- Author: Reka Vasicsek
- Author: Carolyn Rider
Local Health Departments are improving their CFHL programs using the Nutrition Policy Institute's LEAP awards. Three hundred thirty-three schools and programs were recognized across California for making strides on health and wellness practices.
The Issue
Establishing healthy eating and physical activity practices during childhood has become a priority in education and policy. Promoting nutrition and physical activity best practices in school and childcare programs is key to ensuring the next generation of Californians grows into healthy, active adults.
How UC Delivers
The University of California's Nutrition Policy Institute (NPI), in collaboration with the California Department of Public Health's CalFresh Healthy Living (CFHL) program, coordinates evaluation in schools, early care and education centers, and out-of-school time programs to assess nutrition and physical activity policies and practices. NPI's Site-Level Assessment Questionnaires (SLAQs) are used to assess programs and support plans for program development and improvement. CFHL programs target schools and childcare programs in low-income communities to create health-promoting environments for children.
“Thank you for sharing this! I am meeting with my team next week to discuss our school approach for FY24 and this will be super helpful to help identify new/expanded areas for working with the schools.”
- Local Health Department CFHL Project Director
NPI launched the Leaders in Eating and Activity Practices (LEAP) program in 2023, recognizing 131 schools, 124 early care and education programs, and 78 out-of-school time programs across California for achieving best practices in healthy eating and active living. All 333 sites received recognition in one or more specific areas: nutrition, physical activity, gardens, or breastfeeding support. Additionally, 38 sites were awarded gold, silver, or bronze for comprehensive achievement of overall nutrition and physical activity practices.To receive a LEAP award, sites reported wellness practices on a SLAQ and partnered with their Local Health Department's CFHL program to plan and implement health promotion projects. These projects target a range of children's nutrition and physical activity behaviors by changing policies, systems, and the environment at schools and childcare programs. NPI provided LEAP winners with personalized certificates and a digital promotions package to help them promote their achievement through social media, newsletters, or other media.
“Oh how exciting! Especially since we may be working more closely with middle schools in FY24-26 and this recognition might just encourage them join on for more PSE [policy, systems, and environmental change] focused work.”
- Local Health Department CFHL Project Director
The Impact
LEAP recognition of successful wellness programs can invigorate partnerships and inspire more impactful work. LEAP aims to motivate schools and childcare programs to implement comprehensive, evidence-based strategies to improve child health outcomes. The program also encourages Local Health Departments and their partners to promote their wellness efforts among families and community members, building community awareness of and support for CFHL. Within six months of launching the program, two-thirds of surveyed Local Health Departments reported utilizing the LEAP digital promotions package to promote their partners' healthy eating and physical activity interventions and 22% reported utilizing the LEAP award criteria to inform intervention planning at their partner sites. LEAP awardees and LHD partners have been featured on social media and in community newsletters, newspaper articles, and press releases, enhancing public awareness of CalFresh Healthy Living and UC's Nutrition Policy Institute.
Testimonials from Local Health Department CFHL Project Directors:
“I'm thrilled for our schools and extra excited for the Gold Award!! I can't wait to celebrate ourschools and the fabulous work they are doing. THANK YOU so much for this.”
This family childcare home gained LEAP recognition with a Gold Award and all four badges (Nutrition, Physical Activity, Gardens, and Breastfeeding Support).
“I never thought I would be serving asparagus to the kids. I had a hard time getting them to even eat fruits! After doing all the garden activities, they became more excited and more adventurous to try new foods. They were also very excited to check on their plants every day. They tell me they can't wait to eat the stuff they are growing.”
- Author: Eli Israel Figueroa
- Editor: Andra Nicoli
CalFresh Healthy Living (CFHL), University of California Cooperative Extension (UCCE) in Contra Costa County promotes healthy communities with a nutrition education curriculum designed to improve teens' eating and fitness choices. Of the 117 middle school youth who participated in EatFit, 30% increased the number of times they ate vegetables.
The Issue
Food and beverage companies invest over $1 billion in marketing each year to advertise their food products to Black and Hispanic consumers, specifically the youth. Students at Hillview Jr. High School (HJHS)–which is located in a low-income neighborhood of Pittsburg and has a 60% Hispanic and 19% African American student population– are not exempt from these widespread and targeted food marketing campaigns. Fast food restaurants, convenience stores, and gas stations line the main street avenue near the school, attracting hungry teens.The easy availability and promotion of these foods, which are linked to negative life-long consequences, influence the food choices made by youth every day. When hunger strikes, healthy eating and active living are out of sight and out of mind to many teens.
