Georgia Shape Annual Report

Transcription

1 Georgia Shape Annual Report

2 TABLE OF CONTENTS Overview Physical Activity Fitnessgram Georgia, The Cooper Institute Fitnessgram Booster Sessions for Secondary Teachers, GaDOE Power Up for 30, DPH The Power of Play, Playworks Georgia Walk Georgia, University of Georgia at Athens Governor s Shape Honor Roll, DPH Georgia s School Physical Activity and Nutrition Toolkit, GSU Childhood Obesity Prevention Secondary School Setting, The Centene Foundation Nutrition School Physical Activity and Nutrition Grantee Project Smart Start Toolkits Strong4Life Smarter Lunchroom School Nutrition Program Local Food Procurement Toolkits State Procurement Communications and Marketing Power Up for 30: Branding and Communication Georgia Shape Radio and Pandora Advertisements Your Child s Brain on Exercise Georgia Youth Obesity Prevention Research and Practice: Public Health Reports Special Supplement Healthcare Primary Care Coding of Childhood Obesity Related Visits Educating Physicians/Practices in their Communities (EPIC ) Childhood Obesity Program Strong4Life: Using Healthcare Providers to Combat Childhood Obesity Access to Breastfeeding Support through ZipMilk.org Georgia Shape 5 Star Hospital Recognition Program Data Collection and Evaluation Health Empowers You Georgia s Elementary School Setting Physical Activity Survey Georgia Shape Data and Evaluation Framework Shape Policy Implementation: Barriers, Facilitators, and Costs

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8 FITNESSGRAM Booster Michael Tenoschok Health and Physical Education Program Specialist Georgia Department of Education The Georgia Department of Education (GaDOE) in collaboration with Georgia Shape is addressing the problem of childhood obesity in Georgia through education and fitness assessment in the public schools. This is the third year of the Shape initiative and the required FITNESSGRAM Fitness assessment. The initial training and rollout has been outstanding. At this point, teachers are in need additional training sessions to move the program to the next level. Multiple Physical Best Trainings have been conducted over the past year. The Physical Best program addresses physical fitness concepts through active learning and physical education lessons. An online FITNESSGRAM 101 course, developed by Human Kinetics, provides Professional Development Credit for teachers through the FITNESSGRAM website. This site also has additional resources related to the teaching and assessment programs. FITNESSGRAM Assessment Booster Sessions have also been developed for future teacher training in secondary school settings. These sessions will focus on best practices as they relate to scoring accuracy, avoidance of administrative errors, time management, and improvement of instruction. An incentive program is available for interested schools and school systems. Certificates are provided to systems for all students achieving the Healthy Fitness Zone (HFZ) in all five test categories. Over one million Georgia students completed the FITNESSGRAM assessment during , and 140,000 students were recognized through the incentive program. The GaDOE continues to monitor the training, data collection, and resources related to this statewide program. The Georgia model has been adopted as the national model by Human Kinetics and FITNESSGRAM. In February of 2014, the President s Council on Fitness, Sports and Nutrition sent a commendation to Governor Nathan Deal for the success of Georgia Shape and FITNESSGRAM Implementation efforts. Power Up for 30 Kelly Cornett, MS Physical Activity Coordinator Georgia Department of Public Health Power Up for 30 is a physical activity program designed to allow every school in Georgia to create daily opportunities for students to move an additional 30 minutes each day in a way that fits the needs and wants of the individual school. The Georgia Department of Education, the Georgia Department of Public Health, and HealthMPowers have partnered to enhance the learning environment in schools across Georgia. Research shows a strong positive relationship between physical fitness and academic achievement. Incorporating just 30 minutes of physical activity into the daily school routine can make children more alert and ready to learn. All elementary schools who sign the Power Up for 30 Pledge are eligible to attend a free one-day training session with HealthMPowers to receive a personalized school-based physical activity assessment and to learn about proven and effective K-5th grade physical activity resources. These materials and programs help elementary school teams and leaders increase physical activity before, during, and after school for students, school staff, and families. A team of three representatives from each school are invited to attend: an Page 6

