Connecticut Childhood Obesity Policy Work Group Policy recommendations produced at August 23, 2011 meeting

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1 Connecticut Childhood Obesity Policy Work Group Policy recommendations produced at August 23, 2011 meeting NOTE: The numbers after each policy correspond to those on the large policy menu which was presented at the August 23rd meeting. Communities: Policies that Promote Healthy Communities Transportation Infrastructure and health impact Complete Streets (#1) Develop Complete Streets vision and plan, and implement P.A directing 1% of state and local highways/street transportation funds for bicycle and pedestrian usage. Coordinate this DOT strategy with state health goals being developed in DPH chronic disease initiative. Complete Streets reporting (#13) Require ongoing reporting by DOT of Complete Streets (accommodations for all users) purposes and expenditures by state and localities under P.A Sidewalks (#11) Require sidewalks in new developments, provide incentives for communities to put sidewalks in existing developments, & require cities/counties to consider physical activity in planning/zoning actions. Expand the Family Ramble Program (#16) WalkCT works to encourage active lifestyles for those of all ages and abilities. Expand this effort directly into urban areas to appeal to at risk communities. Increase access to healthy foods Federal Food Security Program funds (#2) Develop state strategy to fully maximize federal food security program funds. Increase incentives for healthy food purchases (#6) Increase number of farmers markets accepting EBT/Food Stamps; expand Farmers Market Nutrition Programs; allow use of WIC fruit and vegetable vouchers at markets; exempt sales at certified farmers markets from sales tax. Fresh Food Financing (#8) Provide incentives/promotions for supermarkets to build in low income neighborhoods, and for corner stores/farmers markets to increase access to affordable, fresh food in underserved areas. BMI measurement to guide decision making Track rates of overweight and obesity among children (#3) Track statewide and regional rates among children, and racial and ethnic disparities. Screening In pediatric practices (#18) Implement reimbursement for nutritional counseling; support to integrate into comprehensive community early childhood plans for school readiness (e.g. in early care and education promote good practices related to nutrition, physical activity). 1 P age

2 Schools: Policies that Promote Healthier Food & Physical Activity in Schools Farm to school Encourage farm to school by making more resources available and building school gardens Coordinated approach to school health (#8) District Wellness Committees Require districts to have school wellness committees that develop nutrition, physical activity and other student health goals. Employ a strong accountability mechanism to ensure that the committees are functioning. Require districts to report annually to the State Department of Education how their wellness policies were implemented. District Health Coordinator Every school district employs a full time CSH district coordinator. Coordinated Approach to School Health Every school district annually assess its health policies and implement a comprehensive plan for a well coordinated approach to school health. Create a coordinated approach to school health, including: a. Add indicators in the Strategic School Profiles for whether school participates in (1) school breakfast, (2) Healthy Food Certification, (3) Farmto School programs, (4) schools districts have created, publically posted, continue to update and implement a strong school wellness policy with regular reporting to CSDE. (#1) b. Prohibit public schools and child care providers from using foods or beverages as rewards for academic performance or good behavior, unless this practice is allowed by a student s individualized education plan (IEP), and from withholding food or beverages as punishment. (#15) c. Prohibit teachers and other school personnel from imposing any punishment on students that involves (1) physical activity or exercise (e.g. running laps, pushups) or (2) withholding opportunities for physical activity (e.g., not being permitted to play with the rest of the class, or being kept from recess or physical education class as a consequence for behavior or incomplete assignments). (#17) d. Nutritional education for Food Service staff this was suggested by the School Nutrition Association of CT representative: School Food Service directors and staff can be trained on healthy food choices, how to set up systems for choosing quality food and other areas. e. Recess must be held at least once a day for grades to, preferably before lunch. (#18) Comprehensive Health Education Training for Teachers All elementary education teachers must complete at least one course on methods of teaching health education, which by definition, includes nutrition and physical education training, and is for all (not only health teachers). 2 P age

