Partners for a healthy city: implementing policies and environmental changes within organizations to promote health.

Current research has suggested that obesity prevention efforts should promote policy and environmental changes. The Partners for a Healthy City project, implemented in Douglas County, Nebraska, focused on collaborating with local organizations to help them select and implement 1 or more policies that promoted healthy eating and physical activity. Of the 346 organizations participating in the project and completing the follow-up assessment, 92% implemented at least 1 new policy or expanded an existing policy related to healthy food and drink options and physical activity, totaling 952 individual policy changes. Common policies included providing water as the primary beverage and installing bike racks to support active commuting to and from work. These findings suggest widespread support for policy changes that promote community health.

Stakeholders' interest in and challenges to implementing farm-to-school programs, Douglas County, Nebraska, 2010-2011.

INTRODUCTION: Schools are uniquely positioned to influence the dietary habits of children, and farm-to-school programs can increase fruit and vegetable consumption among school-aged children. We assessed the feasibility of, interest in, and barriers to implementing farm-to-school activities in 7 school districts in Douglas County, Nebraska. METHODS: We used a preassessment and postassessment survey to obtain data from 3 stakeholder groups: school food service directors, local food producers, and food distributors. We had a full-time farm-to-school coordinator who was able to engage multiple stakeholders and oversee the development and dissemination of a toolkit. We used descriptive statistics to make comparisons. RESULTS: Seven food service directors, 5 distributors identified by the food service directors, and 57 local producers (9 completed only the preassessment survey, 16 completed only the postassessment survey, and 32 completed both) completed various components of the assessment. Interest in pursuing farm-to-school activities to incorporate more local foods in the school lunch program increased during the 2-year project; mean interest in purchasing local foods by food service directors for their districts increased from 4.4 to 4.7 (on a scale of 1 to 5). CONCLUSION: Implementing farm-to-school programming in Douglas County, Nebraska, is feasible, although food safety and distribution is a main concern among food service directors. Additional research on feasibility, infrastructure, and education is recommended.

From good ideas to actions: a model-driven community collaborative to prevent childhood obesity.

OBJECTIVE: Activate Omaha Kids, a community collaborative, was designed, implemented, and evaluated with the aim of preventing childhood obesity in the Omaha community. Activate Omaha Kids brought together key stakeholders and community leaders to create a community coalition. The coalition's aim was to oversee a long-term sustainable approach to preventing obesity. Following a planning phase, a business plan was developed that prioritized best practices to be implemented in Omaha. METHODS: The business plan was developed using the Ecological Model, Health Policy Model, and Robert Wood Johnson Foundation Active Living by Design 5P model. The three models helped the community identify target populations and activities that then created a single model for sustainable change. RESULTS: Twenty-four initiatives were identified, over one million dollars in funding was secured, and evaluation strategies were identified. CONCLUSION: By using the models from the initial steps through evaluation, a clear facilitation of the process was possible, and the result was a comprehensive, feasible plan. The use of the models to design a strategic plan was pivotal in building a sustainable coalition to achieve measurable improvements in the health of children and prove replicable over time.

Healthy weight in young perinatal women: exploring beliefs.

The purpose of this brief is to explore beliefs about health and body weight in young perinatal women. Thirty-two women were interviewed. Findings point to the importance of young women receiving education related to physical activity, nutrition, and the link between these components and a healthy weight during reproductive years.

Effectiveness of a presentation on infant oral health care for parents.

PURPOSE: The aim of this study was to evaluate an infant oral health education programme, using a pre-post test design, for parents attending a paediatric clinic. METHODS: The subjects were parents attending the well baby appointments at 3, 6, and 9 months of age. The study participants were men and women, all with an infant between 3 and 12 months of age. A 16 question assessment in the form of a questionnaire was completed immediately before and after the introduction of a 30 min educational intervention in the form of a PowerPoint presentation and a video of infant oral hygiene for parents. The parents completed the questionnaire twice (pre-post test design) in the same visit. Recruited parents attended only one presentation. The presentation educated parents about infant oral health and provided anticipatory guidance. RESULTS: Forty-seven parents or caretakers participated in the study. On the pre-test 28% had a score of 70% or less, and on the post-test 87% got a score of 88% or better. On the pre-test, 72% had a score of 70% or higher, and on the post-test 87% got a score of 88% or higher. Most parents (80%) reported that the presentation was helpful and indicated that the information would change the way they care for their baby's teeth at home. CONCLUSION: This study demonstrated the effectiveness of a 30 min PowerPoint and Video presentation in improving the oral health knowledge of parents caring for an infant.

Effectiveness of a basic training presentation on infant oral health care for pediatric medicine residents.