9 administrator (or their designee), a physical education teacher, and a classroom teacher. Thanks to generous funding from the Coca-Cola Foundation, substitute reimbursement is provided to all physical education and classrooms who attend the session. One Professional Learning Unit (PLU) is available to training attendees, and signing the Pledge and attending a training session are also both criteria components for the Gold and Platinum levels in the Governor s Shape Honor Roll recognition program. As of February 1, 2015, 1) ~230,000 students have been touched by the initiative; 2) 70% of elementary administrators have completed the Power Up for 30 Survey; 3) 461 elementary schools have signed the Power Up for 30 Pledge; 4) 362 school teams have completed the one-day training with HealthMPowers; and 5) 528 elementary schools have submitted all survey entries. In the coming months and following school year, Shape has the capacity to offer at least 50 more training sessions to elementary schools across the state. The Power of Play Playworks Georgia Ellen McCarty Executive Director Playworks Recess and play, critical parts of every child s development, are both at risk particularly at low-income schools. As the American Academy of Pediatrics notes in its 2012 policy statement, The Crucial Role of Recess in School, recent surveys and studies have indicated a trend toward reducing recess to accommodate additional time for academic subjects. Furthermore, the period allotted to recess is less abundant among children of lower socioeconomic status and in the urban setting. Playworks is a national nonprofit organization that improves school climate, reduces bullying, and increases teacher instructional time through play and increased physical activity. Playworks was founded in 1996 at two schools in California and has grown into a $33 million organization. In , Playworks will serve 900 schools across the U.S., reaching 425,000 students. Playworks vision is that every child in the U.S. will have access to safe, healthy play at school every day. Their goal is to establish play and recess as a core strategy for improving learning in schools. The Robert Wood Johnson Foundation, the nation s leading public health foundation, invested over $32 million in Playworks during the major expansion phase based on a belief that the programming positively impacts children s health. Playworks launched in Georgia in July 2014 with support from the Atlanta Falcons Youth Foundation. Playworks leverages recess into an asset that can transform the entire school and create a more productive learning environment. We place a well-trained adult coach at our low-income partner elementary schools to teach and model new language and activities through a five-component, evidence-based recess program-- on the playground, in the classroom, before and after school, and at sports leagues. Coaches impart new social, emotional, and cognitive skills that engage students in ways that are healthy and fun while shifting the school climate so that it becomes un-cool to exclude or ridicule any child for any reason. In 2013, Stanford University and Mathematica Policy Research, a national leader in social policy research, released results of a randomized control study involving Playworks. This level of evaluation is considered the gold standard for research. Several findings were found to be statistically significant indicating that impact did not happen by chance but was rather a result of Playworks programming. A key finding revealed that 43 percent of the students were engaged in more vigorous physical activity based on accelerometer data showing that children in Playworks schools spend significantly more time in vigorous physical activity at recess (14% versus 10% of recess time, which is a 43% difference). Page 7

10 Walk Georgia Maria Bowie Program Director University of Georgia at Athens Walk Georgia began in 2008 as a University of Georgia Extension program, and it is one of the most visible outreach programs of UGA s Obesity Initiative. The goal is to champion Georgia s most foundational priority of encouraging fitness and nutrition while also curbing the obesity rate in the state. In 2013, Walk Georgia received a grant from the Coca-Cola Foundation to help expand programming to reach every county. Walk Georgia is packaged in a simple, easy-to-use website that is user-friendly for all ages and stages. It is designed to work for individuals or groups including schools, businesses, and other organizations by tracking, measuring, and encouraging physical activity. In addition to tracking and measuring fitness, by February 1, 2015, Walk Georgia will feature content that includes simple, easy-to-use fitness demos, meal recipes, free local fitness and activity resources, and even a fitness dictionary for beginners. More than 50,000 participants have already taken part in Walk Georgia, logging over four million miles worth of physical activity. Their goal is to empower 100,000 more Georgians by 2016 and to decrease the number of physically inactive people in all 159 counties by five percent. If every county in Georgia had just 55 participants each month during 2015, this programming would change the lives of over 100,000 more people by Furthermore, it could change the way the state sees itself and portray a strong, fit, healthy, and diverse population. To be a part of Walk Georgia, visit For resources on how to get a community involved, visit to find additional information, training tools, lesson plans for teachers, and more. Governor s Shape Honor Roll Georgia Shape Office of the Chief of Staff Georgia Department of Public Health The annual Governor s Shape Honor Roll award system recognizes elementary, middle, and high schools for their dedication to creating a healthy school environment and a culture of wellness for staff, students, and community. Georgia's K-12 public schools are invited each spring to submit an application to be recognized by the Governor's Office, the Georgia Department of Education, and the Georgia Department of Public Health for their exceptional participation in the annual fitness assessment data collection process as well as their commitment to efforts that improve student wellness such as providing weekly/daily recess, participating in Power Up for 30 training, allocating required hours for health and physical education, and creating a school wellness council. All applicants who meet the requirements of recognition and submit proper documentation are rewarded for their outstanding efforts by four tiers of criteria: Bronze, Silver, Gold, and Platinum. Recipients receive certificates of honor from state leadership, banners to display in their school buildings, and prize packages consisting of fitness equipment for their schools. During the school year, 16 schools were recognized for attaining bronze status, 67 for silver, 38 for gold, and 29 for platinum. Page 8

