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2013 Model Practices (Public)

Practice Title
The SEL Project
Submitting LHD/Agency/Organization
Cuyahoga County Board of Health
City
Parma
State
OH
Submitting LHD/Agency/Organization Web Address (if applicable)
www.ccbh.net

Provide a brief summary of the practice in this section. This overview will be used to introduce the model or promising practice in the Model Practices Database. Although this section is not judged, the judges use it to get an overall idea about your practice. You must include answers to the following questions in your response:

• Size of population in your health department’s jurisdiction
• Who is your target population/audience, what is the size of your intended population/audience for this practice and what percent of your target population did you reach?
•Provide the demographics of your target population (i.e. age, gender, race/ethnicity, socio-economic status) 
• Describe the nature and gravity of the public health issue addressed
• List the goal’s and objective(s) of the practice and clearly link them to the problem or issue the practice is addressing.
• Describe the potential public health impact of the practice, and the likely effectiveness of the practice being implemented as intended, and the ease of adoption of the practice by other LHDs.

In your description, also address the following
• When (month and year) the practice was implemented.
• Briefly describe how the practice was implemented, what were major activities, and any start-up and in-kind costs and funding services.
• Outcomes of practice (list process milestones and intended/actual outcomes and impacts.
• Were all of the objectives met? 
• What specific factors led to the success of this practice?

1) Size of population in health jurisdiction: 854,000 2) Target population: Students in grades K-12 in the South Euclid Lyndhurst School District (SELSD) 3) Demographics: The SELSD has a diverse population of 4,000 students (60% African American, 5.6% Multi-Racial, 31.2% Caucasian, 2.1% Asian, and 1% Hispanic). Fifty-two percent of students qualify for free and reduced meals, and forty-eight percent of students reside in households that meet the criteria for economic disadvantage. 4) Nature of Issue: Childhood obesity has contributed to an increased number of students coming to school with adult chronic diseases and has led to a generation of children with shorter life expectancies. Results from the 2010 and 2011 Cuyahoga County Youth Risk Behavior Surveys show that only 26.9% of middle school and 22.6% of high school students met the recommendations for fruit and vegetable intake, while 68.9% of middle school and 75% of high school students consumed fast food at least one day per week. These alarming statistics prompted the Cuyahoga County Board of Health (CCBH) to create innovative strategies to combat childhood obesity and create healthy eating environments that support decreasing chronic disease rates, with a particular focus on the County's most disadvantaged school districts. 5) When was the practice implemented: September 2010 6) Goals and Objectives: -Increase the number of students participating in the SELSD meal program -Increase dollars spent in the Northeast Ohio food economy -Increase the number of experiential learning opportunities for students around agriculture and nutrition 7) How was the program implemented, major activities, start up costs: Since 2009, the CCBH has been a regional leader in bringing the nationally recognized Farm to School (F2S) program to Northeast Ohio as an innovative strategy to address childhood obesity. A strong, four-way partnership between the CCBH, SELSD, AVI Fresh, and Red Basket Farm, resulted in the successfully implemented first farm to school program in Cuyahoga County in September 2010. Major Activities: August 2010: Program planning • September 2010: The SEL Project kick-off • November 2010: All six district cafeterias receiving locally procured produce from Red Basket Farm • November 2010-June 2011: Continued integration of locally procured produce into meal program; monthly strategic planning meetings held • September 2011-June 2012: Continue integration of locally procured produce into meal program; monthly strategic planning meetings held • November 2011: Year one outcomes report released • December 2011: Passed board-approved wellness policy containing F2S language • March 2012: NACCHO Promising Practice Award • September 2012-June 2013: Continued integration of locally procured produce into meal program; monthly strategic planning meetings held • November 2012: USDA Farm to School grant announcement (pending) and release of year 2 outcome report (pending) Funding Sources: • CCBH in-kind support provided by the Ohio Department of Health Child and Family Health Services grant • Grant awards received during practice implementation: o $18,000 awarded from the Great American Salad Bar project o $2,000 from the Ohio Department of Agriculture o $1,500 from the CCBH Child and Family Health Services o $7,500 from the Legacy Village Foundation o $22,000 from Fuel Up to Play 60 o $350 from Sunview PTA o $2,000 from the Whole Foods Foundation o $700.00 from Greenview PTA

