The ABC's of Health Literacy by tmf12618


									Support for this newsletter is provided by the Robert Wood Johnson Foundation as part of its Leadership for Healthy Communities national program

                       The ABC’s of Health Literacy                                                                            September, 2008
                             Gail Kouame, Consumer Health Coordinator
                  National Network of Libraries of Medicine, Pacific Northwest Region                       In This Issue…
According to Dr. Richard Carmona, former US Surgeon General, low health literacy is one of the              News
largest contributors to our nation’s epidemic of overweight and obesity. And yet it is a barrier that       Washington Schools to Provide Local,
is often overlooked when developing health promotion and childhood obesity prevention pro-                  Fresh Produce to Students
grams. The American Association of School Administrators (AASA), the International City/                    Eat up Kids, This Spud’s for You
County Management Association (ICMA), and the National Association of Counties (NACo) in-
vited Gail Kouame to author this article on health literacy to help our members, as local policy-           California Central Valley Communities
makers, school officials and community advocates, better understand the importance of addressing            Fight Obesity
health literacy issues in programs and materials you develop in order to ensure success and provide         Utah Schools Partner with Transporta-
ideas for incorporating the issues into your community’s obesity prevention efforts.                        tion Department to Map Safe Routes to

                                            O  ne of my co-workers often says, “Good in-
                                         formation is the best health insurance.” The issue,
                                                                                                            Back to Basics
                                                                                                            Coordinated Approach to Child Health
                                         however, is how to get to the “good stuff.” What
                                         we’re talking about here is health literacy – defined              Financing Childhood Obesity Prevention
                                                                                                            Programs: Federal Funding Sources and
                                         by Healthy People 2010 as “The degree to which indi-
                                                                                                            Other Strategies
                                         viduals have the capacity to obtain, process, and
                                         understand basic health information and services                   Research
                                         needed to make appropriate health decisions.”                      Obesity on the Kids' Menus at Top Food
                                         Sounds easy, but it has been reported that poor
                                         health literacy is a stronger predictor of a person’s              F as in Fat: How Obesity Policies are
                                                                                                            Failing in America, 2008
health than age, income, employment status, education level and race. Patients with inade-
quate health literacy have less health-related knowledge, receive less preventive care, have                Progress or Promises? What’s working
                                                                                                            for and against Healthy Schools
poorer control of their chronic illnesses, and are hospitalized more frequently. Health
literacy affects people’s ability to navigate the healthcare system, share personal informa-                Funding Opportunities
tion, engage in self-care and chronic disease management, and understand concepts such                      Healthy Sprouts Awards
as probability and risk. People in rural communities are at even greater risk. National                     Love Your Veggies Nationwide School
organizations like the Institute of Medicine, the Office of the Surgeon General, and the                    Lunch Campaign
Agency for Healthcare Research and Quality are providing a focus on this issue.                             Model Program of the Month
So what can communities do to ensure that families, especially those dealing with health Get Fit Great Falls
risks such as childhood obesity, have the information they need to make informed health Cascade County, MT
Currently, millions of Americans are going online to search for health information—but just where are they going and what are
they finding? To evaluate the quality of health information, be it online or in print, it pays to remember your ABC’s. My medi-
cal library colleagues and I suggest using the following criteria when looking at health information to determine whether it’s trust-
Authority: Ask yourself – are there authors listed? If so, who are they? Are they from a medical profession? If no author is

Your 15 Minutes of Fame!
AASA’s Leadership for Healthy Children & Schools seeks to promote promising practices of
all types to school leaders across the country. If you have successfully implemented a policy or
practice that you would like to share with AASA and your colleagues, read more and submit
your success story through our online form today!
Walk to School Day is 10/8/2008!                                October is International Walk to School Month - and October 8, 2008 is
                                          official Walk to School Day in the United States. If you haven't already taken steps in your
                                          community to get students walking and biking to school safely - consider this great opportu-
                                          nity to get started. For ideas on how to plan an event, visit and for re-
                                          sources on making walking and biking to school an integral part of your community, visit the
                                          Safe Routes to School National Partnership at

