A Mission Becomes A Mandate by Alicia Stahlberg

A MISSION BECOMES A MANDATE: CAMPAIGN FOR SCHOOL WELLNESS

CONTENTS SCHOOL WELLNESS: IT’S NO LONGER OPTIONAL

TAKING STOCK, SHARING, AND STRATEGIZING: THE HEALTHY SCHOOLS SUMMIT 2005

RAISING THE BAR FOR THE FUTURE: STATEMENT FROM DAVID SATCHER, MD, PhD

OF EPIDEMIC PROPORTIONS: OVERWEIGHT & OBESITY AMONG OUR CHILDREN

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: SIX CRUCIAL STEPS

• WE’RE HELPING TO MAKE LOCAL WELLNESS POLICIES HAPPEN

• WE’RE OFFERING HELP TO SCHOOL HEALTH ADVISORY COUNCILS

• WE’RE BOOSTING STUDENTS’ PHYSICAL ACTIVITY

• WE’RE IMPROVING SCHOOL NUTRITION

• WE’RE MAKING AFTER-SCHOOL PROGRAMS HEALTHIER

• WE’RE ADDRESSING DISPARITIES IN EDUCATION AND HEALTH

EMBRACING ALL THE PLAYERS: INDUSTRY, GOVERNMENT, EDUCATION, HEALTH AND PHILANTHROPY

THE ROAD AHEAD: CAMPAIGN FOR SCHOOL WELLNESS

CHARTING THE COURSE: OPPORTUNITIES AND CHALLENGES AHEAD

THANKING OUR SPONSORS

PARTNER STEERING COMMITTEE

BOARD OF DIRECTORS 2006

“

Partnerships are critical. Reversing childhood obesity will take all of our collective energies — that of parents, teachers, schools, and government. We need to work at a grand level. Dedication and action must follow

”

our words. Failure is not an option.

The Honorable Mike Johanns Secretary of the U.S. Department of Agriculture Addressing the Healthy Schools Summit

SCHOOL WELLNESS

SCHOOL WELLNESS: IT’S NO LONGER OPTIONAL The U.S. Child Nutrition and WIC Reauthorization Act of 2004 required that nearly all school districts in the United States implement a Local Wellness Policy by July 1, 2006 — to increase students’ healthy eating and physical activity in order to address the nation’s obesity epidemic. That deadline has arrived, and with it a new era in the fight against childhood obesity, an arena in which Action for Healthy Kids (AFHK) has been quietly working for these past four years — building coalitions, informing opinion-leaders, developing science-based guidelines to inform school policy, and helping to implement new programs, practices, interventions, and curricula in districts and schools. What is Action for Healthy Kids? It’s a public-private partnership of more than 50 national organizations and government agencies representing education, health, fitness, and nutrition. In existence since 2002, AFHK is a non-profit entity whose sole mission is to address the epidemic of overweight, sedentary, and undernourished youth by focusing on changes in schools. As AFHK marks its fourth anniversary, thousands of its volunteer school administrators, policy-makers, educators, health professionals, parents, and others take daily action at the state, district, and school levels — through AFHK Teams that operate in all 50 states, the District of Columbia, and New York City. The current national legislative imperatives of implementing Local Wellness Policies happen to coincide with AFHK’s approaching fourth birthday — and they’ve turned our mission into a mandate. Those imperatives also offer an opportunity to provide this snapshot of where we’ve been, and where we’re going, both as an organization and as a nation dedicated to solving vital health problems affecting future generations. This document recaps the achievements of the Healthy Schools Summit 2005, which offered an opportunity not only for stock-taking, strategizing, and sharing, but also for setting a course for Action for Healthy Kids’ Campaign for School Wellness. The report closes with a description of that Campaign, an initiative that will ensure that the systemic change now mandated by federal legislation — and so vigorously supported by AFHK’s work thus far — will be implemented, monitored, and encouraged, and that the changes now set in motion will not merely continue, but will gain momentum in the months and years to come.

“

Parents want good nutrition and physical activity to be a requirement at school.

”

Alicia Moag-Stahlberg, MS, RD Executive Director, Action for Healthy Kids

Addressing the Healthy Schools Summit

“

We can’t go back and make a new start for our children, but we can go forward and make a new end.

”

Jean Ragalie, RD Executive Vice President of the National Dairy Council

Addressing the Healthy Schools Summit

In September 2005, over 500 leaders from the education, health, physical activity/physical education, and nutrition fields convened in Washington, D.C. at the Healthy Schools Summit. The 2005 Summit came three years after the inaugural event at which the nationwide Action for Healthy Kids (AFHK) initiative was formally launched as a vehicle for informing, motivating, and mobilizing schools, school districts, local communities, private industry, and states to chart a healthier course for our nation’s children and adolescents. The 16th U.S. Surgeon General, Dr. David Satcher, opened the Healthy Schools Summit 2005 event, while First Lady Laura Bush served as Honorary Chair. The 2005 event, entitled Raising the Bar: New Challenges, New Opportunities, brought together representatives from more than 300 national, state, and local education and health organizations from both the public and private sectors, all dedicated to taking action for our children’s health. The AFHK Partner Steering Committee, which consists of over 50 national organizations dedicated to promoting physical activity and nutrition in our nation’s youth, played an instrumental role in planning and executing the event. Participants at the 2005 Summit explored innovative approaches to creating healthier school environments and shared ideas about what’s working in schools, districts, and states across the nation. Action for Healthy Kids Teams, which were established at the 2002 event, shared lessons learned and “best practices” from their efforts to make a difference at the state and local level. Representatives from private industry, philanthropy, the media, and government discussed the resources and programs they have available to help. In addition, these public and private stakeholders engaged in an open discussion about the challenges and opportunities they face, and the various roles they can play (both independently and in partnership with each other) in combating the nation’s childhood obesity epidemic.

This report provides an overview of the presentations and success stories shared at the Healthy Schools Summit. The full report, including transcripts and speaker presentations, is available on the Action for Healthy Kids web site: www.ActionForHealthyKids.org.

This report highlights the strategies, programs, and solutions that were shared at the 2005 Summit for creating heath-promoting schools that support sound nutrition and physical activity. It also features the variety of potential partners, resources, and tools available to AFHK Teams and other organizations as they embark on this important work. In addition, it sets an agenda for the future by highlighting the major opportunities we have to promote the health and well-being of our nation’s youth. As the meeting’s title suggests, discussion focused on how to further build upon the great progress that has been made in three short years since the launch of AFHK. Lastly, and looking forward, this report provides an important introduction to Action for Healthy Kids’ “Campaign for School Wellness,” the framework that will encompass much of AFHK’s important work in the next few years. Campaign for School Wellness is a direct response to the U.S. Child Nutrition and WIC Reauthorization Act, mandating the development and implementation of Local Wellness Policies across the United States. One of AFHK’s primary near- and long-term goals is, quite simply, to help our nation realize the full potential of this important legislation.

TAKING STOCK, SHARING AND STRATEGIZING

TAKING STOCK, SHARING, AND STRATEGIZING: THE HEALTHY SCHOOLS SUMMIT 2005

â&#x20AC;&#x153;

The great tragedy in life is not in not reaching your goals, but in not having goals to reach . . . it is not failure but low aim that is sin. Let us together not be guilty of low aim.

â&#x20AC;?