3 Child Care: Policies that Promote Healthier Child Care Environments 21 st Century Community Learning Centers training and technical assistance Require the state department of education to provide training and technical assistance to grantees of the 21st Century Community Learning Centers and state after school grants of at least two hours annually. State licensing standards and Quality Rating and Improvement System (QRIS) Strengthen the licensing standards and QRIS to support best practices and to include the following recommendations: Beverages: Child care nutrition policies allow only water, up to 4 ounces/day 100 percent juice, and low or non fat, unflavored milk (except for children under 2 years of age) to be served in child care settings. No beverages with added sugar permitted.(#1) Screen time: In order to be licensed, child care centers must limit screen time: (1) infants to 2 years: NONE; (2) ages two and older, less than one hour per day, consisting only of quality educational programs that are connected to learning goals and standards or that actively engage child movement; and (3) no screen time during meals or snacks. (#5) Physical activity: In order to be licensed, child care centers must Provide toddlers (ages 1 2) with at least 30 minutes structured and 60 minutes unstructured physical activity daily; Provide preschoolers (ages 3 5) with at least 60 structured/60 unstructured minutes daily. Do not allow toddlers and preschoolers to be sedentary (except while sleeping) for more than 60 minutes at a time. (#6) Professional training: child care CEUs shall include training on childhood obesity prevention including nutrition, physical activity, screen time and other related topics. (#7) Breastfeeding: Establish a supportive breastfeeding policy, providing knowledge and support for mothers; require all staff be aware of and follow the policy. New staff is trained within six months of hire. (#11) BMI surveillance Add height and weight fields for children 2 years and older to current annual immunization reports (required for all child care centers) for purposes of BMI surveillance. 3 P age

4 Health Care: Policies that Integrate Obesity Prevention into Health Care Systems Data: (#1,5,6) Centralize existing databases, break data down by municipality and make them easily available. Note: This recommendation was developed because the group believed there are many useful data already available and that the policies on the menu related to this would require longer term efforts (see below). Develop a surveillance system of childhood obesity as a longer term goal. Note: Given complexities of who should measure and who should report, and fiscal/infrastructure needs, the group thought that this would not be achievable in the short term but is important to work towards in the longer term. Better care through medical home (#2,3,4,8,9,10,11,12) Incentivize better care through medical home by: Training providers in evidence based counseling/treatment; Paying for obesity related monitoring and provision of anticipatory guidance and behavior modification techniques; Providing nutrition counseling by nutrition specialist (dietitian); and Providing preconception care. Breastfeeding (#7) Review evidence based studies for relationship between breastfeeding and obesity prevention and 2.determine recommendation. Note: This process step was determined necessary by the group due to internal disagreement about association between breastfeeding and childhood obesity prevention. 4 P age

5 General policy Council On Childhood & Adult Obesity Establish a permanent council on childhood and adult obesity that consisting of legislators, consumers, advocates, health care providers, and state agencies to advise the General Assembly and state agencies on strategies to promote environmental change in order to prevent obesity, and provide better access to health care for obese individuals. The council could seek to accomplish the following objectives: o track federal grants o coordinate state activities, local governmental and community initiatives related to obesity prevention o propose legislative and regulatory remedies o create an information packet on all relevant state agency programs o update materials and distribute them widely o plan a council led roundtable of all local childhood obesity coalitions o engage in a cross agency results based accountability (RBA) process to set goals, share agency plans and coordinate actions o incorporate emerging best practices into inter agency projects through master contracting and memoranda of understanding o conduct a regional listening tour in coordination with local obesity prevention coalitions o develop a public outreach campaign, starting with donated public service announcement time o conduct a leadership survey of other states obesity coordination efforts o apply for foundation funds on behalf of the Council o serve as a team to prepare cross agency applications for federal funding through the federal stimulus and other opportunities o advise state leaders on policy and programmatic matters. 5 P age

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