Healthy Food Choices

Healthy Food Choices

By: Kara Derry, Nichole Kraai, Jessica Olcheske, Nicole Towns, & William

Winowiecki

U.S. Statistics● 31.8% of children and adolescents 2-19 years were either overweight or

obese● 70 to 80 percent of overweight children become obese adults● More than 25 percent of all U.S. health care costs are related to obesity

and inactivity● Between 1979 and 1999, obesity-associated hospital costs for children

tripled from $35 million to $127 million

● Empty calories from added sugars and solid fats contribute to 40% of daily calories for children and adolescents aged 2–18 years ○ Nearly half of these empty calories come from six sources: Soda, fruit

drinks, dairy desserts, grain desserts, pizza, and whole milk

(Ogden, Carroll. Kit, & Flegal, 2012)

(Center for Disease Control and Prevention [CDC], 2013)

(Healthy Kids, Healthy Michigan [HKHM], n.d.)

U. S. Statistics● Adolescents drink more full-calorie soda per day than milk

○ Males ages 12–19 drink more than twice as much soda as milk

○ Females drink on average 2 and ½ times soda than milk

● Obese children ages 6–11 in the U. S. increased from 7% in 1980 to nearly 18% in 2010.

● Obese adolescents ages 12–19 in the U.S. increased from 5% to 18% over the same period

● In 2010, more than one third of children and adolescents were overweight or obese

(CDC, 2013)

(HKHM, n.d.)

Michigan Statistics18.2 percent of Michigan youth ages 10-17 are overweight and 12.4 percent are considered obese, compared to the U.S. percentage of 15.3 overweight and 16.4 obese.

(Healthy Kids Healthy Michigan, 2007)

Kent County StatisticsAccording to Kent County Health Connect (2013), the following statistics stand true for Kent County

• 29% of adults are obese• 34% of youth report eating healthy or balanced

meals• 19,200 people do not have access to a grocery

store or fresh produce

(Kent County Health Connect [KCHC], 2013)

Community Problem DiagnosisAccording to Michigan Public Institute (2011), access to healthy food has a national benchmark of 92% and Kent County is at 89%. With that being said, we would like children ages 18 and under in Kent County to have access to healthier foods with an overall goal to meet the national benchmark of 92%.

Our vision is that we want the children of Kent County to live a healthier lifestyle.

(Michigan Public Health Institute [MPHI], 2011)

Current Kent County Resources

Kent County Coordinated School Health Program (KCCSHP)

● Works with income-eligible schools in promoting healthy behaviors of students

● Helps schools assess nutrition and physical activity● Supply access to community resources and implement plan of

action

Action for Healthy Kids (MAFHK)• Non-profit org fighting against childhood obesity by partnering with

schools to improve nutrition and physical activity

• Offer education series to elementary, middle and high school children

(Access Kent, 2013)

Community Strengths● Strengths include having resources already available in the

community and in place like KCCSHP and MAFHK

● Noticing that changes need to be made and taking the steps to do it

● Having information available on accesskent.com under school wellness, which includes contact information

● Having access to healthy foods at local farmers markets for families to shop at

(Access Kent, 2013)

Community Barriers/ Unmodifiable Factors

• According to MPHI (2011),

• Lack of healthy food resources

• Where resources are available they are often very expensive

o As many as one fifth of children in Kent County live in poverty

• Lack of options for people with dietary restrictions

• Health foods are not always available in schools

o Vending machines

• Convenience and abundance of fast foods chains with affordable prices

(MPHI, 2011)

Causative/ Modifiable Risks or Factors

• Eating healthy helps reduce the risk of obesity which can reduce the risk of many other diseases

• Insufficient nutrition can weaken the immune system • Children from birth to age 5 are at risk for nutrition deprivation

o Inhibit their ability to learn, grow and fight infections

A second indicator of access to healthy foods is ‘food insecurity.’ Food insecurity is calculated based on responses to a population survey conducted by the US Census. The rate is made up of three questions, including 1) are you worried your food will run out before you have money to buy more, 2) if the food you bought doesn’t last, do you have money to buy more, and 3) can you afford to eat balanced meals. The food insecurity rate for Kent County is 15% overall, but households with children in Kent County experience a much higher food insecurity rate of 23%. (MPHI, 2011)

Social Learning TheoryAccording to Harkness and DeMarco (2012) a social learning theory,

is a behavior change approach affected by environmental influences, personal factors, and attributes of the behavior itself. Most importantly, a person must believe in his/her capability to perform the behavior (self-efficacy) as well as perceive an incentive to do so (positive expectations outweigh the negative). The immediate or long-term benefits must be valued" p. 78

• Explains some of the factors that contribute to the failure for Kent County to meet the national benchmark

• Explains how we can provide intervention to help kids make healthier food choices

Role of th Public Health Nurse• There are approximately 12 roles and obligations that public nurses must

followo Awareness, recognizing multiple social determinants of healtho Capitalizing on community strengthso Leadership o Achieving cultural competence o Assessment population diagnosis and priority settingo Partnering with others o Creating environment for careo Advocacyo Educating current and future nurses in the public nursing work forceo Creating public and agency policies that support and celebrate

diversityo Evaluation and research

We would need our public health nurse to display these characteristics as they would be facilitating the interventions and measuring outcomes.

