Think Big. Start Small. Plansbook

THINK BIG. Start Small.

A campaign for Kansas Action for Children

Table of Contents Introduction 2.......................................Executive Summary

4...........................................................Introduction 6.........................................Situational Analysis 10..........................................Secondary Research 20........................................Primary Research 33...........................Summary of Key Findings

P lanning

36.......................................SWOT Analysis 41..........................................Target Audience 43.........................................Goals & Objectives 46........................................Strategies & Tactics

Conclusion 75........................Predictions & Evaluations

81.........................................Budget Outline 83..........................................Appendix

Meet theTeam Volcanic Communications aspires to be more than an advertising agency. Our team of innovators and creative entrepreneurs help clients to reframe challenges and fight marketing clutter with bold solutions. Our focus is on solving business challenges, not making ads. We think differently, which is why our office is located inside a public library and our team consists of randomly selected 22-yearolds. Volcanic puts in the hard work it takes to get the job done, as long as that hard work doesn’t interfere with Thursdays, Fridays or Saturdays. We believe in creatively driven ROI, which is why we make every effort to bring joy, and results, to our clients.

Emily Hess

Tom Wittler

Sarah Lamphere

Account Executive

Research Director

Strategic Communication Director

Tabatha Bender

Jack Esberg

Kaitlin DeJong

Strategic Communication Director

Creative Director

P lansbook Director

Executive

Summary

Executive Summary Kansas Action for Children (KAC) seeks to make positive changes in the food and beverage environment for children ages zero to five.

To help KAC achieve its goal, Volcanic Communications devised “Think Big. Start Small.” This campaign provides a cohesive plan with consistent messaging ready to be utilized by KAC. “Think Big. Start Small.” is rooted in research and brought to fruition through an informational and interactive multimedia presence. It utilizes advertising, public relations, education, media advocacy, social media and strategic partnerships. This campaign targets providers at family child care homes (FCCHs), parents and children ages zero to five. This campaign works to enact changes in a number of realms with one end goal in mind: positively influence the food and beverage environment for Kansas children ages zero to five.

Paid media, such as Facebook and Google advertisements, will be used year long to drive the target audiences to the “Think Big. Start Small.” website and Facebook page. After an initial following is established through its partner, Child Care Aware (CCA) and these online advertisements, a radio spot and television advertisement will be released in March to increase the general public’s awareness.

The “Think Big. Start Small.” website and its YouTube account will host both the television advertisement and a public service announcement that provides information on the obesity issue.

This campaign also provides beneficial information in the form of a “Think Big. Start Small.” 2015 content calendar, which will further engage FCCH providers and parents all year long. Newsletters highlighting each month’s specific theme will be distributed to parents and providers through CCA and the “Think Big. Start Small.” website. Parents and FCCH providers can utilize this information to positively influence the health behaviors of the children in their care.

During the months of May, June and July, “Think Big. Act Small.” will sponsor “Eat Well, Play Well,” a child-friendly, interactive and bilingual exhibit that promotes a healthy lifestyle in Wichita’s downtown Exploration Place. To generate earned media, a news release connecting the exhibit to the “Think Big. Start Small.” campaign will be distributed to Wichita-metro news outlets and

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“Think Big. Start Small.” also partners with Kansas Child Care Training Opportunities, to incorporate nutrition education into classes that fulfill the annual mandatory hours of education required of FCCH providers. “Think Big. Start Small.” incentivizes these classes by awarding one provider in each of the first 20 classes a $100 gift card. These classes can be used to educate providers on nutrition practices and drive awareness of programs available to them, such as the Child and Adult Care Food Program (CACFP). “Think Big. Start Small.” then reinforces this with CACFP testimonials posted on its website and Facebook page.

The cost for this campaign amounts to $33,996. Each of the above tactics in some way affects the food and beverage environment of Kansas children. “Think Big. Start Small.” ensures that all these different pieces work together in unison to form one cohesive movement towards a healthier Kansas.

Introduction

Introduction The United States is in the midst of a childhood obesity epidemic and, unfortunately, Kansas is not immune. If society continues down its current path of apathy and laissez-faire, unfortunate consequences lie ahead. Change is needed and, luckily for us, organizations like Kansas Action for Children (KAC) are up for the challenge.

The question remains, is Kansas up for the challenge? There is no denying it: change is scary. It is uncomfortable and unfamiliar.

Looking at the big picture, it is downright daunting. That is why Volcanic Communications exists. As an agency, integrity, transparency, respect and accountability are our greatest qualities. Excellence is our commitment.

Volcanic Communications is dedicated to educating citizens on the issue of childhood obesity. Think Big. Start Small. By taking the big challenge and breaking it into small pieces, KAC can show Kansas the possibility of positive change. The ease of a simple transition. One step, two steps. Slowly but surely, ground is gained. Slowly but surely, change is made.

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Situational

Analysis

Kansas Action for Children For 35 years, Kansas Action for Children (KAC) has strived to make Kansas the best place to raise a child. KAC is able to do this by working alongside lawmakers to change policies regarding its three core areas: health, education and economic stability. KAC has 10 full-time employees and 19 volunteers. According to KAC’s Form 990, it earned a total revenue of $824,161 in 2013 (KAC Form 990).

As a nonprofit, nonpartisan organization, KAC receives its funding from grants and private donations making it a truly independent voice for Kansas children.

Recently, KAC received a $83,000 grant from the Kansas Health Foundation and has embarked on a new statewide initiative focusing on creating a healthy food and beverage environment for children ages zero to five. Its Year One Initiative, Pass on Pop, was incredibly successful. Around 2,500 people took the pledge to have “soda free Sundays.” For the Year Two Initiative, KAC has directed its focus to the nutritional environment in family child care homes (FCCHs). The budget for Year Two is $30,000 with an additional $10,000 in expendable funds.

With the help of Volcanic Communications, KAC will enact positive changes in the food and beverage environment currently in place at FCCHs. The goal of this campaign is to persuade FCCH providers to make positive health changes now. This way, resistance is minimal when KAC begins working with lawmakers to establish policies in year three.

Child Care Aware KAC has partnered with Child Care Aware (CCA) for this endeavor.

CCA is a national organization with four regional offices in Kansas.

According to its 2012 Form 990, CCA has 22 full-time employees (CCA Form 990). CCA is going to play a pivotal role in this initiative.

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Target Audience FCCH Providers: The primary audience for this campaign is FCCH providers. More than 30,000 Kansas children ages zero to five receive child care from FCCHs. There are around 4,600 FCCHs in Kansas. Ninety-eight percent of the time, women run and manage these homes. Their ages vary and the vast majority makes less than $30,000 per year. Social media helps them connect and network with fellow FCCH providers. These providers care deeply for the children in their care and they truly want what is best for them. Volcanic Communications’ mission is to help KAC and CCA determine the appropriate communication channels, create a unique and engaging way to instigate a dialogue with FCCH providers and equip them with the proper information and materials necessary to make a change.

Kansas Children Ages Zero to Five: As of 2013, Kansas children ages zero to five accounted for 6.9 percent of the Kansas population. That means there are roughly 200,000 children in that age range in Kansas (United States Census Bureau). Close to 16 percent of these children are overweight and an additional 13 percent are obese. With more than 30,000 Kansas children receiving child care from a FCCH provider, it is pivotal that the resulting obesity prevention initiatives Volcanic Communications suggests appeal to and target these children.

Parents of Kansas Children Ages Zero to Five: Parents and child care providers share the responsibility of delivering the proper education and resources necessary for children to develop a healthy lifestyle (Barnes, 19). A child can be engrossed in a healthful lifestyle at his or her FCCH, but those efforts can be totally negated if the child’s home life is full of junk food and sugary drinks. Volcanic Communications’ initiatives need to provide FCCH providers with accurate nutritional information that providers can then share and talk openly about with parents.

The Media: The media can be a huge asset is gaining campaign awareness, whether it is through paid or earned media. KAC has had past success utilizing radio. Billboards have been found to be ineffective, however. FCCH providers are very active on social media, specifically on Facebook. Videos are another effective medium for both FCCH providers and children. In terms of earned media, an effective use of media advocacy is the best way to gain the attention and interest of reporters.

The Childhood Obesity Environment The United States: According to the Centers for Disease Control and Prevention (CDC), childhood obesity has more than doubled in the past 30 years. The number of obese children in the U.S. is increasing. Obese children are more likely than non-obese children to be obese adults. They are at risk for cardiovascular disease, diabetes, sleep apnea and bone and joint problems. The negative stigmatization of obesity can also lead to social and psychological problems (Centers for Disease Control and Prevention).

Seventeen percent of U.S. children are obese and 35 percent are overweight. Childhood obesity is more prevalent among lower socioeconomic groups (Obesity in Children). When it comes to obesity prevention, parents and caregivers are encouraged to provide healthy meals and snacks, daily physical activity and nutrition education (Prevent Childhood Obesity). The best method is early prevention. This is why FCCH providers are crucial in the fight to turn the tide on the current rise in childhood obesity.

Kansas: Kansas is the 25 most obese state in the U.S. for children ages 10 to 17 (“In Your State”). Thirty percent of Kansas children are overweight or obese. Over 500 Kansas schools are now enrolled in the Healthier Generation’s Healthier Schools Program, which offers schools the necessary resources to create a wellness council, start staff wellness programs and offer healthier foods and more physical activities during the school day (Healthier Generation). Due to programs like these, Kansas was one of 18 states between 2008 and 2011 that saw a decrease in childhood obesity rates among two to four-year-olds from low-income families (The State of Obesity). th

Challenges to Overcome

External: The first external challenge to confront is the child care providers’ nutrition knowledge gap. Unlike schools, there are very few policies and regulations in place regarding the food and beverages served at FCCHs. This lack of policies has led to a lack of knowledge. Providers might not see the harm in their current nutritional plans. By arming care givers with accurate information, they will better understand why the requested changes are positive steps in raising a healthy child. FCCH providers can then reach out to parents and become influential in changing what is served at home. This sharing of knowledge has the added benefit of helping child care providers establish themselves as credible sources of information as well as strengthening their relationship with the parents of the children they serve.

FCCH providers are child care experts. To have an organization tell them to change their practices could be viewed as a personal affront. Volcanic Communications will combat this through highly strategic messaging. KAC cares deeply for children and so do child care providers. Centering the message on this mutual theme will be a positive way to establish a dialogue without insinuating incompetence.

There might be some monetary push back as well. The majority of FCCH providers are low income. They may lack the funds necessary to create this change as well as the free time to go out and get the supplies. The easiest solution to this is to provide them with the materials needed. Supplying these materials gets FCCH providers one step closer to implementing change.

Finally, old habits die hard. The hardest challenge faced will be getting FCCH providers to change themselves. They are role models to these children and they need to be a good example of living healthy. This initiative loses validity without this. By tapping into the FCCH social network, KAC will be able to find quality examples of child care providers who excel in this aspect. KAC can then use these examples to show other providers the benefits of making this change.

Internal: KAC typically spends the majority of its efforts working with policy makers, but this initiative is going to require working directly with FCCH providers. Public sector work is new and exciting for KAC, but it lacks a framework on which to base its work. It is for this reason that CCA going to be a huge asset for this campaign.

CCA already has a system in place for interacting and working with FCCH providers and that is an extremely valuable resource to have.

Another challenge to overcome is the size of the organization.

KAC has 10 incredibly hard working employees whose efforts are spread across a wide array of projects. The implementation of this campaign needs to be very strategic in how it utilizes the time required by KAC employees. The final internal obstacle is reputation.

To some, KAC is seen as aggressive, but this campaign has the potential to alter that viewpoint. Instead of going straight to policy makers, KAC is looking to work directly with child care providers.

This extra step will give the organization a face, a personality. If planned and executed correctly, this campaign will highlight KAC as a genuine, caring organization.

That would fill the Kauffman Stadium

1.5 times.

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The Need to Take Action Now There are multiple reasons why now is the ideal time to take action.

The prevalence of obesity in today’s society is an enormous issue. If unhealthy trends continue at their current rates, this will be the first generation of children who will not outlive their parents (ACSM).

KAC strives to make Kansas the best place to raise a child and childhood obesity is one subject that needs to be addressed before that can happen. The 30,000 dollar budget KAC has reserved for this initiative means the necessary funds are in place for KAC to act.

There are many organizations that work to fight obesity and the initial groundwork has been established. KAC bases its initiatives purely on research and facts. It is proven that early intervention is the best prevention method; therefore, targeting children ages zero to five is the smartest way to tackle this issue. The limited nutritional regulations on FCCHs make these facilities the perfect places to target. By turning child care providers into influential change agents, KAC will be one step closer in fulfilling its mission.

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Secondary

Research

Background on Obesity In an effort to better understand the obesity epidemic currently being faced, scientists studied the history of the human race. Our ancestors were equipped with an important survival mechanism that helped them store fat during times of flood and drought. Over time, humans developed a complex, self-regulating system that made them seek calorie-rich foods. Hormones drove this complex system, triggering sensations of hunger, pleasure and the feeling of being full (Bor, 393).

This self-regulating system does not govern everyone’s weight perfectly. Obesity has been present in all societies throughout history, but it has never been as prevalent as it is right now. We are surrounded by an overabundance of calorie-rich foods — the consumption of which can overwhelm the body’s weight-regulatory system. David Kessler, former commissioner for the Food and Drug Administration, said we are living in an “obesogenic.” He defines obesogenic as an “obesity-causing society where food companies tempt us with products filled with fat, sugar, and salt that lead to a loss of control he calls ‘conditioned hypereating’” (Bor, 393).

When food is digested it is broken down into fat, sugar and protein.

Any excess fat is stored in fat cells. Likewise, any excess sugar is converted into fat and stored in the fat cells. When food is scarce, enzymes break down the stored fat and convert it into energy. This is how organisms lose weight. All organisms are designed to avoid starvation; therefore, all organisms are designed to avoid weight loss. Unique mechanisms ensure we have enough energy to survive, primarily by stimulating us to eat. Whenever we eat we stimulate the release of brain chemicals, or neurotransmitters, that elicit feelings of pleasure” (Bor, 394).

A child with one obese parent

is

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3x as likely to be obese as an adult

“We’re gaining weight more today because we’re ingesting more calories,” Kessler said. “Our food is more energy dense and more available.” A lean person’s fat cells can hold around half a microgram (one-millionth of a gram) of fat. For an obese person, that capacity can rise to a full microgram. The number of fat cells can rise dramatically as well. A lean person has approximately 20–40 billion fat cells, while an obese person may have up to 120 billion (Bor, 395).

Pair this dangerous environment with genetic factors and you have the two primary causes of the obesity epidemic. “It’s the change in our environment that’s allowed the full panoply of the effects of these genes to show up,” Jack A. Yanovski, head of the unit for growth and obesity at the National Institute of Child Health and Human Development, said (Bor, 393-394). Prenatal factors, metabolic disorders and certain medications, endocrine disorders, drug abuse and hypothalamic tumors are other factors that can also potentially contribute to obesity (Clinical Key, “Obesity in Children”).

Genetics’ Role in Childhood Obesity A child with one parent who is obese is three times more likely to become an obese adult than a child with two parents of normal weight. A child with two obese parents is 13 times more likely to become an obese adult than a child with parents of normal weight (Lumeng, 14). Studies of twins have concluded that genetic variations account for about 40 percent of the weight variance seen among individuals, with the rest coming from dietary habits and other environmental factors (Bor, 395).

Though environmental factors play the most important role in childhood obesity, 25 to 35 percent of obesity cases contain some sort of polygenic genetic determinant (Clinical Key, “Obesity in Children”). In recent years, scientists have gained a better knowledge of the difference between normal variation in the body mass index (BMI) and variation caused by polygenic determinants.

The United States uses BMI as its initial screening process when checking for childhood obesity. BMI is calculated by dividing the body weight (measured in kilograms) by the square of the person’s height (measured in meters). Therefore, BMI equals kg/ m2. An individual’s BMI is then charted and compared against the body mass percentile curve. This curve, specifically based on age and sex, determines in what percentile a child’s BMI lands (Barlow, 2). Childhood obesity is defined as having a BMI above the 95th percentile. Anything between the 85th percentile and the 95th percentile is considered overweight (Clinical Key, “Obesity in Children).

Genome-wide studies have identified numerous genetic variants associated with BMI and obesity. These variants, or loci, are found at specific spots on the gene. As of 2011, 23 different loci with correlations to childhood obesity have been identified (Lakshaman, 1774).

In 2007, the first BMI locus was discovered in the FTO gene (Lakshaman, 1774). People with the FTO BMI locus weigh, on average, seven pounds heavier than people with a normal copy of the FTO gene (Bor, 395). Research has concluded that this FTO variation is not associated with changes in fetal growth, but with obesity-leading changes in BMI in children by the age of seven. This change can continue through the prepubescent stage and beyond (Frayling, 4).

In 2008, a second BMI locus was discovered. This locus is located on the MC4R gene (Lakshaman, 1774). Five percent of all severely obese people contain this BMI variation. The MC4R determinant causes overeating by interfering with leptin, the hormone that regulates the amount of fat stored in the body by adjusting sensations of hunger and energy (Bor, 395). Some loci may have a strong association with adult BMI, but a weak association with childhood BMI and inversely. This was the case in 2011, when two loci were discovered in the SDCCAG8 and TNKS/MSRA genes.

These determinants showed a strong association with extreme, early-onset childhood obesity, which means having a BMI above the 99th percentile. These loci showed only a slight correlation with adult BMI (Grant, 4).

In April 2013, a study comparing the genomes of 1,509 children with severe obesity to the genomes of 5,380 children with normal weight identified four new loci strongly linked to early weight gain. One BMI determinant discovered is located in the LEPR gene. The obese children with this specific variation developed obesity earlier than most. Researchers say that understanding how these subtle gene changes drive the body to either obesity or normal weight could lead to new method of combating the obesity epidemic (Sifferlin, “Study Identifies Four New Genetic Markers…”).

Childhood Obesity Environment in the United States Though genetics do play a small role, the vast majority of the childhood obesity problem comes from the environment. According to the Centers for Diseas Control and Prevention, “the genetic characteristics of the human population [has] not changed in the last three decades, but the prevalence of obesity has tripled among school-aged children during that time (Editor).” Indeed, childhood obesity typically results from a high-calorie intake paired with a low level of physical activity likely resulting from obesogenic environment in which we live (Clinical Key, “Obesity in Children”).

