HEALTHY KIDS CHALLENGE Claudia L. Hohnbaum, MA, RD, LD Healthy Kids Challenge Assistant Director

HEALTHY KIDS CHALLENGE Nationally recognized nonprofit Kansas based Led by registered, licensed dietitians 11 years of evidence based best practices Our Mission Use every day ways to guide schools, communities, and programs in creating solutions to help kids and families Connect Health And Needs, Get Excited (C.H.A.N.G.E).

Kansas Kids Connect Activity & Nutrition (C.A.N.) Grant

Kansas Kids C.A.N. Grant  3 year grant funded by the Sunflower Foundation, Health Care for Kansans  Designed to build the capacity of existing youth programs and schools to integrate healthy eating and physical activity into existing policy, program, & practice  Impact – 10,000 kids, 16 counties in southwest Kansas, 50 schools/youth programs over 3 years

Why? The Problems 1 in 4 Kansas kids are overweight or at risk for overweight A majority of Kansas kids are not getting recommended amounts of physical activity (55%) fruits and vegetables (79%) Centers for Disease Control, YRBS 2007

The Problems Like others, western Kansas faces challenges in creating healthy change:  Time  Less than optimal staffing  Funds A unique challenge is the limited number and types of healthcare professionals available to offer leadership and guidance for creating and supporting healthy change.

What were the C.A.N. solutions? Healthy C.H.A.N.G.E. Connect Health And Needs, Get Excited Target Multiple Environments Build Capacity with KidLinks  Build a Foundation with 5 Step Process Use 5 Key Strategies * People who can help kids make healthy eating & physical activity choices a habit.

5 Steps for C.H.A.N.G.E. Grantees were required to 1.Form local partnerships 2.Serve in a mentor program 3.Attend training & use new teaching tools & resources in their programming 4.Participate in distance assistance & support 5.Celebrate & share their successes & challenges

5 Strategies for C.H.A.N.G.E. 1. Assess current policies, programs, practices 2. Create an action plan for healthy change 3. Develop staff wellness 4. Create a common purpose to “rally” around 5. Use consistent, repetitive healthy messages

Assess - Call To Action Are healthy foods offered? Are reward systems nonfood related? Is physical movement included in programs? What policies guide eating & activity? What exists in the environment?

Create an Action Plan Action plans are a tool to Develop participation Communicate changes Build support

Develop Staff Wellness “School staff wellness may be the key to impacting a healthy school environment” James Bogden, MPH, NASBE Center for Safe and Healthy Schools, April 2008

Create a “Rally Point” for Collaboration and Mentoring National Hospital Week Fruit and Veggie Trivia Fat and Sugar Displays MyPyramid Awareness Healthy Behaviors “Collaborations that have developed have been very valuable.” Participant

Use Consistent Messages Increase Fruits and Veggies Increase Physical Activity Decrease Screen Time Eat Breakfast Regularly Choose Smart Servings Replace Soda & Sugary Drinks with Water Attack Snacks: Lower Fat & Sugar Foods

What Were the Results of Actions Taken?

Results – Personal Wellness A 2007 survey of grantee respondents revealed: 81% were eating more fruits and vegetables 70% were choosing more healthy snacks 74% were choosing water over higher sugar/fat beverages 74% were eating breakfast more often 59% were more physically active 55% were drinking more milk

Results – Personal Wellness Healthy breakfast added as a employee health benefit Healthy snack choices added for employees, patients’ families, & visitors Employees offered fresh fruit & veggie trays during Hospital Week “We’re incorporating physical activity programs for the employees.” Participant “Our dietary department is serving salad each day and healthier snacks for staff.” Participant

Results - Collaboration Medical Clinic – Hospital – Library—School develop afterschool “Kids Klub” More activity—healthy rewards—gardening parent connections—healthy snacks fun skill building lessons “ Kids Klub has really changed our house. My son asks for salad now instead of candy… As a family, we do so many more fun activities instead of sitting around the TV… We are really seeing a conscious effort from a lot of the kids to be more active and eat better.” Participant

Results - School Lunch Changes Fresh or canned fruit replaced high-sugar desserts Salad bar added with low-fat dressings More fresh fruits and vegetables Fewer pre-made, processed foods Homemade whole wheat bread Outcome: When the lunch program introduced a fully stocked salad bar, and eliminated traditional desserts, meals served per day doubled.

