Childhood Obesity Prevention Lawmaker Information Gathering Project by ewghwehws


									  North Carolina’s Approach to
Communicating with Policymakers
          Jimmy Newkirk
        Dave Gardner, D.A.
         Lexie Wolf, M.A.
                 Today’s talk
•   Introductions
•   Strategic Focus of PAN Branch
•   PAN’s role with statewide movement
•   Eat Smart Move More Overview
    – Including Policy Platform
• Lessons learned for communicating with
  policy makers
               Our mission
• The mission of the Physical Activity and
  Nutrition Branch (PAN) Branch is to
  reverse the rising tide of obesity and chronic
  disease among North Carolinians by helping
  them to eat smart, move more and achieve a
  healthy weight.
             Strategic Focus
• Impact: Decrease obesity rates and related
  chronic diseases
• Outcomes:
  – Increase Physical Activity
  – Increase consumption of fruits and vegetables
  – Decrease consumption of energy dense foods
 Strategies (to achieve outcomes)
• Enhanced land use and transportation policies
• Creation of or enhanced access to places for PA,
  combined with informational outreach activities
• Promote food policy councils
• Increase access to healthy foods including corner
  stores, farmers markets, community gardens and at
             Our work is …
• Across all levels of the socio-ecological
  model with an emphasis on policy and
  environmental change
• In all “settings” with an emphasis on
  community environment, school aged
  children, and worksites
• Always with partners!
                Our work:
• Enables us to be technical experts for issues
  in the General Assembly, educating policy
  makers (advocacy)
• Supports local efforts of health departments,
  partners, and coalitions who may also be
               PAN’s role
• Statewide movement: Eat Smart Move
  More North Carolina
• Over 60 agencies formally signed on, many
  more informally involved
• NC Division of Public Health is one partner
• PAN provide staff support to the movement
 Eat Smart Move More (ESMM)
• Executive Committee
• Leadership Team – reps from all member
• Ad Hoc Committees:
  – Policy / Advocacy
  – Key Measures
  – Surveillance
    Eat Smart Move More NC
• Eat Smart Move More: North Carolina’s
  Plan to Prevent Overweight, Obesity and
  Related Chronic Diseases 2007 – 2012
• ESMM Policy Strategy Platform *
• Many policy tools and curricula
• Website:
       Policy Strategy Platform
• Focal Point for Policy Action
• Platform: focused but at a strategic level
   – Tactical level (e.g., specific language and sub-
     components of policy issue) is supported by partners
     such as the NC Alliance for Health
• Includes 20 policy strategies
   – organized with frame from CDC’s Community
     Strategies and Measurements Guide
   – state and local; legislative and organizational
 Platform includes strategies to:
• Promote the Availability of Affordable
  Health Food and Beverages
• Support Healthy Food and Beverage
• Encourage Breastfeeding
 Platform includes strategies to:
• Encourage Physical Activity or Limit
  Sedentary Activity Among Children and
• Create Safe Communities that Support
  Physical Activity
• Develop Capacity and Support for Obesity
         Each Policy Strategy:
• General Action – organizational actions that can
  advance the strategy
• Legislative Action – legislative actions that can
  advance the strategy
• Cost - summary of any costs identified
• Sources – list of where strategy has been
  recommended by Task Forces, Organizations, etc.
• Evidence - references to key evidence
• Current Status - (dynamic document)
      Partners use of Platform:
• Common focal point for NC policy action
• Incorporated into organizational platform
  (e.g., one agency can “own” specific issues)
• Educate decision makers (i.e., advocate)
• Some partners able to communicate directly
  with policy makers with specific policy
  “asks” (i.e., lobby)
       Next Steps for Platform
• One pagers to support each policy strategy
  – Include success stories
• Enhance “alignment” with behavioral
• Public tracking system (for “current status”)
• Increase distribution and partners use
      Childhood Obesity Prevention
     Lawmaker Information Gathering
                     Dr. Jodie Abbatangelo-Gray, Sc.D., M.S., M.A.
                             Dr. Jill Fromewick, Sc.D., M.S.
                                      Lexie Wolf, M.A.