Thirty years ago, one snack per day was commonplace. Today, children are eating three snacks per day resulting in an average of 200 additional calories. Portion sizes are two to five times larger than what they were 30 years ago. In the 1970’s, the average sugarsweetened beverage was 13.6 ounces. Today, the average size is 20 ounces (Let’s Move, “Learn the Facts”).

There are approximately 12.7 million obese children and adolescents in the United States (CDC, “Childhood Obesity Facts”).

Approximately one-third of U.S. children are overweight or obese.

For certain ethnic minorities this rate only increases (Lakshman, 1770). Obesity is more prevalent in lower socioeconomic groups, a factor typically attributed to restricted access to affordable, healthy food as well as unsafe neighborhoods that make outdoor physical activity difficult. One in seven preschool-aged, low-income child is obese.

Listed below are additionally statistics that accurately summarize the obesity environment in the U.S. (Clinical Key, “Obesity in Children”):

• 17 percent of U.S. children are obese (Clinical Key, “Obesity in Children”).

• 34 to 36 percent of U.S. children

are overweight (Clinical Key, “Obesity in Children).

• Approximately 21 percent of children two- to five-years-old are overweight or obese (Lanigan, 521).

• 40 percent of African American and Hispanic U.S. children are overweight or obese (Let’s Move, “Learn the Facts”).

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If unhealthy trends continue at their current rates, this will be the first generation of children who will not outlive their parents (Stoler). Obese children are two to three times more likely to be hospitalized and are three times more costly to care for than the average insured child. In 2004, the U.S. spent up to $129 billion on health care costs associated with obesity (Pekruhn, 7,8). There are numerous risks associated with childhood obesity (Clinical Key, “Obesity in Children”):

• Insulin resistance • Type 2 diabetes • Hypertension • Cardiovascular disease • Dyslipidemia • Respiratory problems • Sleep apnea • Cholelithiasis • Venous disorders • Nonalcoholic fatty liver disease • Polycystic ovarian syndrome • Slipped capital femoral epiphysis There are social risks associated with childhood obesity as well.

Overweight and obese children have an increased chance of becoming victims of early social discrimination. This bullying can lead to low self-esteem, which can be detrimental to a child’s success in school and hinder their ability to make friends. This social stigmatization can persist into adulthood (Let’s Move, “Health Problems and Childhood Obesity”). On average, obese children are absent two more school days than their normal-weight cohorts making obesity the number one factor in predicting absenteeism.

They also tend to score lower on reading in standardized tests and are five times more likely to have six or more detentions (Pekruhn, 8).

On average, obese children are absent

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more full school days than their healthy weight cohorts.

Childhood Obesity Environment in Kansas According to 2013 U.S. Census data, there are around 200,000 children ages zero to five in Kansas (US Census Bureau). As of 2012, 15.7 percent of Kansas children between the ages of two and five were overweight. Thirteen percent of these children were obese. This means approximately three out of every ten preschoolage children in Kansas are overweight or obese (CDC, “Kansas’s Response to Obesity”).

The prevalence of overweight and obesity among low-income Kansas children is more than double than that of higher-income Kansas children (NICHQ, “How much do you know about…”). That being said, Kansas was one of 18 states that saw a decline in the obesity rate among low-income Kansas children two- to fouryears-old between 2008 and 2011. During that time the obesity rate fell from 13.3 percent to 12.7 percent, a 0.6 percent decrease.

Despite this fall, Kansas still ranks 31st among all other states in this category (The State of Obesity, “Kansas”). Kansas ranks 25th among all states for childhood obesity in children ages 10 to 17 (“In Your State”).

The Importance of Water for Children One way to combat the rise of unhealthy snacks and drinks is to find a nutritional alternative. One such alternative for sugary drinks is water. Water is the principle chemical component in the body and nearly all the body’s major systems depend on it. Water typically accounts for 60 percent of body weight. Water is lost through our breath, sweat, urine and bowel movements (Mayo Staff Clinic).

This amount of water needs to be replaced. It is recommended that children drink five to eight cups of water every day (“Rethink Your Child’s Drink”). When it’s hot out, it is very important for children to make sure they are drinking even more water than the recommended amount. If they are playing outside it is a smart idea to ensure they drink water before, during and after they come inside (“Why Drinking Water is the Way to Go”).

Childhood Obesity Intervention

A deficiency of water can lead to dehydration. Children are more susceptible to dehydration than adults. Mild dehydration can lead to tiredness, dry mouth, thirst and constipation. This is easily cured through drinking more fluids. The easiest way for children to tell if they need to drink more water is by examining their urine. If there is a lot of light yellow urine that does not smell, the child is hydrated.

However, if there is very little urine, it is dark colored and smelly, the child needs to replenish his or her fluids (“Rethink Your Child’s Drink”).

Besides being very cost efficient, there are numerous health benefits related to drinking water. It plays a significant role in early-childhood obesity prevention. A typical four- to five-year-old consumes 17 teaspoons of added sugar every day. That amounts to 65 pounds of sugar in just one year. A chunk of this unnecessary sugar comes from sugary drinks such as soda and fruit juice. To stay healthy and energetic, children need lots of healthy fluids (water is the ideal choice). It has no calories or sugar, and it plays such a vital role in combatting childhood obesity. Tap water is fine, but children are more apt to drink larger amounts if it is chilled. Parents and caregivers need to set good examples for children and instill in them healthy drinking habits (“Rethink Your Child’s Drink”).

A TYPICAL 4- to 5-year old CONSUMES

17

TEASPOONS OF ADDED SUGAR

In addition to drinking the appropriate amount of water, there are a number of ways to address the U.S. childhood obesity epidemic.

In terms of obesity intervention, weight loss is not typically a smart approach for most young children. They are still growing and diets can interfere with this process. Children should only be put on a diet if a certified physician recommends and supervises it. The goal for obese and overweight children should be to maintain their current weight until they grow to an appropriate height for their weight.

Listed below are suggestions for childhood obesity intervention (“Preventing Childhood Obesity: Tips for Parents”):

• Focus on good health instead of a specific weight goal.

• Do not set overweight or obese children apart, make it a family initiative.

• Establish daily meal and snack times.

• Eat together.

• Plan sensible portions.

Schools are a very common setting for obesity intervention because they provide continuous interaction with children. A review based on the results of 27,946 children found strong evidence suggesting that in-school health initiatives have beneficial effects. The initiatives with the best results tend to implement lessons about healthy eating, physical activity and body image in the school’s curriculum.

The study shows that these obesity intervention initiatives decline in success as the age group gets older. In fact, initiatives focused on teenagers tend to show minimal success (Lakshman, 1775).

WHICH EQUALS

lbs 65 EACH YEAR

EVERYDAY

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Childhood Obesity Prevention Evidence suggests the most effective form of childhood obesity intervention is prevention. An overweight three-year-old child is nearly eight times more likely to become an overweight young adult than a normal developing three-year-old (Lumeng, 14). This is because during early childhood, children develop behaviors, patterns and preferences in regard to nutrition (Lanigan, 521).

Early-age prevention presents a “window of opportunity” due to the incredible amount of habits formed during this time. Yet, there have been far fewer studies of obesity prevention in preschool-aged children compared to obesity intervention among school-aged children (Lakshman, 1776).

The three primary tactics for preventing obesity are healthy eating behaviors, regular physical activity and reduced sedentary activity.

For children each meal should consist of five portions, one from each food group. Four- to six-year-olds should eat the serving sizes listed below. Two- to three-year-olds should eat less, except milk. (“Preventing Childhood Obesity: Tips for Parents”):

Grain Group o One slice of bread o One-half cup of cooked rice or pasta o One-half cup of cooked cereal o One ounce of ready-to-eat cereal

Vegetable Group o One-half cup of chopped raw or cooked vegetables o 1 cup or raw leafy vegetables

Fruit Group o One piece of fruit or melon wedge o Three-fourth cup of juice o One-half cup of canned fruit o One-fourth cup of dried fruit

Dairy Group MILK

o One cup of low-fat or fat-free milk or yogurt o Two ounces of cheese

Protein Group

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o Two to three ounces of cooked lean meat, poultry or fish o One-half cup of cooked dry beans, one egg or two tablespoons of peanut butter are meat substitutes that each count as one ounce of meat.

Snacks should include two food groups focused on maximum nutrition (i.e., apple wedges and whole grain crackers). Parents and caregivers need to limit calories from fats and sweet as these should not be consumed daily. Parents and caregivers should involve children in the planning, shopping and preparation of meals.

This increases their knowledge and understanding of what a healthy lifestyle is. It is important not to let children eat while watching television as this can lead to overeating (“Preventing Childhood Obesity: Tips for Parents”).

In addition to eating healthfully, children need at least 60 minutes of moderate to vigorous physical activity everyday (Pekruhn, 11).

It needs to be encouraged and it is important for the whole family to participate. The average U.S. child spends 25 hours per week watching television. This increase in sedentary activity typically leads to an decrease in physical activity. Therefore, television and computer time should be capped at one to two hours each day (“Preventing Childhood Obesity: Tips for Parents”).

The average U.S. child spends

25

hours per week watching TV

The Child Care Industry Since physical activity and nutritional habits are formed early on, it is important to determine where young children are influenced.

As of 2012, 50 percent of all US children under the age of five were enrolled in some type of child care facility (Lanigan, 521). The two major types of child care facilities in the U.S. are center-based care and family child care homes (FCCHs) (“Industries Information | Child Daycare Services Industry”).

Center-based care includes Head Start programs, preschools and child care centers. FCCHs are environments where children are cared for in the provider’s home — not in a center. A study conducted in 2009 concluded that 1.9 million children under the age of five attended FCCHs (Trost, 537). These providers account for the majority of the self-employed workers in the industry. FCCHs do not include babysitters or persons who provide unpaid care for children (“Industries Information | Child Daycare Services Industry”).

Approximately 63 percent of mothers with preschool aged children (two- to five-years-old) are employed in the labor force.

Around 80 percent of the children belonging to these mothers are in some form of non-parental child care. It is most common for these parents to have their children cared for in child care centers or FCCHs. Children spend close to 40 hours per week in these environments (Larson, 1343, 1344).

As of 2012, the U.S. hosts an estimated 53,000 commercial child care facilities and approximately 21,000 child care facilities run by nonprofit organizations (such as the YMCA). That year, the industry was expected to bring in $46.8 billion. This labor-intensive industry hosts more than 830,000 employees who earn an average salary of $38,000 per year (“Daycare Business 2012”).

Growth in this industry in affected primarily through an increase in the youth population, followed by employment rates and then income. Between 2012 and 2017, the industry’s revenue is expected to reach $53.8 billion, a 2.8 percent growth. Between 2010 and 2020 employment in the child care industry is expected to grow by 20 percent (“Daycare Business 2012”).

The Role of the Child Care Provider The child care setting is the ideal place for children to take the first steps in forming a healthy lifestyle. This early prevention will positively impact them the rest of their lives (Drummond, 157). In 2010, The White House Task Force on Childhood Obesity released a document to president Barack Obama containing their suggestions for how to combat this growing issue. The task force concluded early prevention in child care centers and FCCHs to be the initial phase in the childhood obesity solution (Barnes, 19).

Despite this, child care centers and FCCHs have received little attention (Hoelscher, 1379). Some states do not even require all child care facilities to be licensed in order to legally operate. Duke University School of Medicine conducted a review on healthy eating regulations in all states based on 10 “expert-derived” model regulations. On average, states only have 3.7 healthy eating regulations for child care centers and 2.9 healthy eating regulations for FCCHs. The task force recommends states increase licensing standards and devise systems that support healthy nutrition practices as well as physical education. Until then, it is up to providers to deliver quality child care without being forced to do so (Barnes, 19-21).

A study conducted by Washington State University found that it is important to understand the knowledge and beliefs child care providers hold regarding their role in a child’s healthy lifestyle. This needs to be done prior to convincing and encouraging them to implement obesity prevention initiatives. Though most providers feel they play an important role, they are often uncertain how to manage children’s food intake and address weight issues to parents.

The majority of providers who partook in the study disagreed with the emphasis society puts on childhood obesity, believing most children will outgrow it (Lanigan, 521,522).

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The study focused on seven areas — feeding practices, nutrition education, family communication, efficacy, misconceptions, feeding knowledge and priority of obesity prevention. Many providers believed there is nothing wrong with using food as a reward for good behavior. Another common misconception was the general belief that society overreacts in regard to junk food. Many providers also held an incorrect belief that children will eat more when they self-serve (Lanigan, 522).

These incorrect beliefs caused more than half the providers to pre-determine how much food the children should eat. A large number only prepared food they knew the children liked and some even pressured children to eat. Overall, providers showed a lack of knowledge and training over the appropriate health practices as well as an unfounded fear or potentially offending parents. Once the providers were instructed on the correct feeding knowledge and nutrition education there was a significant correlation regarding positive increases in feeding practices, efficacy, communication with parents and priority of obesity prevention. The increased knowledge also led to a decrease in the commonly held misconceptions (Lanigan, 522, 526).

Child Influencers Due to the continued increase in child day cares, infants and preschool-aged children are spending more time with peers.

Research shows that infants are more social with unfamiliar peers than with unfamiliar adults. By the end of the first year, infants can express turn-talking skills with each other. During their second year, toddlers begin developing the ability to play coordinated games with each other (Hanna, 701).

Infants influence one another through imitation. Mutual imitation is infants’ principle form of communication prior to language development. The sense of being imitated by a peer has dynamics of its own. It leads to attraction towards the imitator as well as repetition of the imitated actions. It is this nonverbal communication that keeps infants and toddlers engaged with one another (Hanna, 701, 707).

Andrew Meltzoff conducted a number of experiments in home and child care environments, the results of which support claims of social learning among infants. His studies have shown one-year-olds successfully imitating multi-step sequences from peers and have shown successful infant imitation in both environments even after a 48-hour delay. There is direct evidence that toddlers in daycare settings can perform deferred imitation of those around them, even within a distracting group environment (Hanna, 702, 705, 708).

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It is obvious that imitation plays a significant role in early childhood development, but it does not just apply on a peer-to-peer level.

Research shows that infants are more interactive with adults who imitate their behaviors. It is possible that competence with peers and competence with adults develops simultaneously in infants and toddlers (Hanna, 701).

If the childhood obesity epidemic is to be stopped, it is important for parents and child care providers to utilize this information.

Parents and child care providers impact the nutrition habits of children under their care, not only by making choices regarding the types of food available, but also by influencing children’s attitudes, beliefs and interactions with food. To do this, parents and child care providers need to be models of a healthy lifestyle. Eating nutritious foods, drinking water or healthy beverages when around children, sitting with children during mealtime and eating some of the same food as them area all ways to accomplish this. When infants and toddlers observe and interact with these behaviors they are more like to reciprocate them later on in life (“Staff Modeling of Healthy and Safe Behaviors…”).

Nutrition Environment in Kansas FCCHs Kansas FCCH providers need to be models of good behaviors; however, before this can happen, one first needs to understand the current nutritional state in the Kansas FCCH industry. In 2009, a study was conducted on 297 Kansas FCCH providers. On a positive note, it found that most FCCH providers typically served adequate portions of fruits and vegetables following proper preparation practices. Providers also infrequently served fried foods, high-fat meats, sweets, snack foods and sugary drinks. Barely any providers reported using food as a reward, regularly served junk food or withheld food as punishment. Most reported eating meals with the children. As for water usage, 96 percent of FCCHs had water readily available inside and 70 percent of FCCHs had water readily available outside (Trost, 537-539).

Unfortunately, these FCCHs were not without areas of concern.

Substantial weaknesses were found in regard to meeting established child care standards for nutrition. More than half the providers served 100 percent fruit juice one or more times per day and merely 14 percent reported serving low-fat or skim milk regularly. Only 23 percent served meals family style. Most providers frequently used unhealthy foods for celebrations; however, only 20 percent had guidelines for these special occasions. Less than 50 percent reported receiving nutritional education training and only 53.7 percent had a comprehensive written nutritional policy (Trost, 538, 539).

Interestingly enough, there were some disparities found between the study of Kansas FCCH providers and the study conducted

by Lanigan at Washington State University. A couple of Kansas’ positive factors where discovered to be common misconceptions

found by Lanigan. For example, one of Kansas’ strongest points was •Meal Plan Regulations: Each applicant with a temporary the incredibly low amount of providers who used food as reward. permit and each licensee shall develop and implement menu This same factor was determined to be one of the most common plans for snacks and meals that contain a variety of healthful misconceptions held by the providers examined in the study

foods, including fresh fruits, fresh vegetables, whole grains,

by Lanigan. Despite these differences in results, the root of the

lean meats and low-fat dairy products. Each meal needs to problems was determined by both studies to be the same: a lack of

include one item from the listed food groups. nutrition education.

o Breakfast:

Nutrition Policies and Regulations Applicable to Kansas FCCHs In 2007, BioMed Central conducted a study on obesity prevention in child care environments. This study examined state regulations and determined eight key nutritional and physical activity factors that may contribute to childhood obesity (Benjamin):

1. Water is freely available

2. Sugar-sweetened beverages are limited

3. Foods of low nutritional value are limited

4. Children are not forced to eat

5. Food is not used as a reward

6. Support is provided for breastfeeding

and provision of breast milk

7. Screen time is limited

8. Physical activity is required daily

• Fruit, vegetable or full-strength

fruit or vegetable juice

• Bread or grand product • Milk

o Noon/evening meal:

• Meat or meat alternative

• Two fruits or vegetable or one of each

• Bread or grain product • Milk

o Snack: • Milk

• Fruit, vegetable or full-strength

fruit or vegetable juice

• Meat or meat alternative

• Bread or grain product

• Food Service: Meals and snacks shall be served to each

child using individual tableware that is appropriate for the

food or beverage being served. Food shall be served on The study used data that had not been updated since 1990, but the appropriate tableware for the food. Food shall not be served findings were still surprising. Only two of these regulations — water on a bare surface. availability and not forcing children to eat — applied to Kansas child • Food Quantity: A sufficient quantity of food shall be care centers. Even worse, the study found no regulations or policies

prepared for each meal to allow each child to have a second applicable to Kansas family child care homes (Benjamin).

portion of bread, milk and either vegetables or fruits.

