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Framework

Fit WIC Missouri
Preventing Childhood Overweight

FFY07 Framework for Developing Local Initiatives and Reporting Progress to the State

Local WIC Provider Implementation Plan for Fit WIC Missouri:

Familiarize yourself with USDA’s Fit WIC lessons learned and recommendations at http://www.nal.usda.gov/wicworks/
Sharing_Center/statedev_FIT.html. Become familiar with the Fit WIC Missouri program design (Table 1).
Agency role - Using Family Involvement: Nutrition (Table 2), select 3 nutrition behavior goals as a focus of education in your agency.
Agency role - Using Family Involvement: Physical Activity (Table 3), select 3 physical activity behavior goals as a focus of education in your agency.
Agency role - Select one or more activities as an agency focus of supporting WIC staff in healthy behaviors (Table 4) and/or community involvement (Table 5). Activities from one or both may be selected.
Plan FFY07 Fit WIC Missouri activities based upon goals selected. The target behaviors and activities listed in Table 2, 3, 4, and 5 are evidence-based or best practice recommendations for preventing overweight and are preferred activities for statewide implementation.
Plan FFY07 Fit WIC Missouri evaluation of activities and goals. The sample evaluation tools provided (Table 6 and 7) measure only evidence-based recommendations for preventing overweight and are preferred for statewide evaluation.
Participant role – WIC participant selects one nutrition goal and one physical activity goal, agency documents goals on nutrition education report, and administers pre and post survey questions (Table 6 and 7) to participant at beginning and end of certification period.
Report results of the 3 selected nutrition behavior goals, physical activity behavior goals, and selected activity(ies) from supporting WIC staff and/or community involvement on FFY07 LAP mid-year evaluation (using Table 2, 3, 4 and 5).
Report results of the 3 selected nutrition behavior goals, physical activity behavior goals, and selected activity(ies) from supporting WIC staff and/or community involvement on FFY07 LAP annual evaluation (using Table 2, 3, 4 and 5).

As a participant in FFY07 Fit WIC Missouri, resources you will need are:

Fit WIC: Programs to Prevent Childhood Overweight in Your Community: The Implementation Manual for the Fit WIC Childhood Overweight Prevention Project
Food and Fun for Families 2005 mini-CD (mailed from USDA to LWP’s in 2005, also available on the web),
A list of recommended activities for using in Missouri from Food and Fun for Families (attached), and
The Fit WIC Missouri logo for promotional use in your agency.

Fit WIC MISSOURI PROGRAM DESIGN – TABLE 1
Instructions: The following framework of activities provides a mechanism for Missouri WIC communities to become part of the solution to the problem of childhood overweight.
Fit WIC Missouri Program Design	Explanation	Outcome
Involve families with children ages 2-5	Involve all families with children, regardless of the child’s weight status. It is not necessary that children be identified as at-risk for overweight or overweight to participate in Fit WIC activities.	Initial and exit contact
Pair physical activity and nutrition	Embrace physical activity as an essential element of nutrition assessment and education. Physical activity goes hand-in-hand with nutrition for optimal weight and health.	Each selected intervention must include 1) a nutrition component paired with 2) a physical activity component.
Select nutrition education and physical activity resources from recommended resources	The list of recommended resources that will best meet Missouri goals is provided. All resources are available on the web from Fit WIC’s Food and Fun for Families at www.nal.usda.gov/wicworks/Food_Fun/index.html. LWP’s may also have a Food and Fun for Families mini-CD.	Identify resources used
Create lesson plans with a focus on healthy lifestyle rather than weight	Give parents opportunities to explore ways to help their children improve their diets, increase physical activity, and decrease TV watching. Emphasize problem solving rather than information giving. Include children in activities as much as possible. Offer participatory physical activity and cooking sessions.	Nutrition lesson plans (group or individual) using MO WIC format for Local Agency Nutrition Education Lesson Plan in the FFY07 TAP
COMPONENTS
1) Family Involvement	Help families set goals for health, not for weight. Encourage families to make fruits and vegetables readily available in the home, to limit snack foods and beverages available to children in the home, to allow children to determine their own portions, to offer smaller portions, avoid using food as a reward and limiting TV viewing time to less than two hours per day. Discuss physical activities families can participate in together, both indoor and out. Offer ideas from Food and Fun for Families.	% meeting behavior goal (evaluation tool and participant survey questions provided)
2) Supporting WIC Staff (Choose this and/or Community Involvement component)	WIC staff are the best role models for WIC families. Support staff in making healthy lifestyle choices. Organize activities within the organization to encourage healthy nutrition and physical activity choices (for example, log minutes of exercise daily/weekly, organize a “healthy lunch day” when staff members each contribute a healthy dish.) Offer incentives, if possible. Advertise the success of these programs in the local paper, or post on a bulletin board within the organization.	# of activities accomplished (evaluation tool provided)
3) Community Involvement (Choose this and/or Supporting WIC Staff component)	Join with other groups to make healthy foods more available and affordable, and volunteer to provide nutrition education to groups outside of WIC (for example, Head Start, Parents As Teachers, local YMCA). Work to improve safety of and access to recreation areas, help to make physical activity classes accessible and affordable for low-income families, and/or develop a community physical activity resource guide.	# of activities accomplished (evaluation tool provided)