OBJECTIVE: We hypothesize that viewing educational presentation with video will provide pediatric medicine residents with instructive information on infant oral health. Therefore, the aim of this study was to evaluate an infant oral health education program targeting University of Nebraska Medical Center (UNMC) pediatric medicine residents. METHODS: Assessment of 32 pediatric medicine residents in the form of a questionnaire was completed immediately before and after a 60 minute educational intervention. The intervention was in the form of a Power Point presentation and video of infant oral health for health care providers. The 16-questions (True/false/don't know or multiple choice) questionnaire was based on the information presented in the lecture and video. RESULTS: There was a significant difference between the pre-test and post-test scores (p-value < 0.001). The mean score on the pre-test was 10.09 out of 16 (63%) and the mean score on the post-test was 13.3 out of 16 (83%). There was no significant correlation between age, gender, or year of residency training with pre or post-test scores. Twenty-five (78.1%) reported themselves "very likely" to use the information. CONCLUSIONS: A one hour Power Point and video educational intervention was effective in teaching pediatric medicine residents basic information on infant oral health.

Development and design of an intervention to improve physical activity in pregnant women using Text4baby.

Text4baby is a free, mobile health information service for pregnant and post-partum women. This study aims to understand preferences of physical activity text messages (SMS), sequentially develop prototype SMS, and determine preferred dose of SMS to inform a future study utilizing Text4baby. This study had a user-centered design with three phases: (1) literature review and interviews with pregnant women for development of prototype SMS, (2) interviews with health care professionals and pregnant women for prototype SMS feedback, and (3) survey to determine preferred dose of SMS. Data from interviews identified knowledge and support as major themes. Prototypes were developed (N = 14) and informed 168 SMS. Pregnant women (N = 326) thought three SMS/week were about right (50.2 %) and preferred three SMS/week throughout pregnancy (71.9 %). There is a need for opportunities for behavioral scientists to incorporate evidence-based practices within scalable interventions. As such, this research will inform utilization of Text4baby to potentially improve physical activity participation.

Creating a movement for active living via a media campaign.

BACKGROUND: Activate Omaha (AO), a community-wide health initiative, was awarded a grant by Active Living by Design in 2003. PURPOSE: To establish credibility of the partners in AO and increase awareness of active living in the community by emphasizing promotions (branding, logo recognition). METHODS: Media, including billboards, TV and radio ads, high-profile spokespersons, grassroots efforts, and worksite "toolkits" featuring tips and creative messaging on physical activity were combined to incentivize people to be physically active. Campaign surveys were conducted by the Market Survey Research Group each year from 2005 to 2008. RESULTS: Survey data based on the first campaign indicated that 86% of Omahans wanted to be part of an active community and to be active with younger generations. The second campaign focused on getting families physically active together, and this survey data showed that citizens wanted to be a part of an active community. A third campaign added practical examples of citizens being active within the community and efforts expanded to worksites with consistent messaging for employees. The final survey indicated that 78% of respondents found Omaha to be an active community compared to 63% who had that response 3 years earlier. CONCLUSIONS: Activate Omaha was successful in gaining credibility and leveraging additional funding to implement complementary programming and physical projects, and as a result, changing community perceptions and influencing policy decisions.

Activate Omaha: the journey to an active living environment.

BACKGROUND: Omaha, an urban Nebraska community, represents 26% of the state's population. Activate Omaha, formed in 2003, addressed the obesity epidemic caused by physical inactivity and poor infrastructure to support active living in the community. INTERVENTION: Activate Omaha's efforts focused on a strategic social-marketing campaign, using baseline and annual data for guidance. Complementary programming was implemented parallel to the marketing campaigns. Safe Routes to School infrastructure projects were federally funded, and 20 miles of on-street bicycle facilities were funded privately. The mayor's Bicycle Pedestrian Advisory Committee was formed, including directors from city planning and public works. RESULTS: The initiative became recognized by the community as the lead resource promoting physical activity. This enabled the initiative to be instrumental in infrastructure changes and programming targeting the underserved. The initiative leveraged an additional $1,475,000 over 5 years. These funds created opportunities to invest in shared community resources such as providing bicycles for underserved youth, building infrastructure through Safe Routes to School initiatives, and successful worksite programming. LESSONS LEARNED: Partners should be utilized in a strategic manner, where they are engaged purposefully and serve a role in assuring successful outcomes. Community readiness should determine the focus on policy, physical projects, and promotional and programmatic strategies, as well as the integration of these strategies. CONCLUSIONS: Activate Omaha grew into a credible organization moving public policy and leveraging new public-private relationships through multilevel strategies. This approach ultimately led to sustainable changes in the community infrastructure and the behavior of its citizens.