1. Increase number of WIC mothers who initiate breastfeeding, and increase duration of breastfeeding.
KNN collaborated with WIC and University of Kansas Medical Center in a study to evaluate the effect of incentive gifts on breastfeeding incidence and duration at selected WIC clinics in Kansas. Of the 108 women who participated in this study, 58 women were clients at the comparison clinic and 50 women were clients at the gift clinics. Incentive gifts were provided for breastfeeding initiation and continuance at 30 and 90 days for women enrolled at the clinics in the gift group. A significantly greater percentage of mothers in the gift group than in the comparison group was breastfeeding their infants at 30 days at p=0.02. The percentage of mothers who initiated breastfeeding and who were breastfeeding at 90 days was not significantly different for the two groups of clinics. The results of this study provided partial support for the hypothesis that incentive gifts would improve the duration of breastfeeding. KNN will continue to collaborate with WIC to evaluate different approaches to increase the initiation and duration of breastfeeding among WIC clients and to promote WIC as a source of breastfeeding information and support.
KNN collaborated with WIC on a revision of a curriculum for child care providers to encourage them to accept breastfeeding infants in their care and to provide support to the breastfeeding mother. Since WIC breastfeeding mothers often have to return to work when the infant is still breastfeeding, the existence of supportive child care providers is essential to continuing breastfeeding. Pilot testing of this revision is being conducted this spring and summer, 2001.
2. Increase the number of minutes children in child care programs spend each day in physical activities.
KNN collaborated with KCCTO on a grant request to develop a lesson on physical activity as part of the Good for You! Nutrition Curriculum for Those Who Care About Children. Formative research was conducted and findings from that research were used in developing the lesson. That lesson was pilot-tested in child care sites and in Head Start programs with 180 providers. KNN also received a grant through Healthy Places Initiative to evaluate this lesson to determine the impact on the number of minutes children in child care and Head Start programs spend in physical activity each day as a result of providers and staff being trained with this curriculum.
A telephone interview with 49 of the participants was conducted approximately one month following the training. Providers reported that the children, overall, responded well to the activities as presented and even diverged to create their own movements. Children understood the importance of movement stating it helps “their muscles grow bigger.” They enjoyed the repetition, followed directions well, and incorporated singing into their activities. Providers asked for ready-to-copy materials for parents and community members, and this has been developed. “Family Fun Facts” will be included in the final edition of the curriculum.
3. Increase physical activity among older Kansans participating in programs at Senior Centers, Extension programs, and other sites.
Rather than develop “boxes” as was proposed in the KNN plan submitted last year, focus group data pointed to the possibility of more creative dissemination of nutrition and physical activity resources to programs serving older Kansans. A pilot program called, “SNAP Out of the Box” (Senior Nutrition and Activity Program) has been developed using internet sources of information. Selected Senior Center sites were provided with web addresses of reputable nutrition and physical activity resources. The Center managers were encouraged to use information from those sites in their newsletters, and for weekly nutrition and physical activity programs at their sites. An evaluation of this pilot program showed that many older Kansans did use the internet to access quality nutrition and physical activity information.
Boxes are being developed and will be distributed throughout Kansas to provide nutrition and physical activity resources for those who do not use the internet.
A web site is being developed to provide an entertaining way to entice older Kansans to access nutrition information. The web site will have a “game” format, and include nutrition information.
4. Increase participation in Heartland SHARE, a monthly food purchasing cooperative program that emphasizes fresh fruits and vegetables. Heartland SHARE participants will incorporate more fresh fruits and vegetables into their diets, and will learn low fat cooking methods.
Outreach brochures developed last year by KNN in both English and Spanish were distributed statewide to FNP programs, Head Start programs and other programs serving low income persons. The purpose of the brochure is to provide information on Heartland SHARE and encourage participation in this food purchasing cooperative program. More than 6,000 additional SHARE food boxes have been purchased since October 2000 in comparison to the same 8 month period in the previous year.
A “Ready, Set, Cook” training event for Extension FNP staff and others has been conducted. A “Ready, Set, Cook,” promotional event was held in Meade county; additional events will be held throughout the year. “Ready, Set, Cook” was developed as a result of focus group data which told KNN that people wanted to get nutrition information from small cooking classes. “Ready, Set, Cook” is a fun, innovative outreach event which provides information on one or more nutrition education or nutrition assistance programs, while at the same time incorporating nutrition education messages, including using more fruits and vegetables and low fat cooking methods.