• Infant Feeding: Children under 18 months (1) shall be held A lot has changed since then. According to Child Care Aware,

when bottle-fed until the child can hold his or her own Kansas FCCHs now follow numerous nutritional policies under the bottle and (2) shall not be allowed to sleep with a bottle in Kansas Administration Regulations (“Nutrition, Active Play & Screen

his or her mouth.

Time Child Care Laws in Kansas”): • Breast Milk: Each bottle that contains prepared formula or

breast milk shall be stored in a refrigerator with the nipple

covered. Bottles shall contain the child’s name, the contents

and the date received. Contents of the bottle need to be

used within 24 hours of the date on the label. No formula or

breast milk shall be heated in the microwave.

• Solid Foods: Solid foods shall be offered when the

provider and the parent of legal guardian of the child

determine that child is ready. Opened containers of solid

foods shall be labeled with the child’s name, the contents

and the date opened. Containers shall be covered and

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• Water: Drinking water shall be available at all times when

the child is in care.

• Behavior Management: Punishment that is humiliating,

frightening or physically harmful for the child is prohibited.

Prohibited methods of punishment include (1) withholding

or forcing foods and (2) placing substances which sting or

burn on the child’s mouth or tongue.

The Child and Adult Care Food Program The Child and Adult Care Food Program (CACFP) is a governmentcreated nutrition education and meal reimbursement program. Its goal is to assist child care providers in serving proper, nutritious meals and snacks. This nationwide program serves more than 3.3 million children and 120,000 adults every day (“Child and Adult Care Food Program”). Since 2008, CACFP spends an average of $2.4 billion annually. These funds are used to reimburse child care providers for meals and snacks served to children in their care (Koremann, 325).

CACFP reimburses on a per-meal, per-child basis. All centers are eligible for some level or reimbursement, but the level of reimbursement varies. Listed below are the four factors that determine eligibility and reimbursement levels for CACFP (Koremann, 326):

1. Type of care (center or home, for profit or nonprofit, licensed or unlicensed)

2. Neighborhood income

3. Provider income

4. Family income of children

• Breakfast:

o Three-fourths cup of milk

o One-half cup of a fruit or vegetable

o One-half slice or one-half serving

of a grain

• Lunch/supper:

o Three-fourths cup of milk

o Two half-cup servings of a fruit or vegetable

o One serving of a grain or bread

o One serving (1.5 ounces) of a

meat or meat alternate (i.e. six

ounce serving of yogurt)

• Snacks (two of the following four components):

o One-half cup of milk

o One fruit or vegetable

o One grain or bread

o One meat or meat alternative Some child care centers, like Head Start, require all programs to participate in the CACFP program (Koremann, 327). This is not the case for Kansas FCCHs, however. If a FCCH does choose to participate in CACFP, its reimbursement rate depends on which tier it falls into (“Child and Adult Care Food Program”).

• Tier 1: Located in a low-income area or

run by a low-income provider CACFP seeks to improve dietary quality in child care environments o Breakfast: $1.31 per child through reimbursing meals, providing access to federal nutritional guidelines and monitoring menus in child care environments. These o Lunch/supper: $2.47 per three aspects should increase a provider’s observance of dietary guidelines and, if executed correctly, lead to an increase in a child’s child consumption of milk, fruits, vegetables and grains and a decrease in o Snack: $0.73 per child sweet snacks, pop and flavored juice. CACFP suggest the following

• Tier 2: All others meal plan for children ages three to five (Koremann, 326):

o Breakfast: $0.48 per child

o Lunch/supper: $1.49 per child

o Snack: $0.20 per child

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Primary

Research

THE PROJECT: Recently, KAC received a $83,000 grant from Kansas Health Foundation to make positive strides in Kansas’ fight against childhood obesity. The grant is to be used over a three-year timeframe. KAC’s Year One campaign, “Pass on Pop,” was a success.

More than 2,500 individuals took the pledge to have ‘Soda Free Sundays.”

Interviews

Over the course of Fall 2014, Volcanic Communications participated in and individually conducted 11 different interviews, both inside and outside Professor Yvonnes Chen’s classroom. The section below contains the expertise of individuals from 10 different relevant organizations. These interviews covered everything from the FCCH environment in Kansas to cognitive development in children to media advocacy and beyond. From them, Volcanic Communications attained a clear understanding of all the different factors involved.

For its Year Two initiative, KAC is hoping to positively improve the nutritional environment in family child care homes (FCCHs).

Focusing efforts to FCCHs is a smart way to stimulate early obesity prevention efforts for Kansas’ children. For this campaign, KAC is focusing on prioritizing water, making positive changes to the food and beverage environment and promoting staff wellness. KAC wants FCCH providers to implement and show support for these initiatives that way policies will be easily passed once KAC turns its focus to the legislative sector.

Kansas Action for Children

Listed below are a few reasons why now is the ideal time to act:

Lauren B eattyCOMMUNICATIONS DIRECTOR -- Hilary Gee DIRECTOR of HEALTH POLICY

--

KANSAS ACTION for CHILDREN: Kansas Action for Children (KAC)

works largely through the legislative sector to perform statewide advocacy on behalf of all Kansas children and their families.

It accomplishes this by passing laws, policies and regulations benefitting these groups. KAC focuses on three core areas: health, education and economic stability. An independent voice for

Kansas children, KAC has been operating for 35 years through no government income — it is completely funded by grants and private donations. All work is based on research and data; there are no affiliations to organizations or political connections.

KAC has only 10 employees whose time is split between multiple projects. This well-established organization receives support from community leaders and is well-respected among its numerous partner organization. Unfortunately, some view the organization as aggressive and, because of this, KAC typically separates itself from its campaigns.

The KAC brand has recently undergone a major transition. It strives for a more authentic voice. Currently, KAC is working on a lot of policy and political work with which Kansas citizens are not generally interested. To combat this, KAC has amped up its social media presence. Previous KAC initiatives have found success through social media (both paid and unpaid) as well as radio.

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• Childhood obesity is a major problem in the U.S. • An obese toddler is twice as likely to be an obese adult.

• The growing trend of childhood obesity needs to be curved.

• There is widespread consensus that the key to solving the obesity epidemic is through early childhood prevention.

• There is a lack of regulations on the nutrition environment in FCCHs. THE TARGET AUDIENCE: KAC is targeting FCCH providers, children ages zero to five, their parents and the media. It is important for KAC to reach both providers and parents as their buy-ins are essential if a truly positive impact is to be made in the lives of Kansas children. $30,000 has been allocated towards this campaign. The end result needs to be something engaging and educational for parents and providers and entertaining for children.

The majority of FCCH providers are low-income women of varying ages. These providers have very difficult jobs. Many suffer from financial issues. This leads to an extremely high turnover rate in the industry. Mothers with young children are responsible for establishing a large number of the FCCHs in Kansas. It is common for the mother to then close her FCCH and seek better-paying work once her youngest child starts elementary school.

These providers care for a lot of Kansas’ children and its crucial to ensure they are helping develop healthy habits they can use the rest of their lives. However, providers are not always properly educated and the old negative health habits they carry can be hard to kick.

KAC needs to find an effective way to engage with FCCH providers; however, the organization has little experience dealing in the public sector, let alone dealing specifically with FCCH providers.

For this reason, KAC has partnered with Professor Chen’s Journalism 640 class. KAC does not feel the need to create new resources, but it is happy to promote the ones currently available.

KAC will also be working with one of its partner organizations, Child Care Aware (CCA), an organization that works closely with FCCH providers. This is not the first time KAC and CCA have joined forces.

In July 2010, the organizations worked hard to get “Lexie’s Law” passed. The law made CPR, First Aid, SIDS preventions, safe sleep and education on illness mandatory for child care facilities. However, no policies on food and beverage were included in the law.

Lawrence Douglas County Health Department --

Aundrea ShaferHEALTH PROMOTIONS SPECIALIST

FOOD INSECURITY in KANSAS: On average, 20 percent of U.S. children are food insecure (hungry). In Kansas, that statistic increases to 22.5 percent of children. That is equivalent to 162,000 Kansas children. Woodson, Brown, Wyandotte, Elk and Cherokee counties have the largest number of children suffering from food insecurity. Food insecurity can cause a weakened immune system, increased stress levels, stunted growth development and a decrease in academic performance.

SOCIETAL INFLUENCERS: The first influence a child faces is himself or herself. Children need to try a food 15 to 20 times before they truly know whether or not they like it. Not only do they need to try it a number of times, they need to try it in a variety of ways (i.e., fresh, baked, steamed, ect…). A child’s peers also play a pivotal role in nutritional development. If one child vocally advocates for a certain food, his or her peers are going to be more willing to explore their food palette and try it.

companies have the resources needed to drive demand among children. The environment and culture a child is raised is also a factor. Lower economic areas typically have higher grocery prices.

For example, in Wichita the most expensive gallon of milk can be found in the poorest economic area.

PURCHASING PATTERNS: Low-income families have significantly different purchasing patterns than high-income families. Highincome families are more likely to purchase whole grains, seafood, lean meats, low-fat milk, fresh fruits and fresh vegetables. Contrarily, low-income families frequently purchase a greater number of cereals, pastas, potatoes, legumes, fatty meats, sugar-sweetened beverages, candy bars and donuts.

The items commonly purchased by low-income families seem like a better deal because they come in bigger portions. They are loaded with fat and sugar, which makes a person feel full faster. What they do not realize is that feeling of satisfaction also wears off faster compared to healthier food items.

NUTRITIONAL BARRIERS: A number of barriers lead low-income families to follow the established purchasing patterns. The first and largest barrier is economic inequality. Typically, healthy, fresh food costs more; therefore, families with greater levels of disposable income are able consume more healthier items. However, this is not always the case. Water is both healthier and more affordable than sugar-sweetened beverages, but low-income families still choose to purchase pop. This is because the taste of sugar-sweetened beverages is more satisfying. A person will feel more full after drinking a glass of pop than he or she would after drinking a glass of water. The sugar has a greater impact on one’s body; it is just not a positive one.

Accessibility also poses a problem. A lot of low-income families live in a “food desert” or a “food swamp.” A food desert occurs at any residence where there is no grocery store within a square mile.

Food swamps are found in areas with a saturated number of fast food restaurants, meaning residents are surrounded by unhealthy options. Food swamps are a relatively new term, but research shows they play a more important role in obesity than food deserts Finally, there is a general lack of nutritional knowledge among low-income families. Fortunately, there are a number of programs that address this educational gap. Two such Lawrence initiatives are the “Market Match Program” and “Just Foods.” The Market

Then there are the child’s parents. Understandably, parents are highly influential, which can be good and bad. Some parents do not know how to boil water; others have never used an oven or microwave. These shortcomings can lead to improper food preparations, which can negatively affect a child’s development.

Situational factors play a role as well. If a parent has to take a twohour bus ride home from the grocery store, there is a chance the food might become spoiled.

A large number of outside forces can also influence a child.

Companies like Coca-Cola spend two billion dollars annually on advertisements targeted towards children. Though unhealthy, these

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Hilltop Child Development Center --

Jennifer Wagner CURRICULUM DIRECTOR

JENNIFER WAGNER: Jennifer Wagner, curriculum director for Hilltop Child Development Center, has taught in numerous preschool classrooms, but she recently switched to an administration role. She currently oversees all Hilltop classrooms and helps teachers develop education and nutrition plans. Wagner used to be obese. Growing up she had access to very little information regarding health and nutrition. When she decided to make a change she had to completely alter her way of thinking and hey way of life. Wagner’s experience has led her to become a huge advocate for early childhood nutrition education. She believes this early education can alleviate a lot of obesity related issues.

COGNITIVE DEVELOPMENT IN CHILDREN: In order to educate children, one has to understand how children develop. A child’s cognitive development takes place in four steps, as described below: 1. Sensory-motor (ages zero to two)

a. Children reinforce knowledge of object permanence.

b. Through use of physical and sensory

experimentation, children begin to understand the world.

2. Pre-operational (ages two to seven)

a. A very egocentric stage.

b. A child’s framework for language is established

based on an understanding of symbols.

c. Children struggle to understand conversations or

more than one aspect of a situation.

3. Concrete Operational (ages seven to 11)

a. Children order and classify things based of appearance.

b. They have gained the ability to sequence numbers.

c. Children being able to develop the ability to empathize.

d. Children attain a simplistic understanding of math,

geometry and physics.

4. Formal Operations (ages 11 and up)

a. Children gain the ability to draw conclusions bases

on hypotheses rather than objects.

b. Adolescent egocentrism forms.

c. Children become more logical.

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Since children start off learning through physical and sensory experimentation, educators strive to expose them to as many of the fives senses as possible, starting the minute the children arrive. At Hilltop, early education occurs in both large group and small group (five or less) settings.

POSTIVIE CHILDHOOD RELATIONSHIPS: Children want to make good choices, they just do not always know how. Because of this, children need to have positive relationships with peers, teachers and parents. Through these positive relationships they will find social motivators that assist them in making correct decisions. The more enriched their relationship, the more they are going to learn from it.

When a child is around six months old, they tend to imitate those around them. The see action done and they imitate it. As they get old imitation transforms into emulation, their reasoning for copying actions become intrinsically motivated. They are still copying, but they are just doing it in their own way. Children model themselves after those around them. Starting as early as one, children begin to recognize and follow “the leaders” in the classroom. This peer influence only gets stronger over time. Wagner said, “Children look at everything as a model.” For this reason, adults need to model the behavior they wish to see.

This applies to the food and beverage environment. If children see their peers and teachers eating something, they will try it. It is important that caregivers encourage children to try new foods.

Never should someone force a child to try something. Children should also not be forced to eat all the food on their plate.

THE EVOLVING FOOD GUIDE: The food guide has evolved over time. What was once a food pyramid has transformed into “choosemyplate.” This is the program Hilltop uses. Wagner said choosemyplate has its discrepancies, but it does a good job of teaching the basics. Without the basics, an individual is never going to be able to grow in his or her knowledge.

CHILDREN MODEL THEMSELVES

AFTER THOSE AROUND THEM

STARTING AS EARLY AS

1

Child Care Aware --

Marie Treichel PROVIDER SERVICES MANAGER EASTERN KANSAS OFFICE

CHILD CARE AWARE: CCA deals directly with both centerbased and in-home child care providers. CCA is a major resource, offering providers beneficial classes and information to ensure the children in their care are receiving a quality education. However, the assistance does not stop there. Marie Treichel, Provider Services Manager for CCA’s Eastern Kansas office, said, “CCA aims to make behavioral changes all the time. We do not just provide the information, we assist [providers] in getting the past barriers keeping them from providing that higher quality care.”

Over the last seven years, CCA has downgraded from 13 regional offices to four. Despite downgrading its offices, CCA manages to serve 33 Kansas counties. The four remaining regions are divided based on population density: • Region One (Western Kansas): Salina, Hays and Garden City.

• Region Two (South-Central Kansas): Wichita • Region Three (Eastern Kansas): Topeka, Lawrence and Pittsburg • Region Four (North-Eastern Kansas): Kansas City THE FCCH INDUSTRY: According to Treichel, FCCH providers are 98 percent women. Demographically, they cover the entire age spectrum. Unlike center-based child care programs, which have multiple employees performing designated roles, FCCHs are a one-woman show. These providers take on the role of owner and care giver. They are the decision maker. They are the operator.

Success in this profession relies heavily on leadership skills and dependability. Out of the 5,000 licensed facilities in the state of Kansas approximately 4,600 are FCCHs. This number does not include all the unregulated family child care homes in Kansas, as those numbers are impossible to track.

The majority of these providers have a high school education. Many are stay-at-home mothers who plan to find a better job once their youngest starts kindergarten; however, when that time comes, some decide to stay. Typically, this occurs because the provider realizes the benefits of being one’s own boss. Treichel said the women who decide to stay are the best to work with because they are very serious about their work. They want to market their FCCH, set up retirement funds and, above all else, provide quality care.

The average FCCH provider works 10 hours every day and makes less than $30,000 per year. All outside errands need to be done on the weekend. Spending their entire day with children can leave

leave them feeling isolated. Social Media, specifically Facebook, has been a positive force in altering this issue. It allows providers to connect and network with one another, even if they are the only FCCH caregivers in their town.

CHILD and ADULT CARE FOOD PROGRAM: Treichel said that when these homes get licensed it is rare for there to be a conversation regarding healthy foods and beverages. Very few policies and regulations relevant to the food and beverage environment apply to FCCHs; yet, food is the number one expense for these facilities.

One government program, Child and Adult Care Food Program (CACFP), promotes a healthy food and beverage environment by offering reimbursements to participants. The level of reimbursement is based on the food served, the average income level of the children in the FCCH and the income level of the provider.

Participants in the CACFP fill out forms after each meal cataloging what every child ate. All licensed FCCHs are automatically eligible to participate in the CACFP. This program is mandatory for center-based facilities; however, it is optional for FCCHs. The FCCH providers who do not partake in the CACFP tend to do so because they are discouraged by the amount paper work required.

Many have difficulties (i.e., learning disabilities and other barriers) and require assistance to complete the paperwork. If program participants do not keep attendance and meals up-to-date, they do not get reimbursed.

ROLE MODELS of a HEALTHY LIFESTYLE: Many providers have some sort of eye-opening experience in which they realize that huge impact they have in these children’s lives, causing them to strive for quality care despite the lack of regulations. FCCH providers are role models for the children in their care. It is crucial that they emulate a healthy lifestyle. For this reason, CCA created a Wellness Program. The program emphasizes less screen time, advocates growing a garden and prompts an increase in physical activity achieved through outside play. It is rare for FCCH providers to have any qualms buying into the first two tactics; unfortunately, the same cannot be said for the physical activity aspect.

Some FCCH providers fear opening up a nutritional dialogue with parents. Treichel said providers should not be afraid of informing parents about healthy lifestyle choices. Parent will likely appreciate it. It is important for FCCH providers to realize they are often a parent’s first stop for information regarding childhood development.

