Childcare Policy for
a Healthy Start
Jamie Jeffrey, MD
Project Director, KEYS 4 HealthyKids
Medical Director, CMC & HealthyKids
Pediatric Weight Management Program
Healthy Kids, Healthy Communities
KEYS 4 HealthyKids
 One of 41 sites selected by Robert Wood Johnson
Foundation (RWJF) for the Healthy Kids, Healthy
Communities Grant
 Partnership of over 22 organizations in Kanawha
County
 Facilitating policy and environmental change
 Overall Goal is to provide access to healthy,
affordable food and increased physical activity
K-E-Y-S
Knowledge
 5-2-1-0
Eating Healthy
 Community Gardens
Youth Being Active
 PA Opportunity Maps
 Parks & Greenspaces
Safety & Empowerment
 Joint Use Agreements
NHANES DATA
Age of Onset of Pediatric
Overweight in CMC
Age of Onset of Pediatric BMI Shifting
25
Normal to Overweight
20
Overweight to Obese
Normal to Obese
15
10
5
0
2
3
4
5
6
7
8
-5
Age
9
10
11
12
13
14
Bogalusa Heart Study
Cohort Based 1973-1996
2,610 Children 2-17 years followed to
ages 18-37 years
Mean follow-up 17.6 years
BMI-for-age & Skinfold (SF)
thickness in childhood compared to
adult mean SF (subscapular & triceps
SF)
Bogalusa: Proportion of Children
Who Become Obese Adults
100
90
80
70
60
50
40
30
20
10
0
< 50% BMI
>95% BMI
2-5
years
6-8
years
9-11
years
12-14
years
15-17
years
“Where” are these
younger kids?
Daycare
After-school programs
Pre-schools
Headstarts
Family Home Child Care Centers
Child Care plays a role
~60% of 3-6 year
olds are in some
type of nonparental care
Child Care setting is
ideal for promoting
early development of
health behaviors
What is…
Nutrition
And
Physical Activity
Self
Assessment for
Child
Care
NAP SACC Program Identified as one of three model
programs to address obesity prevention in child care.
The other programs noted were Nemours Childhood Obesity Model,
supported by the Nemours Health and Prevention Services and
I am Moving, I am Learning, a health promotion and obesity
prevention enhancement developed for Head Start.
NAP SACC Steps
1. Self-Assessment
2. Action Planning/Goal Setting
3. Workshop Delivery
4. Targeted Technical Assistance
5. Evaluate, revise and repeat
Self-Assessment
Step 1: SelfAssessment
• Facility director
completes selfassessment
instrument with help
from key staff, such
as the cook or
program planner.
Nutrition Key Areas
Fruits and Vegetables
Meats, Fats, and Grains
Beverages
Menus and Variety
Feeding Practices
Foods Outside of Meals/Snacks
Supporting Healthy Eating
Nutrition Education
Nutrition Policies
Physical Activity
Key Areas
Active Play vs. Inactive Time
Play Environment
Supporting PA
PA Education
PA Policies
KEYS 4 HK
Childcare Workshop
Self Assessment Completed by 1-111
Workshop Mid 1-11
F/U Workshops every 4-6 weeks
TA by phone/email from KEYS
Childcare Consultant
Thru Policy & Environmental Change
www.Keys4HealthyKids.org
304-388-7145
Survey Process
NAP SAAC Toolkit
Entered into Survey Monkey
KEYS Team Members called
Childcare Center and Head Start
Directors
Incentive of $100 gift certificate
Policy Assessment
Nutrition
Physical Activity
Only 17% of policy 47% of policy
questions were able
to be answered
Policies too vague
or non-existent
questions were able
to be answered
Policies better to
find but still
inadequate in
number
Center Survey Results
Sugary Drinks
Center Survey Results
Sweet/Salty Foods
Center Survey Results
Fruit
Center Survey Results
Veggies
Center Survey Results
Active Play
Center Survey Results
Outdoor Active Play
Center Survey Results
Outdoor Play Space
Includes…