Healthy Eating and Active Lifestyles

1. Healthy Eating and Active Lifestyles Thank you all for joining us today to hear a little about the healthy eating and active lifestyles initiative that we are getting ready to role out. Today we’re going to talk about the purpose of this initiative, how we got here, and give you a sneak peak of what’s to come. Let’s get a show of hands– how many of you in this room exercise at least twice a week? How many of you feel like you have a pretty healthy diet? How many of you consider yourself passionate about nutrition and physical activity? Someone who raised their hand… why do you think this is an important topic for Job Corps? Thank you all for joining us today to hear a little about the healthy eating and active lifestyles initiative that we are getting ready to role out. Today we’re going to talk about the purpose of this initiative, how we got here, and give you a sneak peak of what’s to come. Let’s get a show of hands– how many of you in this room exercise at least twice a week? How many of you feel like you have a pretty healthy diet? How many of you consider yourself passionate about nutrition and physical activity? Someone who raised their hand… why do you think this is an important topic for Job Corps?

2. In the early 1990’s the CDC started keeping taps on obesity trends in all of the states. In 1990 you’ll see that all of the states are shaded in one of the two light blue colors. All of the states have obesity rates of less than 15%. By the end of the 1990’s only three states held on to the light blue color, and many states moved into an obesity rate of over 20%, which looks grim by itself. Fast forward 10 years to 2009, and we have a much scarier picture. Some recent projections are showing that by 2015, several states will go over the 50% mark. This number, this BMI of 30, which is a weight to height ratio of which I think most people are aware, is the number where obesity-related ailments, like diabetes and heart disease start appearing. In the early 1990’s the CDC started keeping taps on obesity trends in all of the states. In 1990 you’ll see that all of the states are shaded in one of the two light blue colors. All of the states have obesity rates of less than 15%. By the end of the 1990’s only three states held on to the light blue color, and many states moved into an obesity rate of over 20%, which looks grim by itself. Fast forward 10 years to 2009, and we have a much scarier picture. Some recent projections are showing that by 2015, several states will go over the 50% mark. This number, this BMI of 30, which is a weight to height ratio of which I think most people are aware, is the number where obesity-related ailments, like diabetes and heart disease start appearing.

3. So What’s the Big Deal? 3 There’s also another issue, because of course health concerns are rarely salient with adolescents. We have some brand new data out of George Washington University that shows that obesity is much more expensive than we thought it was. So, being overweight costs both men and women a couple of hundred dollars per year. Obesity costs a few thousands of dollars per year. Any idea why carrying around extra weight is expensive? Sick days, lost productivity, extra gasoline, medical costs. Any ideas why the cost of being obese is so much more for women than men? Employment bias—passed over for jobs and promotions. It’s interesting that men suffer relatively little employment discrimination due to weight while women take the brunt of it. In a world where men and women are more equal than ever, it seems that in the workplace, women need to be thin to reap the benefits. This is one of the reasons that it’s so important in Job Corps, as we both provide healthcare to students, and our success relies heavily on our students ability to find a job after they graduate. George Washington University researchers added in things like employee sick days, lost productivity, even the need for extra gasoline — and found the annual cost of being obese is $4,879 for a woman and $2,646 for a man. Researchers had expected everybody's wages to suffer with obesity, but "this indicates you're not that disadvantaged as a guy, from a wage perspective," said Ferguson, who plans to study why. There’s also another issue, because of course health concerns are rarely salient with adolescents. We have some brand new data out of George Washington University that shows that obesity is much more expensive than we thought it was. So, being overweight costs both men and women a couple of hundred dollars per year. Obesity costs a few thousands of dollars per year. Any idea why carrying around extra weight is expensive? Sick days, lost productivity, extra gasoline, medical costs. Any ideas why the cost of being obese is so much more for women than men? Employment bias—passed over for jobs and promotions. It’s interesting that men suffer relatively little employment discrimination due to weight while women take the brunt of it. In a world where men and women are more equal than ever, it seems that in the workplace, women need to be thin to reap the benefits. This is one of the reasons that it’s so important in Job Corps, as we both provide healthcare to students, and our success relies heavily on our students ability to find a job after they graduate. George Washington University researchers added in things like employee sick days, lost productivity, even the need for extra gasoline — and found the annual cost of being obese is $4,879 for a woman and $2,646 for a man. Researchers had expected everybody's wages to suffer with obesity, but "this indicates you're not that disadvantaged as a guy, from a wage perspective," said Ferguson, who plans to study why.

