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GOING BOLD LD! Ex Expanding Str trateg egies es to o Com Combat t Ch Childhood ood Obesi sity ty Western MCH Nutrition Leadership Network April 5, 2018 Navigators Angie Tagtow & Lorrene Ritchie Ob Objectives Determine

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GOING BOLD LD! Ex Expanding Str trateg egies es to

  • Com

Combat t Ch Childhood

  • od Obesi

sity ty

Western MCH Nutrition Leadership Network April 5, 2018 Navigators – Angie Tagtow & Lorrene Ritchie

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SLIDE 2

Ob Objectives

  • Determine your personal and organization’s readiness to change to

expand childhood obesity prevention strategies to include individual, and policy, system, and environmental change approaches.

  • Adapt system theory models (Spectrum of Prevention) to childhood
  • besity prevention interventions.
  • Apply expanded approaches to childhood obesity within your
  • rganization to include individual and policy, system, and environmental

strategies.

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Re Readiness to Change to I+PSE

Individual

  • Majority currently apply

PSE approaches to childhood obesity (action – maintenance)

Western MCH Nutrition Leadership Network Pre-Meeting Survey, March 2018

Organizational

  • Priority for my organization
  • Strong evidence to support

PSE

  • Colleagues, leadership,

funders, and partners understand and support PSE approaches

  • Will improve services,

efficacy, and impact (ROI)

  • Attracts partners
  • Local officials to be better

informed

  • Recognize the opportunities

for implementation

  • Need more examples and

best practices

  • Need more guidance on

evaluation

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SLIDE 4

To Top To Tools Needed to Expand to I+PSE

Funding Support of leadership Engagement of partners Planning tool Monitoring and evaluation tools

Western MCH Nutrition Leadership Network Pre-Meeting Survey, March 2018

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“1 “100% strongly y agreed or agreed that ex expanding obesity prevention efforts to include individual AND ND policy, system, and en environmen ental str trateg egies es is th the e futu ture e of public public he healt alth prac h practic ice.”

Western MCH Nutrition Leadership Network Pre-Meeting Survey, March 2018

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SLIDE 6

The Journey to Going Bold!

Obesity Prevention Theoretical Models I + PSE Food Systems Best Practices Plan* Act Impact

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SLIDE 7

The Spectrum of Prevention: Developing a Comprehensive Approach to Injury Prevention. The Prevention Institute. Available at http://www.preventioninstitute.org/component/jlibrary/article/id-105/127.html

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Strengthen Individual Knowledge & Skills Promote Community Education Educate Providers Foster Coalitions & Networks Change Organizational Practices Modify Physical Spaces Inform Policy & Legislation

I I + PS PSE Fr Fram amework

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SLIDE 9
  • Enhance personal, individual, or household's capability of healthy

eating and active living

Strengthen Individual Knowledge & Skills

  • Reach groups of people with information and resources to promote

healthy eating and active living

Promote Community Education

  • Inform providers or intermediaries who will transmit skills and

knowledge of healthy eating and active living to others

Educate Providers

  • Convene groups and individuals around healthy eating and active

living to meet broader goals and greater public health impacts

Foster Coalitions & Networks

  • Adapt regulations and procedures by shaping norms that support

healthy eating and active living

Change Organizational Practices

  • Change physical spaces or setting within organizations or larger

public environments that support healthy eating and active living

Modify Physical Spaces

  • Develop strategies to change laws, regulations, and policies that

support healthy eating and active living

Inform Policy & Legislation

Ex Expanding panding Childho hildhood d Obe besit ity Prev eventio ion n Us Using ing I+PSE SE Appr pproac ache hes

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SLIDE 10
  • Personal/Professional
  • Assess knowledge and skills
  • Establish a CPE plan
  • Complete CPEs
  • Network
  • Apply new knowledge and

skills

Enhance personal, individual, or household’s capability of healthy eating and active living Strengthen Individual Knowledge & Skills

