Obesity in Arkansas: From Contemplation to Action

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Obesity in Arkansas From Contemplation to
Action

• Carole Garner, MPH, RD, LD
• Assistant Professor
• UAMS College of Public Health

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Transtheoretical Model Politics/Policy

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance

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Precontemplation

• No intention to change behavior in the
  foreseeable future.

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Contemplation

• Aware that a problem exists
• Seriously thinking about overcoming it

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AR Policy - Legislative History

• 1991 School Breakfast Program
• 1993 5 a Day
• 1995 ADE schools to support nutrition goals
• 1997 Child adolescent nutrition policy

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Comprehensive Child Adolescent Nutrition Policy

• Food insecurity
• Anemia
• Obesity
• Low-birthweight
• Breastfeeding
• Nutrition education
• Nutrition surveillance
• Physical activity
• Food safety

Shall be used as a guide for the development of
future legislation and policy concerning
nutrition in the State of Arkansas.
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The Impact of Obesity

• Raise awareness to problems solutions
• Ensure nutrition education PE K-12
• Worksite wellness
• Create a statewide obesity council
• Develop legislation
• Work with industry
• Prevention programs
• Insurance

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Preparation

• Intending to take action

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AR Nutrition Physical Activity Summit

• Healthier school environment
• State office on nutrition and physical activity
• Obesity on school district report cards
• Fitness test on school district report cards
• Calories on restaurant menus
• BMI vital sign on clinical charts

14 recommendations
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Action

• Overt behavioral changes
• Requires considerable commitment of time and
  energy.

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Act 122084th General Assembly 2003

• Establish a state level Child Health Advisory
  Committee (CHAC)
• Beginning Fall 2003 prohibits vending machine
  sales in elementary schools
• Beginning Fall 2003 requires report on amount
  and source of funds/expenditures from food
  beverage contracts

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Act 122084th General Assembly 2003

• Beginning Fall 2003 requires BMI-for-age on
  every child and a report sent to parents
• Beginning Fall 2004 create district level
  Nutrition Physical Activity Advisory Committees
  (NPAAC)

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BMI Classification AR students PreK-12 2004
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Dispensing Junk How School Vending Undermines
Efforts to Feed Children Well
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Child Nutrition Reauthorization Act 2004
Wellness Policies
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The gestation birthing of Act 1220

• CHAC developed recommendations
• August 2003 first meeting
• June 2004 sent to Board of Education
• ADE converted to proposed rules
• Two sections
• Certification professional development of child
  nutrition staff
• Nutrition and physical activity standards
• BOE approved for public comment 3-14-05 to
  4-25-05

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The birthing continues

• BOE approved for public comment 6-28-05 to
  7-20-05
• BOE approved Rules 8-8-05
• Not there yet .
• Legislature Rules Committee
• 9/1/05 rejected
• 9/6/05 approved

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Maintenance

• Work to prevent relapse
• Consolidate the gains attained during action

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Toddler Supports

• Legislative Activities
• January AFHK Essay Contest
• Restaurant Menu Labeling
• Conferences
• Implementing Policy Changes (NPAAC)
• Health Action Teams
• Obesity the Law
• 3rd Nutrition Physical Activity
• Technical Assistance Tobacco Settlement Funds
• Community Health Nurses
• Community Health Promotion Specialists