advocacy | education | development

Community Action on Obesity A Charlottesville-Albemarle Taskforce

STRATEGIC PLAN (2012-2017)

Childcare

Workplace

Healthcare

Government

Schools:PhysicalActivity

After-School

Community:Nutrition

Community:PhysicalActivity

Schools:Nutrition

CAO

Second printing, November 2011

Community Action on Obesity

Website: www.communityactiononobesity.org

Mailing Address: 703 Concord Avenue Charlottesville VA 22903

 

  1

COMMUNITY ACTION ON OBESITY (CAO) STRATEGIC PLAN

ACKNOWLEDGEMENTS 3

EXECUTIVE SUMMARY 4

STATEMENT OF THE PROBLEM 5 Obesity is an Epidemic 5 Robert Wood Johnson Foundation Report 6 Prevalence of the Problem and Reversing the Trend 7

VISION 10

MISSION STATEMENT 10

HISTORY OF THE TASKFORCE 11 Formation of the Taskforce 11 Taskforce Membership 11 Evolution of Focus and Name 12 Assessment: 1999-2001 12 Awareness and Capacity Building: 2002-2006 12 Piloting Models and Messages in the Community to Address Overweight and Obesity: 2007-2008 13 Community Health Assessment & Review: 2008-2011 14 Strategic Planning Process 15 Strategic Planning Interviews 15

TASKFORCE STRUCTURE AND SUSTAINABILITY 16 Organizational Structure 16 Advisory Board Development 16 Fiscal Management and Sustainability 17 Community Action on Obesity Strategic Plan 18

STRATEGIC ACTION PLAN 19 Focus Area I - Childcare 19 Focus Area Ii - Schools: Nutrition 22 Focus Area Iii - Schools: Physical Activity 25 Focus Area Iv - After-School Programs 28 Focus Area V - Community Food 31 Focus Area Vi - Community Physical Activity 34 Focus Area Vii - Workplace 37 Focus Area Viii - Government 40 Focus Area Ix - Healthcare 43

A CALL TO ACTION 46

  2

COMMUNITY ACTION ON OBESITY

CAO

A Charlottesville-Albemarle County Taskforce

STRATEGIC PLAN (2012-2017) The CAO Steering Committee facilitated the Community Action on Obesity Strategic Plan Barbara Yager, CAO Co-Chair Joyce Green Pastors, CAO Co-Chair Megan Liddle Gude, Administrative Coordinator Judy Berger Alicia Cost Emily Erwin-Wampler Lynda Fanning Jessica Maslaney Erica Sims-Goode Judy Smith Diane Whaley September 2011 Charlottesville, Virginia Kate McIntire, Strategic Planner

  3

ACKNOWLEDGEMENTS Special thanks to the Community Leaders, Healthcare Providers, and School Leaders whose interviews contributed to this plan. Community Leaders

Bob Andoga Gretchen Ellis Sibley Johns Nancy O’Brien James Pierce Judy Smith

Healthcare Providers Dyan Aretakis

Barrie Carveth Susan Cluett Angie Hasemann Jacklene Martin Nancy McLaren Jim Ogan Heather Payne Peggy Brown Paviour Lillian Peake Rita Smith Erika Viccellio Sue Winslow Paul Wisman Anne Wolfe Chris Worsham

School Leaders

Minda Barnett Diane Behrens Jim Henderson

Vicki King Christina Pitsenberger Barbara Rosen Sandra Vasquez

  4

EXECUTIVE SUMMARY

This five-year strategic plan presents background information on the epidemic of obesity in America as it applies to the Charlottesville and Albemarle County area, and as it relates to the formation of a Community Action on Obesity (CAO) taskforce to address the problem. It also outlines the CAO goals and objectives, the research, assessment, and interviews that were conducted in the community to form those goals, and, lastly, identifies strategies and action steps critical to the implementation of the CAO Strategic Plan.

The Community Action on Obesity…a Charlottesville-Albemarle Taskforce…is a 12-year-old Coalition of public agencies and private partners with a vision to create a supportive community that fosters healthy weight and overall fitness for all citizens of our community. Special emphasis is given to children and their families and residents who are lower-income or disadvantaged. This strategic plan represents the voices of the community. It is built upon a thorough analysis of needs, with stakeholder input, and is designed to attain community goals by identifying strategic actions to be undertaken by persons invested in improving the outcome of reducing obesity in the future. The plan covers a five-year time frame and is organized around nine community environments and focus areas: § Childcare § Schools: Nutrition § Schools: Physical Activity § After-School Programs § Community Food § Community Physical Activity § Workplace § Government § Healthcare

The strategic plan is important for a number of reasons. First and foremost, it is a public declaration of nutrition and physical activity standards important to the health of the community. Second, it is a statement of the principles for which the Community Action on Obesity stands and the vision that guides our work. Third, it is a statement of accountability. We are declaring what we consider to be the strategic priorities to achieve a reduction in obesity for our community, and we are establishing targets for improvement. Fourth, we expect that the goals, objectives and strategic actions set forth in this plan will provide direction for the future and will be revised as needed.

  5

STATEMENT OF THE PROBLEM

Obesity is an Epidemic

Overweight and obesity have become a problem of epic proportions and is one of the most critical public health threats for Americans. This epidemic has affected all age groups, boys and girls, men and women, and reached across racial, ethnic and socioeconomic groups. Obesity rates increased slightly during the 1970's, but escalated for both children and adults during the 1980's and 1990's. While the rate of increase may be slowing among adults, there are no signs that the epidemic of childhood obesity is abating. In fact, overweight and obesity are increasing problems in young children, setting the stage for the obesity epidemic to continue far into the future.

