1. 1 Sustaining and Replicating Obesity Prevention Projects: North Carolina’s Fit Together Initiative Lori Carter-Edwards, PhD Claudia J. Graham, MBA Heidi Churchill, MPH Childhood Healthy Weight Collaborative Health and Wellness Trust Fund and Commission (HWTF) Duke University Medical Center (Duke) East Carolina University School of Medicine (ECU) APHA - 161633

2. 2 Purpose To briefly describe the North Carolina Childhood Obesity (Fit Together) Initiative. To briefly describe the North Carolina Childhood Obesity (Fit Together) Initiative. To provide examples of the initiative’s strategies for sustainability. To provide examples of the initiative’s strategies for sustainability. To identify replicable obesity programs or program features. To identify replicable obesity programs or program features.

3. 3 APHA - 161633 Childhood Obesity in North Carolina 12 to 18 years 5 to 11 years 2 to 4 years Percent of NC Children Who Are Overweight by Age Group by Year (1995 to 2005), NC-NPASS* *North Carolina-Nutrition and Physical Activity Surveillance System (NC-NPASS) includes data on children seen in NC Public Health Sponsored WIC and Child Health Clinics and some School Based Health Centers.

4. 4 APHA - 161633

5. 5 Reduce healthy lifestyle barriers. Reduce healthy lifestyle barriers. Significantly increase healthy eating and physical activity in: Significantly increase healthy eating and physical activity in: School and child care settings. School and child care settings. Neighborhoods. Neighborhoods. Healthcare settings. Healthcare settings. Goals

6. 6 APHA - 161633 Grantees Grantees 6 school systems 6 school systems 4 community non-profits 4 community non-profits 4 health departments 4 health departments Project Team 4 statewide agencies 4 statewide agencies 2 hospitals/hospital systems 2 hospitals/hospital systems 1 university 1 university HWTF Fit Together Staff HWTF Fit Together Staff Technical Assistance (TA) Team (Duke) Technical Assistance (TA) Team (Duke) Evaluation Team (ECU) Evaluation Team (ECU)

7. 7 APHA - 161633 Sustainability Sustainability: Sustainability: Continuation over time of community benefits. Continuation over time of community benefits. TA Team Strategies TA Team Strategies Grantee sustainability training Grantee sustainability training Monthly tracking Monthly tracking Conference calls Conference calls Site visits Site visits Annual meetings Annual meetings Grantee semi-annual and annual reports Grantee semi-annual and annual reports

8. 8 APHA - 161633 Network building Network building Cumberland County Public Schools (local) Cumberland County Public Schools (local) Project Move Project Move Built multiple partnerships Built multiple partnerships NC Academy of Family Physicians (statewide) NC Academy of Family Physicians (statewide) Referral system and resource kit for physicians Referral system and resource kit for physicians Partnered with large state agencies Partnered with large state agencies Sustainability Planning - Examples

9. 9 APHA - 161633 Implemented sustainability steps Implemented sustainability steps Durham Public Schools Durham Public Schools Implemented and expanded programs Implemented and expanded programs Executed all sustainability steps from training Executed all sustainability steps from training Southeastern Regional Medical Center Southeastern Regional Medical Center Project HEALTH Project HEALTH In-school interventions and community education In-school interventions and community education Sustainability Planning - Examples

10. 10 APHA - 161633 To help grantees prepare replicable projects, the TA Team: To help grantees prepare replicable projects, the TA Team: Assigned level of program flexibility Assigned level of program flexibility Assessed project reach Assessed project reach Estimated group size Estimated group size Alternate settings for programs Alternate settings for programs Age groups Age groups Projected participant appeal Projected participant appeal Assessed ease of implementation Assessed ease of implementation Replicability

11. 11 APHA - 161633 Selected 24 programs/activities Selected 24 programs/activities Total: Approximately 2-4/grantee Total: Approximately 2-4/grantee Examples Examples Lunch and Learn (Cleveland County Health Dept.) Lunch and Learn (Cleveland County Health Dept.) Lunchtime topic-based discussions for employees Lunchtime topic-based discussions for employees Be Active Challenge (Partnership for Health, Inc.) Be Active Challenge (Partnership for Health, Inc.) Cards with activities; incentive based for elementary children Cards with activities; incentive based for elementary children Replicability - Examples

12. 12 APHA - 161633 Collaborative partnerships are important for sustainability. Collaborative partnerships are important for sustainability. Projects benefit from outside advice on replicable programs. Projects benefit from outside advice on replicable programs. Community childhood obesity programs can be developed and sustained. Community childhood obesity programs can be developed and sustained. Summary

13. 13 APHA - 161633 Our Partners http://www.fittogethernc.org/ Contact Lori Carter-Edwards, PhD Director, Health Promotion and Disease Prevention Division of Community Health, Department of Community and Family Medicine Duke University Medical Center Lori.c.edwards@duke.edu