  • Individual/Household
  • Use MyPlate resources for nutrition

education

  • Provide incentives for healthy eating
  • Assess household access to healthy food
  • Offer healthy cooking classes
  • Refer clients to food and nutrition

assistance programs

  • Offer grocery shopping tours

EXAMPLES

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SLIDE 11
  • Conduct needs assessment to identify gaps in community in nutrition education

and physical activity opportunities

  • Engage the nutrition community to promote consistent messages around healthy

eating and physical activity (i.e., boys and girls’ clubs, YMCA/YWCA, summer camps, fitness centers)

  • Partner with community groups, civic organizations, food retail on social

marketing campaigns

  • Collaborate with planners and engineers to assess walkability of neighborhoods
  • Leverage local media to promote healthy eating and active living messages

Reach groups of people with information and resources to promote healthy eating and active living Promote Community Education

EXAMPLES

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  • Conduct nutrition trainings for teachers, HeadStart, and child care providers
  • n the importance of early childhood nutrition and on engaging kids in

nutrition activities

  • Equip (pediatric) health systems with nutrition education and physical activity

information

  • Offer CMEs/CPEs for health care professionals
  • Inform community leaders of health, social, and economic benefits of healthy

eating and active living

  • Identify opportunities for intermediaries to educate others (4-H, FFA, coaches)
  • Share experiences and outcomes with peers
  • Write articles and publish findings in peer-reviewed publications

Inform providers or intermediaries who will transmit skills and knowledge of healthy eating and active living to others Educate Providers

EXAMPLES

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  • Strengthen existing partnerships and identify new partnerships
  • Examples: WIC, R&Rs/CACFP, SNAP-Ed, HeadStart, food policy councils
  • Assess relationship (e.g., communication, cooperation, coordination, collaboration)
  • Identify and engage with community leaders (champions) with interest in

nutrition and physical activity

  • Engage private and public sectors to build support
  • Establish a coalition, council, or commission focused on obesity prevention
  • Initiate a Community of Practice (peer- to-peer network)
  • Join or establish a division, section and/or practice group within professional
  • rganizations (AND, APHA, ASPHN, ASNNA, SNEB)

Convene groups and individuals around healthy eating and active living to meet broader goals and greater public health impacts Foster Coalitions & Networks

EXAMPLES

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SLIDE 14
  • Explore the integration of services (WIC, SNAP, Medicaid, etc.)
  • Assess current organizational practices and procedures (e.g., procurement, contracts,

employee handbook)

  • Serve on a school wellness committee that may address universal breakfast, after

school snacks, open vs closed campuses (closed campus means more school meals consumed which are generally healthier than outside meals), concession options, and mobile vending around school campuses

  • Supply faith-based organizations with messaging, materials, and suggestions for

improving the healthfulness of food during functions

  • Employ nutrition guidelines on food served at conferences, meetings, events
  • Be an active professional organization member and provide input
  • Serve on boards or committees
  • Develop and/or update resolutions, curricula, protocol, policy statements

Adapt regulations and procedures by shaping norms that support healthy eating and active living Change Organizational Practices

EXAMPLES

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SLIDE 15
  • Increase water access in schools
  • Establish joint use agreements between schools and communities for gym/recreational

space

  • Redesign/refresh school playgrounds and incorporate gardens or edible landscapes
  • Provide vending or concessions with healthy options
  • Identify neighborhoods with low-walkability options
  • Work with municipalities to place curb cuts in sidewalks
  • Assess public transportation options in low-income neighborhoods
  • Establish a farmers’ market in the health clinic or hospital parking lot

Change physical spaces or setting within

  • rganizations or larger public environments that

support healthy eating and active living Modify Physical Spaces

EXAMPLES

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SLIDE 16

Develop strategies to change laws, regulations, and policies that support healthy eating and active living Inform Policy & Legislation

“little p”

Organizational & Community Policy – Changes to procedures or

  • rganizational practices

Clinics, schools, childcare, worksites, restaurants, faith-based

  • rganizations, professional
  • rganizations, long-term care,

hospitals

“BIG P”

Public Policy - Changes to or creation of laws, ordinances, resolutions, mandates, regulations, or rules Local, regional, state, federal, international

