Steps to a Healthier Arizona

Drummond, Rebecca; Staten, Lisa K.; Sanford, Mary Reyes; Davidson, Christopher L.; Ciocazan, Maria Magda; Khor, Kai Ning; Kaplan, Frances F.

doi:10.1177/1524839908331267

Cited by 33 publications

(36 citation statements)

References 2 publications

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“…The program has been used by a number of states [32] and incorporated into the U.S. public health campaign Let’s Move [33]. The program was initially pilot-tested by trained nurse child care health consultants (CCHCs) in North Carolina in a randomized, controlled study [16].…”

Section: Introductionmentioning

confidence: 99%

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

et al. 2014

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BackgroundTo address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children’s body mass index (BMI).MethodsA seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center’s written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children’s nutritional intake, physical activity, and height and weight pre- and post-intervention.ResultsHierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers’ and parents’ knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children’s zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points.ConclusionsThe NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic.Trial registrationNational Clinical Trials Number NCT01921842

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Section: Introductionmentioning

confidence: 99%

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

et al. 2014

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“…As CDC continues to fund communities to do this work, the evidence base for these types of strategies will grow. Although CDC has supported publications that document some Steps communities' successes and lessons learned (30-34), more reports in the scientific literature are needed.…”

Section: Resultsmentioning

confidence: 99%

The Evolution of the Steps Program, 2003-2010: Transforming the Federal Public Health Practice of Chronic Disease Prevention

Nichols¹,

Ussery-Hall²,

Griffin-Blake³

et al. 2012

Prev. Chronic. Dis.

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The Steps program, formerly known as Steps to a HealthierUS, was the first Centers for Disease Control and Prevention (CDC) program to support a community-based, integrated approach to chronic disease prevention. Steps interventions addressed both diseases and risk factors, focusing on the 3 leading causes of preventable deaths in the United States — tobacco use, poor nutrition, and physical inactivity — and the associated chronic conditions of asthma, diabetes, and obesity. When Steps shifted from interventions focused on individual health-risk behaviors to the implementation of policy, systems, and environmental changes, the program became an integral part of changing the way CDC addressed chronic disease prevention. In this article, we describe the shift in intervention strategies that occurred among Steps communities, the model that was developed as Steps evolved, common interventions implemented before and after the shift in approach, challenges experienced by Steps communities, and CDC programs that were modeled after Steps.

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“…Although assessment and development, implementation, and evaluation of action plans toward making environmental change are fundamental for interventions and projects 32,36,37,38 that engage collaborative partnerships, these have not traditionally been part of NE’s jobs. These tasks were found to be less feasible without targeted funding and to demand more readiness and commitment from partners, 35,39 elements that NE often reported to be lacking.…”

Section: Discussionmentioning

confidence: 99%

“…making recommendations and providing information related to promoting environmental changes to their partners across agencies and settings. Since NE frequently networked with agencies for recruitment purposes, they could capitalize on these opportunities to share expertise with others on ways to improve food and physical activity environments, thereby increasing the capacity of community-based practitioners 32,37 to prevention obesity. In essence, exchanging professional expertise is a form of education among leaders and practitioners in the community to enhance collective capacity and consequent collaboration to change the environment.…”

Section: Implications For Research and Practicementioning

confidence: 99%

Development and Application of a Framework to Assess Community Nutritionists' Use of Environmental Strategies to Prevent Obesity

Dickin

Dollahite

2014

Journal of Nutrition Education and Behavior

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Objective To develop and apply a framework exploring the extent of involvement in promoting environmental changes to prevent obesity by a group of nutrition educators (NE) Design Cross-sectional, mixed methods: qualitative interviews informed framework development; survey applied framework to describe NE’s involvement in environmental changes. Setting Cooperative Extension in New York State Participants Interviewees (n=7) selected to vary in environmental change activities and rural/urban location. Survey response rate was 100% (n=58). Phenomenon of Interest/Variables Measured Dimensions and degree of NE’s involvement in promoting environmental change. Analysis Thematic analysis of qualitative data, triangulated with descriptive analyses of NE’s performance of tasks in various settings. Results NE’s promotion of environmental changes was characterized using framework based on settings and tasks, dimensions that emerged from qualitative analysis. NE’s actions varied across these dimensions and ranged from low to high intensity of collaboration and leadership for environmental change. Most NE surveyed reported actions limited to providing information and recommendations on healthy eating and physical activity. Few reported intensive engagement in developing, implementing, and evaluating plans to change environments for obesity prevention. Conclusions and Implications Framework identifies the levels of engagement in promoting environmental changes and supports future research and practice of community nutrition professionals by providing a roadmap for assessing their involvement on multiple levels to prevent obesity.

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Steps to a Healthier Arizona

Cited by 33 publications

References 2 publications

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

The Evolution of the Steps Program, 2003-2010: Transforming the Federal Public Health Practice of Chronic Disease Prevention

Development and Application of a Framework to Assess Community Nutritionists' Use of Environmental Strategies to Prevent Obesity

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