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Learning Session 1:Why Should We

Change?

Nemours is currently funded by the Centers for Disease Control and Prevention (CDC) under a five-year Cooperative Agreement (1U58DP004102-01) to support states/localities in launching early care and education learning collaboratives focused on childhood obesity prevention. The views expressed in written materials or publications, or by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Early Childhood Health Promotion and Obesity Prevention

National Early Care and Education Learning Collaboratives(ECELC) Project

Acknowledgements

A special thank you to:

Centers for Disease Control and Prevention (CDC)

– For generous funding support and expertise

Nemours

– For their expertise, materials, support, and time spent on the project’s implementation

G t h S C t f N t iti Gretchen Swanson Center for Nutrition

– For the evaluation component of this national effort

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Part A:Part A:

The ECELC Project

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j

Early Care and Education Learning Collaboratives (ECELC)

Community of learners for childhood obesity prevention

– Network of shared ideas and mutual support

– Resources for healthy practice and policy changes

– Research on best ways to implement best practices

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Early Care and Education Learning Collaboratives (ECELC)

Aligned with national best practice guidelines from:

– Lets Move! Child Care (LMCC)

– Preventing Childhood Obesity in Early Care and Education Programs (2nd Edition)

– Nutrition and Physical Activity Self-Assessment for Child Care (Go NAP SACC)

Focus on quality ECE, and children’s health as the f d ti f lif lfoundation for life-long success

Obesity prevention in the context of health promotion and wellness made possible by the power of ECE providers

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How are ECE Providers Powerful?

Unique position to impact children and their families

Influence on knowledge, attitudes and healthy habits

Opportunities to create healthy environments

Families look to providers as a resource

We know you make a difference!

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Leadership Team Model

ECE Programs

Self-DefinedLeadership Team

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Owner/Director Lead

Teacher

Foodservice Personnel

Why Should We Change?

How Can We Continue to Make Healthy Changes? Celebrating Success:

Our Plans in Action!

Learning Sessions

ActionPeriodLS1 Action

PeriodLS2 Action PeriodLS3 Action

PeriodLS4 Action PeriodLS5

We Change?

Go NAP SACC*Long-Term Action Plan & Storyboard

Our Plans in Action!

Continue Long-Term Action Plan

What is Our Role in Making Healthy Changes?

Pilot Action PlanPilot Storyboard

How Can We Engage Families as Partners?

Continue Long-Term Action Plan (Emphasis on Parent Engagement)

*Go NAP SACC is a Nutrition and Physical Activity Self Assessment for Child Care for ECE settings comparing their current practices with a set of best practices

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U.S. First Lady Michelle Obama

First Lady Michelle Obama’s welcome and thank you message!

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Complete LMCC Registration and Quiz

As a Leadership Team, complete the registration/quiz:

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Let’s Move! Child Care Website

11www.healthykidshealthyfuture.org

Part B:Part B:Healthy

Development

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The Obesity Epidemic’s Impact

Overweight and obesity increased rapidly in a short period of time among children, youth and adults in the U Sthe U.S.

The upcoming video will shows how adult obesity rates changed in the U.S. since 1989

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Video Module 1

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Video Module 1 Take Away Messages

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State Childhood Overweight/Obesity Rates

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Arizona County-Level Childhood Overweight/Obesity PrevalenceLow-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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California County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Florida County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Indiana County-Level Overweight/Obesity PrevalenceLow-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Kansas-County Level Overweight/Obesity PrevalenceLow-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Kentucky County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Missouri County-Level Overweight/Obesity PrevalenceLow-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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New Jersey County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; 2009-2011)

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Virginia County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; 2009-2011)

Long-Term Impact of Obesity

Health problems in children formerly seen only in adults:

H di– Heart disease High blood pressure (hypertension)

High cholesterol

– Type 2 diabetes

– Hip and joint problems

Serious long-term risks:

– Increased risk of developing co-morbid conditions

– Negative impact on mental health

– Shortened life expectancy

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Discussion:

What Has Contributed to Childhood Obesity Over theChildhood Obesity Over the

Past Thirty Years?What Has Contributed to

Childhood Obesity Over the Past Thirty Years?

