Changing it Up for Better Health

June 1, 2015, Feature, by Dr. Danielle Hollar

Walmart and nutrition literacy create broader awareness of NRPA’s Commit to Health initiative.Since the launch of NRPA’s five-year Commit to Health initiative, kicked off in 2014 in Miami with First Lady Michelle Obama, millions of children in low-income communities nationwide have been provided nutritious summer and after-school meals during out-of-school time (OST), and hundreds of thousands have been educated about healthy eating and physical activity habits in parks and recreation sites that provide healthy environments in accordance with Healthy Eating and Physical Activity (HEPA) standards. Through initiatives such as Commit to Health, parks and recreation agencies are playing a critical role in obesity prevention efforts by providing access to nutritious foods and opportunities for physical activity in healthy environments aligned with standards that support such efforts.

In articles featured in the February 2015 and April 2014 issues of Parks & Recreation, Kellie May and Maureen Hannan described the aims of Commit to Health, including its key components (summer and afterschool meals, nutrition literacy, HEPA standards) and supportive network of nationwide partners (Alliance for a Healthier Generation, National Afterschool Alliance, United States Department of Agriculture [USDA], Food Research and Action Center (FRAC), among others) that are critical to its success. This month, we’re revealing some of the exciting, behavior-changing results of Commit to Health experienced by kids attending park and recreation programs, as well as their parents and parks and recreation staff. 

The Walmart Effect

Thanks to generous funding from the Walmart Foundation, more than three-quarters of a million previously underserved kids received nutritious meals and nutrition literacy as part of Commit to Health grant activities during 2014. In fact, in just one year, NRPA’s 50 Commit to Health grantees served an astonishing 13,030,166 meals to almost 875,000 children attending park and recreation programs — a 1,639,749 increase over the number of meals served during 2013. On top of this great achievement, 257,411 children at 557 sites across the country were part of evidence-based, age-appropriate nutrition literacy programming, and 45,000 children experienced healthy changes in their OST environment thanks to implementation of HEPA standards. 

Nutrition Literacy Leads to Healthier Eating

During just a short summer camp period (averaging approximately six weeks), Commit to Health nutrition literacy programming resulted in significant improvements in nutrition knowledge and healthy eating behaviors for all groups involved — kids, parents and park and recreation staff! While the full results of these great successes will be presented in October at the 2015 Food and Nutrition Conference and Expo of the Academy of Nutrition and Dietetics, here are some of the key findings:

1) Learning specifics about nutrient-rich foods and their bodies leads to impressive changes in kids’ eating behaviors. Children learned a lot about nutritious foods, their bodily organs and how to become healthier overall thanks to the nutrition literacy program provided by NRPA. Through fun, engaging, cartoon-based programming called The OrganWise Guys (which includes cute characters such as Hardy Heart, Peter Pancreas and Peristolic the Large Intestine), the importance of good nutrition and daily physical activity was understood by Commit to Health kids. These lessons were complemented by USDA MyPlate activities, Foods of the Month programming that included focusing on specific nutrient-rich foods each week during the summer months, and an emphasis on daily physical activity. In 2014, as part of a nationwide evaluation by Healthy Networks Design and Research, more than 400 children in select summer camps who had just finished grades four and five were asked questions at the beginning and end of camp to assess their change in nutrition knowledge and eating behaviors. The evaluation included quantitative (pre- and post-surveys) and qualitative (collection of success stories, lessons learned, etc.) activities, and the results were impressive!

Specifically, very large increases in the number of correct responses from children regarding nutrition knowledge were found for topics such as; “Pretend you are getting ready to choose which cereal you would like to have for breakfast. Which of the following would be the best choice?” (options included varying levels of fat and fiber), “Which food is a protein?” (egg, whole wheat bread or broccoli), and “Which organ of the body helps regulate sugar in our bodies?” Children also reported learning more about the types of protein and dairy items that are low in fat, as well as the role of their intestines and pancreas in healthy living — likely due to messages from Peter Pancreas and Peristolic! 

Kids also were asked at the beginning and end of summer camp about their consumption of foods that were part of the Foods of the Month educational efforts. Children reported eating more fruits and vegetables generally, as well as bell peppers and spinach specifically and low-fat dairy items (skim milk, reduced fat cheese) by the end of summer. Slight decreases in consumption of sugar-sweetened beverages were reported, which mirror the reported increases in consumption of water found in qualitative components of the evaluation. Finally, although not nutrition-related, significantly more children reported higher levels of physical activity at the end of the summer camp.