David Satcher, MD, PhD 16th United States Surgeon General and Founding Chair of Action for Healthy Kids, quoting Dr. Benjamin Elijah Mays, the late President of Morehouse College and mentor to Martin Luther King, Jr. Addressing the Healthy Schools Summit

RAISING THE BAR FOR THE FUTURE

RAISING THE BAR FOR THE FUTURE: STATEMENT FROM DAVID SATCHER, MD, PhD 16th U.S. SURGEON GENERAL, FOUNDING CHAIR OF ACTION FOR HEALTHY KIDS Action for Healthy Kids (AFHK) has made tremendous progress in the last four years. Not even a formal organization at the inaugural Healthy Schools Summit in 2002, AFHK now boasts a national network of more than 6,000 individuals who make up 52 Action for Healthy Kids Teams (all states, the District of Columbia, and New York City) that are working in various ways to promote physical activity and better eating in our nation’s youth. From educating state policy-makers about the benefits of physical education and recess, to developing and implementing school breakfast programs, to supporting the development of walking trails around schools, AFHK Teams are making a difference in their local communities. The Teams are assisted in their efforts by AFHK’s Partner Steering Committee, a collaboration of more than 50 national organizations with tremendous expertise in the fields of nutrition, child health, education, and physical activity. Schools are special places, and they represent a great opportunity to reach and influence our children. We now know that there is a connection between living a healthy lifestyle and learning. All of our partners are working toward a common goal — helping children to be healthy and physically fit, so that they are ready to learn. Now is the time to build upon our past success by raising the bar for the future. AFHK’s Partner Steering Committee and Board of Directors are focused on how to leverage the opportunities we have going forward. These opportunities include developing and implementing Local Wellness Policies. This requirement provides schools and school districts with the chance to create the kind of environment where children learn lifetime habits that include engaging in physical activity and eating healthfully. AFHK Teams and others are helping schools and school districts to develop, implement, monitor, and evaluate the impact of these policies. A second opportunity relates to after-school programs. By providing opportunities for physical activity, nutrition education, and healthy snacks, after-school programs can be a valuable tool in the fight against childhood obesity. AFHK is pleased to have formed a partnership with the National Football League on the ReCharge! Energizing AfterSchool Program, which provides 3rd through 6th graders with after-school physical activity, nutrition education and healthy snacks in team-based settings. This program, and others like it, brings schools and communities together in a meaningful way. And of course AFHK’s Campaign for School Wellness is the all-important “umbrella” under which many of these efforts and initiatives are coming to fruition. As we go about our work, we must be mindful of the need to engage our key stakeholders in our efforts. It is common sense that people will respond better to a program if they are a part of its development and implementation. Thus it is critical that we work to ensure that school administrators, parents, teachers, and students themselves are a part of our work, not the subject of it. This is especially true as we reach out to urban communities and communities of color, which face unique challenges in their efforts to promote physical activity and better nutrition. As we look to raise the bar for the future, we need to learn as much as possible from our peers and then take these learnings to create meaningful ways to promote the health of our children.

“

Childhood obesity is a serious problem that demands a serious response.

”

Senate Majority Leader William H. Frist, MD Addressing the Healthy Schools Summit

“

Today many educators are narrowing their focus on academics in order to meet testing and accountability standards. Research shows that doing so is unnecessary and counterproductive . . . You can’t sacrifice one part of a child for another. Focusing on a part of the child is a zero-sum game that forces false choices. Gene R. Carter, EdD.

”

Executive Director and CEO of the Association for Supervision and Curriculum

Addressing the Healthy Schools Summit

Today, the epidemic of childhood obesity continues unabated. Too many children remain overweight, undernourished, and sedentary. Roughly 10% of children and 15% of adolescents are overweight, double and triple the rates of just a few decades ago. Weight problems among children increase the risk factors for certain chronic diseases, including heart disease, sleep apnea, diabetes, gallbladder disease, asthma, respiratory diseases, musculoskeletal problems, and some types of cancer. According to the Centers for Disease Control and Prevention, one-third of all children (and half of all African-American children) born in the year 2000 will get diabetes because of obesity. Diseases and conditions that used to be “old people’s problems,” such as type II diabetes, high blood pressure, and high cholesterol, are now all too frequently being seen in children and adolescents. In 2003, the public paid $39 billion ($175 per taxpayer) to treat obesity-related diseases. By 2020, it is estimated that 20% of health expenditures will be for treatment of diseases and conditions caused or exacerbated by obesity. For more information on how poor

Inactive children, as well as those who eat poorly, not only are at greater risk of disease, they also are ill-equipped to learn. There is a growing body of evidence that physical activity and nutrition have an impact on the ability of our children to learn and to perform well academically. School-breakfast programs, for example, have been shown to improve academic performance. Some of the actions of private industry have helped to exacerbate the childhood obesity problem. Half of all advertisements during children’s television shows are for food, with most promoting high-sugar, high-fat, and high-calorie products. Many grocery store chains have exited urban environments, while fast-food chains have moved in, thus contributing to growing income and racial/ethnic disparities in access to healthy foods.

nutrition, inactivity, and weight problems impact student learning — and take an economic toll on schools — see The Learning Connection: The Value of Improving Nutrition and Physical Activity in Our Schools, an Action for Healthy Kids Report issued in 2004. Available at: www.ActionForHealthyKids.org.

Schools: Both Problem and Solution Schools and school districts may unintentionally be contributing to the problem, as they do not always provide the kind of environment that is conducive to health, physical activity, and nutrition. Only 8% of elementary schools provide daily physical education or its equivalent. Pressured to focus on academics, many school districts have cut back on or even eliminated physical education and/or recess. In an effort to boost badly-needed revenues, the vast majority of schools — 83% of elementary, 97% of middle, and 99% of high schools — allow competitive, mostly non-nutritious foods to be sold in vending machines and school stores.

OF EPIDEMIC PROPORTIONS: OVERWEIGHT & OBESITY AMONG OUR CHILDREN

Schools and school districts, of course, are in an ideal position to be a part of the solution to the childhood obesity epidemic. Schools serve millions of children meals and snacks each day, including breakfasts and lunches that must meet government nutrition standards. For some students, schools represent their best opportunity for healthy, nutritious meals. Schools are also ideal places to promote physical activity, as they generally offer a safe environment with an existing infrastructure that often includes playgrounds, athletic fields, and gymnasiums.

17th U.S. Surgeon General Richard Carmona talks with 16th U.S. Surgeon General and Founding Chair of AFHK David Satcher at the Healthy Schools Summit 2005.

“

Action for Healthy Kids is a great public-private partnership that shows the power of people from multi-sectors and multi-disciplines focusing on a single issue: the health of children.

”

U.S. Surgeon General Richard Carmona, MD, MPH, FACS Addressing the Healthy Schools Summit

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS

WHAT ACTION FOR HEALTHY KIDS IS DOING ABOUT SCHOOL WELLNESS The Healthy Schools Summit 2005 showcased initiatives and resources at the national and state level that demonstrate the tremendous progress made since the inaugural Summit in helping schools and school districts promote physical activity and better eating. The 2005 Summit presentations also highlighted some of the most compelling opportunities for making a positive impact in the future, including Local Wellness Policies, school health advisory councils, programs to improve physical activity and school nutrition, after-school programs, and engaging urban communities.

ACTION FOR HEALTHY KIDS WELLNESS POLICY TOOL

1. Conduct Initial Homework 8. Maintain, Measure, Evaluate 7. Implement the Policy

2. Form the Development Team

Creating a Local Wellness Policy

6. Adopt the Policy

3. Assess the Districtâ&#x20AC;&#x2122;s Needs 4. Draft a Policy

5. Build Awareness and Support To help schools make and sustain progress in developing and implementing their Local Wellness Policies, Action for Healthy Kids has developed a Wellness Policy Tool. This free online resource defines an 8-step process for school wellness committees or teams to follow. To utilize this tool, users can start with Step 1 or go directly to the Step that is relevant to their districtâ&#x20AC;&#x2122;s progress. Included are objectives, audio clips from experts, downloadable templates and tools, and frequently asked questions to guide the journey through the process.

To access the Wellness Policy Tool and other valuable resources to promote school wellness, visit Resources to Improve Schools at www.ActionForHealthyKids.org.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 1

STEP 1 WE’RE HELPING TO MAKE LOCAL WELLNESS POLICIES HAPPEN One of the biggest challenges facing school district leaders today is in complying with the federal government’s mandate to develop and enact Local Wellness Policies that include guidelines and policies related to physical activity and nutrition. This mandate also represents an historic opportunity for these leaders and others who care about the health of our nation’s youth to fundamentally change the school environment to one that promotes healthy lifestyles in our children. As a result, Action for Healthy Kids has made supporting the development and implementation of these policies a priority both at the national and the state level. Some states and school districts are making tremendous progress in developing and implementing Local Wellness Policies. Here are a few success stories shared at the Summit.