Results - Policy The Board of Education of one school adopted the following as part of a new snack policy: A quarterly “Special Lunch”, consisting of soda and candy bar, has been renamed “Snack and Chat” and now features a healthy snack Candy and soda reading goal rewards have been replaced with extra recess time or a new book Healthy snacks replace high sugar treats for classroom parties

Results – Changes in Practice Physical activity is integrated into core curriculum at least 3-4 times per week Classroom lessons are coordinated with others Bulletin boards share healthy messages Healthy messages are incorporated into P.E. classes Healthy eating messages and physical activity have been incorporated into existing events Staff fitness programs have increased participation “This is a change…that has resulted from our school's emphasis on wellness. We truly are all learning more about how to be healthy.” Participant

Results – Program Change Interactive Health Fair Goes P.A.W.S. Collaboration with the local hospital, public library, and county extension resulted in unique twists to their own interactive sessions Families took time to Practice Awesome Wellness Steps (P.A.W.S.) Hands-on “how to” application of healthy eating & physical activity Continuous movement activities for kids Sports skills taught by high school athletes Cooking demos given by high school student Healthy “Snackin’ given by cafeteria “lunch ladies” 85% of participants surveyed said they were positive that the health fair experience would help their family eat healthier and be more active.

Results – Unusual Environments “Camp C.A.N. Do” afterschool library program Kids kept active with hula hoops, dance videos, & outdoor adventures Hands-on healthy eating lessons including making & tasting snacks Kids tracked their progress on charts “The children will approach me in public to share how they have been eating their fruits and vegetables even during the holidays. It’s great to know they are practicing what they learn. They also share what the school is doing for healthy eating and activity.” Participant

Results – MORE Library success! One library revealed its’ own secrets for success: A vision that guides staff to include healthy eating & physical activity in every kids' program Administration & board support healthy programming Policies support a healthy library environment Community group partnerships Parent volunteers for events Staff role-modeling healthy choices Healthy incentives reward kids' successes

Results After Year Two 4 programs reported decreased employee absences and/or health insurance costs 20 programs reported change in DAILY practices 13 programs reported environmental changes to support healthy eating/physical activity 90% of grantees reported their level of commitment to creating healthy changes in their programs/schools between 8-10 on a scale of 1 (very low) to 10 (very high)

Challenges Short-term benefits of early attitude & behavior changes were evident however the greatest challenges to long-term success are: Staff turnovers Broad administrative support

Bright Promises More studies are showing the benefits of healthy eating and physical activity and the risks of poor eating and overweight. A recent study found Overweight students had lower reading comprehension scores Heavier kids had more school absences and were 5 times more likely to have more detentions July 2008 issue of the Obesity Journal Teachers & youth leaders care about kids & when given time & resources, find creative ways to support healthy eating & physical activity through their daily practices.

Implications for Lessons Learned Support grassroots efforts Facilitate collaboration Target multiple environments with associated policies, programs and practices Support employee wellness

Inspiration - Support - Recognition “C.A.N. has been my inspiration to not give up personally, as well as on our children of the future. It's been an amazing resource, full of valuable information and materials. It's been my motivation to reach out to the community and make a difference. I am only one person, but I can try to reach out and help as many people as I can - including myself.”

More Grantees Quotes “This collaboration has been a win-win arrangement all around. I have incorporated some better lifestyle choices in my own family as well.” Participant Not only has (C.A.N.) made a huge difference in my kids’ outlook on food and exercise it has really made me very conscious of the choices that I make as well. I have started the Walk Kansas program, so I take my kids out for walks in the evenings, and I try to fix healthy meals. In turn, our family is much healthier and happier because it brings us together instead of sitting around watching TV or video games!” Participant