June LiveWell eLetter

LiveWell Colorado Communities

Share Your Views on Active Living in Colorado!

LiveWell Colorado's Built Environment Policy Blueprint, the third in our series of policy blueprints, will be used to guide healthy and active community growth throughout the state of Colorado. We need your help to become a leading example for issues related health and the built environment, and are currently gathering data focusing on policy, environmental and lifestyle changes to guide our efforts.

These initiatives will be used to understand how we can begin to remove barriers and increase access to healthy and active lifestyles.

While many places around the state are pursuing specific plans and have already set high goals for the mission of a healthy Colorado, we hope to build on these existing and emerging efforts while identifying opportunities to work together in more strategic, integrated and collaborative ways. We look forward to hearing your thoughts and lessons learned to make healthy active lifestyles the easy choice for all Coloradans.

Early Childhood Education

COPAN: Preventing Childhood Obesity in Colorado

Shana Patterson, nutrition coordinator for the Colorado Physical Activity and Nutrition program (COPAN) recently produced a report focused on preventing childhood obesity in Colorado.  The helpful resource outlines initial community action steps to help people and organizations make a difference in this arena. Below are some excerpts from the resource, including some compelling data and applicable suggestions. To learn more, click here to view the entire PDF.

According to the report, “Early childhood is a biologically and psychologically critical time for the prevention of obesity, during which children rapidly build their brains and bodies, and develop food preferences.”  This is why early interventions are so critical and communities need to work together to get kids started on the right path.

An important factor in discussing childhood obesity is to set the stage.  Research and data are plentiful in this arena, and certainly impactful.

Some data:

• Overall, one third of US children ages 2-19 years are overweight or obese (BMI ‚â•85%); JAMA. 2008; 299(20):2401-2405.
   
• In Colorado, 28.7 percent of children, ages 2 -14 years, are obese or overweight; 2008 Colorado Child Health Survey.

• In Colorado, one third of Hispanic children between the ages of 0-5 years are overweight or obese.

• In Colorado, only 9.7 percent of Colorado children ages 2-14 years eat the recommended amount of at least 2 fruit and 3 vegetable servings per day; Child Health Survey, 2008.
   
• In Colorado, 28.6 percent of children between the ages of 0-5 years living in poverty watch more than two hours of television per day‚Äîsignificantly more than children not living in poverty (16.2%).

COPAN suggests that it is important to “focus on the setting” in tackling childhood obesity. 

“Nutrition, physical activity, and practices in the child care environment influence what children eat and do and can play a key role in preventing childhood obesity.”

COPAN notes that an essential step in these efforts is to “rally the champions,” the organizations that will be integral to ensure the success of the obesity prevention efforts.
Here are a few of their suggestions:

• Early Childhood Councils. Colorado has established a network of 30 local early childhood councils to collaboratively plan, network, develop resources and implement early childhood initiatives within communities to improve the quality of and access to services for young children and their families. (http://www.earlychildhoodcolorado.org/state_initiatives/councils.cfm)

• Head Start. The Colorado Head Start Association (CSHA) supports the work of Head Start programs and their partners with information sharing and advocacy, within the context of the early childhood system in Colorado. (http://www.coloheadstart.org/)

• Qualistar Early Learning. Qualistar Early Learning is a statewide non-profit organization working with child care providers, parents and communities to improve the quality of early childhood education in Colorado. (http://www.qualistar.org)

• Local WIC Clinics.  The Special Supplemental Nutrition Program for Women, Infants and Children (W.I.C.) is a nutrition program that helps pregnant women, new mothers and young children eat well, learn about nutrition and breastfeeding and how to stay healthy. The WIC Program provides nutrition and breastfeeding education, nutritious foods and referrals to health care to low-income women, infants and children. (http://www.cdphe.state.co.us/ps/wic/clinicdirectory.pdf)

COPAN then recommends these initial steps:

Connect with these partners and local child care providers. Build a local coalition (or join existing groups such as the Councils) to address obesity in early childhood.

