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Healthy & Fit:A Community Action Plan forFranklin County Children & Families
E X E C U T I V E S U M M A R Y
Commissioned by:
Osteopathic Heritage Foundation
Richard Vincent, President & CEO
Terri Donlin, Director of Programs
1500 Lake Shore Drive, Suite 230
Columbus, OH 43204
www.osteopathicheritage.org
Community Planning Conducted by:
Children’s Hunger Alliance
William J. Dolan, Chief Executive Officer
Dianne Radigan, Chief Operating Officer
J.D. Beiting, Special Projects Manager
370 South Fifth Street
Columbus, OH 43215
www.childrenshungeralliance.org
The Ohio State University
College of Human Ecology
Dr. Gail Kaye, PhD, RD
1787 Neil Avenue
Columbus OH 43210
Vision Franklin County children, especially those most
at risk, will be fit and have healthy weights as a result
of long term, dynamic communitywide efforts to
create effective, child focused and family centered
programming and environments.
Mission To create an environment that supports life-long,
healthy food and fitness behaviors in Franklin County
children through the efficient and effective coordination
of community resources.
Healthy & Fit:A Community Action Plan forFranklin County Children & Families
Acknowledgements i
Guiding Concepts 1
Prevalence Data 2
The Process 4
The Findings 5
Strategies for Providing 7
a Healthy Food and Fitness
Environment for Children
Continuing the Effort 9
Conclusion 10
Logic Model 11
T A B L E O F C O N T E N T S
Leadership Council
• Lisa Courtice PhD, The Columbus Foundation
• William J. Dolan, Children’s Hunger Alliance
• Terri Donlin, Osteopathic Heritage Foundation
• Jewell K. Garrison, Columbus Medical
Association Foundation
• Janet Jackson, United Way of Central Ohio
• John Jackson, Cardinal Health
• Gail Kaye PhD, The Ohio State University
• Teresa Long MD, Columbus Health Department
• Robert Murray MD, Children’s Hospital
and Abbott Laboratories
• Dianne Radigan, Children’s Hunger Alliance
• Arlene Shoemaker, Franklin County Commissioner
• Charleta Tavares, Columbus City Council
• Susan Tilgner, Franklin County Health Department
• Richard Vincent, Osteopathic Heritage Foundation
Key Stakeholder Survey
Design and Adult Focus Groups
• Gail Kaye PhD, The Ohio State University
• Ana Claudia Zubieta PhD,
Consultant to The Ohio State University
• Claudia Byrne, The Ohio State University
Extension Office
Child Focus Groups
• Leesa Martin, Abbott Laboratories
• Nancy Fritz, The Fritz Group
Survey Design Expert Committee
• Michelle Vander Stouw, United Way of Central Ohio
• Lynnette Cook PhD, United Way of Central Ohio
• Roberta Garber, Community Research Partners
• Kathy Cowen, Columbus Health Department
Nutrition Expert Committee
Facilitated by: Gail Kaye PhD,
The Ohio State University
• Robert Murray MD, Children’s Hospital
and Abbot Laboratories
• Angie Norton, Ohio Department of Health
• Gina French MD, Children’s Hospital
• Shelly Roth, Children’s Hunger Alliance
• Misty Davis, Columbus Public Schools
Physical Activity Expert Committee
Facilitated by: Diane Barnes,
Columbus Public Schools
• Jackie Goodway PhD, The Ohio State University
• Michelle Park, Ohio Parks and Recreation
• Dannell Haines, The Ohio State University
• Monica Turner, YMCA of Central Ohio
Cultural Diversity Expert Committee
Facilitated by: Manisha Maskay PhD,
Columbus Health Department
• Olivia Thomas MD, Children’s Hospital
• Eric Troy, Eternal Sports
• Sylvia Wooden, New Fellowship of
Christians Church
• Hannah Dillard, The Mayor’s Office –
City of Columbus
• Hugo Melgar Quinonez, The Ohio State University
Marketing and Media Expert Committee
Facilitated by: Ray Caruso, The Center
for Participative Leadership
• Pete McGinty, Experience Columbus
• Kim Kelly-Bartley, White Castle System, Inc.
• Julie Carrier, Ohio Food Industry Foundation
• June Wedd, American Dairy Association
& Dairy Council
Acknowledgements
The Osteopathic Heritage Foundation and
Children’s Hunger Alliance thank those who helped
contribute to the community planning process:
i Healthy & Fit: A Community Action Plan for Franklin County Children
Strategy Team Members• Mary Beth Arensberg, Abbott Labs-
Ross Products Division
• Cresha Auck, American Heart Association
• Lynne Ayres, Foundation for Healthy Communities
• Gail Baker, Central Ohio Restaurant Association
• Diane Barnes, Columbus Public Schools
• Diane Bennett, Action for Children
• Andrea Cambern, WBNS-10 TV, Inc.