Overflow: Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

8) Outcomes: 12.5% increase in school meal participation; 38% increase in amount of money spent in Northeast Ohio food economy; 16% decrease in total loss in food service budget; 16 item increase in number of locally procured product integrated into meal program; establishment of 3 school gardens; integration of agriculture curriculum into after school garden club; farm expansion by an additional 8,000 square feet of growing space
You may provide no more than two supplement materials to support your application. These may include but are not limited to graphs, images, photos, newspaper articles, etc.
Describe the public health issue that this practice addresses. (350 word limit)
Recent research on the root causes of chronic disease and disparities associated with them suggest that improving health outcomes, particularly in disadvantaged communities, would be most successful with a greater focus on social, economic, and environmental conditions that drive health. Emerging strategies to address health inequities suggest a multi-pronged, multi-sector approach addressing upstream factors including neighborhood conditions, institutional practices, and values through policy change with a simultaneous investment in human capital. The 2010 American Community Survey estimates that 25% of all children in Cuyahoga County are living in poverty. Childhood obesity rates in the County continue to climb – 37.7% of 3rd graders were overweight or obese in 2010 as compared to 33% in 2005 (Ohio Department of Health). Low income, racial, and ethnic minority children were significantly more likely to be obese compared to other children. While some communities in Cuyahoga County are equipped with resources that support healthy living across the lifespan, other communities could benefit from additional coordinated efforts to achieve the same outcomes. Childhood obesity has contributed to an increased number of students coming to school with adult chronic diseases and has led to a generation of children with shorter life expectancies. Results from the 2010 and 2011 Cuyahoga County Youth Risk Behavior Surveys (YRBS) show that only 26.9% of middle school and 22.6% of high school students met the recommendations for fruit and vegetable intake while 68.9% of middle school and 75% of high school students consumed fast food at least one day per week. These alarming statistics prompted the Cuyahoga County Board of Health (CCBH) to create innovative strategies to combat childhood obesity and create healthy eating environments that support decreasing chronic disease rates, with a particular focus on the County’s most disadvantaged school districts.
What process was used to determine the relevancy of the public health issue to the community? (350 word limit)
Recognizing that we are facing the first generation of children expected to live shorter lives than their parents, the CCBH has been committed to establishing and enhancing partnerships, programs, and services that support healthy choices for our County’s youth. Guidance on how to support these choices has been provided by the recent passage of Ohio Senate Bill 210, The Healthy Choices for Healthy Children Act. Containing provisions to combat childhood obesity by increasing students’ physical activity and ensuring access to healthy meals and beverages at school, the law mandates schools to build physical activity into the school day, increase physical education requirements for both students and teachers, advocates for use of body mass index measurements, and requires the adoption of comprehensive nutrition policies across the school campus. While there is clear evidence that health positively impacts student academic achievement, lack of political will has previously prevented many school-based policy and system change strategies addressing health from moving forward in Cuyahoga County. The CCBH has been fortunate to create a partnership with the South Euclid Lyndhurst School District (SELSD), who not only sees the value in addressing and improving student health but is also committed to making the health choice the easy choice for their students. The SELSD has a diverse population of 4,000 students (60% African American, 5.6% Multi-Racial, 31.2% Caucasian, 2.1% Asian, and 1% Hispanic). Fifty-two percent of students qualify for free and reduced meals, and forty-eight percent of students reside in households that meet the criteria for economic disadvantage. The F2S approach was introduced to the SELSD by the CCBH as a program that had potential to have broad impact on healthy food access within both the school and larger surrounding communities. Since 2009, the CCBH has been a regional leader in bringing the nationally recognized Farm to School (F2S) program to Northeast Ohio as an innovative strategy to address childhood obesity. A strong, four-way partnership between the CCBH, SELSD, AVI Fresh, and Red Basket Farm, resulted in the successfully implemented first F2S program, The Students Eating Locally (SEL) Project in Cuyahoga County in September 2010.
How does the practice address the issue? (350 word limit)
More than thirty-one million children nationwide participate in the National School Lunch Program, making schools the ideal setting to impact the eating habits of children. Growing awareness of the adverse health consequences of poor nutritional choices have expanded interest in the nutritional quality of food served in school cafeterias. Lack of healthy food options, both in school and at home, have contributed to poor eating habits among youth. Nationally, one-third of daily calories consumed by 2-18 year olds are from solid fats and added sugars. Increased consumption of these foods is leading to a group of children who are overweight and undernourished. Coupled with the above mentioned indicators from the Cuyahoga County YRBS and district free and reduced participation rates, there is a clear need for shaping the school environment in a way that will directly alter and improve eating habits as children and adolescents spend one-third of their lives in an academic setting. Unique in design as shaped by individual community needs, the F2S program, which integrates produce from a local grower into a school meal program, increases not only access of and exposure to fresh, local produce but also creates opportunities to educate students, families, and residents about the relationships between dietary choices and health outcomes, the environment, and the food system. The F2S program, currently operational in 12,429 school buildings nationwide, works to improve the economic viability of family-scale farmers while supporting child nutrition efforts. By implementing the F2S program in the SELSD, the CCBH and its partners now have the capacity and capability to create opportunities for students to access fresh fruits and vegetables, to educate about the relationships between dietary choices and health outcomes, to build non-traditional partnerships, and to reinvest in Ohio’s economy. Greater Cleveland and Northeast Ohio has recently been a mecca for the local food movement, with over 200 community gardens and an increasing number of area farmers working to build a sustainable local economy around fresh produce. These local growers hold the promise of job opportunities and offer ideal venues for educating students on cultivation of produce and the nutritional benefits of these endeavors.
Does this practice address any of the CDC Winnable Battles? If yes, select from the following
Please list any evidence based strategies used in developing this practice. (Provide links or other materials for support)
The National Farm to School Network framework
Is the practice new to the field of public health? If so, answer the following questions.
No