Everybody Plays: A Community-Based Approach in Rio Grande City, Texas The Rio Grande City Consolidated Independent School District in Texas has adopted a policy that “all children will play.” (This district is 97% Hispanic, with roughly half of children living below the poverty level and 85% of adults being overweight or obese.) Gym facilities are kept open on weekends and after school to let children play in a climate-controlled environment (the temperature outside is often 100 degrees or more during much of the year). With respect to nutrition, the school’s cafeteria menu has been analyzed and reformulated to reduce fat content. The district has also launched a wellness program for teachers, who serve as role models for children, and is working with the University of Texas at San Antonio Health Science Center on a program that will monitor each student’s weight and body mass index over time. Parents of children who are overweight are encouraged to learn how they can help their children become more active and eat better.

Joining Together: A Public-Private Partnership in Mississippi With the highest percentage of overweight or obese adults in the nation, Mississippi’s Department of Education and the Mississippi Board of Education recognized the need to make physical activity and nutrition a priority in the state’s schools. The state’s educational leaders opened the Office of Healthy Schools, which is working to support local school districts in creating healthy school environments. This office has created the School Wellness Policy Guide, which is specifically designed to assist with the development and implementation of Local Wellness Policies.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 1

In addition, the office has formed a partnership with the Bower Foundation to provide grants to school districts and school sites that support efforts to promote proper nutrition and increased physical activity in the state’s schools. The foundation also provided support for the development of the School Wellness Policy Guide, and continues to provide ongoing support to promote the use of that guide by school districts.

Making Eating Right Possible: Healthier Foods Throughout the School Campus in Chesapeake, Virginia Through the district’s School Health Advisory Board (which includes parents, teachers, school nurses, students, and a pediatrician), Chesapeake Public Schools are developing and implementing a Local Wellness Policy that emphasizes the following: meeting minimal nutritional standards in all foods, more overall physical activity, and more physical education in elementary schools. This school district has adopted a number of changes to its nutrition guidelines, such as eliminating fried foods in elementary schools, using whole wheat pizza crusts, expanding fresh fruit choices, and increasing salad varieties. The district also adopted a healthier snack policy in 2004, emphasizing baked chips, reduced-sugar snacks, low-fat cookies, and reduced-fat ice cream. The only beverages served during lunch are water, low-fat milk, and fruit drinks with a high juice content. A vending machine pilot project conducted in two high schools and middle schools in the Chesapeake district found that switching to more nutritional snacks did not result in a loss of revenue.

Providing the Tools for Policy Change in Rhode Island The Rhode Island Action for Healthy Kids Team met with representatives of each school district to help them form a District Wellness Committee. The Rhode Island AFHK Team developed a variety of tools to assist the committee in developing a Local Wellness Policy, including a self-assessment tool for nutrition and physical activity, model policy language, nutrition guidelines for a la carte and vending-machine foods, an approved product list with over 1,000 products that meet nutritional guidelines, and sponsorship of a trade show to help school leaders sample and obtain these foods. Based on the initial success of the committee, the AFHK Team provided valuable information to Rhode Island legislators who passed a law SPREADING THE WORD that requires every school district to form a wellness subcommittee and to Action for Healthy Kids is publishing submit a wellness plan as a part of its strategic plan. The legislation also requires the state’s Department of Education and Department of Health case studies and success stories to work together to provide technical assistance to the districts. The chronicling the achievements of legislation has clearly gotten the attention of school district leaders, 300 AFHK Teams across America — to of whom attended a three-hour seminar hosted by the AFHK Team about inform, to inspire, and to serve as the law and its implications for schools. blueprints for similar efforts. Visit

www.ActionForHealthyKids.org to read more.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 2

STEP 2 WE’RE OFFERING HELP TO SCHOOL HEALTH ADVISORY COUNCILS School Health Advisory Councils (SHACs) can help to coordinate the resources and activities of schools and school districts with those of community-based organizations that are interested in the health and wellness of students and school staff. Such coordination is critical to maximizing the effectiveness of community-based efforts to promote increased physical activity and better nutrition for youth. AFHK Teams in a number of areas are working with school districts and individual schools to set up SHACs.

10% and Beyond: The Michigan Action for Healthy Kids Team The Michigan Action for Healthy Kids Team has set an objective for 10% of Michigan public schools to have formed a Coordinated School Health Team (CSHT, another term for SHAC) by the end of 2006, and then to use that CSHT to complete an assessment of their school environment and begin implementation of an action plan based on that assessment. The impetus for the creation of this objective came out of a 2001 white paper in which the Michigan Department of Education and other key organizations advocated for Michigan schools to play a more active role in promoting healthy weight in students. To assist schools in their work, the Michigan AFHK Team developed a Healthy School Action Tool (HSAT), which helps schools to create a CSHT, to identify strengths and weaknesses, and to develop an action plan to capitalize on those strengths and address those weaknesses. The HSAT assessment also helps schools to make policy and environmental changes. The Michigan AFHK Team is conducting a “train-the-trainer” program to help teach school leaders how to use the HSAT tool. The Team is also developing web-based reports for Teams that complete the HSAT, and is launching a statewide recognition program for the 47 schools that have been successful in using the tool and making positive changes.

It’s All About Training: The New Mexico Action for Healthy Kids Team In 2003, the New Mexico Action for Healthy Kids Team conducted face-to-face training sessions with ten school district Teams. These four-person Teams included a variety of individuals involved in promoting physical activity and nutrition in the state’s schools. District Team members included principals, nurses, school nutrition directors, physical education teachers, and other teachers. The New Mexico State University Cooperative Extension Service and the local dairy council, Dairy Max, helped support this training. Each Team completed an assessment of the school environment prior to the training, which focused on both the importance of Teams as well as the resources that are available to support the Teams. While expensive to conduct, the training generated great enthusiasm among school districts to share ideas and begin local planning. The training helped to encourage the Albuquerque District Team to develop a nutrition and physical activity toolkit that has been distributed to all schools in the district (which is the largest in the state). In addition, schools in Taos and elsewhere in the

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 2

state have made changes in vending and competitive food policies, while elementary schools throughout the state have implemented the CATCH (Coordinated Approach to Child Health) physical activity and nutrition program. Going forward, the New Mexico AFHK Team plans to provide future training programs, possibly including less-costly, web-based training.

Linking Far-Flung Regions: The Texas Action for Healthy Kids Team The Texas Action for Healthy Kids Team actively trains school districts throughout the state on how to set up SHACs. Because Texas is such a large state, with 28,000 square miles that are divided into 20 education service center regions (each of which has multiple school districts), it is very difficult for local school leaders to travel for training sessions. Working in partnership with the Texas School Health Network (TSHN), the AFHK Team sent content experts and other resources to provide training sessions in eight of the stateâ&#x20AC;&#x2122;s 20 regions. TSHN provided a direct link to schools and school staff, including administrators, foodservice directors, and physical education teachers. The Texas AFHK Team also brought all 20 regional health specialists together for a training session.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 3

STEP 3 WE’RE BOOSTING STUDENTS’ PHYSICAL ACTIVITY Many AFHK Teams are directly involved in supporting programs to increase the amount of physical activity that students get.

Boiling It Down to a Kit: The Alabama Action for Healthy Kids Team The Alabama Action for Healthy Kids Team has a physical activity subcommittee that is a part of the Alabama Nutrition and Physical Activity Committee. The Alabama AFHK Team is focused on providing physical education equipment “kits” to Alabama schools in low-income areas, which often do not have equipment and/or have equipment that is in disrepair. The AFHK Team members distributed the kits to 35 schools that have certified physical education instructors and 50% or more of their students in the free or reduced-price lunch program. Each kit is worth approximately $250 and contains balls, jump ropes, hula hoops, Frisbees, parachutes, a stopwatch, a BMI calculator, and 25 pedometers (which were donated). The kits were distributed and training was provided at the annual meeting of the Alabama State Association of Health, Physical Education, Recreation, and Dance. Estimates suggest that up to 1,000 students use the equipment at least once a week, with up to 700 students using it every day.

