Donna B. Johnson

Objectives Child care is an important setting for the promotion of physical activity (PA) in early childhood. The purpose of this study was to examine the associations between specific PA environments and recommended practices in child care settings as well as the degree to which child care settings met recommended standards for total PA time. Methods In 2013, all programs licensed to care for children ages 2–5 in WA state were surveyed about their PA related practices. Logistic regression was used to determine odds of meeting best-practice standards for outdoor time and PA. Results The response rate was 45.8 % from centers (692/1511) and 32.1 % from homes (1281/3991). Few programs reported meeting best-practice standards for the amount of time children spend being physically active (centers: 12.1 %, homes: 20.1 %) and outdoor time (centers: 21.8 %, homes: 21.7 %). Programs where children go outside regardless of weather and those reporting more adult-led PA had higher odds of meeting best-practice standards for both PA and outdoor time. Meeting best-practice standards for outdoor time was the strongest predictor of meeting best-practice standards for total PA time [centers: OR 15.9 (9.3–27.2), homes: OR 5.2 (3.8–7.1)]. Conclusions for Practice There is considerable room for improvement in licensed child care settings in WA to meet best-practice standards for young children’s outdoor and PA time. Initiatives that create policies and environments encouraging outdoor play and adult-led PA in child care have the potential to increase physical activity in substantial numbers of young children.

The Washington State Nutrition and Physical Activity Plan provides a framework in which policy makers can work together to build and support healthy environments for nutrition and physical activity. The city of Moses Lake, Wash, was chosen to serve as a pilot site to test the conceptual approaches and recommendations of the plan and to develop a model for healthy communities elsewhere in the state. Moses Lake is an ethnically diverse, geographically isolated town with a population of about 15,000. An advisory committee used data from an inventory of local policies and environments, along with the recommendations from the state plan, to develop a plan for Healthy Communities Moses Lake. Three initiatives were chosen for the first actions: a connected system of trails and paths, enhanced facilities for breastfeeding in the community, and a community garden. Records of cumulative actions demonstrated that Healthy Communities Moses Lake continued to be an active and productive project. Initial measures of success were collected by each of the three first action teams. Environmental changes will be monitored by comparison with the initial inventory of local policies. Long-term health outcomes in Moses Lake will be monitored by the Washington State Department of Health. Healthy Communities Moses Lake was successful because the city had leaders and volunteers who were committed to making the city a healthier place. Lessons learned about community-based planning and evaluation are now being applied to Healthy Communities initiatives.

Washington State's Healthy Communities pilot projects were developed to test approaches and recommendations of the Washington State Nutrition and Physical Activity Plan and to provide a statewide model for implementation. The Healthy Communities program included plans for ongoing process evaluation to ensure implementation. Two years into the first project, however, the evaluation team recognized that data for evaluation were inadequate to explain the experiences of the pilot community partnership. The team sought a framework through which to better understand how the community partnership functioned, including what worked well and how guidance and technical assistance could best be provided. The evaluation team identified the community health governance model of Lasker and Weiss through a literature search and applied this model to existing Healthy Communities project evaluation data. The team also designed a new survey tool based on the model and used it in the second pilot community. The new tool provides feedback to community partners to help guide project implementation and tests the applicability of a theoretical model to public health practice.

Purpose.: To evaluate a statewide campaign that was designed to reduce television viewing by clients and staff of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Television reduction is frequently recommended as a strategy for preventing pediatric overweight. Methods.: Data were collected from a convenience sample of 10,445 clients and staff who attended clinics during a 3-week period before the intervention and 9188 clients and staff who attended clinics after the intervention. Chi-square tests were used to compare the proportion of WIC clients watching television 2 or 3 hours per day before and after the intervention. Within the context of WIC, which is a large and complex public health program, it was not possible to measure individual exposures or response rates. Results.: At baseline, 64.2% of WIC clients reported watching 2 or less hours of television per day. After the intervention, 70.5% limited television viewing to this recommended level. Conclusions.: It is feasible to deliver television-reduction messages in large public health programs.