2) Parents learn about healthy eating and their organs, and change their behaviors. Parents of summer campers were asked a number of questions at the beginning and the end of summer, just like their children. We really wanted to know if the things children learned at summer camp had an impact on parents’ eating habits, foods consumed in the home and home gardening. What we found was exciting — parents did learn about, and then make changes to improve, eating habits due to their children having been campers in locations where nutrition literacy programming was implemented. Significantly more parents reported having heard about the educational programs called The OrganWise Guys, and/or the USDA MyPlate program, at the end of summer as compared to the beginning. Nutrition lessons from these programs seemed to have resonated with the campers since improvements in the level of knowledge regarding targeted nutrition and healthy living behaviors were reported by parents. Specifically, more parents indicated at the end of the summer (as compared to the beginning) that they “know which foods have the most antioxidants in them,” “know what foods have lots of fiber in them,” “know how to cook/prepare healthy foods” and “know how to plant a garden,” among several other takeaways. In fact, the number of parents reporting having planted a garden rose by the end of the summer! 

Regarding their own eating behaviors, although parents did not participate directly in Foods of the Month programming, it is apparent that the important nutrition messages about the health benefits of nutrient-rich foods were taken home by children. Parents reported some increases in consumption of vegetables generally, and bell peppers, spinach, summer squash, tropical fruits, stone fruits (peaches, nectarines, etc.) specifically. Additionally, they reported consuming more fish and low-fat dairy at the end of the summer, as compared to the time before their children attended summer camp. 

In order to confirm some of the reports by kids who said they were eating more nutrient-rich foods by the end of the summer, parents were asked some questions at the beginning and end of the summer. They were asked about each Food of the Month, “Does your child like and eat [name of the Food of the Month]?” In the end, parents reported that by the end of summer more of their children were “liking and eating” bell peppers, berries and summer squash.

3) Park and recreation staff change up their eating behaviors. Similar to the exciting improvements in knowledge and healthy eating behaviors of campers and parents mentioned above, parks and recreation staff changed their eating and physical activity behaviors due to learning through teaching nutrition literacy during summer camps. Staff knowledge of nutrition and healthy living behaviors increased tremendously by the end of summer. Specifically, staff learned about “which foods have the most antioxidants in them,” “what the large intestines do in your body,” “what proteins are low in fat,” and more.

This increase in knowledge had a strong influence on foods they consumed. Specifically, fewer staff reported never consuming targeted nutritious foods at the end of the summer as compared to the beginning — they were trying new foods! And because of teaching the Foods of the Month program (including experiential food tasting activities in many instances), staff reported increases in consumption of bell peppers, spinach, tropical fruits, stone fruits, summer squash and lean proteins. A large number of staff reported at the end of summer, as compared to the beginning, that they also planted a garden at home.

Just like the parents, parks and recreation staff were asked about any changes they saw in nutrition knowledge and eating behaviors of kids in their camps during the course of the summer. More staff reported that they felt “children who attend your camp know what kinds of foods are the best” at the end of camp as compared to the beginning. Staff also reported seeing improvements in eating behaviors for all of the foods targeted in the Foods of the Month programming. Specifically, staff reported many more children “liking and eating” fruits, eggs, bell peppers, berries, tropical fruits, stone fruits, summer squash and vegetables. Responses to the qualitative survey questions echoed these findings. 

Healthy Results — A Call for Expansion

As you can see above, kids in Commit to Health summer camps really learned a lot and changed their eating habits thanks to the fun nutrition literacy programming taught by parks and recreation staff. The impressive gains in nutrition knowledge and associated changes in healthy eating behaviors, along with their potential to improve the health of children and their parents throughout our nation, give much support for expansion of similar OST efforts. NRPA’s dedication to expanding Commit to Health and its components (providing nutritious meals, ensuring healthy environment standards, and teaching nutrition literacy) has great potential to improve obesity rates among young children throughout our nation in a fun, engaging way that uses parks and recreation agencies as leaders of such efforts.

Dr. Danielle Hollar is the President of Healthy Networks Design and Research.