While many epidemics can be defeated with a pill or a vaccine, obesity requires changes in behavior as well as access to affordable, nutritious foods and opportunities for physical activity in the places where people live, learn, eat, shop, work and play. Obesity and overweight are currently the second leading preventable cause of death in the United States; they may soon overtake tobacco as the leading cause. Failing to win the battle against obesity will mean premature death and disability for an increasingly large segment of the Charlottesville and Albemarle population. Without strong action to reverse the obesity epidemic, for the first time in our history, children may face a shorter lifespan than their parents.

The latest research shows that the environments we live in and the public policies our leaders enact directly impact the foods our children eat and how much activity they get. When schools have healthy foods and beverages in their cafeterias and vending machines, students eat better. When communities have parks and bike trails in their neighborhoods and vigorous physical education programs in their schools, children are more active. When neighborhoods have supermarkets and farmers’ markets that sell affordable healthy foods, families eat more nutritiously. But when communities are dominated by fast food, with few places to play, our children eat worse foods and are less active, and their health suffers. And we all pay a price—in higher health care costs and lost economic productivity. Efforts to change public policies, community environments to promote improved nutrition, and increased physical activity are critical to reversing the obesity epidemic and are the focus of CAO. All of our citizens deserve to live, learn, work and play in communities that support and encourage healthy eating and active living.

Experts have predicted that the root causes of the obesity epidemic—poor nutrition and physical inactivity—will become the leading underlying causes of preventable deaths in the United States. The financial and personal costs associated with obesity are also increasing, in part because obesity leads to higher rates of many diseases, including heart disease, stroke, diabetes, cancer,

  6

asthma, arthritis, and disability. It is also important to mention a number of psychological conditions affecting those with obesity, including depression, low perceived quality of life, and social marginalization.

Stopping the epidemic will not be easy, but there are precedents for success in other public health endeavors. It will require the input, hard work, skills, talents, and perseverance of many people, a wide array of organizations and groups including the medical, educational, non-profit and business communities, academia and government. While there is a role for individual behavior change, population-focused prevention efforts require both decreasing environmental barriers to accessing healthy foods and supporting healthy food choices and physically active lifestyles. A multifaceted public health policy campaign is needed, with special attention to vulnerable groups, communities experiencing health disparities, and social and physical environments unsupportive of healthy eating and physical activity.

Robert Wood Johnson Foundation Report In July, 2011, the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH) issued a report entitled F is for Fat: How Obesity Threatens America’s Future 2011 that states:

“Obesity is one of the most challenging health crises the country has ever faced. Two-thirds of adults and nearly one-third of children and teens are currently obese or overweight, putting them at increased risk for more than 20 major diseases, including type-2 diabetes and heart disease. It’s not just our health that is suffering: obesity-related medical costs and a less productive workforce are hampering America’s ability to compete in the global economy.”

Adult obesity rates increased in 16 states over the last year and did not decrease in any; rates are most dramatic in the South, which includes nine of the 10 states with the highest adult obesity rates. For the first time, the Robert Wood Johnson report tracks adult obesity rates in each state over the last two decades. Twenty years ago, no state had a rate above 15%. Today, more than two out of three states, 38 in total, have obesity rates over 25%, and just one has a rate lower than 20%. During the past four decades, obesity rates have soared among all age groups, increasing more than four-fold among children ages 6 to 11. According to research from the Center for Disease Control, childhood obesity rates have tripled over the past three decades. Today, nearly a third of children and adolescents are overweight or obese. That is a total of more than 23 million youth. In addition, significant disparities exist. For example, 38% of Mexican-American children and 34.9% of black children ages 2 to 19 are overweight or obese,

  7

compared with 30.7% of white children in the same age range. The numbers are even higher in African American and Hispanic communities where nearly 40% of the children are overweight or obese. There are also significant disparities in terms of access to healthy food and safe places to play. A study of more than 200 neighborhoods found four times as many supermarkets in predominantly white neighborhoods as in black neighborhoods. And communities with high levels of poverty are significantly less likely to have places where people can be physically active, such as parks, green spaces, and bike paths and lanes.

Prevalence of the Problem and Reversing the Trend If we do not change this trend, one third of all children born in 2000 or later will suffer from diabetes at some point in their lives. Overweight and obese children are at higher risk than their healthy-weight peers to face chronic obesity-related problems, including heart disease, stroke, asthma and certain types of cancer. Obese children are being diagnosed with health problems previously considered to be “adult” illnesses, such as type 2 diabetes, high cholesterol, and high blood pressure. In local data collected in Charlottesville elementary school students over the past 12-14 years, 34.4% of third graders were obese or overweight in 1996 compared with 28.7% in 2010, while 35.0% of the fifth graders were obese or overweight in 1998 compared with 31.1% in 2010. While we are seeing a downward trend in the data, hopefully, due to the emphasis on healthy living programs in schools, after-schools, and in the community, we still have much work to do!

  8

  9

If we don’t act to reverse the childhood obesity epidemic, we’re in danger of raising the first generation of American children who may live sicker and die younger than the generation before them. Preventing obesity during childhood is critical, because habits that last into adulthood frequently are formed during youth. Research shows that an obese older teenager has up to an 80% chance of becoming an obese adult. Obesity also poses a tremendous financial threat to our economy and to our health care system. Childhood obesity alone carries a huge price tag—up to $14 billion per year in direct health care costs. It is estimated that the obesity epidemic costs our nation $117 billion per year in direct medical expenses and indirect costs, including lost productivity.

