W1194: Children's Healthy Living Network (CHLN) in the U.S. Affiliated Pacific Region

(Multistate Research Project)

Status: Inactive/Terminating

Project Menu

SAES-422 Reports

Annual/Termination Reports:

[06/16/2017] [07/05/2018] [09/17/2019]

Date of Annual Report: 06/16/2017

Report Information

Annual Meeting Dates: 06/12/2017 - 06/14/2017
Period the Report Covers: 10/01/2016 - 09/30/2017

Participants

Joshua Greenberg, University of Alaska Fairbanks
Patricia Coleman, Northern Marianas College
Tanisha Aflague, University of Guam
Rachael Leon Guerrero, University of Guam
Robert L. Barber, University of Guam
Rachael Novotny, University of Hawaii
Jean Butel, University of Hawaii
Marie FIalkowski, University of Hawaii
Jean Butel, University of Hawaii
Erik Hill, University of Hawaii
Vanessa Wong, University of Hawaii

Brief Summary of Minutes

Monday, June 12, 2017

Introductions/Project Overview/Background/Project Importance. Link to CHLN project https://www.nimss.org/projects/view/mrp/outline/18097

Defined project management standards, policies and procedures. Link to CHLN document 20121113 CHL Guidelines-Procedures.docx

Established project organization & communication standards. Link to CHLN document 20121113 CHL Guidelines-Procedures.docx

Update on CHL Monitoring system

Update on CHL Training

Group updates related to CHLN multi-state project

Tuesday, June 13, 2017

Worked on CHL Center grant (Objective 2)

Established working sub-groups related to Monitoring, Training, & Extension

Work on Proposals Related to Monitoring, Training, & Extension (Objective 2)

Wednesday, June 14, 2017

Developed sub-group work plan

CHLN Elections and Integrate work plans

Reviewed project timeline and Next Meeting Date

Minutes Attachment:

CombinedMinutes:subgroups.pdf

Accomplishments

Background.  The Pacific region has some of the highest rates of non-communicable disease in the world. The FSM and the Marshall Islands are in the top three of rates of diabetes in the world (35%, International Diabetes Federation 2013). Diabetes, heart diseases, strokes, cancer and other NCDs are affecting Pacific peoples at a disproportionate rate compared to other populations, placing a significant burden on their daily functionality, and threatening the national security of these island countries and territories (PIHOA 2010). All of these conditions have a primary causal factor: obesity. Adult obesity is among the highest in the world in these countries, especially among women (FSM 58%, Marshall Islands 48%, Ng et al 2013). Pacific lifestyles continue to transition from native crops to imported foods, and from active forms of work and play to sedentary ones, as in most of the world (World Health Organization, 2015, <a href="http://www.who.int/mediacentre/factsheets/fs311/en)">http://www.who.int/mediacentre/factsheets/fs311/en)</a>.   Data are limited on children of the region. Childhood obesity is an important determinant of adult obesity. Obese children have a higher chance of obesity, premature death and disability in adulthood. Obese children have breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects. Contributors to obesity occur across the life course and include both early undernutrition and nutrition excess. Obesity is associated with social and health problems. Prevention is the best long term solution. The Children’s Healthy Living Network (CHLN) multi-state Hatch Project is building and sustaining activities developed in the CHL program. Project Objectives: 1. Adapt and disseminate CHL child obesity policy, systems and environmentally focused multi-level prevention training and social marketing materials for the Pacific region; 2. Facilitate use of CHL data, findings related to child obesity and its multilevel (policy, system, and environmental) determinants; 3. Promote partnership and coalition building and strengthening in and among Pacific communities and the region around child health; and 4. Build and sustain a child health and nutrition monitoring system in the Pacific. Main Accomplisments of the W1194 "CHLN" multistate group for FY2017. 1) Group members have met on a monthly basis to continue work on the CHL/CHLN objectives; 2) During the 2017 Annual meeting, group members created subgroups (Monitoring, Training, Research, and Extension and Policy) to better define the outcomes, outputs, activies, and milestones. Each of the CHLN subgroups (Monitoring, Training, Research, and Extension and Policy) have a published CHL paper, for reference. Details for each subgroup can be found in attached minutes; and 3) Group members worked together to submit proposal for the USDA-NIFA-AFRI-006346 announcement in July 2017.

