The Role of States in Public Health Nutrition

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The Role of States in Public Health Nutrition

• Assessment
• Policy Development
• Assurance

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Assessment

• State level assessment of population nutrition
  assessment
• Identify high risk areas of state
• Coordinate state and local assessment initiatives
• Provide data to local agencies
• Provide technical assistance training

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Assurance

• Manage/administer/deliver federal nutrition
  programs WIC, NSLP, SNAP
• Manage/deliver state funded programs MSS
• Build state capacity to address nutrition
• Technical assistance/capacity building,
  networking, communication
• Secure and distribute resources for long term
  goals

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Policy Development

• Advise governor and legislature
• State-level planning

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Washington States Nutrition Physical
Activity Plan
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Brief History of the Plan
2001-2002

• Received CDC funding to develop state plan
• Convened advisory group including
• Nutrition and physical activity professionals
• Hunger advocates
• State agencies and organizations - OSPI, WSDA,
  BCW
• Community advocates and other stakeholders
• Conducted formative research, identified target
  populations and specific strategies
• Plan launched with 5-year implementation grant
  from CDC

2003
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Vision Purpose

• Vision Washington residents will enjoy good
  nutrition, have active lives and live in healthy
  communities.
• PurposeProvide a framework in which policy
  makers at the state, local, and institutional
  levels can work together to support and build
  environments that make it easier for Washington
  residents to choose healthy foods and to be
  physically active in order to
• Slow the increase in the proportion of adults who
  are obese
• Reduce rates of chronic disease
• Improve the quality of life

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Creating Supportive Environments
Health and well being are affected by a dynamic
interaction between biology, behavior, and the
environment, an interaction that unfolds over the
life course of individuals, families, and
communities.
Institute of Medicine. Promoting Health
Intervention Strategies from Social and
Behavioral Research.
Washington D.C. National Academy Press, 2000
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Grounded in the Socio-ecological Model
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Criteria for Objectives Recommendations

• Related to obesity and chronic disease prevention
  
• Population based, potential to affect a large
  portion of the population
• Evidence based, theoretically sound, or
  recommended by nationally recognized authorities
  or experts
• Measurable objectives

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The Six Objectives

• Objectives
• ? Access to Health Promoting Foods
• ? Food Insecurity
• ? Proportion of Mothers Who Breastfeed Their
  Infants Toddlers
• ? Free and Low-Cost Opportunities for Recreation
  and Physical Activity
• ? Physical Activity Opportunities for Children
• ? Active Community Environments

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Putting the Plan into Action
2003 - 2008
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Planned Activities

• Partner with agencies, coalitions local
  communities
• Provide technical assistance, training, tools
  resources
• Support pilot programs and development of local
  action plans
• Encourage development implementation of policy
  recommendations by sector

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Planned Outcomes

• Short-Term
• Partnerships established working
• Partners knowledgeable about environ. policy
  issues that impact nutrition phys. activity
• Partners incorporate Plan into their work plans
• Financial support for nutrition phys. activity
  efforts increases

• Intermediate
• Changes in policy the environment
• Increased phys. activity improved dietary
  behavior

• Long-Term
• Decreased obesity
• Decreased incidence of chronic disease

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Partners of the Plan

• Partners pledge to help put the State Plan into
  action by working on one or more of the
  objectives
• Purpose
• Build partnerships
• Facilitate communication
• Support assessment evaluation

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Partners of the Plan Membership

• Members Represent
• More than 250 organizations in 31 counties,
  including
• Local state health departments
• Healthcare organizations
• Schools universities
• Businesses
• Community groups, nonprofit organizations
  coalitions
• Government agencies
• Tribal organizations

Cumulative Membership 2003-2008
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Involvement with Objectives 2004-08
Nutrition Objectives
Physical Activity Objectives
Access to Healthy Foods
Food Insecurity
Breast-feeding
Low Cost Recreation
PA for Children
Active Community Environ.
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Partners Scope of Influence 2004-08
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Setting Impacted By Partners 2004-08
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The State Plan in Our Communities

• Healthy Communities Projects
• The Healthy Communities model was developed to
  help communities
• Identify barriers and assets that impact
  nutrition and physical activity
• Develop an action plan based on strategies from
  the State Plan
• Create policies and community environments that
  support good nutrition and opportunities for
  physical activity for all residents
• Success of pilot projects in Moses Lake and Mount
  Vernon has led 6 other communities to adopt the
  Healthy Communities model

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The State Plan in Our Communities

• Steps to a Healthier WA
• Prevent chronic disease using policy and
  environmental changes that support healthy
  communities and organizations
• 2008 Preventive Health Health Services Block
  Grants
• Funded 9 local health jurisdictions and tribes to
  develop or implement policies that promote
  physical activity and nutrition
• Active Community Environments
• Promote physical activity through transportation
  policy and urban planning approaches

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Community Projects Addressing Plan Priorities
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Partners in Action

• Quarterly update
• Showcase of activities related to 6 objectives
• Work of partners across the state
• Diverse settings

www.wapartnersinaction.org
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Access to Healthy Foods

• Rainier Valley Healthy Restaurant Initiative
• Partner Healthy Active Rainier Valley
  Coalition
• 16 restaurants in SE Seattle
• Dietitians helped identify healthy options based
  on guidelines for calories, fat, sodium, fiber
  fruit/vegetable servings
• Brochure publicized participating restaurants and
  includes a map marked with bike friendly routes

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Reduce Food Insecurity

• Co-Pay Elimination for Reduced-Price School Meals
  
• Partner OSPI
• 2006-07 State eliminated of co-pay for breakfast
• 2007-09 State continued breakfast co-pay
  elimination and eliminated the .40 lunch co-pay
  for K-3 students.
• Reduced-price breakfast co-pay elimination
  associated with
• 36 ? in participation in 2006-07
• 1,270,000 more meals

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Breastfeeding

• Moses Lake Breastfeeding Resolution
• Partner Moses Lake Breastfeeding Coalition
• In 2006, the Moses Lake City Council adopted a
  resolution that states
• The City supports a mothers right to breastfeed
  on public or private property where the mother
  and child are otherwise authorized to be, and
  encourages our citizens to recognize the benefits
  of breastfeeding and allow a mother to breastfeed
  anywhere any other person is allowed to be.
• MLBC offered assistance to businesses that wanted
  to become more breastfeeding-friendly.

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Increase Free/Low Cost PA Opportunities
Stairwell Mural at Wenatchee Valley Medical
Center Partner Steps to a Healthier Chelan,
Douglas Okanogan County

• Local high school and college students painted a
  mural that covers 3 floors of a WVMC stairwell
• The project was designed to
• Promote workplace exercise and opportunities for
  active living
• Support workplace health initiatives
• Has received very positive responses from
  employees and patients

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Increase PA Opportunities for Children

• Active Bodies Active Minds Web Site Toolkits
• Partner UW Center for Public Health Nutrition
• Offer access to field-tested tools and
  information on
• Importance of limiting screen time encouraging
  physical activity for young children
• Resources for child care professionals and
  families
• Evaluation ? screen use in child care
  facilities and ? the of providers who talk to
  parents about screen use.

www.waabam.org
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Active Community Environments

• Safe Routes to School at Lincoln Elementary
• Partner Mount Vernon Healthy Communities Project
• To ? the number of students who can safely walk
  to school, Lincoln Elementary in Mount Vernon
• Offers a walking school bus program 3 days/week
  in spring fall
• Teaches pedestrian/bicycle safety lessons in PE
• Installed missing sidewalks and other safety
  features with SRTS grant funding
• 30 of students now walk to school (? from 10)

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Lessons Learned from Partners

• Partners described positive experiences
  associated with using the Plan to establish
  priorities and select activities
• New partnerships something that we need to
  celebrate!
• Plan puts everyone on the same page
• Plan lends legitimacy and a selling point for
  local projects
• Common barriers and challenges
• Funding, time, resources
• Involving necessary partners and working with
  non-traditional partners
• Learning curve associated with policy and
  environmental approaches

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Plan Revision Process

• Literature/document review Indentify new
  research, evidence-based interventions and
  national guidelines
• Key informant interviewsInput from members of
  original advisory committee and others who have
  used the Plan
• Three stage review processInternal and external
  partners including selected experts and project
  coordinators

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Increasing Healthcare Sector Involvement

• Primary Prevention Advisory Committee formed by
  DOH in 2007
• Internal and external stakeholders including
  healthcare providers, health plans, and academia
• Developed recommendations for clinical medicines
  participation in the State Plan
• Examples of policy and environmental approaches
  within the healthcare sector incorporated into
  Plan

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Other New Features

• Role of families and individuals
• New examples of initiatives across the state
• Updated data and information on cultural
  competence, communication strategies and
  partnerships
• Index to locate sector-related information
• New appendixes and resources

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New and Expanded Resources

• Healthy Communities Toolkit 2 Implementation
  Measuring Success
• New Partners in Action Site
• Web-based version of the Plan
• Increased access to resources
• Both sites to be launched June 2008