Reversing the obesity epidemic requires a coordinated and comprehensive approach that utilizes policy and environmental change to transform our communities into places that support and promote healthy lifestyle choices for all residents. By reversing the obesity epidemic, we will make our nation healthier, save countless lives, increase economic productivity for the next generation of American workers, and ease the tremendous financial strain on our health care system and emotional strain on our citizens caused by obesity-related illnesses.

  10

VISION Community Action on Obesity’s vision for the Charlottesville-Albemarle area is a supportive community that fosters healthy lifestyles for all. The vision is that the prevalence of overweight in the Charlottesville and Albemarle County area will be reduced significantly through an integrated community approach. MISSION STATEMENT CAO’s mission is to prevent and reduce obesity and improve health behaviors in the Charlottesville-Albemarle area by promoting education, facilitating policy development, and supporting increased access to healthy food and physical activity.

  11

HISTORY OF THE TASKFORCE

Formation of the Taskforce The Charlottesville/Albemarle Community Action on Obesity (CAO) taskforce (formerly the Childhood Obesity Taskforce or COTF) was an initiative formed in 1999 under the leadership of Barbara Yager and Peggy Paviour in response to data collected on 1200 school children in 1996, 1997, and 1998 showing the prevalence of overweight in our community and the experience to date of programs addressing the epidemic of childhood obesity. Data collected in local public schools at that time showed 34.4% of 3rd grade students and 35% of 5th grade students were overweight or obese, with a body-mass index (BMI) of 85% or greater. A group of public health workers, school staff, parents, doctors and dietitians came together to support policy change and direct programs to encourage healthy eating and physical activity.

Initially the COTF focused on 4 areas of high importance and strategic value:

1. School and after-school environments and policies 2. Healthcare options and training for healthcare workers 3. Promoting community physical activity 4. Public awareness

Taskforce Membership Our community coalition is focused on the Thomas Jefferson Area Planning District (PD 10) of Central Virginia, which includes the City of Charlottesville and the Counties of Albemarle, Greene, Fluvanna, Louisa, and Nelson. For the immediate future, CAO’s main focus will be on the City of Charlottesville and the County of Albemarle, but membership from the rest of the catchment area is welcomed and it is the intent to widen the geographical focus once the Strategic Plan is underway. Our all-volunteer membership includes representatives from health care, education, recreation and human service organizations, including doctors, nurses, dietitians, and health educators affiliated with Martha Jefferson Hospital, the University of Virginia Health System, the Thomas Jefferson Health District, physical education teachers and nutrition service personnel from Charlottesville City Schools, Albemarle County Schools, Fluvanna County Schools, professors and program coordinators from the University of Virginia, directors and program coordinators from the Alliance of Community Choice in Transportation, the Boys and Girls Club, CHIP, Children Youth and Family Services (CYFS), Virginia Cooperative Extension, Camp Holiday Trails, the Jefferson Area Board for Aging, Charlottesville Parks and Recreation, Albemarle County Parks and Recreation, ACAC, YMCA, the Partnership for Children, parish nurses, and parents of children who have participated in CAO’s programs.

  12

Evolution of Focus and Name Over the past twelve years, CAO has transitioned through several phases of organizational capacity building focus. Comprised of 100+ volunteer members representing those involved since the grassroots beginnings of CAO, members have contributed time, energy and creativity to getting the Taskforce off the ground. There are four phases included in our history:

1) Assessing the scope of the problem of childhood obesity in the community (1999-2001). The original name was the Childhood Obesity Taskforce (COTF).

2) Building Taskforce membership through community awareness of the scope of obesity and its health, social and economic consequences for the community and capacity building of the Taskforce (2002-2006);

3) Piloting evidence-based models and messages for intervention with key community agencies and organizations (2007-2008); and

4) Community health assessment evaluation and 10-year review of the work projects with Taskforce members (2008 to 2011). The name changed to Community Obesity Task Force to reflect a wider focus than childhood.

In 2011 the name changed to Community Action on Obesity (CAO) to reflect the new organizational structure for community collaboration and capacity building.

The sections below describe some of our key accomplishments in each of these phases of our community work.

Assessment: 1999-2001 • Conducted surveys of 3rd and 5th grade children to assess their current

eating behaviors, preferences and physical activity behaviors and preferences to better target our messages.

• Conducted surveys with City Parks and Recreation to assess the physical

activity preferences and current behaviors for their children. • Monitored height and weight data in Charlottesville and Albemarle County

Elementary Schools for 3rd and 5th grades since 1996.

• Conducted height and weight assessments of Head Start children.

Awareness and Capacity Building: 2002-2006

• Presented data and recommendations to Charlottesville School Board, School Health Advisory Boards, and parent-teachers organizations in

  13

Charlottesville and Albemarle.

• Educated the public about problem of obesity and pilot programs through TV, radio interviews, PTO meetings, presentations to civic organizations (Kiwanis, Rotary, Optimists Clubs), and newspaper articles. Educated medical providers on the local data and recommended practices for overweight and obese children by sponsoring Bill William H. Dietz, M.D, Ph.D., Director, Division of Nutrition, Physical Activity, and Obesity NCCDPHP for the Center for Disease Control to give Medical Grand Rounds at the University of Virginia and speak to the Blue Ridge District Dietetic Association. Dietz is the Director of the Division of Nutrition, Physical Activity, and Obesity NCCDPHP for the Center for Disease Control.