FAMILY INVOLVEMENT: NUTRITION – TABLE 2
Instructions: LWP’s will measure change in one or more targeted behaviors through an initial and exit contact with participant. Participant selects one nutrition goal and one physical activity goal (from list below and based on agency education target), agency documents goals on nutrition education report, and administers survey questions (provided) to participant. Agency follows up at conclusion of certification period by administering survey questions to participant again.
Nutrition Behavior (Agency select 3 behavior goals as a focus of nutrition education) (Participant select 1)	Agency goals - Select 3	Number participants who selected goal	Percent participants who met goal
1. Offer new fruits or vegetables multiple times (up to 10 times).
2. Make a variety of nutritious, low-energy dense foods, such as fruits and vegetables, available in the home.
3. Limit purchases of food and beverage items high in calories and low in nutrients.
4. Increase frequency of family meals.
5. Turn the TV off during meals.
6. Serve smaller portions or let children self-select portion size.
7. Avoid using food as a reward or punishment.
8. Do not insist on a clean plate.
9. Provide a positive role model of eating behaviors for your child(ren).

FAMILY INVOLVEMENT: PHYSICAL ACTIVITY – TABLE 3
Instructions: LWP’s will measure change in one or more targeted behaviors through an initial and exit contact with participant. Participant selects one nutrition goal and one physical activity goal (from list below and based on agency education target), agency documents goals on nutrition education report, and administers survey questions (provided) to participant. Agency follows up at conclusion of certification period by administering survey questions to participant again.
Physical Activity Behavior (Agency select 3 behavior goals as a focus of education) (Participant select 1)	Agency goals - Select 3	Number participants who selected goal	Percent participants who met goal
1. Encourage and monitor outdoor play.
2. Walk or bicycle with your child to run errands or as a regular means of transportation.
3. Participate in opportunities for physical activity in the community.
4. Center family outings around physical activity.
5. Give gifts that encourage activity.
6. Limit TV viewing and recreational screen time to less than two hours per day.
7. Provide a positive role model of physical activity behaviors for your child(ren).

SUPPORTING WIC STAFF – TABLE 4
Instructions: Select this or Community Involvement component. LWP’s will support WIC staff in at least one activity from the list below.
SUPPORTING WIC STAFF Activity (Agency select 1 or more)	Date accomplished and brief description
1. Provide training for WIC staff to use a learner-centered (or facilitated education) approach in conducting group nutrition education sessions to more effectively address weight issues.
2. Provide training for WIC staff to use motivational counseling in individual nutrition education to more effectively address weight issues.
3. Provide the opportunity for activity breaks at work.
4. Provide opportunities for healthy snack breaks or meals at work.
5. Provide nutrition education opportunities for all WIC staff.
6. Provide opportunities for employees to sustain breastfeeding.
7. Improve the nutrition environment in the workplace through policies, promotion and practice.

COMMUNITY INVOLVEMENT – TABLE 5
Instructions: Select this or Supporting WIC Staff component. LWP’s will be involved in at least one community activity from the list below.
COMMUNITY INVOLVEMENT Activity (Agency select 1 or more)	Date accomplished and brief description (including # people reached and partners)
1. Form or join a community coalition to address health issues and make obesity prevention a local priority.
2. Assess the type and range of locally available food resources in the community to address food insecurity problems and make one improvement.
3. Begin a program to promote community or school gardens, or farm-to-cafeteria programs.
4. Host “fruit and vegetable snack breaks” for playgroups or sporting events.
5. Post posters promoting healthful food choices (especially fruits/vegetables) at various community sites.
6. Complete a Community Assessment Facility worksheet (from Food and Fun For Families) to establish a plan for communicating with local leaders/organizations.
7. Create a place in the local community where children can safely walk, bike, and play.
8. Improve a built facility to encourage more frequent use by members of the community.
9. Host a physical activity fair at school, church, or local facility.
10. Create a community walking club.
11. Team up with local businesses for gift certificates to places that encourage physical activity.
12. Develop Fit WIC Parent Newsletter (Food and Fun For Families) to encourage physical activity/healthful food choices, or contribute an article regularly to a local newspaper.
13. Hold an Active Play Class for parents/guardians in conjunction with another program (i.e., Parents As Teachers).
14. Form child playgroups.

