KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Preventing Childhood Obesity: Tools for Childcare Providers, Legislators and Regulators American Public Health Association (APHA) October 29, 2012, San Francisco, CA 1 Marilyn J. Krajicek, EdD, RN, FAAN Director of the National Resource Center for Health and Safety in Child Care and Early Education (NRC)

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resource Center for Health and Safety in Child Care and Early Education (NRC) NRC Mission: To improve the quality of out-of-home child care and early education programs and support the health and safety of the children they serve. 2

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resource Center for Health and Safety in Child Care and Early Education (NRC) The Consortium: American Academy of Pediatrics (AAP) American Public Health Association (APHA) National Resource Center (NRC) for Health and Safety in Child Care and Early Education (at University of Colorado) National Training Institute (NTI) (at University of North Carolina Chapel Hill) Funded through the Maternal and Child Health Bureau Cooperative Agreement (MCHB) 3

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resource Center for Health and Safety in Child Care and Early Education (NRC) The NRC supports the efforts of: Child care providers Early educators Families/parents and guardians Health professionals Early childhood comprehensive systems State child care regulatory agencies State and local health departments Policy makers 4

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Caring for Our Children (CFOC) 3 rd Ed. National Health and Safety Performance Standards for Early Care and Education Programs; Guidelines for Early Care and Education 3 rd edition Revision completed and published in June year revision process 10 Technical Panels - 85 panel members - Content Experts from AAP, APHA, and subject specialists 5

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Caring for Our Children (CFOC) 3 rd Ed. Definitive source on best practice in health and safety in early care and education settings Evidence-based standards Expert consensus Model for health & safety practices 6

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing 7 Obesity 1 in 3 low income children are obese or overweight by 5 years

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Health Consequences 8 Seriously reduced quality of life Increased risk of chronic disease: Diabetes Hypertension and Cardiovascular disease GE reflux disease Obstructive sleep apnea, which can contribute to learning problems and behavior problems Asthma Increased cost of health and medical care

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing CFOC Standards 9 Preventing Childhood Obesity, 2 nd Edition NUTRITION variety of healthy foods promote positive mealtime environment PHYSICAL ACTIVITY daily indoor & outdoor activities SCREEN TIME limited

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing How the Standards Address the Problem 10 promote eating a variety of healthy foods advocate breastfeeding of infants emphasize and promote daily physical activity limit access to screen time partner with families to promote healthy eating practices and lifestyles encourage collaboration among families, caregivers, and community health partners

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Using the Standards 11 National and State Campaigns can use to build integrated nutrition and physical activity components in their systems. Caregivers/teachers can use to develop and implement practices and policies and use in staff training. Families can support and join with caregivers/teachers in the implementation of healthy practices. They can also reinforce at home.

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Using the Standards 12 Regulators can use to develop and/or improve state regulations that support the prevention of obesity and promote healthy habits. Legislators can use to understand and support research-based child care regulations that address the prevention of obesity. Academic faculty can use standards as a resource to prepare students for entering the early childhood workplace

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Using the Standards 13 Health care professionals including the Child Care Health Consultant can assist families and providers with sound evidence-based rationale for implementing and following healthy lifestyles.

What can a CCHC do? 1.Partner with a center to self-assess. 2. Help the center identify a plan of action. 3. Provide training on nutrition and physical activity for children, staff and parents/guardians. 4. Develop and distribute materials or incentives. 5. Provide technical assistance. The National Training Institute for Child Care Health Consultants14

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resources NAP SACC: The Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) program Research-tested intervention designed to enhance policies, practices, and environments in child care by improving the: nutritional quality of food served amount and quality of physical activity staff-child interactions facility nutrition and physical activity policies and practices and related environmental characteristics Primarily addresses the inter-personal and organizational levels of the socioecologic model. 15

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing 16 Let’s Move! Child Care National Resources

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resources Healthy Child Care America Resources include: Caregiver Newsletter CFOC Standard of the Month #listserv 17

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Policy Changes & National Initiatives Child and Adult Care Food Program (CACFP) Existing Meal Patterns: Inconsistent with new Dietary Guidelines for Americans and MyPlate Available at: care/ProgramBasics/Meals/Meal_Patterns.htm Meal Pattern Recommendations: Consistent with new Dietary Guidelines for Americans and MyPlate Pending adoption/publication

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Policy Changes & National Initiatives CDC & HHS Grant: CPPW Communities Putting Prevention to Work Funding: Intense – Proven – Sustainable - Community approaches to chronic disease prevention by: Increasing physical activity Improving nutrition Decreasing overweight/obesity Tobacco cessation Initiatives involve partnership of leaders from public health, schools, cities, counties, local businesses, and citizens. 60 communities in 33 states and 3 tribes are involved in this grant currently, 49 addressing obesity 19 munitiesPuttingPrevention toWork/about/index.htm

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing NRC Resources 20 National Resource Center for Health and Safety in Child Care and Early Education (NRC)

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Achieving A State of Healthy Weight NRC assessed child care regulations of all States and D.C. to determine language in conformity with standards in Preventing Childhood Obesity (PCO). 21

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Collections of CFOC, 3 rd Edition Standards Preventing Childhood Obesity (PCO) 22

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Licensing Toolkits: Action sheets especially for: Licensors Child care providers Legislators Current Topics Cover: Avoid or Limit Foods High in Sugar Use of Water and 100% Juice Limiting Screen Time Licensing Toolkits: Using CFOC Standards at Every Level

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Tip Sheets Tip Sheet for Serving of Water and 100% Juice Research & reasons Dos & Don’ts Practical ideas Talking to parents/guardians 24

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Family Checklists English & Spanish 25

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Videos Motion Moments Approx. 7 minutes/video. Demonstrates ideas for incorporating physical activity into child care programs for infants, toddlers, and preschoolers. 26 English & Spanish

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing Screen Free Moments: Promoting Healthy Habits Shows providers simple ways to limit or even eliminate screen time in their family child care home. 27 Video

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing 28 Contains ALL CFOC3 Standards & more! Searchable by Keyword, Chapter, Major Chapter Subdivisions, Chapter Subdivision, & Standard. User Friendly & Section 508 Compliant. New CFOC3 Database

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing 29 Includes: CFOC3 Collections, FAQs Downloadable & Printable Content Includes: Standard Content Inside Cover (PDF) Introduction (PDF) Acknowledgments (PDF) Guiding Principles (PDF) Advice to the User Major Changes New and Significant Changes (PDF) Acronyms/Abbreviations Glossary New CFOC3 Database

KIDS (5437) ©2012 National Resource Center for Health and Safety in Child Care and Early Education University of Colorado College of Nursing National Resource Center for Health and Safety in Child Care and Early Education Website- Telephone E. 19 th Ave., F541 Aurora, CO 80045