But, it’s just a cupcake…

1. But, it’s just a cupcake… Childhood Obesity and Community Collaboration Pat Caulkins, RN, BSN, MS Augusta Health WOW Children/Youth Program

2. Objectives • To connect the health issues of childhood obesity with the educational issues of academic success • To understand community collaboration as a tool for achieving mutual goals with limited resources • To find creative ways to increase the chance for a child to succeed without increasing your stress

3. My job is to: • Make sure you know what you are eating • Make sure you know the consequences & the resources Your job as an individual is to: • Make sure you know what is best for your health • Make the right decision most of the time

4. Where is the joy?

5. Now heart health will be personal…everyone stand • Sit down if you smoke • Sit down if you have uncontrolled high blood pressure • Sit down if you haven’t had your cholesterol checked in the last year • Sit down if you don’t have a regular exercise program of moderate to vigorous exercise for at least 2-3 times per week

6. More healthy heart risks… • Sit down if you are more than 20% above your ideal body weight • Sit down if you don’t have enough healthy coping mechanisms in place to deal with the stress in your life • Sit down if you’ve eaten anything fried in the last 2 days • Sit down if you haven’t had any fruit in the last 2 days • Sit down if you haven’t had any fish in the last 3 days • Sit down if you didn’t eat breakfast

7. We love our children! Yet, we reward them with unhealthy things: pizza parties, doughnuts for dads, candy jars & cupcakes – we would never think of rewarding them with a cigarette!

8. Did you know? 60% of overweight 5-10 year olds have at least one risk factor for heart disease 20% have at least two risk factors (high cholesterol, high blood pressure, elevated insulin)

9. It’s all about the health • Diabetes • High Blood Pressure • High Cholesterol • Heart Disease • Bone and Joint Problems • Worsening of Asthma • Sleep Apnea • Social and Emotional Problems • Teasing • Viewing themselves as unworthy • More likely to be bullied • More likely to bully • Being left out

10. If it’s all about the health, you might know, but why should you care… • since it’s not the school’s fault. • if schools are for education, not for medical care. • …because, after all, it’s just a cupcake.

11. What is health? • Physical & mental wellbeing • Freedom from disease, pain or defect • Normalcy of physical & mental functions • Soundness • Being able to do what you want to be able to do – the capacity to do the things that matter to you

12. Whole Child Tenets “Each student enters school healthy and learns about and practices a healthy lifestyle” Association for Supervision & Curriculum Development

13. Is it in your best interest? “But schools cannot be expected to take steps to address these issues unless it is in their interest to do so.” Action for Healthy Kids

14. But, I have the best curriculum! “…Even the best teacher armed with the most interesting curriculum cannot reach a student who is absent due to asthma, distracted by a toothache, or preoccupied with fears of violence.” Dr. Gregory Austin, The California Education Supports Project

15. Breakfast… “Increased participation in breakfast programs is associated with increased academic test scores, improved daily attendance, and better class participation, and has also been shown to reduce tardiness.” Action for Healthy Kids

16. Physical Activity… • “A single 20-minute, moderately intensive walk led to improved accuracy, memory, and attention one hour later. It also improved reading comprehension.” • “Adding an hour of physical education to the school day allows students to get an equal amount of work done – despite the break from classroom learning.” “Of brawn and brain”, Carol Lloyd, www.greatschools.org

17. Economic costs… “A single-day absence can cost a district between $9-$20 per student. One study found that severely overweight students miss one day per month or nine days per year…the extrapolation shows a potential loss of state aid of $95,000 per year in an average-sized school district in Texas.” Action for Healthy Kids

18. Who’s fault is this? School lunches are to blame… Actually, only 16% of meals that a child consumes in a year are school lunches

19. Causes of Childhood Obesity Calories in vs. Calories out

20. New additional thoughts… • Genes, metabolism, behavior, environment, culture, socioeconomic status • Ghrelin, leptin, insulin resistance, glucocorticoids; highly palatable foods; potent, chemical compounds not seen in nature; marketing • The foods we eat, our physical activity level, emotional issues, stress levels, family dynamics, finances and societal influences…

21. Children learn in three environments Home Community School

22. Opportunities for Prevention • Individual Healthy Choices & Healthy Home Environments including Physical Activity and Television and Computer Use • Creating Healthy Child Care Settings • Creating Healthy Schools • Creating Healthy Work Sites • Mobilizing the Medical Community • Improving Our Communities The Surgeon General’s Vision for a Healthy and Fit Nation, January 2010

23. Other Initiatives… • “Let’s Move” • Weight of the State • American Academy of Pediatrics • Institute of Medicine • Action for Healthy Kids • Alliance for a Healthier Generation

24. Healthy Nutrition – Mixed Message The only subject taught in the classroom that we don’t expect students to practice.

