How this all began

1. How this all began • ASPHN wrote a letter to Dr. Michael Lu, MCHB Chief • In this letter they requested the MCHB to increase nutrition visibility and services for children and families • Then ASPHN and the MCHB funded Nutrition Training Programs joined forces to begin the discussions on how this could be done.

2. Workgroup held in 2013 That developed a framework for addressing nutrition services under the ACA http://media.mchtraining.net/nutrition/highlights-2014-05/documents/ACA-and-nutrition-summary-2014-02.pdf

3. The Maternal and Child Health Bureau was very interested in the nutrition community pursuing the recommendations in red

4. Example Driver Diagram: Improving Prevention Treatment, Assessment and Treatment in Child/Adolescent Obesity AIM INTERMEDIATE AIMS PRIMARY DRIVERS SECONDARY DRIVERS 100% of the states in the pilot phase of the pediatric obesity CoIIN have improved policy in at least one of the 10 spectrum of opportunities The Pediatric Obesity and Nutrition CoIIN will increase the proportion of children ages 2-5 within a healthy weight range from __% to ___% by December 2015. States will act to insure policies and practices affecting early care and education facilities result in improved nutrition, breastfeeding support, and physical activity; and reduced screen time. Policies and practices that support healthy weight behaviors Clinical and community settings will improve quality messaging (including social marketing) to patients and their families regarding healthy living as a standard practice Consistent messaging improves nutrition and physical activity in children Evidence-based communication strategies Providers will refer and assure transitions of appropriate patients to high-quality, weight management providers to optimize patient care Increased provider referral to trained nutrition providers and increased reimbursement for nutrition services Optimal care coordination practices

5. Policy and System Change Package Change concept:  States will act to insure policies and practices affecting early care and education facilities result in improved nutrition, and physical activity; and reduced screen time and adequate sleep. Key Changes: Teams will implement policy changes and practices in the early care and education (ECE) system in their state that support healthy eating and physical activity behaviors. Everything for this change is on the website www.eceobesityprevention.org. This evidence-based website is an outcome of cooperation between ASPHN and CDC. Specific changes: States could choose to work in any or all three of the areas listed on the next two slides.

6. Area 1: Education • Include obesity prevention strategies in  Pre-service & Professional Development requirements. • Strengthen Technical Assistance requirements related to obesity prevention strategies. • Revise Early Learning Standards to emphasize nutrition, physical activity and screen time. Area 2: Environment • Increase  Child & Adult Care Food Program (CACFP) participation and exposure. • Start a  Quality Rating and Improvement System (QRIS) with nutrition, physical activity and screen time standards. • Use Facility-level Interventions to promote nutrition and physical activity and to limit screen time. • Promote Access to Healthy Environments.

7. Area 3: Policy • Adopt Licensing and Administrative Regulations to promote healthy eating and decrease obesity. • Enhance obesity prevention efforts with Funding and Finance • Family Engagement to support successful implementation of improved policies and practices. Data • Baseline data: • # of policies/practices related to obesity prevention strategies. • Evaluation data: • # of policies/practices related to obesity prevention strategies either drafted or revised. (trying to catch not just new policies but strengthening of existing policies)

8. Commitment required to participate in the CoIIN • Form a team with representatives from each sector of the project Meet at least monthly over webinars and/or teleconference calls for approximately 6 months (funding permitting). • Educational opportunities • Discussions of success and barriers • A face-to-face meeting on June 17, 2015

9. Budget • Will cover the cost of your team traveling to the face-to-face meeting. • All other costs will come from the state. This includes personnel costs to attend meetings and costs associated with implementing any changes at the state level. • ASPHN is working to find funds to cover minimal expenses for in-state team work.

10. Application Process • An “Intent to Apply”must be received by 5 PM Eastern Time on January 30, 2015. • Submit the “Intent to Apply” via email to Sandy Perkins at Sandy@ASPHN.org. • Answer the question, “Which one of the three strategies would your state team choose to address first?”

11. Application Process • A Technical Assistance webinar will be held on February 6, 2015 to address questions pertaining to the application process. • Webinar details will be sent to States who submit an “Intent to Apply.” • Please send any questions in advance to Sandy@ASPHN.org.

12. Application Process • A completed “Application” must be received by 5 PM Eastern Time on February 20, 2015 • Submit the “Application” via email to Sandy Perkins at Sandy@ASPHN.org. • Acceptance notifications will be sent by March 6, 2015.

13. Questions