listed, is the information posted to the site of a reputable organization such as the National Institutes of Health, the Robert
Wood Johnson Foundation or the American Cancer Society?
Accuracy: Are the sources of information clearly cited? Is the author drawing conclusions and generalizations based on his or
her personal experiences? Is the information consistent with other sources? Is the information well-written, well-organized, and
logically presented? Is it free from spelling and grammatical errors?
Bias: Can you judge the author's purpose in posting the information? If they are trying to persuade you to a point of view or
sell you something, you must judge the information accordingly. Who paid for or sponsored the literature or web site? Might
they have a vested interest? When it comes to health information, the best information is based more on valid scientific research
findings and less on individual, personal experiences.
Currency: In the world of medical and health information, new research is taking place all the time. It is vital for information to
be up-to-date, especially when describing treatments of different medical conditions. On web pages, dates are not always in-
cluded. If they are included, what do they mean? Is it the date the page was originally created? Or, is it the date a page was re-
vised? Is the information likely to change? Is it recent enough to be useful?
Coverage: Many health sites are not comprehensive. The information they give may be accurate, but important information may
be left out. Don't stop with a single site unless you can answer these questions to your satisfaction: How does this information
compare with other sources (including published print sources) on the same topic? Is a better source available? Does the site
have a disclaimer that describes any limitations, purpose, scope, currency, or authority of the information?
Health-related information requires attention due to its potential to impact people’s quality of life. While Google and other
search engines are great for certain types of information, there are much better starting places for health information—sites that
are intended to be portals to quality health information to support the informed health decisions we all desire for ourselves and
our loved ones. One of the best starting places is—the National Library of Medicine’s consumer health site. It
contains information on over 750 health topics, including childhood obesity and children’s nutrition (
obesityinchildren.html). Other great sites for families dealing with childhood obesity and related issues are:
 • Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation
 • , sponsored by the American Academy of Family Physicians
 • , sponsored by the Nemours Foundation
 • The United States Department of Agriculture
 By going to trusted starting places first, instead of “shopping around” on the Internet, families can be assured of finding quality
 information. For more guidance on how to find the best information, talk to your local librarian. And, of course, no amount of
 information can replace interactions with your personal health care professionals. By getting to “the good stuff,” people can
 enter those interactions armed with the right questions and hopefully get on the path to optimal health.

Washington Schools to Provide Local, Fresh Produce to Students
Washington schools will begin serving state-grown fruits and vegetables to their
students this fall under legislation passed earlier this year, the Seattle Post-
Intelligencer reports. The Local Farms-Healthy Kids bill seeks to increase the avail-
ability of fresh produce to schoolchildren while providing a new market to local
farmers. The bill, combined with funding from a federal program, will double the
number of Washington schools receiving extra money to serve nutritious, fresh,
locally grown food. The state-funded grant supplies $57 per child, and schools
with a larger proportion of students from low-income families are also eligible
for part of a $600,000 grant. But the hiring of two staff members to connect
schools with local farmers has been delayed. Advocates for the positions, which
were written into the bill, say they are a critical component of the program. De-
partment of Agriculture spokesman Jason Kelly noted that the Going Local 
positions would "make a meaningful contribution to a more nu- How to start a farm‐to‐school movement in your district 
tritious diet for Washington school kids and economic opportu-
                                                                    • Look around and see who the local farmers are. Seek them out, ask 
nity for the state's fruit and vegetable growers". Read the Seattle
                                                                      what kinds of fruits and veggies they could provide for your schools.
Post-Intelligencer article, or view the legislation.
                                                                    • Build support from parents, teachers and the school’s nutrition 
                                                                       director. Barriers such as added cost and labor can be hard to over‐
Eat up Kids, This Spud’s for You
                                                                   come, so it’s crucial to engage the broader community. Try holding 
As we enter the 2008-09 school year, districts across the country discussions or expert talks on childhood obesity or local agriculture. 
are signing on to the burgeoning "farm-to-school" movement. Bring a farmer to the next PTA meeting. 
As a result, a growing number of schools are purchasing fewer
                                                                 • Start small. You don’t have to revamp the entire menu at once. Try 
fruits and vegetables from large distributors in favor of working a “harvest day” event featuring locally grown foods at the school 
individually with local farmers. While that can be more expen- cafeteria or at a parent taste‐test. Or try changing one menu item—
sive and may involve more work—from procurement to prepa- tossing french fries and switching to local potatoes, for instance. 
ration —food directors say it pays dividends in fresher, better-
tasting produce that more kids eat.
Signing up more kids for school lunches can help the bottom line, since schools receive a per-student subsidy from the National
School Lunch Program of the U.S. Department of Agriculture. At the same time, schools are bolstering regional agricultural
economies. More than 50 million students eat lunch in school cafeterias daily. Currently, much of the produce that appears on
their trays is shipped from far-away states. While that may sometimes be necessary in colder climates, increasing concerns about
food safety and childhood obesity are prompting more districts to seek local fare when it's in season. In past years, the biggest
obstacle to the go-local movement may have been the federal government, whose regulations restricted schools from "geographic
preferences" in procuring food. But the federal Farm Bill passed earlier this year loosened that restriction, giving the movement a
big boost. Read the entire Wall Street Journal Article.
                            Utah Schools Partner with Transportation Department to Map Safe Routes to Schools
                              The Utah Department of Transportation is collaborating with teachers and parents across the state to
                              map the safest routes for children to walk and bike to school, the Deseret News reports. Supported by
                              state funding, the Student Neighborhood Access Program (SNAP) is designed to improve compliance
                              with a state law requiring elementary, middle and junior high schools to create plans outlining the saf-
                              est walking and biking routes for students. SNAP encourages school administrators, teachers and par-
                              ents to work together to identify optimal routes, which are uploaded to a SNAP software program that
                              generates printouts advising parents about recommended routes to their children's schools. The soft-
                              ware helps identify needed improvements, such as crosswalks, sidewalks or other safety precautions on
                              potential routes. Adan Carillo, the transportation agency’s public information officer, says that SNAP
                              aims not only to address childhood obesity by encouraging more children to exercise but also to re-
                              duce the traffic congestion and pollution associated with driving students to and from school. Read
                              the Dessert News article, visit the SNAP webpage, or test their mapping software.
California Central Valley Communities Fight Obesity
Public health directors in California's Central Valley region have joined together to create a program to promote physical activity
and healthy diets in both adults and children, called the Central California Regional Obesity Prevention Program (CCROPP).
CCROPP is a 3-year initiative to reduce disparities in obesity and diabetes in Merced, Madera, Fresno, Tulare, Kings and Kern
counties. Under the initiative, participating counties have each created their own obesity prevention council to guide community
initiatives. Some communities, for example, have created walking groups, cleaned up and renovated parks, and improved access
to recreation facilities. In Tulare and Kings counties, several schools have agreed to open their play yards after-hours for the com-
munity to use. In addition, several communities have appointed new physical education faculty for schools. To improve access to
nutritious food, meanwhile, a number of counties have petitioned the federal government to allow the use of food stamps at
farmers markets and other non-traditional retail outlets. In Fresno, community members also are trying to strike down a zoning
law that hinders the creation of farmers markets and working to attract small markets that offer fresh produce. Reflecting on the