25. Why aren’t we making changes? Photo taken from The Heart and Stroke Foundation of Canada

26. First, you have to believe! Believe that wellness is important to the child’s present and future success as a student and a citizen. It’s not something you add to your job, it’s something you believe and incorporate into your job.

27. So…if we believe it, why can’t we do it? • It is unpleasant • It is overwhelming

28. Community Collaboration Successful and fun collaborations are the perfect answer to times of “economic downturn” – not so overwhelming, not so unpleasant

29. Body Mass Index-for-age • Pilot in 2004/05 with 6 elementary schools in Augusta County • Modeled after Chesterfield County • Collaboration with School Nurses • Staunton, Waynesboro & Augusta County – 33 schools, 4 grades, 4400 students • Locally - 21% obese, 16% overweight

30. Families, Food & Fun • After school program for parents and students • Collaboration among Virginia Cooperative Extension, the Blue Ridge Area Food Bank, the school and Augusta Health • Healthy nutrition and physical activity on a budget

31. Family Fitness Nights • Physical activity with a non-competitive focus for families • Collaborative effort among the school, the Waynesboro & Staunton YMCAs, the Staunton Department of Parks & Rec, and Augusta Health

32. Shared Dietitian • Collaborative effort among Augusta County, Waynesboro & Staunton School divisions & Augusta Health • Monthly meetings with the shared dietitian, the WOW Children/Youth Coordinator and the 3 School Nutrition Services managers • Nutrikids, local produce/beef, POS, regional staff development

33. Physical Education • Collaboration among our 3 school divisions and Augusta Health • Regional staff development • Grant from Augusta Health Foundation for equipment to support FitnessGram • Curriculum revision

34. Other Examples • RPPS (Regional Partners for Prevention Services) • Community Health Forum • Physician Offices – Nutrition Packets • Counseling Packets (guidance, PE, nurses) • School Health Advisory Boards • Healthy Fundraising

35. THE “HOW” – from Cupcakes to Swiss Cheese The Swiss Cheese Method of Time Management! How to Get Control of Your Time & Your Life By Alan Lakein

36. Time Management Principles • Time is life • Think about how you use your time so you can work smarter, not harder; do more of the things you want to do; & enjoy life more • Be more effective, not more efficient • Know how you function best

37. Poke some holes in it… • Get started as soon as you have identified it as an “A” priority or a task of high value • Turn something overwhelming into Swiss Cheese by poking some holes in it with instant tasks • Instant tasks require 5 minutes or less of your time • Do a leading task

38. Possible Swiss Cheese Holesfor Weekly Wellness Messages • Get a folder out and label it • Decide how to send messages – email, morning announcements, newsletters • Search one website for nutrition tips • Come up with a title • Get permission from your administrator • Count how many messages you will need for the school year

39. Pyramid People Bingo

40. Best Quick Wellness Strategy… Model the behavior! • No Cokes on your desk • No candy for rewards • Walk before or after school • Practice what you preach – at least at school

41. Overwhelmed? Swiss Cheese still works! • Can you close your office for 30 minutes a day? • Can you close your office for 30 minutes a week? • Can you come in 10 minutes early? • Don’t stay late/don’t take work home • Do think outside the box!

42. Identify who can help • Who has the fire or passion for good health? • Who runs marathons or eats organic foods? • Who has made lifestyle changes for the better? • Who has resources? • Who has a stake in the wellness world at school? Don’t forget the students

43. Identify resources • Explore one internet resource at a time • The amount of information can be overwhelming • Don’t reinvent the wheel

44. Identify community resources • YMCA • Department of Parks and Recreation • Boys and Girls Club • Food Banks • Virginia Cooperative Extension • Universities • Hospitals

45. Identify school resources • Maintenance • Art Departments • Librarian • Reading Resources • Computer Specialist • Physical Educators • Cafeteria Managers • School Nurses, Counselors, Psychologists

46. Identify who has the power to get things done • What is the chain of command? • How formal is your administration? • How powerful is you parent organization? • How respected is your position? • Who do you need on your committee to lend it credibility with administration? • Who can be trusted with delegated tasks?

47. Identify who has money • Community Foundations • Local Hospital • Grants • Shared Programs • Wal-Mart, Home Depot, Target, etc.

48. Decide on when and where • Make one phone call • Reserve a room • Get one email address • Look up one phone number • Compose one email

49. Now that you know how to poke holes… Some Tips from Experience • Decide who needs to know first • Decide who needs buy in • Decide when to push, pull or step back • Don’t get frustrated – you are trying to change a culture! We call it organized chaos…

50. In Conclusion, wellness - • Believe it • Think it • Model it • Do it • Love it – for yourself, as well as for the children!