How UC Delivers
CFHL, UCCE in Contra Costa County partnered with HJHS to deliver EatFit during the 2022-2023 school year. EatFit is a nutrition education goal-setting curriculum designed to challenge middle school students to improve their eating and fitness choices. The program reached 149 students who participated in activities focused on goal setting, nutrition facts label, energy, breakfast, exercise, fast food, and the media's influence on food choices.
In one of the EatFit lessons, students learned about food marketing. They were asked to name a commercial or ad on the Internet about water or healthy food. None could. However, when asked for examples of fast food or soda ads and commercials, all hands went up. Some students even sang the jingle or acted out the commercial. Students realized that food companies target young people and hardly promote healthy foods. Instead, TV commercials and advertisements on the Internet and social media try to persuade teens to eat and drink unhealthy foods and sugary beverages that harm their health. In the same lesson, students also learned about food marketing techniques and were encouraged to create fruit and vegetable posters to promote healthy choices at school.
With support from the principal, the school's busiest hallways were decorated with students' colorful fruit and vegetable posters. Not one poster was vandalized or torn off.
The Impact
One hundred and seventeen students in grades 6-8 completed the Eating and Activity Tool for Students (EATS) pre-post survey at Hillview Jr. High to assess changes in their behaviors after participating in the FY 2023 EatFit lesson series. Respondents were ten to thirteen years old, and identified as Latino or Hispanic (48%), Black or African American (18%), or more than one race (27%). After taking part in EatFit, the student survey results included the following:
- 34% increased the number of time they ate fruit yesterday.
- 30% increased the number of time they ate vegetables yesterday.
- 50% reduced the number of times they drank sweetened beverages yesterday - with the largest decreases seen in fruit drinks, soda, and sweetened coffees and teas.
- 40% increased the number of days they were physically active for 60 minutes or more last week.
“One change I made to eat healthier/be more physically active is to exercise/stretch when I wake up and lower how much unhealthy food I eat (high fat food, high calories etc) and start eating more fruits and veggies.” — EatFit Participant
This work is vital in adolescents as they begin to become more independent in the way they think, learn, and interact with food. Likewise, nutrition education intervention efforts in majority Black, Indigenous, and People of Color (BIPOC) communities are of particular importance because these groups have been expressly targeted as potential consumers of nutrient-poor food while also facing barriers to accessing affordable and convenient healthy food. By supporting students to reflect critically on how unhealthy food and beverages are advertised to them and then develop their counter-messages to promote healthy choices, inclusive SNAP-Ed-approved programs like EatFit and others can help improve nutrition behaviors among low-income adolescent Californians and prevent the chances of developing chronic disease later in life.
CFHL, UCCE staff will continue to partner with Hillview Jr. High to deliver quality nutrition education during the 2023-2024 school year. The fruit and vegetable posters made by students serve as a friendly reminder to all that food marketing does not steal your independence; you can still make a healthy, tasty choice.
“Before, I use to just get snacks to eat them but a lot of them were unhealthy and I got cavities. During the lesson we learned that the labels are actually important. Now I check the label to compare and buy the snack that is more healthy. It is working I am more healthy and happy.”— Jacob Ponce, EatFit Participant
- Author: Beatriz Adrianna Rojas
- Author: Andra Nicoli
CalFresh Healthy Living (CFHL), UCCE Kern County aims to improve health in farm working families by encouraging healthy eating and physical activity. As a result of a partnership with Head Start centers serving migrant communities, youth completed over 140 hours of physical activity and 92% of adult family members intended to use nutrition facts when shopping.
The Issue
According to County Health Rankings & Roadmaps, Kern County is ranked among the least healthy counties in California in terms of length and quality of life and a significant portion of residents have one or more risk factors that threaten their longevity and quality of life. For instance, 34% of adults are either overweight or obese, 35% of residents are physically inactive, and 23% are food insecure.
Children and adults with these risk factors are more likely to develop chronic diseases like heart disease and diabetes.
How UC Delivers
In order to work with residents on early healthy start interventions, CFHL, UCCE Kern County partnered with Community Action Partnership of San Luis Obispo (CAPSLO), which has five migrant Head Start centers in Kern County. CAPSLO provides no-cost childcare and preschool services to low-income families whose primary occupation is agricultural production and harvesting in the Arvin, Lamont/Weedpatch, Wasco, and Delano communities.
CFHL, UCCE Kern has conducted evening adult nutrition education at the centers.
- 94 parents received evidence based lessons from Plan, Shop, Save, and Cook (PSSC) and Healthy, Happy Families.