• Dan Kirschenbaum, PhD, also provided Pediatric Grand Rounds at UVA on his experience working with obese and overweight children in a camp and secondary school setting. Dr. Kirschenbaum received his Ph.D. in Clinical Psychology in 1975 from the University of Cincinnati and is a Fellow of the American Psychological Association and a former president of its Division of Exercise and Sport Psychology in Chicago.

Piloting Models and Messages in the Community to Address Overweight and Obesity: 2007-2008

• Piloted a free clinic through Pediatric Associates for overweight and obese children and their families. This served as a model for the Children’s Fitness Center at UVA.

• Developed and implemented a curriculum for a Family Health and Fitness Camp to address obesity in families of overweight children for two years at Camp Holiday Trails.

• Developed a curriculum for physical education teachers to empower them

to teach nutrition messages during their PE classes and increase the level of activity in Albemarle, Louisa and Nelson County schools.

• Conducted and implemented a CATCH after-school curriculum for all city

school CLASS (Creative Learning After School & Summer) programs.

• Developed 'Healthy Snack Pyramid' for school-age children and disseminated to all public schools.

• Created a Youth Physical Activity Resource Guide for area families to

improve engagement in community physical activity program.

  14

• Drafted School Wellness Policy with School Health Advisory Board and School Nutrition Committee.

• Developed nutrition standards for school lunch which were adopted by the

Virginia Action for Healthy Kids organization and implemented state-wide in Virginia.

• Created healthy snack bar and vending machine guidelines in schools.

• Improved school lunch menus (low-fat milk, salad bars, reduced sugar

content in chocolate milk).

Community Health Assessment & Review: 2008-2011

Health District Assessment (MAPP)

• MAPP (Mobilizing for Action through Planning and Partnerships), a Community Health Status Assessment conducted by the Thomas Jefferson Health Department. (2008)

• Resulted in obesity being named one of the 4 priority health issues for the

Health District to address.

Ten Year Review with Taskforce Membership

• Community focus groups conducted by COTF/CAO to assess what was working well and where there were still perceived gaps in addressing obesity.

• Resulted in a consensus amongst community members that the work of the organization was not yet finished.

  15

Strategic Planning Process

• CAO accepted the national and local challenge to address the issue of obesity by coordinating a strategic planning process involving a broad array of stakeholders and experts. In 2009, Joyce Green Pastors and Barbara H. Yager, Co-Chairs of the Community Action on Obesity Taskforce, attended the Centers for Disease Control Conference Weight of the Nation and learned about a tool for community assessment and evaluation from the Strategic Alliance and the Prevention Institute entitled ENACT (Environmental Nutrition and Activity Community Tool). CAO conducted a formal community assessment looking at the nine ENACT community areas and assessed strategies that research demonstrated to be effective in addressing obesity at the community level.

• We adopted the ENACT strategy tool to assess the current status of key strategies that would assure access to nutritious foods and quality physical activity in Charlottesville and Albemarle County. The ENACT assessment defines the community into 9 areas: Focus Area I Childcare; Focus Area II Schools: Nutrition; Focus Area III: Schools: Physical Activity; Focus Area IV: After-School Programs; Focus Area V: Community Food; Focus Area VI: Community Physical Activity; Focus Area VII: Workplace; Focus Area VIII: Government; Focus Area IX: Healthcare.

• The nine ENACT community focus areas were evaluated by 50 taskforce

volunteers. The assessment included 2 rankings: 1) the degree to which key strategies were in place and operational; and 2) a general prioritization of strategies to focus upon during the next five years.

Strategic Planning Interviews

• In late 2010, Kate McIntire was hired to serve as the Strategic Planner to conduct interviews with key community members to ensure community leadership participation, guidance, and input to inform the strategic plan. The results of the ENACT Assessment Process were incorporated with the input received from 26 interviews with 34 community leaders, healthcare providers, steering committee members, and school leaders into a Strategic Plan. The overall final report recommended three ways in which the community felt that the taskforce would be most effective if applied to the nine ENACT environments. They include advocacy, community education, and development (resources, fiscal support, and policy).

  16

• Enough time had passed between the implementation of the ENACT initiative (Summer, 2010) and completion of the interviews (Summer, 2011) that awareness of the obesity issue had been heightened, a feeling of connectedness between community leaders around the issue had emerged, and it had become apparent that the leaders were ready for action. In the intervening time, those interviewed have developed a good sense for what they think CAO should be doing going forward and they have offered valuable suggestions for how CAO can support them. They are ready for CAO, under Barbara Yager’s and Joyce Pastors’ well-appreciated leadership, to move from creating awareness about the issue to a higher level and more permanent organizational structure with a mission to support anti-obesity community programs.

TASKFORCE STRUCTURE AND SUSTAINABILITY

Organizational Structure The strategic planning interviews informed the leadership on the sustainable structure for the Taskforce. Membership will continue to be volunteer, diversified, and representative of the nine community focus areas. Leadership will remain with two Co-Chairs supported by an Advisory Board that would represent each of the nine community areas and reflect diversity of age, gender, race and professional skills. The Action Plan will be accomplished by the member community agencies, services or individuals with aligned purposes. The Advisory Board will facilitate communication and collaboration amongst these members and groups, facilitate the development of resources and policies to support these efforts, and provide leadership in community education.