11 Georgia s School Physical Activity and Nutrition Toolkit Andrew Young Health Policy Center Georgia State University This new toolkit provides a one-stop shop for schools in need of physical activity and nutrition information. Information includes Georgia school health facts, policy changes, systems changes, environment changes, free tools and resources, best practices, and evidence-based programs. The toolkit begins with an overview of Georgia s physical activity and nutrition facts followed by a summary of state and federal policies related to physical activity and nutrition. Additionally, content addresses coordinated school health and models for school wellness, nutrition, and physical activity policies. Users will also receive Georgia-based highlights of best practices and policy examples in school nutrition, physical activity, and wellness. The kit also includes guidance for school health policy adoption and implementation, ideas for communications and social marketing, and a list of programs/resources. Moving forward, the development team plans to obtain feedback from Shape school advisory groups, Shape school champions, and the Georgia Department of Education. They will utilize the evaluation feedback to create sub-tools or new sections as well as create a dissemination strategy. Once completed, the toolkit will be distributed at events such as the Healthy Schools Summit, Power Up for 30 trainings, and other school health events. Childhood Obesity Prevention Secondary School Setting Peach State Healthcare The Centene Foundation Centene Foundation for Quality Healthcare (Foundation) will invest $250,000 over the next three years to combat childhood obesity. Georgia is the pilot state for the Foundation s Childhood Obesity Prevention initiative. With an actively engaged Department of Public Health, along with state and community organizations committed to combatting childhood obesity, Georgia is a viable market for the Foundation to launch the initiative and leverage existing efforts. In the first year, as part of the Georgia Shape initiative, the Georgia Department of Public Health and Centene/Peach State Health Plan (one of Georgia s health insurance companies for Georgia s Medicaid and Peach Care for Kids population) are supporting a small pilot project in one rural middle school in Decatur County and one urban middle school in Cobb County. The initiative s focus is impacting student behavior related to both physical activity and nutrition. Page 9

12 NUTRITION School Physical Activity and Nutrition Grantee Project Matt Yancey Former Deputy Director of Chronic Disease Prevention Section Georgia Department of Public Health As part of the Georgia Shape initiative, the Georgia Department of Public Health s (DPH) Chronic Disease Prevention Section awards mini-grants to assist local schools in enhancing their physical activity and nutrition efforts. Grant funding and expert technical assistance is provided to schools to assist in improving student fitness based on the results of the FITNESSGRAM assessment. Moreover, Georgia Shape grantees are assisted in testing new strategies that support implementation of federal laws, including the Healthy Hunger Free Kids Act requirements. At no cost to the grantee, subject matter experts are made available to provide training and ongoing technical assistance. Examples of technical assistance include helping grantees conduct health assessments and identify priorities, providing reference tools, conducting peer learning and trainings, and assisting with evaluation. Led by the Georgia Health Policy Center and DPH s Chronic Disease Prevention Section, other committed partners also play a role in providing support to the Georgia Shape grantees. These partners include HealthMPowers, the Georgia Departments of Education, Agriculture and Community Health, the Southeast United Dairy Industry Association, and the Alliance for a Healthier Generation. Recently, DPH announced that 25 new schools have received a total of $122,000 in Georgia Shape school grants. The schools include elementary, middle, and high schools throughout the state. Four schools received Core Awards of $3,000 each to be used to improve nutrition programs. Twenty schools received Enhanced Core Awards of $5,000 each to improve both school nutrition programs and physical activity. Fowler Drive Elementary School in Athens, Georgia, was awarded the first Dr. Clifton A. Baile Georgia Shape Grant in the amount of $10,000. Dr. Baile, who passed away May 2014, was well-known and respected for his public service throughout Clarke County and Georgia as well as for establishing the University of Georgia Obesity Initiative. Since 2012, 72 schools throughout Georgia have received a Shape grant. Among the grantees, schools have implemented a wealth of policy, systems, and environmental change strategies related to physical activity and nutrition. These include the adoption of local school food policies, the creation of multidisciplinary school wellness teams, and the creation of school gardens to improve access to fresh fruit and vegetables. Smart Start Toolkits Donna DeCaille MS, RD, LD Georgia Department of Public Health The Smart Start Toolkit will serve as a resource and technical assistance product for early care providers to create healthier environments in daycare centers and homes. The kit will include hands-on tools to implement recommended healthy eating and physical activity policies for children 2-5 years old. The objective of the toolkit is to provide needed resources such as curriculum suggestions, guidelines, and interactive/educational materials to childcare providers in at-risk communities throughout Georgia. In conjunction with hands-on training from the Georgia Department of Public Health, the toolkits will equip Page 10

