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Article 1 PROMOTING HEALTHY EATING AMONG YOUTH: ENGAGING COMMUNITIES THROUGH MULTI-LEVEL STRATEGIES
CALIFORNIA ADOLESCENT NUTRITION AND FITNESS PROGRAM
Presented by Arnell J. Hinkle, RD, MPH, CHES at the American Dietetic Association Food & Nutrition Conference & Expo October 4, 2004. THE CHALLENGE Youth encounter daily food promotion advertisements as part of contemporary culture. Advertisers spend billions of dollars each year on food promotions while health and nutrition related programs and messages are far less prevalent.The environment, particularly that of low-income individuals, is constantly bombarded with messages telling us what to eat without necessarily indicating what is healthy. Messages about how to choose and prepare foods as well as how to enjoy new foods have been replaced with those about what foods to consume; however, the foods promoted may not be the healthiest choices. The Institution of Medicine of the National Academies has reported that it is unreasonable to think that individuals will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change. Despite the development of more programs promoting a healthier lifestyle, the vast majority of these do not “speak” to low-income and/or ethnic-specific communities in a manner that motivates them to make long-term behavior changes that could literally save their lives. Oversimplified “Just Do It!” messages fail to resonate. For example, messages urging people to buy more fruits and vegetables, when many urban neighborhoods have more fast food and liquor outlets than supermarkets, are no more effective than those urging residents to exercise on the streets where they don’t even feel safe walking to the bus stop. It is common knowledge that low-income ethnic audiences are more adversely affected than others by obesity-related health issues. But the question is: “What do we do about it?” Even the disproportionate health statistics have not been enough to spur many adults to change. How do we begin to break through barriers to behavior change and provide realworld solutions for harder-to-reach children, teens and young adults? How do we stem the tide of increasing obesity rates in communities of color? OVERVIEW OF THE CANFIT PROGRAM The California Adolescent Nutrition and Fitness (CANFit) Program is a statewide, non-profit organization whose mission is to engage communities and build their capacity to improve the nutrition and physical activity status of California´s low-income African American, American Indian, Latino, Asian American, and Pacific Islander youth 10-14 years old.The mission is specific and focused so that culturally-appropriate and specific programs can be created in ways that insure that skills and expertise are left with the community. The CANFit philosophy is to work in the after-school and community environment to give youth many of the skills and competencies needed to change their health-related social norms.The program attempts to “build” future healthy adults by guiding youth in their physiological development and in the acquisition of beneficial social, intellectual, and emotional skills. The work of CANFit is rooted in principles of youth development which include the acquisition of attitudes, competencies, values, and social skills that will carry youth forward into a successful adulthood.The CANFit model includes five components: community-based funding; training and technical assistance; scholarship and awards programs; advocacy for organization and policy changes; and ethnic-specific community campaigns.
Community-Based Funding
Communities need financial resources if meaningful programming is to take place. CANFit raises money in order to be able to give money to community-based organizations in the form of planning and intervention grants.
Training and Technical Assistance
CANFit provides training and technical assistance to
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organizations that serve youth directly, non-profit organizations, groups providing funding for community programs, government entities, consultants, and others working to improve nutrition and physical activity and prevent obesity in low-income communities of color. CANFit creates specialized professional development programs for community-based organizations, after school programs, and middle schools on nutrition education and physical activity. Information is presented to interested parties through several different venues. A workshop training program for teachers, counselors, administrators and other youth-service professionals across the country, helps prepare these service providers and volunteers who work with young people to communicate with them more comfortably and effectively. Recipes for Success are four-hour interactive, hands-on workshops designed for youth providers working with low-income, multi-ethnic youth ages 10-14.These are regional training workshops. CANFit professionals lead training and presentations on a range of topics including youth development, obesity prevention in communities of color, and effective strategies for implementing adolescent health programs. The content of the workshops includes nutrition and physical activities as well as games that have been tested and proven effective with adolescent audiences.The focus is on attendee participation and learning effective strategies for improving the nutrition and physical fitness status of the youth. Workshop topics include: • Nutrition – The needs of adolescents, reading food labels, what makes a snack a healthy choice, and sample activities • Physical Activity – Guidelines for adolescents, sample games and management strategies • Body Image – The role of mass media, peers, and family influences and sample activities • Healthy Snacks – Tips for choosing and planning nutritious and delicious reimbursable snacks for youths ages 10-14. In addition, training and technical assistance includes providing resource materials in both English and Spanish and consultation to organizations on nutrition, physical activity, obesity prevention, and healthy snack development.
Hispanic students expressing financial need to study nutrition, physical education, or culinary arts in the state of California.
