Turning Wellness Policies into Action at a Healthy Teacher Network Workshop

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Rodney Tripplett

by Rodney Tripplett, School Programs Intern

On November 27, 2012, CLOCC’s Healthy Teacher Network hosted a workshop with the theme Wellness Policies into Action: Making Healthy Students Happen that was attended by teachers, counselors, and school nurses.  It began with a presentation of the highlights of the new Chicago Public Schools (CPS) Local School Wellness and Healthy Snack and Beverage policies from Annie Lionberger, CPS Senior Manager of Student Health and Wellness. This provided an opportunity for participants to gain a better understanding of the key requirements and guidelines of the new wellness policies. Participants also engaged in breakout sessions that focused on key components outlined in the wellness policy such as forming wellness teams, implementing activities to engage all students during recess, and integrating nutrition education into the school day. 

To provide tools for addressing the nutrition education requirement of the new CPS wellness policies, Rebecca Calendo, CLOCC Health Educator, facilitated a session focused on a nutrition and food access curriculum called Cultivating Change. This curriculum includes a series of lesson plans for middle school grades to develop students’ awareness of their food choices as well as food access and health issues that impact their communities. In the session, participants learned project ideas, recipes, and activities to launch a unit on food and health. 

Likewise, Urban Initiatives led an engaging session and dialogue on implementing activities to get students moving during recess. Play with Potential, a recess program developed by Urban Initiatives, includes games that are adaptable to a variety of spaces including outdoor fields, classrooms, and multi-use areas. Program Manager April Lillstrom encouraged school staff to engage all students in physical activity and emphasized the importance of recess as being safe, fun, and active as well as an opportunity to facilitate positive youth development. At the end of the session, participants experienced a sample of Play with Potential activities, gaining a better sense of how recess can be improved at their respective schools. 

Overall feedback on the workshop was very positive.  Participants particularly enjoyed the breakout sesson on how to initiate wellness councils. This included a success story from Kristen Janko, adult facilitator for Young Organizers Leading Others (YOLO) at Instituto Health Sciences Career Academy. YOLO tackles issues students want to address in the school and broader community. It began when students decided to raise funds to expand the school’s fitness center and add new equipment. YOLO has raised over $3,000 from fundraising efforts which include school health awareness dances, bake sales, and walk-a-thons. In the breakout, Kristen explained successes and challenges as well as tips for other schools wishing to replicate their work. Kristen strongly encouraged staff struggling to start a wellness council to involve youth, be open to their ideas, gain support from faculty and parents, and ensure student wellness groups are inclusive and accountable. 

As at past workshops, participants networked at the Resource Fair with a variety of community organizations that promote student wellness, healthy eating and physical activity. Twenty-one organizations participated – the largest number to date! Educators from the Lower West Side, North Lawndale, and Chicago Lawn/West Edison were among the most represented at the workshop, with many first time as well as returning staff.

The Healthy Teacher Network fall workshop provided tools to put the wellness policies into action, and we look forward to hearing how they help attendees to create healthier students throughout the city of Chicago.

Looking Back and Looking Forward: Our Tenth Year and Beyond

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Adam Becker

by Adam Becker, PhD, MPH, Executive Director

Welcome to the fourth and final quarter of our 10th anniversary year!  I hope you have found this year to be an exciting review of our decade of the accomplishments we have achieved together and an interesting examination of the things that make CLOCC tick.   This quarter, we are looking toward the future of childhood obesity prevention in Chicago and beyond. 

In CLOCC’s early days, under the energetic leadership of Matt Longjohn and the thoughtful guidance of our founder, Katherine Kaufer Christoffel, the staff’s main focus was building the consortium from dozens to hundreds, organization by organization.  We developed and implemented strategic approaches to demonstrating that there was indeed an obesity epidemic in Chicago and that collaboration among diverse partners was essential to combat it.  In some ways, our work now is easier – very few would argue that there isn’t an obesity epidemic!  The combination of our local surveillance and organizing work and an emerging national understanding of the scale of the epidemic has helped Chicago recognize that we have a serious health problem on our hands.  However, the work is also more complicated as we learn more about obesity and its many causes and risk factors.  It has become increasingly apparent that there is no single solution.

Early on, a lot of our collective efforts were focused on programming – short-term, specific programs and interventions developed to start or keep individual children on a path to a healthy lifestyle.  Our attention to individually-focused approaches and the recognition that  children and families needed sound information make good decisions when it came to nutrition and physical activity led us to develop the 5-4-3-2-1 Go!® healthy lifestyle message.  The message was intended to be a roadmap for children and families to follow to ensure healthy and active lives.  As the years unfolded and the national and local research and experience base matured, we began to recognize the importance of altering the environments in which children and families find themselves – making health easier where kids and families live, work, learn, and play.  Known as policy, systems, and environmental change (PSE) strategies, these approaches support communities with the goal of making healthy options the default options.  5-4-3-2-1 Go! public education remains a foundation of what we do as a consortium, but it is now squarely supported by environmental change solutions that help families to achieve these recommendations more easily.  Our Healthy Places initiative is firmly rooted in the promotion of PSE strategies.

As the decade progressed, new research also emerged indicating that our initial focus on the three to five year old caused us to miss important opportunities to start prevention early in life.  An important study by Elsie Taveras showed that weight gain in the first six months of life was more predictive of weight at age 3 than was weight at birth.  Staff and partners began to look at emerging approaches across the country to reach children from “day 1” and even reach their parents during or just before pregnancy.  Breastfeeding emerged as an important strategy that we needed to support, and a focus on childcare institutions as a key context for obesity prevention solidified.  We created the Early Childhood Working Group to guide the consortium in these new enterprises. 