Annual Indoor Air Quality Tools for Schools National Symposium
AASA is now accepting applications for district leadership teams to travel and participate in the Environmental Protection
Agency’s 9th Annual Indoor Air Quality Tools for Schools National Symposium. This meeting will be held December
4-6, 2008, in Washington, D.C. AASA will be sponsoring a limited number of teams. Please download and complete
the application form (Word) and submit by Friday, September 26, 2008 to be considered. Visit the EPA’s Symposium
Website to learn more.
                                     Model Program of the Month
                                                                Get Fit Great Falls
    Find your community’s walkability score, as                 Cascade County, MT
    well as closest grocery stores, parks, schools,
                         etc.                                                                         The Cascade County Physi-
                                                                                                      cal Activity Council is a col-
                                                                                                      laborative of local, state, fed-
impetus for the projects, the program's director notes that,
                                                                                                      eral, private and non-profit
"if [residents] don't have programming, parks and easy,
                                                                                                      organizations formed to pro-
convenient access to fresh foods, they will make unhealthy
                                                                                                      mote physical activity and
food choices because that is what is available". Read the
                                                                                                      healthier eating by using the
Los Angeles Times Article or visit the CCROPP website.
                                                                                                      area’s national parks and
                                                                                                      public lands as a resource
Resources                                                                                             for environmental education.
Back to Basics
In many places, it’s rare for people to walk when they go       This school year, with seed money from the “More Kids in the
out on an errand or to meet a friend for lunch. The typical     Woods” program of the U.S. Forest Service, the Council is coordi-
routines of daily life encourage driving because walking,       nating Get Fit Great Falls, an environmental education program
even when it’s safe, is so often impractical, inconvenient,     that will offer two days of hands-on learning to all 750 fifth grad-
or unpleasant.                                                  ers in the Great Falls Public Schools. After one classroom learning
                                                                day, the students will spend a full day in the Lewis and Clark Na-
But many local government leaders are putting their com-        tional Forest learning how to snowshoe. They will then travel
munities on the path to change. Pedestrian-friendly design      around the cross country ski course to six stations where they will
is fast becoming an essential quality-of-life feature as com-   learn about different aspects of winter ecology, including:
munities try to adapt to an aging population, rising rates of
obesity, growing fatigue with traffic, and rising gas prices.      •    Snow properties
                                                                   •    Weather/Climate
Champions of walkability tout its economic, public health          •    Unstructured Play
and environmental benefits. The challenge is trying to             •    Winter Survival and Adaptations
achieve it in diverse settings, particularly in existing com-      •    Tree Characteristics
munities where most of the development occurred at a               •    Map and Compass
time when planning focused on moving cars rather than           The program includes intensive teacher training and purchase of
pedestrians. The question is: What are the core elements        snowshoe equipment for all 750 students, including winter coats,
of walkability, whether retrofitting an older neighborhood      gloves, scarves and snowshoes, at a total program cost of $18 per
or building a new one?                                          student. The equipment will then be available free of charge to
To explore the answers, ICMA hosted an interactive work-        Cascade County Residents, and participating students are encour-
shop titled “Walkable Communities–Building Prosperity           aged to come back to the mountains with their families to take
by Getting Back to Basics” at its 2008 Annual Conference        advantage of the snowshoe loan program at the ranger station. It
in Richmond, VA. The workshop was led by Dan Burden,            is the program's hope that these 11-year-olds will introduce the
who has worked with local governments across the coun-          whole family to a safe, low cost outdoor recreational activity.
try as the founder and director of Walkable Communities.
He was joined by urban design colleague Edward Erfurt.          Get Fit Great Falls will also be offered to all students at the Mon-
                                                                tana School for the Deaf and the Blind, and is working on a strat-
The workshop covered a variety of features that make get-       egy to include harder to reach students, including those in the ru-
ting around on foot or by bicycle easy and pleasant. Par-       ral parts of the county
ticipants heard about walkability in a variety of settings,     and home and parochial
from a revitalized downtown to a fast-growing community         students (approximately
in the suburbs. The workshop included a walkability au-         250).
dit, during which participants toured a Richmond
neighborhood and reviewed its walking conditions, as well       For more information
as small-group reviews of actual development plans to as-       on Get Fit Great Falls,
sess whether they are pedestrian-friendly. For more infor-      visit their website or
mation and materials, contact Christine Shenot                  contact Commissioner                                               Peggy Beltrone at pbel-
Healthy Foods, Healthy Moves
The national Healthy Foods, Healthy Moves: Delivering the Childhood Obesity Prevention Message to Schools and
Communities conference will take place on October 2 – 3, 2008 in Chicago. It will provide participants with strategies, tools,
and materials to address the childhood obesity epidemic in their own schools and communities. Also, through workshop tracks
on school and community partnerships, social marketing, and youth advocacy, attendees will be able to focus on their own spe-
cific areas of interest. For more information and to register online, please visit

