Acknowledgements. A special thank you to: Centers for Disease Control and Prevention (CDC) For generous funding support and expertise

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1 Learning Session 1: Why Should We Change? Early Childhood Health Promotion and Obesity Prevention Nemours is currently funded by the Centers for Disease Control and Prevention (CDC) under a five-year Cooperative Agreement (1U58DP ) 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. 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 Gretchen Swanson Center for Nutrition For the evaluation component of this national effort 2 1

2 Part A: The ECELC Project 3 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 4 2

3 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 (2 nd Edition) Nutrition and Physical Activity Self-Assessment for Child Care (Go NAP SACC) Focus on quality ECE, and children s health as the foundation for life-long l success Obesity prevention in the context of health promotion and wellness made possible by the power of ECE providers 5 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! 6 3

4 Leadership Team Model ECE Programs Self-Defined Leadership Team Owner/ Director Lead Teacher Foodservice Personnel 7 Learning Sessions Why Should We Change? Go NAP SACC* How Can We Continue to Make Healthy Changes? Long-Term Action Plan & Storyboard Celebrating Success: Our Plans in Action! Continue Long-Term Action Plan LS1 Action Period LS2 Action Period LS3 Action Period LS4 Action Period LS5 Action Period What is Our Role in Making Healthy Changes? Pilot Action Plan Pilot Storyboard How Can We Engage Families as Partners? Continue Long-Term Action Plan (Emphasis on Parent Engagement) 8 *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 4

5 U.S. First Lady Michelle Obama First Lady Michelle Obama s welcome and thank you message! 9 Complete LMCC Registration and Quiz As a Leadership Team, complete the registration/quiz: 10 5

6 Let s Move! Child Care Website 11 Part B: Healthy Development 12 6

7 The Obesity Epidemic s Impact Overweight and obesity increased rapidly in a short period of time among children, youth and adults in the U.S. The upcoming video will shows how adult obesity rates changed in the U.S. since Video Module

8 Video Module 1 Take Away Messages 15 State Childhood Overweight/Obesity Rates 16 8

9 Arizona County-Level Childhood Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 17 California County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 18 9

10 Florida County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 19 Indiana County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 20 10

11 Kansas-County Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 21 Kentucky County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 22 11

12 Missouri County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 23 New Jersey County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 24 12

13 Virginia County-Level Overweight/Obesity Prevalence Low-income, ages 2 to < 5 years (PedNSS; ) 25 Long-Term Impact of Obesity Health problems in children formerly seen only in adults: 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 26 13

14 Discussion: What Has Contributed to What Childhood Has Contributed Obesity Over to the Childhood Past Thirty Obesity Years? Over the Past Thirty Years? 27 Changes in Our Society and Environment More Calories In Higher caloric foods Large portion sizes Consumption of soda & sweetened beverages More meals away from home Growth of food industry and advertising Less Calories Out Less physical activity Lack of sidewalks Automobile travel Perception of safety Watching more TV More labor assisting devices 28 14

15 The New Social Norm? 29 Screen Time: What Do Children See? 30 15

16 Our Food Environment: Sugar, Salt, and Fat 31 Drive-Through Makes It Easy 32 16

17 Food Marketing to Children 33 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 engaging environments to explore, good nutrition Foundation for success in learning and life 34 17

18 Foundations of Healthy Development Safe, Supportive Environments Stable, Responsive Relationships Appropriate Nutrition & Health Behaviors 35 Physical Activity Break 36 18

19 Part C: ABCs of a Healthy Me

20 ABCs of a Healthy Me Handout 39 ctive play reastfeeding ut down on screen time rink milk and water at healthy foods 40 20

21 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) play Toddlers: At least minutes of active play per day Infants: Tummy time, at least 4 times daily, longer periods as enjoyed 41 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 42 21

22 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 43 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 returning rning to pre-pregnancy pregnanc weight Decreased risk of breast and ovarian cancer 44 22

23 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 older No more than 30 minutes per week in ECE setting No more than 2 hours per day from all sources 45 Benefits of utting Down on Screen Time Increases time for physical activity Decreases exposure to food and beverage advertisements Decreases snacking and consumption of high caloric foods 46 23

24 rink Water or Milk Water is a great choice anytime Should be visible and accessible for self-serve, inside and outside Choose milk for meals Whole milk for ages 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 47 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) 48 24

