Advocate, Activate, Act! Lessons Learned from the Northern Virginia Healthy Kids CoalitionWeight of the State Conference 2011October 5, 2011

Sandy Thompson, RN, MSNSupervisor of Administrative ServiceManassas City Public Schools

Margaret Goldberger, MHAExecutive DirectorPrince William Health Partnership

Co-Chairs, Northern Virginia Healthy Kids Coalition

Learning Objectives

• Summarize the Northern Virginia Healthy Kids Coalition findings regarding youth health behaviors in the Northern Virginia region

• Provide each participant with the tools and resources to replicate promising practices in building a community based coalition based on the Institute of Medicine’s promising practices

• Identify key Coalition success and strategies to overcome obstacles

Introduction

• Inova Health System and Northern Virginia communities partnered in 2005 to develop a Healthy Kids Coalition to address the childhood obesity epidemic in our community.

Inova Health SystemInova Health System is Northern Virginia's leading not-for-profit healthcare provider, servingmore than 1 million people each year and governed by a volunteer board of community members.• 6 hospitals to serve Northern Virginia communities• Integrated delivery system of:

― Hospitals― Ambulatory services― Long term care― Emergency and urgent care― Home health care― Mental health― Blood donor services― Wellness and Community Health

Northern Virginia

• Population of 2.1 million• 9 cities and counties • 1,300 square miles • Includes more than 697,000 (32%) racial minorities:

— White or Caucasian – 67.2%— Hispanics or Latino - 13.9%— Asian/Pacific Islanders – 12.5%— African Americans or Blacks – 11.6%— American Indians or Alaskan Natives – 0.4%

• 17% of the population lives below poverty level• 9 – 16% of Virginians are uninsured• Northern Virginia demonstrates dramatic disparities in death rates

for diseases such as diabetes, HIV, heart disease, cancer, and cerebrovascular disease

Virginia Burden of Obesity*

• Ranked 30th in the U.S. for adult obesity.

• Adult obesity rate is 25.9 percent.

• Adult combined obesity and overweight rate 61.2% ( 5.2% in the past 10 years).

• Childhood obesity rate is 15.2% and is ranked 23.

*F as in Fat: How Obesity Threatens America's Future 2011Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

Northern Virginia Burden of Obesity

• Prior to 2007 there had been no comprehensive primary statisticson the rate of being overweight or obese

• Collaborated with Professional Research Consultants to undertakea comprehensive survey on obesity among parents and children, aged 2-18

Survey Objectives• To assess the knowledge, attitudes and behaviors among

families regarding the obesity trends • Results assisted Inova and its partners with the formation of

community based interventions including the design and development of a social marketing campaign

• The educational content of the social marketing campaign reflects the following nationally accepted guidelines:

— 9 hours of sleep— 5 fruits/vegetables per day— No more than 2 hours screen time per day— At least 1 hour or more of physical activity daily— Almost no drinks containing sugar

Survey Methodology• Phone survey contained 85 questions on topics such as:

—Dietary habits—TV and computer screen times—Exercise and fitness regimens

• Random sampling of 2,000 parents of children in the household:—Arlington County—City of Alexandria—Fairfax County—Greater Prince William Area—Loudoun County

Research Results - Key Findings

• 46.6% or approximately 700,000 parents were either overweight or obese

• 26.4% or approximately 100,000 children were either overweight or obese

• Differences were found between jurisdictions— 18.4% of children/adolescents in the City of Alexandria

are at risk for being overweight compared to 8.5% in Loudoun County

Research Results - Key Findings• One out of four Northern Virginia children/adolescents

overweight or at risk of becoming overweight— Totaling over 100,000 children and adolescents age 2-18

• Low income, African American children at greatest risk:— Poor nutrition— Access to fresh fruits/vegetables— Physical inactivity— Screen time

• Parents typically fail to recognize when their child is overweight, and physicians are not advising parents that child is overweight

• 232,000 children/teens spend four or more hours per day in front of a screen

Northern Virginia Healthy Kids Coalition: Mission• Implementation of an evidence-based public health program:

— comprehensive— grassroots in nature— involves multiple stakeholders from diverse segments of the community

• Engage the entire Northern Virginia community in collaborative, family focused efforts to promote better health via the 9-5-2-1-0 for Healthmessage for children of all ages. The message provides a simple way to remind our children about five healthy daily habits which can help them maintain a healthy weight and overall good health. — 9 - Get at least nine hours of sleep a night— 5 - Eat five servings of fruits and vegetables— 2 - Limit screen time outside of school - no more than two hours — 1 - Get at least one hour of physical activity— 0 - Eliminate or minimize consumption of sugary beverages

Coalition Vision

• The Coalition is envisioned as a vehicle for turning community concerns into community action for improving child health.

