CALIFORNIA 5 a DAY CAMPAIGN: WORKING WITH LOW-INCOME FAMILIES TO IMPROVE THE HEALTH OF THE COMMUNITY

1. CALIFORNIA 5 a DAY CAMPAIGN: WORKING WITH LOW-INCOME FAMILIES TO IMPROVE THE HEALTH OF THE COMMUNITY California 5 a Day Campaign California Department of Health Services Public Health Institute CMA Foundation NEPO Summit October 1, 2006 Melanie Hall, MS RD

2. Purpose of the California 5 a Day Campaign Reduce the risk of chronic diseases, such as: cancer heart disease type 2 diabetes hypertension overweight and obesity Empower low-income Californians to eat the recommended amounts of fruits and vegetables and engage in physical activity every day Encourage the use of nutrition assistance programs such as food stamps among those who are eligible

3. Chronic Disease Risk

4. Nutrition and PA Related Conditions

5. Chronic Disease Prevention General Recommendations from the Dietary Guidelines for Americans Eat More Fruits and Vegetables Eat More Whole Grains Eat Less Solid Fat Eat More Calcium Rich Foods Eat Less Sodium Do Not Eat Excess Calories Be More Physically Active

6. The Approach: Social Marketing A consumer-focused, comprehensive program employing the traditional elements of advertising, public relations, promotion and personal sales.

8. 5 a Day Campaign Target Audiences Children aged 9-11 in Low-income Californian Families Low-income Latino Californians Low-income African American Californians Food Retailers Located in Low-income Communities Businesses that employ Low-income Californians Low-income Vietnamese, Hmong, and Korean Californians

9. Evidence-Based Practice Each Campaign conducts extensive formative research to guide its direction Literature reviews Focus groups Key informant interviews Community-level and statewide surveys Each Campaign component is pilot tested to ensure its effectiveness Large-scale impact evaluation studies Process evaluation measures ensure each Campaign is implemented as planned

10. Effective Messaging Familiar images and concepts

11. California 5 a Day Campaigns African American Churches Retailers Cultural Festivals Low-income Housing Direct Health Service Providers Targeted Media Latino Retailers Farmers’ Markets Cultural Festivals Direct Health Service Providers Targeted Media

13. Campaign Reach Each year, the Latino Campaign reaches over 1.6 million Latino adults at community interventions. The African American Campaign reaches over 1 million African American adults. Each year, the Campaigns administer over 3,000 consumer surveys at community intervention sites. Findings show approximately 2/3 of respondents are aware of the recommended levels for fruits and vegetables and P.A. However, only about 1 out 3 report meeting these goals

14. Collaboration and Grassroots Efforts Create Community Change 2005 Latino Health Awareness Month Latino Health Summit Sponsored by Kaiser Permanente with support from The California Endowment and the California League of Cities-Latino Caucus Highlighted community “walkability assessments” To date, local leaders and community groups have joined forces to: Repair broken sidewalks leading to a local grocery store Fill in an unused canal to create a safer walking route to new Farmers’ Market Clean up local parks to encourage family recreation – plans for a FM Enhance law enforcement patrols in unsafe neighborhoods

15. Collaboration and Grassroots Efforts Create Community Change 2006 Black History Month - Community Empowerment Forums Central Valley residents worked to establish a farmers’ market in a low-income community A West Fresno church worked with community groups, local advocates, Black Farmers Association, and city officials to establish a weekly farmers’ market Farmers’ market accepts EBT for purchase of fruits and vegetables Provides nutrition education workshops and healthy food demonstrations Connects residents with local resources

16. Direct Health Service Provider and Community-Based Organization Channel Develop relationships with DHSPs and CBOs that serve low-income Latino and African American communities (sample list) Health Net of California Kaiser Permanente Community clinics Hospitals Migrant Education WIC Network funded projects American Cancer Society Encourage these organizations to promote the 5 a Day and physical activity messages as part of their own outreach efforts

17. Barriers for our Target Audiences Perceptions of health “Healthy” weight Leisure activity Common myths Channels of influence Unfamiliar foods Patient Doctor Culturally inappropriate interventions

18. Current Issues in Nutrition Misinformation Recommendations Terminology Vitamin/supplement use Fresh, frozen, dried, canned, juiced Organic vs. Non-organic Outbreaks

19. Nutrition Promotion in the Clinical Setting Use appropriate language Stress the importance of nutrition and physical activity Distribute culturally appropriate nutrition education materials Know the community you work with Cultural sensitivity Environmental barriers Meet your referral dietitian

20. Areas for Collaboration and Increased Communication Adopt and/or adapt the California 5 a Day Campaign messages for your target audience Implement the 5 a Day Fruits, Vegetables, and Physical Activity Toolbox for Community Educators, which includes nutrition, physical activity, and community empowerment lessons Volunteer as an expert health spokesperson to promote increased access to fruits and vegetables and safe physical activity opportunities in your community Work with community groups to educate policy makers on the importance of building healthier environments to improve health disparities e2e2

21. Other Opportunities Build strategic partnerships with private, nonprofit, and public sectors at the local, state, regional, and national levels to remove barriers to a healthy lifestyle Keep the issues in front of opinion shapers, the media, and key decision-makers until resolution is found

22. Acknowledgements Funding agencies USDA Food Stamp Program Preventive Health and Health Services Block Grant of the Centers for Disease Control and Prevention Over 500 private- and public-sector partners

23. For more information, contact Melanie Hall, mhall@dhs.ca.gov, 5 a Day Retail Program Valarie Scruggs, vscruggs@dhs.ca.gov, African American 5 a Day Campaign, Mark Martin, mmartin2@dhs.ca.gov, Latino 5 a Day Campaign, Dona Francis, dfrancis@dhs.ca.gov, 5 a Day—Be Active! Worksite Program, Tanya Garbolino, tgarboli@dhs.ca.gov, Children’s 5 a Day—Power Play! Campaign,