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Changes in Our Society and Environment

Less Calories OutMore Calories In Less physical activity

Lack of sidewalks

Automobile travel

Perception of safety

Watching more TV

Higher caloric foods

Large portion sizes

Consumption of soda & sweetened beverages

More meals away from

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Watching more TV

More labor assisting devices

home

Growth of food industry and advertising

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The New Social Norm?

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Screen Time: What Do Children See?

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Our Food Environment: Sugar, Salt, and Fat

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Drive-Through Makes It Easy

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Food Marketing to Children

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What is Healthy Development?

Healthy development is the capability of children, with appropriate support, to:

– Develop and realize their potential

– Satisfy their needs

– Interact successfully with their physical and social environments

Multidimensional and cross-domain

Influenced by responsive relationships safe and

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Influenced by responsive relationships, safe and engaging environments to explore, good nutrition

Foundation for success in learning and life

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Foundations of Healthy Development

Safe,

Appropriate Nutrition &

Stable, Responsive

Safe, Supportive

Environments

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Nutrition & Health

Behaviors

ResponsiveRelationships

Physical Activity Break

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Part C:Part C: ABCs of a Healthy Me

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ABCs of a Healthy Me Handout

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ctive play

reastfeeding

ut down on screen time

rink milk and water

at healthy foods

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ctive Play, Every Day

Daily, indoors and outdoors, for all children:

– Active play outdoors 2-3 times per week

– Opportunities to practice age-appropriate motor and movement skills

– Engage in moderate to vigorous physical activity (MVPA)

Preschoolers:

– At least 120 minutes of active play per day

– Opportunities for “breathless” (MVPA) playpp ( ) p y

Toddlers:

– At least 60-90 minutes of active play per day

Infants:

– Tummy time, at least 4 times daily, longer periods as enjoyed

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Benefits of ctive Play Supports exploration, development and learning

Helps manage weight and maintain a healthy body mass index (BMI)

Builds and maintains healthy bones and muscles

Increases strength, coordination and fitness

Lowers risk of chronic disease

Improves self-esteem

Lowers stress

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reastfeeding Support

AAP recommends:

– Exclusive breastfeeding for the first 6 months of life

– Continued breastfeeding for 1 year or longer

ECE programs provide important support

– Access to a private, quiet, comfortable place to breastfeed or pump

– Encouragement, support and information on breastfeeding

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Benefits of reastfeeding

Reduces risk for chronic diseases

Provides developmental benefits

Encourages maternal-infant bonding

Improves child and maternal health

– Child: Reduced risk for diarrhea and respiratory tract infection

– Mother: Faster rate of ret rning to pre pregnanc eight Faster rate of returning to pre-pregnancy weight

Decreased risk of breast and ovarian cancer

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ut Down on Screen Time

What is screen time?

– TV, DVDs, videos

– Computer time

– Smart phone, tablets

– Handheld video games

No screen time for children under age 2 years

Limit or eliminate screen time for children ages 2 years and olderyears and older

– No more than 30 minutes per week in ECE setting

– No more than 2 hours per day from all sources

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Benefits of utting Down on Screen Time Increases time for physical activity

Decreases exposure to food and beverage advertisements Decreases exposure to food and beverage advertisements

Decreases snacking and consumption of high caloric foods

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rink Water or Milk

Water is a great choice anytime

– Should be visible and accessible for self-serve inside and– Should be visible and accessible for self-serve, inside and outside

Choose milk for meals

– Whole milk for ages 12-24 months

– 1% or fat-free milk for ages 2 years and older

Limit or eliminate fruit juice

– 4-6 ounces per day (between home and ECE setting)

– If offered, serve only 100% juice

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Benefits of rinking Water and Milk Do not contribute to childhood obesity

Do not contain added sugars

Do not contribute to dental cavities

Milk provides calcium, protein, and

vitamin A & D (if fortified)

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at Healthy Foods Serve fruits and/or vegetables at every meal and snack

Serve fried/pre-fried foods only 1 time per month or never

Make half of grains whole grains Make half of grains whole grains

Choose low-fat dairy (1% or fat-free)

Choose lean meats and protein

Providing meals “family style” is considered best practice

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Benefits of atingHealthy Foods Fruits and vegetables provide vitamins and minerals

that are essential for a child’s growth

Low-fat dairy contains calcium and protein to help build strong bones and muscles

Whole grains, fruits, and vegetables contain fiber to help:

– Increase fullness

– Maintain a healthy weighty g

– Decrease risk for developing chronic conditions

Eating healthy foods at a young age helps children develop life-long healthy habits

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Partnering with Families to Support Healthy Habits

Teach parents to learn and follow the ABCs of a Healthy Me!Healthy Me!