(Schmelzer et al., 2009)

InterventionsCollaborate with other agencies by Incorporating Foodcorps in Kent County Schools

• Foodcorps provides education and interventions to help provide better access to healthy foods across the county and locally with the help of The Michigan State Universities Center for Regional Food Systems

• Foodcorps objectiveso Teach children about locally grown foodso Help them plant and grow gardenso Make local healthy foods available in school cafeterias

(Foodcorps, 2011)

InterventionsThe USDA has a set of standards for schools

• Whole grain rich foods and a first ingredient which may include a fruit, vegetable, dairy product or protein

• Snack options must have less than 200 calories • Entrée items must have less than 350 calories• Must sell plain water, unflavored low fat milk, and

unflavored fat free milk • 100 percent fruit or vegetable juice

School-based health programs are effective to reduce adolescent obesity

(Eisenberg, 2013) (United States Department of Argriculture [USDA], 2013)

InterventionsW.K. Kellogg Foundation reaches out to communities and help those that are in need.

• Foundation is funded by grants and donations• Establish access to fresh, healthy foods• Increases community engagement to encourage

consumption of local foods

(W.K. Kellogg, 2013)

InterventionsCafeteria will offer taste testing of new healthy recipes of foods.Many fresh fruits and vegetables, whole grains, and beans are unfamiliar to children and adults, so they need to be given opportunities to sample the foods. Taste-testing and cooking demonstrations in the classroom, at school assemblies, or even in the lunch line can be a fun marketing approach to introducing students to healthy foods that may be unfamiliar to them.” (Gibbons, 2009, p.28 )

Cafeterias will make healthier options cheaper than unhealthy ones. For students who are sent with money each day, they will get a bigger bang for their buck if they choose healthier options.

Desired Outcomes1. 92% of the children that participated in Foodcorps can name one healthy food grown locally that they liked the taste of

2. Schools will have a minimum of 75 percent compliance with the new standards set by the USDA by 2014. Then in 2015 they should have 100 percent compliance with these standards

3. Every time a new healthy option is introduced it will be offered as a sample 100 percent of the time before serving to see if students will comply with eating these healthier choices

4. Kent County will increase the percentage of those with access to healthy foods by 3% in the next five years in order to meet the current national benchmark. That would bring Kent County from 89% to 92%

Outcome Measures/ Evaluation

Outcome 1: The school will offer an annual survey to the children.

Outcome 2: A daily audit will be completed by the cafeteria workers. The school will calculate and submit their results annually.

Outcome 3: The school will complete a monthly audit. The school will collect data and submit results annually.

Outcome Measures/ Evaluation

Outcome 4: In order to measure access of healthy foods for Kent County to meet the national benchmark, we will mimic the process used to obtain the current result. Four years after full implementation of our interventions we will start a one year process of data collection to identify if we have met our goal of 92% access to healthy foods.

• 4 Community Input Walls (January, April, July, October)• 12 Focus Groups (1 meeting the first week of each month with 10 different

members of the community)• 365 Intercept Interviews conducted by trained community members (one per

day)

Social Learning TheoryIn changing the environment in the school system to support healthy eating, children will start to change behaviors. Through education the students will improve in their self-efficacy.

This theory works full circle. The same factors that can contribute to unhealthy food choices can turn around and support children to make healthy choices with the right interventions.

ReferencesAccess Kent. (2013). School wellness. Retrieved from www.accesskent.com

Center for disease Control and Prevention. (2013). Retrieved from http://www.cdc.gov/

Healthy Kids Healthy Michigan. (2007). Childhood obesity epidemic in michigan. Retrieved from http://www.healthykidshealthymich.com/childhood-obesity-facts-and-statistics.html

DeMartini, D.L., Beck, A.F., Kahn, R.S., & Klein, M.D. (2013). Food insecure families: Description of access and barriers to food from one pediatric primary care center. Journal of Community Health. doi: 10.1007/s10900-013-9731-8.

Downtown Market. (n.d.). Retrieved from http://downtownmarketgr.com/

Eisenberb, J. (2013). Childhood obesity prevention programs: Comparative effectiveness. Agency for Healthcare Research and Quality, 13.

Foodcorps. (2011). Retrieved October 7, 2013 from https://foodcorps.org/

Fulton Street Farmers Market. (n.d.). Retrieved From http://fultonstreetmarket.org/history/market-facts/

Gibbons, H.W. (2009). Marketing Healthy Choices in the School Cafeteria. Retrieved on October 12, 2013 from http://www.kchealthykids.org/Resource_/ResourceArticle/33/ File/MarketingHealthyFoods.pdf.

ReferencesHarkness, G., DeMarco, R., (2012) Community and Public Health Nursing Practice: Evidence for Practice.

Wolters Kluwer/Lippincott, Williams & Wilkins: Philadelphia

Healthy Kids, Healthy Michigan. (n.d.). Retrieved from http://www.healthykidshealthymich.com/

Kent County Health Connect. (2013). Retrieved from http://www.kentcountyhealthconnect.org/en-us/healthyeatingactiveliving.aspx

Michigan Farmers Market Association. (2012). Retrieved from http://mifma.org/find-a-farmers-market/

Michigan Public Health Institute. (2011). Kent County: 2011 health needs assessment and health profile. Retrieved from http://www.kentcountychna.org/pdfs/healthprofile.pdf

Ogden, C., Carroll, M., Kit, B., & Flegal, K. (2012). Prevalence of obesity and trend in body mass index among S.S. children and adolescence 1999-2010. Journal of American Medical Association, 305(5), pp. 483-490. doi: 10.1001/jama.2012.40

Schmelzer, M., Cravetz, M., LaRosa, G., Fischer, N., Smith, F., Garvey, . (2009). The public health nurse’s role in achieving health equity: Elementary inequalities in health. New Mexico Nurse, 54(4), 6

United States Department of Agriculture [USDA]. (2013). Retrieved from http://www.usda.gov/wps/portal/usda/usdahome

W. K. Kellogg Foundation. (n.d.). Michigan. Retrieved from http://www.wkkf.org/where-we-work/united-states/michigan.aspx#2