# Presentation: 466191

## Hawaii State Department of HealthTobacco Settlement ProjectHealthy Hawaii InitiativeHealthier Community

*4**th** Annual National Prevention Summit:  *
*Prevention, Preparedness, and Promotion*
*October 26, 2006*

**Notes:**
4th Annual National Prevention Summit:  Prevention, Preparedness, and Promotion
U.S. Department of Health and Human Services
 October 26 to 27, 2006, Washington, D.C.
Hawaii State Department of Health
Tobacco Settlement Project
Healthy Hawaii Initiative
October 27, 2006
Learning Objectives:
The participant will be able to identify three strategies to address the health risk factors of physical activity and nutrition through a social ecological model.
The participant will be able to identify how environmental, systems and policy changes can support sustainable changes to promote physical activity and healthy eating.  

## The Healthy Hawaii Initiative

- HHI is an integrated and comprehensive approach to increase the years of healthy life for all people of Hawaii and to reduce existing health disparities among ethnic groups in Hawaii.

## How Do We Affect Behavior?

## Engineering the Future

## What we hope to accomplish

- 2-5
- years

- 5-10
- years

- 10-20
- years

**What we hope to accomplish**

## The Healthy Hawaii Initiative

- The goal is to reduce the incidence of chronic disease through addressing the primary prevention areas of physical activity, nutrition and tobacco use.
- Objective is to increase sustainable changes in physical activity and healthy eating.
- HHI funds and coordinates tobacco prevention and control with other divisions across the department.

## Adult Obesity & Overweight

- Adult Obesity & Overweight

- Year

- %

- Source: BRFSS

- HHI

**Notes:**
No significant change reported in:
Obesity rates for adults from 2001 to 2005 (2005 BRFSS 19.7%)
Overweight rates from 1999 to 2005 (2005 BRFSS 33.3%)2005 obesity rate is the second lowest in the nation, and the combined rate for overweight and obesity is the lowest rate in the nation

## Adult No Leisure Time PA

- Year

- %

- Source: BRFSS

- HHI

- Significant increase in leisure time physical activity by adults from 1999 to 2005

**Notes:**
While rates of no leisure time physical activity are decreasing rapidly, we still have half of the population that does not get adequate regular physical activity. 

## Adults moderate PA +30 minutes +5 days/wk or vigorous +20 minutes +3 days/week

- Increase in PA from 2003  to2005

- BRFSS

- No increase in youth at risk for overweight from 1999 to 2005 (2005 YRBSS 14.2%)

## Understanding Health Behaviors

- Individual – Pub. Ed.

- Social Norms – Pub. Ed.

- Social Professional –
- Teaching & Prof. Ed.

- Policy/Structure/Environment - Schools

- Policy/Structure/Environment
- - Communities

- Policy/Structure/Environment –
- County/State

**Understanding Health Behaviors**

## The Healthy Hawaii Initiative Overview

**Schools**
- Coordinated School Health Program
- Teaching to Health & Physical Education Standards
**Communities**
- Coalition Building
- Community RFPs
- Technical Assistance
**Food Stamp Nutrition Education Program**

**Education**
- Public
- Professional
**Tobacco Prevention**
- Counter Marketing
- Enforcement
**Surveillance, Evaluation and Research**

## Integrated School Health Framework

- Coordinated approach to school health for prevention
- Sustainable and consistent state to complex to school infrastructure to promote health
- Professional development, technical support and resources to link components of school health

## Partnership with Education

- Health education
- PE
- Coordinated School Health Program
- YRBS, YTS Coordinated
*Over 80% of MS HS classroom teachers reached with professional development*
*Graduate level courses*
*Trained CSHP sites*
*School Wellness Policy*

## Moving Forward

- Capacity building
- Sustainability
- Health Disparity
- Improving Evaluation

- Creating Teacher Learning Communities for HE and PE
- Statewide CSHP Rollout for Schools
- State School Wellness Policy
- Training Tracker Results
- Adapting a comprehensive fruits and vegetable nutrition education program in a Hawaii school garden project

## Community Intervention Projects  Hawaii and Kauai

**Kohala**

**Waikaloa**

**So. Hilo**

**Laupohoehoe**

**Central**** Hilo**

**Pahoa**

**Ka’u**

**Kea’au**

**Kapaa**

**Waimea**

**Waimea, Central Kauai, and Kapaa**
** **

**Island-wide, Great Kauai Weight**** Out**
** **

**West Hawaii**

**Island-wide, PANU campaign**
** **

## Community Intervention Projects Oahu and Maui County

**Waialua/Haleiwa**

**Waianae**

**Nanakuli**

**Waipahu**

**Kaneohe/Kahaluu**

**Pearl City**

**Nuuanu/Makiki**

**Kapolei**

**Kalihi, Palama**

**Kaimuki/Palolo**

**Molokai**

**Lana’i**

**Makawao**

**Hana**

**DOT County-wide** biking and pedestrian safety

**County-wide PANU campaign**

**Windward**

**Kihei**

## Community Intervention Projects

- Communities implemented a variety of programs including:
- planning and renovating walking paths
- making physical activity venues accessible to older adults
- establishing a demonstration garden with walking paths
- increasing healthy choices in restaurants
- community-wide walking campaign

## Targeted Intervention

- Projects included traffic calming around schools
- Joint land use agreements between the Honolulu City and County Department of Parks and Recreation and the HDOE to increase physical activity opportunity in an urban region
- Development and adoption of Native Hawaiian food literacy curriculum in Hawaiian language charter schools.

## Public EducationSocial Marketing Campaigns

**Phase I:  General Awareness Raising:  ****Start.Living.Healthy.**
**Phase II:  Specific Message:  **
**	****1% or Less is Best**
**	**
**Phase III:  Specific Message: ****30 minutes of physical activity a day**
**	****5+ servings fruits and vegetables a day**
**	****Direct marketing to FSP**

**Notes:**
70% of the population reported being aware of the HHI social marketing campaign (HHI household survey)
Result of social marketing campaign to change milk consumption resulted in significant increase in low-fat milk consumption from 30.2% to 40.8% of milk drinkers (approximately 65,000 people switched to low-fat milk)70% of the population reported being aware of the HHI social marketing campaign (HHI household survey)
Result of social marketing campaign to change milk consumption resulted in significant increase in low-fat milk consumption from 30.2% to 40.8% of milk drinkers (approximately 65,000 people switched to low-fat milk)

## Moving Forward

- Capacity building
- Sustainability
- County level work
- Health Disparity

- State and County Coalitions
- More Technical Assistance and Training
- County/Community Level RFPs
- FSP Direct Marketing
- Grocery Store Project

## Moving Forward

- Still needs work
- Slight increase in youth overweight from 1999 to 2005 (2005 YRBSS 13.5%)
- 1999 to 2005 no significant change in eat five or more servings of fruits and vegetables by adults or youth
- 1999 to 2005 no significant change in vigorous or moderate physical activity levels by youth (2005 YRBSS 64.9% met previous national recommendations for PA; new recommendations** met is 30.2%)**

## Aloha!