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

Healthy Kids, Healthy Communities

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

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

NHANES DATA

Age of Onset of Pediatric Overweight in CMC

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

Bogalusa: Proportion of Children Who Become Obese Adults

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

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

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

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.

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

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

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

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

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

Thru Policy & Environmental Change

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

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

Center Survey Results Sugary Drinks

Center Survey Results Sweet/Salty Foods

Center Survey Results Fruit

Center Survey Results Veggies

Center Survey Results Active Play

Center Survey Results Outdoor Active Play

Center Survey Results Outdoor Play Space Includes…