What process was used to determine that the practice is new to the field of public health? Please provide any supporting evidence you may have, e.g. literature review.

How does this practice differ from other approaches used to address the public health issue?
Is the practice a creative use of an existing tool or practice? If so, answer the following questions.
Yes
What process was used to determine that the practice is a creative use of an existing tool or practice?  Please provide any supporting evidence you may have, for example, literature review.
Conducted in 2008, the meta-analysis "Do Farm-to-School Programs Make a Difference? Findings and Future Research Needs" (A. Joshi, A. Azuma, G. Feenstra 2008) reviewed 15 studies that include data on farm to school programs. While the studies demonstrated a few positive trends in behavior change that would impact healthier lifestyles for students, there is limited literature on the effectiveness of the approach. Further research is needed in the areas of student fruit and vegetable consumption and the impact of that consumption at home, impact on school meal programs, effect on knowledge and attitudes related to agriculture and healthy eating, impacts of policy change, and behavior and attitudes of growers.

What tool or practice (e.g., APC development tool, The Guide to Community Preventive Services, HP 2020, MAPP, PACE EH, etc.); did you use in a creative way to create your practice?  (if applicable) (300 word limit total)
a. Is it in NACCHO’s Toolbox; (if not, have you uploaded it in the Toolbox)?
b. If you used a tool or practice to implement your practice, how was your approach to implementing the tool unique and innovative for your target area/population?

The Guide to Community Preventive Services addresses both promoting good nutrition and obesity prevention and control in school-based programs. The Task Force found insufficient evidence in both of these categories to determine the effectiveness of school-based interventions in each of these areas. In 2003, when the evidence-base was last reviewed, many of the studies looked at behavior change and showed small, but positive, steps toward improvement in behaviors and weight status. Based on more current research related to health disparities and broad-based population impacts, The SEL Project will be contributing to a newer evidence base that supports addressing the root causes of poor food access and contributes to innovative strategies that improve child and adolescent health and support a more academically fit child.

How does this practice differ from other approaches used to address the public health issue? 

