2. What is STEP UP? STEP UP is Nevada’s version of the national WIC initiative know as FIT WIC. The FIT WIC Program is a group of childhood obesity prevention projects funded by the USDA’s Food and Nutrition Service (FNS). STEP UP will be based on promoting 6 healthy habits for the whole family to address childhood obesity.

3. Campaign Components Information that addresses key healthy lifestyle habits. Group Classes Tools to approach excessive weight issues Goal setting folders and strategies Family Challenge Program Evaluation/Surveys

4. STEP UP Messages S- Step away from the screen T- Take a healthy plate E- Enjoy being active together daily P- Pass on sugary beverages U- Use your sleep time to recharge P- Plan time for family meals *Note: Messages will be rolling out in reverse order P to S.

5. Group Classes 6 group classes have been developed, one for each of the STEP UP messages. Classes are appropriate for families with 1-5 year olds. Each class will run for 3 months Class format – Facilitated discussion format – 5 sections (Introduction, 2 discussion sections, goal setting and closing) – Tips/Idea boxes – CPA Message Guide

6. Group Classes Cont’d Class discussion questions can be used in a 1-on-1 setting as appropriate. Handouts – Offer materials; let participants know taking one is optional Incentive items – There will be one for each class that compliments the core messages. – Incentives items will only be available for the roll out of each class and will not be available ongoing or on the clinic supply form.

7. Incentive items Step away from the screen - Children’s music CD Take a healthy plate- MyPlate Plate Enjoy being active together daily- Rubber Ball Pass on sugary beverages- Water Bottle Use your sleep time to recharge- Bedtime Book Plan time for family meals- Children’s Cookbook

8. Class Demonstration!

9. Discussing Excessive Weight How do you currently discuss excessive weight with parents? What specific words or phrases do you use? How do you feel Participants respond to your approach? Do you feel there is room for improvement?

10. What Moms Have Told Us How mom’s don’t want to be approached: – The word “shouldn’t” was a barrier – Being “downgraded” for something they were doing that works for them – Being made to feel like they “messed up” – Feeling like they were being judged – Being made to feel like they are blamed for their child weight – Left feeling hopeless Slide from Kay Klumpyan’s FIT WIC Focus Groups

11. What Moms Have Told Us How WIC moms want to be approached about their child’s weight – They liked it when WIC asks them what they are doing in regards to their child’s health – They like being given credit for what they are doing positive – They want to know what to do to fix it – They want someone to take time to make a plan with them – Find out what they are already doing & build on it – They want to leave the appointment feeling like they accomplished something (set goals) – They want to feel good as a mom Slide from Kay Klumpyan’s FIT WIC Focus Groups

12. Suggestions for Approaching Excessive Weight Avoid using labels (i.e. overweight, obese, fat, big, heavy, chubby, chunky, hefty, fluffy etc.) – Instead explain what is happening (i.e. Your child’s weight has been growing faster than his height.) – Remember to look at growth history. The goal is for a child’s BMI to follow a percentile consistently, no big peaks or valleys.

13. Suggestions for Approaching Excessive Weight Focus on the habits not the weight Focus on improving health not weight Suggest changes for the whole family to make together. – Usually a cause is a family issue not an individual issue. – Will help avoid being restrictive with child Suggest scheduling meals and making better food choices vs. restricting specific foods. – All children should eat as much as they need to be full. But what is served is up to the parents. – All children should be allowed treats and sweets, but set ground rules for how often.

14. Goal Setting Materials – Goal Tracking From To be used at one-on-one appointments (certification, individual NE, health assessments and high risk appointments) – STEP UP Folders To be handed out at one-on-one appointments. A tool to help participants and sponsors stay organized.

15. Stages of Change

16. Goal Setting Tips Remember it is their life and their decision whether or not to change. Your role is to help motivate them to change and support them through the process. – Explore ways to make the change important to them. – Most people don’t change because it is simply good for their health, find what motivates them. (e.g. role model the behaviors you want your child to follow, not do as I say not as I do.) It is not your fault if they choose not to change, but don’t give up. – Let them know you will continue to check in with them about it in future appointments. – Make it safe for them to come back to you when they are ready. – You can ask if you could share some information for them to take home.

17. Family Challenge A fun way for families to explore healthy habits together. Families can receive entries to a statewide raffle for completing the challenge. Raffle prizes can include ( books, cooking items, interactive DVD’s etc.) Staff members whose families are enrolled in WIC will not be able to enter the raffle. You will have other raffle opportunities that are limited to just staff.

18. Family Challenge Rules For every 14 activities a family completes they will receive an entry into the statewide raffle. – 3 entries max per family – Raffles will happen quarterly until the end of the roll out period. (tentatively May, August & November 2013 and February, May & August 2014) Participants will need to bring their Family Challenge sheet into the clinic and turn it in to be entered into the raffle. A designated staff member will mail family challenge sheets to the State quarterly, before each drawing.

19. Program Evaluation/Surveys Program evaluation is required by the USDA. Program evaluation will be in 2 parts – MIS Data – Participant Surveys Surveys will be sent to designated clinics and distributed 3 separate times throughout the program. Surveys will be anonymous There will be questions on the surveys addressing each of the 6 health messages of STEP UP.

20. Questions??