Anyone Can Play: The Connecticut Action for Healthy Kids Team The Connecticut Action for Healthy Kids Team has supported the Connecticut at PLAY! program, which seeks to encourage children in grades K-8 to enjoy more physical activity throughout the day, both at school and at home with their families. The program is designed to create and reinforce the link between home and school with respect to healthy habits. The first Connecticut at PLAY! took place in March 2003, with roughly 12,000 children participating in the month-long program. The initial goal for the April 2005 program was to increase participation to 15,000 children from 100 schools. The Connecticut AFHK Team actively promoted the 2005 version of the program. Their efforts drew the interest of 279 schools that collectively educated more than 112,000 Connecticut students. In March 2005, each of these schools was sent an action guide developed by the AFHK Team that provided suggestions and tips for parents on how to get their kids to be more active, and on how to be more active themselves (and thus serve as a role model for their children). The schools were also sent other materials, including a resource guide that lists available tools and materials to support physical activity in schools and at home.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 3

PARENTS AS PARTNERS IN CHANGE First Step: Make Them Aware of the Problem Important to many of the Action for Healthy Kids Teams’ success stories shared at the Healthy Schools Summit 2005 is the involvement of parents. Parents want what is best for their children. They want them to be healthy and to succeed in school, and they have more influence on their children than any other adult. Parents are role models to their children as well, and their lifestyle habits with respect to physical activity and nutrition may well be emulated by their children. Finally, parents can serve as community leaders, taking what they learn about health and sharing it with others at their work sites, places of worship, service clubs, and youth organizations. The first step in engaging parents is to make them aware of the gap between their expectations and the reality that is taking place in their children’s schools. Action for Healthy Kids conducted a survey in 2005 that was designed to understand parents’ beliefs and expectations with respect to wellness practices in their children’s schools. The survey uncovered a significant gap between parental expectations and reality.

For example: • Parents think that schools are providing nutrition education to all students and they would like such education to be part of the core curriculum two days each week. In reality, the typical curriculum devotes only five hours a year to nutrition education, and such education is provided in some (not all) grades. • Seventy percent of parents want less exposure to high-calorie, low-nutrient foods at school, and half of parents think that schools are doing a good job in this area. In reality, the vast majority of schools allow students to purchase such foods during the school day. • Parents believe that lunch should be 36 minutes long, but the typical child has only 23 minutes to eat once seated at the lunch table. One in five schools give students less than 20 minutes to eat. • More than three-quarters (77%) of parents want daily physical education that lasts 48 minutes, and the majority think their child’s school is doing a good job in this area. In reality, only 6% to 8% of schools provide daily physical education. The vast majority of parents (83%), moreover, have no knowledge of the Local Wellness Policy requirement. But parents have clear views on what they think should be done in their children’s schools with respect to nutrition and physical activity. For example, the survey found that parents believe that the following are important and should be required as a way to encourage good nutrition practices: daily breakfast; daily promotion of healthy food choices in school meals; applying nutrient standards to all foods sold on the school campus; providing nutrition education in all grades; limiting high-calorie, low-nutrient food offerings; and providing information on nutrition to parents. With respect to physical activity, parents believe that the following are important and should be required: daily physical education and recess, along with a variety of other opportunities for children to be active during the day; after-school programs that promote healthy snacks and physical activity; and education and promotion of the opportunities available for physical education.

For the full Action for Healthy Kids Report, Parents’ Views on School Wellness Practices, go to www.ActionForHealthyKids.org.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 4

STEP 4 WE’RE IMPROVING SCHOOL NUTRITION Action for Healthy Kids Teams are supporting the implementation of programs that are designed to provide children with more nutritious food options. Examples of successful programs are described below.

Free Breakfast Every Day: The Ohio Action for Healthy Kids Team The Ohio Action for Healthy Kids Team helped support the implementation of a Breakfast in the Classroom (BIC) program that provided all students in the Lima City School District with a free breakfast every day. The district’s leadership was interested in this program because they found that many children came to school hungry (76% of the district’s children received free or reduced-price meals), and there was a concern that proficiency scores were suffering as a result. In fact, the district had been declared an area of “academic emergency” in 2002-2003, and was placed on “academic watch” in 2003-2004 and 2004-2005. The hope was that giving every child breakfast (only 40% participated before the program) would help to improve attention spans and attendance, and decrease tardiness. With a change in the school administration and a school district restructuring on tap, 2005 seemed like the right time for a change. The Ohio AFHK Team was instrumental in identifying low breakfast participation rates as an issue for Ohio schools; the state ranked 47th in the nation in this area. The AFHK Team also helped build an alliance with many other partner organizations that cared about this issue, including the Children’s Hunger Alliance (which took the lead on educating legislators and other key stakeholders), the Dairy Council Mid East (which provided incentives, coolers, and grant funding), the Ohio Department of Education (which provided technical assistance and training), and other organizations. The Team also helped to secure a UPS Foundation grant to help fund the program. The Breakfast in the Classroom program has been a big success, with participation rates doubling to 83% in two years. Ohio has climbed to 32nd in the nation in breakfast participation rates. Teachers report that students’ attention spans have improved, and test scores in the district improved by 2% since the program was implemented. (At one school, scores rose 7%.) While there has been no significant change in attendance or tardiness rates, visits to the school nurse have fallen by 37%, much more than expected. At the site of a pilot program, student body mass index (BMI) scores have improved as well. In addition, reimbursement from the USDA for school breakfasts has increased 43%, providing the district with much-needed funds to support other foodservice activities.

Putting Policies in Place: The Arizona Action for Healthy Kids Team In 2002, the Arizona Department of Education conducted a Centers for Disease Control and Prevention School Health Education Profile which found that only 9% of schools in the state had a policy to ensure healthy food options within the school environment, compared to 20.8% of schools in the rest of the country. As a result, development of a healthy school environment policy became a priority for state leaders. The Arizona Action for Healthy Kids Team led a coalition

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 4

of 11 organizations (including the PTA, School Nutrition Association, and others) that developed a policy covering four areas — foodservice operation, food choices in school, nutrition education, and physical activity. There was some concern, however, about implementing the nutrition aspects of the policy without having a negative financial impact on the schools. To test this proposition, a USDA Team Nutrition grant was awarded to fund a pilot project to examine the feasibility of the nutrition policies. Eight schools applied for and won competitive mini-grants of between $5,000 and $10,000 to implement the foodservice operations and food choices sections of the policy for one semester in the fall of 2004. Based on pre- and post-evaluation of the policies, the nutrition profiles of each school’s food offerings improved dramatically, while no school incurred a meaningful loss in revenues. The success of the program convinced the Arizona legislature to pass a bill eliminating soda, candy, and junk food throughout the school day for grades K-8. Because there was some skepticism that similar changes could be made in the high school setting, a second Team Nutrition grant has been awarded to study the policy’s implementation in secondary schools.

Setting Standards: The North Carolina Action for Healthy Kids Team The North Carolina Action for Healthy Kids Team was a part of a consensus-based process that produced a set of voluntary nutrition standards for North Carolina schools. The voluntary standards are grade-specific and cover all foods available in the school, including vending beverages, vending snacks, after-school programs, school meals, and a la carte foods. General guidance (not standards) is provided with respect to foods served at school events. The standards are flexible within each grade level, with school leaders able to set goals as to how they want their school to perform with respect to the standards. Different “grades” are assigned to different levels of performance, ranging from “needs improvement” to “superior.” Schools can use the standards to assess their current practices and evaluate their readiness to change and willingness to find fiscal solutions. Thanks in part to the voluntary nutrition standards, the governor of North Carolina signed into law a ban on soft drinks and vending machine snacks in the state’s elementary schools. A ban on soft drinks was also enacted for middle schools, while limits on soft-drink offerings were put in place for high schools. In addition, school districts throughout the state are using the voluntary standards to help them develop the Local Wellness Policies that are required by the federal government by the start of the 2006-2007 school year.