There are significant inequities in prevalence of and health outcomes associated with chronic disease linked to the economic, social, and community conditions in which people live, work, learn, and play. Traditionally, public health has focused on health promotion through health behavior modification and emphasis on personal responsibility, and expanding access to healthcare. However, research on the root causes of chronic disease and health inequities suggests that population-based prevention and “place-based” strategies are more effective in reducing the burden of chronic disease. These types of strategies place a greater focus on improving neighborhood environments, engaging and empowering the community, and improving day-to-day management of chronic disease. The CCBH recognizes that disparities exist in many of our communities. Many of the health disparities that exist within our health jurisdiction are concentrated in our urban core. Residents of these communities are less healthy overall than the general population and suffer from more negative social determinants such as poor housing, substandard education, low socio-economic status, limited transportation, lack of healthy food choices, high rates of crime and disproportionate environmental hazards. In response, the CCBH is developing and realigning programs to address the larger social context of disparities and inequities. The F2S framework is one such program, established to address healthy food access in the school population. The F2S program is an innovative school-based nutrition intervention as its moves beyond behavior modification and is focused on policy, environmental, and system change strategies within the school eating environment that support making healthy food access a viable option for students.
If this practice is similar to an existing model practice in NACCHO’s Model Practices Database (www.naccho.org/topics/modelpractices/database), how does your practice differ? (if, applicable)
This practice is an expansion of the CCBH Promising Practice award in 2012 - Farm to School: Fresh Produce in the Cafeteria
Who were the primary stakeholders in the practice?
Chad Welker, Director of Business Services, SELSD Kevin Needham, Executive Chef, AVI Fresh Floyd Davis, Owner and Grower, Red Basket Farm Alison Patrick, Child and Family Health Services Program Manager, CCBH
What is the LHD's role in this practice?
The success of the program has stemmed from the establishment of multi-sector partnerships with school stakeholders, the local growing community, and community based organizations. The CCBH serves as the lead agency on The SEL Project, as it currently coordinates school-based healthy eating and active living initiatives on a county-wide basis. The CCBH, in partnership with the SELSD, is responsible for leading the strategic planning and implementation processes for The SEL Project. Meetings are held on an ongoing basis to discuss menu planning, current initiatives, and future initiatives the district would like to undertake. The CCBH also seeks funding to support, enhance, and sustain The SEL Project. It has been instrumental in securing over $50,000 in the SELSD to support program expansion.
What is the role of stakeholders/partners in the planning and implementation of the practice?
The newly formed partnership between SELSD and Red Basket Farm has facilitated program expansion at a faster pace than expected and has established communication practices that had not existed in previous years. The SELSD routinely meets with Floyd Davis, as opposed to working through a third-party distributor, to directly place orders, arrange produce deliveries, and discuss upcoming plans for the next growing season. The district foodservice director has begun changing the menu planning process to better coincide with Ohio’s growing season and is also exploring innovative use of produce during the off season. Students across all grade levels have benefited from the new partnership, such as through the schools gardens that have been established at three school buildings. These opportunities serve as mechanism to meet the new wellness policy goals as they are relatively inexpensive, promote academic achievement, improvement in health status, and support positive youth development. The SELSD also serves as a role model to school meal programs in the region and continues to share successes and challenges through guest speaking opportunities and information sharing.

What does the LHD do to foster collaboration with community shareholders?
Describe the relationship(s) and how it furthers the practice's goals.