Determine what centers and homes are licensed in the area. Of those that are licensed, who participates in CACFP?

Outreach.  If centers and homes are NOT participating in CACFP, recruit/encourage them to do so:

• Send Information Sheet about CACFP
• Connect homes with their Family Day Care Sponsor
• Ensure that a Licensing Specialist is involved with the outreach

Support centers and homes that are already licensed and participating with CACFP by hosting continuing education trainings for the providers and even parents.

Assist with information about resources that provide opportunities for increased physical activity and quality nutrition. This can be done by developing a list of these resources and/or providing funding to purchase the resources if a cost is associated. Two examples of Colorado based nutrition and physical activity programs are Food Friends and Mighty Moves.

Participate in Colorado’s Early Childhood Task Force. Identify at least one representative from your community to attend the monthly meetings conducted by Colorado Department of Public Health & Environment. Contact Shana Patterson to be added to the task force enrollment (shana.patterson@state.co.us).

Click here to view the entire PDF of this flyer.

K-12 Education

Case Study: Physical Activity in One Elementary School Classroom Leads to Improved Learning Outcomes

In elementary school, balance beams, soccer balls and jump ropes are generally relegated to the gymnasium. But in one Jefferson County elementary school classroom, they’ve become an integral part of everyday instruction.  

Inspired by research that shows that students who move more experience improved learning outcomes, Erin O’Dougherty, a third grade teacher at Ute Meadows Elementary School in Littleton, incorporated movement into her students’ daily routines. 

Her primary focus was to improve the learning environment by helping students build stronger core muscles and facilitating left and right brain communication.

“It blew me away once I brought this program into the classroom and started to see that my struggling academic kids had no core strength and they had trouble with cross lateral activities ‚Äì the two sides of their brain weren’t communicating,” explains O’Dougherty.  “Research shows that a stronger core leads to higher reading fluency, better reading comprehension and math skills, and improved fine motor skills.”

One study O’Dougherty referenced, which was published in the Journal of Neuroscience in September 2006, showed that exercise seems to enhance brain performance in three basic ways. First, it increases the flow of oxygen to the brain and may help build tiny blood vessels that pave the way for the growth of new cells.  Second, it boosts substances called growth factors, including one called brain-derived neurotrophic factor that is critical to the survival of new nerve cells.  And finally, physical activity increases chemicals in the brain called neurotransmitters, such as dopamine, serotonin and norepinephrine, which play roles in cognition.

Implementation
O’Daugherty took a three pronged approach to improving her students’ core strength and cross lateral brain communication:

1. Replacing classroom chairs with stability balls. Students have the option of sitting on the ball or on a chair.  Sitting on the stability ball helps them to develop stronger core muscles.
2. “Brain breaks” throughout the day.  Every 17-20 minutes, students engage in a 30-second burst of cross-lateral physical activity to facilitate the flow of oxygen to their brains and help both sides of their brain communicate.  Examples of cross lateral activities include “elbow taps,” where students tap their right elbows to their left knees (and vice versa) as they walk across the room, and repetitions of “windmill” exercises, where students touch their right hand to their left foot (and vice versa).
3. Individualized circuit center challenges.  Once a day, students complete a physical activity circuit.  In each circuit, students complete four activities ‚Äì one cardio activity, a core strength activity, a cross lateral activity and a flexibility exercise.   Circuit activities are individualized per each student, based on his or her fitness level.

“Each student has his or her own chart.  They monitor their fitness level and set their own fitness goals,” explains O’Dougherty.

The program’s costs were minimal to both O’Dougherty and Ute Meadows.  She sourced the balance balls for $10 each from a local discount retailer, and asked each parent to donate the money for their purchase.  She bought balance balls for the students who were unable to purchase their own.  Other materials, including a cedar plank balance beam, soccer balls and stopwatches, were either donated or borrowed from the school gymnasium.