“

Elementary school students love having a dollar in their pockets to spend. If you sell it, they will buy whatever is available.

”

Traci Grgich Arizona Department of Education

Addressing the Healthy Schools Summit

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 5

STEP 5 WEâ&#x20AC;&#x2122;RE MAKING AFTER-SCHOOL PROGRAMS HEALTHIER After-school programs offer an additional opportunity to engage children in physical activity and allow them to learn about and practice healthy nutritional habits. As an integral part of the school, the after-school program can support or even lead the way in improving school wellness. There is both a need and a demand for after-school programs. They help parents fill the care gap between the end of school and when they get home from work, providing a safe environment that helps children succeed in school and improve their health and well-being. Studies show that participation in after-school programs leads to higher grades and test scores, increased graduation rates, and decreased absenteeism and tardiness. Unfortunately, there is a shortage of after-school programs; the Afterschool Alliance estimates that the families of 22 million children want after-school programs, but at present only 6.5 million of these children are enrolled in such programs. The majority of after-school programs are provided by the public schools, with YMCAs, religious organizations, Boys and Girls Clubs, and private schools also being important providers. In some cases, programs offered within the public schools are run by outside organizations, such as the YMCA. Action for Healthy Kids and its Teams have an exciting opportunity to help improve studentsâ&#x20AC;&#x2122; physical activity and nutrition during the after-school hours through ReCharge! Energizing After-School, a new program from AFHK and the National Football League (see page 22). With funding from Pfizer Animal Health, Action for Healthy Kids awarded seven Teams with ReCharge! grants to help improve after-school snacks (and gain federal funding for such snacks), reach out to parents and the community, and provide training and technical assistance to afterschool program instructors. Action for Healthy Kids expects to offer additional financial incentives to Teams in the future, along with online technical assistance for ReCharge!

Action for Healthy Kids has joined forces with the National Football League to launch the ReCharge! Energizing After-School Program. This initiative helps students learn how and why they need to eat well and be physically active. It also allows them to practice healthy habits by engaging in physical activity and eating healthy snacks, and to develop life skills, such as learning the importance of teamwork, goal setting, and balancing their “energy in” (nutrition) with their “energy out” (physical activity). Designed to reinforce national education standards and the “best practice” criteria developed by leading organizations (including the National Association for Sport and Physical Education, National PTA, USDA, AFHK, and others), ReCharge! includes 29 engaging activities for students in grades 3-6 that are framed as play and that get students out of their seats. The activities vary widely and are highly flexible, including both indoor and outdoor activities that can be engaged in daily, weekly, or only once a month. Through training materials, instructors are taught how to make these activities easier or more difficult depending upon the group’s abilities. ReCharge! also provides nutrition education, including tools that students can use to track their “energy in” and “energy out.” ReCharge! includes training for school foodservice directors on how to provide healthy snacks in after-school programs, along with outreach to parents and other family members to get them involved in teaching and role-modeling healthy habits.

For information on ReCharge! Energizing After-School, go to www.ActionForHealthyKids.org.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 6

STEP 6 WE’RE ADDRESSING DISPARITIES IN EDUCATION AND HEALTH It will not be possible to have a meaningful impact in the fight against childhood obesity without significant progress being made in urban communities. Nearly one quarter (23%) of public school students attend school in the 100 largest school districts in the country, while 43% attend school in the largest 500 districts. These 500 districts, which represent less than 3% of all school districts, include many of our nation’s largest cities. Most of these districts, moreover, are home to a large number of racial and ethnic minority children, many of whom come from low-income families. In fact, 69% of students in the 100 largest districts are minorities, compared to 40% of students in all districts combined. Over half (54%) of the students in these 100 districts are eligible for free or reduced-price lunch, compared to 39% nationwide. There are a number of unique challenges in trying to combat childhood obesity in urban communities and communities of color. • Increased risk: African-American, American Indian and Hispanic populations have higher rates of childhood obesity and the diseases/conditions that are associated with being overweight or obese. • Economic challenges: The most recent data shows that more than half of African-American and Hispanic children come from low-income families, compared to just 25% of non-Hispanic white children. Most of these children live in families where one or both parents work at least part-time. Facing time and income constraints, these families often dine on inexpensive foods that are not healthy. • Cultural norms: In some cultures, high-fat, high-calorie, and high-sugar foods are frequently consumed. Some cultures also do not view being thin as physically attractive. In addition, families new to the U.S. can be particularly susceptible to advertising of poor-quality foods, as they may think that eating these types of food is the “American way.” • Environmental challenges: Challenges abound at home, in school, and in local communities. Many low-income communities and communities of color have limited access to high-nutrient, low-calorie foods in their neighborhoods. Many of these urban communities have few grocery stores and plenty of fast-food restaurants. These communities also lack green/recreational space and are characterized by high crime rates and dangerous traffic, making it difficult to engage in physical activity. Schools in these areas may lack professionally trained staff (e.g., physical education instructors, nutrition counselors) and have playgrounds that are in a state of disrepair. Perhaps because of these challenges, minority youth tend to have higher rates of overweight/ obesity than do their non-minority peers. Mexican-American and African-American youth, for example, are more likely to have weight problems than are non-Hispanic white youth. Thus, in these communities there is a tremendous need to change the environment so as to promote physical activity and better nutrition. As the Institute of Medicine concluded, “it is unreasonable to expect that people will change their behavior so easily when so many forces in the social, cultural, and physical environment conspire against such change.”

NOBODY CAN GO IT ALONE Helping Districts Implement Wellness Policies Funding from the Kellogg’s Corporate Citizenship Fund helps Action for Healthy Kids Teams assist districts and schools with the implementation of Local Wellness Policies. Eleven Teams were awarded grants for projects that build upon their ongoing work. The AFHK Teams collaborate with a number of partners including institutions of higher education, state agencies, local school district staff and PTAs, and all of the Teams are working with evaluators to help assess the impact of their project in terms of changes in policy, implementation of policy changes, and changes in the knowledge and skills of those trained under the project to continue this work.

Helping Students Make Better Food Choices in School During the 2004-2005 school year, a dozen Chicago-area schools participated in a project to test various approaches to improving school-based nutrition. These schools implemented strategies to improve student food choices. Several organizations and businesses, including Action for Healthy Kids, were part of a working group which provided technical support and expertise to the schools. With funding from Robert Wood Johnson Foundation, Action for Healthy Kids produced a report, Helping Students Make Better Food Choices in School, on the work undertaken with these 12 schools. Importantly, this report includes several key findings regarding how we can best support our schools as they move from developing their Local Wellness Policies to actually implementing and monitoring those policies.

Visit www.ActionForHealthyKids.org for Action for Healthy Kids’ full report, Helping Students Make Better Food Choices in School. Taking the Next Step: School Cafeteria-Focused Promotions to Improve Student Food Choices Findings from the project above led to a USDA-funded initiative to educate students and school personnel about healthy food choices and ways to improve nutrition in three Illinois school districts. Strategies were pursued for introducing students to food groups they need to consume more of (low-fat or nonfat dairy, fruits and vegetables and whole grains) and for increasing knowledge about good nutrition practices. Using the school cafeteria as the focus of activities, the project motivated youth to make better food choices during the school day. Notably, it also included activities to increase school staff’s attention to wellness.

ReCharge! Energizing After-School Funding from Pfizer Animal Health allows Action for Healthy Kids Teams to work with schools and districts to use the ReCharge Energizing After-School program, developed by Action for Healthy Kids and National Football League. AFHK Teams train after-school program coordinators to lead ReCharge! activities and provide technical assistance to ensure the program’s success. In addition, the AFHK Teams inform school decision-makers about ways the ReCharge! program assists schools in implementing their Local Wellness Policies. ReCharge! Energizing After-School provides a proven, effective example for AFHK Teams building awareness among students, teachers, parents, school administrators, and foodservice personnel about the importance of healthy snacks and physical activity during after-school hours.