More and more science continues to emerge about the role that access to unhealthy foods and beverages plays in the obesity epidemic – that improving access to healthy options was necessary but not sufficient if we were really going to succeed at reducing childhood obesity rates in Chicago.  Following the lead of national organizations, we have begun to look at effective approaches to reducing the “at-your fingertip” access to foods and beverages high in calories from fat and sugar but low in nutritional value and to partnering with childcare, schools, workplaces, and city government to strike a better balance between access to healthier and less healthy foods and beverages.  In a similar vein, the field of obesity prevention practitioners has begun to look to non-traditional partners for increasing access to safe opportunities for physical activity. This involves partnering with land use planners, transportation professionals, and the business sector to increase access to parks, playgrounds, safe streets, and sidewalks where people, and especially children, can walk, run, ride, and engage in other forms of activity. 

Throughout this tenth anniversary year, we have been taking stock, asking questions, and doing some serious strategic thinking.  We have had three retreats involving staff, leadership, and national expert advisors to explore where the data and evidence suggest we must go in the coming decade.  We have gathered feedback from the consortium along the way through various means to ensure that these emerging plans are grounded in the experience and lessons learned of the many partners that make CLOCC what it is – a thriving, ever-growing national model for comprehensive, community-based childhood obesity prevention.  All of this information has been sifted and sorted, and it is the basis for our planning for the next decade.  New approaches to public education, refined strategies for policy and environmental change, innovative partnerships beyond the traditional obesity prevention advocates and practitioners, a strengthening focus on early childhood approaches, and effective methods for reducing access to and promotion of unhealthy foods and beverages will all be part of this next decade of work.  And, as ever, we will remain open to new ideas, emerging research and evidence, and the increasing collection of local and national best practices so the next decade is grounded in the many successes and lessons of our past, but also full of yet uncharted and endless possibility.  We are putting the final touches on a “blueprint for accelerating progress in childhood obesity prevention in Chicago,” and we are very excited to present it at the December 6 Quarterly Meeting.   We look forward to unveiling our plans with you, the culmination of this year of reflection and information gathering.  And we are inspired by the emerging vision of what we can do together in 2013 and beyond to achieve them!

Making Connections: Ten Years of Unique Partnerships

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Adam Becker

by Adam Becker, PhD, MPH, Executive Director

Welcome to the third quarter of our 10th anniversary year!  This quarter, we are focusing on one of the things that makes our consortium truly unique – the innovative partnerships that help us to span professional and geographical boundaries and take a holistic approach to confronting the childhood obesity epidemic in Chicago and beyond. 

In addition to the community-based organizations we highlighted last quarter, CLOCC also includes other segments of our community that are very engaged in our work and bring their own unique perspective.  These include our clinical, school, corporate, and advocacy partners.  From CLOCC’s beginning back in 2002, we recognized the importance of these segments and the importance of engaging them as we built our consortium.  In fact, the Clinical Practices, Government Policies and Programs, and School Systems Working Groups are among the original working groups from those early days!

The clinical perspective has always been a significant part of CLOCC’s focus and make-up.  Our founder, Dr. Katherine Kaufer Christoffel, was a pediatrician on staff at the Ann and Robert H. Lurie Children’s Hospital of Chicago (formerly Children’s Memorial Hospital).  Her vision for the consortium grew out of her daily experience in her clinical practice – seeing increasing numbers of obese patients in the Nutrition Clinic she also founded.  Being based at Lurie Children’s meant that we were immersed and well-versed in the clinical significance of this epidemic. 

Also from the beginning, we recognized that we could not address childhood obesity without significant engagement with local neighborhood schools and Chicago Public Schools as a district.  Children spend a significant percentage of their day in schools, eat at least one and sometimes as many as three meals a day on school grounds, and thus schools are ideal places to educate children about healthy eating and physical activity and create daily opportunities for them to practice healthy behaviors.  Our partnership with Chicago Public Schools extends all the way back to 2003, when we worked with school nurses to gather student body mass index (BMI) data using the Illinois Child Health Examination Forms submitted by every child at school entry.  This project led to a significant event in CLOCC’s history – the release of the first-ever prevalence data for Chicago children ages 3 – 7 in December of 2003.  This release, which was front-page news in the city, alerted Chicagoans that the obesity rate among these young children in Chicago was 2 ½ times the national average, and it put CLOCC “on the map.”  This marked the beginning of a very productive relationship with CPS, and they remain engaged in CLOCC in very important ways.  In fact, one of the major pillars of our Healthy Places project involves a partnership with CPS and Healthy Schools Campaign to promote school wellness and help CPS schools achieve “gold status” in the HealthierUS School Challenge.  Over the years, we have also worked with charter schools, Head Start centers, and other settings where children learn and play, and these environments continue to be a significant focus in our work. 

The corporate sector is a group whose active engagement in CLOCC generates a lot of interest.  CLOCC established the Corporate Advisory Committee (CAC) in 2004.  The CAC provides an opportunity for CLOCC and for-profit leaders to understand and learn from each other regarding the challenges and opportunities for obesity prevention from a unique perspective.  The CAC also gives corporations a place at the table to explore and implement obesity prevention strategies using their unique skills and resources.  We understood early on that the corporate sector has a role to play, and we have relied on their vision, expertise, and enthusiasm to tackle this problem over the years.  The CAC supported the work that went into creating our public education message, 5-4-3-2-1 Go!®, and they continue to support our efforts to spread the message throughout the city and state by helping to fund training, outreach, and educational materials.  These relationships are not without challenges as public health and for-profit priorities are not always exactly “in sync,” but we remain committed to active engagement and cross-learning and firmly believe that all organizations have a role to play if we are truly going to turn the tide on childhood obesity in Chicago and across the nation. I want to take this opportunity to especially thank our 10th Anniversary Sponsor, BlueCross and BlueShield of Illinois, whose generous support is making special 10 year anniversary activities possible.  You can read more about these activities here.