– Spruce up your parent bulletin boards to include flyers on healthy habits

– Send home weekly or monthly newsletters that include healthy recipes

– Send home information regarding screen time

Invite parents to participate in meal time on site

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You are the Key to Helping Kids Grow Up Healthy!

The healthy habits you Have fun being active model and teach will

last a lifetime!with your children!

Remember: We are here to help you and the program’s families on your journey!52

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ABCs of a Healthy Me

Idea Exchange

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Lunch

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Part D:Part D: Staff

Wellness

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Essential Questions

What is wellness?

Why is staff wellness beneficial to your program?

What are your personal health goals?

How can your ECE program support you in achieving your health goals?

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What is Wellness?

Conscious, self-directed and evolving processand evolving process

Multi-dimensional and holistic

Positive and affirming

Requires awareness and directed, thoughtful attention

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Discussion:

What are some benefits of staff wellness efforts?

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Benefits of Staff Wellness Efforts

Helps staff identify opportunities to improve their healthhealth

Enhances productivity

Reduces absences, idleness and health care costs

Shifts focus from treatment to prevention

Increases loyalty & retention

Creates role models for children and one another

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Staff Wellness Focus Areas

Healthy Eating

Physical Activity Physical Activity

Healthy Weight

Breastfeeding

Screen Time

Stress Reduction

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Healthy Eating

Dietary Guidelines for Americans, 2010

– Enjoy your foods, but eat less

– Avoid oversized portions

– Make half your plate fruits and vegetables

– Make at least half your grains whole grains

– Compare sodium in foods like soup, bread and frozen meals and

choose the foods with lower numberschoose the foods with lower numbers

– Switch to fat-free or 1% milk

– Drink water instead of sugary drinks

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Eating Out

Difficult to eat healthy & maintain healthy weight

Strategies: U l b lmaintain healthy weight

– High calorie foods

– Very large portions (3-4x normal)

– Large glasses and plates

Free refills

– Use menu labels

– Ask for half portions

– Share with a friend

– Ask for dressing on the side

O d ill d/b k d– Free refills

– Limited nutrition information at many restaurants

– Order grilled/baked instead of fried

– Avoid buffets

– Ask for a doggy bag

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Physical Activity

Doesn’t have to be hard, stressful or boring!stressful or boring!

Recommendations for adults:– 2 hours + 30 (150 minutes) a week of moderate-intensity

– 1 hour + 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity

– Muscle strengthening exercises at least 2x/week

Episodes should last at least 10 minutes

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Healthy Weight

Healthy weight means you are not overweight or obese

Weight is a concern because of health, not appearance

Healthy weight ≠ health

Small changes can make you feel great!

Remember, weight should not be discussed with children

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Healthy Weight To maintain weight, energy in = energy out

Energy (calories) in gy ( )– Find your calorie goal– Increase awareness!– Increase fruits and veggies– Reduce portion sizes– Eat a nutrient dense breakfast

E ( l i ) t Energy (calories) out– Increase physical activity– Limit inactivity (screen time, sitting, etc.)

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Breastfeeding

Breastfeeding is more than a lifestyle choice, it’s a public health issue

Benefits for employers– Moms miss fewer days of work

Benefits for society– Decreased abuse and neglect– If 90% of mothers breastfed

for 6 months: 1,000 infant deaths could be prevented

U.S. could save $13 billion

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Breastfeeding at Work

Affordable Care Act requires support of hourly employeespp y p y

If staff want to breastfeed upon return to work, they should have a:– Reasonable break time

Private space– Private space– A place to store their pumped

milk– Work support system

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Screen Time

Includes all time spent in front of a screen for tasks not related to work or school

Can lead to “mindless eating”

Includes exposure to commercials advertising unhealthy foods

Is “sedentary” time—time spent sitting. Aim for less sitting, more movingmore moving

Takes time away from healthy activities

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Ways to Reduce Screen Time

Keep track of screen time using a log – set goals to cut down!

