Prevention of Childhood Obesity in Thesis

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(Institute of Medicine, 2009)

Strategy 3: Community Food Access - Promote efforts to provide fruits and vegetables in a variety of settings, such as farmers' markets, farm stands, mobile markets, community gardens, and youth-focused gardens. (Institute of Medicine, 2009)

Action Steps: (1) Encourage farmers markets to accept Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package vouchers and WIC Farmers Market Nutrition Program coupons; and encourage and make it possible for farmers markets to accept Supplemental Nutrition Assistance Program (or SNAP, formerly the Food Stamp Program) and WIC Program Electronic Benefit Transfer (EBT) cards by allocating funding for equipment that uses electronic methods of payment; (2) Improve funding for outreach, education, and transportation to encourage use of farmers markets and farm stands by residents of lower-income neighborhoods, and by WIC and SNAP recipients. Introduce or modify land use policies/zoning regulations to promote, expand, and protect potential sites for community gardens and farmers' markets, such as vacant city-owned land or unused parking lots (3) Develop community-based group activities (e.g., community kitchens) that link procurement of affordable, healthy food with improving skills in purchasing and preparing food. (Institute of Medicine, 2009)

Strategy 4 - Public Programs and Worksites - Ensure that publicly-run entities such as after-school programs, child-care facilities, recreation centers, and local government worksites implement policies and practices to promote healthy foods and beverages and reduce or eliminate the availability of calorie-dense, nutrient-poor foods. (Institute of Medicine, 2009)

Action Steps: (1) Mandate and implement strong nutrition standards for foods and beverages available in government-run or regulated after-school programs, recreation centers, parks, and child care facilities (which includes limiting access to calorie-dense, nutrient-poor foods); (2) Ensure that local government agencies that operate cafeterias and vending options have strong nutrition standards in place wherever foods and beverages are sold or available; (3) Provide incentives or subsidies to government run or regulated programs and localities that provide healthy foods at competitive prices and limit calorie-dense, nutrient poor foods (e.g., after-school programs that provide fruits or vegetables every day, and eliminate calorie-dense, nutrient poor foods in vending machines or as part of the program). (Institute of Medicine, 2009)

Strategy 5: Government Nutrition Programs - Increase participation in federal, state, and local government nutrition assistance programs (e.g., WIC, school breakfast and lunch, the Child and Adult Care Food Program [CACFP], the Afterschool Snacks Program, the Summer Food Service Program, SNAP). (Institute of Medicine, 2009)

Action Steps: (1) Put policies in place that require government-run and -regulated agencies responsible for administering nutrition assistance programs to collaborate across agencies and programs to increase enrollment and participation in these programs (i.e., WIC agencies should ensure that those who are eligible are also participating in SNAP, etc.); (2) Ensure that child care and after-school program licensing agencies encourage utilization of the nutrition assistance programs and increase nutrition program enrollment (CACFP, Afterschool Snack Program, and the Summer Food Service Program). (Institute of Medicine, 2009)

Strategy 6: Breastfeeding - Encourage breastfeeding and promote breastfeeding-friendly communities. (Institute of Medicine, 2009)

Action Steps: (1) Adopt practices in city and county hospitals that are consistent with the Baby-Friendly Hospital Initiative USA (United Nations Children's Fund/World Health Organization). This initiative promotes, protects, and supports breastfeeding through ten steps to successful breastfeeding for hospitals; (2) Permit breastfeeding in public places and rescind any laws or regulations that discourage or do not allow breastfeeding in public places and encourage the creation of lactation rooms in public places; (3) Develop incentive programs to encourage government agencies to ensure breastfeeding-friendly worksites, including providing lactation rooms; (4) Allocate funding to WIC clinics to acquire breast pumps to loan to participants. (Institute of Medicine, 2009)

Strategy 7: Drinking Water Access - Increase access to free, safe drinking water in public places to encourage water consumption instead of sugar-sweetened beverages. (Institute of Medicine, 2009)

Action Steps: (1) Require that plain water be available in local government-operated and administered outdoor areas and other public places and facilities; and (2) Adopt building codes to require access to and maintenance of fresh drinking water fountains (e.g., public restroom codes). (Institute of Medicine, 2009)

Goal 2: Reduction of Access to and Consumption of Calorie-Dense, Nutrient-Poor Foods.

