Healthy Kids Make Healthy Communities

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Healthy Kids Make Healthy Communities

• The Project Healthy Schools Grant

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Our Commitment to Michigan

• Blue Cross Blue Shield of Michigan is a
  non-profit organization a surprise to many!
• We give back millions of dollars a year to
  Michigan residents, in the form of grant funding
  (such as the Project Healthy Schools Initiative),
  subsidies, in-kind donations, and staffing for
  policy and advocacy work.
• The Health Policy and Social Mission department
  has worked on physical activity and nutrition,
  access for the uninsured, depression, and
  domestic violence for the past three years.
• The times they are a changin For 20072011,
  well retain physical activity and nutrition and
  access, and add smoking cessation and maternal
  and child health.

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Background Project Healthy Schools

• Blue Cross Blue Shield of Michigans Project
  Healthy Schools grant funds efforts to increase
  physical activity and promote healthy diets for
  children.
• The Leslie (Mid-Michigan), Grand Rapids (West
  Michigan) and South Redford (Metro Detroit)
  school districts were selected from a pool of 47
  applicants statewide. The three districts were
  funded at 50,000 per year over two years, for a
  grand total of 300,000. 5,000 children were
  impacted.
• BCBSM worked collaboratively with the Michigan
  Dept. of Community Health and Dept. of Education
  to develop grant guidelines and select
  applicants.

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Background Project Healthy Schools

• Schools created multi-faceted programs
• Nutrition awareness and physical education
  (walking clubs)
• Changes to food service and menu options
• Greater parental involvement
• Nutrition policy change
• Staff development
• The Blues are committed to Project Healthy
  Schools, and designated it a long-term corporate
  goal tied to executive incentive compensation for
  2004-2006.

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Core Requirements

• Schools were given flexibility in program
  design, but there were a few core requirements
  that guided their efforts
• 1. Coordinated School Health Teams (CSHT)
• The CSHT is a multi-disciplinary committee that
  shapes school wellness policies and takes
  responsibility for the direction and
  implementation of the grant. Teachers,
  administrators, nursing and social work staff,
  parents, and students were all encouraged to be
  part of the effort.

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Core Requirements

• 2. Healthy School Action Tool (HSAT)
• This is an assessment tool to help schools
  determine what changes they should make to
  improve school health. The questions in the HSAT
  reflect current research findings on what is most
  critical to creating healthy school environments.
  
• Questions were asked about school wellness
  policies, cafeteria menus, vending choices, the
  built environment, the community in which the
  school resides, staff demographics, etc. The
  questions were grouped into modules and results
  were derived from them.

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Core Requirements

• 3. Community Collaboration
• As part of the grant, schools were required to
  collaborate with community partners such as
  hospitals, universities, and business owners. For
  example, Leslie Schools collaborated with
  Michigan State University and Foote Hospital of
  Jackson, Michigan.

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Demographics of Target Communities
Grand Rapids Number of Students Setting Income Nationality
Grand Rapids 2550 students from 6 middle and elementary schools Urban 92 percent eligible for free and reduced lunch 48 percent African American 21 percent Multi-racial 18 percent Hispanic 12 percent Caucasian
Leslie 552 elementary students 390 middle school students Rural 35 percent eligible for free and reduced lunch 99 Caucasian
South Redford 1440 students from 4 elementary schools Suburban 26 percent eligible for free and reduced lunch African American 45 Asian 1 Caucasian 49 Hispanic 4 Middle Eastern 1
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Leslie Highlights

• Widespread improvements made to lunch menu
  unhealthy foods have significantly decreased and
  all foods are now baked, not fried.
• Leslie teachers received ethnically diverse books
  with positive messages on nutrition and physical
  activity to incorporate into reading time.
• Built an indoor climbing wall that is available
  for use by over 900 students and community
  members.
• Sin tax Increased prices of unhealthy items,
  then sales decreased.
• Staff participated in walking programs, too!
  