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BEST TACTICS to REACH FCCH PROVIDERS: FCCH providers are business owners who are often low on cash. Any free event — especially one with door prizes, educational value and a stipend — is going to peak the interest of FCCH providers. The less paperwork the better. Providers tend to be playful people. The more hands-on and engaging the campaign is the more enthusiastic providers will be.

FCCH providers are busy people. They might not have time or money to go out and gather a bunch of supplies. The more materials provided, the greater the chance they will implement the change. This applies to information as much as it does to supplies.

FCCH providers need to understand why it is important to make these nutritional modifications. One cannot expect these caregivers to implement a behavioral change unless they firmly believe it is in the children’s best interest. Videos are one possible medium that can get a message across in a very clear way.

It can be difficult to reach FCCH providers in rural areas. Below are tactics Treichel provided for accomplishing this task:

• Hold support groups where providers can all come and network.

• Send direct mail.

• Offer face-to-face meetings.

• Utilize the CCA coaches who have established relationships with these FCCH providers.

These providers care deeply for the children in their care. If they are provided the correct information and it is clear the suggested alterations will bring positive change, Treichel said she would not suspect any resistance against the campaign.

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Kansas State Department of Education --

Peggy McAdoo ASSISTANT DIRECTOR for CHILD NUTRITION and WELLNESS

CACFP in KANSAS: The CACFP is a national program overseen in Kansas by the Child Nutrition and Wellness branch of the Kansas State Department of Education. Kansas FCCHs can register for the CACFP through one of the state’s 20 sponsoring organization. As of October 2014, there were 3,240 Kansas FCCHs participating in the CACFP. This means 70.43 percent of the approximately 4,600 Kansas FCCHs are registered in the CACFP. In October 2014, Child Nutrition and Wellness ran a report on FCCH enrollment based on the CACFP’s average lunch participation reimbursement claims, submitted by providers for August 2014. The report found that, on average, 25,843 Kansas children in FCCHs are affected each day by the CACFP. Peggy McAdoo, assistant director for Child Nutrition and Wellness, said that it is likely they number found in this report is slightly under the actual number, as some FCCH providers may not have finalized their August claims in time.

Child Care Aware --

QUALITY IMPROVEMENT Star Robinson KANSAS RATING SYSTEM COACH: EASTERN KANSAS OFFICE

HOW to REACH FCCH PROVIDERS: Star Robinson, a Kansas Quality Improvement Rating System Coach for CCA’s Eastern Kansas office, said that the most effective ways to reach FCCH providers are through mailings, flyers and classes. Every year caregivers at center-based facilities and FCCH providers are required to participate in a certain amount of educational classes and programming. The classes offered vary from region-to-region, as each of the four separate Kansas offices are in charge of providing channels for providers to accomplish these mandatory hours.

Due to the laundry list of things FCCH providers are required to do everyday, they are notoriously stretched thin on time. The final campaign needs to be incredibly time conscious. Creating a completely separate initiative would just be adding to the providers’ already overwhelmingly busy schedule. In an effort to make things as smooth and simple as possible, Robinson said to use a preexisting channel — such as CCA — to get KAC’s message across to providers.

This would be a mutually beneficial move. As the most time conscious solution, FCCH providers would be more willing to actively participate, KAC would get its campaign distributed to its target audience through a channel FCCH providers know and trust and CCA gets new and unique content for its programming.

In a statement similar to Treichel’s, Robinson said FCCH providers are more than likely to implement healthier eating and drinking initiatives if they are provided with the correct nutritional information. Providers need to be made aware of the benefits offered by these healthy alterations. “If the providers have the right information, most of them will think it makes sense,” Robinson said. “The key will be education.” Robison said most FCCHs are already very health conscious. In fact, children tend to eat healthier when they are at their FCCH than when they are at home. “You aren’t tackling a huge monster,” Robinson said. “Most programs are already health conscious.”

“ EDUCATION

THE KEY WILL BE

“

Kansas Department of Health and Wellness --

Kansas Child Care Training Opportunities --

Linda Logan PROGRAM DIRECTOR

Kansas Child care Training Opportunities offers online classes available for any and all Kansas child care providers. Completion of said classes can help fulfill the annual mandatory hours required of child care providers. These classes are typically one week long, spanning from Thursday to Tuesday. They are offered through Kansas State University and course completion is determined by a provider’s level of interaction in the course module.

Linda Logan, program coordinator for Kansas Child care Training Opportunities, said the organization has 300 to 400 providers participating in their courses each week. Between Sept. 30th, 2013, and Oct. 1st, 2014, more than 10,000 child care providers took the classes.

Logan said she was very open to the idea of implementing KAC material into the organization’s curriculum. She suggested the possibility of embedding content into the 12-week nutrition course currently being offered. Logan also brought up a new class Kansas Child care Training Opportunities is developing in partnership with Child Care Exchange Magazine. The class is going to focus on childhood obesity prevention and Logan said it might be possible to get KAC involved there.

DIRECTOR and BOARD OF Mary Murphy UNIT DIRECTORS MEMBER FOR CHILD CARE AWARE

FCCH REQUIRED PROGRAMMING: Mary Murphy, Unit Director at the Kansas Department of Health and Wellness said that FCCH providers are required to complete both initial and ongoing professional development. As for their initial training, FCCH providers are required to attend an orientation where they receive training in a number of categories: child abuse and neglect, basic child development, safety practices, first aid and CPR. This initial programming is then followed by yearly requirement of five hours of professional development programming. This programming convers a wide array of topics and is run by Kansas Child care Training Opportunities, based out of Manhattan, Kansas.

When it comes to required hours of programming, Kansas is on the low end of U.S. standard, but Murphy said these FCCH providers are already so busy and they “don’t want to break the camel’s back.”

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Family Child Care Home Provider --

“Jane” ANONYMOUS WESTERN KANSAS FCCH PROVIDER

RURAL KANSAS FCCHs: “Jane” is a FCCH provider from Scott City, Kansas — a small western town located just 62 miles from the Colorado border. With a population of fewer than 4,000 residents, Scott City provides an accurate portrayal of a rural Kansas town.

Despite the fact that the closest Walmart is 30 minutes away, “Jane” said there is no lack of resources. “The people in Eastern Kansas think that Little House of the Prairie is our way of life,” “Jane” said. “I think they would be shocked if they came into my facility and saw that we live the exact same way as people in Eastern Kansas. We just go to the grocery store, not Walmart.”

An active user of Pinterest and Facebook, “Jane” has eight children in her FCCH. She participates in the CACFP. Calling it a norm for her area, “Jane” said the program makes it easier for her to plan meals.

The children in “Jane’s” care receive no screen time. When the weather permits it, they spend at least two hours playing outside.

“I love my job and I am good at it,” “Jane” said. “So are the other providers I know.”

Department of Communication at Virginia Tech --

Hannah Shinault PROFESSOR

MEDIA ADVOCACY: Media advocacy is the use of media and societal activism to create positive change. This technique aligns perfectly with KAC’s goal. Virginia Tech professor, Hannah Shinault, said media advocacy is a tactic, just like press releases, advertising and social media. Unlike other tactics, media advocacy is more about framing than agenda setting. Effective media advocacy requires building mutually beneficial relationships with reporters.

Media advocacy takes time and effort.

When working with media, it is important to consider the target audience: what they currently know and what they need to learn.

Once this task is accomplished, it should be easy to choose the right media outlets for which to focus one’s efforts. For a story to get picked up, it is necessary for it to have newsworthy components. These can vary depending on how the story is framed.

27

ONE OF THE BEST WAYS TO DRAW

BOTH PUBLIC AND MEDIA ATTENTION

IS BY HOSTING OR SPONSORING

AN EVENT

KOAM-TV --

Kristi Spencer NEWS DIRECTOR

MEDIA ADVOCACY: Kristi Spencer is the news director for KOAMTV, the CBS affiliate for Kansas, Oklahoma, Arkansas and Missouri.

Spencer said that any story a journalist writes needs to have a purpose or a reason. It needs to be relevant. A story’s relevancy can be determined using T.I.P.C.U.P.:

• Timeliness • Impact • Prominence • Conflict • Uniqueness • Proximity

These are key factors journalists consider when writing a story.

The more of these factors reached by KAC’s campaign, the greater chance there is of various media outlets taking an interest in KAC’s work.

One of the best ways to draw up both public and media attention is by hosting or sponsoring an event. Spencer said people are very visual so when they can physically attend an event it is going to make a bigger impact on them. Press releases and public service announcements (PSAs) are two other effective tools used to gain media attention. Spencer said it is best to keep PSAs interesting enough to maintain the viewer or listener’s attention.

When it comes to interacting with reporters, Spencer said it is very important to avoid sounding like a salesperson. This is a big turnoff and may lead to the reporter questioning the person’s motives.

Reporters need to be communicated with in a professional manner that highlights the public’s benefits of receiving the suggested news. That being said, journalists are always looking for the next story. If they are approached in an appropriate way and the suggested story has some level of relevancy, chances are it will receive coverage.

22

Focus Groups

On Oct. 21st, 2014, Volcanic Communications — with assistance from CCA — held two different focus groups: one for center-based child care providers and one for FCCH providers. These focus groups allowed Volcanic Communications to further its knowledge of these unique child care environments as well as determine any similarities or differences that exist between the two. It also gave Volcanic Communications the opportunity to see how FCCH providers interact with one another and, by the end of the focus group, the strong sense of community in the FCCH industry became blatantly clear.

Center-Based Child Care Providers THE HEALTH ENVIRONMENT at HOME: Douglas County Child Care Association (DCCCA) members who participated in the focus group said the majority of a child’s unhealthy habits are formed at home. Parents typically claim their busy schedules prevent them from preparing healthy, unique meals everyday. Focus groups participants pointed to breakfast as a particularly disconcerting meal. Providers witness many parents opting for the convenience of a greasy McDonalds Dollar Menu meal. Even more discouraging, some participants provided examples of parents providing their children with candy bars for breakfast.

THE HEALTH ENVIRONMENT in CENTER-BASED CHILD CARE: DCCCA members said that bad nutritional habits are not rooted within child care centers. One hundred percent of DCCCA members participating in the focus group claimed to adhere to the strict CACFP nutrition guidelines. The CACFP guidelines ensure all children receive a healthy balance of proteins, vegetables, fruits, grains and dairy products. Water is readily available at all times throughout the day and juice and milk are provided during meals and snacks.

Providers said many DCCCA centers have recently begun focusing on farm-to-table initiatives. These interactive initiatives allow children to witness food preparation from start to finish. Many centers are very conscious of a child’ developing taste sensitivities.

For this reason, child care providers constantly introduce children to a number of new dietary variations. Participants in the focus group have found that the social, interactive environment provided in centers makes it easier to get children to eat healthy. Meal schedules are inflexible so children do not have a lot of room to be picky. They eat what they are provided or they go hungry.

The majority of focus group participants felt that obesity was not a noticeable issue in the center-based child care environment. Young children are naturally active for a large chunk of day and many centers require at least an hour of structured activity (i.e., walks,

musical therapy or stretching). Participants came to a consensus that the real problem emerges when student reach grade school as the health environments there are not as well structured (CenterBased Child Care Providers).

Family Child Care Home Providers THE HEALTH ENVIRONMENT AT FAMILY CHILD CARE HOMES: There was a 100 percent agreement among FCCH focus group participants that child care providers play an integral role in the nutritional development of a child. The nutritional environments described in the FCCHs were very similar to those described in the center-based facilities. Despite it not being a requirement for FCCHs, each provider in attendance participates in the CACFP. They all find the program to be very beneficial, agreeing that it helps set guidelines and ensures children eat healthy. One provider said she would do it even if she did not get paid.

Like at the centers, children in FCCHs can either eat what is on their plate or they go hungry. . One provider said that some days you see the majority of the food gets thrown out. Unlike the centers, FCCH providers said that seeing food goes to waste is a very difficult part of the job. Similar to the center-based providers, FCCH providers cited a recent transition towards farm-to-table food practices. Most of the FCCHs have its own garden that children help maintain.

All but one provider said the children eat healthier under their guidance than they do at home. These providers said they attempt to get beneficial information to parents, but they are unsure how many parents actually pay attention (Family Child Care Home Providers).

FROM

FARM TO TABLE 28

Observations

At the conclusion of the FCCH focus group, Volcanic Communications asked participants if anyone would be willing to let two group members spend a day observing her facility. One provider, Nancy Winchester, happily agreed to serve as host and subject for Volcanic Communication’s experimental emersion into the FCCH environment. It is one thing to listen to someone describe his or her day; it is another to witness it first-hand. On Nov. 3rd, 2014, Volcanic Communications received an inside perspective of the industry it has been studying all semester. This opportunity was incredibly beneficial as if reaffirmed many of the beliefs Volcanic Communications holds regarding the FCCH industry.

Precious Child Day Care --

Nancy Winchester FCCH PROVIDER

Nancy Winchester is the owner and operator of Precious Child Day Care, a FCCH located on the north side of Lawrence, Kansas.

Precious Child Day Care is located in Winchester garage. It is open Monday through Friday from 7:30 a.m. to 5:30 p.m. Winchester has been in the FCCH business for 15 years. She has cared for up to 10 children at once. Currently, she has four: an 18-month-old and a two-, three- and four-year-old.

With the exception on meal times, the children play outside everyday from 9:30 a.m. until 1:00 p.m., at which time they break for a nap that lasts until 3:00 p.m. In the event of inclement weather, outside play is replaced by obstacles courses and tunnels set up in the garage. Winchester does this to promote large motor activity.

Every Wednesday, Winchester takes the children on an educational field trip. The destinations vary, but past field trips have included the grocery store, the library, different park, a pumpkin patch and the zoo.

On Monday, Nov. 3rd, 2014, two Volcanic Communications representatives observed Precious Child Day Care from 9:30 a.m. until 12:15 p.m. Listed below are key observation points taken from the event:

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• A large number of toys are available outside, ready for

the children’s use. Toys include trikes, a balance beam, a

slide, playhouses and many others.

• Precious Child Day Care has its own garden, consisting

of cucumbers, tomatoes, basil, lettuce, two pear trees and a

grape vine. Winchester said the garden is used to help the

children learn about growing vegetables and fruits.

• Winchester allows the children to problem solve individually.

• Winchester promotes creativity.

• Winchester said that she is normally very active with the

children during outside playtime, but she injured her foot

over the weekend.

Winchester said the parents of her children are very health conscious. Each week they check and see what she will be serving.

Winchester prepares for her meals the night before. Luckily for her, her husband is a chef and he always helps her out. At 8:00 a.m. the children ate breakfast. It is now around 10:00 meaning it is time for a snack:

• Winchester serves the children their snack.

• Today’s snack was cinnamon biscuits and two percent milk.

• Winchester did not sit down with the children during snack time.

• Winchester described cinnamon as a “super food” to the

children and asks the boys what other super foods they can

think of.

• Three of the children respond. Answers included broccoli,

carrots, lettuce, tomatoes and apples.

At 11:30 a.m., Winchester begins to prepare for lunch:

• Winchester is very clean. We were asked to wash our hands as soon as we entered the center. Winchester and the children washed and sanitized their hands and surfaces multiple times upon entering the center.

• Lunch consisted of half a banana, cherry tomatoes, carrots, whole wheat bread with butter, thigh meat from chicken served with teriyaki sauce, broccoli and two-percent milk.

• Ranch was offered as a dipping sauce for veggies.

• Children were served seconds if they requested it.

• Winchester did not sit with the children after she served them lunch.

• Each child has his own sippy cup of water set out and available at a moments notice.

• Children did not request a drink of water until lunch after their milk was gone.

• Winchester noted that she forgot to take their water bottles outside, but that they are normally readily available to the children during outside playtime as well.

• The 18-month-old likes to be held, but Winchester refuses his requests and allows him to be active.

Every year, FCCH providers are required to complete five hours of “professional development.� If a FCCH provider is a member of the CACFP, she or he has to complete an additional two hours.

This means Winchesters has seven mandatory hours of training each year. Winchester said she averages 40 hours each year. She accomplished this by seeking programs offered by Douglas County Child Care Aware Chapter, the local health department and hospital.

At the end of lunch, Winchester fills out a CACFP form. These forms are turned in at the end of each month. CACFP annual forms are turned in at the end October, or when a new child joins her center.

Winchester informed us that children age out of the CACFP when they turn 13. Care providers must claim their own children as part of the program, but they are not reimbursed for their attendance at meals. Winchester fears the main reason other FCCH providers choose not to participate in the CACFP is because of the three surprise visits every year, not the extensive paperwork.

Survey The efforts of FCCH providers to positively influence the food and beverage habits of children are going to be less effective if parents do not join the cause. Their implementation of these health changes is a necessity if this campaign is going to be a true success.

However, there is a lack of secondary research regarding the views Kansas parents have concerning the childhood obesity epidemic.

For this reason, Volcanic Communications created a 35-question survey targeted towards this influential group.

Kansas Parents, Child Care Survey 77 Respondents More that 90 percent of the 77 respondents from across the state that took this survey have children ages zero to four, meaning the information gathered from this survey is incredibly relevant to the campaign. Almost three-fourths of the parents surveyed (72.73 percent) send their children to some form of child care facility and 37.5 of these children are enrolled at a FCCH. The average Kansas child spends between five to nine hours in this child care setting every day.

By plugging the parents’ responses into a word cloud, Volcanic Communications is able to visually depict the most important factors considered when determining a child care provider:

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Based on the results it appears the number one factor sought by parents is a positive learning environment. “Food” is not too far behind. In fact, it gets mentioned more than “safety” “experienced”, “healthy” and “quality”. Other food-related words like “feeds,” “meals” and “foods” also managed to make it onto the cloud. When 96 percent of parents say they would at least consider paying more for a child care provider if it meant their child or children would receive a better quality diet, it becomes obvious that a facility’s nutrition environment, undoubtedly, plays an integral role for Kansas parents when it comes to selecting a child care provider.