In an effort to bring the F2S program to a larger scale, the CCBH builds upon already-established obesity/nutrition focused partnerships and/or consortiums: • The Cleveland-Cuyahoga County Food Policy Coalition exists to promote a healthy, equitable and sustainable food system, with the goal of establishing broad reaching policies that improve the infrastructure for urban agriculture and access to healthy foods. The CCBH supports this coalition with representation on the coalition at-large and serves as the co-convener of the Health and Nutrition working group. The Health and Nutrition Working Group is currently developing a county-wide F2S initiative. • The Prevention Research Center for Healthy Neighborhoods was established at the Case Western Reserve University School of Medicine in 2009. The Center’s mission is to foster partnerships within Greater Cleveland’s urban neighborhoods for developing, testing, and implementing strategies to prevent and reduce the burden of chronic disease through a community-based participatory research approach. The CCBH supports its core project Freshlink and is a member of the Food Policy Research Working Group. The CCBH is also participating in the Partners in Education, Evaluation and Research (PEER) program, an 18-month mentored program designed to increase research capacity in community organizations. • Supervisors and Nutrition Directors (SAND), the Northeast Ohio chapter of the School Nutrition Association, promotes healthful meals and nutrition education by providing education, supporting school meal standards and federal and state policy, and representing the nutrition interests of Ohio’s school children through school food service directors. Since the inception of the F2S program in the SELSD, the CCBH has been an active participant in this group to inform, educate and promote the initiation of farm to school in additional school districts in Northeast Ohio. • Ohio State University Extension (OSUE) strives to meet its mission of engaging residents to strengthen their lives and communities through research-based educational programming and has been a local leader and innovator in nutrition education, urban agriculture, and food policy. The CCBH has been a long-standing partner of the OSUE on local food policy initiatives.
Describe lessons learned and barriers to developing collaborations.
To date, the CCBH has learned many valuable lessons during the implementation of The SEL Project, both at the district level, as well as the potential expansion of the program county-wide. The establishment of multi-sector partnerships in the SELSD facilitated the implementation with the F2S program with relatively few barriers. However, program rollout has provided the CCBH with the opportunity of sharing The SEL Project successes and meeting with additional school districts about program implementation. The CCBH has learned that expansion of this program county-wide could potentially encounter the following barriers: CCBH/SELSD lessons learned: Overarching positive lessons the partnership has are: 1) students will eat fresh fruits and vegetables when given the opportunity and 2) local procurement is not as costly as perceived. As with any learning experience, initial program implementation has also provided insight on future opportunities: 1) We need to expand our reach to engage parents, additional school stakeholders, and the community at large, 2) there is room to menu additional items that include locally procured product, 3) the salad bar program should be offered daily as opposed to 2-3 days per week, 4) experiential learning opportunities need to be expanded to the K-12 curriculum as opposed to only being offered during the after school gardening clubs, and 5) new partners from the local food/growing community should be brought to the table. As with any new program implementation, the CCBH has experienced some challenges within the F2S framework in the SELSD. In order to further expand local food procurement, production, and service as components of the school meal program, the CCBH and SELSD will have to address infrastructure needs in the district. Specifically, the aging equipment, lack of cold storage space, lack of kitchen supplies (i.e. processors, salad spinners, etc.), and ability of the grower to meet growing district demand are limiting factors to program expansion. CCBH county-wide lessons learned: The SEL Project allows the CCBH to share F2S experiences and results. The CCBH continues to engage foodservice directors and the local growing community in a broader county-wide farm to school discussion to garner support and gain feedback. Through this process, the CCBH learned: School Meal Program/Director Concerns: 1) Schools are nervous about partnering with local producers without guidance from the local health department, 2) Many directors perceive that purchasing from a local grower is more expensive than from a large distribution company, 3) a large misconception exists that product delivered from a local grower is not as safe as food processed and delivered through a large distribution company, and 4) most directors assume that serving fresh, local produce increases labor costs. Growing Community Concerns: 1) small to mid-size growers are unsure they can adequately meet the supply demand of school districts, 2) small to mid-size growers are generally not capable of delivery to schools due to limited staff capacity, and 3) local growers perceive schools as difficult to work with for receipt of payment. Based on all the feedback received, the CCBH is conducting a county-wide F2S capacity assessment. Utilizing its registered sanitarians during their annual school inspection, the goal is to further expand F2S in Cuyahoga County. Expansion will increase market demand for fresh produce, increase the capacity of local growing operations, and reinvest in our local economies.

Evaluation assesses the value of the practice and the potential worth it has to other LHDs and the populations they serve. It is also an effective means to assess the credibility of the practice. Evaluation helps public health practice maintain standards and improves practice.


Two types of evaluation are process and outcome. Process evaluation assesses the effectiveness of the steps taken to achieve the desired practice outcomes. Outcome evaluation summarizes the results of the practice efforts. Results may be long-term, such as an improvement in health status, or short-term, such as an improvement in knowledge/awareness, a policy change, an increase in numbers reached, etc. Results may be quantitative (empirical data such as percentages or numerical counts) and/or qualitative (e.g., focus group results, in-depth interviews, or anecdotal evidence).

