speed |
Overcoming challenges & meeting goals |
VI |
Moderation & a balanced diet |
Agility |
Self-assessment of positive growth |
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Who can use TAT lessons?
A sampling of lessons is provided at this time. These lessons may be downloaded and used by other organizations or individuals, provided that the following acknowledgment is included: The Taking Action Together curriculum was developed by the following individuals: Barbara Green, Sharon Fleming, Joanne Ikeda, Rita Mitchell and Marisa Neelon.
Download Week 1 Lesson Samples:
| Module 1, Week 1 |
Nutrition |
Low-Fat Choices |
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Self Esteem |
Self Awareness |
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Physical Actitivy |
Flexibility |
Core 1 |
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For more information:
For more information about the project please contact Professor S.E. Fleming at fleming@nature.berkeley.edu.
Funding for this project was provided by the USDA CSREES National Research Initiative, the Dr. Robert C. and Veronica Atkins Foundation, the Food Stamp Nutrition Education Program/USDA, The Agriculture Experiment Station and University of California Cooperative Extension, and by Lawrence and Victoria Johnson.