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Local

  • School board
  • City council
  • County supervisors
  • Soil and water

commissioners Federal

  • Federal agencies
  • Congress
  • White House
  • Federal Advisory

Committees

  • Appointees

Develop strategies to change laws, regulations, and policies that support healthy eating and active living Inform Policy & Legislation

State

  • State government offices
  • Judicial
  • State legislature
  • Governor’s office
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SLIDE 18

Organizational/Community Policy

  • Nutrition standards in procurement

policies and concessions

  • Gardening clause in Homeowners

Association contract

  • Submit a resolution on healthy foods

served at conferences Public Policy*

  • Write a policy brief
  • Provide testimony at a hearing
  • Submit written comments
  • Serve on Federal Advisory Committee
  • Provide input on state performance

measures

  • Federal Legislation – Annual

appropriations, Child Nutrition Act, Farm Bill, Older Americans Act, Bill Emerson Good Samaritan Act, National Nutrition Monitoring and Related Research Act

Develop strategies to change laws, regulations, and policies that support healthy eating and active living Inform Policy & Legislation

*Informing and educating v advocating and lobbying

EXAMPLES

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Recommended PSE Act ctivities for Obesity Prevention

Assess the social and political environment

  • These are powerful forces in constraining

policy options. Understanding the environment can inform planning and build an awareness of the types of PSE strategies that may be possible. Identify and frame the problem

  • Efforts aimed at PSE should frame the

issue of interest in a manner that leads it to be recognized by decision makers and placed on the agenda. Engage, educate, and collaborate

  • Stakeholders representing diverse

constituencies should be engaged to articulate the urgency of the problem, to provide input on appropriate solutions, and to advocate for the adoption of proposed policies. Building broad engagement and support early will be beneficial in advancing other key activities.

Lyn R. et al. Policy, Systems, and Environmental Approaches for Obesity Prevention: A Framework to Inform Local and State Action. J Public Health Manag Pract. 2013;19(3 Suppl 1): S23-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943076/

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Recommended Act ctivities to Advance ce Obesity Pr Prevention

Use available evidence and identify policy solutions

  • The identification of plausible policy

solutions requires consideration of current evidence, feasibility, acceptability, reach, and impact. Build political will

  • Policymakers respond positively to

policy proposals that carry the support of their constituencies and colleagues, including public officials, community leaders, organized collaborative groups, and the general public (i.e. voters). It is vital to assess the local context and work cooperatively to build support across all stakeholders.

Lyn R. et al. Policy, Systems, and Environmental Approaches for Obesity Prevention: A Framework to Inform Local and State Action. J Public Health Manag Pract. 2013;19(3 Suppl 1): S23-33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943076/

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Go Goin ing Bold ld! ! Exercis cise

  • Step 1 – Tell Your Story Worksheet
  • Step 2 – Brainstorm Innovative Activities using the I+PSE Framework
  • Step 3 – Take Action
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St Step 2 2 – Br Brainstorm rm Innovative Ac Activities

  • Review Step 1 Worksheet
  • Brainstorm current and potential activities that fit in each level of the

I+PSE framework

  • The sky is the limit, go for bold!
  • Once all ideas are captured, identify one activity in each level that

motivates you

  • 30-minutes
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St Step 2 2 – Sma Small Group Discussion

  • Each person has 2 minutes to share one idea for each level
  • Tablemates provide (brief) feedback in the form of a suggestion or

question

  • 25 minutes
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St Step 3 3 – Ta Take Action

  • Review all of your current and potential activities from Step 2
  • Which one activity has the greatest likelihood of being implemented?
  • What is one thing you will do in the next:
  • Two Weeks?
  • Six Months?
  • Two Years?
  • 5 minutes
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St Step 4 4 – Gr Group Dis Discu cussio ion

  • What were the highlights of the table exercises?
  • What action steps did you identify?
  • What are your questions?
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Ne Next S Steps…

  • Maternal and Child Health (MCH) Nutrition Training Program
  • Competing Continuation Funding
  • Competing Supplement Funding
  • Discussion: What is your preference for the focus area of the supplemental

funding?

  • Positive deviance
  • Rural health
  • Healthy eating behaviors in childhood