Publications

Novotny, R., F. Li, L. Wilkens, M. Fialkowski, T. Fleming, P. Coleman, R. Leon Guerrero, A. Bersamin, and J. Deenik. 2017. Economic Influences on Child Growth Status, from the Children’s Healthy Living Program in the US-Affiliated Pacific Region. ADBI Working Paper 698. Tokyo: Asian Development Bank Institute. Available: <a href="https://www.adb.org/publications/economic-influences-child-growth-status" target="_blank" rel="noopener">https://www.adb.org/publications/economic-influences-child-growth-status</a>. Rachel Novotny, Fenfang Li , Rachael Leon Guerrero , Patricia Coleman, Aifili J. Tufa , Andrea Bersamin , Jonathan Deenik and Lynne R Wilkens. Dual burden of malnutrition in US Affiliated Pacific jurisdictions in the Children’s Healthy Living Program. Novotny et al.BMC Public Health (2017) 17:483 DOI 10.1186/s12889-017-4377-6. Esquivel MK, Fialkowski MK, Aflague T, Novotny R (2016) Engaging Head Start Teachers on Wellness Policy Implementation to Improve the Nutrition and Physical Activity Environment in Head Start Classrooms: A Qualitative Study of the Children’s Healthy Living Program (CHL) in Hawai’i. J Family Med Community Health 3(5): 1094. Nigg, C.R., Ul Anwar, M.M., Braun, K.L., Mercado, J., Fialkowski, M.K., Areta, A., Belyeu Camacho, T., Bersamin, A., Leon Guerrero, R., Castro, R., DeBaryshe, B., Vargo, A.M., Braden, K.W., Novotny, R. A review of promising multicomponent environmental child obesity prevention intervention strategies by the children’s healthy living program. Journal of Environmental Health. 2016; 79(3): 18-26. Mikkelsen, B.E., Novotny, R., Gittelsohn, J. Multi-Level, Multi-Component Approaches to Community Based Interventions for Healthy Living—A Three Case Comparison. Int. J. Environ. Res. Public Health. 2016; 13:1023. doi:10.3390/ijerph13101023 Novotny R., Li F., Fialkowski M.K., Bersamin A., Tufa A., Deenik J., Coleman P., Leon Guerrero R., Wilkens, L.R. Prevalence of obesity and acanthosis nigricans among young children in the children’s healthy living program in the United States Affiliated Pacific. Medicine (2016) 95:37(e4711). <a href="http://dx.doi.org/10.1097/MD.0000000000004711">http://dx.doi.org/10.1097/MD.0000000000004711</a>

Impact Statements

CHL Center grant submission (USDA-NIFA-AFRI-006346) — CHL’s goal is to serve as a Center of Excellence to continue to build capacity in a partnership among 11 jurisdictions of the US Affiliated Pacific - to provide training, research and extension/outreach to maintain and extend the CHL network, examine long-term effects of the multilevel CHL intervention and provide access to best practices in policy, systems and environmental approaches for prevention of child obesity. CHL addresses the USDA NIFA priority areas of 1) food safety, nutrition and health 2) agricultural systems and technology and 3) agricultural economics and rural communities. CHL supports long-range improvement in and sustainability of agriculture and food systems in remote underserved (EPSCOR) US jurisdictions of the Pacific Region that are not represented in National Nutrition and Health Monitoring (NHANES).

