Intervention Guide

Childhood Obesity Prevention Project

This guide provides supplementary information about the interventions included in the Request for Application (RFA # A173) for the Childhood Obesity Prevention Project.

Partnership Development

Resources:

The NC Division of Public Health, Physical Activity and Nutrition Branch, Health Promotion Unitwill provide or direct counties to technical assistance and resources for this intervention.

Sustainability Toolkit: 10 Steps to Maintaining Your Community Improvements

Community Tool Box

Capacity:

The partnership should contain all key stakeholders needed to successfully implement the intervention strategies and gather necessary resources. Suggested members include:

  1. Healthy Carolinian Coalition partners
  2. Media
  3. Planners
  4. Transportation officials
  5. City/Town Leaders
  6. Daycare Directors and Staff representatives
  7. Parents
  8. Pediatricians/Family Practitioners
  9. Physician Assistants
  10. Nurses
  11. Social Workers
  12. Nutritionists
  13. Cooperative Extension Agents
  14. Health Educators
  15. Diabetes Educators
  16. School Administration-Superintendent, Principals
  17. School Staff: Teachers, School Counselors
  18. Hospital Administration and staff
  19. Advocacy groups
  20. School Health Advisory Council member(s)
  21. Faith leaders and representatives
  22. Community representatives
  23. Businesses
  24. College/University representatives
  25. Fitness Experts
  26. Law enforcement
  27. At least one person directly involved in implementing each intervention for the Childhood Obesity Prevention Project

Assessment:

Partnerships should use the Eat Smart, Move More (ESMM) Coalition Self-Assessment tool to assess their strengths. The tool is currently being developed and will be available on the Eat Smart, Move More website. Partnerships will also complete a post-project survey that is currently in development.

Potential Strategies:

Examples of potential strategies could include:

  • Complete a partnership member assessment to identify ways to improve member engagement and satisfaction
  • Assess (and possibly revise) the current structure and organization of the partnership
  • Conduct a marketing campaign to increase the visibility of the partnership
  • Assess progress toward the partnership’s current strategic plan, and consider revisions to include/align with the Childhood Obesity Prevention Project
  • Assess (and possibly revise) the internal partnership communication practices to ensure that members are informed and engaged in activities of the partnership
  • Conductor provide the opportunity for members to attend capacity building workshops to develop skills (e.g.,train-the-trainer Advocacy Workshop, October 14-15, 2008; training on leadership, group facilitation, advocacy, etc., for the partnership)

Evaluation:

Partnerships should use the ESMM Coalition Self-Assessment annually to monitor their development. Process and outcome measures will be collected to measure progress in strengthening the partnership and implementing the Childhood Obesity Prevention Project interventions.

The Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

Health Communications/Social Marketing

Resources:

The NC Division of Public Health, Physical Activity and Nutrition Branch will provide or direct counties to technical assistance and resources for this intervention.

Obesity Prevention Coordinators’ Social Marketing Guidebook

CDCynergy

Health Marketing web site from CDC

Information on the Youth Risk Behavior Surveillance System (YRBSS)

Capacity:

A health communications/social marketing team should be formed to design the media campaign. This team must work with the community partnership to develop and implement the campaign. Team members should include:

  1. Project Coordinator
  2. Media buyer
  3. Media partner(s)

Assessment:

Counties are expected to contract with a national survey company to conduct a phone survey assessment developed by the NC Division of Public Health, Physical Activity and Nutrition Branch. The North Carolina Agency for Public Telecommunications (APT) is a recommended (but not required) vendor for this service. Information about APT is available at:

Potential Strategies:

  • The media campaign should be designed to utilize all the media sources (e.g., television, radio, newspaper, internet, advertising, and billboards) available in the county.
  • The partnership may work with the NC State Center for Health Statistics and the CDC Division of Adolescent and School Health to conduct oversampling of YRBSS in the county for comparison to state and national data.

Evaluation:

Counties will be expected to contract with the same survey company that conducted the pre-campaign survey to conduct the media campaign evaluation.

Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

Bicycle/Pedestrian Plan Implementation

Capacity:A team should be formed to assess the current status of the Bicycle/PedestrianPlan and determine which of the priorities to focus on for this project.The team willdesign and implementthis intervention and should include representation from:

  • City or town planning staff and consultants, including engineers,landscape architects, and community design specialists
  • Transportation department
  • Elected officials
  • Police or sheriff’s office
  • School district administration or school board
  • Health department
  • Parks and recreation department
  • Hospital outreach staff
  • Wellness coordinators for large employers
  • Local media
  • Fitness club staff

Recruitment:

  • Schedule face to face meetings to invite selected individuals to join the planning team
  • Show how the goals of the projectalign with those of the decision makers/elected officials that you are recruiting
  • Recruit interested citizen volunteers by creating a media “buzz” around the plan
  • Recognize the participation of all members of the planning team

Assessment:

The ACEs Community Assessment should be used to assess the community’s current status and track progress over time.