• Tom Carlisi, The Winners League
• Marie Carmen Lambea, Ohio Hispanic Coalition
• Julie Carrier, Ohio Food Industry Foundation
• Vonda Castro, Communities in Schools
• Suzanne Christman, Dietetics Association
• Diane Conley, Westerville City Schools
• Linda Day Mackessy, YMCA of Central Ohio
• Hannah Dillard, City of Columbus
• Rosalyn dePalo, Osteopathic Heritage Foundation
• Pam Early, South Western City Schools
• Mike Eiland, ClearChannel Radio
• Lynn Esselstein, Ohio Dietetic Association
• Mary Ey, Columbus Public Schools
• Josephus Foster, Fountain of Hope
• Chuck Gillespie, WSYX ABC 6
• Humberto Gonzalez, Legg Mason
• Cheryl Graffagrino, OhioHealth
• Jeanne Grothaus, Central Ohio Diabetes Association
• Peg Hanley, Metro Parks
• Sidney Hargro, The Columbus Foundation
• Sloan Harl, G & J Pepsi Co.
• Judy Hatcher, Columbus Metropolitan Area
Community Action Organization
• Dudley Hawkey, Columbus Public Schools
• Cheryl Hay, Greater Columbus Chamber of Commerce
• Laura Hill PhD, The Center for
Eating Disorders & Psychotherapy
• Alan Huff, Neighborhood House
• Mattie James, Child Development Council Head Start
• Saunie Jones, White Castle System, Inc.
• Kim Kelly-Bartley, White Castle System, Inc.
• Mary Kershaw, The Ohio State University
Extension, Franklin County
• Betsy Loeb, Action for Children
• Manisha Maskay PhD, Columbus Health Department
• Pete McGinty, Experience Columbus
• Pat McKnight, Mount Carmel College of Nursing
• Hugo Melgar-Quinonez, The Ohio State University
• Karen Morrison, OhioHealth
• Sara Neikirk, Communities in Schools
• John O’Meara, Columbus Metro Parks
• Joy Parker, Mount Carmel Outreach
• Kellee Patterson, Children's Hospital
• Dave Proctor, Columbus Metropolitan Area
Community Action Organization
• Nancy Rini, Columbus Public Schools
• Laura Rooney, American Cancer Society,
Ohio Division
• Shelly Roth, Children's Hunger Alliance
• Gary Serelson, Columbus Recreation & Parks
• Vicky Steck, Sanese Services
• Maggie Summers, United Way of Central Ohio
• Mari Sunami, Southside Settlement House
• Jason Tinch, Directions for Youth
• Carol Trowbridge, YWCA
• Eric Troy, Eternal Sports
• Michelle Vander Stouw, United Way of Central Ohio
• Steve Votaw, Directions for Youth
• Noreen Warnock, Greater Columbus Foodshed Project
• June Wedd, American Dairy Association
& Dairy Council
• Vanessa Williams, Greater Columbus
Chamber of Commerce
• Jerome Willis, Trinity Baptist
• Julie Winland, Columbus Public School Nurses
• Greg Winslow, American Heart Association
• Heather Witt, Columbus Medical
Association Foundation
• Sylvia Wooden, New Fellowship of Christians Church
• Sally Yurchuck, United Way of Central Ohio
iiHealthy & Fit: A Community Action Plan for Franklin County Children
1. Research and evidence-based,
effective programming will be at the
core of the efforts.
2. The plan will be guided by strong
leadership and provide for input from
a variety of community sources.
3. It is critical to remain sensitive to
the needs and beliefs of the varied
cultures in Franklin County.
4. The plan will build upon existing
services, expanding and enhancing
organizational capacities
where appropriate.
5. Collaboration is essential in this
multi-faceted, multi-sector approach
to influence policy, expand programs
and make a significant impact.
6. Community members, especially those
in under-resourced neighborhoods, must
be involved in the developmental and
interventional processes.
7. The role of parents must be recognized
and respected.
8. Communication efforts will be simple,
consistent and evidence-based.
9. The plan will be dynamic, evolving
as new evidence, models and
programs emerge.
10. An effective leadership structure
is necessary to sustain a unified,
consistent and successful community
wide effort.
11. Quality outcomes measurement
is necessary to demonstrate impact.
Executive Summary
G U I D I N G C O N C E P T S
The Osteopathic Heritage Foundation,
aware of and concerned about the growing
prevalence of overweight children in
Franklin County, earmarked foundation
funding to address the issue. Thus began a
process to create a comprehensive community
plan based on primary research and literature
review, as well as local leadership and
community input from a variety of sources.