A project of The North Carolina Center for Health and Wellness (NCCHW) at University of
                                  North Carolina Asheville

        Funded by the Blue Cross and Blue Shield of North Carolina Foundation
                    Project goal:
     To learn more about North Carolina policymakers’
          attitudes about childhood obesity including:

   knowledge & gaps in knowledge
   what they believe are the causes of childhood obesity
   opinions about policy areas that could prevent
    childhood obesity
   how they research and make policy decisions
               Project design:
   Survey distributed through Survey Monkey to
    members of the North Carolina General

   In-depth interviews with 14 North Carolina
    policymakers (3 municipal lawmakers, 6 county
    commissioners, and 5 state representatives)
  Identification & recruitment of
 interview subjects: municipal and
         county lawmakers

Used websites to obtain biographical information
when available; selected a pool of prospective
interviewees that was diverse with respect to
geographic locale, age, gender, ethnicity, party
affiliation, and exposure to issues related to
childhood obesity
      Identification & recruitment of
    interview subjects: state legislators

   Spoke to representatives who did not have a
    history of involvement in childhood obesity or
    related issues

   Sought variation with respect to party affiliation,
    gender and location of district
                Subject areas:
   Magnitude of problem: how serious?
   Causes of problem
   Role of lawmakers and policy in childhood
    obesity prevention
   How they make policy decisions: where they get
    information, how they do research, etc.
          Magnitude of problem

   10 out of 15 lawmakers termed childhood
    obesity “serious” or “very serious”
   2 lawmakers: “extremely serious” and “crisis
   2 lawmakers: “not earth-shaking” (mayor) and
    “not a huge problem” (state legislator)
How have they come to believe that
 childhood obesity is a problem?

                     “You can tell just from
                      looking at them on the

                    “Because I look at all the
                      young people around
                      me, and all of them are
                        bigger than I am”

                   “I see many young people
                        – in our church for
What are the causes of the problem?
   Modern family life: less             “I suspect few children
    unstructured play, lack of           are getting training and
                                          discipline in terms of
    home cooking and family               food in their families
    meals, more screen time                    these days”
                                           -County commissioner

 “ I think that parents have      Most framed this as parental
   got to take some kind of
   responsibility. I know of     choice, just a few noted
  families who just let their    contextual/structural factors
 kids eat out of boxes every
             night.”             influencing family lifestyles
      - County commissioner
    What is the role of the lawmaker in
                this issue?
   Much variation in how
    lawmakers viewed their own
    roles and responsibility with
    respect to this issue

   Many county and municipal
    lawmakers did not
    immediately think that this
    was an issue that fell within
    their jurisdiction
            Framing the issue
“We’re putting in                    Lawmakers at all levels did
walking tracks and                    not want to be perceived as
                                      “intervening” and
bike trails through
                                      “legislating” health
the town. So I think
we’re certainly
doing our part, but                  Local lawmakers seemed
we don’t want to                      more comfortable with the
cram it down                          idea of “promoting health
                                      and fitness” rather than
anybody’s throat,                     “obesity prevention.”
you know?”
-Mayor of small central NC town
     Jurisdiction & policy settings
   State legislators more likely to discuss school
    policy interventions than county or municipal

   Local lawmakers articulated built environment
    policy solutions such as trails and sidewalks
    more often than did state lawmakers
  Policy interventions for healthy
“Certainly I’m not going to blame the fast food
  industry. Thank goodness for Burger King and
McDonald’s. They feed an awful lot of people. And
  doing away with them is only going to bring up
 something. You know, we’re not going to live on
     tofu and yogurt. So what we have to do is
personally come to an understanding that we have
         some control over our own lives.”
        -Mayor of small municipality in central NC
        Making policy decisions
   All five state lawmakers and all six county
    commissioners reported that they viewed
    evidence and research before making decisions
    as very important

   However, nearly every interviewee referenced
    personal anecdotes and observations during the
    course of the conversation
     Key findings & implications for
   While many lawmakers may feel that
    childhood obesity is a major problem, they
    may have a limited understanding of the
    depth, severity, and macro-level impacts of
    the disease.

   Understanding of causes, impacts and
    possible solutions may be based on personal
    experiences and observations

   Lawmakers may not always see the
    connection between policy and behavior or
    see their role in childhood obesity prevention.

   Policies that create opportunities or incentives
    will likely be received more positively than those
    that are more regulatory in nature.
           PAN: Communicating with
• The Healthy
  Initiative: goal is to
  implement state level
  policies that promote
  healthy environments
  and active lifestyles in
  North Carolina
   Communicating with policymakers about
 healthy environments: “bottom-up” approach

• Communications campaign will begin by
  educating communities and citizens about
  how they can shape their built
  environments for active living

• Education about the relationship between
  the built environment and physical activity
  will provide context for future policy action
   Making the connection through
         personal stories
• NC youth to participate in a video contest
  exploring features in their community that
  help or hinder active living; videos
  showcased in community

• Communications campaign will utilize
  personal stories and anecdotes to raise
  awareness about the relationship between
  physical activity, policies and
  environments, and health

• When communicating with decision makers
  at all levels:
  – Bridge the gap between personal choice and
  – Don’t assume an understanding of the issue
  – Provide the facts, e.g., research, but use
    personal stories and case studies
  – Collaboration is, quite simply, the way to move
    policy forward

      Jimmy Newkirk
       Dave Gardner
        Lexie Wolf

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