Potential Strategies:

Examples of strategies could be to influence:

  • Environmental change through the construction of pedestrian crosswalks
  • Interpersonal change through implementation of a walking school bus program

Evaluation:

The ACEs Community Assessment should be used to track progress over time.

Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

Preschool/Child Care

Resources:

An online training for the County NAP SACC Coordinator is available at:

Counties may choose to contract for in-person training on NAP SACC. The NC Division of Public Health, Physical Activity and Nutrition Branch will assist counties with identifying a trainer, if desired.

NAP SACC Program information:

Capacity:

A Child Care team should be formed to determine the strategies to implement the intervention and what level of performance is expected from the participating child care facilities. The team will design and implement the intervention and should include representation from:

  1. Local child care consultant or other health professional(s) who can dedicate the necessary amount of time (dependant upon the number of facilities to participate) to provide technical assistance and trainingto address each participating child care facility. (The NAP SACC intervention requires approximately .0375 FTE of a health care professional time (or 1.5 hours/week/child care facility)to serve as the NAP SACC consultant over a six month period.))
  2. 1-2 child care facility manager/owner(s) OR 1-2 members of the local child care provider’s professional association
  3. A child care provider (other than the owner/manager)
  4. A parent representative

Recruitment:

What will encourage the child care facilities to participate? Potential incentives include:

  • Provide workshops to fulfill the providers’ need for Continuing Education Units (CEUs) that can be offered to all staff at times that best fit their schedule(s)
  • Offer funds that can be spent to provide facilities with resources (e.g., education curriculum, additional physical activity equipment, etc.)
  • Offer mini-grants to facilities for upgrades (e.g., improve existing outdoor play areas, purchase healthier foods, etc.)

Assessment:

The NAP SACC Self Assessment is to be completed by all participating preschools/child care centers at the beginning of project implementation and again after six months. At this time preschools/child care centers are to revise their Action Plans to include new goals and objectives. The County NAP SACC Coordinator provides technical assistance throughout this process.

Potential Strategies:

Examplesof strategies could be to influence:

  • Organizational policy change by requiring all participating child care centers to create or modify a written policy to provide and enforce guidelines for all foods served in the center. Centers are required to target all areas of the self-assessment tool where they did not meet the minimum nutrition standard.
  • Individual behavior change by all children in each center receiving nutrition education through a standardized curriculum one time per week or more. (Use of the Color Me Healthy Preschool Curriculum is recommended.)

Evaluation:

Data collected from the NAP SACC Self Assessment (pre and post) will be used to measure changes within the preschools/child care centers due to the intervention.

Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

HealthCare: Pediatric Obesity Tools

Resources:

Five Community Care of North Carolina (CCNC) Networks are currently piloting the Kate B. Reynolds Charitable Trust (KBR) Childhood Obesity Prevention Pilot Project that includes training for health care practices/providers on the use of the Pediatric Obesity Tools. Within these networks, CCNC will provide counties with training, technical assistance, and materials to support implementation of the intervention, including data collection and analysis. Counties within the five pilot networks shouldlist any KBR resources toward this effort as in-kind contributions in the application budget.

Counties that are not within a CCNC network currently piloting the KBR Childhood Obesity Prevention Pilot Project are encouraged to partner with their CCNC and/or their Area Health Education Center (AHEC) and/or others to implement the intervention. Counties may consider contracting a Trainer well-versed in use of the Pediatric Obesity Tools to provide the training to county health care practices/providers. For this intervention, counties should include funds for training needs, printing of materials, incentives for health care practice/provider participation, data collection and data analysis.

The Pediatric Obesity Tools are available at:

Capacity:

A HealthCare Pediatric Obesity team should be formed to determine the strategies to be used to implement the intervention and what level of performance is expected from the participating health care practices/providers. The team willdesign and implementthis intervention and should include representation from:

  1. Partners connected with county practices/providers, such as CCNC or an AHEC to assist with recruiting practices/providers for participation, possibly providing training, and strategizing about program implementation.
  2. A Trainer/Educator that can provide the training on the Pediatric Obesity Tools and facilitate the Continuing Medical Education (CME) credits. Counties that are a member of the Community Care of North Carolina (CCNC) may opt to contract with CCNC to provide this training.
  3. A Coordinator that can work with practices/providers to 1.) recruit participation in the training, 2.) facilitate the completion of the pre and post survey, and 3.) provide follow-up technical assistance on the use of the tools. The coordinator will be responsible for coordinating all aspects of the training(s).
  4. Practices and health care providers in the county

Recruitment:

What will encourage health care practices/providers to participate? Potential incentives include:

  • Offering CME credits for the training, and offering the training at times/locations convenient to the practices/providers
  • Offering incentives (e.g.,providing lunch/dinner) to key staff at the practice(s) who cal implement suggested changes are made to the management and/or treatment of patients

Assessment:

Each health care practice/provider participating in the intervention will complete a baseline survey to collect information oncurrent needs and practices related to pediatric obesity assessment and care. This survey should be completed by the participating practices/providers two to three months after the training to collect information on changes as a result of being trained on the Pediatric Obesity Tools.