A socio-ecological model was utilized to
identify and develop strategies to fully
engage those who are in the position of
influencing nutrition and fitness choices
of our youth and families.
A Leadership Council was convened to
provide insight, establish guiding concepts
and develop a vision and mission for the
effort. The Leadership Council included
representatives from the Osteopathic
Heritage Foundation, Columbus Medical
Association Foundation, Columbus
Foundation, United Way of Central Ohio,
Columbus and Franklin County health
departments, Cardinal Health, The Ohio
State University, Columbus City Council,
Franklin County Commissioners and
a pediatrician. Children’s Hunger
Alliance facilitated the process.
1 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
Franklin County
zip codes with
highest prevalence
of overweight adults.
Obesity has risen to epidemic levels in the U.S. It leads
to devastating and costly health problems and reduces life
expectancy. Obesity is a significant risk factor for serious
conditions such as type 2 diabetes,
heart disease, certain cancers and
is associated with depression and
several other medical conditions.1
The economic impact of obesity
has grown dramatically. In 2000,
the total cost related to obesity –
including both health care and
expenses and the loss of productivity
– was estimated to be $117 billion
($61 billion direct and $56 billion
indirect).2 This estimate of cost
is 9.1% of total US health
care expenditures.
According to the 2000 Franklin County/Columbus Health Assessment, the highest
prevalence of overweight adults is found in the following urban zip codes:
Downtown Columbus 43215 5. 43211 = 69.3%
3. 43219 = 70.0%
1. 43203 = 71.7%
43205 = 64.2%
43206 = 62.3%
6. 43232 = 66.4%
4. 43207 = 69.6%
2Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The Prevalence Data: Health Implications for Obesity on the Rise
2. 43223 = 70.3%
Obesity in adults is stated in terms of body mass
index, (BMI), a measure defined as weight relative to
height (kg/(m2)). In adults, being overweight is defined
as a BMI ≥ 25, and obesity as a BMI ≥ 30.
A 5’10” man’s, healthy weight
would be 130-179 pounds (BMI of 19-24).
He would be considered overweight at
180-209 pounds (BMI of 26-29). At 210
pounds or more, he would be considered
obese (BMI 30 or higher). For Franklin
County adults in 2002, self reported
heights and weights indicated that 61.7%
of adults were overweight and 26% obese.
“I like to
jump rope,
jog, run,
play with
the dog.”
– 9 yr old female
The Prevalence Data: Health Implications for Obesity on the Rise
3 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
Over the past three decades, the rate of obesity has
more than doubled in pre-school children and adolescents.
It has more than tripled in children ages 6 to 11 years.3
The obesity trends are considered by many as
an epidemic.
The 2002 Franklin County Health Assessment
demonstrated that specific subgroups of children –
including girls, African Americans, inner city and
poor children – are disproportionately affected:
Determining overweight and “at risk” for overweight children
Age (in years)
4
8
12
16
Boys at 85thpercentile
(“at risk” foroverweight)
41 lbs.
68 lbs.
114 lbs.
165 lbs
Girls at 85thpercentile
(“at risk” foroverweight)
41lbs.
70 lbs.
118 lbs.
148 lbs.
Boys at 95thpercentile
(overweight)
45 lbs.
78 lbs.
130 lbs.
188 lbs.
Girls at 95thpercentile
(overweight)
45 lbs.
80 lbs.
135 lbs.
172 lbs.
In children, overweight and obesity (BMI) is calculated differently for boys than for girls.
Children are considered “at risk” for being overweight if they are at the 85-95th percentile
of children their age. Weight at or above the 95th percentile is considered overweight.
• 25% of Franklin County children are overweight,
compared to the national average of 16%
• 30% of Columbus children are overweight
• 41% of Columbus children living in the 100-200%
poverty range (household incomes of $18,850-37,700
for a family of four) are overweight
• 31% of girls in Franklin County are overweight
• 48% of Non-Hispanic African American
children are overweight
0
20%
40%
60%
80%
100%
18.4%
31.4% 29.1%33.2%
9.9%
35.6%41.3%
21.8% 20.9%
47.7%
BoyGirl
5/Under6 to 12
13 to 17<Pov
100-200% Pov>200% Pov
NH WhiteNH Afr. Am.
O V E R W E I G H T C H I L D R E N
Source: 2002 Franklin County Health Survey, Professional Research Consultants
Notes: 1. The definition of overweight is based on children’s Body Mass Index status above the 95th percentile of U.S. growth charts.
2. Asked among all parents of children under 18 at home.
3. It is important to use caution when interpreting the results since observed differences between demographic
groups may not be statistically different.
4Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The Process: Developing a Community Action Plan
The collaborative effort brought together various service
providers and stakeholders involved in the nutrition and
fitness of youth in Franklin County. A Leadership Council
was formed, consisting of local foundation, corporate,
government and health leaders, to bring knowledge,
skills, and resources to the initiative. A Strategy
Team, with broad-based
membership across nine
community sectors, provided
additional advice and
knowledge to ensure an
assessment was conducted
in the most effective
manner. Expert Advisory
Committees provided
content in the areas of
survey design, nutrition,
physical activity, cultural
considerations, and social
marketing. The Ohio State University College of
Human Ecology provided faculty as well as undergraduate
and graduate student support for survey design, conducting
focus groups and interviews. The effort involved an
evaluation of community assets, best practices, model
programs and gaps in services. This led to the development
of a long-term strategic plan designed to overcome issues
and barriers contributing to the prevalence of overweight
children as well as to identify funding streams to support
strategic recommendations.
Assessment methodology included gathering data
and input from a variety of sources, including families,
schools, businesses, government, early childhood
providers, the food and fitness industries, the media,
the medical community and the faith-based community.
This was important as the intent was to identify major
contributing factors
from the perspective of
professionals, parents,
and kids. Results from
a Key Stakeholder Survey
revealed the actions various
community sectors can take
to address childhood over-
weight and the behaviors
contributing to the
trends. Parent Focus
Groups disclosed the
food and fitness behaviors
and barriers that contribute to the issue in various
neighborhoods. Sixteen Child Focus Groups provided
insight into youth food and fitness behaviors and
perceptions. National experts were interviewed, some
during visits to Chicago, San Diego, and Cleveland, to
learn more about successful strategies and programs used
in other cities. Also, a Literature Review assessing clinical
publications, quality evidence-based programming and
position papers provided substantial knowledge of the
contributing factors and potential opportunities for
addressing the childhood obesity epidemic.
“Raven said that it
is good for you to exercise.”
– 8 yr old female
5 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The Findings: Behaviors Contributing to Overweight Prevalence
Addressing this health issue is complex
due to the genetic, cultural, socioeconomic,
psychological, and environmental factors
involved. Over several decades, these factors
have produced a gradual trend toward ‘energy
intake’ greater than ‘energy expenditure’,
resulting in more people being overweight.
The following findings are an indication
of this imbalance:
Nutrition• The average infant consumes 10-23% more calories
than the Estimated Energy Requirement 4
• Carbonated soft drinks account for more than 50%
of American children’s total beverage consumption 5
• In middle and high schools, 75% of the drinks and
85% of the snacks are of poor nutritional value 6
• The increase in portion size parallels the prevalence
of overweight and obesity 7
• When used as a reward, food usually tends
to be of low nutritional value 8
Physical Activity• Children attending daily physical education
dropped from 42% in 1991 to 32% in 2001 9
• 48% of girls and 26% of boys do not exercise
vigorously on a regular basis 10
• Children spend an average of five-and-a-half
hours a day watching TV and using media such
as computers and video games 11
• Exposure to media advertising and obesity
are positively correlated 12
• Televised advertising messages lead to
unhealthy eating habits, particularly for children
under eight years of age who are unable to
understand the difference between information
and advertised messages. 13
Environmental Findings• Many parents do not feel their children are safe
when they play outside 14
• Low-income families have limited access
to physical activity venues 8
• Low-income communities often have limited
access to nutrient-rich and low calorie foods 8
• Uninformed parents misjudge their children’s
weight status and misunderstand the health
implications of excess weight 14
• Children are more likely to have an active lifestyle
if their parents exercise with them 14
• Research confirms the need to deliver consistent
food and fitness messages that are positive, realistic,
make life easier and relate to alleviation of disease. 15
6Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The Findings: Behaviors Contributing to Overweight Prevalence
From Vision to Resulting Key Behaviors:Once the factors and trends leading to
childhood overweight and obesity were understood,
a Socio-Ecological Model was applied to identify the
main sectors of the community that influence children’s
lives and behaviors. The model, used successfully by
other communities to achieve behavior change, identifies
groups that are key to achieving a change in youth and
family eating and physical activity habits.
Although the solution to the childhood overweight
epidemic may seem as simple as balancing the equation
of “energy in = energy out”, the issues are complex and
involve societal and individual behavior changes to
influence overfeeding and physical inactivity. Impacting
behavior changes throughout a community requires a
commitment from families, schools, faith organizations,
community organizations, the food and fitness industries,
the medical community, the media, and government.
Each sector must be involved in the sustained prevention
effort, providing programming and support as well
as communicating a consistent message about healthy
food and fitness behaviors.