4. Step 1: JC Data Collection Collaboration Leadership Motivation Variety 4 We went through several steps researching this project. In 2008, we wanted to get a grasp of what JC health and wellness programs were doing to address obesity and all of the components like food service and recreation. We sent out an informal data collection to get a grasp on what was going on. Boy, were the responses to this data collection oozing with frustration. For, the most part, wellness center managers completed the forms. Most of them had tried several programs that failed dismally. A lot of times they had something like a Biggest Loser competition that got everyone on center all excited, they gave out a bunch of water bottles, then 90% of the students dropped out by week 6. A lot of the managers who completed the survey were frustrated with their colleagues. There were issues that there were not enough healthy choices in the cafeteria, sometimes only a very limited salad bar, and portion sizes were way too large. Others mentioned that there weren’t enough recreational activities, especially for girls and anyone who didn’t want to play basketball. There were also a few complaints about an unsupportive center director, but I’m sure all of those center directors are long gone. Every few surveys there was a glimmer of hope. There was a program that succeeded or at least didn’t fail miserably. And from these small successes, we found the four predictors of a successful program. First--Collaboration between wellness, food service, recreation and administration increased the likelihood of program success. The more people involved, the more successful the program. Second, leadership. This is both leadership by center administration and the person who orchestrated the program. Program leaders do not have to be nurses—or health providers at all! Successful programs were led by TEAP specialists, counselors, and other staff outside of the wellness center. We asked a question about why the specific person was chosen to lead the program. Those with successful programs listed adjectives, like dynamic, personable, relates well with students. The ones with the depressing down and out programs often wrote things like, “because it’s in my job description.” There were a few centers out there that hired an outside dietician or personal trainer, Hiring a dietician or pt did not have much effect on program success, especially if this person didn’t relate well to students. Incidentally, Center Director support was the strongest predictor of success. Third, we placed an open-ended question “how did you motivate your students?” on the questionnaire. If this survey had been administered in person, I think I would have gotten a lot of blank stares. Several people listed goodies like water bottles and t-shirts, which incidentally had no correlation with program success. Some others admitted that they didn’t even really think about it. Then, some of the successful ones had some good ideas. They had peer support programs and faculty buddies. They had weekly meetings. Regardless of the strategy, a strategy to motivate and keep students interested was vital to program success. Finally, students needed access to healthy foods and recreation activities. Centers that offered a wide variety of recreation activities (e.g., dance and aerobics classes, walking groups, sports) to appeal to a diverse group of students had more success than those with limited offerings.We went through several steps researching this project. In 2008, we wanted to get a grasp of what JC health and wellness programs were doing to address obesity and all of the components like food service and recreation. We sent out an informal data collection to get a grasp on what was going on. Boy, were the responses to this data collection oozing with frustration. For, the most part, wellness center managers completed the forms. Most of them had tried several programs that failed dismally. A lot of times they had something like a Biggest Loser competition that got everyone on center all excited, they gave out a bunch of water bottles, then 90% of the students dropped out by week 6. A lot of the managers who completed the survey were frustrated with their colleagues. There were issues that there were not enough healthy choices in the cafeteria, sometimes only a very limited salad bar, and portion sizes were way too large. Others mentioned that there weren’t enough recreational activities, especially for girls and anyone who didn’t want to play basketball. There were also a few complaints about an unsupportive center director, but I’m sure all of those center directors are long gone. Every few surveys there was a glimmer of hope. There was a program that succeeded or at least didn’t fail miserably. And from these small successes, we found the four predictors of a successful program. First--Collaboration between wellness, food service, recreation and administration increased the likelihood of program success. The more people involved, the more successful the program. Second, leadership. This is both leadership by center administration and the person who orchestrated the program. Program leaders do not have to be nurses—or health providers at all! Successful programs were led by TEAP specialists, counselors, and other staff outside of the wellness center. We asked a question about why the specific person was chosen to lead the program. Those with successful programs listed adjectives, like dynamic, personable, relates well with students. The ones with the depressing down and out programs often wrote things like, “because it’s in my job description.” There were a few centers out there that hired an outside dietician or personal trainer, Hiring a dietician or pt did not have much effect on program success, especially if this person didn’t relate well to students. Incidentally, Center Director support was the strongest predictor of success. Third, we placed an open-ended question “how did you motivate your students?” on the questionnaire. If this survey had been administered in person, I think I would have gotten a lot of blank stares. Several people listed goodies like water bottles and t-shirts, which incidentally had no correlation with program success. Some others admitted that they didn’t even really think about it. Then, some of the successful ones had some good ideas. They had peer support programs and faculty buddies. They had weekly meetings. Regardless of the strategy, a strategy to motivate and keep students interested was vital to program success. Finally, students needed access to healthy foods and recreation activities. Centers that offered a wide variety of recreation activities (e.g., dance and aerobics classes, walking groups, sports) to appeal to a diverse group of students had more success than those with limited offerings.