Outcomes
Since the program’s February implementation, outcomes have been overwhelmingly positive.  Students are more focused, test results have improved, and several students have experienced better than average success. 

“The biggest success that I’ve seen is a student improve his reading level from 20 to 34,” explains O’Dougherty.  “Parents are also on board.  One mom told me her children’s behavior is like night and day.  They like to write, they want to sit down and read now.  Just the fact that they like school and that they want to perform ‚Äì she swears it’s because of what we’ve done in the classroom.”

O’Dougherty acknowledges that starting a program like this may be a risk for an elementary educator, but she emphasizes that it’s important for educators to look to solutions like these as students face increasing medical and behavioral hurdles.  

“With increasing levels of obesity, anxiety, depression, sensory disorder and autism, educators have to think outside the box ‚Äì the prescriptive teaching doesn’t work anymore ‚Äì you have to think of other ways,” she explains.

Higher Education

Study Monitors Behavior Change for Obesity Prevention in Young Adults

In 2008, the Nutrition and Food Science Department of the University of Rhode Island conducted a study in an effort to educate its students about obesity prevention. Though the study was conducted two years ago, the findings can still assist colleges and universities in designing obesity prevention programs today.

The study’s objective was to develop and actively test a web-based, non-diet class centered on obesity prevention in young adults (18-24 years of age).  By studying class participants, researchers would determine how effective tactics such as this are in reducing the rate of weight gain in college students and altering dietary and physical activity behaviors (i.e. increased consumption of fruits and vegetables and an increased participation in physical activities).

The study focused on non-dieting approaches to obesity prevention such as self-regulation, increased awareness of hunger and satiety, respecting one’s own and others’ body size and shape. Along with a focus on these mentalities, the study also included a 10-session, non-diet web-based class that provided individually tailored feedback to participants. The 10 sessions included the following topics: nutrition, body size acceptance, internal regulation of food intake, how to enhance food variety, eating enjoyment and long-term energy balance regulation. In order to effectively measure the success rate of this program, participants were evaluated and measured upon entering the study or treatment, closely following the treatment (three months later) and after time had passed (15 months later).

This pilot study was successful in helping the 172 student participants maintain weight – no weight was gained or lost by students during the study. There was also an overall increase, although minimal, in the consumption of fruits and vegetables and moderate physical activity. Additionally, participants also experienced a decrease in uncontrolled or emotional eating that is often a leading cause of unwanted weight gain.

To read more about the study, outcomes and modifications after complete evaluation, please visit http://www.reeis.usda.gov/web/crisprojectpages/202638.html.
 

Worksites & Businesses

Shape Up the Nation Shares Five Reasons to Add Social Networking to Your Wellness Program

Founded in 2006 by Brad Weinberg and Rajiv Kumar, Shape Up the Nation is an organization dedicated to helping people achieve a healthy lifestyle through social incentive programs.  Their vision is simple: improve the health individuals by connecting them with the people who care about them the most, such as family, friends and colleagues.  With a strong support system, the individual will stay focused, motivated and feel accountable for achieving a healthier lifestyle.  According to Shape up the Nation, adding social networking to your company’s wellness program will strengthen group participation and foster positive results. Here are five reasons why:

1. Maximize Participation: A trusted social networking site boosts participation through peer-to-peer encouragement and support.  A little bit of friendly competition is a great motivator for people to get involved. Individuals or groups can create challenges such as losing weight, most miles walked or quitting smoking.
    
2. Boost Retention: People are more likely to get involved and more importantly stay involved in a wellness program when social networking is put into place. Employees can create their own exercise groups, share healthy recipes and challenge each other in friendly competition. The more engaged they feel, the more likely they are to sustain a healthy lifestyle.
    
3. Change Behaviors: According to Dr. Nicholas Christakis, the people around us have a tremendous impact on our health.  When employees lose weight, quit smoking and regularly exercise, their peers are more likely to embrace healthier habits.
    