A successful collaborative effort will result
in a widespread practice of six key behaviors for
maintaining a healthy and fit weight in children:
1. Children are active for at least 60 minutes every day
2. Infants and children gain motor skills for
lifetime activity
3. Children limit TV and video game/computer use
time to less than 2 hours a day
4. Parents and guardians provide infants and children
with nutritious, age-appropriate foods. Infants are
breastfed, when possible
5. Caregivers and schools provide children with
nutritious portions of food that meet energy needs
6. Children choose nutrient-rich foods and healthful
beverages that meet energy needs
Media Government
Food Industry
Neighborhood Environment
SchoolsMedical Community
Early Childhood Providers
AfterschoolTime/Faith-based
Societal Level
Community Level
Inter-personal Level
CHILD
Family
The Workplace
Policy
S O C I O - E C O L O G I C A L M O D E L
Following is a summary of how sectors identified in the Socio-Ecological Model
will fulfill their respective roles in ensuring Franklin County’s children are healthy
and fit. Detailed strategies are included later in this report.
7 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
LeadershipAn effective leadership infrastructure will sustain a
unified, consistent and community wide effort to provide
nutrition and physical activity resources for children.
This work will be done by a facilitating entity,
with guidance from the Leadership Council and support
from the Strategy Team, Expert Advisory Workgroups
and contracting strategic partnerships. This entity will
be instrumental in increasing awareness, engaging
stakeholders, generating
resources, implementing/
assisting others in
implementing programs,
and assessing and reporting
progress on food and fitness
behaviors. Work will include
creating a community wide
social marketing campaign
targeted at parents and youth
with positive messages from
many sectors; assessing the
cultural appropriateness
of programs; creating an
evaluation system to
measure effectiveness
of community programs; and continuing to
support consumer and best practices research
for effective programming.
The CommunityLocal government, food and fitness industries, and
community-based organizations will expand existing
efforts to provide healthy nutrition and physical activity
programs and venues.
Local government agencies have critical roles to
play and can make the health of children a priority by a)
helping to increase resources; and b) by supporting the
development of policies that promote access to healthy
food, and environments that foster physical activity.
Government agencies will partner to develop and
implement an integrated plan for Columbus and Franklin
County. The plan should be based on an assessment
of current status related to community access to
healthy food and opportunities
for physical activity.
The food industry will
increase access to and provide
information about healthy food
choices; develop educational
tools for grocers; provide
improved nutrition information
on restaurant menus; and
offer more nutritious foods
in restaurants, vending machines
and other food purchase venues.
The fitness industry will provide
convenient recreation and fitness
opportunities – especially to
underserved populations – by supplying resources
and in-kind support to communities.
By coordinating existing efforts and resources,
Community-based organizations, neighborhood
leaders and residents will improve access to food
sources, educate and deliver culturally appropriate
services to low-income families, and locally promote
a lifestyle of healthy nutrition and fitness.
Strategies for Providing a Healthy Food and Fitness Environment for Children
8Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The Education SystemEarly childhood programs, schools, and after-
school programs will provide a positive environment
to help children gain skills, knowledge, and habits
for lifetime fitness.
Early childcare providers have a direct impact
at a critical age for developing life-long food and fitness
behaviors. Building on existing initiatives, childcare
providers will offer nutritious food, utilizing USDA
funded food and resources where possible, and will
schedule time for daily physical activity.
Schools will teach healthy eating and fitness
behaviors and will provide nutritious food and daily
physical activity, establish wellness councils, expand
federally funded school breakfast and lunch programs
and provide high nutritional valued foods in vending
machines. Schools will be encouraged to incorporate
BMI and related nutrition and fitness information in
routine health screenings, appropriately communicating
findings to parents and guardians. Schools will explore
the possibility of creating a “model school feeder system”
that bundles multiple interventions into one school
system. If successful, this feeder system can serve
as a model for future initiatives.
After-school programs, through existing initiatives,
will provide an environment and curriculum to support
nutrition education, healthy eating, utilizing USDA
funded food and resources where possible, and daily
physical activity.
FamiliesThe medical community, faith-based providers, and
employers will deliver effective programming, consistent
messages, and support to help families adopt healthful
food and fitness practices.
Physicians and other health providers have
significant influence and will offer families a broad
spectrum of advice, education and services. This will
include providing advice focusing on prevention and
education activities, intervention and referrals for the
co-morbid conditions of obesity including endocrine,
gastrointestinal, cardiovascular, nutritional, and sleep
conditions. Research will help identify best practices
in education, prevention, and intervention and these
best practices will be provided to physicians and they
will be encouraged to utilize family visits to promote
food and fitness behaviors.