Take the TV out of the bedroom

Turn off the TV during mealtimes

Focus on other activities

Discover different ways to unwind (e.g., listening to music)

Take up a new active hobby Take up a new, active hobby

Plan screen-free activities with family and/or friends

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Stress Reduction

What is job stress?– Harmful physical and emotional responses

– Short-term and long-term Short term: headaches, sleep problems, upset stomach, short

temper, job dissatisfaction, low morale, etc.

Long-term: cardiovascular disease, musculoskeletal disorders, l h l h bl (d i & b ) k lmental health problems (depression & burnout), workplace

injury, etc.

– Not the same as being challenged

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Stress Reduction

Characteristics of low-stress organizations:

A i i l l h– An organizational culture that values the individual worker

– Recognition of employees for good work performance

– Opportunities for career development

– Management actions that align with organizational valuesManagement actions that align with organizational values

Stress management techniques

Organizational support + stress management = healthy workplace

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Role Modeling

“The most important role models in people's lives, it seems, aren't superstars or household names. They're 'everyday‘ people who quietly set examples for you--coaches, teachers, parents. People about whom you say to yourself, perhaps not even consciously 'I want to be likeconsciously, I want to be like that.' “

- Tim Foley

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You are a Role Model!

Children learn through interactions

Young children want to do what you do

Working withWorking with families gives you a unique opportunity

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Discussion:

What are ways you can role model healthy behaviors?

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Role Modeling Handout

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Role Modeling

1. Show by example

2. Go “food shopping”

6. Focus on each other at the table

together

3. Get creative in the kitchen

4. Offer the same foods for everyone

5 Reward with

7. Listen to your child

8. Limit screen time

9. Encourage physical activity

10. Be a good food role model

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5. Reward with attention, not food

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Wrap Up & Questions

“The part can never be well unless the whole is well.” - Plato

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Physical Activity Break

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Part E: Facilitating gChange in

Your Program

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Video Making Health Easier: Healthy Changes Start in Preschool

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LS1 Action Period

Why Should We Change?

How Can We Continue to Make Healthy Changes? Celebrating Success:

Our Plans in Action!

ActionPeriodLS1 Action

PeriodLS2 Action PeriodLS3 Action

PeriodLS4 Action PeriodLS5

We Change?

Go NAP SACC*Long-Term Action Plan & Storyboard

Our Plans in Action!

Continue Long-Term Action Plan

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What is Our Role in Making Healthy Changes?

Pilot Action PlanPilot Storyboard

How Can We Engage Families as Partners?

Continue Long-Term Action Plan (Emphasis on Parent Engagement)

*Go NAP SACC is a Nutrition and Physical Activity Self Assessment for Child Care for ECE settings comparing their current practices with a set of best practices

Facilitating Change in Your Program: LS1 Action Period

Facilitated by the program Leadership Teamy p g p

– Training for program staff

– Mini-version of the Learning Session that the Leadership Team attended

Opportunity to identify program strengths and areas for improvement

– Program will complete action tasks related to makingProgram will complete action tasks related to making healthy change

Trainers provide technical assistance (TA)

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Go NAP SACC Go NAP SACC is an evaluation tool used to:

– Assess programs’ strength and areas of improvement in th fthe areas of: Child nutrition

Infant feeding & breastfeeding

Infant & child physical activity

Screen time

G id t id tif i t th ld– Guide programs to identify improvement areas they would like to focus on throughout the Collaborative

– Create Pilot Action Plans (LS2) around the findings

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LS1 Action Period

The Leadership Team will:

– Set up a time to train program staff

– Guide program staff through completing Video Module 1 Group Discussion Worksheet

– Show Video Module 1

– Instruct program staff to complete Go NAP SACC in small groups by classroom

– Summarize the Go NAP SACC results as a whole

– Facilitate a discussion on five things the program does well and five things to improve upon

– Bring all Action Period materials back to LS2

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TA Breakout Groups

Question & Answer

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Questions?

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LS1LS1 Feedback

Forms

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