1. Childcare Policy for a Healthy Start Jamie Jeffrey, MD Project Director, KEYS 4 HealthyKids Medical Director, CMC & HealthyKids Pediatric Weight Management Program

2. Healthy Kids, Healthy Communities

4. KEYS 4 HealthyKids One of 41 sites selected by Robert Wood Johnson Foundation (RWJF) for the Healthy Kids, Healthy Communities Grant Partnership of over 22 organizations in Kanawha County Facilitating policy and environmental change Overall Goal is to provide access to healthy, affordable food and increased physical activity

5. K-E-Y-S Knowledge  5-2-1-0 Eating Healthy  Community Gardens Youth Being Active  PA Opportunity Maps  Parks & Greenspaces Safety & Empowerment  Joint Use Agreements

6. NHANES DATA

7. Age of Onset of Pediatric Overweight in CMC

9. Bogalusa Heart Study Cohort Based 1973-1996 2,610 Children 2-17 years followed to ages 18-37 years Mean follow-up 17.6 years BMI-for-age & Skinfold (SF) thickness in childhood compared to adult mean SF (subscapular & triceps SF)

10. Bogalusa: Proportion of Children Who Become Obese Adults

11. “Where” are these younger kids? Daycare After-school programs Pre-schools Headstarts Family Home Child Care Centers

12. Child Care plays a role ~60% of 3-6 year olds are in some type of non- parental care Child Care setting is ideal for promoting early development of health behaviors

13. What is… N utrition A nd P hysical Activity S elf A ssessment for C hild C are

14. NAP SACC Program Identified as one of three model programs to address obesity prevention in child care. The other programs noted were Nemours Childhood Obesity Model, supported by the Nemours Health and Prevention Services andNemours Childhood Obesity Model I am Moving, I am LearningI am Moving, I am Learning, a health promotion and obesity prevention enhancement developed for Head Start.

15. NAP SACC Steps 1. Self-Assessment 2. Action Planning/Goal Setting 3. Workshop Delivery 4. Targeted Technical Assistance 5. Evaluate, revise and repeat

16. Step 1: Self- Assessment Facility director completes self- assessment instrument with help from key staff, such as the cook or program planner. Self-Assessment

17. Nutrition Key Areas Fruits and Vegetables Meats, Fats, and Grains Beverages Menus and Variety Feeding Practices Foods Outside of Meals/Snacks Supporting Healthy Eating Nutrition Education Nutrition Policies

18. Physical Activity Key Areas Active Play vs. Inactive Time Play Environment Supporting PA PA Education PA Policies

20. KEYS 4 HK Childcare Workshop Self Assessment Completed by 1-1-11 Workshop Mid 1-11 F/U Workshops every 4-6 weeks TA by phone/email from KEYS Childcare Consultant

21. Thru Policy & Environmental Change www.Keys4HealthyKids.org 304-388-7145

28. Survey Process NAP SAAC Toolkit Entered into Survey Monkey KEYS Team Members called Childcare Center and Head Start Directors Incentive of $100 gift certificate

29. Policy Assessment Nutrition Only 17% of policy questions were able to be answered Policies too vague or non-existent Physical Activity 47% of policy questions were able to be answered Policies better to find but still inadequate in number

30. Center Survey Results Sugary Drinks

31. Center Survey Results Sweet/Salty Foods

32. Center Survey Results Fruit

33. Center Survey Results Veggies

34. Center Survey Results Active Play

35. Center Survey Results Outdoor Active Play

36. Center Survey Results Outdoor Play Space Includes…