Advocacy for Organizational and Policy Changes
Part of CANFit’s work is done through alliances with other state and national groups. For example, work with the Strategic Alliance for Healthy Eating and Activity Environments centers around trying to reframe the obesity debate from one of “a simple matter of individual choice” to one of “corporate and government responsibility.” CANFit consults with organizations serving youth on how research findings and past experiences can be used to develop effective strategies and tools to incorporate nutrition education and physical activity into current programs in order to strengthen and expand primary prevention efforts. CANFit provides guidance on how to do interviews, focus groups, and community mapping. Additionally, CANFit is able to use what is expressed by and learned from working directly with communities in its advocacy efforts at the state and national levels.This may take the form of advocating for policies that enhance nutrition and physical activity in after school and community settings.
Ethnic-Specific Community Campaigns
CANFit’s research-based strategies were developed from more than a decade of working with youth in at-risk environments. In the course of providing training and technical assistance to CANFit Program grantee organizations, CANFit has had experience in working directly with the residents of over eighty low income African American, Latino, Southeast Asian, Filipino, and American Indian communities throughout California. CANFit has provided consultation to numerous private, state, and national agencies including the 100 Black Men of America, Inc., Northern Plains Indians Diabetes Prevention and Intervention Research Project, the U.S. Bureau of Maternal and Child Health, and the Centers for Disease Control and Prevention. All programs are designed with youth input, and they are piloted and evaluated so that communities can use the materials developed on an ongoing basis. A SUCCESS STORY Promoting Healthy Activities Together, P.H.A.T., is one of CANFit’s success stories.The goal of this multi-media presentation is to use hip hop culture as a vehicle for making changes for African American youth. The objectives are to promote increased consumption of water and enhanced participation in physical activities while decreasing the intake of soda and fast food.
Scholarship and Awards Programs
The CANFit Program hopes to encourage more students to consider careers that will improve adolescent nutrition and fitness by providing undergraduate and graduate scholarships. These scholarships are available for African American, American Indian/Alaska Native, Asian American, Pacific Islander or Latino/
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Using hip hop culture as a vehicle for change was selected as a viable approach as a result of CANFit’s use of focus groups to explore what music youth were listening to and what logos appealed to them. Hip Hop professionals helped with the campaign design and local DJs helped the youth create hip hop beats.The youth created positive message about nutrition and physical activity that were then set to hip hop dance routines. A pilot project included 80 youth who showcased their hip hop moves at a large community event. Based on pretests and followup assessments, there were positive results for youth in terms of increased activity and water consumption. Additionally, parents reported beneficial learning from their youth. As a result of the success of programs such as P.H.A.T., CANFit's efforts to produce culturally appropriate nutrition and physical activity education training resources emphasizing youth leadership are nationally recognized. Edited by Carolyn J. Haessig, PhD, RD, CDN, Professor, Nutrition and Dietetics, SUNY College at Oneonta, Oneonta, NY 13820 FOR FURTHER INFORMATION The CANFit Website is http://www.canfit.org/index.html. CANFit has received two Dannon Institute Awards for Excellence in Community Nutrition. For more information on the programs, visit the case studies found on the Community Nutritionary section of this website: • Promoting Healthy Activities Together (P. H. A.T.) • The 100 Way Project This project was supported by an educational grant from the Dannon Institute and the Community Nutritionary.
LESSONS LEARNED
CANFit’s projects are not simply interventions. Rather, the programs focus on positive changes in social norms. Communities are learning to encourage youth to “spur arguments” that professionals can then help youth counter in peer-to-peer educational endeavors. CANFit’s efforts have resulted in the development of tools that non-nutrition professionals use with youth.Youth are guided in becoming effective messengers for positive health and nutrition information. Ultimately, it becomes “cool” to drink water rather than 6-8 sodas a day. The CANFit Model can be adapted by other groups to make it theirs. And best of all, it isn’t dependent upon the continuing presence of professional staff to endure.
ABOUT ARNELL J. HINKLE
Arnell Hinkle is the founding Executive Director of the California Adolescent Nutrition and Fitness (CANFit) Program. She is responsible for grant-writing, program development, fiscal management, training, and technical assistance and the day-to-day operation of a statewide program serving low-income, multi-ethnic adolescents. Prior to this position, Ms. Hinkle was Project Coordinator of the Hunger and Chronic Disease Prevention Program of the Contra Costa County Health Services Department, a position she held for 3 years. An active community volunteer, she serves on numerous local, state, and nonprofit boards. Ms. Hinkle has a AB degree in Geology from Princeton University, and both a BS in Nutrition and Clinical Dietetics, and a Masters in Public Health from the University of California, Berkeley. She is a Registered Dietitian and Certified Health Education Specialist. In addition to her work in the United States, Ms. Hinkle has been involved in international development projects in India, Ecuador and Scotland. Ms. Hinkle is a recipient of the 2003 Robert Wood Johnson Community Health Leader Award, and a 2005 Rockefeller Foundation Bellagio Fellowship for her work with the CANFit Program.
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