25 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 Choose low-fat dairy (1% or fat-free) Choose lean meats and protein Providing meals family style is considered best practice 49 Benefits of ating Healthy 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 weight Decrease risk for developing chronic conditions Eating healthy foods at a young age helps children develop life-long healthy habits 50 25

26 Partnering with Families to Support Healthy Habits Teach parents to learn and follow the ABCs of a 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 51 You are the Key to Helping Kids Grow Up Healthy! The healthy habits you model and teach will last a lifetime! Have fun being active with your children! 52 Remember: We are here to help you and the program s families on your journey! 26

27 ABCs of a Healthy Me Idea Exchange 53 Lunch 54 27

28 Part D: Staff Wellness 55 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? 56 28

29 What is Wellness? Conscious, self-directed and evolving process Multi-dimensional and holistic Positive and affirming Requires awareness and directed, thoughtful attention 57 Discussion: What are some benefits of staff wellness efforts? 58 29

30 Benefits of Staff Wellness Efforts Helps staff identify opportunities to improve their health 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 59 Staff Wellness Focus Areas Healthy Eating Physical Activity Healthy Weight Breastfeeding Screen Time Stress Reduction 60 30

31 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 numbers Switch to fat-free or 1% milk Drink water instead of sugary drinks 61 Eating Out Difficult to eat healthy & maintain healthy weight High calorie foods Very large portions (3-4x normal) Large glasses and plates Free refills Limited nutrition information at many restaurants Strategies: Use menu labels Ask for half portions Share with a friend Ask for dressing on the side Order grilled/baked d instead of fried Avoid buffets Ask for a doggy bag 62 31

32 Physical Activity Doesn t have to be hard, 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 vigorousintensity aerobic physical activity Muscle strengthening exercises at least 2x/week Episodes should last at least 10 minutes 63 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 64 32

33 Healthy Weight To maintain weight, energy in = energy out Energy (calories) in Find your calorie goal Increase awareness! Increase fruits and veggies Reduce portion sizes Eat a nutrient dense breakfast Energy (calories) out Increase physical activity Limit inactivity (screen time, sitting, etc.) 65 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 66 33

34 Breastfeeding at Work Affordable Care Act requires support of hourly employees If staff want to breastfeed upon return to work, they should have a: Reasonable break time Private space A place to store their pumped milk Work support system 67 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 moving Takes time away from healthy activities 68 34

35 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 Plan screen-free activities with family and/or friends 69 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, mental health problems (depression & burnout), workplace injury, etc. Not the same as being challenged 70 35

36 Stress Reduction Characteristics of low-stress organizations: 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 values Stress management techniques Organizational support + stress management = healthy workplace 71 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 like that.' - Tim Foley 72 36

37 You are a Role Model! Children learn through interactions Young children want to do what you do Working with families gives you a unique opportunity 73 Discussion: What are ways you can role model healthy behaviors? 74 37

38 Role Modeling Handout 75 Role Modeling 1. Show by example 2. Go food shopping together 3. Get creative in the kitchen 4. Offer the same foods for everyone 5. Reward with attention, not food 6. Focus on each other at the table 7. Listen to your child 8. Limit screen time 9. Encourage physical activity 10. Be a good food role model 76 38

39 Wrap Up & Questions The part can never be well unless the whole is well. - Plato 77 Physical Activity Break 78 39

40 Part E: Facilitating Change in Your Program 79 Video Making Health Easier: Healthy Changes Start in Preschool 80 40

41 LS1 Action Period Why Should We Change? Go NAP SACC* How Can We Continue to Make Healthy Changes? Long-Term Action Plan & Storyboard Celebrating Success: Our Plans in Action! Continue Long-Term Action Plan LS1 Action Period LS2 Action Period LS3 Action Period LS4 Action Period LS5 Action Period What is Our Role in Making Healthy Changes? Pilot Action Plan Pilot 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 81 Facilitating Change in Your Program: LS1 Action Period Facilitated by the program Leadership Team 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 making healthy change Trainers provide technical assistance (TA) 82 41

42 Go NAP SACC Go NAP SACC is an evaluation tool used to: Assess programs strength and areas of improvement in the areas of: Child nutrition Infant feeding & breastfeeding Infant & child physical activity Screen time Guide programs to identify improvement areas they would like to focus on throughout the Collaborative Create Pilot Action Plans (LS2) around the findings 83 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 LS

43 TA Breakout Groups Question & Answer 85 Questions? 86 43

44 LS1 Feedback Forms 87 44