List up to three primary objectives for the practice. For each objective, provide the following information:  (750 word limit per objective)

• Performance measures used to evaluate the practice: List the performance measures used in your evaluation. Depending on the type of evaluation conducted, these might be measures of processes (e.g., number of meetings held, number of partners contacted), program outputs (e.g., number of clients served, number of informational flyers distributed), or program outcomes (e.g., policy change, change in knowledge or attitude, change in a health indicator)
• Data: List secondary and primary data sources used for the evaluation.  Describe what primary data, if any were collected for each performance measure, who collected them, and how.
• Evaluation results: Summarize what the LHD learned from the process and/or outcome evaluation. To what extent did the LHD successfully implement the activities that supported that objective? To what extent was the objective achieved?
• Feedback:  List who received the evaluation results, what lessons were learned, and what modifications, if any, were made to the practice as a result of the data findings.


 

Objective 1:

1.) Primary Objective: Increase the number of students participating in the school meal program. The number of students in the SELSD eligible to participate in the free and reduced meal program has steadily increased since 1995, when the district free and reduced participation rate was 2.5%. In 2012, the district free and reduced participation rate sits at 52% given current economic conditions. The F2S program currently provides all students access to fresh fruits and vegetables, foods that some student may not have access to outside the school day. After inclusion of local produce into the meal program, participation rates have steadily increased. From 2010-2011 there was a 7.5% increase in overall participation rates from the previous school year, and the 2011-2012 school year saw an additional increase in overall rates. Grades K-6 experienced the largest increases last year, with an additional 5% of students across these grades levels purchasing school meals. The 12.5% increase in reimbursable meals purchased over the last two years has increased revenue for the school meal program, without increasing labor costs. Data utilized for this project was received in the following ways: • District free and reduced participation rates were through the district direct certification process and through a paper application process using income verification. • Meal participation rates were tracked and calculated using information from the SELSD point of sale system. The SELSD was responsible for collecting data and providing data to the CCBH. The CCBH was responsible for calculating the data and presenting the SELSD with the results. Through other interactions with school districts, the CCBH recognizes that measuring impacts of school-based policies and programs is a challenging task for many school districts. The CCBH advised the SELSD on which indicators would most demonstrate the impacts of The SEL Project. The CCBH learned: • School districts can, and will, gather data when given guidance and assistance • Students will make healthier choices when available • F2S can be successful in a district with a relatively high free and reduced participation rate

Overflow (Objective 1): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

For the current academic year, the SELSD will begin to use its point of sale system to track specific produce purchases made by students Red Basket Farm. The SEL Project year two project report is attached to this application. This report will be disseminated to the community in November 2012.

Objective 2:

The F2S movement was responsible for a $13 million investment by schools in locally purchased foods during the 2011-2012 school year. The school meal program represents a $12 billion market nationally. The F2S framework can make a dramatic impact on local businesses and the prevention of chronic disease in adulthood. Prior to the implementation of The SEL Project, the district was sourcing all of its produce through its main food distributor, making no investment in the Northeast Ohio food economy. Food being served in the district meal program was, in some cases, traveling over three weeks accounting for twenty-six hundred miles. The foodservice staff was noticing that food was arriving either rotten or required extensive prep to be ready for consumption. At the start of The SEL Project in 2010, the SELSD began investing in Ohio’s food economy, spending 7% of their produce budget with Red Basket Farm during the first year of the program. From year one to year two, the district increased spending with Red Basket Farm by 38%. As prices through Red Basket Farm remained unchanged, SELSD also increased the number of local offerings served on the menu from 6 items to 22 items. Not only has the SELSD increased its investment in the Northeast Ohio food economy, it has also experienced positive financial impacts. Facing a $2.3 million budget reduction for the 2012-2013 school year, with additional fiscal constraints forecasted for the next three academic years, fiscal caution is being required of each district department. Since The SEL Project began, the SELSD has documented a 16% reduction in total amount loss within the foodservice budget line item. Coupled with the increase in revenue from increased participation rates, this has solidified the F2S approach as a sustainable program. Momentum built within The SEL Project has extended into the broader community and has impacted Northeast Ohio’s regional food economy through increased capacity and revenue in the regional farming community. Simultaneously, the increase in spending at Red Basket Farm has catalyzed farm expansion, from 2,000 square feet at initiation to 10,000 square feet with its expansion into the school market. The farm investment and expansion has come in the form of high tunnel greenhouses that allow for season extension and support year round production and service.