5. Step 2: Public Schools 5 We wanted to see what public high schools were doing to combat obesity, because schools of course are receiving a good amount of attention about their highly processed menus that count french fries as a vegetable. This is an interesting book. A few years ago, the CDC collected school nutrition success stories to share best practices from schools around the country. After reading through this book, we visited two of the most interesting schools—fairfax county, virginia and NYC. We really wanted to learn about how these schools revamped their menu choices…that is… how they enticed students to eat healthy foods. We wanted to know their tricks of the trade. A lot of this information was used to build the food and nutrition website, which we’ll talk about in a little while. We wanted to see what public high schools were doing to combat obesity, because schools of course are receiving a good amount of attention about their highly processed menus that count french fries as a vegetable. This is an interesting book. A few years ago, the CDC collected school nutrition success stories to share best practices from schools around the country. After reading through this book, we visited two of the most interesting schools—fairfax county, virginia and NYC. We really wanted to learn about how these schools revamped their menu choices…that is… how they enticed students to eat healthy foods. We wanted to know their tricks of the trade. A lot of this information was used to build the food and nutrition website, which we’ll talk about in a little while.

6. Step 3: Job Corps Centers 6 At the same time we visited some Job Corps centers to see what they were doing. We spent time in the kitchens with the food service personal, conducted a few focus groups with students and staff, and ate a few meals in the cafeteria. And then we liked the food at DE Valley so much, we went back for a few more days. Really, we went back, because DE Valley was doing some neat things. They really had awesome fruit and salad bars. They had broiled fish offered at most meals. The kitchen staff made most of the food from scratch. There really wasn’t any of the opening a packet of chicken nuggets and dumping it in the fryer. This is a picture of one of their lunchtime offerings. Looks good enough to eat right? And the students overwhelmingly liked the food in the cafeteria. And they were a lot quieter and better behaved than at a lot of the other centers. And the best thing… wait for it. Chef Steve made up a huge budget deficit and ended up with surplus money during his first year as food service manager. He helped us develop the cost control portion of the food and nutrition website. At the same time we visited some Job Corps centers to see what they were doing. We spent time in the kitchens with the food service personal, conducted a few focus groups with students and staff, and ate a few meals in the cafeteria. And then we liked the food at DE Valley so much, we went back for a few more days. Really, we went back, because DE Valley was doing some neat things. They really had awesome fruit and salad bars. They had broiled fish offered at most meals. The kitchen staff made most of the food from scratch. There really wasn’t any of the opening a packet of chicken nuggets and dumping it in the fryer. This is a picture of one of their lunchtime offerings. Looks good enough to eat right? And the students overwhelmingly liked the food in the cafeteria. And they were a lot quieter and better behaved than at a lot of the other centers. And the best thing… wait for it. Chef Steve made up a huge budget deficit and ended up with surplus money during his first year as food service manager. He helped us develop the cost control portion of the food and nutrition website.

7. Step 4: A Meeting of the Minds 7 Finally, we took all of our research, and a whole bunch of literature and collaborated in several ways to come up with this program. You see a picture of a workgroup from last summer. We brought together several representatives from contractors, the national office, the forest service, and subject matter experts and hashed out this program. We had some corporate folks, some CDs, a food service manager, and a health and wellness manager. Here’s a picture from our summer workgroup. Finally, we took all of our research, and a whole bunch of literature and collaborated in several ways to come up with this program. You see a picture of a workgroup from last summer. We brought together several representatives from contractors, the national office, the forest service, and subject matter experts and hashed out this program. We had some corporate folks, some CDs, a food service manager, and a health and wellness manager. Here’s a picture from our summer workgroup.

8. 8 So… we are introducing the healthy eating and active lifestyles program. As you can see, this program contains portions for everyone on center to contribute.So… we are introducing the healthy eating and active lifestyles program. As you can see, this program contains portions for everyone on center to contribute.