4. Save Money: Companies don’t always have the budget required to make financial incentives a part of their wellness program. Social networks are free and a much more powerful tool in creating and sustaining healthy behaviors.
    
5. Get Recognized: A successful social networking site will gain lots of positive attention thus boosting employee participation and retention.

Nelnet, a company based in Lincoln, Nebraska, made social networking a part of their wellness program and reported a number of positive results.

• Cholesterol reduced by 42 percent
• Weight loss of more than 7 percent
• Blood pressure lowered by 15 percent
• Tobacco use reduction of 32 percent while also transitioning to a tobacco-free workplace.

Nelnet’s social network-based wellness program was consistently rated as one of the most popular benefits offered by the company and more than half of the employees participated. The company also lowered their overall healthcare costs.

To learn more about Shape Up the Nation’s social network wellness program, visit their website at www.shapeupthenation.com.
 

Healthcare

Colorado Children’s Campaign Releases 2010 KIDS COUNT Report

The KIDS COUNT report is an annual resource published by the Colorado Childrens’ Campaign to report the challenges that Coloradans face and determine the best ways to support kids and families. The 2010 report, released in April, provides specific information on childhood poverty ‚Äì including which children are living in poverty and where ‚Äì and details on childhood obesity rates.

In the most recent national analysis, Colorado and its children ranked 22nd in the United States in overall child well-being. This ranking places Colorado children roughly in the middle of the pack, generally faring about average. However, through further research via the 2010 KIDS COUNT report, it was revealed that many of Colorado’s children are far from average.

Overall Colorado is one of the healthier states, but according to the report, gaps still exist between Coloradans who face more health risks than those who do not. These gaps most often occur based on ethnicity, the rural or urban nature of a community or poverty. When these three overlap for a given population, it would be more likely to experience significant health risks.

The report states that resulting health outcomes are visible from these risks in four ways:

1. With regard to physical location, some groups of people might live in communities with few grocery stores available and are therefore less likely to have healthy food options readily available.
2. The economic and social conditions of a community might be in constant flux due to a change in the community’s industry or because it is persistently low-income.
3. Barriers exist for certain groups as they try to get health insurance. For example, some groups are less likely to be able to find high-paying jobs that offer health insurance, so they remain uninsured.
4. The quality of healthcare for different populations across the state is affected if systems and providers are not culturally responsive to the community with which they are working and providing healthcare for.

Care of the Robert Wood Johnson Foundation and University of Wisconsin’s new county-by-county rankings, it was determined that almost 360,000 or 29 percent of Colorado children live in counties with numerous factors contributing to an unhealthy environment.

Although the primary focus of this year’s report was childhood poverty, some striking information revealed a positive correlation between poverty and obesity. Poor children are more likely to suffer from nutritional deficiencies; it is also strongly associated with obesity in children.

The number of obese children across the nation and in Colorado is steadily increasing. From 2005 to 2007, 14 percent of all Colorado children were obese; and this number has only since risen.

It was also found that the prevalence of childhood obesity ‚Äì when a child’s body mass index is at or above the 95th percentile ‚Äì in the state of Colorado varies greatly by race and ethnicity.

View the full report

Local Health Agencies

Convergence Partnership Announces Healthy People Healthy Places Webinar Series

The goal of the Convergence Partnership is simple: Improve the overall health of the community by improving the conditions in which they live. In an effort to support their cause, the Convergence Partnership has launched the Healthy People Healthy Places webinar series to promote community participation in the creation of healthy and safe environments for all. All calls take place on Tuesdays; more information and registration is available at: www.convergencepartnership.org.

We encourage you to mark your calendars for any of the following webinars that are applicable to you:

June 29:  A Path from Hope to Change: Implementing Equity-focused Principles and Strategies
All to often, low-income communities lack the kind of healthy choices available to middle and upper class environments. This includes anything from local grocery stores with nutritional food options to safe parks and playgrounds.  In this session, people will learn how equity-based strategies and principles can lead to improvements in low-income neighborhoods.