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 6

Despite the problems in the school environment, schools still represent the best opportunity for many urban youth and racial/ethnic minority children to engage in physical activity and to eat healthy meals. The key to improving the school environment is to embark on sustainable strategies that combine both education and institutional changes in a comprehensive approach that is tailored to a local culture (e.g., introducing healthy menu items that are popular within the local culture). The most successful improvement programs make a point to include students in the planning process. A number of organizations are active in trying to implement this kind of environmental approach in urban communities and communities of color, including the following, which were showcased at the Healthy Schools Summit 2005.

“

The California Endowment’s Healthy Eating Active Communities program seeks to advance policies that improve access to and availability of healthy foods while limiting access to unhealthy foods. The program also seeks to improve the quality of and participation in school meal programs, and to advance policies that foster participation in daily physical education We need to get the people from grades K-12. To that end, the California Endowment is working to link school leaders who are closest to the problem, with the expertise of public health departments, because they are also closest and to recruit youth from various cultures to to the solution. serve as leaders in promoting environmental change through peer-to-peer contact. As a part George R. Flores, MD, MPH of this effort, the California Endowment is also Senior Program Officer with supporting health outreach workers who work The California Endowment with Hispanic communities to promote healthy lifestyles and to facilitate access to preventive Addressing the Healthy Schools Summit and other needed healthcare services.

”

100 Black Men of America, Inc. is working to engage inner cities and communities of color in the fight against childhood obesity. This organization serves 125,000 youth through 103 local chapters that are staffed entirely by volunteers. 100 Black Men of America, Inc. focuses on four areas — education, health/wellness, economic development, and mentoring. Within the area of health and wellness, the organization develops comprehensive, turnkey programs distributed through local chapters. The programs benefit from public-private partnerships, which help with content development, program implementation, and funding. For example, 100 Black Men of America, Inc. worked with the Centers for Disease Control and Prevention (CDC) and other partners to develop a document entitled Nutrition and Physical Activity: The 100 Way that the organization’s volunteers use in local communities. The Compass Project is a national service organization with more than one million community volunteers who are exploring the expertise and capacity of Hispanic and African-American communities to address childhood obesity by promoting physical activity and better nutrition. The Compass Project works closely with other organizations that have close ties to minority communities. These entities represent a “parallel service delivery system” that can be invaluable in understanding and addressing the unique factors (e.g., safety issues, fear of the police, feeling unwelcome in local schools) that are driving the problems of overweight and obesity within local

WHAT AFHK IS DOING ABOUT SCHOOL WELLNESS: STEP 6

minority communities. The Compass Project has a vast communications network to assist in this effort, including not only written materials through a web site and newsletters, but also a series of regular meetings that bring together key stakeholders within local communities.

Wrestling with Cultural Norms: District of Columbia Public Schools and the Washington, D.C. Action for Healthy Kids Team The Washington, D.C. Action for Healthy Kids Team has embarked on a three-pronged effort to engage the community, one where two-thirds of the children receive free or reduced-price lunches. The first part of the approach is to be sensitive to and listen to the community’s concerns. During focus groups with children, the Washington, D.C. AFHK Team learned that terms such as “overweight” or “obese” did not resonate. The children did not perceive themselves to have weight problems; in fact, looking “thick” is considered to be an attractive feature. People support what Thus, any discussion of healthy eating and physical activity needed to be framed as a “health” or “lifestyle” issue, not an they help to create. appearance issue. The second part of the strategy involved empowering the community by letting them participate in the Janice Ford Griffin planning and development efforts, including pilot projects. For Director of The Compass Project example, children helped choose the kinds of healthy foods Addressing the that would be put into vending machines as part of a new Healthy Schools Summit policy passed by the city council in 2004. Finally, the third part

“

of the strategy involved engaging the media. Members of the AFHK Team appeared as guests on call-in radio shows, which proved to be an excellent way to educate and engage parents on the new vending machine policy. Student leaders were also encouraged to make appearances at press conferences, write editorials, and talk with reporters about the policy.

Challenging the Bureaucratic Status Quo: Cleveland Municipal School District In the Cleveland Municipal School District (CMSD), 100% of students qualify for free meals through the National School Breakfast and Lunch Programs. Like many large urban school districts, CMSD is plagued by a very fragmented school-based health infrastructure, with multiple layers, department heads, superintendents, and board members being involved. Funding for school health is also fragmented within the district. The net result is that while every agency and organization wants to help, their efforts are uncoordinated, highly variable, and inconsistent. While some students receive quality programming, others receive little or nothing at all. To get around this problem, CMSD hired a Director of Health and Support Service to run a newly created Health Services Office. The city council also solicited input from the community to develop a District Comprehensive Health Plan that laid out goals and objectives that were developed by the community itself. The School Board approved the plan in 2002. Implementation plans were developed and approved in 2003. One key element of the plan is that all activities that encompass health promotion and prevention are now centralized in the newly created office.

”

GETTING IT DONE: MAKING CONCRETE OPERATIONAL STRATEGIES WORK It is difficult if not impossible for Action for Healthy Kids Teams to successfully implement the kinds of programs discussed here without the right organizational structure, adequate financial resources, and necessary buy-in from key stakeholders and audiences, including parents, students, and school administrators. The Healthy Schools Summit 2005 highlighted some of the “best practices” being used by Teams and others as they seek to implement effective operational strategies that allow for the kinds of programmatic successes featured in this summary. For a full report on operational “best-practices” shared at the Summit, go to www.ActionForHealthyKids.org. Find out: • • • •

How AFHK Teams are structuring themselves to achieve a true statewide presence How they are successfully securing financial and in-kind resources to support their work What operational strategies they are pursuing to drive change How AFHK Teams are engaging key audiences in their work, including parents, students and school leaders

“

If you get smart people sitting around, you’ll come up with solutions. Sanjay Gupta, MD

”

Senior Medical Correspondent, CNN Facilitating the Strengthening the Common Ground Dialogue at the Healthy Schools Summit

From left to right: Steven M. Sweeney, CEO, Chartwells Education Dining Services, Vicki Perkins, Executive Director, Anthem Blue Cross Blue Shield Foundation, Celeste A. Clark, Senior Vice President, Corporate Affairs, Kellogg Company, and Terry Bazzarre, Senior Program Officer, Robert Wood Johnson Foundation.

EMBRACING ALL THE PLAYERS

EMBRACING ALL THE PLAYERS: INDUSTRY, GOVERNMENT, EDUCATION, HEALTH AND PHILANTHROPY Action for Healthy Kids has played, and will continue to play, an important “convening” role in bringing together leaders from business, government, health, and education sectors to discuss challenges and solutions to the childhood obesity crisis. Action for Healthy Kids is committed to bringing these stakeholders together, not only to raise awareness, but to motivate and enable them to take action. A special session at the Healthy Schools Summit in 2005 brought together a diverse group of leaders to conduct just such a dialogue. Facilitated by Sanjay Gupta, MD, Senior Medical Correspondent at CNN, the session involved members of AFHK’s Board of Directors and Partner Steering Committee (PSC), which includes over 50 leading national education, health, nutrition, and fitness organizations and government agencies. (See page 38 for a full listing of PSC members.) Also included were the following leaders from the business community: • Michael Donahue, Vice President, Communications, McDonald’s USA • Lance Friedmann, Senior Vice President, Health and Wellness, Kraft Foods • Timothy S. Knowlton, Vice President, Corporate Social Responsibility, Kellogg Company • Bill Kraus, Vice President of Marketing, Under Armour Performance Apparel • Vicki Perkins, Executive Director, Anthem Blue Cross Blue Shield Foundation • Jean Ragalie, Vice President, Public and Industry Relations, National Dairy Council • Abigail Rodgers, Vice President of Wellness Strategies and Communications, The Coca-Cola Company • Steven M. Sweeney, Chief Executive Officer, Chartwells Education Dining Services

The Role of Industry in Addressing the Problem It is in corporate America’s own self-interest to address the childhood obesity epidemic by promoting healthier eating and physical activity, both inside and out of our nation’s schools. Such actions can have long-term benefits in terms of improving productivity (since healthier students become healthier, more productive adults) and reducing long-term healthcare costs, which is critical to the future global competitiveness of America’s businesses. Such actions can also help to align corporations with what their customers want for their children (as indicated in a recent Action for Healthy Kids survey of parents) — see “Parents’ Views on School Wellness Practices,” available at www.ActionForHealthyKids.org.