13 childcare providers with an understanding of best practices and tools to lead in-class educational activities that engage, educate, and entertain. It will accompany regional training and be distributed throughout the state to early care centers, home and group daycares. The toolkit will be self-contained in a branded case that allows for easy transport. Materials will include a customized, program binder with suggested curriculum and lesson plans. The kit will also contain educational pieces, such as the portion plate, in addition to game pieces and interactive classroom activities. Bright from the Start interacts with more than 10,000 child care facilities in Georgia, more than 6,000 of which participate in the Child and Adult Care Food Program (CACFP). These numbers indicate the extent to which Bright from the Start can communicate with and provide training to caregivers and how DPH may help to influence and actively promote healthy eating and increased physical activity among young children. Strong4Life Smarter Lunchroom School Nutrition Program Wendy Palmer Child Wellness Manager Children's Healthcare of Atlanta Children s Healthcare of Atlanta launched Strong4Life as a wellness movement designed to ignite societal change and reverse the epidemic of childhood obesity and its associated diseases in Georgia. By partnering with Georgia Shape, Strong4Life is able to help create meaningful nutrition-based change across the state. Nearly one million of Georgia s children are overweight or obese, which means nearly one million kids in the state are facing a medical crisis. Children's Healthcare witnesses this crisis in hospitals every day. Overweight children are suffering from diseases that were once only seen only in adults, such as heart disease, hypertension, liver and kidney disease, and type 2 diabetes. Strong4Life reaches families through public awareness, policy change efforts, school programs, healthcare provider programs, community partnerships, and more. Strong4Life delivers fun, simple solutions that inspire today s kids and families to develop lifelong healthy habits one positive step at a time. The Strong4Life School Nutrition program is rooted in evidence-based principles of The Smarter Lunchroom Movement. The curriculum trains school nutrition staff how to utilize low- and no-cost strategies that they can implement in their lunchrooms to impact healthy eating. The goals of the program include implementation of Smarter Lunchroom strategies in school cafeterias through provision of innovative tools, increased confidence of school nutrition staff to serve as a positive role model in the cafeteria, and increased participation in school meal programs. With the implementation of stronger school nutrition standards, schools are serving more nutritious foods and more variety to create an environment in which healthy choices are the easy choice. The beauty of behavioral economics is that small environmental changes can have a large impact. Something as simple as putting fresh fruit in an attractive fruit bowl near the cash register can increase fruit consumption. Considering factors like presentation and prompting, as well as targeted promotions, also increase student engagement in eating healthy foods served in school lunchrooms. Strong4Life s evaluation of their pilot programming shows a nearly five percent increase in meal participation among students in the intervention schools. Page 11