Strategy 8: Policies and Ordinances - Implement fiscal policies and local ordinances to discourage the consumption of calorie-dense, nutrient-poor foods and beverages (e.g., taxes, incentives, land use and zoning regulations).

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(Institute of Medicine, 2009)

Action Steps: (1) Implement a tax strategy to discourage consumption of foods and beverages that have minimal nutritional value, such as sugar-sweetened beverages; (2) Adopt land use and zoning policies that restrict fast food establishments near school grounds and public playgrounds; (3) Implement local ordinances to restrict mobile vending of calorie-dense, nutrient-poor foods near schools and public playgrounds; (4) Implement zoning designed to limit the density of fast food establishments in residential communities (5) Eliminate advertising and marketing of calorie-dense, nutrient-poor foods and beverages near school grounds and public places frequently visited by youths; (6) Create incentive and recognition programs to encourage grocery stores and convenience stores to reduce point-of-sale marketing of calorie-dense, nutrient-poor foods (i.e., promote "candy-free" check out aisles and spaces). (Institute of Medicine, 2009)

Goal 3: Raise Awareness about the Importance of Healthy eating to prevent childhood obesity.

Strategy 9: Media and Social Marketing - Promote media and social marketing campaigns on healthy eating and childhood obesity prevention. (Institute of Medicine, 2009)

Action Steps: (1) Develop media campaigns, utilizing multiple channels (print, radio, internet, television, social networking, and other promotional materials) to promote healthy eating (and active living) using consistent messages; (2) Design a media campaign that establishes community access to healthy foods as a health equity issue and reframes obesity as a consequence of environmental inequities and not just the result of poor personal choices; (3) Develop counter-advertising media approaches against unhealthy products to reach youth as has been used in the tobacco and alcohol prevention fields. (Institute of Medicine, 2009)

Actions for Increasing Physical Activity

Goal 1: Encourage Physical Activity.

Strategy 1: Built Environment - Encourage walking and bicycling for transportation and recreation through improvements in the built environment. (Institute of Medicine, 2009)

Action Steps: (1) Adopt a pedestrian and bicycle master plan to develop a long-term vision for walking and bicycling in the community and guide implementation; (2) Plan, build, and maintain a network of sidewalks and street crossings that creates a safe and comfortable walking environment and that connects to schools, parks, and other destinations; (3) Plan, build, and retrofit streets so as to reduce vehicle speeds, accommodate bicyclists, and improve the walking environment; (4) Plan, build, and maintain a well-connected network of off-street trails and paths for pedestrians and bicyclists; (5) Increase destinations within walking and bicycling distance; (6) Collaborate with school districts and developers to build new schools in locations central to residential areas and away from heavily trafficked roads. (Institute of Medicine, 2009)

Strategy 2: Programs for Walking and Biking / Promote programs that support walking and bicycling for transportation and recreation. (Institute of Medicine, 2009)

Action Steps: (1) Adopt community policing strategies that improve safety and security of streets, especially in higher crime neighborhoods; (2) Collaborate with schools to develop and implement a Safe Routes to School program to increase the number of children safely walking and bicycling to schools; (3) Improve access to bicycles, helmets, and related equipment for lower-income families, for example, through subsidies or repair programs; (4) Promote increased transit use through reduced fares for children, families, and students, and improved service to schools, parks, recreation centers, and other family destinations; (5) Implement a traffic enforcement program to improve safety for pedestrians and bicyclists. (Institute of Medicine, 2009)

Strategy 3: Recreational Physical Activity - Promote other forms of recreational physical activity. (Institute of Medicine, 2009)

Action Steps: (1) Build and maintain parks and playgrounds that are safe and attractive for playing and in close proximity to residential areas; (2)( Adopt community policing strategies that improve safety and security for park use, especially in higher crime neighborhoods; (3) Improve access to public and private recreational facilities in communities with limited recreational options through reduced costs, increased operating hours, and development of culturally appropriate activities; (4) Create after-school activity programs, e.g., dance classes, city-sponsored sports, supervised play, and other publicly or privately supported active recreation; (4) Collaborate with school districts and other organizations to establish joint use of facilities agreements allowing playing fields, playgrounds, and recreation centers to be used by community residents when schools are closed; if necessary, adopt regulatory and legislative policies to address liability issues that might block implementation; (5) Create and promote youth athletic leagues and increase access to fields,.....

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