Overflow (Objective 2): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

Data: • SELSD meal program invoices, both main distributor and farm • SELSD revenue and expense tracking through Director of Business Services Evaluation results: • Increasing the amount of fresh produce offerings does not necessarily correlate with an increase in expenses • Produce sourced locally is not more expensive than produce purchased through a major distributor • Fresher produce can decrease labor hours spent on food preparation • Sourcing locally means produce is staying fresher longer and staff are spending less time on food prep than before
Objective 3:
3.) Primary Objective: Increase the number of experiential learning opportunities for students around agriculture and nutrition. School gardens can substantially contribute to the fulfillment of the federally mandated school wellness policies and the recent passage of Ohio SB 210. The establishment of gardens on school campuses are an appealing intervention strategy for carrying out district wellness policy goals because they are relatively inexpensive, promote academic achievement, improvement in health status, and support positive youth development. A 2011 study, published in the Journal of Health Promotion Practice, revealed several policy and practice implications related to school gardening. The findings suggest interventions to increase the availability of fresh produce in schools should be coupled with hands-on experiences in the garden. It is unlikely that increasing fruit and vegetable offerings in the cafeteria and/or classroom alone with solely increase consumption. Strategies must encompass experiential learning opportunities for students to taste and learn about produce. The study also noted that students’ consumption of vegetables at home did not improve solely because of the existence of a school garden, indicating that programs should include home and community components that increase access to produce and teach parents/caregivers/residents how to prepare food in ways that students prefer. Given the above mentioned fiscal constraints, field trips and extracurricular activities within the district have been restricted or eliminated in recent years. However, The SEL Project stakeholders recognized the need to integrate educational experiences for students to achieve sustained impacts of the program. The SEL Project has been able to support experiential learning opportunities for students without any associated costs. Students have further their education by:

Overflow (Objective 3): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

• Veggie U Earth to Table Curriculum: The CCBH financially supported the inclusion of this curriculum into the after-school garden club at the upper elementary building. • Schools gardens: Three school gardens have been established since 2010. In particular, the revitalization of the greenhouse at the high school has created a self-sustaining space that allows students to experience working with plants, learn about agriculture, be exposed to the health benefits associated with growing food, and learn about job opportunities related to agriculture. Participating students in these gardens were able to visit Red Basket Farm and attend cooking classes offered by the district foodservice director. • Funding: SELSD doubled the amount of funding they have received from year one to year two of The SEL Project. Over $50,000 has been awarded to support components of the F2S framework. Integration of experiential learning opportunities into The SEL Project is building a culture of youth and adult advocates for increased access to fresh, healthy foods in their school district.
What are the specific tasks taken that achieve each goal and objective of the practice?
In 2009, the CCBH conducted a survey of school-level administrators to assess the importance of wellness policies to schools, the barriers and success encountered with implementation and evaluation, and to determine how the CCBH might best provide technical assistance with the policy. Through the responses of seventy-four individuals (39.4% were administrators) from 25 school districts, the CCBH learned that: • Only 33.3% of schools were actively implementing their policy • 39.4% agree that wellness policies have a positive impact on student health and academic achievement • The majority of activities taking place focused on nutrition or physical activity to reduce childhood obesity, rather than nutritional policy changes • The barriers to moving the policy forward include time, money, and dedicated staff The above mentioned survey enabled the CCBH to identify a school district with a renewed interest in addressing student health through the implementation of new and innovative evidence-based strategies. The SELSD agreed to become the seminal district for implementation of the first Farm to School program in Cuyahoga County. A separate survey process also allowed CCBH to identify a local grower, Red Basket Farm, who was already working in the County and was interested in establishing a relationship with a school district. With thoughtful planning, ongoing assessment, and evaluation of efforts, the CCBH, SELSD, and Red Basket Farm have ongoing discussions and meetings to assess program progress, set benchmarks, and discuss next steps.
What was the timeframe for carrying out these tasks?
The SEL Project began in 2010. The partners continue to meet monthly to discuss program implementation and next steps. The creation of a district F2S committee, co-convened by the SELSD and the CCBH, is currently under consideration. Evaluation of the program is ongoing, with reports created and distributed annually.
Please provide a succinct outline of some basic steps taken in implementing your practice.
• August 2010: Program planning • September 2010: The SEL Project kick-off • November 2010: All six district cafeterias receiving locally procured produce from Red Basket Farm • November 2010-June 2011: Continued integration of locally procured produce into meal program; monthly strategic planning meetings held • September 2011-June 2012: Continue integration of locally procured produce into meal program; monthly strategic planning meetings held • November 2011: Year one outcomes report released • December 2011: Passed board-approved wellness policy containing F2S language • March 2012: NACCHO Promising Practice Award • September 2012-June 2013: Continued integration of locally procured produce into meal program; monthly strategic planning meetings held • November 2012: USDA Farm to School grant announcement (pending) and release of year 2 outcome report (pending)