9. The Program Holistic and individualized Step-by-step guide Website for food service staff Evidence-based curriculum A guide for recreation staff Policy (food service, recreation, programmatic) Webinars Tips to create a healthy environment 9 This program has been delivered to the national director and we are awaiting final approval. I will share with you what we have submitted, with the caveat that this may not exactly be the final product. For starters, this program is meant to be holistic and individualized. It is not meant to look the exact same way on every center. Of course, there will be similarities, like offering healthy food and plenty of recreational activities, but it’s also meant to be something that calls on your staff’s strengths and the individual needs of your students. Most of these components will be housed on a website on the JC community site. We are offering you ideas to tailor to your needs in the form of a step-by-step guide. This guide is broken down by position on center. So, each person has their own individualized tools and suggestions. We will have a whole separate website for food service staff, as they have one of the more vigorous roles in this program. There is a curriculum that can be used as a whole or broken into pieces to help satisfy the requirements in PRH 3.17. We’re providing separate information for recreation staff. To be consistent with the behavioral ecological model, there will be PRH changes, most of which will come in food service, as that policy was very out of date. There is also a requirement for a committee to steer this program. We will provide webinars to help your centers implement the program and learn more about food and nutrition. These webinars will be targeted towards different staff people, many toward food service staff. Finally, we offer tips to think about creating a healthy environment and a center culture that embraces health. This program has been delivered to the national director and we are awaiting final approval. I will share with you what we have submitted, with the caveat that this may not exactly be the final product. For starters, this program is meant to be holistic and individualized. It is not meant to look the exact same way on every center. Of course, there will be similarities, like offering healthy food and plenty of recreational activities, but it’s also meant to be something that calls on your staff’s strengths and the individual needs of your students. Most of these components will be housed on a website on the JC community site. We are offering you ideas to tailor to your needs in the form of a step-by-step guide. This guide is broken down by position on center. So, each person has their own individualized tools and suggestions. We will have a whole separate website for food service staff, as they have one of the more vigorous roles in this program. There is a curriculum that can be used as a whole or broken into pieces to help satisfy the requirements in PRH 3.17. We’re providing separate information for recreation staff. To be consistent with the behavioral ecological model, there will be PRH changes, most of which will come in food service, as that policy was very out of date. There is also a requirement for a committee to steer this program. We will provide webinars to help your centers implement the program and learn more about food and nutrition. These webinars will be targeted towards different staff people, many toward food service staff. Finally, we offer tips to think about creating a healthy environment and a center culture that embraces health.

10. What Makes a Successful Program? Collaboration Leadership Motivation Variety 10 We’re going to come back to these four items that we learned through our JC data collection make a program successful. We want to target the first two right now—collaboration and leadership, because that’s really where you come in.We’re going to come back to these four items that we learned through our JC data collection make a program successful. We want to target the first two right now—collaboration and leadership, because that’s really where you come in.

11. The Triumvirate Three powerful individuals, each a triumvir The core: health and wellness, recreation, and food service 11 Now that you have your important passionate person or people in place it’s time to consider the nuts and the bolts of the operation. All of what we’ve designed relies on the thought process that there are three powerful groups in charge of promoting student health: the health and wellness center, including nursing, physicians, mental health, TEAP, and oral health; recreation staff; and food service. Change in nutrition and physical activity takes members from all three of these groups to be truly effective. Now that you have your important passionate person or people in place it’s time to consider the nuts and the bolts of the operation. All of what we’ve designed relies on the thought process that there are three powerful groups in charge of promoting student health: the health and wellness center, including nursing, physicians, mental health, TEAP, and oral health; recreation staff; and food service. Change in nutrition and physical activity takes members from all three of these groups to be truly effective.

12. Who Else? Social Development Instructors CD/Administration Finance SGA Community Connections Others 12 And it can’t stop there. There are so many other people on center—social development, instructors, administration, finance, SGA, and the community that play a vital role. Someone from one of these groups may be one your passionate leaders, others may contribute in a smaller way. Anyway you look at it you have the makings of a holistic program. And it can’t stop there. There are so many other people on center—social development, instructors, administration, finance, SGA, and the community that play a vital role. Someone from one of these groups may be one your passionate leaders, others may contribute in a smaller way. Anyway you look at it you have the makings of a holistic program.

13. Best Health Mentor Competition Each member of the Job Corps community may nominate one staff member and one student as the center’s Best Health Mentor. Nominees should be individuals who both model healthy behaviors and help others adopt these behaviors. One staff member and one student will be selected from each region as a Best Health Mentor. 13

14. What’s Coming? “Best Health Mentor” competition A marketing kit for your center Two new websites Guidance on how to select a HEALS committee Staff trainings Ongoing program support Guidance to kick off the program 14

15. Any questions about your piece of the puzzle? 15