2003 Model Practice Application (Public)

Eat Well, Play Hard

Elyria City Health Department

“Eat Well, Play Hard” is a multi-faceted program that promotes healthy nutrition and physical activity practices in children. It targets elementary age children and their families. Using the “Eat Well, Play Hard” theme, with permission of the New York State Health Department, the program utilizes a variety of materials and activities to provide children with consistent and positive messages about nutrition and physical activity. The goals are to increase developmentally appropriate physical activity, to increase the consumption of fruit and vegetables by children, and to increase the consumption of low-fat milk products and calcium-rich foods. The long- range goal is to incorporate this theme into the life of Lorain County children through collaboration with schools, agencies and facilities that provide services and activities for children and their families. The program has reached members of the target audience through elementary school and recreation department programs.

The program addresses the need to reduce the prevalence of overweight children through increasing their activities in concert with the introduction of healthful eating habits. Innovative approaches have included the utilization of healthful snacks for children at an after-school recreation department program and the provision of incentives (jump ropes, Frisbees, water bottles) for the completion of food diaries by elementary age children. These “diaries” need to show that the child has eaten fruits and vegetables every day for the interval which is usually two weeks. The registered dietician has worked with schools to make “small step” changes – the replacement of whole with 2% milk in a cafeteria program, presentation of a Healthy Snack Tasting as part of a school field day, the integration of the theme into Health Fairs at which the Health Department participates throughout the year.

The Elyria City Health Department, working with the nutritionist, sponsored the program through the Child and Family Health Services (CFHS) MCH grant. The program has been integrated into every activity of the county CFHS Consortium, providing the theme for most of the collaborative community activities. Public schools in the three urban centers of the county (Elyria, Lorain and Oberlin) have willingly participated as well as one parochial school. The Elyria Parks and Recreation Department has integrated the “Eat Well, Play Hard” theme and program into its elementary school activities for the past two years. Collaboration with community agencies has been facilitated because it is clear that the theme can easily be integrated into existing programs without major revisions. The goal continues to be to make it a theme for all of Lorain County – not only for children but for all!

One fast food chain has been willing to add fresh whole fruit as a dessert choice in one site frequented by school age children. There has been some progress in encouraging teachers and room mothers to incorporate healthy choices into elementary classroom parties.

The program has an annual budget of $10,500, supported by the CFHS grant through the Ohio Department of Health. Approximately, 60% of the budget covers the part-time nutritionist expenses. The remainder supports the purchase of incentives and snack food ingredients, printing of local educational material, and the purchase of carefully selected commercially developed material. The collaboration with local groceries as well as national cereal companies has netted donations used as “treats,” and resulted in sustained partnerships with proprietary organizations.

Funding has been part of the CFHS grant for five years and it is anticipated that it will continue to be funded in that way. It has proven to be a positive and successful public health activity with potential for permanent inclusion as a community-wide theme.

The permanent changes in food available in schools and food service organizations are indicative of influence and impact. The increased request for presentations about the program is another measure of impact. There are no statistical data at this point. The program is focusing on changing behaviors, a difficult outcome to measure. There have been incremental changes and they are expected to continue.

The expectations for the program have been kept at a realistic level. When dealing with behavior change, it is essential to be willing to appreciate “small steps.” It is also important to be consistent, persistent, and subtle in the integration of this concept into the “normal” activities of the community. It needs to just evolve until it is just a “given” in the community’s perspective.

It is essential to involve local groceries and food establishments as well as national companies that can provide samples which become the healthy snack incentives. Additionally, working with a recreation department provides another opportunity to provide a “fun” setting for children to learn.

The absolute essential element has been and will continue to be a nutritionist who has taken the lead, who is enthusiastic and yet realistic, and who is willing to be flexible in her availability. She definitely has approached this project with an “out of the box” perspective that has sustained its development through the past five years. A second essential is the attitude of the ECHD administration that acknowledges that the “small steps” are worth celebration and ongoing support.