14 Local Food Procurement Toolkits Georgia Organics In partnership with Georgia Organics, the Georgia Department of Public Health has created a local food procurement guide for child nutrition programs across the state. This provides education and instruction for more effectively utilizing local resources and connecting with those who distribute local produce, dairy, and other Georgia-grown products to serve in the school setting. Additionally, the Golden Radish recognition program is awarding school districts that are excelling in the utilization of farm-to-school efforts of serving, procuring, and highlighting local food items. The Georgia Departments of Education, Agriculture, Public Health and the Governor s Office have partnered to support this recognition. State Procurement Georgia Department of Education Georgia Department of Public Health Several state agencies and organizations have partnered for a collective impact including the Department of Education, the Department of Public Health, the Department of Administrative Services, the Department of Agriculture, Georgia Organics, the Atlanta Falcons Youth Foundation, Royal Foods, and Fieldale Farms. Together, these entities are improving the process and accessibility related to state procurement. The Department of Education polled school nutrition directors to identify their interest in purchasing along with their estimated dollars spent on three items to then send results to the Department of Administrative Services for evaluation. Currently, their findings suggest that there is a desire to participate in state procurement as well as identifying expenditures of $20 million spent on chicken, $60 thousand spent on fresh eggs, and $60 million spent on fruit and vegetables. Moving forward, the coalition plans to analyze best practices in other states, create an expert panel to guide future efforts, and create a list of pilot foods. Page 12

15 COMMUNICATIONS AND MARKETING Power Up for 30: Branding and Communication Padra Franks Power Up for 30 Project Leader HealthMPowers Two logos were created to give Power Up for 30 a visual identity. The first, a simple word logo, communicates with an adult audience, but the second is designed specifically to resonate with students. With sneakers and a dialogue bubble, the child-centric second logo aims to speak a language that students understand: Keep your brain strong and healthy! This logo received the name Sarah Bellum at the conclusion of a statewide contest and round of voting among schools, teachers, and social media followers. The Power Up for 30 training highlights a variety of materials and strategies for increasing student physical activity. Each school team receives a materials folder, two Mind in Motion DVDs, a pedometer, and an integrated physical activity classroom kit (which uses physical activity to teach actual Math standards). Eventually, every Power Up for 30 School will receive a Kindergarten Kit and a 4th Grade Kit. The training practices what it preaches by facilitating a model that incorporates physical activity throughout the day. Other training items branded with the Power Up for 30 logo include clipboards, journals, stickers, grocery totes, socks, bookmarks, and Shape Flags. A password to access the online Power Up for 30 Resource Guide is provided to schools after they complete their training session. The Resource Guide includes over 50 physical activity resources to get students up and moving before, during, and after school. It also includes a staff wellness and community/family engagement physical activity resource for schools to use as they implement their Power Up for 30 Action Plans. The Georgia Shape website features an updated list of pledged schools, trained schools, and additional training information such as quotes from participating teachers. The website will continue to act as a major vehicle for communicating with trained and potential Power Up for 30 schools. Lastly, the Power Up for 30 monthly newsletter, launched in October 2014, includes a featured update story, a school s success story, a highlighted Power Up for 30 Resource, and ideas for continuing to pitch Power Up for 30 after the training. The participating schools have been excellent resources in terms of offering feedback about the current branding and communication efforts. They are evaluating what works and meets their needs, which is critical for the continued development and execution of branding and communication plans. Georgia Shape Radio and Pandora Advertisements Communications Department Georgia Department of Public Health The Georgia Shape webpage re-launched in the summer of 2014 with the Power Up for 30 component as the central focal point. The new aim markets the Shape program by leveraging its impact as the true solution to childhood fitness and nutrition problems in the state. The site features an active scroll bar across the top with rotating information on the programming streaming below. It highlights how to participate in programming and provides updated information from real schools who have taken the pledge. Since the launch, the site has received over 3,800 page views, including 2,785 unique page views. To help drive traffic to the webpage, the Page 13

16 Georgia Department of Public Health purchased radio time to extend awareness of the program to the most difficult to reach areas of the state. The ads have been purchased and aired in three segment areas: Original Radio Buy ($50k) 2 nd Radio Buy ($20k) 3 rd Radio Buy (In-progress) Savannah, Augusta, Macon, Waycross, Albany, Columbus, Albany, Waycross Valdosta Clayton County (including ATL) After evaluating 250 entries submitted by local, state, and territorial health departments across the United States, a panel of seven judges, mostly faculty from Grady College s Center for Health and Risk Communication at the University of Georgia, awarded the campaign a Gold Medal of Excellence on behalf of the Centers for Disease Control and Prevention National Public Health Information Coalition. Your Child s Brain on Exercise The Georgia Prevention Institute Medical College of Georgia and Georgia Regents University Dr. Catherine L. Davis, professor of Pediatrics, Physiology, & Graduate Studies in the Georgia Prevention Institute at the Medical College of Georgia and Georgia Regents University has led many Georgia-specific research efforts related to youth physical activity, health outcomes, and brain development. Her findings suggest that just 20 minutes per day of vigorous activity is enough to make meaningful impact on overweight, sedentary children's health. Additionally, exercise among an at-risk population of Georgia s youth caused brain changes which might affect child development such as increases in cognitive control, enhanced math achievement, and improved myelination/connectivity. These findings are available in a narrative video that can be accessed for viewing at Georgiashape.org. Georgia Youth Obesity Prevention Research and Practice: Public Health Reports Special Supplement Georgia Department of Public Health Chronic Disease Section and Georgia Shape Georgia Shape will be hosting a Research and Practice Symposium in September 2015, with a call for abstracts in March This event aims to be an outlet for sharing information and generating new collaboration ideas. Accepted content will showcase findings and data on Georgia youth physical activity and nutrition surveillance, research, and interventions. Participants will include Georgia researchers, partners, and public health practitioners with measureable results. Additionally, Georgia will be featured through a special peerreviewed supplement on youth obesity prevention, surveillance, research, practice, and policy in Public Health Reports (PHR). PHR is the official publication of the U.S. Surgeon General and is published by the Association of Schools and Programs of Public Health. Selected abstracts from the Shape Symposium will be invited to submit full manuscripts to be published in the supplement to be released in November Page 14

17 HEALTHCARE Primary Care Coding of Childhood Obesity Related Visits Kylia Crane Nutrition Director Georgia Chapter of American Academy of Pediatrics The Healthcare Subcommittee of the Georgia Shape Initiative has taken on a project to improve coding practices in primary care of obesity-related health visits. Coding & Reimbursement remains a major obstacle for healthcare providers which impacts medical management of childhood obesity. The Georgia Chapter of the American Academy of Pediatrics is collaborating with the Georgia Department of Public Health, Georgia Shape, Children s Healthcare of Atlanta, PeachState Health Plan, and the Obesity Action Network on this statewide effort. The goal is to identify the barriers to proper coding, assess the needs of providers and payers, and develop resources to clarify the Healthcare Effectiveness Data and Information Set (HEDIS), quality measures for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), and coding requirements from payers. Educating Physicians/Practices in their Communities (EPIC ) Childhood Obesity Program Kylia Crane Nutrition Director Georgia Chapter of American Academy of Pediatrics The Georgia Chapter of the American Academy of Pediatrics developed the Educating Physicians/Practices In their Communities (EPIC ) Childhood Obesity Program in 2012 to meet the needs of physicians by designing training for physician practices based on evidenced-based best practices regarding the prevention, assessment, and treatment of childhood obesity. The EPIC model is a peer-led physician and staff training program designed to increase clinician knowledge of assessment, prevention, and treatment of childhood obesity. It provides applicable resources in a time-limited setting which offers resources to aid clinicians. The Georgia Chapter of the American Academy of Pediatrics (GA-AAP) is a non-profit, tax-exempt, professional association comprised of nearly 1600 general pediatricians, pediatric medical, and pediatric surgical subspecialists. The mission of the Chapter is twofold: to improve the health and welfare of infants, children and adolescents in Georgia, and to unite qualified pediatricians in the state into a representative organization for the advancement of the practice of pediatrics. The Chapter s major activities focus around child advocacy, physician education, and public policy advocacy on major health and safety issues impacting children. Since 2000, the Georgia Chapter has operated the EPIC Immunization program. In 2007, the EPIC Breastfeeding Program launched as an effective model for providing physician practice education. Even though the program is in its infancy, the Childhood Obesity Program has successfully trained 185 clinicians and improved competence and performance in managing pediatric obesity. Strong4Life: Using Healthcare Providers to Combat Childhood Obesity Trisha Hardy Director of Child Wellness Children s Healthcare of Atlanta As part of the Strong4Life movement, Children s Healthcare of Atlanta has been working to engage healthcare providers throughout the state around childhood obesity treatment and prevention. In 2011, Children s Page 15

