Healthy Food Choices By: Kara Derry, Nichole Kraai, Jessica
Olcheske, Nicole Towns, & William Winowiecki
Slide 3
U.S. Statistics 31.8% of children and adolescents 2-19 years
were either overweight or obese 70 to 80 percent of overweight
children become obese adults More than 25 percent of all U.S.
health care costs are related to obesity and inactivity Between
1979 and 1999, obesity-associated hospital costs for children
tripled from $35 million to $127 million Empty calories from added
sugars and solid fats contribute to 40% of daily calories for
children and adolescents aged 218 years Nearly half of these empty
calories come from six sources: Soda, fruit drinks, dairy desserts,
grain desserts, pizza, and whole milk (Ogden, Carroll. Kit, &
Flegal, 2012) (Center for Disease Control and Prevention [CDC],
2013) (Healthy Kids, Healthy Michigan [HKHM], n.d.)
Slide 4
U. S. Statistics Adolescents drink more full-calorie soda per
day than milk Males ages 1219 drink more than twice as much soda as
milk Females drink on average 2 and times soda than milk Obese
children ages 611 in the U. S. increased from 7% in 1980 to nearly
18% in 2010. Obese adolescents ages 1219 in the U.S. increased from
5% to 18% over the same period In 2010, more than one third of
children and adolescents were overweight or obese (CDC, 2013)
(HKHM, n.d.)
Slide 5
Michigan Statistics 18.2 percent of Michigan youth ages 10-17
are overweight and 12.4 percent are considered obese, compared to
the U.S. percentage of 15.3 overweight and 16.4 obese. (Healthy
Kids Healthy Michigan, 2007)
Slide 6
Community Problem Diagnosis According to Michigan Public Health
Institute (2011), access to healthy food has a national benchmark
of 92% and Kent County is at 89%. With that being said, we would
like children ages 18 and under in Kent County to have access to
healthier foods with an overall goal to meet the national benchmark
of 92%. Our vision is that we want the children of Kent County to
live a healthier lifestyle. (Michigan Public Health Institute
[MPHI], 2011)
Slide 7
Kent County Statistics According to Kent County Health Connect
(2013), the following statistics stand true for Kent County 29% of
adults are obese 34% of youth report eating healthy or balanced
meals 19,200 people do not have access to a grocery store or fresh
produce (Kent County Health Connect [KCHC], 2013)
Slide 8
Current Kent County Resources Kent County Coordinated School
Health Program (KCCSHP) Works with income-eligible schools in
promoting healthy behaviors of students Helps schools assess
nutrition and physical activity Supply access to community
resources and implement plan of action Action for Healthy Kids
(MAFHK) Non-profit org fighting against childhood obesity by
partnering with schools to improve nutrition and physical activity
Offer education series to elementary, middle and high school
children (Access Kent, 2013)
Slide 9
Community Strengths Strengths include having resources already
available in the community and in place like KCCSHP and MAFHK
Noticing that changes need to be made and taking the steps to do it
Having information available on accesskent.com under school
wellness, which includes contact information Having access to
healthy foods at local farmers markets for families to shop at
(Access Kent, 2013)
Slide 10
Community Barriers/ Unmodifiable Factors According to MPHI
(2011), Lack of healthy food resources Where resources are
available they are often very expensive o As many as one fifth of
children in Kent County live in poverty Lack of options for people
with dietary restrictions Health foods are not always available in
schools o Vending machines Convenience and abundance of fast foods
chains with affordable prices (MPHI, 2011)
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Causative/ Modifiable Risks or Factors Eating healthy helps
reduce the risk of obesity which can reduce the risk of many other
diseases Insufficient nutrition can weaken the immune system
Children from birth to age 5 are at risk for nutrition deprivation
o Inhibit their ability to learn, grow and fight infections A
second indicator of access to healthy foods is food insecurity.