Coalition Goals• Promote Healthy Living Concept

— Promote adequate sleep— Increase the consumption of nutritious foods— Reduce the amount of recreational screen time for children— Increase daily physical activity among children and families— Decrease consumption of energy-dense foods and beverages

• Create social, monetary and policy driven incentives that reinforce long-term environmental and behavioral changes.

Strategic Approach: Data Driven• Among Northern Virginia children and

adolescents age 2 – 18:— Over 100,000 were overweight (an

estimated 66,1000 children)— 9.9% were at-risk (an estimated 39,7000)— 286,000 did not eat enough fruits and

vegetables— 227,000 did not engage in moderate or

vigorous exercise on a daily basis— 232,000 spent four or more hours per day

in front of a TV or computer screen— The highest risk was seen among

elementary school-aged children, children living at lower incomes, and African-American children/adolescents

Strategic Approach

• The Coalition’s eight core strategies are:— Raise Awareness— Engage Partners— Give Voice— Develop & Mobilize Resources— Support Regional Strategies— Support Collaboration— Build Technical Capacity— Evaluate Impact

Community Capacity-Building Strategies

Social Awareness Strategy• Two-pronged approach:

— Change the behavior of children and families (nutrition, physical activity, sleep, screen time)

— Change the behavior of community organizations (policy, program, practice change)

• Community partners essential: deliver social awareness messages & supports

• Web-based communication: raise awareness and attract community partners

• Message content: fit strategically with current community themes

Community Partners

2007• Local Governments• Parks & Recreation• Public Health Divisions• Public officials and agencies• Schools

2008 – 2011• Child Care Providers• Faith Communities• Families• Food Services• Foundations• Health Care Providers• Individuals• Media• Parent Organizations• Youth Organizations

Tools and Resources to Replicate Promising Practices

• The Coalition’s core strategies to build community capacity throughout the region are based to the Institutes of Medicine’s key points for accelerating change and moving forward with obesity prevention:

—Empowering communities and neighborhoods—Changing the environment—Forging strategic partnerships—Garnering and mobilizing political support—Educating stakeholders—Identifying leaders and building on cultural assets—Collecting and disseminating local data—Evaluating programs and interventions—Translating successful interventions to other communities

Empowering Communities and Neighborhoods

Wonhee Kang (Fairfax Region BGCGW Director), Congressman Jim Moran, Delegate Scott Surovell, Maria Harris Tildon (SVP Public Policy and Community Affairs CareFirst), Dr. N. Thomas Connally (CareFirst Board Member) and Anne Rieger (Assistant VP Community Safety Net IHS)

Changing the Environment• Prevention Connection: School Vending Machine Mini

Grants— http://www.preventionconnections.org/funding.shtml#Vending

Changing the Environment• Grants for Fresh Produce

— Manassas City Public Schools– FFAVORS - Fresh Fruits and Vegetables

programs– 2010-2011: $26,000– 2011-2012: $45,000

– Let's Move Salad Bars to Schools - Awarded 4 salad bars

– The National School Lunch Program– The National School Breakfast Program

— Prince William County Schools– Received grant for 12 schools: 2011-2012– $65.00 per child

— Virginia awarded $3.6 million for the FFVP Grant which was awarded to 127 schools in 40 divisions

Changing the Environment• Grants for Fresh Produce

— Fairfax County Public Schools was named the 2010 District of the Year in School Nutrition today duringthe 2nd General Session of the School Nutrition Association’s Annual National Conference– Food and Nutrition Services Director, Penny McConnell, RD, SNS,

accepted the award of $25,000 to further improve and enhance thedistrict’s school nutrition program operations.

— A FFVP grant, based on the theme Mount Vernon Woods Elementary School: TOURS GLOBAL GARDENS was awarded to Mt. Vernon Woods Elementary School and Food and Nutrition Services. – All students receive an afternoon fresh fruit or vegetable snack every

week. In addition Food and Nutrition Services is required to provide nutrition activities and a parent monthly nutrition newsletter.