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Grand Rapids Highlights

• Sponsored Healthy University (Healthy U) after-
  school program in 6 schools
• 12-week program with 4 weeks of instruction on
  nutrition, fitness and exercise.
• Students visit the YMCA to utilize state of the
  art kid-sized fitness equipment and do activities
  such as yoga, African drumming, and salsa
  dancing.
• Mini-markets at schools encouraged the purchase
  of fresh fruits and vegetables. Over 400 families
  have purchased produce from the mini-markets to
  date.
• Mentorship program w/ at-risk students as leaders.

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South Redford Highlights

• South Redford students produced their own PSAs.
  Theyve been viewed by over 1,200 students
  district-wide.
• Developed a voluntary walking program, where
  students walked the number of miles needed to
  reach Mexico. A Cinco de Mayo celebration was
  held later to recognize student achievement.
• Conducted several health fairs for parents and
  their children wonderful experience!
• Provided healthy snacks to children during school
  hours to encourage kids to eat more fruits and
  veggies and try new/different ones.

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HSAT Results

• Leslie
• Staff health promotion changed 57
• Nutrition services changed 24
• Family/community involvement changed 27
• Grand Rapids TBD
• South Redford
• Each of the four schools experienced improvements
  of approx. 10 with the food service module
• Three of four schools experienced a change of
  approx. 33 (avg.) with regard to
  family/community involvement.

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Overall Physical Activity Results

• Our goal over two years was to see a 10 increase
  over baseline in physical activity in two of
  three districts. This goal was accomplished.

District Baseline ( of students) Target Actual Change
Grand Rapids (Healthy U) 1,665 1,832 2,152 29
Leslie (Walking Club) 285 427 489 72
South Redford (Walking Club) 1,211 1,322 995 -18
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Overall Nutrition Results

• Our goal was to see a 10 improvement over
  baseline (represented in the table below) in
  healthy eating behaviors in two of the three
  districts. This goal was not accomplished. For
  the results below, students were asked which of
  the following healthy behaviors they had done
  yesterday.

District Had break-fast Ate fruit or vegetable Drank milk Ate a healthy snack
Grand Rapids 36 33 26 39
Leslie 4 5 2 2
South Redford -1 1 -3 -2
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Corporate Goal ?

• Since the BCBSM corporate goal required that both
  physical activity and nutrition be improved in at
  least two communities by 10 percent, our
  corporate goal for physical activity and
  nutrition was not met.
• While we met the goal for physical activity, only
  one school was able to improve nutrition by 10.
• But, the students, staff and parents loved it
  and we learned some valuable lessons for next
  time!

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Walking and Climbing in Leslie

• Students had fun using the climbing wall and
  participating in the walking club.

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Working Out in Grand Rapids

• The kid-sized fitness equipment at the Grand
  Rapids YMCA was a blast, too!

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Barriers to Success

• Varying levels of expertise among the districts,
  in terms of program implementation and
  management.
• Evaluation It was a challenge to consistently
  obtain needed information from all schools in a
  given district this stemmed from intra-district
  communication issues.
• Teachers and administrators already have a LOT on
  their plate.
• Changing deeply ingrained behaviors and lifestyle
  choices is hard work!

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Potential for Replication

• Parts of program are replicable such as CSHT
  component and HSAT (or similar assessment tool
  customized for your state or region).
• Schools were given free reign in program design
  and development, but all three incorporated some
  sort of physical activity club (or regular,
  incentivized activity) and changes to their
  school menus and vending machines.
• By improving physical activity and nutrition, we
  were trying to target the two key variables in
  obesity that individuals can actually control.

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Sustainability

• One of our primary goals with this grant program
  and every grant program we do - was to fund
  activities that would be sustainable after the
  two-year grant cycle had ended.
• Programmatic elements such as the climbing wall,
  healthy plate option, and nutrition-friendly book
  bags can be continued well into the future with
  little or no additional funding required.

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Questions?

• Questions about the Project Healthy Schools grant
  program may be directed to Tyffany Shadd-Coleman,
  MHSA.
• Tyffany is a Project Leader at Blue Cross Blue
  Shield of Michigan and can be reached via email
  at tshadd_at_bcbsm.com, or via phone at 248-448-5045.