July 27: Talking about Healthy People in Healthy Places: Linking Values to Policy and Environmental Change
For most people in the U.S., the starting point for change of any kind is the individual. However, it is important to effectively understand and communicate the influence environments can have on health. With the proper framing, people are receptive to messages about policies that can change those environments. Panelists will discuss language and techniques that can help link environmental conditions to policy change in public speaking and other group settings.

Sept. 21: The Art and Science of Evaluation: Sound Methods for Assessing Policy and Environmental Change
It is difficult to push for change if we can't prove that it will actually work. In this session, panelists will emphasize the importance of evaluation and how to measure for success when implementing healthy community based strategies.

To register, visit: www.convergencepartnership.org. All calls are on Tuesdays, 11-12 p.m. PST (1-2 p.m. CST; 2-3 p.m. EST).

Community Planning, Recreation & Transportation

"Get Outdoors" on Saturday June 12

Summertime is approaching and the forecast calls for sunny skies and warm temperatures.  Do you know where your kids are? Twenty years ago, the answer was easily “playing outside.” Today, the odds of your child choosing the great outdoors over their favorite video game are very low. In its third year, National Get Outdoors Day gives parents an opportunity to introduce their children to Mother Nature and all she has to offer. This year's event will take place on Saturday, June 12 at City Park in Denver. Denver is among 67 U.S. cities simultaneously hosting events.

National Get Outdoors Day is the collaboration of over 100 agencies, nonprofit organizations and companies. Their goal: Encourage a healthier and more active lifestyle for families and youth. Created in partnership between the U.S. Forest Service and the American Recreation Coalition in 2008, the Denver event has become the signature and largest Get Outdoors Day event in the nation. Last year the event drew more than 5,000 people to City Park.  

“National Get Outdoors Day will open doors for kids of every demographic and age group to adventures in their own backyard,” said Susan Alden Weingardt, partnership liaison for the United States Forest Service. “We believe it will inspire kids of all ages to be environmental stewards and to be curious about the world outside their front doors.”

According to recent studies, today's youth spend an average of 6.5 hours in front of a television screen. They are six times more likely to play some form of electronic media than ride a bike.  Over the past twenty years, the rate of childhood obesity has tripled and the amount of time a child spends outside is down fifty percent. “The statistics surrounding the health of our nation’s kids are frightening and National Get Outdoors Day is a trigger to help motivate our local youth to become healthy and active,” said Weingardt.

The event includes a multitude of safe and supervised activities to choose from:

• Learn how to ski, rock climb, fish, canoe, mountain bike, hula hoop, prepare and pack food for a camping trip, put up a tent and find family friendly hiking trails
• Take part in obstacle courses, fitness challenges, Junior Ranger Camp, earn Scout Merit Badges and the world's largest Chicken Fat Dance
• Learn how to garden and utilize local farmer's markets
• Enjoy music, food, dancing and earn prizes such as ski passes and outdoor gear
• Meet Smokey Bear and Woodsy Owl

For more information on Denver's third annual National Get Outdoors Day, visit www.getoutdoorscolorado.org.

Food Systems & Retailers

Sourcing Local Food is Easy with Colorado MarketMaker

Buying food locally has several advantages: it strengthens regional economies, supports family farms, provides “fresh-from-the-field” foods, preserves the local landscape and helps create a sense of community.

For restaurants and retailers, it can be difficult to identify where to find local fare for customers, thus preventing many of the advantages from actually coming to fruition. Providing locally produced food gives restaurants the chance to offer high-quality, fresh foods while giving back to local farms and creating more jobs within the region. Buying local also lets restaurant owners and managers connect directly with their food producers ensuring safe farming practices and excellent nutrition of the food.