96

PERCENT OF PARENTS

SAY THEY WOULD CONSIDER

PAYING MORE

ON CHILD CARE IF THERE WAS

A BETTER QUALITY DIET

The majority of respondents agreed that obesity is a community issue, but only 10.94 percent agreed with the statement, “I am concerned about my child being overweight.” This might be because 50 percent of respondents claimed that their children eat fast food zero time per week; 46.88 percent said their children eat fast food once or twice per week. More than 80 percent said their kids never drink soda.

These children are not drinking soda, but they also are not drinking water either. A little over 45 percent of respondents said their children only drink one or two, eight ounce glasses of water each day. A little over 40 percent of parents have children that drink three or four glasses.

45 percent of respondents said their children only drink 1 or 2, 8 ounce glasses of water each day out of the suggested 6.

Survey respondents tended to be aware of the food and beverage choices served to their children (75 percent). Only 7.15 percent claimed to be unaware. When asked what they looked for in regards to the food served at child care facilities, parents said:

“Real fruit and vegetables being available at meals, no sweets except on special occasions, high quality snacks (hummus, raisins, fruit, pretzels - no prepackaged junk food).”

“Fruits, vegetables and milk. Make sure snacks are not packed with sugar or empty calories and the child will stay full longer.”

Surprisingly, less that half of the parents surveyed think their child is aware of the importance of living a healthy lifestyle. When it comes to getting advice for building healthy habits with children, 87.5 percent of parents go to their family physician, 67.19 percent use the Internet, 68.75 percent turn to friends, 57.18 percent seek help from other family members and 51.56 percent of parents ask their child care provider.

“Locally prepared food, balanced meals, as few processed foods as possible, few sweets Where parents get advice for building healthy (not daily dessert).” habits with children “Healthy options that are freshly prepared.”

Family Members

Family Physician

Child Care Provider

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Friend Advice

Internet

Almost 80 percent of survey respondents support an increase in food regulations for child care facilities:

“It is such an important part of their day and overall well-being.”

“More regulation would provide additional standardization and would hopefully lead to more access to healthy food.”

Of the parents surveyed, 89.29 percent say they normally communicate with their child care provider through in-person contact, followed by email (8.93 percent) and then telephone (1.79 percent). Parents say that the best way for them to be reached with educational material would be through email (86.15 percent) or social media (49.23 percent).

Parents say that the best way to be reached with educational materials would be through

“Our current daycare provider is in the state food plan so I know there are things she can and cannot give to the kids. She does a great job with well balanced meals. I would like to see this done in all daycares to give all children a healthy and well balanced meal.”

20 percent of parents thought otherwise:

“It’s the parents business what their children eat, not any organizations.”

or Social Media

Email

(49.23 percent)

(86.15 percent)

“I’m not a fan of blanket rules that limit personal choices. If parents care enough to have their children eat healthy, they will demand it of their child care providers, and the market will adapt.”

“I think it is up to the parent to choose an appropriate daycare. If the parent doesn’t like the food, then they can go somewhere else. I don’t think that the daycare needs to be regulated by the government. There also seems to be a discrepancy in what pediatricians recommend versus the government. An example, the government has regulated that starting at age one, children will receive 2% milk in a licensed center, but my doctor thinks up until age two the child should have whole milk.”

32

Summary

of Key

Findings

PARENTS OF KANSAS CHILDREN

Ages Zero to Five

Obesity Prevention

• A review based on the results of 27,946 children found strong evidence suggesting beneficial effects of inschool, obesity intervention initiatives; however, the success of these initiatives declined as students got older. In fact, obesity intervention initiatives focused on teenagers typically show minimal success (Lakshman, 1775).

• Evidence suggests the most effective form of childhood obesity intervention is actually childhood obesity prevention (Lumeng, 14).

• Early-age obesity prevention presents a “window of opportunity” due to the large number of habits formed during this time (Lakshman, 1776).

• The child care environment is the ideal setting to assist children in the formation of a healthy lifestyle, which will positively influence them throughout life (Drummond, 157).

The Food and Beverage Environment FCCH

• Parents also play a significant role in a child’s development

on nutritional habits so they too need to be models of a

healthy lifestyle (“Staff Modeling of Healthy and Safe Behaviors…”).

• Ninety-six percent of Kansas parents surveyed said they

would at least consider paying more for a child care

provider, if it meant their child or children would receive a

better quality diet.

• Children tend to eat healthier at FCCHs than they do at home.

• Parents typically claim their busy schedules prevent them

from preparing healthy, unique meals every day.

• There is a general lack of nutritional knowledge among

low-income parents and their families:

o Food items commonly purchased by low-income

families tend to come in larger portions, making them

seem like a better deal than the items commonly

purchase by high-income families.

o These products are typically loaded with fat and

sugar, which makes the consumer feel full faster;

however, this feeling of satisfaction dissipates at a

quicker rate than it would for healthier food item.

Providers

• There are around 4,600 FCCH providers in Kansas.

o These providers are role models for the children in

their care. It is crucial that they emulate a healthy lifestyle.

o Despite this, the nutritional environment in FCCHs

receives very little attention (Hoelscher, 1379).

o In fact, when a Kansas FCCH provider gets licensed

it is rare for a conversation regarding healthy foods

and beverages to occur.

• A study of 297 FCCH providers in Kansas found that less

than 50 percent reported receiving nutritional education

training and only 53.7 percent had a comprehensive written

nutrition policy (Trost, 539).

• There is a general lack of knowledge among FCCH

providers regarding the food and beverage environment

(Lanigan, 526).

• “The key will be education,” Star Robinson, KQIRS coach

for CCA said.

• Kansas Child Care Training Opportunities, which offers

online classes to Kansas child care providers, said it would

be open to idea of implementing KAC’s nutritional

information into its classes.

• As of October 2014, 3,240 FCCH providers in Kansas (70

percent) were enrolled in the CACFP.

• Many FCCH providers find the CACFP to be very beneficial,

as it sets guidelines and ensures children eat healthy.

KANSAS CHILDREN

Ages Zero to Five

• There are 200,000 children between the ages of zero and five in Kansas (United States Census Bureau).

• Almost 16 percent of Kansas children ages two to five are overweight. Another 13 percent are obese (CDC, “Kansas’s Response to Obesity”).

• Children develop the majority of their nutritional behaviors, patterns and preferences during the early part of their lives (Lanigan, 521).

• Children need to try something 15 to 20 times in a variety of ways before they truly know whether or not they like it.

• More than 25,800 Kansas children in FCCHs are affected daily by the CACFP.

34

PARENTS OF CHILDREN

Ages Zero to Five

Why Act Now? • David Kessler, former commissioner for the Food and Drug Administration, said the U.S. is an “obesogenic” — an obesity-causing society where food companies tempt people with unhealthy products leading to “conditioned hypereating” (Bor, 393).

• Over the last thirty years, the genetic characteristics of the human population has not changed, but the rate of obesity has tripled among school-aged children (Editor).

• The typical four- to five-year-old consumes the equivalent of 65 pounds of added sugar every year (“Rethink Your Child’s Drink”).

• There are 12.7 million obese children and adolescents in the U.S. (CDC, “Childhood Obesity Facts”).

• Roughly three in ten Kansas children between the ages of two and five are overweight or obese (CDC, “Kansas’s Response to Obesity”).

• Obese children are two to three times more likely to be hospitalized and three times more costly to care for (Perkruh, 7,8).

• If these unhealthy trends continue at their current rate, this will be the first generation of children who will not outlive their parents (Stoler).

Target Audiences FCCH

KANSAS CHILDREN

Ages Zero to Five

• Children start off learning through physical and sensory

experimentation meaning child care providers need to strive

to expose them to as many senses as possible.

• Research shows a possibility that competence interacting

with adults and peers develops simultaneously in infants and

toddlers (Hanna, 701).

• Jennifer Wagner, curriculum director for Hilltop Child

Development Center, said, “Children look at everything as models.”

• At six months old, children begin to imitate those around

them. As they get older this imitations evolves into emulation.

• For this reason, it is important for children to have positive

relationships with peers, parents and caregivers.

“ AS MODELS

CHILDREN LOOK AT

Providers

• FCCH providers care greatly for the children in their care.

• There is no lack of resources among rural FCCH providers.

• FCCH providers tend to be active on social media,

specifically Facebook, because it allows them to connect

with other providers.

• The most effective way to reach them is through mailings,

flyers and classes.

• FCCH providers would value any free event — especially if

is has educational value, a stipend or some sort of door prize.

• Videos are one possible medium to get a message across

to all audiences clearly.

35

• Parents communicate with their child care provider

primarily through in-person contact (89.29 percent),

followed by email (8.93 percent) and telephone (1.79 percent).

• The two best ways to reach parents with educational

information are through email (86.15 percent) and social

media (49.23 percent).

“

EVERYTHING

MEDIA

• When working with the media, it is important to consider the target audience.

• Every story needs to newsworthy components.

• One of the best ways to draw public and media attention is by hosting an event.

• Press releases and public service announcements are two additional tools that are effective in gaining media attention.

SWOT

Analysis

The SWOT analysis is way to analyze research. It identifies the strengths, weaknesses opportunities and threats for Kansas Action for Children (KAC). By identifying topics in each category, it sets the stage for the strategic planning process.

Strengths are internal positive factors that KAC has control over.

Topics in this category are where KAC succeeds in comparison to competitors. Weaknesses are internal negative factors of KAC that currently exist and how they relate to competitors. Opportunities are external, environmental factors that may exist for KAC in the future. Topics in this section show opportunities for KAC to expand on and help to launch its second year initiative. These factors present possibilities for KAC and how it can address current issues. Threats are external factors that may also exist in the future. Threats are factors that could hurt KAC whether it be by competitors or other current issues. After identifying factors in each quadrant we will begin the process of analyzing data and planning for future action.

Strengths

Opportunities

• Driven to create change

• Great financial support

• Successful marketing strategies

• Experienced in child health advocacy

• Minimal resources v.

Major advertisers • Children are less active • Low health IQ by parents and child care providers • Healthier food = expensive • Reputation

Weaknesses 37

• Use social media to engage • Water, a healthy beverage alternative is free • Environmental changes • Child care providers generally want what is best for children

• Insufficient knowledge of

healthy alternatives

• Monetary barriers

• Advertising of less healthy foods

• Lenient Regulations

• Lack of parental knowledge & concern

• Fear of change

• Increase food consumption

Threats

Strengths KAC and employees are driven to create change in the conversation on childhood obesity.

• KAC has grown to become one of the leading child

advocacy organizations in the country (KAC website).

• Over the past 35 years, KAC has worked to make sure all

Kansas children are represented in all levels of power in

Washington, D.C. (KAC Website).

• KAC has the best interest of children in mind when

working to pass legislation and policy changes. It works

to create programs and regulations in child care facilities to

help change statistics in childhood obesity.

KAC has ample financial backing from grants and private donations that contribute to campaigns aimed toward policy changes.

• KAC receives no state or federal funding and works solely

from grants and private donations.

• KAC is able to maximize every campaign with added

private donations.

• KAC encourages donations on website and other social

media platforms.

KAC has successful marketing strategies.

• KAC works hard to maintain the brand it has created over

the last 30 years.

• For each campaign it creates unique social media

platforms, but still maintains a consistent KAC voice.

• KAC is well-known across the state as one of the top child

advocacy organizations with its 35 years of experience. Even

after 35 years, KAC works hard to achieve a unique

authentic voice as well as has a set of specific visual identity tactics.

KAC is experienced in child health advocacy.

• KAC is focused on the essentials of health, education and

economic stability for every child (KAC website).

• KAC has already facilitated an overhaul of child care

licensing to ensure that every child care facility in Kansas is

inspected and registered.

• KAC has also worked to establish healthier schools in

Kansas. It has helped reinforce healthy eating and exercise

habits at school.

• KAC has already established the Soda-Free Sundays

campaigns, which is a statewide initiative to encourage

children, families and organizations to take the pledge and

“Pass on Pop” (KAC website).

Weaknesses Minimal resources for KAC and other nonprofits versus major advertising spends for soda and junk food companies

• The top 10 soda and sweetened-beverage companies each

spend over $1 billion a year on advertising alone.

• Children are targets of nearly a quarter of the food

industry’s advertising budget. Research has shown that they

are particularly vulnerable: they are more receptive to sweet

tastes than adults, and young children, in particular, do not

recognize persuasive intent.

Today’s children are more exposed to electronics, which leads to a sedentary, less active lifestyle.

• While more of an issue outside of our target age group,

the AHA suggests that all children over the age of two

participate in at least 60 minutes of enjoyable, moderate intensity physical activities every day that are

developmentally appropriate and varied.

Low health IQ by parents and child care providers.

• Child care providers must be enthusiastic and excited to

implement our efforts – this is hard because they feel like

they know everything – important to reach them in new

ways (KAC).

• Refusal to drink fluoridated tap water is an issue in

Western Kansas (KAC).

• Gatorade and other sports drinks are not healthy

alternatives. They do have a place only when

participating in a high-intensity endurance event that lasts

longer than 90 minutes, like a high school basketball game.

For most children, therefore, a sports drink is really not

necessary, especially as a fluid replacement at home.

Healthier food can be expensive compared to cheaper alternatives

• Unhealthy food is about $1.50 cheaper per day, or about

$550 per year, than healthy food.

• A low-income family would have to devote 43 to 70

percent of its food budget to fruits and vegetables to

meet the 2005 Dietary Guidelines, which recommends five

to nine servings of fruits and vegetables a day.

• Geographic location affects consumption – low-income

areas may not have access to fresh produce or as many

healthy alternatives.

38

Opportunities Social

Media • CCA has found that many of the providers frequent social media sites to stay connected.

• This is a great opportunity for KAC to target groups of child care providers and get conversations started about healthy food and drink choices.

Water

is free.

• According to the Child Daycare Service Industry, if the salary of a child care provider was averaged in an hourly wage it was $9.76 in 2004 (Industry Information). As KAC is trying to push for healthier choices to be made, one of the main problems will be that healthy food is more expensive than unhealthy food.

• One of the things KAC is pushing is for child care providers to stop serving sugary drinks. KAC wants water to be the beverage of choice.

• This should be an easier sell, because they can stop buying Sunny Delight and other drinks that cost money.

Environment Changes

• “The places where we live, work, shop, play and learn

shape our health in many ways… To succeed, the care

delivery and public health communities need to develop

partnerships in order to address the social and

environmental determinants of health. When a pop is sat

in front of me, I drink pop. Conversely when water is sat in

front of me, I drink water. Generally we, especially at the age

of 5 and under, do what is easiest. The great part about

what KAC wants to accomplish is that if the child care

providers simply change the environment, children will make

healthier ‘choices.’”

Child care Providers generally want what is best for children.

• Most of the long-term child care providers are in this

profession because they enjoy it. “The first five years

of a child’s life are fundamentally important. They are the

foundation that shapes children’s future health, happiness,

growth, development and learning achievement at

school, in the family and community, and in life in general”

(Child Development and Early Learning).

• They know they have an opportunity to better the lives of

these children.

• They just need to know how important their jobs are in the

lives of these children. If this is the case, it is a great

opportunity to educate the providers on the negative

effects of a poor diet and help them come up with ways to

better implement healthier food and drinks.

39

Threats Insufficient knowledge

• Many caregivers serve food and beverages that are

seemingly healthy. For example, Gatorade is often seen as

a better alternative to pop; however, it is packed with

sodium and sugars.

• This concern was voiced during an interview with KAC

representatives as one of the biggest barriers to

implementing change in child care settings.

Monetary Barriers

• Healthy food and beverage options are often more

expensive than unhealthy alternatives.

• A study done by BMJ Research showed that on average

healthier choices are $0.29 more expensive per serving than

the less healthy choices in all food categories (Rao, Afshin,

Singh, Mozaffarian, 4)

• During an interview with KAC representatives stated that

many providers are operation on a very low-profit income

and food budgets are tight.

• According to the Early Childhood Research Quarterly, “If

a person cares for one child 55 hours per week, charging

a fee of $80 per week, gross receipts (before deducting

costs) would be a paltry $1.45 per hour; with six children

receipts would equal $8.72 per hour.” This rounds to about

$15,500 per year with 12.8 percent of gross income going to

food expenses. This does not leave much discretionary

income for healthier food options (Helburn, Morris and

Modigliani, 522) Advertising of unhealthy foods

• A study published by the Centers for Disease Control and

Prevention, foods that are high in calories, sugars, salt and

fat are highly advertised and marketed through media

targeted to children and adolescents.

• Large companies have large advertising budgets: Coca Cola spent $2.9 billion on advertising in 2010 (Brandweek).

Lenient Regulations

• The Kansas state regulations regarding child care have

proven to be difficult to update. Although the most recent

addendum was put into effect in 2010; regulations had not

been updated before that date since 1990.

• American Dietetic Association research showed Kansas

is one of only five states that do not have regulations related

to obesity in child care services that operate within family homes.

Lack of Parental Support/Knowledge/Concern

• According to American Dietetic Association research,

communication between child-care providers and parents

is important to prevent obesity and promote healthy weight

in children attending child care (Larson, et. al., 2011).

• In addition, research indicates that parents are unlikely

to recognize a preschool-aged child is obese and

considerable portions of parents of normal-weight children

perceive their child to be underweight.

Fear of Change

• Some child care providers do not understand how healthy

alternatives can be affordable through the CACFP, nor do

they want to put in the work to claim the benefits.

• In an interview with KAC representatives, we learned that

many feel as though healthy alternatives aren’t needed. “I

served my kids Coke and Cheetos and they turned out fine.”

Increased Food Consumptions

• According to the Let’s Move Campaign, “Thirty years ago,

kids ate just one snack a day, whereas now they are trending

toward three snacks, resulting in an additional 200 calories a

day. And one in five school-age children consume up to six

snacks a day,” (Let’s Move).

• If these snacks are unhealthy, it is a threat to healthy weight.

Conclusion Overall, a lack of financial resources and education are the largest barriers to improving the state of childhood obesity. Funding for programs is limited and intervention efforts require a lot of planning in regard to budgeting and implementation.

Many child care providers would be hesitant in changing their ways, especially if someone is telling them that they have to. It is more productive to make suggestions and offer free resources and information to child care providers to educate and help them understand that the changes they can make would benefit the children’s lives.

Another key part of making a positive impression on child care providers is keeping consistent contact with them. Marie Treichel of CCA said child care providers are typically fun, playful people who are most attracted to campaigns that have fun, entertaining names.