What were some lessons learned as a part of your program's implementation process?

Lessons learned • School districts have the ability to gather data, provided they are guided as to which outcomes they need to measure. • The misconceptions that students will only eat food that tastes good (i.e. pizza, chips, ice cream, chicken nuggets) can be changed and students will make healthier choices if they are available. • Increasing the amount of fresh produce offerings does not correlate with an increase in expenses. • Farm to School can be implemented in a school district with a high free and reduced meal participation rate. • Produce sourced locally is not more expensive then produce purchased through a major distributor • Fresher produce can actually decrease labor hours spent on prep
Provide a breakdown of the overall cost of implementation, including start-up and in-kind costs and funding services.
Funding Sources: • CCBH in-kind support provided by the Ohio Department of Health Child and Family Health Services grant • Grant awards received during practice implementation: o $18,000 awarded from the Great American Salad Bar project o $2,000 from the Ohio Department of Agriculture o $1,500 from the CCBH Child and Family Health Services o $7,500 from the Legacy Village Foundation o $22,000 from Fuel Up to Play 60 o $350 from Sunview PTA o $2,000 from the Whole Foods Foundation o $700.00 from Greenview PTA
Is there sufficient stakeholder commitment to sustain the practice?  Describe how this commitment is ensured.
Solidifying its commitment to improve food offerings throughout the district meal programs, the SELSD became the first district in the State of Ohio to pass a Board Approved Wellness Policy containing farm to school language in December 2011. Policy language addresses school gardening, agriculture-focused experiential learning opportunities, nutrition education, and the inclusion of locally procured produce into all aspects of the school meal program. The implementation of The SEL Project has revitalized the school district’s commitment to improving student health. The wellness committee, inactive since 2006, recently began meeting again in 2010, with a renewed focus on being proactive in addressing the health needs of their student population. The majority of activities have focused on the improvements in the healthy eating environment. Each school building now offers a salad bar daily as a reimbursable meal option and the after school program has established a school garden and has taken trips to Red Basket Farm to learn about where their food is coming from. As meal participation has increased during lunch hours, the district is also now offering breakfast in the classroom. Initiated in 2011 at the elementary level and in 2012 at the junior high level, there has been a 200% increase in breakfast participation, a meal that the majority of students were coming to school without eating.
Describe plans to sustain the practice over time and leverage resources.
The SEL Project goal is to source almost of all of the produce served within its meal programs from Red Basket Farm. The SELSD is assisting Red Basket Farm with the search for grant funding and other business opportunities that will support farm expansion. The addition of high tunnel hoop houses and acquisition of additional land will enable the farm to grow year round. The CCBH continues to utilize existing grant programs as in-kind resources to support expansion of The SEL Project. The CCBH is also developing a strategic framework for a county-wide approach to incorporating locally grown food in school meal programs within our health jurisdiction.
Practice Category Choice 1:
Chronic Disease (Obesity)
Practice Category Choice 2:
Community Involvement
Practice Category Choice 3:
Other?
No

Please Describe: