
In an effort to impact early health habits for young families, Community Health Improvement at Parkview Health introduced the Simple Solutions imitative. Kathy Wehrle, community outreach dietitian, had no doubt the series of lessons, taught by home visitation facilitators, would be beneficial, but when it came to the exact data, she reached out to the Research team at the Parkview Mirro Center for Research and Innovation for guidance.
“We put questions together for what we wanted to measure,” Kathy said, “but then they took us under their wings to say, ‘Maybe word this question like this, instead.’ In the future their team will help guide us on the data that is statistically significant.”
Evaluation consists of a pre, mid and post questionnaire to determine changes in health attitudes and behaviors. The team also surveys the home visitors and agency leads to assess program administration and effectiveness. The strong collaboration between research and outreach, Kathy hopes, can only lead to more success for Simple Solutions in years to come.
Understanding Simple Solutions
Simple Solutions is a Community Health Improvement Initiative of Parkview Health. It is an 8 lesson healthy living curriculum delivered through agencies using “home visitation” models, serving low income, young families. The curriculum offers needed advice on nutrition/feeding in the critical early years of life, as well as overall healthy habit guidance for young vulnerable families. The overarching purpose of Simple Solutions is to support at-risk families and prenatal mothers with health strategies to prevent overweight and obesity from developing in their children from 0 – 3 years of age.
Currently, many infants, toddlers and preschoolers are not meeting the guidelines for nutrition and activity, which are putting children’s health and development at risk. We know that, starting in pregnancy, a mother’s health and eating habits have a significant impact on the development and future health of her child. Once a child is born, chronic poor nutrition and insufficient activity continues to impair development and sets the stage for obesity and other chronic diseases. It is easier and more effective to prevent overweight and obesity during early childhood than reverse trends later in life. Health intervention in the early years pays the biggest dividends. Rates of overweight and obesity are highest among low income children and racial and ethnic disparities persist as they age.
The curriculum and tools
The Simple Solutions course with its accompanying tools, offers tangible help for families at this critical juncture. The aim is on prevention of childhood obesity and overweight, improved nutrition quality, improved physical activity and other general health behaviors (such as importance of sleep, mindfulness, feeding dynamics, etc.) which all have the potential to enhance brain development, school success, growth and improved immunity in these children.
Program overview:
8 Interactive videos and a simple 8 mini-lesson manual were developed to provide comprehensive education to clients with easy actionable steps for enhancing a more nutritious diet and positive feeding environment to reduce childhood feeding problems. Other healthy living attributes are blended into lessons. Each of the agencies have home visitors that are trained on Simple Solution curricula. During their home visits, program facilitators show videos, discuss key concepts and help families with goal setting as they fill out an interactive workbook.
Families receive desperately needed cooking and activity tools after each lesson to reinforce material learned. These tools are provided by an internal Community Health Improvement grant from Parkview. These tools help bridge the gap between theory and application. Many low income families often lack basic kitchen tools in addition to resources to foster activity. All curriculum videos have been dubbed into Spanish and Burmese. The workbook has also been translated into Spanish.
What the home visitation facilitators are saying …
“Many clients changed sugar and pop intake as that was eye opening in the education.”
“I am serving over 60 families and they are loving the information and items. One Hispanic family was especially excited as their 7-year-old daughter was diagnosed with high cholesterol.”
“Clients used the tools to track healthy living and make grocery lists. Many families also started spending more time eating together in the evenings versus watching TV or being on their phone.”
“One of my clients started a new habit with her children that they try one new fruit or vegetable each month – and she has kept it going for a few months now. She said her older children have started looking forward to it and asking about it.”
“The ladies on my caseload really liked the apple slicer and slow cooker. I have a Mom who has made lifestyle change and has not eaten fast food in weeks, which is really a big deal for her because she had an ‘eat whatever you want’ mindset.”
What the data tells us …
- Eating together as a family. Out of 74 families, 33 saw improvement (44.6%) as a result of this intervention.
- Turning off the TV and restricting phones, tablets and laptops during family meals. Out of 76 families, 40 saw improvement (52.6%).
- Preparing meals together as a family. Out of 76 families, 35 saw improvement (46.1%).
- Planning family meals and snacks ahead of time. Out of 77 families, 43 saw improvement (55.8%).
- Letting children choose which food to eat at each meal. Out of 70 families, 35 saw improvements (50%).
- Letting children choose how much food to eat at each meal. Out of 73 families, 32 saw improvement (43.8%).
- Making a grocery list after planning meals for the week. Out of 76 families, 39 saw improvement (51.3%).
- Trying new fruits or vegetables once a month. Out of 73 families, 46 saw improvement (63%).
- Having children drink milk or water with meals and snacks. Out of 72 families, 29 saw improvement (40.3%).
- Restricting children’s TV, video game, and/or internet time to less than 2 hours each day. Out of 72 families, 29 saw improvement (40.3%).
Key references:
http://pediatrics.aappublications.org/content/pediatrics/141/2/e20173716.full.pdf
http://fhop.ucsf.edu/sites/fhop.ucsf.edu/files/custom_download/1000Days-NourishingAmericasFuture-Report-FINAL-WEBVERSION-SINGLES_0.pdf
http://homvee.acf.hhs.gov/HomVEE_Executive_Summary_2016_B508.pdf?utm_source=5+things+to+know+about+early+childhood+home+visiting&utm_campaign=e-news+10%2F26&utm_medium=email