- Parents learned how to read the nutrition facts label, save money on food and how to start healthy habits with their children. Parents also learned how to incorporate physical activity in their everyday family routine. Physical Activity Guidelines for Americans (2018)recommends moderate-to-vigorous physical activity to reduce the risk of many chronic diseases among children and adults.
In order to impact families CFHL, UCCE Kern provided CAPSLO teachers with four hour training on Coordinated Approach to Child Health Early Childhood Education (CATCH ECE). CATCH ECE provides children with skill development exercises to develop locomotor, non-locomotor, manipulative skills and nurture their love for physical activity through games and activities. Teachers conducted CATCH 2-4 days per week for 30 minutes.
The Impact
Seventeen parents who received the PSSC lesson on understanding food labels completed an “Intent to Change” survey. Results of the survey include:
- Of the 12 respondents who did not use the “Nutrition Facts” label prior to the lesson, 92% reported that they will use the nutrition facts on the food label to choose foods the next time they go shopping.
- A parent shared how the workshop helped her family and that they are “eating better and know how to choose foods with better nutrition.”
From August to October 2022, 130 children participated in 143 hours of physical activity through CATCH ECE lessons delivered by 15 teachers at CAPSLO's centers. Research shows that regular moderate-to-vigorous physical activity reduces the risk of many chronic diseases among children and adults.
“All my children enjoy the CATCH activities. The CATCH program is fun and beneficial,” one teacher shared. The Center Director said “I really like how teachers and children are physically active with CATCH. The nutrition sessions given to the parents also makes it more impactful for the whole family.”
By motivating and teaching CFHL participants to adopt healthier lifestyle practices, and training ECE teachers to support physical activity, CFHL, UCCE Kern helps create healthier families and communities.
- Author: Betsy George
- Author: Carolyn D Rider
- Author: Janice Kao
- Contributor: Christina Becker
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SNAP-Ed practitioners adopt a practical, effective tool from UC ANR's NPI to evaluate program impact in schools, ECEs, after-school programs, and grocery stores, adding workforce capacity to public health agencies.
The Issue
In recent decades, increasing attention has been placed on improving access to healthy foods and opportunities to participate in physical activity in California communities with high rates of poverty and food insecurity. Schools and other places where children receive care are important partners in promoting wellness, as are the retail establishments where families purchase food. Supplemental Nutrition Assistance Program Education (SNAP-Ed) interventions partner with these community sites to promote healthy eating and physical activity.
UC ANR's Nutrition Policy Institute (NPI) has developed and tested Site-level Assessment Questionnaires (SLAQs) to empower local health departments (LHDs) and other agencies working with schools, early childhood education centers (ECE), out-of-school programs, and grocery stores to perform annual assessments of wellness practices at each site. A SLAQ is a setting-customized, easy-to-use questionnaire comprised of multiple sections, each of which addresses a specific wellness domain, such as the school food environment or prominence of healthy food displays in a grocery store. Topic experts, including extension and SNAP-Ed professionals, education professionals with nutrition expertise, and academic researchers,reviewed SLAQs and provided valuable contributions regarding their questionnaire validity and content. The SLAQs were then pilot-tested in the field for feasibility, validity, and reliability.
Extension programs can partner with schools, ECEs, out-of-school programs, and grocery stores to use completed SLAQs to identify areas of need and create action plans for improvement. As sites perform annual reassessments, they receive concrete data that reflect the progress of their programs. SLAQ scores from multiple sites can be aggregated to measure the degree of health promotion in a community, a county, or across the state. Extension programs can also examine how improving health-promoting practices over time relates to changes in health outcomes.
The Impact
In the first year, SLAQs were implemented across 46 California counties receiving SNAP-Ed funding, including 161 schools, 144 ECE sites, 68 out-of-school programs and 87 grocery stores. Additionally, SLAQs were adopted for use by five California LHDs who received CDC SPAN funding and SNAP-Ed funded elementary schools in Washington.
Local SNAP-Ed implementing agencies are already working with sites to tailor interventions based on the individual site's areas of strengths and opportunities. SLAQ users appreciate having a standardized tool to gather data, pinpoint weaker areas of performance, and strengthen their efforts to improve the health of California's children. NPI's role in expanding science-based evaluation practices demonstrates UC ANR's commitment to promoting healthy people and communities. Maridet Ibanez, Project Director for Orange County Health Care Agency's CalFresh Healthy Living program, highlighted how SLAQs helped them create a “menu” of intervention options that they were ready and willing to collaborate with their sites to implement:
We were able to compare 10 different [ECE] sites. It was a uniform tool that we could use to assess our sites. This wouldn't have been possible without the SLAQs. - Maridet Ibanez, Project Director