Advisory Board Development

• In the fall and winter of 2011-2012, we will invite community leaders to serve on the CAO Advisory Board. We will seek Advisory Board members who have funding expertise, interest in the issue of overweight and obesity in children, youth and adults, and the abilities to facilitate, delegate, and collaborate.

• Responsibilities of the Advisory Board will include:

o Vision: Imagining and guiding the strategies to meet our vision; o Guidance: Providing guidance as needed to the taskforce members

focused upon increased access to healthy food and physical activity;

o Accountability: Maintaining financial and strategic oversight of the Taskforce;

  17

o Fundraising: Pursuing grants and private donations to support the programs and collaborative efforts of the Taskforce;

o Media Relations and Policy Engagement: Representing the Taskforce to public officials and the media and guiding Taskforce members in gaining publicity to support education and fundraising. Initially, the Advisory Board will meet monthly. In addition to attending meetings, members will participate in advisory work between meetings;

o Partnerships: creating new community and private-public partnerships;

o Mentoring: as experts, serve as mentors to peers or community members with interest in obesity and willingness to facilitate, delegate, collaborate, or provide funding to the CAO

Fiscal Management and Sustainability

• CAO efforts are entirely supported by volunteers and partners and funded through grants and donations from community organizations and individuals. In 2000, the Taskforce received a grant from Martha Jefferson Hospital to implement nutrition and physical activity projects in Charlottesville elementary schools. Since 2005, the Taskforce has received financial awards from the Charlottesville Triathlon Club in exchange for providing the volunteer help needed to put on a triathlon (about 45 persons assist for each event). CAO members volunteer for 3 events each summer and, for these efforts, the Taskforce receives $12,000-$15,000 annually.

• In 2010 CAO received a $60,000 grant from the Virginia Foundation for

Healthy Youth. With assistance from the Foundation, CAO was able to hire a strategic planner/grant writer, a web designer who works on member communications and web design, and a pilot program in 3 City Schools for cooking and physical activity clubs. Recent grants have come from the Charlottesville Triathlon Club, Coordinated Approach to Child Health (CATCH), State Farm, Kohl’s Foundation, and the Virginia Cooperative Extension Service.

• In November 2007, the fiscal management of the CAO funds shifted from

Martha Jefferson Hospital to Virginia Organizing (VO) to provide CAO with a 501 (c) 3 status. VOP is a statewide grassroots organization dedicated to challenging injustice by empowering people in local communities to address issues that affect the quality of their lives. As a non-partisan organization, VO encourages the participation of those who have traditionally had little or no voice in our society. It has an extensive history of community organizing and advocacy with a particular focus

  18

towards minorities. This change enabled CAO to apply for and receive grant funding for anticipated growth and added fiscal accountability to the general organization. The advantage of having CAO serve as the lead agency is that it can provide broad, diverse coordination of information and programming to the community to effect comprehensive policy and environmental change to support the reduction and prevention of childhood obesity.

• In the near future, CAO will approach several new funders for support.

Future grants will be sought to hire a part-time Executive Director, a part-time grant writer and a fundraising consultant to develop and implement a strategic fundraising plan. Building a larger individual donor base will complement CAO's successful grant seeking program and help ensure the financial future of community programs addressing the obesity epidemic.

Community Action on Obesity Strategic Plan

§ The Community Action on Obesity’s vision for the Charlottesville-Albemarle area is a supportive community that fosters healthy lifestyles for all. The vision is that the prevalence of overweight in the Charlottesville and Albemarle County area will be reduced significantly through an integrated community approach. CAO’s mission is to prevent and reduce obesity and improve health behaviors in the Charlottesville-Albemarle area by promoting education, facilitating policy development, and supporting increased access to healthy food and physical activity.

• CAO’s mission provides direction for the Strategic Plan and its

implementation. The goals and strategies will encourage the adoption of policies, strategies, and best practices to reduce and prevent childhood, youth and adult overweight and obesity and to utilize funding to support the collaborative programmatic efforts of our partners in the community.

• The Community Action on Obesity Taskforce’s Strategic Plan (FY2011)

reflects its commitment to positioning itself as the lead organization in childhood, youth, and adult obesity prevention and reduction in Charlottesville and Albemarle County. CAO aims to become a clearinghouse of funding and other resources while working with numerous partners to improve the health of individuals and communities in order to reduce disease, disability and death related to overweight and obesity. The Strategic Plan includes key goals in strategic focus areas that will create the opportunity for CAO to be comprehensive in its scope of obesity prevention and reduction activities, while reaching targeted population segments throughout the City and County.

  19

STRATEGIC ACTION PLAN The CAO Action Plan is structured around nine community focus areas that were identified during the 2010 ENACT community assessment initiative. Each focus area addresses a general goal and evidence-based strategies that contribute to the reduction of obesity.The three approaches that CAO takes to address the strategies include Community Education, Advocacy, and development. Under each component are the strategic objectives to be achieved using these approaches.

FOCUS AREA I - CHILDCARE Goal: Assure that childcare reflecting optimum nutrition practices and opportunities for active play are available to all families regardless of income.

A. Community Education:

Strategy: Educate childcare providers and community partners using evidence-based resources for providing nutrition and physical activity opportunities for children ages 0-5. Objective 1 - Research best practices and educational resources for nutrition and physical activity (by age and by developmental stage). Objective 2 - Introduce community partners to available resources for childcare. Examples:

a. Staff training curricula. b. Education resources for childcare workers and parents.