– Special activities were planned for Healthy Virginians week promoting locally grown produce.

– This supports the Farm to School initiative.

Changing the Environment

• Arlington Public School Nutrition Services — Children can purchase a fresh fruit or vegetable every day— Much of the produce in our cafeterias comes from local farms within

100 miles of Arlington— Upgrading our kitchens so meals can be freshly prepared on-site in

all elementary schools — Breads, rolls, waffles, and French toast are made with whole wheat

• Alexandria City Public Schools— Funding received to furnish fresh fruit and whole grain snacks to

1200 Pre K and Kindergarten students for 2011-2012

Forging Strategic Partnerships

HHEALTHY EEATINGAACTIVELLIVING

Garnering and Mobilizing Political Support

Senator Barker at the March 2009 Kick­off event and April 2011 Let’s Move the Needle on Childhood Obesity event

Delegate Surovell at the CareFirst, Inova Health System, Fairfax Region BGCGW and Coalition check presentation/family night event August 2011

Educating Stakeholders

• Inova Health System• The Community Foundation for

Northern Virginia• Voices for Virginia’s Children• Northern Virginia Healthy Kids

Coalition• Event that convened local Northern

Virginia business, community and government leaders to further the engagement our community-at-large to move the needle on childhood obesity

Let’s Move the Needle on Childhood Obesity: April 29, 2011

Educating Stakeholders

Incorporate physical activity into the planning and design of every physical improvement to the city4

Enhance public safety near parks and other public spaces5

Promote spaces for community members to be active and prioritize the development of these spaces in underserved areas6

Work with school officials to develop joint‐use agreements so that community residents can use school facilities for physical activity, and school officials and students can use community facilities for physical activity7

Participate, and encourage other groups and organizations to participate in the Presidential Active Lifestyle Award program7

Become a Let’s Move City or Town – learn more at letsmove.gov7

Promote Safe Routes to Schools12

Policy Makers/Government Officials

Have each class compete in a marathon where the students are charged to run a mile each week for 26 consecutive weeks1

Provide more physical activity during PE classes –moderate activity for at least 50% of the class time7

Provide other activities so that students can be physically active not just during PE class but throughout the day and year24

Create after school activity clubs that promote physical fitness25

Schools

Participate in a local community event as a company (encourage employees to include their family) such as a 5k, 10k, marathon and create a running club to prepare for the race14

Start a walking club or competition to encourage employees to walk together during lunch or after work17

Start a long term weight loss challenge among employees or departments19

Pledges for ActivityBusinesses

Pledge Total

Educating Stakeholders

Identifying Leaders and Building on Cultural Assets

Identifying Leaders and Building on Cultural Assets

Identifying Leaders and Building on Cultural Assets

Collecting and Disseminating Local Data

Local Northern Virginia Youth Demonstrate the

9-5-2-1-0 for Health Message

March 2009

Evaluating Programs and Interventions• Prince William County Schools

Evaluating Programs and Interventions

• HEAL Survey

Evaluating Programs and Interventions

•9-5-2-1-0 for Health

Toolkit Program

•Pre-survey –

Fairfax Region BGCGW

Translating Successful Interventions to Other Communities • > 15 states have used Coalition materials and information• 2 Countries – Canada and United Kingdom have accessed and used

Coalition materials

The Eastern Highlands Health District

Connecticut

Accomplishments: The Numbers• > 250,000 students in Northern Virginia exposed to 9-5-2-1-0 for

Health message— Fairfax County Public Schools: In October 2010 9-5-2-1-0 for

Health message was expanded throughout the school district: 139 elementary schools sent out 6000 teacher packets and 95,000 Bookmarks. The message reached a total of 95,000 elementary students.

— Arlington Public Schools: Promoting healthy choices is one of Claremont Elementary School’s priorities. P.E. teacher Renee Seay talked about Claremont’s participation in the 9-5-2-1-0 for Healthprogram and a video was produced: http://youtu.be/bW5Bvt2ubug

— Prince William County Public Schools: The PWCS Nurses Health Awareness Committee, in cooperation with the Wellness Advisory Committee, promoted a division wide awareness campaign of the “9-5-2-1-0 Tipping the Scales For Better Health Program” during National Nutrition Week in March 2011. As part of the campaign they produced 5 public service videos: http://www.youtube.com/user/PWCSchools#p/u/18/R8nljtGIbdE

Accomplishments: The Numbers• > 250,000 students in Northern Virginia exposed to 9-5-2-1-0

for Health message— Manassas City Public Schools: The entire division has embraced

the 9-5-2-1-0 For Health message. Family Fitness Nights promoting this message have been held at all elementary schools. The schools nurses and Wellness Chairs serve as ambassadors at each site to promote the health message. The message has extended to reach 6,900 students. A kick off campaign occurs each fall. A major launch took place in October 2010.