NUTRITION BEHAVIOR EVALUATION - TABLE 6
Instructions: WIC participants will select one nutrition behavior and one physical activity behavior as their individual goal. LWP’s will ask the WIC participant to respond to only the questions for selected behaviors at the beginning of the certification. The same questions will be asked of the participant at the conclusion of the certification. LWP’s shall retain survey question responses in agency.
Nutrition Behavior Survey Questions	Initial Contact	Exit Contact		Goal Met? Staff Use Only
1. Offer new fruits or vegetables multiple times (up to 10 times). What new fruit or vegetable did you offer your child? How many times was the new fruit or vegetable offered? Did the child try the new fruit or vegetable? Did the child like the new fruit or vegetable?
2. Make a variety of nutritious, low-energy dense foods, such as fruits and vegetables, available in the home. How many days in the past week was the child offered fruit (fresh, frozen or canned)? How many days in the past week was the child offered vegetables (fresh, frozen or canned)? How many days in the past week was the child offered french fries?
3. Limit purchases of food and beverage items high in calories and low in nutrients. How many days in the past week has soda been available for your child in your home? How many days in the past week has low-fat milk been available for your child in your home? How many days in the past week have some type of sweet snack, like cookies, cakes or candy, been available for your child in your home? How many days in the past week have ready-to-eat fruits or vegetables been available for your child in your home?
4. Increase frequency of family meals. How many days in the past week have you eaten dinner at home with your children?
5. Turn the TV off during meals. How many days during the past week did your child eat breakfast at home? ____ During how many of those breakfasts was the TV turned off? ____ How many days during the past week did your child eat lunch at home? ____ During how many of those lunches was the TV turned off? ____ How many days during the past week did your child eat dinner at home? ____ During how many of those dinners was the TV turned off? ____
6. Serve smaller portions or let children self-select portion size. Is your child allowed to serve himself/herself? Do you normally serve your child ½ sandwich or a whole sandwich? Do you serve your child the same size main dish portion as you serve yourself? Have you decreased the portion size of the main dish served to your children as a result of what you learned at WIC?
7. Avoid using food as a reward or punishment. Is food used in your home as a reward? Is food or denial of food used in your home as punishment?
8. Do not insist on a clean plate. Are your children encouraged to clean their plate? Must your children clean their plate before they have dessert?
9. Provide a positive role model of eating behaviors for your child(ren). How many days during the last week did you eat at least 5 servings of fruits and vegetables? How many times in the past week did you consume low-fat milk with a meal eaten with your child? How many meals during the past week have you eaten at home with the TV off?/How many eaten with the TV on?	/		/

PHYSICAL ACTIVITY BEHAVIOR EVALUATION – TABLE 7
Instructions: WIC participants will select one nutrition behavior and one physical activity behavior as their individual goal. LWP’s will ask the WIC participant to respond to only the questions for selected behaviors at the beginning of the certification. The same questions will be asked of the participant at the conclusion of the certification. LWP’s shall retain survey question responses in agency.
Physical Activity Behavior Survey Questions	Initial Contact	Exit Contact	Goal Met? Staff Use Only
1. Encourage and monitor outdoor play. How many days in the past week did your child play outside? What was the average length of time each day that your child played outside? How many days in the past week did you play outside with your child?
2. Walk or bicycle with your child to run errands or as a regular means of transportation. How many days in the past week did you walk or bicycle with your child to run errands or as a means of transportation?
3. Participate in opportunities for physical activity in the community. How many days in the past week did your child participate in community supported physical activity, for instance, play group, biddy basketball, t-ball, soccer, swimming, gym events, recreational leagues, or day camps?
4. Center family outings around physical activity. How many days in the past week did a family outing include at least 20 minutes of physical activity?
5. Give gifts that encourage activity. At the most recent gift-giving holiday, did you give your child any gift that encourages activity, for instance, jump ropes, balls, sports equipment?

Framework

Fit WIC Missouri Preventing Childhood Overweight

Fit WIC Missouri
Preventing Childhood Overweight