Coordinated Approach to Child Health
CATCH (Coordinated Approach to Child Health) is an evidence-based Coordinated School Health Program designed to pro-
mote physical activity, healthy food choices, and prevent tobacco use in elementary school children. By teaching children that
eating healthy and being physically active every day can be fun, the CATCH Program has proved that establishing healthy habits
in childhood can promote behavior changes that carry into adulthood.
The CATCH Program focuses on coordinating four components: the Eat Smart school nutrition program, K-5 and 6-8 Class-
room curricula, a Physical Education program, and a Family program. Coordinating health messages among these four compo-
nents is critical to positively influencing children's knowledge and behavior. For more than 10 years CATCH has guided schools,
families and children in the process of being healthy. CATCH, the largest school-based health promotion study in the U.S., has
demonstrated that behaviors such as eating foods high in saturated fat and physical inactivity can be changed. Visit the CATCH
Texas website for curriculum material, evaluation tools, and training opportunities, as well as funding opportunities.

Financing Childhood Obesity Prevention Programs: Federal Funding Sources and Other Strategies
This brief represents The Finance Project’s first published resource on financing childhood obesity prevention. It provides a brief
guide to relevant federal funding sources as well as frameworks of financing strategies and childhood obesity prevention strate-
gies. It also illustrates the potential of these funding sources and strategies for childhood obesity prevention with examples of
creative initiatives in states and communities across the country. It is our hope that this work contributes to knowledge in the
field and informs and assists state and local decision makers as they seek to develop, sustain, or expand effective initiatives to
combat childhood obesity. Read the guide here.

