1. Marisha DiCarlo, PhD, MPH Healthy Active Arkansas Lead, ADH Marisha.dicarlo@arkansas.gov Namvar Zohoori, MD, MPH, PhD Healthy Active Arkansas Science Lead, ADH Namvar.Zohoori@arkansas.gov

2. Healthy Active Arkansas FRAMEWORK Healthy Active Arkansas FRAMEWORK SUMMIT 2012 SUMMIT 2012 Steering Committee Steering Committee Advisory Committee Advisory Committee Scientific Committee Scientific Committee Participants Framework Taskforce Editorial Advisory Board Editorial Advisory Board Assembly Team Assembly Team

3. Healthy Active Arkansas FRAMEWORK Healthy Active Arkansas FRAMEWORK Launched by Governor Oct. 2015 Launched by Governor Oct. 2015 Leadership Team Operations Team Operations Leads Nine Priority Area Team Leads and Teams Communications Team Communications Team

4. Casey R. Covington, PE, AICP Metroplan CARTS Study Director Covington@metroplan.org HAA Priority 1 Lead

5. Priority Area #1 Defining Statement: Encourage all stakeholders to create livable places that improve mobility, availability and access within the community where they live, work and play.

6. Adults Who Met Recommended Levels of Physical Activity Arkansas and United States, 2001-2013

7. Strategies Create communities that are denser and more connected and livable Encourage design principles that support a statewide healthy highways policy Ensure the built environment supports access to sources of healthy foods. Increase formal joint-use agreements between communities and organizations Policy makers to create incentives to encourage denser, more walkable communities and multi-use developments Create a shared community vision to develop and improve livability and economic vitality

8. Why Physical and Built Environment? The way we design and build our communities has a profound impact on Physical Activity Social Opportunities Environment (air pollution) Opportunity to Age in Place Economic development

9. Levy, North Little Rock - Current Conditions

10. Levy, North Little Rock - Concept Rendering

11. Complete Street Policies Conway Fayetteville Hot Springs Little Rock Rogers North Little Rock

12. HAA Priority 2 Co-Leads Rosemary Rodibaugh, PhD, RD, LD Professor- Nutrition University of Arkansas Division of Agriculture rrodibaugh@uaex.edu Jennifer Conner, DrPH, MPH, MAP Regional Program Associate- Obesity Reduction University of Arkansas Division of Agriculture jennconner@uaex.edu

13. Priority Area #2 Defining Statement: Ensure uniform access to healthy foods and beverages to consumers in government, institutional and private sector settings.

15. Two Strategies 1.Implement Health and Sustainability Guidelines for Federal Concessions and Vending Operations. 2.Generate a culture of and a demand for healthier foods.

16. Main Goal Maximizing a healthier and sustainable food service by: 1.Increasing the offering of healthier and sustainable food and beverage choices; 2.Eliminating trans fats; 3.Decreasing the sodium content in available foods; 4.Allowing individuals to make informed choices…through the labeling of menu items.

18. Priority Area #3 Defining Statement: State and local governments, early child care providers, school districts, and colleges will provide food and beverages that align with the Dietary Guidelines for Americans and promote health and learning.

19. Student BMI Classification Arkansas 2014-2015 Source: Arkansas Center for Health Improvement. “Assessment of Childhood and Adolescent Obesity in Arkansas: Year 12 (Fall 2014 – Spring 2015).” Little Rock, AR: ACHI, December 2015.

20. Percent of Students Overweight and Obese by Race/Ethnicity, Arkansas 2014-2015 Source: Arkansas Center for Health Improvement. “Assessment of Childhood and Adolescent Obesity in Arkansas: Year 12 (Fall 2014 – Spring 2015).” Little Rock, AR: ACHI, December 2015.

21. Percent of Students Overweight and Obese by Grade, Arkansas 2014-2015 Source: Arkansas Center for Health Improvement. “Assessment of Childhood and Adolescent Obesity in Arkansas: Year 12 (Fall 2014 – Spring 2015).” Little Rock, AR: ACHI, December 2015.

22. Strategies Provide mandatory evidence-based nutrition education to improve the health of children attending early child care centers though college. Increase participation in federally funded school meal programs. Increase access to fresh, affordable, healthy foods. Create learning environments with easy access to healthy choices.

23. Brett A. Stone, PhD Dean, Division of Education, Business, and Communications The University of the Ozarks Bastone@ozarks.edu HAA Priority 4 Lead

24. Defining Statement State and local governments, early child care providers, school districts and colleges ensure that all students have opportunities for daily physical activity and quality physical education that promotes health lifestyles

25. Strategies Create an environment that complies with appropriate physical activity federal standards Create a mindset that promotes lifelong physical activity Integrate physical activity with learning

26. Christina Clark Chief of Staff to the Chancellor University of Arkansas for Medical Sciences clclark2@uams.edu HAA Priority 5 Lead

27. Defining Statement Worksites will establish healthy environments that promote health through prevention, reduce health care costs associated with chronic illness and disability and improve employee productivity.