They should be approached with a light-hearted attitude and make sure the information is presented in a way that is not too pushy.

Most child care providers want what’s best for the children so keep in mind that they’re not doing anything wrong; there are just things that they can do better. A lack of knowledge on the subject is sometimes the main issue, and simply informing the child care providers could improve how they run their facilities.

1 5

in CHILDREN CONSUME UP TO

6

SNACKS

EACH DAY 40

Target

Audiences

1

CHILD CARE PROVIDERS According to our primary research the most common way parents communicate with their providers is in person. It’s important to form strong relationships with child care providers for this reason. Besides face to face contact, many parents were in favor of receiving take home newsletters. 80 percent of the parents who took our survey would support more regulation on food and beverages served in child care facilities so creating a strong relationship between providers and parents could help push for change.

2

PARENTS

According to research found on Prizm, the average midscale parent in Kansas ranges in age from 25-44. They typically live in suburban areas and have some level of college education. Our research indicates that parents are key when it comes to their children’s health and the habits they form. According to our survey taken by 77 parents in Kansas, a majority of parents do believe that obesity is a community issue but most are not concerned about their own child being overweight. Based off of their responses, parents are on average only feeding their children fast food one to two times per week and only giving them one to two sodas on average.

3

CHILDREN

Children ultimately have the final say in what they eat and drink.

By promoting healthy eating to be trendy and the “cool thing to do,” we believe more children will be inclined to do so. When we asked the group of 77 parent survey takers if they believed that their actions regarding food and beverage consumption affect any other members of their family, about 3 percent strongly disagreed and approximately 69 percent said they strongly agreed. We want to encourage children to develop a healthy diet at a young age so they are able to continue eating well as they grow up and the number one way to do that is to have good influencers in their lives.

4

MEDIA

Based on our interview with Kristi Spencer from KOAM TV, the key thing to keep in mind when targeting media as your audience is TIPCUP: timeliness, impact, prominence, conflict, unique and proximity. The media is always looking for the next story and the more you can incorporate elements of relevancy the more likely your story will be covered. One of the best ways to reach a large audience is through hosting an event. You can leave a strong impression on attendees and by making it newsworthy you can also earn free media.

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Goals

& Objectives

1

Parents

To educate parents on the importance of creating a healthy environment for their children.

Objective 1: Attract 1,500 unique visitors and 5,000 page views to “Think Big. Start Small.� website within the first three months.

Objective 2: Establish a following of 1,000 Facebook users within the first three months.

Objective 3: Connect with 15 percent of Kansas parents with children ages zero to five through targeted paid media.

Objective 4: Attract 250,000 exhibit visitors to Exploration Place in Wichita, KS, during Summer 2015.

2

Providers

To create a healthy food and beverage environment for children in child care facilities.

Objective 1: Partner with Child Care Aware to send out relevant information to all providers registered under Child Care Aware (CCA).

Objective 2: Ensure 80 percent of licensed FCCH providers are educated on the importance of cultivating a healthy food and beverage environment in their facility.

Objective 3: Enroll 460 FCCH providers in the Child and Adult Care Food Program, a 10 percent increase in the number of FCCH providers currently registered.

Objective 4: Attract 250,000 exhibit visitors to Exploration Place in Wichita, KS, during Summer 2015.

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3

Children

To develop healthy eating and drinking habits.

Objective 1: Expose 80 percent of Kansas children ages zero to five who attend FCCHs to the benefits of a healthy lifestyle.

Objective 4: Attract 250,000 exhibit visitors to Exploration Place in Wichita, KS, during Summer 2015.

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Strategies

& Tactics

Strategy: Tactics:

Provide curated content including healthy eating advice, easy recipes, inexpensive meals, featured bloggers, videos and more.

“Think Big. Start Small.” Website and Page Block

The “Think Big. Start Small.” website is a colorful, inviting place where visitors are free to explore the numerous ways they can make small steps towards leading a healthier lifestyle. This website will provide both curated and original content. Healthy recipes, inexpensive meals and nutritional tips are only a click away. Frequent visitors to the web page will be quick to catch on to the seasonality of this site. As part of a greater message, www.thinkbigstartsmall. com will operate in unison with the “Think Big. Start Small.” 2015 content calendar. This means each month a new theme and nutritional focus will take center-stage on the website’s home page.

Under the “About” tab visitors can delve into the reasoning behind the “Think Big. Start Small.” campaign, discover its goals and explore its next steps. Drop down the “Learn” tab and watch as an avalanche of health-related information falls right into your lap. The tabs in bottom-right corner of the webpage allow visitors to contact “Think Big. Start Small,” leave feedback and connect to the campaign’s Facebook page.

Though all guests are welcome, “Think Big. Start Small.” aims to turn two particular audiences into frequent visitors: family child care home (FCCH) providers and Kansas parents with children ages zero to five. The “Think Big. Start Small.” websites offers useful information for both these groups. In the “Provider” tab FCCH providers can check out the current classes being offered by the Kansas Child Care Training Opportunities and view information, testimonials and tips regarding the Child and Adult Care Food Program. The “Parent” tab will be full of vital information parents can implement to ensure their child is on the right path to developing healthy habits.

The “Think Big. Start Small.” website will launch at the start of the campaign in January 2015. This website will run through the end of this campaign. The domain provider, Wix, offers webpages for $8 per month, or $96 for the year.

As an additional tactic, “Think Big. Start Small.” developed a page block. This page block will pop up when visitors first enter the website. Its purpose is to get people registered for the monthly newsletters and drive Facebook likes.

Status: 47

Website: Conceptualized, but not built Page Block: Conceptualized, but not built

Website

48

Page Block

49

Tactics:

“Think Big. Start Small.” 2015 Content Calendar, Monthly Newsletters and Web Posters

“Think Smart. Start Small.” aims to enact positive change in the Kansas’ food and beverage environment in an engaging and entertaining way. In order to do this, a content calendar was developed. This calendar breaks down each month into a specific nutritional theme that directly relates to the month in which is it located. At the beginning of each month, a newsletter will be sent out to parents and providers. These newsletters will provide themed information, healthy recipes, nutritional tips and an interactive, educational activity for children.

In addition to the newsletter, each month’s theme will be cohesively conceptualized across the “Think Big. Start Small.” website Facebook pages. This cohesive branding will come in the form of relatable, shared content, original posts and shareable “Think Big. Start Small.” web posters specific to each month’s theme.

Status:

Content Calendar: Complete Monthly Newsletter: The January newsletter is complete. Newsletters for the other months have not been developed.

Web Posters: January and October posters are complete. Other months have not been developed.

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51

January Newsletter

January

February

March

New Year, New Habits

Fall in Love with (Healthy) Food

Practice Planning Ahead

It’s 2015, start the year off right by learning new habits and sticking to old ones.

This Valentine’s month, try something new for dinner each week, and who knows, you might have your heart stolen.

Eating healthy is easy if you plan ahead. Learn to schedule your meals in advance and always use a shopping list to avoid impulse purchases

April

May

June

Plant a Garden

Shop in Season Part 1

Why Order a Pizza When You Can Make One?

Learn a new skill that both you and your children can enjoy. Grow the rainbow and enjoy inexpensive meals with a sense of pride.

Why go organic? Learn to love the inexpensive veggies at your local grocery store with recipes and cooking advice from our experts.

It’s cheaper and healthier than you think! Explore DIY dinner options and spend time with your kids.

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July

August

September

It’s Hot Out, Drink Water

Back to School

Shop in Season Part 2

Water is an essential part of staying healthy and in-shape. Enjoy these tips to stay cool during the steamy summer months.

Healthier lunches are all the rage this year. Learn how to save money and create easy lunches for your kids.

Enjoy the foods of fall.

It’s ok to be a vegetarian a few nights a week. It’s cheaper than meat and provides you with all the nutrients your body needs.

October

November

December

Fast Food is Scary!

Be Thankful for Leftovers

Celebrate Good Food

Halloween is here and the scariest monsters this year are burgers and donuts.

Learn to keep a healthy diet during the candy month.

Learn to reuse leftovers and make the most of the meals you cook. Portion control is important this time of year, especially with Thanksgiving.

The holidays are here and what better way to celebrate than with warm treats and home cooked meals? Stay inside by the fire and cook dinner with the family.

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DON’T LET THE

January Web Poster

YOUR PLANS

Did you know the average person gains 2 to 4 pounds during the winter months? Don’t use this time to hibernate – instead, get with the whole family and try a new activity like ice skating, sledding or simply a walk in the park. Think big by starting small.

Visit www.ThinkBigStartSmall.com for more information.

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October Web Posters

Sweets CAN BE

SCARY

Did you know it would take a walk from Kansas City to Topeka to burn off all of the calories from the candy your child collects on Halloween. This year, consider giving out healthier alternatives like pretzels, granola or popcorn. Think big by starting small.

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Visit www.ThinkBigStartSmall.com for more information.

FAST FOOD CAN BE A REAL

WITCH

Did you know most US children can recognize the word McDonalds before they can speak? Skip the drive-thru and plan breakfast before bed to save time in the morning.

Don’t fall under the spell. Think big by by starting small.

Visit www.ThinkBigStartSmall.com for more information.

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SKIP THE soda IT’S A

NO BRAINER

Did you know the average US household spends over $850

a year on soft drinks? Next time you eat out, skip the soda and opt for a glass of water. Save money and leave that unnecessary sugar for the zombies. Think big by starting small.

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Visit www.ThinkBigStartSmall.com for more information.

Strategy: Tactics:

Use Facebook’s advertising platform to promote the page and educate through selected posts among our target demographics.

“Think Big. Start Small.” Facebook Page, FCCH Facebook Group and Facebook Advertisements

A social media presence is a necessary for this campaign’s success. Considering its usage by the majority of the target audience, Facebook is the perfect medium to employ. The “Think Big. Start Small.” Facebook page will serve as a complimentary medium to the campaign’s website. The two will be directly linked to each other. It will be used to share recipes, tips and educational information relatable to each month’s theme. Facebook posts will be tailored directly to its audience. This free page will launch in January 2015 and last the duration of the campaign.

Research show that FCCH providers use Facebook to stay connected. Implementing a FCCH Facebook Group will strengthen the FCCH community in Kansas. This page will allow providers to network with one another, seek advice and share ideas. In January 2015, Child Care Aware will provide a link to all Kansas FCCH providers inviting them to join this free group. It will stay active as long as FCCH providers find it useful.

Facebook advertisements and promoted posts will be purchased in order to drive traffic to the “Think Big. Start Small.” Facebook page. This type of advertising can be highly targeted. Using demographic filters and user interests, these will undoubtedly connect “Think Big. Start Small.” to its target market.

Status:

“Think Big. Start Small” Facebook Page: Conceptionalized, but not built.

FCCH Facebook Group: Incomplete Facebook Advertisements: Conceptionalized, but not built.

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Facebook Page

59

Facebook Advertisement Think Big. Start Small.

Our children don’t have to be a obesity statistic, but they need our help.

Think Big. Start Small.

A Health Initiative by Kansas Action for Children 1,000 people like this.

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Strategy: Tactic:

Research shows this is the first generation of children that may not outlive their parents. “Think Big. Start Small.” strives to educate parents about the current state of childhood obesity and the role they play in the health environment of their children.

“Think Big. Start Small.” Television Advertisement

“Think Big. Start Small.” implements two, 60-second advertisements. One of these will be used to depict the positive effects of a healthy lifestyle; the other will be used to show the negative repercussion of an unhealthy lifestyle. For the television spots, these two advertisements will be meshed together to tell one compelling story. Three different production companies have said they can produce these videos in price range of $8,000 to $10,000. This price includes the casting, production and editing required for this project. Contact information is listed below:

1. Chris at Through a Glass Productions: info@throughaglass.com; 877.430.6510.

2. Jeremy at Cinematic Visions: jwood@cinematicvisions.com; 816.600.6300.

3. Brad at Real Time Media: brad@realme.com; 913.754.1901.

The television advertisement will be used to earn widespread awareness of the “Think Big. Start Small.” campaign.

These television spots will run in March, after an initial following for the campaign has been established through CCA, Facebook advertisements and Google AdWords advertisements. They will be aired during primetime in the Kansas City, Wichita, Topeka and Salina markets. The estimated cost for airing the commercial is $5,400. In addition, the “Think Big. Start Small.” Facebook pages and website will provide a link for the advertisements via a “Think Big. Start Small.” YouTube channel.

Status: 61

“Think Big. Start Small” Television Advertisement: The storyboard is complete. Cost estimates have been issued. Actual production of this spot is incomplete.

Television Advertisement Storyboard “Small Changes Can Make A Big Diffference” Storyboard - Broadcast / YouTube Execution Runtime: 60 sec (2 min full reel) 12/11/14

Hospital

Preschool

Elementary

High School

College

Work

Heart Attack

Hospital Return

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Tactic:

“Think Big. Start Small.” Radio Advertisement

A “Think Big. Start Small.” radio spot will run concurrently with the television advertisements during the month of March. This multimedia approach will assist in gaining widespread awareness for the overall campaign. The radio spots will run during the evening commute home.

The radio advertisement is targeted towards parents and children ages zero to five. It will feature a child talking to his mother about the importance of eating healthy. This tactic is free to produce, but the cost of placing the advertisements is estimated to be $4,200.

Status:

“Think Big. Start Small” Radio Advertisement: Complete

Radio Advertisement Script 0:01 -- Music starts

0:02 -- Kid: Mom did you know that big people like you might live longer than little kids like me? Three out of ten children in Kansas are too big. Today I learned that you can help me be strong like superman.

Sometimes I don’t like to eat my vegetables, but www.thinkbigstartsmall.com has recipies that will help me like them more. How about we make a change mommy? What do you think?

0:26 -- Announcer: Parents, check out www.ThinkBigStartSmall. com to learn more about the small changes you can make that will create a big difference in your children’s lives!

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Tactic:

“Think Big. Start Small.” Google AdWords Advertising

By using Google AdWords, “Think Big. Start Small.” can directly target Kansas parents using Google’s search engine.

These advertisements can be geographically targeted so they will appear solely to Kansas citizens who search online for information regarding obesity, healthy eating habits and local events. This form of advertising is charged on a costper-click basis. Though actual costs may vary, “Think Big. Start Small.” has set aside $250 per month for this tactic.

Status:

“Think Big. Start Small” Google Adwords: The strategy for this tactic is complete. A potential advertisement has been conceptualized. Actual production is incomplete.

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Proposed AdWords Strategy Kansas Action for Children currently runs no search advertising and would benefit greatly by researching users who are actively seeking information online. By utilizing AdWords, KAC will be able to actively attract visitors to its new “Think Big. Start Small.” website using Google’s intuitive Adword platform. The organization will be able to easily target interested visitors, solicit email sign-ups and draw traffic to its “Eat Well, Play Well” exhibit in Wichita, KS. For this campaign, KAC will focus on two main objectives:

1. Build Awareness -- drive online site visits 2. Event Timing -- draw traffic to the “Eat Well, Play Well” exhibit in Wichita

There will be an Ad Group created for each campaign objective.

More will be incorporated once keyword popularity and quality score data is available to analyze. The plan is to start simple and then expand efforts across other KAC objectives.

Experiment -- Measure -- Learn -- Adjust KAC will utilize the Search Network only. Optimizing for clicks will be used for automatic bidding which will help maximize impressions within our target budget. Our goal is a target CTR of 2 percent with a CPC of 15 - 25 cents. Measurable objectives on the KAC end will include increased donations, volunteer leads and informational email sign-ups. The organization will determine a conversion rate based on clicks that translate to these measurable objectives. Since KAC is a non-profit organization based in Kansas, searches by geography will be incredibly relevant since information seekers will be associating their search within the state.

1. Build Awareness - general information

Keywords: Kansas children, obesity help, childhood obesity, obesity prevention, overweight children, obesity causes, improve Kansas, healthy kids, active kids, children future Negative Keywords: insurance, jobs, supplements

Small Steps Can Make Big Changes

Help build a healthier Kansas and improve our childrens’ future.

www.ThinkBigStartSmall.com

Obesity Affects All Of Kansas Learn more about how you can make our state a better place to raise a child. www.ThinkBigStartSmall.com/sign-up

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2. Event Timing - draw traffic to the “Eat Well, Play Well” exhibit in Wichita

Keywords: Riverfest 2014, local events Wichita, healthy eating, Kansas events, Wichita events, Wichita May, Wichita June, Wichita July, kid’s activities, healthy fun, local exhibit, Kansas fun Negative Keywords: insurance, jobs, supplements Join Us At The Wichita Riverfest!

Learn about healthy eating habits in an interactive, child- friendly environment. www.ThinkBigStartSmall.com/EatWellPlayWell

Small Changes Can Make A Big Difference In Your Child’s Life

Join us at the Wichita Riverfest and learn how healthy can

be fun for the whole family.

www.ThinkBigStartSmall.com/EatWellPlayWell Based on our overall budget of $1800, a daily allowance of $5 and a weekly allowance of $35 will be allocated for the duration of our year-long campaign. We plan to monitor results daily and adjust keywords and ad copy accordingly to experiment with the success of certain words that generate clicks. The keywords tool within the AdWords ecosystem will serve as a valuable resource for predicting CPC, evaluating competition between words and exploring alternate keyword options. The Traffic Estimator will also be valuable in estimating clicks and allocating budget effectively. Starting simple will allow us to learn the AdWords platform while determining the best metrics for KAC.

AdWords Example

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Tactic:

“Think Big. Start Small.” PSA Video

Status:

“Think Big. Start Small” PSA Video: Complete

“Think Big. Start Small.” has developed a public service announcement video that will provide viewer with a visual depiction of the problem Kansas is facing. The campaign’s website, Facebook pages and YouTube channel will all house this PSA.

PSA Script

We have a situation on our hands. In the state of Kansas 3 out of 10 are overweight or obese. This is Sam. By the age of five Sam will be classified as one of those children. He will be at risk for heart disease, diabetes, cancer and many other health complications as he grows up. Sam’s generation is the first that parents are projected to live longer than them.

How did he get here?