Colorado MarketMaker (http://co.marketmaker.uiuc.edu/index.php), managed by the Colorado Department of Agriculture and the Colorado State University Department of Agriculture and Resource Economics, assists Colorado food and agricultural companies in selling their locally grown products across a variety of markets. By collecting livestock and produce market news from around the state, MarketMaker works to provide the highest quality of food.

MarketMaker allows business across the state of Colorado to make valuable and useful connections with other businesses with whom they frequently interact. For example, if a producer takes its products to farmers markets throughout the state, the producer has the ability to connect (or link) with those particular farmers markets. Having these connections (or links) allows consumers to see exactly where you sell your products.

If you are a producer and your particular products may only be appealing or useful to a certain market, MarketMaker offers you the ability to search for restaurants, retailers, etc., within that specific market to ensure your products are getting to the right people. The resource allows you to query census data in the following areas: education, foreign born, household type, income, income by race, and race. Through the “Find a Market” function on MarketMaker, producers can identify specifics and where within a county, state or multistate location these markets exist.

For more information on Colorado MarketMaker and what it has to offer, visit the website at http://co.marketmaker.uiuc.edu/index.php.
 

Legislators & Policymakers

National Governors Association Center for Best Practices Presents Healthy Kids, Healthy America Program

One in three children in the United States today are classified as overweight or obese. Experts estimate that by the year 2015, 23 million American children will be obese if nothing is done to curb this growing epidemic. In response to these staggering figures, governors from fifteen states have committed to improving the overall health of children by implementing a set of policies for preventing childhood obesity.

NGA Center’s Healthy Kids, Healthy America Program
The National Governors Association Center for Best Practices (NGA Center), with funding from the Robert Wood Foundation and the Centers for Disease Control, awarded fifteen states up to $110,000 to implement policies to reduce the number of obese children. These statewide obese prevention strategies came in three categories:
(1)    Child care settings
(2)    Policy planning and prioritization
(3)    School-based programs.

Childcare Settings:
More than 12 percent of American children ages 2 to 5 years are obese. With the help of the Healthy Kids, Healthy America program, Tennessee and Kentucky voluntarily pursued pilot obesity policy and prevention programs in child care settings. The Tennessee Gold Sneaker Initiative provides child care workers nutrition and physical activity training. In Kentucky, an early childhood committee was established to create standards for nutrition and physical activity as well as training for licensed early child care centers.

Policy Planning and Prioritization:
Most state-wide child obesity programs fail because common objectives and goals are never established. Project coordination and strong leadership across community and state providers is also lacking. Four states, Michigan, Minnesota, Mississippi and New Mexico, all chose to pursue a unilateral approach to preventing childhood obesity by combining the efforts of local and state government, the private sector, community-based organizations and parents. By combining efforts, states are able to:

• Create and utilize one coherent strategy;
• Reduce duplication and maximize limited budgets;
• Provide centralized leadership; and
• Analyze and tackle problems as they arise.

By utilizing these methods, each governor can collect and analyze relevant data, track trends and properly fund programs aimed at improving the health of children.

School-based Efforts:
Monday through Friday, nearly one-fifth of the nation is in a school setting.  This makes school-based efforts one of the greatest opportunities to tackle childhood obesity. Nine states (Indiana, Louisiana, New York, Rhode Island, South Dakota, Utah, Virginia, West Virginia and Wisconsin) have all implemented school-based efforts through the Healthy Kids, Healthy America Program. Some examples of these programs include:

• Guidelines for nutritional and physical activity programs
• Non-food incentives in the classroom
• Adding physical activity time to the day
• Comprehensive wellness checks for all incoming kindergarteners
• Incentive awards for schools implementing nutrition and physical activity programs

The obesity prevention initiatives put in place by these 15 states and their results can be examined in greater detail in by reading “Shaping a Healthier Generation: Healthy Kids, Healthy America State Profiles in Progress” at http://www.nga.org/Files/pdf/1003HEALTHYKIDSPROFILES.PDF.