Potential Strategies:

Examplesof strategies could be to influence:

  • Organizational policy change by advocating to participating providers to create or revise protocols, policies or procedures on the use of the body mass index (BMI) growth charts, calculation of BMI during routine well-child visits, counseling on weight management, and referring patients to the WakeMed ENERGIZE! Program

Evaluation:

A pre and post survey (noted under Assessment) targeting needs and practices related to pediatric obesity assessment and care should be used to collect data and analyze changes due to the training.

Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

WakeMed ENERGIZE! Program

Resources:

WakeMed Health and Hospitals and the NC Division of Public Health, Diabetes Prevention and Control Branch will provide training and technical assistance on the implementation of the WakeMed ENERGIZE! Program. This will include training for health care providers on screening and referral protocols, training for Diabetes Prevention/Health Educators and Fitness Facility Instructors who will be involved in program implementation, technical assistance to the county ENERGIZE! Program Coordinator throughout implementation, assistance developing strategies for data collection, and provision of data analysis.For information, contact Cindy Haynes-Morgan / (919) 707-5347.

Counties implementing WakeMed ENERGIZE! with funding from the Kate B. Reynolds (KBR) Charitable Trust, in partnership with the NC Division of Public Health, Diabetes Prevention and Control Branch, will not be required to use demonstration project funds to support the WakeMed ENERGIZE! Program. The KBR funding should be listed as in-kind in the Application Budget.

Information about the WakeMed ENERGIZE! Program is available at:

Capacity:

A team should be formed to replicate the WakeMed ENERGIZE! Program. Team members should include:

  • CountyWakeMed ENERGIZE! Coordinator
  • Physician Advisor
  • Key non-profit community partners, including but not limited to health care practices/providers such as pediatricians, family practice, community health centers, and clinics
  • Diabetes Prevention/Health Educator
  • Youth fitness partners (including facility administrators and instructors)
  • Local hospital staff/administration(collaboration is strongly encouraged)

Recruitment:

How will you recruit local physicians to participate? How will you recruit youth and their families to participate? Potential incentives include:

  • Providing free labwork to youth program participants
  • Providing media recognition to all participating physicians who refer patients to the program
  • Offering cash/gift card incentives to program participants who complete 80% of the program sessions
  • Offering physical activity “kits” to all youth participants

Assessment:

The WakeMed ENERGIZE! Program includes a health assessment of all participating youth (including labwork). Youth who qualify for the program and their families complete a Readiness-to-Change assessment. Program participants are to return for follow-up health assessments (including labwork) at 6 and 12 months after completing the WakeMed ENERGIZE! classes.

Potential Strategies:

The WakeMed ENERGIZE! Program is specifically designed to influence individual behavior change in youth identified as being at risk for developing diabetes. The strategies will need to target how to successfully implement this program in the county. Consider the following:

1)Hiring/contracting with diabetes educator to teach education sessions

2)Contracting with YMCA or local fitness center to provide space and fitness professionals to teach the fitness education sessions

3)Promoting the program through the media to ensure both parent and medical provider interest

4)Contacting pediatric medical providers to inform/recruit participation in the WakeMed ENERGIZE! referral process

5)Recruiting school nursing staff to facilitate referral of potential youth participants

Evaluation:

Evaluation will include tracking progress in implementing the intervention, changes in health status of program participants, and changes in physical activity and nutrition behaviors or program participants.

Key indicators for measuring progress and outcomes for this intervention are outlined in RFA Evaluation Measures (Attachment E) document, which is available on the Eat Smart, Move More website:

Hospital Worksite Wellness

Resources:

The NC Division of Public Health, Physical Activity and Nutrition Branch, Worksite Wellness Unit will provide technical assistance for this intervention.

Worksites Eating Smart and Moving More

A guide for worksite wellness committees is available at:

Capacity:

A Worksite Wellness team should be formed to determine the strategies to be used to implement the intervention and determine what level of performance is expected from the participating hospital. Team members should include:

  • Worksite wellness coordinator
  • Hospital staff including representation from human resources, information systems, all levels of management, administrative and support staff
  • Members of existing hospital committees (e.g. safety, quality assurance)

Recruitment:

How will you recruit hospital staff to form the worksite wellness committee? Potential incentives include:

  • Offer incentives for attending meetings (e.g. lunch/dinner provided, door prizes)
  • Allow employees to spendtime on wellness activities during normal work hours
  • Recognize employees for participation in the wellness committee

Assessment:

Assessment should collect information including the current policies and environments in the hospital that support healthy eating and physical activity. Employee’s current behaviors related to physical activity and nutrition and their interest in participation in wellness programs/initiatives should also be assessed.