He He He He

spent multiple hours in front of a screen each day drank more fruit juice than water was given multiple snacks each day was given food as a reward for good behavior

The environment that he lives in has shaped these bad habits that could follow him the rest of his life.

We need a solution.

Let’s rewind to when Sam was 1. He attends a child care facility that uses regulated portions of fruits, veggies, grains and proteins. In this facility, providers don’t use food as a reward, his peers around him stay active, and as a result he lives in an environment that promotes a healthy lifestyle.

By doing small things like replacing sugary beverages with a glass of water, or French fries with fruit, we can make a big impact on our children’s lives. Early age prevention creates a window of opportunity allowing children to develop healthy habits they will carry with them for the rest of their lives.

67

Decisions child care providers and parents make early on can make the difference. Think big, and start small to change a child’s life.

Strategy: Tactic:

Educate parents, providers and children on what it means to live a healthy lifestyle. Increase awareness for the exhibit through the use of earned media.

“Eat Well, Play Well” Exhibit and News Release

“Think Big. Start Small.” understand that interactive learning is the best form of learning, especially for children. It order to bring implement this into the campaign, “Think Big. Start Small.” plans to rent the Oregon Museum of Science and Industry’s (OMSI) traveling “Eat Well, Play Well” exhibit. This child-friendly display explores eight components relating to healthy eating and fitness. OMSI can be contacted at 503-797-400.

By placing this exhibit at Exploration Place in Wichita, KS, “Think Big. Start Small.” during between May 2015 and July 2015. A marketing kit provided by OMSI paired with a “Think Big. Start Small.” news release tying exhibit into the overall campaign will be distributed to Wichita metro news outlets as well as health-oriented organizations across the state. These factors will ensure this $7,000 exhibit optimizes its potential for success.

Status:

“Eat Well, Play Well” Exhibit: Contacted and ready for purchase.

News Release: Complete with list of outlets.

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Press Release FOR IMMEDIATE RELEASE May 2015 Contact: Lauren Beatty Phone: (785) 232-0550 Email: lauren@kac.org Web: KAC.org Eat Well, Play Well Exhibit To Be Feature At The Wichita River Festival WICHITA, Kan. – Kansas Action for Children is partnering with FIT Wichita to sponsor an interactive exhibit for both parents and children to educate on how to live a healthy lifestyle.

The exhibit, titled, Eat Well, Play Well features eight components that help visitors explore the importance of nutrition and fitness. Through interactive touch points, children and parents can learn fun ways to incorporate healthy eating and being active into their daily lives.

KAC is hosting the event in light of its “Think Big. Start Small.” statewide campaign that focuses on creating a healthy environment for Kansas children. The organization will be hosting the traveling exhibit in 10 cities around Kansas.

The event is bilingual and will last the duration of RiverFest. All are welcomed to attend with a free admission. ###

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Television Broadcast

• KWCH • KAKE • KSN

Newspaper

• The Wichita Eagle • Ark Valley News • Salina Journal • Newton Kansan • McPherson Sentinel

• Derby Informer • Butler County Times-Gazette • Harvey County Independent

Radio Station

• KFDI • KZCH • KPTS

• Big Brothers, Big Sisters of Wichita • Kansas Health Foundation • YMCA of Wichita • Sedgwick County Health Department

Organization 70

Strategy: Tactic:

Partner with Kansas Child Care Training Opportunities (KCCTO) to educate 80 percent of inhome child care providers on the importance of a healthy lifestyle.

“Think Big. Start Small.” FCCH Nutrition Education Class Partnership

Each year, FCCH providers are required to complete five hours of additional education. If these providers are enrolled in the CACFP program, this requirement raises to seven hours. The majority of these providers fulfill at least part of this requirement by taking classes from the Kansas Child Care Training Opportunities (KCCTO) through Kansas State University.

Linda Logan, the program coordinator for KCCTO, said she would be happy to partner with “Think Big. Start Small.” to implement nutrition education into the classes currently offered. These classes could also be utilized to show the benefits of enrolling for the CACFP. Logan can be contacted at lindalogan@k-state.edu. In order to incentive these classes, “Think Big. Start Small.” will provide a $100 VISA gift card to one random FCCH provider each of the first 20 classes, totally $2,000.

Status:

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“Think Big. Start Small” FCCH Nutrition Education Classes: A potential venue for these classes has been established. Class curriculum has not been developed.

Strategy: Tactic:

Emphasize how simple the CACFP enrollment process is and inform child care providers of the benefits of the CACFP.

“Think Big. Start Small.” CACFP Promotions

“Think Big. Start Small.” realizes how beneficial the CACFP can be in improving the food and beverage environment for children ages zero to five in Kansas. This campaign utilizes an array of venues to promote the CACFP. By working with Linda Logan from KCCTO, “Think Big. Start Small.” with get information regarding the programs benefits implemented into the classes offered. The ‘Provider” tab on the campaign website will provide instructions for registering, step-bystep instructions on how to fill out the paperwork and testimonials from Kansas FCCH providers currently enrolled in the program. These testimonials can also be posted in a FCCH Facebook group.

Status:

“Think Big. Start Small” CACFP Promotions: An example of a filled out form is completed. Testimonials have been gathered. Implementation of the programs benefits into classes is incomplete.

72

Testimonials Brandy Hurrelbrink: “A majority of people are trying to do their best with the more knowledge they get. You look at the benefits and see how much cheaper it is.

All of the training and exposure helps.”

Tasha Wolff: “The entire food program is really helpful. It sets guidelines and makes serving food so easy. You have to fulfill the requirements and give the kids reasonable servings. I like it because it sets the guidelines for me. I would probably use it even if it paid less! I definitely think if more providers did it, it would be benefiicial.

Sheila White: “There’s a lack of education about it. The entire CACFP program has evolved over the years. It’s income-based and at the end of the year you end up getting it all back.”

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CACFP Form

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Predictions

& Evaluations

Overall Goal :

To make positive, healthy changes in the food and beverage environment for children ages zero to five in Kansas.

Prediction :

We predict that through the use of the Volcanic Communications’ “Think Big. Start Small.” campaign, Kansas Action for Children (KAC) will see undeniable, positive change in Kansas’ food and beverage environment for children ages zero to five.

Evaluation :

Through the evaluation of each of the tactics, the overall campaigns success can then be evaluated.

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Parents :

Objective 1: Attract 1,500 unique visitors and 5,000 page views to the “Think Big. Start Small.” website within the first three months.

Prediction: We predict that through our tactics we will meet this

objective of 1,500 unique visitors and have 5,000 pageviews.

Evaluation: We will use Google analytics to track website traffic. We will

also drop code on the backend that enables Google to keep tabs on total page visits, unique page visits, geographic hits and link clicks.

Objective 2: Establish a following of 1,000 Facebook users within the first three months.

Prediction: If the tactics are utilized we predict we will have even more

than 1,000 Facebook users after the first three months.

Evaluation: At the end of March check the “Think Big. Start Small.”

Facebook page to see how many likes the page has generated.

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Objective 3: Reach 15 percent of Kansas children ages zero to five by connecting with their parents through the use of targeted media.

Prediction: Following our tactics we will reach at least 15 percent of

Kansas children age zero to five.

Evaluation: 15 percent is equivalent to 30,000 Kansas children ages zero

to five. Our survey results indicate that Kansas parents tend to have 1.5 children in this age range. Therefore, in order to reach 15 percent, we need to connect with 20,000 Kansas parents. By evaluating the number of parents with kids registered in FCCH’s, “Think Big. Start Small.” Facebook likes, website visits and attendance rates at Exploration Place during Summer 2015, we can determine the success of this objective.

Objective 4: Attract 250,000 exhibit visitors to the Exploration Place in Wichita, Kansas, during Summer 2015.

Prediction: We predict that the “Eat Well, Play Well” exhibit will have

250,000 impressions in the three months it will be in the Exploration Place.

Evaluation: The Exploration Place will be able to give numbers for an

accurate evaluation of visitors.

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Providers :

Objective 1: Ensure 80 percent of licensed in-home providers are educated

on the importance of creating healthy food and beverage environments in their facility.

Prediction: We predict that with the partnership with Kansas Child

Care Training Opportunities (KCCTO), KAC will reach at least 80 percent of in-home providers.

Evaluation: KCCTO keeps accurate records of who takes its classes

KCCTO and will be able to give KAC an accurate evaluation.

Objective 2: To enroll 460 additional FCCH providers in the CACFP, a 10 percent increase in the number of providers currently registered.

Prediction: With the “Think BIG. Start small.” campaign, we believe that

there will be at least a 10 percent increase in providers enrolled in CACFP.

Evaluation: At the end of 2015, attain the total number of Kansas

FCCH providers enrolled in CACFP from Peggy McAdoo of the Kansas State Department of Education’s Child Nutrition and Development. If there are 3,360 FCCH providers enrolled, this objective was accomplished.

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Objective 3: Partner with Child Care Aware (CCA) to send out relevant information to all Kansas FCCH registered under CCA.

Prediction: CCA will send out all information KAC deems relevant to all

licensed providers.

Evaluation: Simple follow ups with Star Robinson of CCA is an effective

and accurate way to ensure the information gets transmitted to the FCCH providers.

Children :

Objective 1: To expose 80 percent of Kansas children ages zero to five who attend FCCHs to the benefits of a healthy lifestyle.

Prediction: If each tactic is followed we believe that at least 25 percent of

children will be exposed to the benefits of a healthy lifestyle.

Evaluation: There are 200,000 children in Kansas ages zero to five. In

order to be successful we will need to expose 50,000 of these children to the benefits of a healthy lifestyle. Through the in-home child care facilities as well as through targeted media we believe that providers and parents will be educated on the benefits. In turn they will educate their children.

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Budget

Summary

Budget “Eat Well, Play Well� Exhibit...........................................................$7,500 Facebook Advertising ($250 per month)....................................$3,000 Google Advertisement ($150 per month)....................................$1,800 Website ($8 per month)........................................................................$96 Radio Advertising (See Appendix for breakdown of cost).....$4,200 $100 Visa Gift Cards for 1 Random Provider in each of the first 20 online classes provided..............................$2,000 Television and YouTube Video Production Cost...................$10,000 Suggested Weekly Advertisements Cost....................................$5,400

$33,996 TOTAL 82

Appendix

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Barnes, Melody. “Solving the Problem of Childhood Obesity Within a Generation.” White House Task Force of Childhood Obesity Report for

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Benjamin, Sara E., and Angie Cradock, et all. “Obesity Prevention in Child Care: A Review of U.S. State Regulations.” BMC Public Health.

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Bor, Jonathon. “Health Affairs.” Health Affairs 29.3 (2010): 393-97. The Science Of Childhood Obesity. Mar. 2010. Web. 30 Sept. 2014. <http://content.healthaffairs.org/content/29/3/393.full>.

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Drummond, Rebecca L., MA; Staten, Lisa K., PhD, et all. “Steps to a Healthier Arizona: A Pebble in the Pond: The Ripple Effect of an

Obesity Prevention Intervention Targeting the Child Care Environment.” Health Promotion Practice. April 2009. Volume 10, No. 2.

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to Childhood and Adult Obesity.” National Health Institute Public Access (2007): 1-7. National Center for Biotechnology Information.

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Hannah, Elizabeth, and Andrew N. Meltzoff. “Peer Imitation by Toddlers in Laboratory, Home, and Day-Care Contexts: Implications for Social

Learning and Memory.” Developmental Psychology 29.4 (1993): 701-10. Washington.edu. American Psychological Association.

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Hoelscher, Deanna M., PhD, RD, LD, Kirk Shelley, PhD, RD, LD, et all. “Position of the Academy of Nutrition and Dietetics: Interventions for

the Prevention and Treatment of Pediatric Overweight and Obesity.” Journal of the Academy of Nutrition and Dietetics 133.10

(2013): 1375-394. Eat Right. Oct. 2013. Web. 7 Oct. 2014. <http://www.andjrnl.org/article/S2212-2672(13)01292-6/fulltext>.

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childhood_obesity/?gclid=CKyq_vTu4MEC FRWUaQod8x8AAg>.

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14 Sept. 2014. <https://collegegrad.com/industries/edhea01>.

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for Biotechnology Information. U.S. National Library of Medicine, 02 Oct. 2012. Web. 02 Oct. 2014. <http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3785130/>.

Lanigan, Jane D., PhD. “The Relationship between Practices and Child Care Providers’ Beliefs Related to Child Feeding and Obesity Prevention.” Journal of Nutrition Education and Behavior 44.6 (2012): 521-29. Journal of Nutrition Education and Behavior. Depart of

Human Development, Washington State University, 7 May 2012. Web. 19 Oct. 2014. <http://www.jneb.org/article/S1499 4046(11)00606-3/fulltext>.

Larson, Nicole, PhD, and Dianne S. Ward, EdD, et all. “What Role Can Child-Care Settings Play in Obesity Prevention? A Review of the

Evidence and Call for Research Efforts.” Journal of the American Dietetic Association 111.9 (2010): 1343-362. Eat Right. American

Dietetic Association, 22 Oct. 2010. Web. 2 Oct. 2014.

“Let’s Move.” Health Problems and Childhood Obesity. Let’s Move!, n.d. Web. 01 Oct. 2014. <http://www.letsmove.gov/health-problems-and childhood-obesity>.

“Let’s Move.” Learn The Facts. Let’s Move!, n.d. Web. 30 Sept. 2014. <http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity>.

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Oct. 2014. <http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/water/art-20044256>.

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Health Data. NICHQ. Web. 1 Oct. 2014. <http://www.childhealthdata.org/docs/nsch-docs/kansas04_23_508-pdf.pdf>.

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Web. 22 Oct. 2014. <http://www.ks.child careaware.org/Images/Nutrition%20Active%20Play%20%20Screen%20Time%20Child%20 Care%20Laws%20in%20Kansas.pdf>.

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Polis, Carey. “Eating Healthy vs. Unhealthy Will Cost You $550 More Per Year, Study Reveals.” The Huffington Post. TheHuffingtonPost.com,

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Rao, Mayuree, Ashkan Afshin, Gitanjanli Singh, and Dariush Mozaffarian. “Do Healthier Foods and Diet Patterns Cost More than Less

Healthy Options? A Systematic Review and Meta-analysis.” BMJ Open. Open Access Research, 2013. Web. 14 Sept. 2014.

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Survey Results

Parents Survey

Volcanic Communications conducted a 35 question online survey targeted towards Kansas parents with children ages zero to five.

In total, 77 parents completed the survey. Located below are the results: 1. How many children do you have?

1. 1 - 40.26%

2. 2 - 45.45%

3. 3 - 7.79%

4. 4 - 3.9%

5. 5 - 1.3%

6. 6 or more - 1.3% 2. What is the age range of your children? Check all that apply.

1. 0-2 - 53.25%

2. 3-4 - 40.26%

3. 5-6 - 29.87%

4. 7-8 - 18.8%

5. 9 or older - 18.8% 3. Is/are your child/children enrolled in a child care facility?

1. Yes - 72.73%

2. No - 27.27% 4. What type of child care have you used for your child/

children? Check all that apply.

1. Part-time care - 21.43%

2. Full-time care - 58.93%

3. Babysitter/Nanny - 32.14%

4. Child Care Center - 58.93%

5. Family Child Care Home - 37.50%

6. Other (please specify) - 10.71%

1. Part-time preschool program 2. Preschool

3. Montessori pre-school/summer camp - Raintree

4. Boys and Girls Club after-school care 5. Preschool 5. How many hours per day is your child/children in a child care facility?

1. 1-4 - 12.5%

2. 5-9 - 82.14%

3. 10 or more - 5.36%

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6. What do you look for in a child care provider?

1. “[A] Person who sees the best in every child. Person who

knows First Aid, CPR and is educating self about how to be

the best teacher possible. Good honest communication.”

2. “Loving, fun, involved, educated, safe and clean.”

3. “Purposeful care, schedule. Healthy environment (little or

no media, outdoor play), healthy food, positive/calm

atmosphere, learning plan, etc.”

4. “Small amount of children.”

5. “Patience, health conscious, ability to care for a child.”

6. “Kids around the same age, day that is scheduled, time

spent learning, solid nap/rest time, cleanliness, someone

who enjoys my child, good balance meals.”

7. “Honesty, integrity, experience, able to interact with the

children appropriately.”

8. “Having experienced many different child care setups, I

prefer in home daycare.”

9. “My current provider has a very clean, welcoming

environment. She does a preschool curriculum, and lots

of structure in my daughter’s day. She has over 20 years of

experience. My only complaint is that she feeds my daughter

too much processed foods, or “toddler foods” like chicken

nuggets. I understand where she is coming from. If she

feeds the kids what she knows they will eat, parents won’t

complain that their kids aren’t eating anything at her place.

These types of foods also require less of her time to prepare.

I could have left my daughter with another lady who makes

homemade organic food like we do at home, but she

just has the kids play and watch TV all day. I like that where

my daughter is right now they go to the park every day,

have a themed book/art and circle time.”

10. “Safety of my children first and foremost, then education

and teaching.”

11. “Knowledge of child development stages, similar

environment to home (e.g. hugs, time-outs for discipline,

mixture of free play and structured play, clearly defined

rules and expectations, kind/affirming words, recognition

that we’re raising this child together, cloth diapering as

an option, not a lot of sugar and sodium in child’s diet),

favorable reviews from other parents.”

12. “Licensed, caring, degree in childhood education is a plus.”

13. “Warm, friendly, genuine, knowledgeable, experienced,

encouragement of development.”

14. “Positive environment focused on reinforcing desired

behaviors rather than punishing undesired ones; engaging

activities for children that promote learning.

15. Organization, cleanliness, activities for children that

enrich, communication, strategy/theory that is explained to

me such as Montessori, healthy food.”

16. “Strong learning environment, Montessori educational

philosophy, love and logic discipline practices, healthy food,

clean, safe environment, qualified instructors.”

17. “Safety of facility, multiple caregivers to enable “breaks”

for any one employee, quality meals, creative and engaging

academic environments.”

18. “Ability for children to go outside, Safe play area, clean facility.”

19. “High quality learning environments, focus on

community, outside time, high quality food, educated

personnel, accommodating schedule.“

20. “Educational focus, safe environment, diversity, variety of activities.”