Date of Annual Report: 07/05/2018

Report Information

Annual Meeting Dates: 05/30/2018 - 05/31/2018
Period the Report Covers: 06/01/2017 - 05/31/2018

Participants

University of Alaska Fairbanks: Leslie Shallcross
American Samoa Community College: Travis Fleming, Pauline McFall
University of Arizona: Melanie Hingle
University of Guam: Rachael Leon Guerrero, Robert L. Barber, Mark Acosta, Tanisha Aflague
University of Hawaii at Manoa: Rachel Novotny, Marie Revilla, Jeannie Butel, Monica Esquivel, Ashley Yamanaka, Claire Ing, Lynne Wilkens, Erik Hill, Jinzeng Yang, Jim Davis

Brief Summary of Minutes

Minutes Attachment:

20180601 CHLN Meeting .docx

Accomplishments

<ul> <li>Group members met on a monthly basis, in addition to holding an annual meeting, to continue to work on the CHLN objectives</li> <li>Group awarded 2 USDA grants: USDA NIFA 2018-38413-28140 and USDA NIFA 2018-69001-27551</li> <li>Subgroups continue to work on meeting their stated outcomes, outputs, activities and milestones (Details can be found in attached minutes, subgroup action plans and guidelines)</li> </ul>

Publications

Novotny R, Davis J, Butel J, Boushey CJ, Fialkowski MK, Nigg CR, Braun KL, Leon Guerrero R, Coleman P, Bersamin A, Areta AAR, Barber LR, Belyeu-Camacho T, Greenberg J, Fleming T, Delacruz-Talbert E, Wilkens LR. Children's Healthy Living Multilevel Multicomponent Community Randomized Trial Reduced Young Child Overweight, Obesity and Acanthosis Nigricans in the US Affiliated Pacific. JAMA.

Impact Statements

CHL Dietetics Scholars Program USDA NIFA 2018-38413-28140 funded to build regional capacity in childhood obesity prevention by increasing the number of Native Hawaiian students to complete a baccalaureate degree in dietetics that is enhanced with an evidenced-based child obesity prevention online curriculum, mentoring, a learning environment that incorporates Hawaiian values and service learning in the community.

Date of Annual Report: 09/17/2019

Report Information

Annual Meeting Dates: 07/18/2019 - 07/19/2019
Period the Report Covers: 07/17/2018 - 07/17/2019

Participants

Attendees:
Alaska:
Am. Samoa: Mary, Travis
Arizona: Melanie
CNMI: Patty, Robby
Guam: Mark, Tanisha
FAS:
Hawaii: Marie, Rachel, Jeanie, Ashley, Monica, Courtney
West Virginia: Melissa

Brief Summary of Minutes

Minutes Attachment:

