# Presentation: 920422

## Promoting Healthy Eating and Physical Activity Behaviors Among Limited Resource Preschoolersin Pennsylvania

- Kevin A. Alvarnaz, MBA
- Chief, Cardiovascular Health Section
- Bureau of Chronic Diseases and Injury Prevention
- Pennsylvania Department of Health
- October 24, 2005

## The Issue

- Pennsylvania Assessment of Overweight Children and Youth*
- 17.0% of eighth graders are at risk of overweight, with a BMI-for-age ≥ 85th and <  95th percentile
- 18.2% of eighth graders are overweight, with a BMI-for-age ≥ 95th percentile
- National Study of Low-Income Preschool Children**
- Increase from 18.6% (1983) to 21.6% (1995), based on 85th percentile cutoff point for weight-for height
- Increase from 8.5% (1983) to 10.2% (1995), based on 95th percentile cutoff point for weight-for-height
- *   Pennsylvania Department of Health, 2004.
- **  Pediatrics, January 1998, data from the National Pediatric Nutrition Surveillance System (PedNSS).

## Intervention Selection

- Selected *Color Me Healthy (CMH) *program
- Developed by North Carolina
- Target audience: preschoolers, ages 4 and 5
- Uses color, music, and exploration of the senses to teach children that healthy eating and physical activity are fun
- Demonstrated success (evidence-based) in NC
- 96.6% of providers rated CMH excellent
- 97.4% and 98.7% indicated that CMH increased physical activity and knowledge of healthful eating, respectively

## Keystone Color Me Healthy Implementation

- Selected five counties for pilot implementation in 2003-2004, based on:
- Cultural diversity
- Geographic representation
- Health disparities (including low socio-economic status)
- Existing programs participating in pilot project
- Childcare centers
- Family literacy programs
- Head Start programs

## Keystone Color Me Healthy Implementation

- Program expansion:
- 2004-2005: twelve (12) additional counties trained
- 2005-2006: seventeen (17) additional counties trained
- Program changes (2005-2006):
- Name change – Keystone Color Me Healthy
- Revised evaluation – focus on utilization and childcare provider behavior changes
- Development of parental component(s) based on June 2005 study

## June 2005 Study

- Goals:
- Determine if providing nutrition education materials & fresh produce to parents is an effective way of reinforcing the nutrition messages in KCMH.
- Utilize survey responses to assist in pilot program development.
- Study design:
- Partnership with Department of Community & Economic Development (DCED)
- Outreach through Community Action Programs (CAPs)
- Two counties selected – Adams and Luzerne – based on strength of CAPs

## June 2005 Study

- Study design (continued):
- CAPs selected participating programs based on Food Bank membership, need, number of children, and/or volunteerism
- Three study groupings
- Control – only received standard KCMH program materials
- Education (E1) – standard KCMH program materials + supplemental nutrition education materials (i.e., recipes)
- Produce (E2) – standard KCMH program materials + supplemental materials + weekly supply of fresh produce (4 weeks)

## Sample Distribution

|  | # Centers | # Parents | Pre-Response Rate | Post-Response Rate |
| --- | --- | --- | --- | --- |
| Control | 2 | 30 | 90.0% | 63.3% |
| Education (E1) | 3 | 76 | 48.7% | 44.7% |
| Produce
(E2) | 5 | 13 | 74.8% | 47.3% |
| Total | 10 | 237 | 68.4% | 48.5% |

- Identified Issue: Non-random selection and assignment led to uneven group sizes.  Therefore, a random probability sample was not realized.

## Fruit & Vegetable Consumption

- Result: Although larger increases in consumption occurred within the Control and Produce (E2) groups, no significant differences in actual F & V consumption was realized between groups, either pre- or post-test.

## Fruit Preferences

## Vegetable Preferences

## Barriers to F & V Consumption

## June 2005 Study

- Additional data collected
- Sources parents most often use for cooking
- Common sources of nutrition information
- Reasons parents would try a new food
- Knowledge of the health benefits of eating fruits and vegetables
- Data collected in this study is helping to guide the expansion of KCMH to include additional pilot projects aimed at involving parents in the program.

## Comments on Study

- "My mom and me made vegetable soup.  We cut up the carrots and celery and potatoes and put them in.“
- "Because we have it at the house now, they are asking for fruit for a snack."

## Thank you for your time!

- Contact Information:
-   Kevin A. Alvarnaz, MBA
-   _[kalvarnaz@state.pa.us](mailto:kalvarnaz@state.pa.us)_
-   (717) 787-5876