Our policy and advocacy work brings together the efforts of multiple sectors to make sure that children (and the adults that care for them) have opportunities to eat healthy and be physically active where they live, work, learn, and play.  Policy and advocacy work is one of the original cornerstones of CLOCC’s work.  In 2005, our efforts resulted in the adoption of Public Act 093-0966, which created the Illinois Childhood Obesity Study and Prevention Fund.  Also at that time, we convened over 80 stakeholder organizations to create the Illinois Childhood Obesity Prevention Consensus Agenda, resulting in five legislative bills whose passage we supported, with four of them being adopted as Public Acts.  These acts put tighter parameters on physical education waivers that schools could seek, added a nutrition and physical activity agenda to the mandate of the Illinois Early Learning Council, created an Illinois Food Policy Council, and created the state mechanism for disseminating federal safe routes to school funds.  In 2006, CLOCC established the City of Chicago Inter-Departmental Task Force on Childhood Obesity (IDTF), led by the Chicago Department of Public Health.  Originally comprised of four city agencies, the IDTF has grown to include 11 city agencies, all working together to address the childhood obesity epidemic as a city by deploying resources in a coordinated way. 

These details just scratch the surface of all the ways that our consortium has engaged diverse partners from multiple sectors in Chicago and beyond.  And strong diverse partners is exactly what our consortium will continue to depend on as we look toward the work of the fourth and final quarter of this remarkable celebration of our 10 years together!  Look for a new post from me in October when I will talk about CLOCC’s vision for the future.  With a decade under our belts as a consortium focused on the childhood obesity epidemic, what do we think the next ten years should look like?  Our fourth quarter activities will focus on what promises to be an exciting and challenging future.  Talk to you again soon!

Catching Up With the Go Team

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From 2006 – 2008, CLOCC ran a pilot program where we trained high school students from across the city to become members of the “Go Team,” a group charged with teaching the 5-4-3-2-1 Go!® message to young children across the city by leading them in games and activities. Over 25 high school students served as Go Team members over the two years, and they presented the message to over 5,000 children throughout Chicago. Recently, as part of our 10th anniversary celebration, we caught up with four of our alumni to find out what they are up to and to hear about their memories of the Go Team experience.

Ivan Zavala

Ivan Zavala Ivan Zavala Taste of Chicago

Ivan Zavala, a graduate of Kelly High School, was the only Go Team member to participate in the project from beginning to end. He is now 20 years old and a second-year student at the Pacific College of Oriental Medicine in Chicago working toward becoming a practitioner of Traditional Chinese Medicine. Ivan credits his experience in Go Team with giving him a foundation in health and starting him on a path that has led him to his interest in alternative medicine. He enjoyed his time with Go Team and its focus on teaching young children. “I like the commitment of Go Team to educate kids,” he stated. “We have an epidemic of childhood obesity and modern disease. I like that we went to the kids because kids are the foundation to the future. This nation is the tree and the kids are the root, and if you water the root, the tree will be prosperous.” Ivan is committed to healthy choices in his own life, sharing, “I take a walk every day, and I always follow the five fruits and vegetables a day recommendation. I have developed a taste for them – my palate has changed!”

Click on the video below to hear Ivan share one of his favorite Go Team memories:

Jamal Nelson

Jamal Nelson    WYCC Interview Jamal Nelson

Jamal Nelson, a graduate of Robeson High School, is now 20 years old and a sophomore at Knox College in Galesburg, IL, majoring in education and literature.  He plans to become a teacher and to pursue his interests in writing and art. Jamal credits his Go Team experience with giving him more confidence, stating, “Go Team had a big effect on me. It was my first job – having that kind of responsibility. Being in front of people and having to lead – that was my first experience like that ever.” Go Team was also Jamal’s first experience being around young children. “It was fun seeing the kids’ face – they enjoyed everything we were doing. I miss that – the enjoyment.  I found out that kids can laugh and have fun and play around with me, and I became freer about playing with them.  They were all having fun and smiling. I never thought I would have the ability to be that personable with young kids. I really enjoyed that.”

Jamal’s favorite Go Team memory is of his very first event as a member of the team: “One of the best memories I have was actually the first day that I started. We were at this preschool in Little Village. I remember freaking out before I even started. I was sitting there and trying to get myself ready to do this. I’m like, ‘I know what I’m going to say, I know what I’m going to say,’ and then, as soon as all the kids came out, there were so many of them. I stood there and thought, ‘Oh my God. I’m not ready to do this.’ I looked at my teammates, and they are looked at me like, ‘Calm down. You’re all right.’ And I thought, ‘You could tell me that but I’m not going to be able to do that.’ And then they pretty much throw me out there and say, ‘Do what we just did. You know what to do.’ And I remember when they first let me talk, and I just started doing it. I don’t know how, I don’t know what in my body let me do it, but as soon as they gave me the floor, I was able to conduct the event just like they did it. As scared as I was, I was able to do it.  And then they all said, ‘Good job, good job – you know what you’re doing.’ The reason why that is such a good memory of mine is because I just remember being in front of so many kids and my first-ever experience of talking in front of a big crowd and just accomplishing it. It was something I never thought I could do, and I did it – not just for the members on the team but also for myself. The first day – that’s what I’m always going to remember.”

Keanna Johnson

Keanna Johnson    Keanna Johnson    Keanna Johnson

Keanna Johnson, a graduate of the Chicago Math and Science Academy, is now 21 years old and attending school studying elder-care nursing and home assistance. She is also the mother of a three-year-old daughter, who Keanna is raising to follow the 5-4-3-2-1 Go! recommendations. Keanna enjoyed her time in Go Team and particularly liked meeting other high schoolers who shared the same interests as she did. Some of the information she learned about barriers to healthy eating as a Go Team member has resonated with her now that she is a mom. “I realized that although this is a good message to send out, it can also be an expensive message depending on the neighborhood you live in. I try to keep my family healthy, but trying to keep the refrigerator filled with fruits, vegetables, and dairy products can put a dent in my pocket. I also remember learning in Go Team that, depending on the neighborhood you live in, the prices of the healthy food can vary, and I noticed that is true.” Keanna’s favorite Go Team memory is about the team spreading the word about 5-4-3-2-1 Go!: “The memory that stands out is the thought of a group of young people travelling all around Chicago together to promote healthy eating and physical activity to children. That just really stands out to me.”