Objective 3 - Showcase the information collected regarding research of best practices and guidelines, training curriculums, and educational resources. Examples of events:

a. Virginia Dietetic Association meeting– Fairfax, VA; April 2011. b. Partnership for Children meeting - Charlottesville, VA; June 2011. c. Weight of State meeting – Richmond, VA; October 2011. d. Health Summit – Charlottesville, VA; October 2011.

  20

B. Advocacy: Strategy: Work with community partners to assure implementation of policies and staff training. Objective 1 - Work with the Virginia Department of Medical Assistance Services to standardize state training for regulated childcare workers. Training should meet guidelines and best practices identified in April 2011. Objective 2 - Increase access to guidelines and best practices for day care centers, especially for good nutrition, positive feeding behaviors and active play. Include both regulated facilities and non-regulated day care centers.

  21

C. Development: Strategy: Strengthen the funding and training infrastructure within childcare settings in the Charlottesville-Albemarle area.

Objective 1 - Assure periodic review of regulated and non-regulated childcare setting to determine if policies are being implemented and training of staff has been adequate. Objective 2 - Seek funding to host local and regional trainings for Children, Youth and Family Services, Jefferson Area CHIP, and others. Objective 3 - Identify potential providers or develop a speaker’s bureau for staff development in physical activity and nutrition. Objective 4 - Publicize accomplishments and coordination/collaboration with partners.

  22

FOCUS AREA II - SCHOOLS: NUTRITION Goal: Assure that schools provide optimum nutrition to all students.

A. Community Education:

Strategy: Educate parents, children, and school staff about school food services and optimum nutrition for students. Objective 1 - Work with parent groups, Student Health Advisory Board (SHAB), and school nutrition services to research best practices and resources to educate parents, school staff, and administration about ideal nutrition practices. Objective 2 - Identify and post educational resources, products, and information on our website and provide link to schools for parents, children, and school staff. Objective 3 - Promote taste testing and cooking clubs in local schools to introduce children to new foods, methods of preparation, and healthy eating. Objective 4 - Educate the public regarding the constraints that schools face in making changes and inspiring possibilities for more positive environments.

  23

B. Advocacy:

Strategy: Advocate for comprehensive school food policies that a) ensure access to quality meals and b) promote positive eating environments and eating behaviors in school settings. Objective 1 - Promote a wellness policy that will lead our schools toward best nutrition practices. Objective 2 - Adopt a comprehensive food policy that develops healthy guidelines for purchasing to ensure meals, snacks, vending machines, and a la carte food and beverages that are healthy and sustainable choices. Objective 3 - Improve nutrition quality and appeal of school meals. Objective 4 - Help nutrition services work to change product content to fit our standards (For example: Taking out high fructose corn syrup and reducing added sugar in milk; and reducing, sugar, fat, sodium in other products). Objective 5 - Communicate with state and federal agencies (USDA, etc.) to address the barriers for quality food provision in schools.

  24

C. Development: Strategy: Strengthen the funding and training infrastructure within school food service settings in the Charlottesville-Albemarle area. Objective 1 - Facilitate assessment of training needs for food service managers and kitchen workers in schools. Objective 2 - Identify and pursue funding in collaboration with school systems for redesigning school kitchens and school cafeterias as a model for ideal food preparation and delivery. Objective 3 - Identify experts and resources for training and support to food services and school staff to help them meet nutrition standards and prepare healthier meals. Objective 4 - Seek funding to expand our model cooking clubs to Albemarle County schools. Objective 5 - Utilize news media to share success stories. Objective 6 - Publicize accomplishments and coordination/collaboration with partners.

  25

FOCUS AREA III - SCHOOLS: PHYSICAL ACTIVITY Goal: Facilitate school systems to incorporate more quality physical activity and physical education into the school day.

A. Community Education:

Strategy: Educate parents, children, and school staff about school physical activity and optimum physical activity for students. Objective 1 - Promote the importance of physical activity to parents through media and events. Objective 2 - Utilize Local Motion website to support Safe Routes to School efforts. Objective 3 - Survey schools in Albemarle and City of Charlottesville for those with Safe Routes in place. Objective 4 - Facilitate development of guidelines for schools to adopt Safe Routes to School programming. Objective 5 - Continue oversight of Virginia Foundation for Healthy Youth-Healthy Communities Action Team grant in Charlottesville City schools through 2012. Objective 6 - Facilitate training of after-school and community agency staff in techniques of assisting to improve self-motivation and promote self-esteem in school-age children.

  26

B. Advocacy: Strategy: Advocate for increased physical activity during the school day. Objective 1 - Promote a wellness policy that will lead our schools toward best physical activity practices. Objective 2 - Involve community agencies in the implementation of Safe Routes to School in Charlottesville City elementary schools. Objective 3 - Advocate for daily recess in schools and meet or exceed requirements for minimum minutes of physical education. Objective 4 - Advocate at the state and federal level for ways to have PE Standards of Learning tested to assure children have basic skills for life. Objective 5 - Find community sponsor for “Local Motion” program.

  27

C. Development: Strategy: Strengthen community funding and collaboration to assure student access to physical activity during the school day for students. Objective 1 - Complete the ENACT physical activity assessment for schools in Charlottesville and Albemarle. Objective 2 - Engage community partners and school systems in dialogue to develop creative ways to incorporate physical activity into the school day or before school (e.g., ‘walk to school’ day). Objective 3 - Identify and pursue funding in collaboration with school systems to sponsor Safe Routes to School activities. Objective 4 - Publicize accomplishments and coordination and collaboration with partners.