Faith-based organizations will support the health
and fitness of their members by providing internal health
programs, group support services and positive messages
about the benefits of healthful food and fitness behavior.
Employers will provide information, incentives
and programs for workers to adopt healthful food
and fitness practices for their families. Employers
will be encouraged to adopt proven fitness programs,
supporting obesity prevention efforts with employee
incentives, and participating in the countywide
social marketing campaign.
Strategies for Providing a Healthy Food and Fitness Environment for Children
“Without family you
wouldn’t have any support.”
– 13 year old male
9 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
The future of this initiative has been
informed by the partners of the community
planning process over this past year. Their
recommendations describe an ongoing
leadership infrastructure to support the work
of all and facilitate funding, implementation
and evaluation of the effort. The key leadership
components of this community initiative
include the following:
Facilitating Entity• Each sector will be involved in the sustained
prevention effort, providing programming and
support as well as communicating a consistent
message about healthy food and fitness behaviors.
The facilitating entity will ensure that the effort’s
strategies stay focused, relationships are built
and maintained, additional funding is secured
and the evaluation and social marketing efforts
are informative as well as comprehensive.
Leadership Council• The role of the Leadership Council is to assure
the mission and vision are realized and to support
the initiative with time, influence and resources.
The Leadership Council will review progress, assure
resources and funding are utilized effectively and
a social marketing campaign, policy initiatives,
and evaluation are carried out.
Strategic Working Groups• Strategic working groups will develop more
specific plans for each sector, advise on plan content,
progress, additional needs, message/media, policy,
funding and evaluation components. Each committee
will be based on one of the following sectors:
• Government Agencies
• Education Systems
• Community and Faith Based Organizations
• Medical and Health
• Food and Fitness Industry and Corporations
• Marketing/messaging
Using the strategies from this report, the
leadership infrastructure will produce specific
and detailed actions aimed to promote positive fitness
behaviors. Collectively, the work of this infrastructure
will result in the engagement of the broader community
via a planned approach. It is a system that encourages
all sectors of the community to work in concert to
encourage good nutrition and physical activity and
to make resources available that support healthy
choices and quality lifestyles. Some of these actions
can occur immediately, while others will take longer
to implement. Overall, this leadership infrastructure
is adaptable to the ever changing needs of the
community effort to address obesity in
children and families.
Continuing the Effort
“… my kids are seeing it first hand now with
my mom being ill … then I had diabetes … I lost 30 lbs …
we are all more aware of what we eat.”
10Healthy & Fit: A Community Action Plan for Franklin County Children & Families
It is important to note the challenges
faced by the community in impacting
positive behavioral changes and reversing
the reported trends toward overweight and
obesity. Significant and measurable progress
will take years and will only occur with the
steadfast commitment of the partners that
have provided input into the definition of
the problem and requisite long-term strategies
to impact the health status of the community.
Just as changes in tobacco use have taken
generations, we believe to truly impact the
issue of obesity in children and families will
also take decades. This work, while well
planned and thoughtful, is a beginning
step in a long-term effort.
New partnerships, visions, and ideas are forming
as a result of the meetings of leadership and strategy
teams. A collective understanding of the severity of the
1 US Dept of Health and Human Services. Strategic plan for NIH obesity research. NIH publication no. 04-5493. August 2004.
2 DHHS (U.S. Dept of Health and Human Services). 2001a. The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: Public Health Service, Office of the Surgeon General
3 Ogden CL, Flegal KM, Carroll MD, Johnson CL. 2002a. Prevalence and trends in overweight among US children and adolescents,
1999-2000. J Am Med Assoc 288(14): 1728-1732
4 Feeding Infants and Toddlers Study: What foods are infants and toddlers eating? J. Am Dietic Assoc. (2004) 104:S22-S30
5 Kennedy E, Powell R. Changing eating patterns of American children: a view from 1996. J Am Coll Nutr 1997;16:524-9
6 Carangelo C. Why are Americans so fat? Food Management. 1995; 30:63-68
7 Young LR, Nestle M. The Contribution of Expanding Portion Sizes to the US Obesity Epidemic.
American Journal of Public Health. 2002; 92:246-249
8 Chamberlin LA, Sherman SN, Jain A, Powers SW, Whitaker RC. The Challenge of Preventing and Treating Obesity
in Low-Income, Preschool Children. Arch Pediatr Adolesc Med. 2002;156:662-668
9 CDC, Youth Risk Behavior Survey, 1999
10 CDC, Youth Risk Behavior Survey, 1999
11 Roberts D, Foehr U., Kids & Media in America, (Cambridge, MA: University Press, 2004)
12 Kaiser Foundation. The Role of Media in Childhood Obesity. (Issue Brief, February, 2004: pg. 5)
13 Wilcox BL, Kunkel D, Cantor J, Dowrick P, Linn S, Palmer E. 2004. Report of the APA Task Force on Advertising and Children.