28. Strategies Employers establish wellness programs Reduce health care costs of obesity related chronic conditions Educate employers regarding business case for worksite wellness Increase number of worksite wellness programs and employee participation in them

29. Benefits Healthy more productive working employees Lower stress levels Lower turnover / high employee retention rates Fewer sick days Lower insurance premiums Higher self-esteem and a greater team building mentality Increased energy and vitality in the workplace More optimistic and positive attitude Improvement in family life brings improvement into the workplace Greater community synergy, greater company synergy

30. Companies in Arkansas with a Wellness Program Walmart Nabholz Blue Cross and Blue Shield Good Earth Baptist Health

31. HAA Priority 6 Co-Leads: Kathy Webb, Executive Director Arkansas Hunger Relief Alliance kwebb@arhungeralliance.org Dr. Judith Weber Arkansas Children’s Hospital Research Institute Department of Pediatrics WeberJudithL@uams.edu

32. Defining Statement State & local governments and other stakeholders will promote education, public policies and access to affordable, healthy foods for all Arkansans.

33. Areas Designated as Food Deserts Arkansas, 2015

35. Prevalence of Food Insecurity United States, 2012-2014 Source: Household Food Security in the United States in 2014. USDA Economic Research Report No. (ERR-194), September 2015

36. Strategies Eliminate food deserts Expand local garden projects, small farms, farmers’ markets and gleaning programs Increase participation in nutrition assistance programs Utilize evidence-based nutrition education programs Educate health care professionals and cross-functional hospital teams in nutrition education and about access to healthy food Expand current public policies to assure inclusion of healthy foods for distribution to low-income Arkansans

37. Carole Garner MPH, RDN, LD Senior Policy Analyst, ACHI cbgarner@uams.edu HAA Priority 7 Lead

38. Defining Statement Adopt comprehensive strategies to reduce overconsumption of sugar-sweetened beverages (SSBs)

39. SSBs – Health Consumption of sugar drinks promotes weight gain Peoples who drink sugar drinks regularly have a 26% greater risk of developing type 2 diabetes Consumption of sugar drinks promotes dental caries

42. Strategies Reduce consumption of sugar-sweetened beverages (SSBs) in worksites, public places and recreation Reduce consumption of SSBs in schools Use policy incentives and disincentives (availability, size etc.) that will impact sugar sweetened beverage purchases Eliminate use of SSBs in licensed day care centers

43. Jessica Donahue, RN Baptist Health Expressly for You Jessica.Donahue@baptist-health.org HAA Priority 8 Lead

44. Priority Area #8 Defining Statement: Women, health service providers, employers, communities and other key stakeholders will adopt, implement and monitor policies that support and increase the proportion of mothers who initiate and continue optimal breastfeeding practices.

45. Breastfeeding Initiation Rates

46. 6 Month Any Breastfeeding

47. Lack of exclusive breastfeeding is significantly associated with an increase in the risk of: (AHRQ; WHO, 2007; Kotsopoulos et al., 2014; Kelishadi et al., 2014) Infant/ Child Mother otitis media gastroenteritis respiratory tract infections atopic dermatitis asthma obesity type 1 and 2 diabetes childhood leukemia necrotizing enterocolitis mother-to-child transmission (MTCT) hypertension lower intelligence & academic achievement type 2 diabetes breast cancer ovarian cancer maternal postpartum depression non-communicable diseases (NCDs)

48. Strategies With programs, support, and awareness, promote breastfeeding as the optimal way of infant nutrition Encourage adoption of CDC “baby friendly” guidelines Develop awareness and encourage limitations on the marketing practices of infant formula Ensure support for breastfeeding within child care centers Generate breastfeeding support within the community Recognize the cultural diversity of communities Develop worksite lactation support programs

50. Jeff LeMaster Director of Communications and Marketing Winthrop Rockefeller Institute jlemaster@uawri.org HAA Priority 9 Lead

51. DEFINING STATEMENT Develop and implement a robust, sustained and culturally appropriate targeted communications and marketing program aimed at changing norms and behaviors with respect to physical activity and nutrition.

52. … aimed at changing norms and behaviors …

53. STRATEGIES Create a community culture of fitness and good nutrition through an evidence-based marketing strategy Implement appropriate communications strategies and engage various media to reach the greatest number of people Engage local champions that can influence the “culture of health.”

54. Work with local coalitions and organizations to identify and recruit key champions (That’s where you come in)

55. Ways to Get Involved Today Join a working Priority Area Team! Promote the plan! Be a “proud supporter of” HAA! Pick a strategy in the plan and work on implementing it in your school or district. Each Priority Area includes strategies and action items. Want to be a co-lead…?