Food insecurity is calculated based on responses to a population
survey conducted by the US Census. The rate is made up of three
questions, including 1) are you worried your food will run out
before you have money to buy more, 2) if the food you bought doesnt
last, do you have money to buy more, and 3) can you afford to eat
balanced meals. The food insecurity rate for Kent County is 15%
overall, but households with children in Kent County experience a
much higher food insecurity rate of 23%. (MPHI, 2011)
Slide 12
Social Learning Theory According to Harkness and DeMarco (2012)
a social learning theory, is a behavior change approach affected by
environmental influences, personal factors, and attributes of the
behavior itself. Most importantly, a person must believe in his/her
capability to perform the behavior (self-efficacy) as well as
perceive an incentive to do so (positive expectations outweigh the
negative). The immediate or long-term benefits must be valued. (p.
78) Explains some of the factors that contribute to the failure for
Kent County to meet the national benchmark Explains how we can
provide intervention to help kids make healthier food choices
Slide 13
Role of the Public Health Nurse There are approximately 12
roles and obligations that public nurses must follow o Awareness,
recognizing multiple social determinants of health o Capitalizing
on community strengths o Leadership o Achieving cultural competence
o Assessment population diagnosis and priority setting o Partnering
with others o Creating environment for care o Advocacy o Educating
current and future nurses in the public nursing work force o
Creating public and agency policies that support and celebrate
diversity o Evaluation and research We would need our public health
nurse to display these characteristics as they would be
facilitating the interventions and measuring outcomes. (Schmelzer
et al., 2009)
Slide 14
Interventions Collaborate with other agencies by Incorporating
Foodcorps in Kent County Schools Foodcorps provides education and
interventions to help provide better access to healthy foods across
the county and locally with the help of The Michigan State
Universities Center for Regional Food Systems Foodcorps objectives
o Teach children about locally grown foods o Help them plant and
grow gardens o Make local healthy foods available in school
cafeterias (Foodcorps, 2011)
Slide 15
Interventions The USDA has a set of standards for schools Whole
grain rich foods and a first ingredient which may include a fruit,
vegetable, dairy product or protein Snack options must have less
than 200 calories Entre items must have less than 350 calories Must
sell plain water, unflavored low fat milk, and unflavored fat free
milk 100 percent fruit or vegetable juice School-based health
programs are effective to reduce adolescent obesity (Eisenberg,
2013) (United States Department of Argriculture [USDA], 2013)
Slide 16
Interventions W.K. Kellogg Foundation reaches out to
communities and help those that are in need. Foundation is funded
by grants and donations Establish access to fresh, healthy foods
Increases community engagement to encourage consumption of local
foods (W.K. Kellogg, 2013)
Slide 17
Interventions Cafeteria will offer taste testing of new healthy
recipes of foods. Many fresh fruits and vegetables, whole grains,
and beans are unfamiliar to children and adults, so they need to be
given opportunities to sample the foods. Taste-testing and cooking
demonstrations in the classroom, at school assemblies, or even in
the lunch line can be a fun marketing approach to introducing
students to healthy foods that may be unfamiliar to them. (Gibbons,
2009, p.28 ) Cafeterias will make healthier options cheaper than
unhealthy ones. For students who are sent with money each day, they
will get a bigger bang for their buck if they choose healthier
options.
Slide 18
Desired Outcomes 1. 92% of the children that participated in
Foodcorps can name one healthy food grown locally that they liked
the taste of 2. Schools will have a minimum of 75 percent
compliance with the new standards set by the USDA by 2014. Then in
2015 they should have 100 percent compliance with these standards
3. Every time a new healthy option is introduced it will be offered
as a sample 100 percent of the time before serving to see if
students will comply with eating these healthier choices 4. Kent
County will increase the percentage of those with access to healthy
foods by 3% in the next five years in order to meet the current
national benchmark. That would bring Kent County from 89% to
92%
Slide 19
Outcome Measures/ Evaluation Outcome 1: The school will offer
an annual survey to the children. Outcome 2: A daily audit will be
completed by the cafeteria workers. The school will calculate and
submit their results annually. Outcome 3: The school will complete
a monthly audit. The school will collect data and submit results
annually.
