Obesity Prevention and Control Branch

1. Applications of the CDC – National Park Service Healthy Foods Evaluation for State and Local Parks Obesity Prevention and Control Branch Division of Nutrition, Physical Activity and Obesity LCDR Alyson B. Goodman, MD, MPH EIS Officer, Division of Nutrition, Physical Activity & Obesity January 12, 2012

2. Healthy Parks Healthy People US Initiative In April 2011, National Park Service (NPS) Director announced service-wide Healthy Foods Strategy to provide healthy food options for all 280 million national park visitors annually Collaborate with CDC to conduct a baseline assessment of food environment in national parks Develop & implement health and sustainability guidelines for concessions contracts Track effect of health promotion messaging and access to healthy foods over time so NPS can make informed decisions Serve as a model for state and local parks & other open spaces OVERVIEW

3. CDC – NPS Nutrition Environment Collaboration • CDC Lead: LCDRAlyson Goodman, MD, MPH • CDC Supervisor: CAPT Heidi Blanck, PhD • NPS Office of Public Health: CDR David Wong, MD, MPH • NPS Chief of Concessions: Kurt Rausch

4. May Pilot (Epi-Aid) • Pilot of survey tools adapted from NEMS • NEMS = Nutrition environment measures surveys • Validated instruments for objectively assessing access, pricing & promotion of healthy/unhealthy foods • 11 national parks in Southwest US • Dissemination: • APHA poster presentation • White House Summit on Healthy Foods in Parks

5. May Pilot Results:Beverage Vending “Healthier” Vending Machine = Proportion of sugar drinks <50% In this sample, 7 out of 41 (17%) Derived Variables Healthy drink: Water, milk, 100% juice Diet drink: artificially-sweetened soda, tea, water, energy or sports drink Sugar drink: sugar-sweetened soda, tea, water, energy or sports drink

6. May Pilot Results – Restaurants

7. May Pilot Results – Kids Menus

8. Mean price per ounce of drinks sold in 17 NPS stores at 11 pilot national parks, May 2011

9. September Field Investigation • Nationally-representative sample of parks • 50 parks chosen based on: • # annual visitors • Region • Urban/rural • Type of concessioners • Identified 33 individuals to survey 50 parks in 35 states • EISOs (3 headquarters and 14 state-based) - 17 • DNPAO, NPS, state/local health department staff & partners - 15 • CDC Experience Fellow – 1 • Training • NEMS website • 90 minute webinar

10. National Parks Survey in September National Park (n=395) Surveyed (n=49) Alaska: Glacier Bay, Denali

11. September Results:Beverage Vending “Healthier” Vending Machine = Proportion of sugar drinks <50% In this sample, 29 out of 83 (35%) Derived Variables Healthy drink: Water, milk, 100% juice Diet drink: artificially-sweetened soda, tea, water, energy or sports drink Sugar drink: sugar-sweetened soda, tea, water, energy or sports drink DRAFT: Analysis ongoing

12. September Results – Kids Menus DRAFT: Analysis ongoing

13. Assessment Tools • Standardized with protocols • 5 modules: • Restaurants • Snack Shops • Vending Machines • Beverage • Foods • Stores • Grocery • Convenience • Water

14. Assessment Tools – Beverage Vending

15. Assessment Tools – Snack Shops

16. Android Phone Application

20. Epi-Info 7/Android Data

21. Healthy Parks Healthy People US Initiative In April 2011, National Park Service (NPS) Director announced service-wide Healthy Foods Strategy to provide healthy food options for all 280 million national park visitors annually Collaborate with CDC to conduct a baseline assessment of food environment in national parks Develop & implement health and sustainability guidelines for concessions contracts Track effect of health promotion messaging and access to healthy foods over time so NPS can make informed decisions Serve as a model for state and local parks & other open spaces OVERVIEW

22. Study Applications • Dissemination of results/lessons learned from the CDC – NPS assessments & experience • Adaptation of tools for state/local parks, recreation areas & public open spaces • Pilot in 2012 • Tools planned to be available online for partners in summer 2012

23. Please contact me with: Current health promotion work in state/local parks, recreation areas or public open spaces Interest in piloting/applying assessment tools LCDR Alyson B. Goodman, MD, MPH 770-488-5105 agoodman@cdc.gov Division of Nutrition, Physical Activity and Obesity Obesity Prevention and Control Branch

24. Partnering with State Parks Ruth Coleman Director California State Parks President National Association of State Park Directors

25. Continuum of Park Agencies Federal State Regional County City District

28. Concession Language • Network of farmers • Healthy Foods • No sugar-added beverages • Interpretive materials and demos • Food and quality of life • Cooking demos

29. Market Driven Initiatives

30. National Efforts

33. California State Parks

34. Track Trails • Promote Play in Natural Areas • Highlight existing trails • Bring in new users • Self guided program – brochures and signs

35. Contact For More Information contact: Nina Gordon Senior Policy Coordinator California State Parks ngordon@parks.ca.gov (916) 653-9377