  28

FOCUS AREA IV - AFTER-SCHOOL PROGRAMS Goal: Support community programming for active play, healthy food and good eating behaviors to address obesity.

A. Community Education: Strategy: Increase capacity of school and community staff able to provide programming in after-school settings. Objective 1 - Adapt existing lesson plans and cooking modules to implement cooking classes for various grade levels, based on the resources developed in the Virginia Foundation for Healthy Youth Healthy Communities Action Teams (VFHY-HCAT) grant. Objective 2 - Facilitate training for after-school providers in techniques for building self-motivation for children to stay physically active. Objective 3 - Facilitate provision of age-appropriate physical activity curriculums and practices to community partners. Objective 4 - Use website to communicate resources, events, opportunities for staff training, and availability of funding.

  29

B. Advocacy: Strategy: strengthen after-school policies to support access to nutritious food, positive eating environments, and active play during after-school programming. Objective 1 - Develop comprehensive food policy for nutritious snacks and beverages in after-school settings. Objective 2 - Engage community partners and school systems in a dialogue to develop creative ways to incorporate physical activity in after-school programs.

  30

C. Development: Strategy: Strengthen community funding and collaboration to ensure that at-risk students have access to opportunities for physical activity, including a variety of active play options Objective 1 - Continue oversight of Virginia Foundation for Healthy Youth-Healthy Communities Action Team grant in City Schools through 2012. Objective 2 - Identify experts and resources for motivational training for staff and youth participating in after-school physical activity clubs. Objective 3 - Work with partners to develop tools for evaluation and collection of outcome data. Objective 4 - Publicize accomplishments and coordination/collaboration with partners.

  31

FOCUS AREA V - COMMUNITY FOOD Goal: To support the local food system, focusing on accessibility to quality foods by school children and low-income families.

A. Community Education: Strategy: Educate parents and children in homes and in schools about growing, preparing and storing fresh produce. Objective 1 - Establish a template for starting a school garden and share with surrounding schools. Objective 2 - Prepare brochures to go home with students on how to find, cook and store fresh local food. Objective 3 - Introduce gardening as part of biology, ecology and environmental sciences & math curriculum. Objective 4 - Students of all ages visit the Local Food Hubs educational garden. Objective 5 - Increase local food served in lunch menus along with educational aspect. Objective 6 - Create a documentary on navigating a super market in a quest for healthy food

  32

B. Advocacy: Strategy: Increase access to healthy, local food for low-income individuals. Objective 1 - Identify food deserts within one mile of city. Objective 2 - Identify transportation available to food sources within one mile of city. Objective 3 – Make Electronic Benefits Transfer (EBT) and Supplemental Nutrition Assistance Program (SNAP) benefits available at all farmer markets. Objective 4 – Create mobile farmer markets in all low-income neighborhoods. Objective 5 - Identify and propose location of city market. Objective 6 - Work with small local stores on display and product offered to enhance nutrient quality to provide more nutritious fresh foods and display them prominently.

  33

C. Development: Strategy: Increase the presence of systems and funding that support the production, purchase and distribution of fresh, local food. Objective 1 - Conduct a feasibility study for a local flash freezing and canning production operation. Objective 2 - Create local Food System Council to support local food efforts in an ongoing capacity: for grant writing, micro loans, strategic planning, and networking. Objective 3 - Explore use of commercial kitchens for added value and testing by farmers and entrepreneurs. Objective 4 - Publicize accomplishments and coordination/collaboration with partners.

  34

FOCUS AREA VI - COMMUNITY PHYSICAL ACTIVITY Goal: Support and facilitate increased access and use of public facilities for active recreation by underserved populations.

A. Community Education: Strategy: Educate the public about physical activity options including ways to increase self-motivation. Objective 1 – Use the Local Motion website to promote physical activity in community and encourage formation of walking clubs or neighborhood walking groups. Objective 2 - Facilitate implementation of Let’s Move Outside! programs in communities. Objective 3 - Partner with community agencies to establish a local fitness challenge that sets goals for physical activity. Objective 4 - Facilitate revision of existing physical activity resource guide by expanding the scope for everyone in the community.

  35

B. Advocacy: Strategy: Increase safe access to physical activity throughout the community. Objective 1 - Establish a “walk to school day” for area schools. Objective 2 - Develop strategies to market walking programs. Objective 3 - Support community using bikes for transportation with adequate placement of bike racks to improve accessibility. Objective 4 - Promote enhanced safety at intersections for pedestrians and bikers. Objective 5 - Partner with Charlottesville Transit System, University Transit System and Jaunt to install bike racks throughout the community. Objective 6 - Prioritize destination walk-ability and biking for needed services in low-income neighborhoods.

  36

C. Development: Strategy: Strengthen the funding and community collaboration to assure access to safe physical activity, particularly for lower income residents. Objective 1 - Develop programming for summer fitness and walking programs that can be incorporated by area camps and community organizations. Objective 2 - Partner with community agencies to enhance usability of public space in low-income neighborhoods (trash receptacles, policing, lighting, etc.) Objective 3 - Publicize accomplishments and collaboration with partners.

