preventing childhood obesity: tools for childcare providers, legislators and regulators

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1. Preventing Childhood Obesity: Tools for Childcare Providers, Legislators and Regulators American Public Health Association (APHA) October 29, 2012, San Francisco, CA. Marilyn J. Krajicek, EdD , RN, FAAN - PowerPoint PPT Presentation

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Preventing Childhood Obesity: Tools for Childcare Providers, Legislators and RegulatorsAmerican Public Health Association (APHA)October 29, 2012, San Francisco, CA

1Marilyn J. Krajicek, EdD, RN, FAANDirector of the National Resource Center for Health and Safety in Child Care and Early Education (NRC)

1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing1National Resource Center for Health and Safety in Child Care and Early Education (NRC)NRC Mission:To improve the quality of out-of-home child care and early education programs and support the health and safety of the children they serve.

21-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingNational Resource Center for Health and Safety in Child Care and Early Education (NRC)The Consortium:American Academy of Pediatrics (AAP)American Public Health Association (APHA)National Resource Center (NRC) for Health and Safety in Child Care and Early Education (at University of Colorado)National Training Institute (NTI) (at University of North Carolina Chapel Hill)

Funded through the Maternal and Child Health Bureau Cooperative Agreement (MCHB)

31-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingNational Resource Center for Health and Safety in Child Care and Early Education (NRC)The NRC supports the efforts of:Child care providersEarly educatorsFamilies/parents and guardiansHealth professionalsEarly childhood comprehensive systemsState child care regulatory agenciesState and local health departments Policy makers

41-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingCaring for Our Children (CFOC) 3rd Ed.National Health and Safety Performance Standards for Early Care and Education Programs; Guidelines for Early Care and Education

3rd edition Revision completed and published in June 20114-year revision process10 Technical Panels - 85 panel members - Content Experts from AAP, APHA, and subject specialists

51-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingCaring for Our Children (CFOC) 3rd Ed.Definitive source on best practice in health and safety in early care and education settingsEvidence-based standardsExpert consensus Model for health & safety practices61-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingNationally recognized source since 1992 when first edition was published by the American Academy of Pediatrics and the American Public Health Association. In earlier editions, mainly expert consensus but as more research has been conducted in child care, there is more evidence-based material to support the standards.

67Obesity

1 in 3 low income children are obese or overweight by 5 years1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingCFOC standards are VOLUNTARY standards of best practice not regulations but have been used by many to produce model regulations and policies for health and safety.

If youd like to address standard vs. guideline vs. regulation:

How is Guideline different from Standard?Guideline is a statement of advice or instruction pertaining to practiceIs often intended for a particular circumstanceNot necessarily required for legal operationComment sections of some CFOC standards often include guidelines on how to put standard into practice

How is Regulation different from Standard?Regulation required for legal operationOriginates with authoritative agencyHas power of lawLinked to enforcement activityIs often intended for a particular circumstance7Health Consequences8Seriously reduced quality of lifeIncreased risk of chronic disease:DiabetesHypertension and Cardiovascular diseaseGE reflux diseaseObstructive sleep apnea, which can contribute to learning problems and behavior problemsAsthmaIncreased cost of health and medical care1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing8CFOC Standards9Preventing Childhood Obesity, 2nd Edition

NUTRITION variety of healthy foodspromote positive mealtime environment

PHYSICAL ACTIVITY daily indoor & outdoor activities

SCREEN TIMElimited

1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing9How the Standards Address the Problem10promote eating a variety of healthy foods

advocate breastfeeding of infants

emphasize and promote daily physical activity

limit access to screen time

partner with families to promote healthy eating practices and lifestyles

encourage collaboration among families, caregivers, and community health partners1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing10Using the Standards11National and State Campaigns can use to build integrated nutrition and physical activity components in their systems.

Caregivers/teachers can use to develop and implement practices and policies and use in staff training.

Families can support and join with caregivers/teachers in the implementation of healthy practices. They can also reinforce at home.

1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of NursingIf you want to give an overview of the process:

After the Technical Panels achieved consensus, then the draft documents were sent out to stakeholders individuals and organizations that use the standards in their work. All of their hundreds of comments and recommendations were collated and fed back to the Technical Expert Panels for their review, acceptance or rejection.The Technical Panels are currently coming to consensus on each final chapterThese Panel approved chapters will go to the Steering Committee and Boards of the Partner Organization for final approval and sign off.

11Using the Standards12Regulators can use to develop and/or improve state regulations that support the prevention of obesity and promote healthy habits.

Legislators can use to understand and support research-based child care regulations that address the prevention of obesity.

Academic faculty can use standards as a resource to prepare students for entering the early childhood workplace1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing12Using the Standards13Health care professionals including the Child Care Health Consultant can assist families and providers with sound evidence-based rationale for implementing and following healthy lifestyles.

1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing13

What can a CCHC do? Partner with a center to self-assess.2. Help the center identify a plan of action.3. Provide training on nutrition and physical activity for children, staff and parents/guardians. 4. Develop and distribute materials or incentives. 5. Provide technical assistance.The National Training Institute for Child Care Health Consultants14National ResourcesNAP SACC:The Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) program Research-tested intervention designed to enhance policies, practices, and environments in child care by improving the:nutritional quality of food servedamount and quality of physical activitystaff-child interactionsfacility nutrition and physical activity policies and practices and related environmental characteristics Primarily addresses the inter-personal and organizational levels of the socioecologic model.15http://www.center-trt.org/index.cfm1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing15

http://healthykidshealthyfuture.org16Lets Move! Child CareNational Resources1-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing16National ResourcesHealthy Child Care Americawww.healthychildcare.org

Resources include:Caregiver NewsletterCFOC Standard of the Month http://www.healthychildcare.org/ENewsCaregiver.html#listserv

171-800-598-KIDS (5437)http://nrckids.org2012 National Resource Center for Health andSafety in Child Care and Early EducationUniversity of Colorado College of Nursing Policy Changes & National InitiativesChild and Adult Care Food Program (CACFP)

Existing Meal Patterns:Inconsistent with new Dietary Guidelines for Americans and MyPlate Available at: http://www.fns.usda.gov/cnd/care/ProgramBasics/Meals/Meal_Patterns.htm

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2011 Meal Pattern Recommendations: Consistent with new Dietary Guidelines for Americans and MyPlatePending adoption/publication