Washington, DC: American Psychological Association
14 The Robert Wood Johnson Foundation. Active Living, Diversity Project Report. 2003
15 The Robert Wood Johnson Foundation. Active Living, Diversity Project Report. 2003
problem, its impact on health, and mobilization of
the community to address it is realized now more than
ever. The common theme in key stakeholder gatherings
throughout this assessment process has been to shift the
social paradigm to a new direction, or create a “tipping
point” for healthier children and families. It is up to the
Franklin County community to advance the initiative
to the point where we can state with confidence that
our children and families are healthy and fit.
Contact Information:If you are interested in getting more information
about the content of this report and/or are interested
in participating in this community initiative,
please contact:
J.D. Beiting
Children’s Hunger Alliance
(614) 341 7700 x 219
Conclusion
11 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
L O G I C
Nutrition• The average infant consumes
10 to 23% more calories than theEstimated Energy Requirement16
• Carbonated soft drinks account for over 50% of American children’stotal beverage consumption17
• A survey of vending machines in middle and high schools reports 75% of the drinks and 85% of the snacks are of poor nutritional value18
• The trend toward larger portion sizes has occurred in parallel with increases inthe prevalence of overweight and obesity18
• Food is used as a reward, and usuallytends to be food of low nutritional value19
Physical Activity • The percentage of children attending
daily physical education dropped from 42% in 1991 to 32% in 200120
• A Centers for Disease Control andPrevention (CDC) survey reports 48% of girls and 26% of boys do notexercise vigorously on a regular basis.21
• Children today spend an average of five-and-a-half hours a day watching TV and using media.22
• At least 6 studies positively correlatemedia advertising and obesity 23
• The American Psychological Association recently concluded that televised advertising messages can lead to unhealthy eating habits, particularly for children under eightyears of age who are unable to criticallycomprehend advertised messages.24
Environmental Factors • Parents do not feel that their children
are safe when they play outside25
• Low income families have limited access to physical activity venues 26
• Low income communities often havelimited access to nutrient rich and low calorie food.25
• Uninformed parents misjudge their children’s weight status and misunderstand the health implications of excess weight 27
• Parents want their family to be healthy and do the right thing 27
• Children are more likely to have an active lifestyle if their parents exercise with them 28
• Research confirms the need to deliverconsistent food and fitness messages thatare realistic, make life easier, are positive,and related to alleviation of disease. 29
References for Contributing Factors are listed on following page
Leadership InfrastructureCreate an infrastructure representing all sectors to: • Sustain a unified, consistent communitywide effort• Increase awareness through a communitywide social
marketing campaign aimed at parents and youth• Engage stakeholders on an ongoing basis• Identify and generate resources to support the initiative• Evaluate the effort, and report progress on the food and fitness
behaviors of children• Continue and support research on best practices and
effective programming
The Community• Franklin Co., Columbus, and local municipal leaders:
• Increase resources and support policy to improve the food and fitness of children in schools and community
• Revise zoning and capital improvement plans for future developments to include spaces for recreation and physical activity
• Increase access to nutritious food venues, gardens, and markets• Increase access and program capabilities of parks, green space,
and recreation venues• Improve the safety of streets, sidewalks, and routes to school • Continue community health assessments• Provide resources for culturally appropriate services,
including social marketing • The food industry expands access to and delivers knowledge of healthy
food choices through industry and government educational programs• The fitness industry and government entities provides convenient
opportunities for regular recreation and physical activity for families • Community based organizations and neighborhood leaders expand
community gardens, educate and deliver services to help families develop a lifestyle of healthy food and fitness
The Education System• Childcare providers are trained using evidence-based nutrition and
physical activity programming, with assistance from content specialists.• Childcare providers offer nutritious USDA funded food and physical
activities on a daily basis• Schools, school agencies, parents and other stakeholders
form school wellness councils to guide food and fitness curriculum and environment in schools
• Schools teach healthy food and fitness behaviors and provide nutritiousUSDA funded School Breakfast, Lunch and physical activity daily.
• School Health Services incorporate BMI measurement, appropriate referrals and parent education into routine health assessments.
• Schools use evaluation tools to assess the quality of food they make available to students, and they offer nutritious choices.
• After school programs provide nutritious meals, nutrition education and physical activity programs that build skills, with assistance from content specialists.
