1. Strong4Life WIC Program
Improving the Effectiveness of Childhood Obesity Counseling
Welcome and thank you all for being here tonight. I am excited to be here to talk about the great work we are doing with the Strong4Life WIC program and to recognize our Strong4Life Champions tonight.
Wendy Palmer MS, RDN, LD, CHES

2. First we would like to thank our funder for this work, Georgia SHAPE, as well as our collaborators on this work, GA WIC and GA DPH.
We know working to solve the obesity crisis in our state takes a multitude of efforts and collaborations like this are necessary to make an impact.

3. Strong4Life Provider Training
Strong4Life has been working with healthcare providers across the state since 2012 providing training and tools to improve the effectiveness of our obesity counseling.
As you can see from this map, even after a large training effort the white counties represent places where a provider that is trained to use consistent counseling messages does not exist. We looked at this map and thought how are we going to fill the gaps?
What resources and programs exist that would reach these hard to access communities?
WIC does do that and has access to high risk families with younger children. What an opportunity to obesity prevention.
We know that the WIC program does address nutrition, healthy habits and provides nutritious foods to families and children that need it. But we also know WIC staff find it challenging to initiative and have successful conversations with families around behavior changes that can reduce obesity.

4. Strong4Life WIC Program Objectives
Improve client centered counseling skills of WIC staff to facilitate behavior change and the incorporation of healthy habits
Improve goal setting techniques of WIC staff to include setting SMART goals with all clients
Effectively use the WIC Provider Toolkit components to assist with counseling and goal setting
With support from GA SHAPE and GA WIC we embarked on a plan to enhance the skills of WIC staff across the state to provide healthy habit counseling and goal setting.
The goals of the training and program are:

5. Guide to Client-Centered Counseling
Ask, don’t tell
We provided training to WIC nutritionist and staff on client-centered counseling.
Instead of having the conversation driven by the nutritionist, we want to alter our approach to being centered around the client and family and working towards their goals and objectives, which may or may not be the same as ours. As part of this transformation, nutritionists exchange information with families, not just tell information to families. Nutritionists and families collaborate a game plan together that helps the family help themselves, rather than the sole responsibility falling on the healthcare providers shoulders.
We have to remain nonjudgmental, focusing on achieving goals (as small as they may be), and discuss setting behavior goals (not weight goals).
Reminders - two ears and one mouth for a reason right.
You may also hear this referred to as patient centered counseling or motivational interviewing
Ask for permission to share
Listen more than you talk
Place responsibility for change with the client
Don’t force change

6. Guides counseling for behavior change
5 A’s for Obesity Counseling
Ask
Assess
Advise
Agree
Assist
Guides counseling for behavior change
Client centered counseling is based on a framework called the 5A’s. This is an evidence based framework for counseling that has been proven effective for obesity counseling. The nice things about this process is that it is easily implemented in busy practice settings and when used consistently improves efficiency and outcomes.
Vallis M, Piccinini-Vallis H, Sharma AM, Freedhoff Y. Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care. Can Fam Physician Jan;59(1):27-31

7. Tools
Strong4Life also provides a set of tools that facilitates the 5A’s process without much effort.
The HHA is filled out in the waiting room and preps the client for a conversation on healthy habits.
The BMI poster can be used to easily explain to a client where their child falls and what their color category means.
The Goal Sheet facilitates setting a SMART goal by asking what the client will work on, when, who will support them and when will they start.
The take home handout is a reminder for the healthy habits and provides short, simple ideas on the back.

8. Strong4LIfe WIC Training
531
WIC nutritionists and Staff
Here is our map today, due to statewide training at all 18 public health districts we now have trained WIC providers across the state that are able to close the gaps we saw earlier. You have the unique ability to reach a significant portion of our GA residents to help break the cycle of obesity.
Please give yourselves a hand! [lead clapping]

9. Strong4Life WIC Champions Program
Questions
Input
Observations
Feedback
Support
Resources
WIC
Champion
Nutritionists
Strong4Life
In order to provide ongoing support and technical assistance across the state we developed the Strong4Life WIC Champions program. Each district has 1 or more champions who were provided extra training and support from a Strong4Life mentor to go back to their districts and champion implementation of the strategies learned in training.
Champions also assisted in doing counseling observations, at least one per month, to help provide direct feedback on counseling skills and for program evaluation.
Strong4Life WIC Champions have played a key role in this program and are a vital link between the entire WIC team and the Strong4Life Program team at Children’s Healthcare of Atlanta. Without the champions and their extra time and effort put into observations, surveys, feedback and extra training we would not have a successful program. In addition, Champions have had the opportunity to build their own professional development skills by offering support and coaching to other nutritionists.
Information Sharing

10. Strong4Life WIC Champions
Vickie Andrews
Susan Bell
Cameron Boyle
Morgan Brantley
Suzie Davis
Mena Forrester
Hans Hammer
Tellas Hanford
Jean Hill
Kimberly Howell
Lindsey Jordan
Jodie Lovell
Sharon McLeod
Carla Moore
Nina Nolasco
Afiya Paige
Cindy Paramore
Jessica Ryan
Ryan Saccucci
Celeste Salter
Rodasha Scott
Amir Shaheer
Lyndsey Tison
Natalia Torres-Negron
Syreeta Wainaina
With that I would like to take the opportunity to personally thank each Champion for their efforts to support Strong4Life. On behalf of GA SHAPE and Children’s Healthcare of Atlanta we would like to thank you with a special gift. When we call your name, please come up and receive your certificate and gift bag and stay up for a photo.

11. Strong4Life WIC Champions
Danica Carswell
Pat Mobley
Holly Rountree
Greta Sebestyen
Barbara Stahnke
In addition to those already up here we have a few NSD’s who have also spent time as a Champion, either before their promotion to NSD or in the absence of their district champion. We would also like to thank and recognize….
And last but certainly not least, I would like to say a special thank you to my colleague at the state level for WIC. She is certainly a champion for all of GA WIC but has been especially wonderful to work with on this Strong4Life Program.

12. Thanks for all
you do!
Now, to celebrate just how awesome you are – we bring you this happy dance segment. Thanks so much for all you do!!!