18 conducted several focus groups and surveys to gain insights into families knowledge and beliefs about childhood obesity. One critical finding was that parents rely on their healthcare provider as the primary source of information about a child s weight and health. Yet, few parents reported that healthcare providers had engaged in conversations about their child s weight or healthy habits. Further investigation with the healthcare provider community revealed that many providers did not feel comfortable having these difficult conversations and had not been trained to do so. In response, Children s created the Strong4Life Provider program. The goal of the program is to equip providers with patient centered counseling/motivational interviewing skills and tools that promote healthy habits with their patients. Tools include posters, education materials, and a series of healthy habits books for parents to take home. As follow up to the training, Children s offers a maintenance of certification program (MOC) for pediatricians and a series of webinars that review the latest treatment protocols for conditions that often present with obesity (high blood pressure, diabetes, asthma, etc.). To date, Children s has trained more than 2,700 providers throughout the state reaching 105 of Georgia s counties. In collaboration with the Department of Public Health, Children s is currently implementing the Strong4Life Provider program to WIC staff throughout Georgia. Equipping the WIC nutritionists with the same information and tools as primary care providers ensures patients are receiving consistent messages. Initiative Target Audience Trained to date Strong4Life Provider Program: Motivational Interviewing All healthcare providers 2,775 providers Maintenance of Certification Peds 128 Treatment Webinars PCPs 396 S4L Healthy Habits Book Program PCPs 265 S4L Goal Tracker App All healthcare providers In pilot S4L Educational Videos All healthcare providers In development Access to Breastfeeding Support through ZipMilk.org Claire Eden Georgia Breastfeeding Coalition Breastfeeding Coordinator The Georgia Breastfeeding Coalition (GBC) has partnered with ZipMilk is a non-commercial, geographically-based online database of breastfeeding resources made available at no cost to mothers and those working with new families. It was developed by the Massachusetts Breastfeeding Coalition and is Page 16

19 currently utilized by six states including Georgia. It is administered in Georgia by the GBC, and submitted listings are verified before being published as well as at least annually thereafter. Those submitting listings have the option of updating their listing at any time to keep the database current. It also includes six categories of breastfeeding support so that mothers can choose which best suits their needs and healthcare providers can make appropriate referrals. CDC Guide to Breastfeeding Interventions (2014) calls for this type of resource to be made available to families in order to increase breastfeeding initiation, exclusivity, and duration rates. Strategy 3, Access to Professional Support, Action Step 4, states Develop and disseminate a resource directory of local lactation support services available to new mothers. Strategy 1, Maternity Care Practices, Step 5 states Create links between maternity care facilities and community breastfeeding support networks across your state. The GBC chose the ZipMilk project in an effort to assist hospitals in Georgia that were pursuing Baby Friendly Hospital designation through the 5 STAR Program and the NICHQ Best Fed Beginnings Program. Georgia Shape 5 Star Hospital Recognition Program Georgia Department of Public Health Maternal and Child Health Section Hospital initiation of breastfeeding is a primary predictor of many health-related outcomes. The primary drivers of success include policies, staff education, skin-to-skin protocol, lactation support services, and discharge support. Georgia s efforts to improve breastfeeding support programming include training and technical assistance, a 5-day collaborative learning session, monthly webinars, and monthly data collection. In the first year of dissemination, participating Georgia hospitals saw increases across all areas of support services. Nine hospitals across the state are currently engaged in this effort. Page 17

20 DATA COLLECTION AND EVALUATION Health Empowers You Christi Kay President HealthMPowers HealthMPowers was funded by Blue Cross Blue Shield of Georgia Foundation (BCBSGAF) for the school year to increase physical activity in elementary schools using the Coordinated School Physical Activity Program Model, promoted by CDC and SHAPE America. This one year grant provided funding for 39 schools in five school districts (Bibb, Baldwin, Henry, Jones, Monroe) to receive over 20 hours of professional development, technical support, program and curriculum resources, physical activity equipment, tracking devices, and external evaluation services. Evaluation results were compiled by two professors in the Health and Kinesiology Department at Georgia State University. Results indicated the following: Knowledge of important physical activity concepts improved Moderate to vigorous physical activity time in physical education increased Classroom physical activity time increased Before school physical activity programming increased Aerobic capacity scores improved with more students in the healthy fitness zone BMI percentiles improved HealthMPowers is also providing training and evaluation support for the Power Up for 30 initiative. Results from the BCBSGAF work helped guide the training and resource development for Power Up for 30 as well as provide the evidence needed to show that schools can increase physical activity before and during the school day resulting in positive health outcomes for students. Georgia s Elementary School Setting Physical Activity Survey Patricia Cheung MD/PhD Candidate Emory University While the health benefits of physical activity (PA) are well-known and a public health priority, most youth do not meet the recommended 60 minutes of daily PA, of which more than half should occur during regular school hours. Serving more than 95 percemt of US children ages 5-17, the school environment offers a valuable opportunity to engage students in PA throughout the day. The School Setting Physical Activity Survey was developed by HealthMPowers with input from a multidisciplinary team including Emory University, University of Georgia, Georgia State University, University of West Georgia, and the Departments of Public Health and Education. The survey was sent to all 1,320 public elementary schools in Georgia. School Figure 1. Reported frequency of physical activity facilities across Georgia elementary schools. Page 18