• Explore possibility of creating a model school feeder system, that bundles multiple interventions into one neighborhood
The Family• Physicians and health professionals offer families a broad spectrum of
services including a primary focus on prevention and education programs• Expand medical treatment, intervention, referral and research
programs for childhood obesity • Faith-based organizations provide programs, support services and
positive messages about the benefits of healthful food and fitness behavior • The Workplace provides information, incentives and programs
for parents to adopt healthful food and fitness practices for their family
Contributing Factors Strategies
12Healthy & Fit: A Community Action Plan for Franklin County Children & Families
M O D E L
• All key sectors participate in influencing healthful food and fitness behaviors of children
• Multi-media messages result in healthy food and fitness behaviors of youth and families
• Continued assessment and evaluation leads to successful program interventions, and improved program outcomes
• Funding is secured to continue efforts that impact food and fitness of youth
1. Children are active
for at least 60 minutes
every day
2. Infants and children
gain motor skills for
lifetime activity
3. Children limit TV and
video game/computer
use time to less than
2 hours a day
4. Parents and guardians
provide infants and
children with nutritious,
age-appropriate foods.
Infants are breastfed,
when possible
5. Caregivers and schools
provide children with
nutritious portions
of food that meet
energy needs
6. Children choose
nutrient-rich foods
and healthful beverages
that meet energy needs
• The physical environment of Franklin County has safe neighborhoods for walking and exercising, accessible greenspace for recreation, free or low cost activity programs and venues, and access to nutritious food for all families
• Community coalitions and public health agencies use evaluation tools to measure the impact and availability of food and fitness activities and programs
• Grocery stores and restaurants sell healthy options, portion sizes equal to energy needs, and provide resources for nutrition and physical activity education for children
• Families receive neighborhood support and resources fromcommunity based organizations to live healthy and fit lifestyles.
• All Franklin Co. childcare centers and caregivers provide nutritious food and physical activity
• Wellness councils guide healthy school environments• Healthy breakfast and lunch programs are available
in all Franklin Co. schools • Competitive food venues offer nutritious options• Franklin County schools provide 30 minutes
of continual movement daily• Model school feeder system demonstrates multiple
interventions successfully improve the food and fitness behaviors of children
• All Franklin Co. after school programs provide nutritious food and healthy physical activity environment for children
• The medical community provides effective guidance to families to help children be fit
• Faith-based organization’s provide opportunities for healthy lifestyle activities
• The workplace becomes a supportive environment for parents to receive messages and programs about healthful food and fitness for their families
Future BehaviorsOutcomes
13 Healthy & Fit: A Community Action Plan for Franklin County Children & Families
16. Fox MK, Pac S, Devaney B, Jankowski L. Feeding infants and toddlers study: What foods are infants and toddlers eating?. JADA. January 2004, (S) 104:1
17. Kennedy E, Powell R. Changing eating patterns of American children: a view from 1996. J Am Coll Nutr 1997;16:524-9
18. Young LR, Nestle M. The Contribution of Expanding Portion Sizes to the US Obesity Epidemic. American Journal of Public Health. 2002; 92:246-249
19. American Institute of Cancer Research. New Survey shows Americans ignore importance of portion size in managing weight. Available at: http://www.aicr.org. Accessed October 27, 2000.
20. U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
21. CDC, Youth Risk Behavior Survey, 1999
22. Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fatness among children: Results from the Third National Health and Nutrition Examination Survey. JAMA 1998;279:938-42.
23. Dietz, W and Gortmaker, S., “Do We Fatten Our Children at the TV Set? Obesity and Television Viewing in Children and Adolescents”, Pediatrics 75 (1985): 807-812
24. Kaiser Foundation. The Role of Media in Childhood Obesity. (Issue Brief, February, 2004: pg. 5)
25. The Robert Wood Johnson Foundation. Active Living, Diversity Project Report. 2003
26. Burdette HL, Whitaker RC. Neighborhood playgrounds, fast food restaurants, and crime: relationships to overweight in low-income preschool children. Preventive Medicine 38 (2004) 57-63
27. Crawford PB, Gosliner W, Anderson C, Strode P, Becerra-Jones Y. Counseling Latina Mothers of Preschool Children about Weight Issues: Suggestions for a New Framework. JADA (2004) 104:387-394
28. Chamberlin LA, Sherman SN, Jain A, Powers SW, Whitaker RC. The Challenge of Preventing and Treating Obesity in Low-Income, Preschool Children. Arch Pediatr Adolesc Med. 2002;156:662-668
29. Agrams WS, Hammer LD, McNicholas F. 2004. Risk factors for childhood overweight: A prospective study from birth to 9.5 years. The Journal of Pediatrics 145(1):20-25
R E F E R E N C E S T O L O G I C M O D E L C O N T R I B U T I N G F A C T O R S
“Our communities are going
to have to back each other up to make
a difference in the health of our kids.”
- Mother of 4 school age children