Additional focus groups were conducted in Meade county to determine what people knew about Heartland SHARE, what they viewed as the barriers to participation, and their interest in a “Ready, Set, Cook” event. Information gleaned from those focus groups was used in developing the event in Meade.
A video of the event was made by K-State Communications and was used in training FNP agents in how to conduct a “Ready, Set, Cook” outreach event.
An evaluation of the effectiveness of “Ready, Set, Cook” to reach low income persons and connect them to existing nutrition education and nutrition assistance programs and to provide them with nutrition education will be conducted.
5. Promote the four messages to low income families with young children through collaboration with KACAP on the nutrition calendar.
The 2001 calendars were developed and distributed to 8,000 Head Start children. The calendars were newly revised from previous calendars based on survey information from Head Start parents and staff. Nutrition education resource packets were developed by KNN partner agencies and provided on a monthly basis to the Head Start programs. The packets include information on such topics as the importance or breakfast, trying new foods. An important part of the calendar is information on many nutrition education and nutrition assistance programs, including food stamps, WIC, school breakfast and lunch, etc., and how to sign up for each of these programs. More than 50% of the parents surveyed by KACAP reported that they used the information in the calendars to access nutrition assistance programs, such as WIC and food stamps.
6. Use focus group data to develop plans to partner with KCNS to do a social marketing campaign for older Kansans to increase participation in congregate meals.
KCNS members and staff from other agencies serving older adults conducted focus groups. Information was analyzed by KNN to look at the perceived barriers and benefits of participation in congregate meal programs. Training in social marketing was provided by KNN to KCNS member agencies. A social marketing plan has been developed to increase participation in congregate meal sites by recruiting additional volunteers and by providing additional training for volunteers and site managers. During the training, two social marketing plans were developed: (1) to increase participation in congregate meals through staff motivation; and (2) to increase the number of volunteers for home delivered meals.
7. Begin development of a food stamp promotional campaign.
KNN received a grant from the United Methodist Health Ministry Fund to develop a food stamp promotion campaign. KNN coordinated with SRS in the selection of one community for the development of a pilot program to increase participation in food stamps among families with young children. One focus group has been conducted with non-participants of food stamps at a Head Start site. All knew about food stamps, but expressed concerns about administrative barriers. It was determined to explore the possibility of promoting the new changes in food stamps, such as the waiver for one vehicle. Additionally, the committee is looking at increased training among service providers to make them aware of the new changes in food stamps and to encourage them to provide food stamp applications to their clients. At least one additional community will be chosen to develop a food stamp promotional campaign.
A social marketing campaign is being developed, which will initially include three “themes:” the first an informational campaign, the second will emphasize the new, simplified enrollment form, and the third will stress the partnership between SRS and the prospective food stamp client. All will use the term “Food Assistance Program” rather than “food stamps.”
8. Begin development of a plan to use cable access TV and PBS to disseminate nutrition messages and nutrition outreach information to low income persons.
Plans are being formulated to partner in the development of a PBS series to include nutrition education messages and outreach information to connect new clients to existing nutrition education and nutrition assistance programs, such as food stamps, WIC, school breakfast and lunch, etc.
Additionally, KNN is looking at other innovative means
of delivering nutrition messages and nutrition outreach information, such
as interactive kiosks; materials
for persons with limited reading skills; different ways of providing nutrition
information to child care providers, Head Start staff, and others who provide
care to young children. Focus groups of child care providers have been held
throughout the state to determine what other means of receiving nutrition information,
rather than the “traditional” two hour block of time, they might
find helpful. Information from these focus groups will be used to pilot some
innovative ways of delivering nutrition information to child care providers.
At least 20,000 persons were reached through KNN’s nutrition outreach efforts. The target audience is low income persons, including 8,000 Head Start children, more than 12,000 persons reached through the Heartland SHARE brochures, and others through the breastfeeding promotion and Ready, Set, Cook event.
KNN provided training in social marketing to KCNS, which is now using social marketing techniques to increase participation in congregate meals.
KNN is developing and evaluating innovative nutrition education and nutrition outreach efforts, including “Ready, Set, Cook,” SNAP Out of the Box, Good for You! Nutrition Curriculum for Those Who Care About Children, and the curriculum for child care providers to encourage them to provide care for breastfeeding infants.
KNN is being recognized as a leader in providing social marketing training and in developing innovative nutrition education and nutrition outreach efforts: