A Child Care Center Intervention

1
A Child Care Center Intervention

• Promoting Policy and Menu Change in Early Care
  and Education in Ohio
• Autumn Trombetta MS, RD, LD
• Cheryl Graffagnino MS, RD, LD

2
Obesity In Ohio (BMI gt 95 ile)
¹ Pediatric Nutrition Surveillance System
(PedNSS), CDC and ODH, 2006 2 Ohio Family Health
Survey (OFHS), ODJFS/ODH/ODI/ODMH, 2008
3
Program Development

• Began in 2004
• Focus groups with parents
• Identified child care providers as trusted source
  of health information
• Created training toolkit for child care
  provider staff

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Evolution of a Statewide Initiative

• Began in 2010
• Voluntary designation
• Provides Step Up To Quality
• Education CEUs
• Monitored through Professional Development
  Registry

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Becoming an Ohio Healthy Program..

• Attend Step Up To Quality approved trainings
• Implement a healthy policy
• Increase the nutritional content of menus
• Include parent participation

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Becoming an Ohio Healthy Program1.
SUTQ-Approved Trainings

• Session 1 Healthy Habits (10 Hour series)
• Healthy Activity
• Healthy Eating and Feeding
• Healthy Growing
• Healthy Families
• Session 2 Healthy Menus (2.5 hours)
• Session 3 Healthy Policies (2.5 hours)

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Becoming an Ohio Healthy Program2. Implement a
Healthy Policy

• Television, video, computers and other visual
  recordings shall not be used with children under
  two years of age.
• Breastfeeding mothers shall be provided a
  private and sanitary place to breastfeed their
  babies or express milk. The area will have an
  electrical outlet, comfortable chair, and nearby
  access to running water.
• Staff members consume the same food and drinks
  as the children. Staff members do not consume
  other foods and drinks in front of the children.

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Becoming an Ohio Healthy Program3. Ohio Healthy
Programs Menu

• Includes variety every day of the week
• Non-fried Vegetables
• Whole Fruit
• Whole Grain Food
• Offers fried foods no more than twice a week
• Offers only low fat milk (1 or skim) to children
  ages 2 and up
• (adapted from Healthier US School Challenge
  2010)

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Becoming an Ohio Healthy Program4. Parent
Participation

• Parent Bulletin Board
• Parent Newsletter

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Statewide Train-The-Trainer

• Local Resource and Referral agencies
• 27 Education Specialists
• Ohio Department of Healths Healthy Child Care
  Ohio
• 37 Nurses
• 1 Dietitian

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Ohio Healthy Programs Results

• January 2010 March 2011
• 65 statewide trainers
• 349 trainings
• 1300 child care staff
• 608 centers
• 13 Ohio Healthy Programs

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Local Programming

• Recruiting child care centers
• Technical assistance
• RD and/or DTR
• 2 week menu review and recommendations
• Parent/Policy Handbook review and recommendations
• Environmental Assessment

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Local Programming

• Sustainable Supporting Materials
• 100 for Ohio Healthy Program Menu
• 100 for Ohio Healthy Program designation
• 100 per policy
• maximum of 300

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Intervention MeasureCenter Policies

• Since January 2011
• 26 licensed centers
• 404 policies(mean15)
• 284 nutrition
• 9 breastfeeding
• 110 physical activity
• 10 Nutrition and physical activity promotion for
  parents

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Child Care Centers Number of Policies by Zip,
Columbus, OH
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Adult Obesity by Zip CodeColumbus, Ohio
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Pre- Post Intervention Measures Menu Changes
29.0
287.6
53.2
27.7
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Pre- Post Intervention Measures Menu Changes
50.1
56.6
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Next Steps

• Statewide
• Incorporate Ohios Healthy Program criteria into
  statewide voluntary quality rating systems
• Enhance parent engagement efforts
• Local
• Ongoing evaluation of long-term, sustained
  environmental change
• Continue to seek sustainable funding source

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Questions?

• Autumn Trombetta
• altrombetta_at_columbus.gov
• Cheryl Graffagnino
• clgraffagnino_at_columbus.gov
• http//publichealth.columbus.gov/healthy-children-
  healthy-weights.aspx