Deonta Blandin

Deonta Blandin Deonta Blandin

Deonta Blandin, a graduate of Al Raby High School, is now 21 years old and a student at Wright College in Chicago. He is also a courier with FedEx and the father of a two-year-old son. Like fellow parent Keanna, he is also following the 5-4-3-2-1 Go! recommendations at home, sharing, “I still use the fun tips and facts we learned about a healthy lifestyle in Go Team. We buy more fruits and vegetables at home and keep active as a family.”   Deonta liked the flexibility of the message, noting, “I liked that the message wasn’t just for a specific person, but for everyone of all ages – kids, teens, adults, parents, and grandparents.” He found his time in Go Team “a life changing experience,” and felt that it would be great if the Go Team reach went even further than it did, stating, “We did a lot of events that I wish we were still doing. It was what the city needed, and I think it is what our country needs.” Deonta has several favorite Go Team memories: “I just remember the smiles and laughter on the kids’, teens’, and adults’ faces when we challenged them, how most people caught on quickly to what we were teaching. I remember being part of the team – brainstorming, being educated also, doing interviews, and making videos. We had a great pact, and we were a great Go Team!”

DePaul Students Enhance Evaluation, Schools, and Advocacy Work at CLOCC

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DePaul University sign

by Elizabeth Katta, Meredith Jones, and Carolyn Jillson, Guest Bloggers

For the past two years, CLOCC has served as a 9-month practicum site for Master of Public Health students from DePaul University. After participating in an application and interview process, the students are matched with a position and site supervisor. This year, we hosted three talented students: Elizabeth Katta, Evaluation Intern; Meredith Jones, Schools Intern; and Carolyn Jillson, Advocacy Programs Intern. We are very grateful for their contribution to our work and their reflections below demonstrate the experience was also meaningful for each student.

Elizabeth Katta – As CLOCC’s Research and Evaluation intern, I was excited to see how a data driven organization conducts research and shares its results with Chicago partners. Working with Dr. Maryann Mason, Community and Evaluation Research Director, and Sarah Welch, Evaluation Manager, provided me the opportunity to take part in various activities within the Consortium, including data collection, community trainings, and organizational meetings. One of my favorite experiences was a SOPLAY (System for Observing Play and Leisure Activity in Youth) training at the Chicago Children’s Museum at Navy Pier. Sarah, Becca Calendo (CLOCC’s Health Educator) and I demonstrated a simple method to quantify activity in enclosed spaces. The fun, interactive activity demonstrated the Consortium’s dedication to providing useful services to their community partners. The bulk of my time at CLOCC was spent collecting data for my Capstone thesis, centered on an evaluation of CLOCC’s first breastfeeding study with the PCC Wellness clinic in the Austin community. I was able to see how community-based research is conducted as well have an opportunity to exercise my developing public health skills. My practicum time was invaluable because of these opportunities, and I hope to build upon the skills that CLOCC has helped me develop.

Meredith Jones – Serving as the School Systems Intern at CLOCC over the past year has afforded me the opportunity to understand the challenges and triumphs Chicago schools, teachers, principals, and PE teachers experience in sustaining a healthy classroom. Specifically through the Healthy Teacher Network, I enhanced practical skills such as event coordination and organized networking, evaluative skills when constructing instruments for program and workshop evaluation, and data collection and analysis as I compiled and streamlined large amounts of data on schools, individual teachers, and Chicago communities. Getting to know the structure and admirable objectives of the Healthy Teacher Network , which provides an environment conducive to teacher training and the exchange of valuable ideas for educators to use in their classrooms, will aid in my practice as a public health practitioner concerned with examining the structural determinants of health and coming to solutions for my community. The highlight of my time with CLOCC and the School Systems Working Group was the opportunity to interact directly with Chicago teachers who are passionate about implementing health-based strategies like physical activity breaks and nutrition education in their classrooms in order to improve the lives of their students. Their energy and devotion to the Healthy Teacher Network and CLOCC’s mission is truly contagious and emphatic.

Carolyn Jillson – I have really enjoyed working with CLOCC for my practicum at DePaul. I worked with Christine Bozlak, CLOCC’s Advocacy Program Manager, who provides technical assistance to the City of Chicago Inter-Departmental Task Force on Childhood Obesity (IDTF). I worked with CLOCC and IDTF to create a business plan for an IDTF Wellness Campus, a community-level intervention to coordinate and improve programing to improve health outcomes in neighborhoods with an especially high prevalence of childhood obesity. I found this project challenging, in that it required a big picture vision while I had to stay focused on the limitations of what is actually feasible. I learned a great deal about environmental approaches to complex health problems. Through this project I also became more familiar with a variety of governmental agency programs and partnerships and I was encouraged by the variety of effective and innovative programs and services currently being implemented in Chicago.

Thanks to our great DePaul practicum students for your enthusiasm, dedication, and hard work!  For more information on the Master of Public Health program at DePaul University, visit their website.

What Makes CLOCC Tick: 10 Years of Community Partnerships

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Adam Becker

by Adam Becker, PhD, MPH, Executive Director

Partners and friends,

April marks the beginning of the second quarter of our 10th anniversary year! This quarter, we are focusing on two of the hallmarks of the consortium’s operations – our community work and partnerships as well as public education in community settings.

Community partners are really what make CLOCC a consortium. When we started ten years ago, community organizations and advocates were among the first groups to get involved with the consortium and help to spread the word about the growing obesity epidemic in Chicago. The partnerships that formed and the voices of community partners shaped CLOCC’s mission, priorities, and intervention strategies. At the beginning, we literally built CLOCC organization by organization until we honed community intervention strategies that allowed us to bring partners together more effectively. Once a critical mass of organizations engaged, we formed working groups with specific areas of focus and expertise.