  37

FOCUS AREA VII - WORKPLACE Goal: Support and promote work environments that support breastfeeding for working mothers, healthy food options, and incentive programs for active lifestyles.

A. Community Education: Strategy: Generate and facilitate awareness in the working community of local resources for workplace-based initiatives for health and obesity prevention/reduction. Objective 1 - Partner with the Chamber of Commerce to promote regular communication about the health benefits of increased physical activity and healthy eating in the workplace. Objective 2 - Promote trail information and alternate transit information on our website for area employers. Objective 3 - Promote resource information about local food use on our website and facilitate increased distribution of local foods at worksites throughout the community.

  38

B. Advocacy: Strategy: Facilitate partnerships with businesses and employers to assure workers have access to healthy food options and incentives for healthy lifestyles. Objective 1 - Promote posting signage and administration support for stair usage. Objective 2 - Promote meeting or exceeding federal law requirements for space and time to breastfeed. Objective 3 - Encourage research on the relationship of workforce productivity and obesity/health.

  39

C. Development: Strategy: Strengthen community collaboration with area businesses to assure an infrastructure for workers to have access to wellness programs and healthy lifestyles in the workplace. Objective 1 - Promote and support research in workplace on costs of chronic disease versus wellness, and affects of obesity on productivity and wellness Objective 2 - Publicize what is working.

  40

FOCUS AREA VIII - GOVERNMENT Goal: Support local government infrastructure and systems that address quality of life, access to healthy foods, and active lifestyles to address obesity.

A. Community Education: Strategy: Collaborate with City and County officials to avail the community residents’ evidence-based information and resources to address obesity. Objective 1 - Share Community Action on Obesity Strategic Plan with City Council, School Board, Chamber of Commerce, Partnership with Children. Objective 2 - Share resources to all agencies and organizations in the area. Objective 3 - Utilize the website to make resources, data and training available to the community.

  41

B. Advocacy: Strategy: Increase active participation of government officials in community efforts to address obesity. Objective 1 - Support a “Let’s Move” Cities & Towns campaign in Charlottesville & Albemarle. Objective 2 - Health Summit 2011-Focus will be Obesity and Reproductive Health/Pregnancy.

  42

C. Development: Strategy: Increase community infrastructure and collaboration to receive funding that assures sustainability of obesity reduction efforts in all community environments. Objective 1 - Publicize efforts to attain funding. Objective 2 - Facilitate support letters for all community efforts to address obesity. Objective 3 - Increase awareness of larger collaborative grant funding opportunity. Objective 4 - Publicize accomplishments and collaboration with partners.

  43

FOCUS AREA IX - HEALTHCARE Goal: Collaborate with area hospitals and health care providers to enhance community education efforts to reduce obesity and chronic disease.

A. Community Education: Strategy: Promote healthy behaviors for people who are overweight or obese by facilitating communication between the community and health care providers. Objective 1 - Encourage health care providers to support education on healthy behaviors by involvement in community events (e.g., volunteering/participating in area triathlons and community walking programs, promoting community gardens and involvement in promoting use of local foods and farmer’s markets). Objective 2 - Promote use of local and healthy foods in area health care settings for patients, employees, and visitors (hospitals, outpatient care centers, long-term care facilities). Objective 3 - Educate health care providers on importance of communication and counseling regarding physical activity, eating habits, and breastfeeding at each patient contact.

  44

B. Advocacy: Strategy: Facilitate partnerships with area health care to assure that patients and employees have access to education promoting healthy lifestyle and an environment that offers healthy food options and incentives for healthy lifestyles. Objective 1 - Advocate for including evidence-based standards for nutrition and physical activity practice in healthcare settings and provider associations. Objective 2 - Collaborate with community partners and insurance companies to assure coverage for preventative services, including nutritionists. Objective 3 - Continue to identify gaps in service or patient education to address obesity.

  45

C. Development: Strategy: Strengthen community collaboration with area health care settings to assure an infrastructure that promotes healthy lifestyles. Objective 1 - Work with partners to gather data and develop standards of practice for routinely screening patients regarding physical activity/eating behavior. Objective 2 - Identify experts in obesity, nutrition and physical activity and assist to develop a referral system to improve access for at-risk patients. Objective 3 - Identify resources for obesity treatment, nutrition education and physical activity programming & make these resources available to health care providers. Objective 4 - Identify potential research projects that will further community efforts to address and evaluate programming for overweight persons. Objective 5 - Publicize accomplishments and coordination/collaboration with partners.

  46

A CALL TO ACTION

The Community Action on Obesity Strategic Pan is a framework to help Charlottesville and Albemarle County residents to organize around a set of common goals to address overweight, obesity and their prevention. The active involvement of all individuals, organizations, and communities is essential to accomplish this plan. Here are some ways that you can help.

1. Join the Community Action on Obesity taskforce as a partner to address overweight and obesity initiatives.

2. Use the Community Action on Obesity taskforce to guide actions in your organization or local community.

3. Communicate your programs and your successes with the Community Action on Obesity taskforce membership so that we may benefit from your progress and collaborate on initiatives.

4. Share data to enhance information about the burden of overweight and obesity prevention efforts in Charlottesville and Albemarle County and our progress in reducing the burden.

5. Make a tax-deductible donation to the Community Action on Obesity taskforce to support implementation of the CAO Strategic Plan. Checks may be made payable to Virginia Organizing—Community Action on Obesity.

Website: www.communityactiononobesity.org

Mailing Address: 703 Concord Avenue Charlottesville VA 22903