Obesity on the Kids' Menus at Top Food Chains
A new report from the Center for Science in the Public Interest (CSPI) found that the
majority of children's meals offered at the nation's top restaurant chains are too high in
calories. Ninety-three percent of children’s meal options at the 13 chains examined ex-
ceed 430 calories—one-third of the Institute of Medicine’s recommended calorie intake
for children aged four through eight.
Besides being almost always too high in calories, 45 percent of the kids' meals at the 13
chains studied are too high in saturated and trans fat, and 86 percent are too high in so-
dium. That’s alarming, according to CSPI, because a quarter of children between the ages
of five and ten show early signs of heart disease, such as high LDL (the "bad" choles-
terol) or elevated blood pressure. Read the report.

F as in Fat: How Obesity Policies are Failing in America, 2008
Adult obesity rates increased in 37 states in the past year, according to the fifth annual F as in Fat: How Obesity Policies Are Fail-
ing in America, 2008 report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).
Rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states. No state saw a decrease.
Though many promising policies have emerged to promote physical activity and good nutrition in communities, the report con-
cludes that they are not being adopted or implemented at the levels needed to turn around this health crisis.
Recommendations for Combating Obesity. The report calls on the federal government to convene partners from state and local govern-
ments, businesses, communities and schools to create and implement a realistic, comprehensive National Strategy to Combat
Obesity. Some key policy recommendations include:
• Investing in effective community-based prevention programs that promote increased physical activity and good nutrition;
• Improving the nutritional quality of foods available in schools and childcare programs;
• Increasing the amount and quality of physical education and activity in schools and childcare programs;
• Increasing access to safe, accessible places for physical activity. Examples include creating and maintaining parks, sidewalks
    and bike lanes and providing incentives for smart growth designs that make communities more livable and walkable;
• Improving access to affordable, nutritious foods by providing incentives for grocery stores and farmers' markets to locate in
    underserved communities;
•   Encouraging limits on screen time for children through school-based curricula and media literacy resources;
•   Eliminating the marketing of junk food to kids;
•   Encouraging employers to provide workplace wellness programs;
•   Requiring public and private insurers to provide preventive services, including nutrition counseling for children and adults;
•   Providing people with the information they need about nutrition and activity to make educated decisions, including point-of-
    purchase information about the nutrition and calorie content of foods.
Progress or Promises? What’s working for and against Healthy Schools
Two years after the federal government required schools to implement wellness policies, Action for Healthy Kids has released a
report outlining progress to date, United Press International reports. The report finds that nearly 70 percent of the wellness poli-
cies adopted by school districts fail to meet minimum federal requirements, and many parents feel that schools could do more.
For example, while many schools have removed junk foods from cafeteria menus, most have not introduced additional fruits,
vegetables and other healthy fare. The report also points out that schools nationwide continue to scale back or eliminate physical
education programs amid funding and staffing constraints. Reflecting on the reasons for schools’ limited progress, the researchers
suggest that educators “do not view students’ health and wellness as part of their core mission” and propose “weaving physical
activity and healthful eating into the fabric of the school culture” as one way to address this issue. The report recommends that
schools refocus their funding and purchasing patterns to emphasize physical education and food service programs and take steps
to ensure that budgetary shortfalls do not result in cuts to those programs. In addition, the authors call on schools to engage par-
ents in encouraging healthy student behaviors, particularly in underserved communities. Read the full report.

Funding Opportunities
Healthy Sprouts Awards
Application Deadline: October 15, 2008
The National Gardening Association and Gardener's Supply Company have partnered to support schools and community organi-
zations that use gardens to teach about nutrition and explore the issue of hunger in the United States. The selection of winners is
based on the demonstrated relationship between the garden and nutrition education and hunger awareness. At least 10% of the
food produced from the program should be donated.

Love Your Veggies Nationwide School Lunch Campaign
Application Deadline: November 7, 2008
Each grant award will support an elementary school in developing a program
offering fresh vegetables and fruits lasting through the 2009-2010 school year.
Funding must be spent on any of the following:
• Fresh produce (vegetables and fruits)
• A vegetable station (such as a dedicated salad bar)
• Kitchen equipment (primary usage must relate to proposed program)
• Program staffing (cafeteria personnel, lunchroom staff, etc.)
• Nutrition education supplies
• Food Safety Training
More information available at

     Christina Rowland                    Rebecca Roberts                                 Christine Shenot
     (202) 942-4267                       (703)-875-0759                                  (202)-962-3662                               

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