— Alexandria City Public Schools: The school nurses at each school have held contests and unveiled what each number means as a way to promote the 9-5-2-1-0 for Health message. The entire learning community has embraced the health message of 9-5-2-1-0 for Health. Cora Kelly School for Math, Science and Technology created a video: http://www.acps.k12.va.us/videos/95210/

Accomplishments: The Numbers

• > $172,000 in grants and donations • > 270 Coalition members and contacts representing all sectors• > 263 pediatric patients and family members exposed to message• > 100 childcare center workers and managers exposed to information

Accomplishments: The Numbers• > 35 public speaking engagements – local, state and regional• > 25 Coalition partners from public and private sectors

Virginia Cooperative Extension Prince William County Nutrition Program had two 9-5-2-1-0 for Health displays at the Greater Prince William Community Health Center in Woodbridge during National Health Center

Week August 7-13, 2011.

Margaret Goldberger, and Inova iPATH Program Coordinator, Whitney Strand, were interviewed by Delegate Plum on Comcast's Virginia Report. They discussed the NVHKC activities and the Let's Move the Needle on

Childhood Obesity event.

Accomplishments• Community-wide survey• Partnership relationships with local government, public health

and school officials in all 9 jurisdictions• Program vision, mission and goals• Community Wide Coalition with partners from major sectors• Development and promotion of 9-5-2-1-0 for Health message• Developed, produced and launched website:

— Handouts/posters— Video education library— Success stories— Toolkits

• Communicating 9-5-2-1-0 for Health message to school students and community-at-large

Let’s Move the Needle on Childhood Obesity

Let’s Move the Needle on Childhood Obesity

Let’s Move the Needle on Childhood Obesity

SpeakersWelcome• Rod Williams, VP Community Affairs,

Inova Health SystemOpening Remarks• Knox Singleton, CEO,

Inova Health System• Eileen Ellsworth, President,

Community Foundation for Northern VirginiaOpening Speaker• Dr. Diane Helentjarsis, Director of Family

Services, Virginia Department of HealthExpert Panel Moderator• Dr. Kevin Vigilante, Partner,

Booz Allen Hamilton

SpeakersExpert Panel• Government/Public Policy: The Honorable George Barker, Virginia

State Senate• Faith: Reverend Henry Brinton, Fairfax Presbyterian Church• Business: Bill Germanokos, The Biggest Loser and Quest Diagnostics’

Wellness Ambassador• Schools: Mr. Jordan Greene, Physical Education Instructor,

Springwoods Elementary School• Family/non-profit: Dr. Khalid R. Randolph, Vice President of Programs

and Outcomes, Boys and Girls Clubs of Greater WashingtonKeynote Luncheon• Sheila C. Johnson, CEO, Salamander Hospitality, LCC, Vice-Chairman

Monumental Sports & Entertainment, President & Managing Partner of WNBA’s Washington Mystics and co-founder of BET (Black Entertainment Television)

Let’s Move the Needle on Childhood Obesity – Follow-up• www.inova.org/letsmovetheneedle

Let’s Move the Needle on Childhood Obesity – Follow-up• eBulletin

Let’s Move the Needle on Childhood Obesity – Follow-up

• In keeping with the overall objectives of the Let’s Move the Needle on Childhood Obesityinitiative, and reaffirming Inova Health System’s commitment to promote healthy communities and reduce childhood obesity, Inova and The Washington Mystics presented Get Movin’Family Fun Day featuring Radio Disney “Shake It Up” Dance Zone! on Saturday 24, 2011

Let’s Move the Needle on Childhood Obesity – Follow-up

• 2nd Annual Let’s Move The Needle on Childhood Obesity• 2012• Date – To Be Announced

HEAL Grant Partners• The Prince William Health Partnership (PWHP) – A local non-

profit organization promoting healthy habits and lifestyles for the area youth and the citizens of the Greater Prince William Area.