2019 CHLN Annual Meeting Minutes.docx

Accomplishments

(Obj 1,3) Increase academic courses and training on obesity prevention in the region. Seek grants for graduate and undergraduate program development and student support. Products <ul> <li>Assessment and evaluation tool for CHL SI (learning outcomes)</li> <li>National collaboration readiness awareness tool and interactive website</li> <li>AN training online</li> <li>Articulation agreements across institutions</li> <li>2019-2021 MOA with revised CHL tuition revenue rates issued</li> <li>Identify 5 scholars for CHLD</li> <li>Minimum of 100 students completing any CHL SI</li> <li>Multiple grant proposals submitted</li> <li>CHL SI course FSHN 454 (foundations) added to Dietetics curriculum at UHM as a substitute for FSHN 480 (obesity)</li> <li>Continuing education units in CHL SI</li> </ul> (Obj 1,2,3) Building tools and evidence for obesity prevention in the Pacific. Current Key Activities <ul> <li>TFP (Alaska)</li> <li>FFMM (Guam)</li> <li>Food Cost manuscript</li> <li>Main intervention effect manuscript</li> <li>Intervention process manuscripts</li> <li>K-Award (CT) - evaluation of adults BMI and BP to CHL Time 3</li> <li>Further analyze CHL data</li> <li>Using CHL intervention findings, create activity to establish the evidence for extn. program</li> </ul> Student Led: <ul> <li>AN & meat sources thesis research (AC)</li> <li>Epidemiologic transition and Pacific BMI dissertation (AY)</li> <li>Pacific Child FFQ (Guam [ML] and AS [PM])</li> <li>Guam diet paper (ML)</li> <li>Fast food environment (ED)</li> <li>Diet quality and food security (ES, MH [Az])</li> </ul> New Activities <ul> <li>Develop a CHL Healthy Eating Index</li> <li>Develop a traditional and/or local foods index</li> <li>Define the Healthy Pacific Diet</li> <li>Generate manuscript ideas and proposals using the CHL diet data</li> <li>Connect the USDA Food Surveys Research Group (FNDDS) with CHL data to ensure those Pacific-specific foods are incorporated into FNDDS</li> </ul> Products <ul> <li>Publications</li> <li>Presentations</li> <li>CHL diet quality index</li> <li>local/traditional foods index</li> </ul> (Obj 1) Translate evidence-based approaches into feasible Pacific-focused/relevant policy interventions to be used by all CHLN jurisdictions and toolkit made available on CHL website (Obj 2) Integrate PSE into extension programs through evidence-based research in the Pacific to address children’s health needs. (Obj 3) Strengthen community partnerships using Community Template to influence policy (e.g. Local School Wellness Policy) and programs (e.g. Farm to School Network) Current Key Activities  W2W (Guam) SPARK Training for GDOE (Guam) SNAP-Ed work (GU, HI, AK) Farm to School Network (Guam) SNAP-Ed Pacific Rim cohort OHA School Lunch Program (HI) Community partnerships for policy (OHA, NCD, etc.) Continue work with community partners New Activities  Review of Best Practices for CHL-behavior Policies influencing children School assessment to inform update and implementation of Local School Wellness Policy Reconvene with community partner to distribute CHL reports, engage community in discussions on future Revise/expand community partner section on CHL website Products Statewide distribution of findings to community Policy Template (to develop CHL website toolkit)   (Obj 4) Create a self-sustaining monitoring system that addresses the social determinants of health. Current Key Activities  <ul> <li>I – Training and standardization (CHL Center, CHL IMPAC, CHLSI)</li> <li>IE – Disseminate measurement manuals (0-1, 2 - 10, and 11+)</li> <li>R – Developing tools for future monitoring (own toolkit: includes things such as R-training, manage data, BMI reports, determining BMI calculator for monitoring (e.g. EpiInfo/WHO Anthro), hardware (encrypted computer) and software for a system (including server))</li> </ul> <ul> <li>E – Preparing for BMI data collection in 2019-2020 school year (CNMI as a part of CHL Time 3, AS, Pohnpei, age 0-5)</li> <li>E – Pull existing monitoring efforts together</li> <li>RE – Food Cost Survey data collection across Jurisdictions</li> <li>R - Development of Pacific Child FFQ (Guam)</li> <li>R- Development of methodology for Pacific Child FFQ creation</li> <li>RE - CHL Center data collection Time 3 (CAT, Walkability, TFP, participant measures with expanded data collection to include food insecurity and health literacy)</li> <li>I- Revision of CHL SI monitoring course</li> </ul> New Key Activities  <ul> <li>RE - Identify how to analyze the Food Cost Survey data</li> <li>E - Investigate expansion of Food Cost Survey to inform USDA Thrifty Meal Plan</li> <li>RE- Develop criteria and manual for measurement standardization trainers (train-the-trainer manual)</li> <li>WHO collaboration global child surveillance system- pilot in Marshall Islands</li> <li>CHL-Adult data collection (Claire)</li> </ul> Products  <ul> <li>iPad Food Cost data collection process</li> <li>CAT and Food Cost data collection for Time 3</li> <li>Approximately XX standardized for child and 3 for adult anthropometric measurement</li> <li>Approximately XXX children and 240 adults measured</li> <li>Criteria for standardization trainer</li> </ul>