Slide 20
Outcome Measures/ Evaluation Outcome 4: In order to measure
access of healthy foods for Kent County to meet the national
benchmark, we will mimic the process used to obtain the current
result. Four years after full implementation of our interventions
we will start a one year process of data collection to identify if
we have met our goal of 92% access to healthy foods. 4 Community
Input Walls (January, April, July, October) 12 Focus Groups (1
meeting the first week of each month with 10 different members of
the community) 365 Intercept Interviews conducted by trained
community members (one per day)
Slide 21
Social Learning Theory In changing the environment in the
school system to support healthy eating, children will start to
change behaviors. Through education the students will improve in
their self-efficacy. This theory works full circle. The same
factors that can contribute to unhealthy food choices can turn
around and support children to make healthy choices with the right
interventions.
Slide 22
References Access Kent. (2013). School wellness. Retrieved from
www.accesskent.com Center for disease Control and Prevention.
(2013). Retrieved from http://www.cdc.gov/ Healthy Kids Healthy
Michigan. (2007). Childhood obesity epidemic in michigan. Retrieved
from
http://www.healthykidshealthymich.com/childhood-obesity-facts-and-statistics.html
DeMartini, D.L., Beck, A.F., Kahn, R.S., & Klein, M.D. (2013).
Food insecure families: Description of access and barriers to food
from one pediatric primary care center. Journal of Community
Health. doi: 10.1007/s10900-013-9731-8. Downtown Market. (n.d.).
Retrieved from http://downtownmarketgr.com/ Eisenberb, J. (2013).
Childhood obesity prevention programs: Comparative effectiveness.
Agency for Healthcare Research and Quality, 13. Foodcorps. (2011).
Retrieved October 7, 2013 from https://foodcorps.org/ Fulton Street
Farmers Market. (n.d.). Retrieved From
http://fultonstreetmarket.org/history/market-facts/ Gibbons, H.W.
(2009). Marketing Healthy Choices in the School Cafeteria.
Retrieved on October 12, 2013 from
http://www.kchealthykids.org/Resource_/ResourceArticle/33/
File/MarketingHealthyFoods.pdf.
Slide 23
References Harkness, G., DeMarco, R., (2012) Community and
Public Health Nursing Practice: Evidence for Practice. Wolters
Kluwer/Lippincott, Williams & Wilkins: Philadelphia Healthy
Kids, Healthy Michigan. (n.d.). Retrieved from
http://www.healthykidshealthymich.com/ Kent County Health Connect.
(2013). Retrieved from http://www.kentcountyhealthconnect.org/en-
us/healthyeatingactiveliving.aspx Michigan Farmers Market
Association. (2012). Retrieved from
http://mifma.org/find-a-farmers-market/ Michigan Public Health
Institute. (2011). Kent County: 2011 health needs assessment and
health profile. Retrieved from
http://www.kentcountychna.org/pdfs/healthprofile.pdf Ogden, C.,
Carroll, M., Kit, B., & Flegal, K. (2012). Prevalence of
obesity and trend in body mass index among S.S. children and
adolescence 1999-2010. Journal of American Medical Association,
305(5), pp. 483-490. doi: 10.1001/jama.2012.40 Schmelzer, M.,
Cravetz, M., LaRosa, G., Fischer, N., Smith, F., Garvey,. (2009).
The public health nurses role in achieving health equity:
Elementary inequalities in health. New Mexico Nurse, 54(4), 6
United States Department of Agriculture [USDA]. (2013). Retrieved
from http://www.usda.gov/wps/portal/usda/usdahome W. K. Kellogg
Foundation. (n.d.). Michigan. Retrieved from
http://www.wkkf.org/where-we-work/united-
states/michigan.aspx#2