21. “A clean facility where teachers employ positive behavior

strategies and are concerned about meeting the needs of

my child.”

22. “Reputation, educational program, qualifications of the

administrators and teachers, satisfaction of parents with

children already in the program, safety.”

7. Would you be willing to pay more for a child care provider if you knew your child/children was/were going to receive a better quality diet?

1. Yes - 48.21%

2. Maybe - 48.21%

3. No - 3.57% 8. How important are the following items when choosing a child care facility? 1 being unimportant and 5 being very important.

1. Safe environment

1. 1 - 3.57%

2. 2 - 0%

3. 3 - 0%

4. 4 - 1.79%

5. 5 - 94.64%

2. Clean environment

1. 1 - 1.79%

2. 2 - 1.79%

3. 3 - 1.79%

4. 4 - 16.07%

5. 5 - 78.57%

3. Accessibility to water

1. 1 - 3.57%

2. 2 - 1.79%

3. 3 - 12.5%

4. 4 - 19.64%

5. 5 - 62.5%

4. Brands of food served

1. 1 - 23.21%

2. 2 - 19.64%

3. 3 - 35.71%

4. 4 - 17.86%

5. 5 - 3.57%

5. Healthy meals and snacks

1. 1 - 0%

2. 2 - 1.79%

3. 3 - 8.93%

4. 4 - 44.64%

5. 5 - 44.64%

6. Equipment for playing and learning

1. 1 - 1.79%

2. 2 - 1.79%

3. 3 - 3.57%

4. 4 - 28.575

5. 5 - 64.29%

9. How aware are you about what food and beverage choices are available to your child/children by your child care provider?

1. Very unaware - 1.79%

2. Unaware - 5.36%

3. Somewhat aware - 17.86%

4. Aware - 48.21%

5. Very Aware - 26.79% 10. How do you usually communicate with you child care provider?

1. In person - 89.29%

2. Email - 8.93%

3. Phone - 1.79% 11.Do food options that are available affect how you choose a child care provider?

1. Yes - 46.43%

2. No - 53.57% 12. If yes, what do you look for?

1. “Fruits, vegetables and milk. Make sure snacks are not

packed with sugar or empty calories and the child will stay

full longer.”

2. “Locally prepared food, balanced meals, as few processed

foods as possible, few sweets (not daily dessert).”

3. “Healthy options that are freshly prepared.”

4. “I wanted to put yes to the question above, but I put ‘no’

because while it’s important to me other things are more

important. It is just so hard to find good care, and ‘perfect’

care just doesn’t exist.”

5. “Healthy, unprocessed food. Fruits and vegetables.

Limited sugar and empty calories.”

6. “Healthy food options are important to me, but not the

primary factor in choosing a child care provider. I look for

providers that provide balanced meals with fruits/veggies,

low amount of sugar, not too many processed food items.

Our current provider could do better on this, but she’s

wonderful in so many other ways that I turn a blind eye to

areas of food options I’m not as happy with (it’s not all bad)

and try extra hard to make sure I provide healthy meals at home.”

7. “For less than two weeks, we had him at a place that

served donuts for breakfast and chips for afternoon snack.

There were other issues with that place, but the poor food

choices were definitely a factor in us moving him. We moved

him to a provider who understood our concern that he be

given better, healthier food and beverage choices. She also

uses the state-approved food program so we know that

there’s an agency that monitors his (and the other

children’s) diet.”

8. “Healthy options for snacks, fruits and vegetables at every meal.”

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9. “We delayed putting our first child, and are still delaying

putting our second child, into Hilltop by two years after they

were accepted because the food they offer at Hilltop is

abysmal and the in-home daycare we started them out

at makes all the food from scratch, provides FRESH fruits

and vegetables twice daily, all whole grains, with a majority

of the food coming from her garden. We continued to

pay $200/month MORE at the in-home daycare than

we would have at Hilltop because I feel that providing

a strong nutritional foundation is absolutely critical to brain

functioning and overall learning at development at that

young age. Once our kids reached (and will reach) 4, we

sent them to Hilltop because the benefits of being around

more kids and attention to reading became more important.”

10. “Real fruit and vegetables being available at meals, no

sweets except on special occasions, high quality snacks

(hummus, raisins, fruit, pretzels - no prepackaged junk food).”

11. “We looked for one that would work with our choices. As

well, the menu they have is well rounded and includes many

healthy options as well as “fun” learning foods for toddlers.”

12. “The provider prepares meals and is open to dietary

needs of the children. The provider is thoughtful and does

not prepare packaged or processed foods.”

13. Overall how satisfied are you with the care your child/children receives at their child care center?

1. Very unsatisfied - 1.79%

2. Unsatisfied - 1.79%

3. Neither unsatisfied or satisfied - 5.36%

4. Satisfied - 23.21%

5. Very satisfied - 67.86% 14. Obesity is a community issue.

1. Strongly disagree - 0%

2. Disagree - 9.38%

3. Neither disagree or agree - 7.81%

4. Agree - 46.88%

5. Strongly agree - 35.94% 15. I’m concerned about my child being overweight.

1. Strongly disagree - 28.13%

2. Disagree - 45.31%

3. Neither disagree or agree - 15.63%

4. Agree - 9.38%

5. Strongly agree - 1.56% 16. How many times per week does your child eat fast food?

1. 0 - 50%

2. 1-2 - 46.88%

3. 3-4 - 3.13%

4. 5-6 - 0%

5. 7 or more - 0%

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17. How many sodas per week does/do your child/children drink?

1. 0 - 81.25%

2. 1-2 - 17.19%

3. 3-4 - 1.56%

4. 5-6 - 0%

5. 7 or more - 0% 18. How many 8 oz. glasses of water does/do your child/children drink per day?

1. 1-2 - 45.31%

2. 3-4 - 40.63%

3. 5-6 - 10.94%

4. 7 or more - 3.13% 19. Suitable alternatives to water for my children include fruit juice, fruit punch, juice boxes, vitamin water, Gatorade, etc.

1. Strongly disagree- 40.63%

2. Disagree - 39.06%

3. Neither disagree or agree - 10.94%

4. Agree - 4.69%

5. Strongly agree - 4.69% 20. I believe that my actions regarding food and beverage can affect the other members of my family.

1. Strongly disagree - 3.13%

2. Disagree - 0%

3. Neither disagree or agree - 0%

4. Agree - 28.13%

5. Strongly agree - 68.75% 21. How concerned are you about the amount of screen time your child is exposed to?

1. Very concerned - 20.31%

2. Concerned - 25%

3. Somewhat concerned - 32.81%

4. Unconcerned - 18.75%

5. Very unconcerned - 3.13% 22. In your opinion is nutrition or exercise more important for your child’s health?

1. Nutrition - 15.63%

2. Exercise - 3.13%

3. Equally as important - 81.25% 23. How aware do you think your child/children is/are about the importance of living a healthy lifestyle?

1. Very unaware - 9.38%

2. Unaware - 18.75%

3. Somewhat aware - 29.69%

4. Aware - 31.25%

5. Very aware - 10.94%

24. I look to these sources for advice on building healthy habits with my child/children. Check all that apply.

1. Physicians - 87.5%

2. Other family members - 57.81%

3. Friends 68.75%

4. Child care providers 51.56%

5. Media outlets 20.31%

6. Internet - 67.19%

7. Other (please specify) - 25%

1. History - what worked/didn’t work for husband and

I growing up.

2. Own knowledge

3. I am a health care provider so I look to published research

4. Parents as teachers provided a lot of helpful, calm information.

5. Books

6. Moms group

7. LiveWell Lawrence 8. School

9. Common sense 25. When you buy food for your family, how important is each of the following? 1 being unimportant and 5 being very important.

1. How safe the food is to eat

1. 1 - 1.54%

2. 2 - 3.08%

3. 3 - 3.08%

4. 4 - 21.54%

5. 5 - 70.77%

2. Nutrition Facts

1. 1 - 0%

2. 2 - 3.08%

3. 3 - 15.38%

4. 4 - 44.62%

5. 5 - 36.92%

3. Price

1. 1 - 1.56%

2. 2 - 12.5%

3. 3 - 21.88%

4. 4 - 35.94%

5. 5 - 31.25%

4. Taste

1. 1 - 0%

2. 2 - 1.56%

3. 3 - 6.25%

4. 4 - 54.69%

5. 5 - 37.5%

5. How long the food keeps

1. 1 - 7.69%

2. 2 - 20%

3. 3 - 38.46%

4. 4 - 29.23%

5. 5 - 4.62%

6. How easy the food is to prepare

1. 1 - 4.62%

2. 2 - 13.85%

3. 3 - 24.62%

4. 4 - 38.46%

5. 5 - 20% 26. I would support more regulation on food and beverages served in child care facilities.

1. Yes - 78.46%

2. No - 21.54% 27. Please explain:

1. “I work at a center based daycare/preschool I am a teacher

I have seen first hand how sugared up foods, such as

strawberries with lots of sugar added, hot cereal buttered

and sugared up, pop tarts and other foods that have no

value don’t stay with the kids and they end up hungry and

very upset quickly after they have ate. Children need to

start good eating habits at daycare cause most of the

children eat Breakfast, Lunch and Snack Monday-Friday.”

2. “If regulations involved improving quality/quantity/safety

of food, I would support [them].”

3. “It depends on what that regulation is. Healthier food

would be great (no processed, sugar, etc.), but there are

*many* factors in what’s available and what a center can

realistically do. Sometimes regulations don’t seem rooted in

reality - or allow places to serve daily dessert as a bribe (like

school systems).”

4. “It’s the parents business what their children eat, not any organizations.”

5. “It is such an important part of their day and overall well being.”

6. “More facilities need to participate in the food program.”

7. “Our current daycare provider is in the state food plan so I

know there are things she can and cannot give to the kids.

She does a great job with well balanced meals. I would like

to see this done in all daycares to give all children a healthy

and well balanced meal.”

8. “I feel like child care providers are already strongly

regulated and have enough to keep track of and deal with in

being licensed. In choosing a child care provider, I am

trusting them to provide my kids with nutritious food.”

9. “I’m not a fan of blanket rules that limit personal choices.

If parents care enough to have their children eat healthy,

they will demand it of their child care providers, and the

market will adapt.”

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10. “I think it is up to the parent to choose an appropriate

daycare. If the parent doesn’t like the food, then they can

go somewhere else. I don’t think that the daycare needs

to be regulated by the government. There also seems to

be a discrepancy in what pediatricians recommend versus

the government. An example, the government has regulated

that children age 1 will receive 2% milk in a licensed center,

but my doctor thinks up until age 2 the child should have

whole milk.”

11. “I think the Food Program requires too much bread. They

should replace some of the bread with fruit. I think there

should be rules about how much processed food the kids

can eat (if it comes in a box, or was frozen before

preparing). My daycare lady is a rule follower, so if the

regulations said she couldn’t feed french toast sticks for

breakfast and goldfish crackers for snack, she would. I’d love

to see the kids eat cheese and grapes for snack instead.

I’ve let this go, because everything else about my daycare

lady is amazing, and I hope that the influence my husband

and I have with what we prepare and feed my daughter at

home as a bigger impact than the influence she has at daycare.”

12. “I would need to know more about what the regulations

being proposed were. I can’t see any regulations that

would improve the nutrition at my current daycare but I

could see how other daycare centers, or home care could

have different standards.”

13. “More regulation would provide additional

standardization and would hopefully lead to more access to

healthy food.”

14. “I would support more regulation along with education

and resources for support to improve the food environment

at our home daycare, especially to limit sugar and processed

food intake.”

15. “Tough question: I feel like the day care that my child is in

right now has the correct amount of regulation. However,

I felt bad for the kids at the other day care (the one that

we took my son out of). I also felt bad for the parents since

this particular day care is more affordable than other day

cares so they might be caught in a financial bind. Perhaps by

sending their children to this sugar-laden day care they are

able to save some money and get veggies and fruits in their

whole family’s diets. As hopeful as I am that this is the case,

I’m doubtful that it is. Some people simply don’t read

nutrition labels and are swayed by the marketing blurbs on

the packages.”

16. “I think there are certain standards, but a facility’s ability

to provide fresh fruit and vegetables is often times

determined by the market and this can have a huge impact

on child care costs that are passed onto parents.”

17. “Although I am not worried about my own, I would

imagine it is probably needed in some daycare facilities and

in-home daycares. I think it could also encourage parents to

do the same at home. If children are eating healthy for two

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meals of the day, they will be more used to eating healthy and develop those habits.”

18. “There are some good regulations in place already. My providers have always exceeded the minimum requirements and have communicated their meal plans and daily foods eaten to me.”

19. “I would really need to know the specific regulations being considered before I can answer yes or no. If the regulation were, “Only certified organic foods may be served,” I would not be in support. If the regulation were, “Fresh fruits and vegetables must be offered at each meal and snack,” I would support the regulation.”

20. “As stated before, the food our children receive in the larger daycare facility (Hilltop) is abysmal. They do not get a green vegetable daily (they consider corn and carrots to count as the vegetable), virtually no fruits and vegetables are fresh, they all come from a can, there are little to no whole grains, and there seems to be no cap on the amount of sugar (sometimes they serve eggo waffles and syrup as their “breakfast” with an iced cinnamon role to serve as “snack”). Hot dogs, fish sticks, pancakes... It is shameful -and I understand Hilltop is still better than most.”

21. “I would like to see at least one vegetable required. Right now my children get mainly a starchy main course and fruit.

No green veggies are ever on the menu.”

22. “My nephew went to child care where candy, cookies, chips were the norm. It was hard on his parents to get him to eat fruit/vegetable when he was accustomed to eating sweets/salt/fat as a regular diet.”

23. “I still think they serve too many carbs and breads at daycare centers. They also serve too many fats. Like cinnamon rolls for 1-2 year olds or brownies. They don’t need that yet.”

24. “My daughter will start attending child care after her 1st birthday (next month), and one of the things we looked at closely when researching our child care options, was the food/drink that would be provided at the daycare.

Maintaining a healthy lifestyle is important to us, and it is something that I believe is important for all children in the community. There are so many social issues to content with, but I believe supporting a healthy diet is one issue that should be more easily dealt with at the community level.”

25. “I removed my child in 2009 from the KU Hilltop facility in part due to the poor lunch (white bread and processed cheese ONLY) I observed her receiving one day, as well as their unwillingness to apply sunscreen multiple times a day (only one application was “approved”). This may be different now, but I was mortified at what they believed was a nutritious lunch. I was much more impressed with Sunnyside/Educare where my son was in daycare.”

26. “I know that fruit juices aren’t very recommended for little ones, yet I see many in-home care places giving “fruit juice”-the sugary kind, even if they gave fresh juice it would be better.”

27. “This is very needed. We should not be giving our children food and drinks that do not support their health and well-being.”

28. “At some point, parents need to take responsibility for

what goes in their own child’s mouth. If they do not agree

with what the child care facility is serving than 1. find a new

provider or 2. bring their own food to day care.”

29. “All kids should be exposed to a vegetable at each major meal.”

30. “I’m not sure about the regulations now, but I would like

to see the basics: fruits, vegetables and protein. Kids don’t

need junk food to eat.”

28. What is the best way to reach you with educational materials related to creating a healthy food and beverage environment?

Check all that apply.

1. Phone call - 9.23%

2. E-mail - 86.15%

3. Social Media - 49.23%

4. Direct Mail - 18.46%

5. Conferences - 7.69%

6. Other (please specify) - 6.15%

1. Through the child care center or school.

2. I’ll contact those I choose.

3. I know this sounds arrogant, but I really don’t need

any information. I read a lot, I’ve thought about these

issues a lot.

4. Doctor’s office or school.

29. Are you male or female?

1. Male - 4.69%

2. Female - 95.31%

3. Prefer not to respond - 0% 30. What is your age?

1. 18-24 - 1.56%

2. 25-34 - 45.31%

3. 35-44 - 50%

4. 45 or older - 3.13%

33. Which of the following best describes your current relationship status?

1. Married - 87.5%

2. Widowed - 0%

3. Divorced - 4.69%

4. Separated - 1.56%

5. In a domestic partnership or civil union - 1.56%

6. Single, but cohabiting with a significant other - 3.13%

7. Single, never married - 1.56%

8. Prefer not to respond - 0% 34. What is the highest level of education you have completed or the highest degree you have received?

1. Less than high school degree - 1.56%

2. High school degree or equivalent (e.g., GED) - 1.56%

3. Some college but no degree - 3.13%

4. Associate degree - 10.94%

5. Bachelor degree - 32.81%

6. Graduate degree - 50%

7. Prefer not to respond - 0% 35. How much income did your household earn in 2013?

1. $-$9,999 - 0%

2. $10,000-$19,999 - 1.56%

3. $20,000-$29,999 - 3.13%

4. $30,000-$39,999 - 1.56%

5. $40,000-$49,999 - 1.56%

6. $50,000-$59,999 - 9.38%

7. $60,000-$69,999 - 9.38%

8. $70,000-$79,999 - 3.13%

9. $80,000-$89,999 - 9,38%

10. $90,000-$99,999 - 15.63%

11. $100,000 or more - 37.5%

12. Prefer not to respond - 7.81%

31. Which metropolitan area is closest to you?

1. Salina - 9.38%

2. Hays - 1.56%

3. Lawrence - 59.38%

4. Topeka - 9.38%

5. Kansas City - 7.81%

6. Pittsburg - 0%

7. Wichita - 4.69%

8. Garden City - 7.81% 32. What is your ethnicity?

1. White - 96.88%

2. Black or African-American - 1.56%

3. American Indian or Alaskan Native - 0%

4. Asian - 1.56%

5. Native Hawaiian or other Pacific Islander - 0%

6. From multiple races - 0%

7. Prefer not to respond - 0%

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Manhattan • 97.5 Power Hits

• $20 per 30 second spot

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• 60% of audience is women

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River Festival Advertisement

EAT, DRINK AND BE HEALTHY Join us May 29th - June 6th during the Wichita River Fest!

Come check out our interactive exhibit at the Exploration Place and learn about healthy eating, fitness and tackling the issue of childhood obesity.

To learn more about us, visit www.ThinkBigStartSmall.com/EatWellPlayWell

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