EMBRACING ALL THE PLAYERS

Private sector leaders clearly believe that their organizations have an important role to play in addressing the childhood obesity epidemic. Panel participants highlighted several strategies that they are pursuing in this area: • Changing product mix and offerings to be more healthful: Many companies are changing existing products to make them more healthful, and introducing new, healthy food options. For example, McDonald’s sold 400 million salads in 2004, and has also introduced apple snacks for children and Happy Meals featuring 1% flavored milk chugs. The Coca-Cola Company has introduced 15 new low-calorie products in the last two years. At present, roughly 50% of the company’s sales are in zero-calorie or low-calorie products; bottled water is the company’s fastestgrowing product.

“

Virtually all of the food companies in the industry are trying to take steps forward, and we want to be part of that, as well. Lance Friedmann

”

Senior Vice President, Health and Wellness, Kraft Foods

Addressing the Healthy Schools Summit • Developing products specifically designed to encourage physical activity: For example, Under Armour Performance Apparel has an explicit goal of developing products that will allow all children — even those who might not think of themselves as being athletic — to be active and to participate in sports. • Changing practices to promote health: For example, Kraft Foods is eliminating advertising of unhealthful products in schools, creating national standards for products sold in vending machines, and reformulating some of its products to make them healthier (e.g., whole grain macaroni and cheese). Chartwells Education Dining Services has introduced its Balanced Choices program, which provides healthy breakfasts and lunches to millions of children each day in schools across the country. • Sponsoring in-school and after-school activities that emphasize physical activity and nutritious snacks: Many companies are looking outside their own doors to support after-school programs in their local communities. For example, the Kellogg Company recently formed a partnership with Action for Healthy Kids in which the company is providing grants to AFHK Teams to assist them in implementing Local Wellness Policies with districts in their states. The National Dairy Council, founding sponsor of Action for Healthy Kids, is actively involved in assisting AFHK Teams working at the grass-roots level to help advance nutrition and physical activity for children and youth in schools. And in partnership with the National Football League, Action for Healthy Kids recently launched ReCharge! Energizing After-School, a program designed to help students learn about and practice healthy eating and physical activity during out-of-school time. • Promoting prevention and wellness: For example, Anthem-Wellpoint, the largest health benefits company in the nation, is working in partnership with major universities, professional associations (e.g., the American Dietetic Association), health providers, churches, and other stakeholders on a variety of prevention and wellness programs that are designed to empower individuals to prevent chronic diseases, and to improve the health of those individuals who already have them. One example of Anthem’s programs is the sponsorship of health fairs and other initiatives in partnership with Hispanic and African-American churches.

EMBRACING ALL THE PLAYERS

What Remains to Be Done Each of the stakeholders has an important role to play in supporting behavior changes that lead to increased levels of physical activity and better eating by our nation’s youth. Private industry, all levels of government (local, state, and federal), schools, foundations, and other philanthropic organizations, healthcare insurers and providers, community-based organizations, and the media must work individually and in partnership to promote change. Such change must occur in three distinct areas — the environment, the policy, and the individual. • Encouraging change at the policy level: It is critical to advocate for those policies that will make a difference to the health of children over the long term, including USDA’s school-based meal programs. • Encouraging school and communitylevel change: It is critical to leverage those resources that already exist at the community level. Implementing Local Wellness Policies will help to change the school environment. For example, 35 million children and 70 million households live within three miles of a YMCA, making these facilities a potentially important part of any solution to the childhood obesity epidemic.

“

We believe innovation goes beyond the research center for food and also innovates into marketing initiatives and partnerships at the school level…

”

Timothy S. Knowlton Vice President, Corporate Social Responsibility, Kellogg Company

Addressing the Healthy Schools Summit

• Encouraging individual behavior change: Change will not occur without listening to the voices of those whose behavior you are trying to change — that is, the students. Students often have the best ideas on the kinds of programs that will or will not work, and thus students should be involved in the design, development, and implementation of programs whenever possible. For example, Under Armour Performance Apparel regularly conducts research with children about the kinds of sports that they enjoy playing. This research has found that today’s kids are interested in different sports than their parents were; soccer and lacrosse are becoming quite popular. Girls, moreover, are much more involved in sports than in past generations. Female athletes represent 45% of Under Armour’s business. For its part, industry must become involved in each of these three levels, as outlined below: • Companies must change their internal practices and programs to support physical activity and better nutrition. As noted earlier, many companies are already actively involved at this level.

“

Our motivation is to improve the students from an early age and condition them to be healthy and productive adults. Steven M. Sweeney

”

• Companies must move outside of their own organizations to become involved with health and education, community and non-profit organizations. Several industry leaders are providing support for initiatives; however, more help is needed. Importantly, industry must collaborate in a manner determined by the public health community.

Chief Executive Officer, Chartwells Education Dining Services

Addressing the Healthy Schools Summit

EMBRACING ALL THE PLAYERS

â&#x20AC;˘ Companies must be active on the policy front as well. At a minimum, companies must not become obstacles to change (e.g., by lobbying against legislative efforts to ban non-nutritious foods in school vending machines). Better yet, companies could actively support sound policies at the local, state, and federal level, even if they might create short-term risks to their organization. The long-term benefits to the health of our nationâ&#x20AC;&#x2122;s youth clearly outweigh any short-term financial considerations, as it is in everyoneâ&#x20AC;&#x2122;s economic interest to have healthy children who will grow into productive citizens, workers, and consumers in the future.

THE ROAD AHEAD

THE ROAD AHEAD: CAMPAIGN FOR SCHOOL WELLNESS Action for Healthy Kids is pleased to launch its Campaign for School Wellness, a national, grassroots outreach and communications campaign to foster the implementation of Local Wellness Policies and practices in schools. Nationally, ad hoc progress is certainly being made in school wellness practices but, for a sustainable impact on children’s nutrition and physical activity habits, systemic school change is necessary. To create an environment that is supportive of children’s health, the entire system must be addressed because of the many interacting, interrelated parts that form the whole school-based experience of the child. Consequently, we must address all levels of the school system (national, state, district, and building) and all school areas — school practices, operations, before, during, and after-school programs, and curricula. As pointed out in the introduction to this report, as of July 1, 2006 nearly all school districts were required to have Local Wellness Policies in place that have the goal of promoting better nutrition, physical activity, and wellness. With this legislation enacted, there is an extraordinary opportunity to make changes at schools that can benefit children’s health and learning. However, schools already have a full agenda with meeting improvement goals for performance and overcoming the challenges of financial constraints. Schools face growing budget challenges and increasing pressures to devote resources to improving performance goals and will, therefore, need assistance — not only from government, but also from parents, students, community groups, and philanthropic and corporate organizations — to help make resources available so Local Wellness Policies can be successfully implemented and sustained. Action for Healthy Kids’ Campaign for School Wellness is seeking to generate national, state, and local actions aimed at engaging schools and communities to improve nutrition and physical activity. The Campaign for School Wellness supplements AFHK Team actions already in motion, and serves as the “umbrella” for wellness efforts during 2006 and beyond. The Campaign features events and outreach tools that target key audiences, including district administrators and policy-makers, parents, and those charged with implementing Local Wellness Policies. Campaign imperatives include: • Directing attention to all phases of the Local Wellness Policy Process — implementation, evaluation, and refinement — motivating schools to continue improvements over time. • Catalyzing actions from multiple sectors, private and public, national, state, and local, to provide further support for the improvement of nutrition and physical activity. • Engaging parents, students, minority and urban communities in supporting wellness practices of good nutrition and improved physical activity at school.