Working Groups continue to be an important engine for the consortium. Although they emerge and dissipate as the needs and interests of the consortium change, and they take different approaches to process and structure, all of them serve three primary functions:

• Keeping the consortium connected to the particular sector they represent and ensuring that the information and resources the consortium has is made available to that sector.

• Ensuring that the consortium as a whole learns from the expertise of those sectors.

• Helping to develop effective strategies for obesity prevention within that sector – sometimes leading to specific funded strategies.

While CLOCC has been and will remain open to partners from communities across Chicago and beyond, leadership agreed early on that we needed to hone our understanding of, and strategies for, addressing the challenges and opportunities for obesity prevention at the neighborhood level. To that end, we partnered with organizations in a few diverse Chicago communities. In 2004, we identified six communities (our “Vanguard Communities”) in which to place neighborhood-based staff and pilot community interventions. We expanded to ten Vanguard Communities in 2006. These community-based staff and their partners helped the consortium as a whole to learn effective ways to reach children, families, and the organizations that serve them. We learned what schools needed and contributed, how parks figure into the community landscape, who was involved in healthy food access activities, and what community priorities were for research and advocacy. In Humboldt Park, our partnership with the Puerto Rican Cultural Center and the Sinai Urban Health Institute, combined with funding from the Otho S. A. Sprague Memorial Institute, resulted in the development of Community Organizing for Obesity Prevention (CO-OP), a key coalition-building strategy of our community-level work. CO-OP was expanded through iterations in Englewood and Pilsen. The CO-OP strategy mobilizes existing community leaders and organizations, supports their collaboration to develop intervention strategies, promotes healthy eating and physical activity at the community level, and links clinical practices to community programs. Specific strategies that are locally relevant emerge under the guidance of CO-OP coalition leaders and members help identify and connect to approaches from other neighborhoods. The CO-OP HP experience is described in-depth in a book edited by staff at SUHI and will soon appear in a new edition of a classic book on community organizing for public health. Although the formal CO-OP structures in the three neighborhoods have merged into other local initiatives, CO-OP remains an option for CLOCC’s engagement in new communities.

In 2011, after a year of review and discussion with CLOCC staff and leadership, we decided to expand from a community-by-community model to a regional approach. Because the field of obesity prevention has matured and we have identified an emerging set of strategies in use in Chicago and across the country that have the most promise for creating change, we are shifting our approach in order to support and engage with more communities across Chicago to ensure that they too have access to this promising set of approaches. Our Community Networkers, formerly assigned to one specific vanguard community, have transitioned into a new role: Community Program Coordinators. In this new role, CLOCC’s community-based staff will connect to more Chicago neighborhoods and bring specific strategies, along with training and support to increase the likelihood of success to partners who are committed to obesity prevention and health-related work. Beginning this quarter, Community Program Coordinators will begin working in city regions – North, West, Southwest, Northwest, and South. We are excited about the new relationships we are already beginning to establish as a consortium as we move to this new model and look forward to connecting to partners in new and innovative ways.

One of the biggest resources we are able to bring to our community partners is our public education message, 5-4-3-2-1 Go!®,  and the tools for training and dissemination that come along with it. The message was developed by CLOCC in 2004, and to date thousands of community partners have been trained on it. Our vision is one of “surround sound messaging” in which children, families, and those who interact with them will see our message everywhere they go, reminding them of the five important elements of a healthy lifestyle – designed with young children in mind but healthy for everyone. To realize this vision, we blanketed Chicago with 5-4-3-2-1 Go! posters, billboards, and CTA advertising in the fall of 2009 as part of a citywide advertising campaign. Hundreds of CLOCC partners helped with distribution, participated in special events, and disseminated the message to their own constituencies. 5-4-3-2-1 Go! materials have been downloaded in 49 states and 18 countries around the world. The demand for 5-4-3-2-1 Go! became so great that we brought on a full-time Health Educator in 2009 to focus exclusively on message training and outreach.

The future of our community work and public education outreach looks bright. Our Healthy Places initiative has helped us to develop and hone a diverse set of environmental change strategies to improve access for all Chicagoans to healthy food and safe opportunities where they live, work, learn, and play – especially in those communities where access is insufficient and obesity-related health disparities occur. Many of these strategies are based on those we piloted in CLOCC’s early work in the vanguard communities. We expect to provide training and technical support to community organizations across the city to support implementation of these new strategies. We will continue to offer free trainings several times a year so interested organizations can learn about 5-4-3-2-1 Go! and explore ways to integrate it into their programming. We are also developing a pilot project to work with organizations to integrate 5-4-3-2-1 Go! more deeply at their organizations in addition to using it in their programs; ensuring that organizational practices, policies, and environments are aligned with the message. As interest in the message grows locally and across the region and nation, we will explore new opportunities to support its use.

CLOCC staff and leadership are grateful to all of the community partners who help keep our consortium strong and vibrant. We are humbled by all that they have taught us. We look forward to new and exciting ways to build on and expand this critical element of our collective work. As a special way to celebrate our community partners during our 10th anniversary, we have launched the We are CLOCC contest with a $2,500 prize – go here for more information.

Next quarter, we will continue along the theme of partnerships and take a deeper look at some of our very unique partnerships beyond those in geographic communities. My July blog post will explore the consortium’s work with corporations, government, schools, and the clinical sector. Talk to you again soon!

Planting a Seed (Grant) and Watching It Grow

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Amy Bohnert

Amy Bohnert

by Amy Bohnert, PhD, Guest Blogger 

As part of our 10th anniversary first-quarter focus on data and research, we asked 2006 seed grant recipient Amy Bohnert, PhD, Associate Professor of Psychology at Loyola University Chicago, to write about her 2006 seed grant project and what happened next.