• Prince William 4-H – A program provided by Virginia Tech, a land-grant university, delivering research driven programs through extension agents. 4-H works to provide leadership, citizenship and life skills to the young people in Prince William County.

• Prince William County Public Schools• Manassas City Public Schools• Manassas Park Public Schools• Fairfax Region BGCGW

HEAL Grant Highlights• In 2008 and 2009 Kaiser Permanente awarded the Healthy

Eating and Active Living (HEAL) grant to the PWHP to support community collaboration and address the national obesity epidemic on a local and county level.

• PWHP, 4-H, and Prince William County Public Schools (PWSPS) have partnered together to offer this program to area students.

• The HEAL Program will be implemented for grades K–12. • Customized learning KITS per grade level on healthy eating and

physical activity will be provided to each school.• The program curriculum can be incorporated with current SOL

and state curriculum. • The program is considered sustainable.

HEAL Grant Highlights• All PWCPS and Manassas City Public

Schools elementary schools are included

• Research-Based Best Practices and Curriculum

• Integration with current SOL and State Curriculum

• Reinforce and Strengthen Existing Wellness Policies

• Enhancement of the Governor’s Scorecard

• Consistent, collaborative, and relevant instruction for all PWCS elementary students

HEAL Grant Classroom Teacher Training Outcomes• HEAL grant origins and overview• Physical education teachers have been trained as trainers and will act

as an in-house resource and grant facilitators• Required nutrition education has been integrated with core subject

SOLs• Grade level specific training• Grant requirements and sustainability

HEAL Grant Sample Lesson

• Suggested Group Activity— Walk this Way— Fifth Grade Kit

CHAMPION Grant• CHAMPION

— Funds awarded to implement BodyWorks in Manassas City Public Schools, Prince William County Schools and Inova Care Clinics for Children

CareFirst BlueCross BlueShield Grant• Funds awarded to Inova Health

System to implement 9-5-2-1-0 for Health Toolkits at the Fairfax Regional Branch of the Boys and Girls Clubs of Greater Washington (Herndon, Falls Church, Alexandria)

• HEAL Toolkits utilized and modified for an afterschool setting

CareFirst BlueCross BlueShield Grant Check Presentation

Wonhee Kang (Fairfax Region BGCGW Director), Congressman Jim Moran, Delegate Scott Surovell, Maria Harris Tildon (SVP Public Policy and Community Affairs CareFirst), Dr. N. Thomas Connally (CareFirst Board Member) and Anne Rieger (Assistant VP Community Safety Net IHS)

Whole Foods Market, Old Town Alexandria,

donated food for the event

CareFirst BlueCross BlueShield Grant Check Presentation

Upcoming Speaking Engagements

• November 4, 2011: Virginia Association of School Nurse’s Annual Fall Conference

• November 5, 2011: Arc Workshop Prince William County

8-5-2-1-0 for Health (for Adults)8 – Seven to eight hours of sleep/night5 – Eat at least five servings of fruits and vegetables/day2 – Limit screen time to no more than 2 hours outside of work 1 – At least 150 minutes of physical activity/week0 – Eliminate or minimize consumption of sugary beverages

Next Steps

2nd Annual Let’s Move The Needle on Childhood Obesity• 2012• Date – To Be Announced

Strategies to Overcome Obstacles

• Garnering senior level community support/ commitment to action: Let’s Move the Needle on Childhood Obesity

• Sustaining “commitment and momentum”— Regular communication— Follow-up on action pledges— Inova Health System partnerships with the Community

Foundation for Northern Virginia and The Washington Mystics

• The Community Foundation for Northern Virginia school grants

9-5-2-1-0 for Health Social Media• NorthernVirginiaHealthyKids.org: site for toolkits, research &

community stories• inova.org/nvhkc: location on Inova Health System to increase

awareness which links to tippingthescales.net• inova.org/letsmovetheneedle: resources for event attendees• Facebook: pages/95210-for-Health-Northern-Virginia-Healthy-Kids-

Coalition-NVHKC/160302604014598

Questions and Contacts

• Rhonda Richardson— Program Coordinator— Inova Health System— rhonda.richardson@inova.org— 703-698-2516

• Margaret Goldberger— mgoldberger@pwhealthpartnership.org— 703-670-1340

• Sandy Thompson— SThompson@mail.manassas.k12.va.us — 571-377-6043