THE ROAD AHEAD

• Educating and promoting the importance of sound nutrition and good physical activity for achievement and health. • Generating resources and facilitating exchange of information and experts to assist districts in all phases of the Local Wellness Policy Process. School districts are making great progress developing school Local Wellness Policies that have the potential to significantly impact student health. The Campaign for School Wellness is keeping, and will keep, the focus on these critical policies as districts move into the implementation and monitoring phases. Most importantly, AFHK Teams are effectively using the Campaign for School Wellness tools and initiatives to advance their action plans and leverage for additional gains.

For more information on Action for Healthy Kids’ Campaign for School Wellness, visit www.ActionForHealthyKids.org.

From left to right: Ivan Juzang, President/Founder of MEE Productions, Cedric D. Jones, Senior Director of Youth Football, National Football League, Dave Watt, Publisher, Sports Illustrated for Kids, and Chandler Converse, Student at McClesky Middle School in Cobb County, GA.

CHARTING THE COURSE

CHARTING THE COURSE: OPPORTUNITIES AND CHALLENGES AHEAD During the last four years the groundwork for progress has been laid. United by a common concern, Action for Healthy Kids and its partners have been instrumental in making the case for action and in putting in place an infrastructure to take action to improve children’s nutrition and physical activity in the school environment. As a result, we are now poised to “raise the bar” and make an even greater impact in the future. Many challenges and opportunities lie ahead, from helping school districts create and implement Local Wellness Policies, to supporting afterschool programs as part of school wellness goals, to engaging urban and minority communities in our work. With a powerful network of over 6,000 volunteers in every state and the District of Columbia, along with a robust partnership of more than 50 national organizations and governmental agencies, Action for Healthy Kids will continue its important work to improve nutrition and increase physical activity in schools, and thereby improve children’s readiness to learn.

ACTION FOR HEALTHY KIDS “COMMITMENT TO CHANGE” Action for Healthy Kids “Commitment to Change” was developed with Action for Healthy Kids’ partner organizations, providing the foundation for our work together. Today, the “Commitment to Change” serves to evolve the content of the original goals so as to better align with the updated Dietary Guidelines for Americans 2005 and The Child Nutrition and WIC Reauthorization Act of 2004 requiring school districts to develop and implement Local Wellness Policies. The “Commitment to Change” serves as a guiding document for Action for Healthy Kids and its Teams’ initiatives, with goals for improving nutrition and physical activity in our nation’s schools. As a group of cross-sector partners, we recognize that healthy students are better able to learn and schools can help optimize student’s readiness to learn by providing an environment that supports positive physical activity and eating behaviors. To help reduce the current high risk of childhood obesity, while ensuring children and adolescents obtain optimal nutrition and physical activity in schools, Action for Healthy Kids considers the following guiding principles: • Encourage adequate nutritional intakes and consumption of nutrient-dense foods, especially those foods that provide nutrients in which children and adolescents are deficient (calcium, iron, potassium, fiber, magnesium and vitamin E); • Offer the foods that need to be encouraged in preference over those foods with low nutritional values. Encourage fruits, vegetables, whole-grain foods, low-fat and nonfat, white and flavored milk and serve with consideration towards safety, packaging, taste and appeal; • Evaluate foods based on the overall nutritional quality using parameters that are of importance to children and adolescents’ growth and development; • Provide comprehensive, preferably daily, physical education for children in grades K-12; (continued on next page)

CHARTING THE COURSE

• Implement physical education, nutrition and health education curricula that emphasizes enjoyable participation and helps students develop confidence to maintain healthy lifestyles; • Provide physical activity instruction and programs that meet various needs and interests of all students, including those with illness, injury, and developmental disability, as well as those with obesity, sedentary lifestyles, or a disinterest in traditional team sports; and • Ensure that children learn practical, life-long lessons about balance of good nutrition and physical activity.

“

Three years ago we were all united by a common concern. Today we are united by a common mission and organization.. William Potts-Datema Former Chair of Action for Healthy Kids

”

Addressing the Healthy Schools Summit

THANKING OUR SPONSORS Action for Healthy Kids received tremendous support from organizations who made this event possible. We gratefully acknowledge the Healthy Schools Summit 2005 sponsors listed below. Champions ($150,000 and above) • National Dairy Council • National Football League • Robert Wood Johnson Foundation Leaders ($50,000 to $149,999) • Aetna Foundation, Inc. • The Coca-Cola Company • Compass Group, The Americas/Chartwells Education Dining Services Friends ($20,000 to $49,999) • Kellogg Company • Kraft, Inc. Associates (up to $19,999) • Land O’ Lakes • General Mills • Cartoon Network • Starbuck’s • Kaiser Permanente

PARTNER STEERING COMMITTEE More than 50 national organizations have partnered with Action for Healthy Kids to promote physical activity and nutrition among our nationâ&#x20AC;&#x2122;s youth. These Partner Steering Committee organizations provided knowledge and expertise that was vital to the development and planning of the Summit. Representatives of these organizations also shared their valuable insights as members of the Summit faculty.

Afterschool Alliance American Academy of Family Physicians American Academy of Pediatrics American Association of Clinical Endocrinologists American Association of Family & Consumer Sciences American Association of School Administrators American Cancer Society American College of Sports Medicine American Diabetes Association American Dietetic Association American Federation of Teachers American Heart Association American Public Health Association American School Health Association Association for Supervision and Curriculum Development Association of School Business Officials International Association of State & Territorial Chronic Disease Program Directors Association of State & Territorial Health Officials Association of State & Territorial Public Health Nutrition Directors Cancer Research and Prevention Foundation Comprehensive Health Education Foundation Council of Chief State School Officers Directors of Health Promotion and Education Family, Career & Community Leaders of America Food Research and Action Center National Association for Sport and Physical Education National Association of Elementary School Principals

National Association of Health Education Centers National Association of Pediatric Nurse Practitioners National Association of School Nurses National Association of Secondary School Principals National Association of State Boards of Education National Association of Student Councils National Coalition for Parent Involvement in Education National Coalition for Promoting Physical Activity National Dairy Council National Education Association — Health Information Network National Future Farmers of America Organization and Foundation National Medical Association National Middle School Association National PTA National School Boards Association Parents Action for Children Robert Wood Johnson Foundation School Nutrition Association Society for Nutrition Education Society for Public Health Education Society of State Directors of Health, Physical Education and Recreation U.S. Department of Agriculture — Food and Nutrition Service U.S. Department of Education — Office of Safe and Drug-Free Schools U.S. Department of Health and Human Services — Office of Disease Prevention and Health Promotion Centers for Disease Control and Prevention President’s Council on Physical Fitness and Sports National Institute of Child Health and Human Development

YMCA of the USA

BOARD OF DIRECTORS 2006 Judy Young, PhD, Chair Vice President for Programs American Alliance for Health, Physical Education, Recreation and Dance Reginald L. Washington, MD, Vice Chair Medical Director Rocky Mountain Pediatrix Cardiology Associate Clinical Professor University of Colorado Health Sciences Center David Satcher, MD, PhD, Founding Chair Director, Center of Excellence on Health Disparities Poussaint-Satcher-Cosby Chair in Mental Health Morehouse School of Medicine 16th United States Surgeon General Jean Ragalie, RD, Secretary and Treasurer Executive Vice President, Nutrition Corporate and Public Affairs National Dairy Council Roger Goodell Chief Operating Officer National Football League Katherine Kaufer Christoffel, MD, MPH Professor of Pediatrics and Preventive Medicine Northwestern University Feinberg School of Medicine Vicki Perkins Executive Director Anthem Blue Cross and Blue Shield Foundation John W. Rowe, MD Chairman Aetna, Inc. Barry D. Sackin, SFNS B. Sackin & Associates Nicholas Valeriani Executive Committee, Worldwide Chairman Cardiovascular Diagnostics and Devices Johnson & Johnson Alicia Moag-Stahlberg, MS, RD Ex Officio, Executive Director Action for Healthy Kids gratefully acknowledges former Director, Nora Howley and former Chair, Bill Potts-Datema for their service to Action for Healthy Kids.