It started as an idea that my best friend and I casually discussed over dinner. What about designing a plate that can help children and families learn about healthy eating? We could even do an experiment to determine whether it works in changing behavior. This was the beginning of the Nutri-plate. The first step was applying for a seed grant from CLOCC to get the money to support the pilot research. Five years later, we had a publication detailing the promising findings from pilot work in the Journal of Nutrition Education and Behavior and had founded a company that sells the Nutri-plate. How did we get there?

The most important step was obtaining the funding from CLOCC to develop and evaluate the plate. This happened by applying for a CLOCC seed grant.  My proposed pilot, Evaluating the Impact of Nutritionally-Designed Dining Ware on Food Choices: A Pilot Study, was funded in June of 2006. In that study, sixteen African American adolescents (mean age = 12.94 years; 66% male) were randomized to participate in either plate design or nutrition education sessions. Adolescents’ input was used to create a dinner plate that would show healthy amounts and types of food that should be eaten at meals, what became known as the Nutri-plate. Participants’ food selection and intake was also evaluated. Adolescents indicated the Nutri-plate should include simple yet colorful visual and textual information about healthful eating. We also found that when using the Nutri-plate, participants selected less food overall, more fruit, and more broccoli au gratin. Participants with higher BMIs selected a greater amount of healthful food when using the Nutri-plate.

Whenever we presented this data, we always got the same question, “Where can we buy one of these plates?” At first, we did not have an answer. The Nutri-plate we manufactured for the study was not cost-effective at more than $20 per plate. We could locate manufacturers, but how could we decide if we should take the risk and invest the capital needed to sell the Nutri-plate? We decided that it would be good to do more market research before proceeding. In June of 2008, we exhibited the Nutri-plate at a childhood obesity conference in Los Angeles, CA and received a very positive response. Based on this, we decided to create a company and pursue the commercial side of our research venture.

Although we had been warned that it would be a long process until we actually could sell plates, we never quite believed it. Much like the process of research, setting up a company to sell a product involved many complex steps. Were it not for our enthusiasm, we might have easily given up. We learned how to write articles of organization to form a corporation, create a website, apply for a trademark, set up simple accounting practices, pay sales tax, secure product liability insurance, and write up a business contract. A critical piece in this process was having friends who were willing to consult with us when we got stuck. We tried to find ways to distinguish our product by publishing the data demonstrating its effectiveness in changing behaviors.

The payoff has not (yet) been monetary—we are still in the “red.” We do have customers all over the world contact us – Canada, Brazil, Costa Rica, England, Australia – with inspiring stories and interest in our product. Some of our favorite stories are close to home. My daughter and many of her friends joyfully takes their Nutri-plates to school every day. These are the rewards, but the ultimate prize is getting children and their families to discuss, engage, and enjoy healthy eating.  To think this all started from my CLOCC seed grant in 2006 – from small seed grants, great things can grow!

Nutri-plate

The Nutri-plate promotes healthy eating by indicating the portions and types of food that make up a healthy meal.

Revealing the Research: 10 Years of Being Data-Driven and Evidence-Based

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Adam Becker

by Adam Becker, PhD, MPH, Executive Director

Happy New Year!  2012 is an especially happy new year for CLOCC as it marks our 10th year as a Consortium collaborating on childhood obesity prevention in Chicago and beyond!  I hope that as partners you will feel as proud of our shared accomplishments as we do as staff members.  Throughout this 10th year we will be reviewing our past successes, highlighting our current collaborative work, and visioning for our future. We have several special events and projects planned that will unfold in 2012 to commemorate this important 10-year milestone – watch for details in the coming weeks and months!  We have organized these activities around quarterly themes that have been important for CLOCC as we’ve grown since 2002 and that will carry us into the next 10 years. In our first quarter, we reflect on data and evidence.  These were instrumental in the consortium’s origins as we built our efforts on what we knew and what we still needed to learn about childhood obesity in Chicago.  We will also focus this quarter on research and how it undergirds our data-driven and evidence-based approach.

So first, I would like to remind you of where we began.

Thanks to the vision of our founder, Dr. Katherine Kaufer Christoffel, and initial funding from the Otho S.A. Sprague Memorial Institute, CLOCC came into being in late 2002. Our first meeting drew about 40 people from across the city – pediatricians, staff from community-based organizations, researchers, representatives from city agencies, and others. We were a diverse group even then! 

It may be hard to believe now, but back in 2002 we faced the hurdle of convincing people that the childhood obesity epidemic was actually real, so data and evidence have always been important to CLOCC. The gathering and dissemination of data served us well at the very beginning when, under the leadership of our founding Executive Director, Matt Longjohn, we started to build our consortium. Most people had no idea where the city stood in terms of childhood obesity rates, but our interest in finding out helped Kathy and Matt to make the case to potential partners that they should get involved in this growing collaborative effort. In fact, back in 2002 the prevalence data were scarce, but even the little we had told an alarming story.  The 1999 National Health and Nutrition Examination Survey (NHANES) data indicated that 13% of children ages 6 – 11 and 14% of adolescents ages 12 – 17 were obese.   Our goals back then were to share the data we had to motivate individuals and organizations to join the consortium and to work toward collecting more.

A major early success was the release of the first citywide prevalence data for Chicago children entering school for the first time (children aged 3 – 7) at the end of 2003. They were collected through a partnership with the Chicago Public Schools and the Archdiocese of Chicago under the leadership of research scientist Dr. Maryann Mason, who now serves as our Community Research and Evaluation Director. The data showed that nearly one quarter (24%) of Chicago children were entering school already obese — two and a half times the national average at that time. This data release literally put CLOCC on the map, with coverage on the front page of both the Chicago Tribune and the Chicago Sun-Times.

