Blueprint for Nutrition and Physical Activity

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• Blueprint for Nutrition and Physical Activity
• Bonnie A. Spear, PhD, RD
• Professor Pediatrics
• University of Alabama at Birmingham

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Blueprint - Mission

• Improve the nations health by
• integrating sound policy, programs,
• resources, services, and messages
• where individuals, children, adolescents, and
• families make healthy choices about
• eating and being physically activity.

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Blueprint - Vision

• Eating healthy and being active
• are an integral part of
• daily life for everyone.

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Blueprint

• Outlines practical, consumer-focused, state and
  local strategies for improving eating and
  physical activity that will lead to healthier
  lives for children, adults, and families.

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Blueprint

• Provides consumers, communities, organizations,
  agencies, and programs with strategies and
  potential actions to address priority nutrition
  and physical activity issues in the context of
  their own community resources and needs.
• Suggested strategies compliment reinforce the
  strategic plan objectives from federal/state
  agencies.

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• Focuses on physical activity eating behaviors
  as cornerstones for improving health and
  well-being.
• Deigned to address more than the problem of
  overweight and obesity.
• Designed around critical eating physical
  activity behaviors to address broad spectrum of
  health promotion and disease prevention.

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Guiding Principles

• Sections are consumer-focused and community-based
  focusing on strengths, assets, and community
  involvement in determining priorities and how to
  address them.
• Strategies reflect cultural dimensions of the
  community through acknowledgement of their
  contributions.
• The cultural competency of individuals and
  organizations participating in the planning and
  implementing of strategies within the community
  is critical for success.
• Physical activity is defined broadly to include
  Healthy People 2010 objectives and increased
  moderate physical activity and reduced sedentary
  behaviors.

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Guiding Principles

• Healthy eating is defined broadly to include
  Healthy People 2010 nutrition-related objectives
  and U.S. Dietary Guidelines for Americans.
• A public health planning process is used to
  engage stakeholders in assessing strengths and
  needs, setting goals and objectives, developing
  and implementing interventions, and evaluating
  outcomes.
• Professionals work collaboratively to lead change
  for improved health outcomes in communities.

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How was the Blueprint developed?

• Initial review by a group of stakeholders in
  April 2004.
• Stakeholders urged a more thorough analysis of
  the document by varied and wider audiences. The
  ultimate objective of this refinement process is
  a framework that outlines the critical actions
  needed to meet national health goals.
• Draft of the blueprint was reviewed by
  stakeholder organizations from June through
  December 2004.

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How was the Blueprint developed?

• April 2005 - second stakeholder group was
  assembled to further clarify and develop the
  Blueprint Goals, Strategies and Initial Steps for
  Action.
• The stakeholders participating in the 2005
  meeting included individuals and organizations
  from the original group of stakeholders as well
  as a broader range of physical activity and
  nutrition representatives.
• Finally, from February through April 2006, an
  editorial panel of nutrition and physical
  activity experts provided a final review of the
  document.

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Who is Blueprint audience?

• Key state and local policy makers,
• public leaders,
• government bodies,
• public health partners,
• businesses,
• voluntary and private organizations
• .with a mission to improve the health and
  well-being of those who live in our communities.

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How can the Blueprint be used?

• Consider suggested strategies and steps
  prioritize/elect them for use in your own
  communities and organizations.
• Add or change the strategies or steps to fit more
  closely with the needs of your community.
• Apply relevant aspects of the Blueprint in the
  assessment, development or planning of their
  policies and programs to address nutrition and
  physical activity.

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THE CORNERSTONES

• ACCESS Assure access to healthy foods and
  locations to engage in physical activity.
• COLLABORATION Promote healthy lifestyles by
  maximizing collaboration and partnerships.
• SCIENCE AND RESEARCH Build the science base and
  accelerate the transfer of science to practice.
• WORKFORCE Increase the diversity, capacity, and
  flexibility of the nutrition and physical
  activity workforce.
• COMMUNICATIONS Promote health and create
  awareness of the investment value of nutrition
  and physical activity through effective
  communications.