21 administrators, physical education teachers, and classroom teachers were surveyed to obtain the most accurate information possible. This survey served three purposes. First, it secured baseline data for tracking the progress and measuring the impact of the Power Up for 30 program. Second, the survey provided individualized data to schools during the Power Up for 30 training for action planning. Finally, it will assess physical activity policies and programs among Georgia elementary public schools. Emory University, along with other university partners, will analyze the survey data at baseline and throughout follow-up to evaluate the impact Power Up for 30 on PA. Figure 2. Recess and physical education frequency and duration across Georgia elementary schools. Page 19 Preliminary analyses from administratorlevel data showed significant disparities by free and reduced lunch rates. Overall, percent of schools offered daily recess. Most reported that recess lasted between minutes (39-46%; Fig. 1). Most students (45-51%) have PE two days per week, with PE most commonly lasting between minutes (71-77%). However, the lowest-income schools had lower recess frequency (times offered per week) and duration (minutes per session). Most schools reported having a gym (98%), field (75%), playground (74%), and blacktop area (56%), but fewer schools reported having a classroom specifically for PE (40%) or a track (26%; Fig. 2). Available facilities also varied by free and reduced lunch rates. Among highest-income schools, the frequency of having a field was 2.2 times higher than the lowest-income schools. Further, the frequency of having a track or a blacktop area was four-times as high among the highest-income schools compared with the lowest-income schools. These data, among others, will allow individualized school data reports to be used during Power Up for 30 training, improve Power Up for 30 implementation, and inform physical activity policies and programs at the school, district, and state levels. Georgia Shape Data and Evaluation Framework Andrew Young Health Policy Center Georgia State University Evaluation within the Georgia Shape framework occurs within the context of a shared stewardship. Multiagency collaboration coupled with private company and foundation support programs facilitate the leveraging of academic research, the creation of resources and technical assistance, and the allocation for training and recognition programs. In , Shape began evaluation efforts by engaging partners to draft evaluation questions, create an evaluation framework, document local/regional/statewide/subgroup activities, record associated measures, update the obesity systems model, and establish measures for context, engagement, health improvement, and policy change. Initial evaluation questions included investigating the progress being made toward specific Shape objectives such as improving student aerobic capacity, increasing the percentage of students being assessed for fitness, improving breastfeeding initiation/duration rates, increasing the number of early care centers receiving the Shape Award, and implementing evidence-based marketing approaches. The collaborators also plan to evaluate how well programs are positioned for sustainability and which strategies are positively impacting equity. A Shape Logic Model visually illustrates how various inputs and activities will produce the desired short- and long-term outcomes.

22 Shape Policy Implementation: Barriers, Facilitators, and Costs College of Public Health The University of Georgia The College of Public Health at the University of Georgia has utilized preliminary analyses of the baseline Power Up for 30 Survey to evaluate several aspects related to school-based physical activity practices across the state. Their findings reveal that on average, Georgia elementary schools participate in 188 minutes of physical activity per week during a combination of physical education, recess, and integrated classroom activity. Rural schools report fewer minutes of physical activity, and five fewer minutes per week were reported for each 10 percent decrease in the percentage of students that receive free/reduced price lunch. Some barriers to providing students with opportunities to be physically active include time, staffing, equipment, space, transportation, and weather while the most common barriers of time, space, and staffing also apply as barriers to conducting the annual FITNESSGRAM assessment. Moving forward, the evaluators propose to assess population awareness of Georgia Shape, school implementation of Shape, and costs associated with implementing Shape. Page 20