Since those early days we have worked hard as a consortium to keep our collective eyes on obesity rate data. We held the Child Health Examination Surveillance System Summit in 2008 to develop statewide consensus and gather recommendations to create a surveillance system using data from the child health examination forms. While attention to the issue has ebbed and flowed over the years, the state is showing re-emerging interest. The Illinois Alliance to Prevent Obesity, a statewide coalition of organizations focused on obesity prevention for all Illinoisans, identified surveillance as one of three top priorities for their first year of action. The city is making great strides as well, with a five-year inter-agency agreement between the Chicago Department of Public Health and Chicago Public Schools to look at prevalence rates now and into the future. These advances have grown out of our consortium’s initial work and are laying the groundwork for a system that would provide up-to-date and annual  obesity prevalence data.  These data will help us as a state and city to allocate resources strategically, where prevention and intervention are needed most – decisions that are best made when data-based.

CLOCC staff and partners conducted a second round of surveillance in 2009. The great news was that we found a reduction of 2% in the overall prevalence of obesity among children aged 3-7 years old. The not-so-great news was that even with this new prevalence rate of 22%, we were still twice the national rate of 10.4%. Knowing that our staff would not have the resources to continue to do this surveillance at the frequency with which it is needed, we have been advocating for the state and the city to create a sustainable system for monitoring child health statistics, with a focus on obesity.

But data and surveillance have not been our only activities related to generating knowledge about the issue. In 2003, we kicked off our Seed Grant Program.  CLOCC Seed Grants provide small amounts of funding to support the development of local research and evaluation efforts to contribute to our knowledge base and to increase the capacity of local investigators to get increased funding to continue or expand their work.  In 2007, we revised the Seed Grant Program to fund fewer projects but at greater amounts.  In 2010, we released a report on the impressive work done through our Seed Grant award recipients.  A number of our grantees have been able to publish in national journals, influence local policy, expand local programs, and obtain large federal grants to continue their work. 

Here in the CLOCC office, some of our staff members have also conducted research; some on behalf of our partners.  For example, I led a study to help the City of Chicago Inter-Departmental Task Force on Childhood Obesity understand that impact that the new standards for food and physical activity in childcare centers have on center practices in low-income communities across Chicago. The findings of this study have already begun to help shape education and training mechanisms for Chicago’s childcare providers and have contributed to a statewide interest in the role that childcare providers can play in the health of the very young. Other research we conducted in our first ten years has included exploration of expanding obesity prevention services tied to distribution of free produce, evaluation of the Open Streets initiative which closed street routes to auto traffic to create safe places for physical activity in five Chicago communities and evaluation of a Chicago Park District program designed to provide opportunities for increased physical activity in after school programming.  We’ve also conducted multiple waves of a community health survey in Humboldt Park and Englewood and done a baseline survey in Pilsen

Looking to the future of our data, research and evaluation activities, we will continue to provide evaluation services and capacity building to CLOCC partners.  We will continue to support CDPH and CPS as they develop a system for reporting on childhood health indicators, including BMI.  We will continue to encourage the State of Illinois to develop a similar system.  And we will continue to monitor and disseminate the most up-to-date research from across the country to help us locally to remain on the cutting edge of best-practice obesity prevention strategies.  You can also look forward to further changes to our Seed Grant program – with a more specific focus on policy, systems, and environmental change – an important emerging element of our work in Chicago communities.

And this brings me to next quarter’s theme!  Look for a new post from me in April when I will talk about the lifeblood of CLOCC, our community partnerships – past, present, and plans for the future. Talk to you then!

Our 2003 data release was the lead story in the December 3, 2003 issue of the Chicago Sun-Times.

Crossing Oceans and Moving Mountains: Reflections from CLOCC’s Founder

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Katherine Kaufer Christoffel

Katherine Kaufer Christoffel

by Katherine Kaufer Christoffel, MD, MPH, Founder and Medical and Research Director 

At the CLOCC holiday dinner this year, I had the chance to present a short talk to reflect on and celebrate nine years of CLOCC. I shared thoughts on how CLOCC went from the twinkle of an idea of mine to the impressive force for change that now involves the many individuals and organizations in the consortium.  Here are some highlights, which may be of interest to the broad range of people who are interested in CLOCC and its work. 

The theme I used was ‘crossing oceans and moving mountains’, reflecting both my meandering path and its lessons, and also the path that CLOCC has taken: to create CLOCC’s broad coalition, we have had to cross boundaries as forbidding as oceans.

My journey started a few years after WWII, when I was born in NYC to two immigrants from Eastern Europe, who crossed oceans in their childhoods to reach a new life and who were actively committed to education and social justice. I was raised in Stuyvesant Town in Manhattan, a kind of urban suburb with a lot of green space and no through traffic.  I had a fine education in the NY public schools, and then in college and medical school.  Much of what I know about ground-up policy change was learned in anti-war activism in Boston during college and the years that followed. That work required base-building and coordination of effort around the campus and around the country. It taught me about compromise and how it is unwise to be too sure about things, as there is always much to learn and history has a way of showing those who are certain to be fools. 

Those early years taught me lessons that I later applied to CLOCC. I learned that oceans can be crossed, life’s obstacles can be overcome, mountains of injustice can be identified and moved. That it takes many to achieve important goal. The successes of the civil rights and anti-war movements taught me boldness and optimism. 

It was when I entered medical school that I dedicated myself specifically to health and health promotion.  My choice of pediatrics was made because I was sure that caring for children would always remain compelling and optimistic.  It was and it has been a pleasure and privilege working with children and families. I am humbled and always will be by the welcome granted to me to enter the private space that children share with their adults. The physical exams are intimate, of course, but in many ways that is the least of it. To be of help, I had to learn how families work, hour by hour, week by week, year by year. People trusted me to pry and spend time with them to learn about them. To cross the ocean that divided us. My attention gradually turned to problems related to primary calorie imbalance, both malnutrition and obesity, and this became my clinical focus for decades. 

After residency, I began my public health studies. This took me beyond a purely clinical focus, and on to research. The research ultimately led to advocacy, particularly related to injury prevention, and most particularly to firearm injury prevention.  I learned many lessons from that work and its challenges and successes, and these informed the design of CLOCC.  Some memorable ones are these:

  • Partner with others who have complementary work preferences and skills.
  • Understand your limited perspective.
  • Remember that many things can’t be controlled.  
  • Work in teams, which achieve the most and provide perspective. 