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CORNERSTONE 1 ACCESS

• Assure access to healthy foods and locations to
  engage in physical activity.
• STRATEGY 1 Assure access to a food supply and
  healthy food choices.
• STRATEGY 2 Assure access to safe, affordable,
  convenient opportunities to be physically active.
• STRATEGY 3 Increase the number and types of
  settings where culturally appropriate nutrition
  and physical activity services are supported and
  offered to people of all income levels, stages of
  life, and abilities.

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Potential Actions

• Identify existing and potential resources and
  assets
• Identify gaps related to nutrition and physical
  activity
• Simplify eligibility application for food
  assistance
• Encourage sustainable food supplies
• Advocate for policies and environmental changes
  that support PA
• Establish worksite wellness programs
• Use School Health Index
• Skill-building that supports lifelong PA and
  healthy food production
• Work with non-traditional partners,

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Examples

• The Food Trust of Philadelphia
• School Market Program
• School Gardens
• Students Grow Food
• Student sell food and learn to run a business
• Local grocery stores donate fresh fruits for
  students to cell
• www.thefoodtrust.org

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Legislation

• Establishing roadside market incentive programs
  (SC, ME, GA, ME)
• School Nutrition
• MS- local school wellness polices shall promote
  increase PA
• OR- minimum standards for food and beverage
• BMI and Fitness screening
• BMI screening- AK, CA, DE, FL, Il , Iowa, MS, NY
  PE, SC, TN, WV- some require aggregate data not
  individual data such as SC
• Fitness Testing- SC

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CORNERSTONE 2 COLLABORATION

• STRATEGY 1 Build new or enhance existing
  relationships among community, public,
  non-profit, voluntary, and private sectors at the
  community, county, state, multi-state, and
  federal levels that directly or indirectly have
  potential to improve physical activity and
  healthy eating.
• STRATEGY 2 Support community-directed
  initiatives to reduce inequalities for healthy
  eating and physical activity that engage the
  community members in addressing community change.

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CORNERSTONE 2 COLLABORATION

• STRATEGY 3 Maintain collaboration efforts by
  building capacity of leaders and members from the
  sectors of the community.
• STRATEGY 4 Identify, Assess, and Access Funding
  Resources and Partners

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Potential Actions

• Expand existing partners
• Identify key community leaders
• Plan a strategy to access adequate funding,
  planning, implementation, and evaluation
• Build and maintain strong communication between
  partners

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Scale Back AlabamaPrivate and Public
Partnerships

• Scale Back Alabama was a statewide weight loss
  effort with an overall goal a healthy lifestyle.
• Targeted to worksites
• Partnership
• Alabama Hospital Association
• Barbers Dairy
• AL Dept Public Health
• Blue Cross of Alabama

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Scale Back Numbers

• Year 1
• 46 of the 67 counties participated 68 of the
  state
• 5,000 teams participated in the contest
• 2,100 teams participated in the final weigh-in
• Participants lost 78,472 pounds or about 9,800
  pounds per week
• Year 2
• gt10,000 teams of 4-5 individuals
• 54/67 counties participating

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• Body and Soul- intervention developed using key
  components of Black Churches United for Better
  Health. Lay counseling conducted 2 MI phone
  calls. Post test showed significant increases in
  fruit and vegetable frequency for participants
  compared to controls

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• SC- Grocery Store Initiative
• Partner with stores, chefs, volunteer dietitians,
  BI-LO stores.
• Research- showed increases in purchansing of
  produce
• Dissemination- popular and BI-LO has agreed to
  support other events.

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CORNESTONE 3 SCIENCE RESEARCH

• STRATEGY 1 Develop a community-based research
  agenda that integrates nutrition and physical
  activity that demonstrate and sustain policies,
  programs and services.
• STRATEGY 2 Utilize and improve data systems to
  measure the development and impact of
  community-based policy and program interventions
  at the individual, organizational, and community
  level.

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CORNESTONE 3 SCIENCE RESEARCH

• STRATEGY 3 Incorporate research and evaluation
  into all phases of policy and program development
  based on the best evidence available.
• STRATEGY 4 Include training on research and
  evaluation of policy and program interventions
  for researchers, health care providers, program
  staff, and community members.
• STRATEGY 5 Use and communicate results of
  program and policy interventions that contribute
  to evidence-based strategies.