In terms of oceans and mountains, this phase taught me not to stop at the oceans (between medicine and other realms), to take the measure of the mountains being moved and plan appropriately (when needed, audaciously), and to take a long view.  

When evidence of the obesity epidemic showed up in my examining room, I saw that protecting kids from this scourge requires approaches well beyond what can be offered in the clinic. This was clearly a very big mountain indeed, spanning many areas of life and unjustly affecting the most those most in need. I took its measure and concluded that what was needed was a very comprehensive approach, with a focus on primary prevention and so an emphasis on young children. 

What I proposed to funders was a multi-sector coalition that would address issues at multiple social levels, from patients to families to communities to society and policy. Chicago was fortunate that the Otho S.A. Sprague Memorial Institute invested in this early, when it was still an idea, and then for several years. With the effort of many and the support of numerous funders, CLOCC today connects regularly with over 1,200 organizations and over 3,500 individuals.   Led by two extraordinary Executive Directors—Matt Longjohn and Adam Becker—and working in every social sector, CLOCC staff and partners have really built something remarkable!    Our experience together confirms that the lessons I learned in other arenas—about oceans and mountains, audacity and optimism—are applicable in this one. 

CLOCC has some big accomplishments that are worth savoring, including (in no particular order): 

  • This month saw CLOCC’s 36th Quarterly Meeting!  Each one draws around 150 or more participants and is remarkable in its diversity.
  • Chicago is home to the award-winning Inter-Departmental Task Force on Childhood Obesity (IDTF), midwifed by CLOCC, led by the Chicago Department of Public Health (CDPH), and now including 12 city agencies.
  • CLOCC’s healthy lifestyle message, once a dream, is the well-established 5-4-3-2-1 Go!.  It has been translated into several languages, is widely taught and used across Chicagoland, and is a living tool in 49 states and several nations around the world.
  • CLOCC, under the leadership of Maryann Mason, CLOCC’s Community Research and Evaluation Director, developed a novel way to use school health forms to measure obesity prevalence in school kids. We documented that 26% were obese at school entry in 2003 and later that this rate had fallen to 23% in 2008, showing the power of the coordinated obesity prevention approach that CLOCC built.
  • Healthy Places is the Chicago obesity prevention project funded by the federal Communities Putting Prevention to Work Program. CLOCC manages it, as the bona fide agent for the City, working closely with CDPH and other city agencies and with community groups. This project is meeting ambitious goals in areas that include increased access to healthy foods, improved safe use of parks and streets, healthy school environments, and increased breastfeeding support in the city’s 19 maternity hospitals.
  • CLOCC has been tapped to share its experience with other cities, with researchers at NIH, with faith and community leaders gathered by the White House, and many others. People around the country know CLOCC and notice what we do. 

In these and other ways that continue to increase and expand, CLOCC consistently crosses oceans to share practical approaches to moving the obesity mountain. Of course there is much still to be done, but we can already be very proud of what CLOCC is and has already done!

I hope the wonderful CLOCC team will always be audacious and optimistic, like the original twinkle of the CLOCC idea.  And I hope that everyone in CLOCC will remember, in this important, collaborative work, the three things that form the heart of all work in public health, which I learned from a colleague who learned it from a colleague … and now some of you are learning them from me.  The 3 Ps are easy to remember:  Patience, Persistence … and a sense of humor.  

Taking Walkability to the Streets at the Safe Routes to School National Conference

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Grant Vitale

by Grant Vitale, Community Programs Manager 

CLOCC Community Networkers Ed Boone, Elvia Rodriguez-Ochoa, and Miguel Morales and I recently attended the Safe Routes to School (SRTS) National Conference.  It was held on August 16-18, 2011 in Minneapolis, Minnesota.

The Safe Routes to School National Conference now in its third year was hosted by the National Center for Safe Routes to School and the Safe Routes to School National Partnership. 

Ed and Miguel presented a Mobile Workshop on Coalition Building and the Neighborhood Walkability Assessment Tool under the conference heading, Coalition Building and SRTS Programming.  Ed’s presentation focused on the successes of neighborhood coalition building in West Humboldt Park and Miguel’s presentation focused on the Neighborhood Walkability Assessment Tool and how to use it in community neighborhoods.  People from a variety of organizations and disciplines attended the workshop.  They turned out to be a group that was quite engaged and interested in the information presented.  They commented on how interesting the CLOCC tool was and how it makes one think about intersections and blocks in a completely different way.  It was great to take them out on the streets and show them how to assess the walking environment.

The SRTS National Conference offered walking tours and bike tours of Minneapolis as well as mobile workshops.  The mobile workshops addressed a number of topics such as design solutions to increase cycling and safety and assessing walkability for users of ages and abilities.  There was also breakout sessions on a wide variety of topics including injury prevention and social equality.  Antonio Rosell from Community Design Group in Minneapolis conducted a presentation on community participatory engagement, which gave great examples on how to ensure community member participation and input for different types of projects and plans.  Some of the concepts and ideas he presented will be very useful for the Networkers to use in neighborhoods when they are working to engage a wide variety of community members on a project.  Ed Ewing from Bicycle Club Cascade presented on the Major Taylor Project which is very successful in engaging youth in cycling in the Seattle area.  I especially enjoyed his presentation because it demonstrated the tremendous benefits of engaging youth in cycling.  The youth learned how to ride bikes and they acquired bicycle maintenance skills.  They were also able to progress from just learning how to ride to participating in endurance rides, which was amazing to see.  This session definitely relates to our work in West Town.

For more information on walkability, visit the Walkability Assessment page on the CLOCC website.  For more information on Safe Routes to School, visit the Safe Routes to School National Partnership website.

SRTS conference

Miguel leads conference participants in a neighborhood walkability assessment

SRTS workshop

Miguel (left) and Ed present at their workshop