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Potential Actions

• Identify, engage, and train community members in
  planning and implementing research
• Identify available data systems
• Share best practices
• Use local data to advocate for programming to
  address needs and policies
• Develop community needs assessment to identify
  strengths and gaps
• Conduct impact and outcome evaluation
• Provide training
• Translate research into practice

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Examples

• TACOS (Trying Alternative Cafeteria Options in
  Schools) worked closely with CNP programs to
  increase lower-fat a la carte food and showed
  that changes in school food environment can
  improve youths intake without loss of money to
  programs. Helped with other schools implementing
  program.

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• Loving Support makes breastfeeding work- a
  community wide campaign for breastfeeding
  evaluated in MS provided a basis for USDA to
  provide funding to other state to launch this
  campaign.

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Examples

• Arkansas Act 1220 (2003)
• Universal BMI measurements in schools
• CME courses for primary care providers
• Child Health Advisory Committee
• Local parent advisory committees
• Limited vending machines access
• Disclosure of contract information with beverage
  companies
• 30 physical activity/day
• Education for cafeteria workers

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Changes in BMI in Arkansas

• Category Year 1 Year 2 Year 3
• 2003-4 2004-5 2005-6
• Overweight 20.9 20.8 20.4
• At risk 17.2 17.2 17.1
• Healthy weight 60.1 60.1 60.6
• Underweight 1.8 1.9 1.9
• Total students 348,710 372,369 371,082
• All available data for years 1 2, and all data
  received by 6/14/06 for year 3 analysis

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• Training on MAPS for communities
• Moving to the Future Training for staff

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CORNESTONE 4 WORKFORCE

• STRATEGY 1 Recruit, hire, and retain a divers,
  competent public health workforce that is
  representative of populations served.
• STRATEGY 2 Increase the number and types of
  well-trained, diverse personnel who plan,
  facilitate, deliver and evaluate services to
  support healthy eating and physical activity.

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CORNESTONE 4 WORKFORCE

• STRATEGY 3 Promote quality training and/or
  credentialing of health promotion professionals
  to support a competent, diverse workforce for
  health education.
• STRATEGY 4 Support training of researchers and
  practitioners on evidence-based interventions
  that promote healthy eating and physical
  activity.

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Potential Actions

• Promote public health nutrition and physical
  activity careers
• Provide incentives for workers to remain in
  community
• Develop training opportunities (healthy
  professionals and lay public) on healthy eating
  and physical activity
• Support credentialing activities for health
  promotion
• Support evidence based reviews and develop
  courses, CE and degrees to use this in training
  PH workforce in translating research

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Examples

• ?

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CORNERSTONE 5 COMMUNICATIONS

• STRATEGY 1 Establish communications plans for
  dissemination of messages, programs and
  services.
• STRATEGY 2 Develop sustained state and local
  public awareness campaigns that support healthy
  eating and PA linked with media.

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CORNERSTONE 5 COMMUNICATIONS

• STRATGEY 3 Design and disseminate consistent and
  accurate culturally and linguist messages to
  individual and communities.
• STRATEGY 4 Improve health literacy by creating
  clear, consistent health messages that are
  culturally and linguistically appropriate to
  enhance understanding and application.

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CORNERSTONE 5 COMMUNICATIONS

• STRATEGY 5 Disseminate evidence and best
  practice model programs that link outcomes and
  benefits to the cost of initiating and
  maintaining programs that support healthy eating
  and physical activity.

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Potential Actions

• Form partnerships to speak with one voice-
  promote consistent messages
• Design campaigns based on formative research
• Reach at risk populations with culturally
  appropriate communication and messages
• Improve health literacy
• Increase opportunities for education (think
  outside the box)
• Disseminate information on programs that work
• Help translate research into practice

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Examples

• Governors leadership
• Indiana- launched InShape Indiana
• South Carolina- partnered with African Methodist
  Episcopal Church to conduct health programs
• Hawaii- health clinics hold weekly cooking
  demonstrations using local produce
• Tennessee- Better Health Its about time a
  public awareness program to take responsibility
  for their health

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• Health Works for Women- a 5 year worksite
  promotion intervention that focused on rural,
  blue-collar women working in small to
  medium-sized manufacturing industries.

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• Lessons Learned
• Reducing alcohol on college campus
• What worked? What did not work?

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• Questions?