Resource Type: Tools & Guides

Strategy Profile: Active School Day

Posted on November 16, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Policy requiring schools to provide opportunities for students to participate in physical activity during the school day for at least 30 minutes a day or 150 minutes a week.

What population benefits?

Children in grades K-8 (ages 5-14).

What are the estimated benefits?

Relative to not implementing the strategy
Increase students’ moderate-to-vigorous physical activity levels and, in turn, promote healthy weight.

What activities and resources are needed?

Activities Resources Who Leads?
Coordinate and support implementation of the active school day policy • Time for school health and wellness staff (Director, Assistant Director, Physical Education Director, Coordinators, and business office staff) to provide support School district
Train Wellness Champions, physical education teachers, and lunch monitors in physical activity promotion • Time for training consultant to train physical education teachers, Wellness Champions, and lunch monitors
• Time for Wellness Champions to attend trainings on policy and implementation strategies (either recess or movement breaks in the classroom)
• Time for physical education teachers to attend training on quality PE strategies
• Time for lunch monitors to attend trainings on recess strategies (in schools implementing recess strategies)
• Travel costs for lunch monitors to attend trainings
• Cost of space rental, food, and promotional flyers for trainings		 School district
Develop and maintain materials to support implementation • Cost to develop an online portal or printed materials to support implementation
• Cost to maintain the online portal or replace printed materials in subsequent years		 School
Implement strategies that promote physical activity in schools • Time for Wellness Champions and instructional coaches to lead implementation of strategies promoting physical activity
• Time for Wellness Champions and school principals to review performance on strategy implementation		 School district
Purchase equipment and materials for a more active school day • Cost of equipment and curricula for promoting physical activity in physical education and in recess or the classroom School district

FOR ADDITIONAL INFORMATION

Cradock AL, Barrett JL, Kenney EL, Giles CM, Ward ZJ, Long MW, Resch SC, Pipito AA, Wei ER, Gortmaker SL. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med. 2017 Feb;95 Suppl: S17-S27. doi: 10.1016/j.ypmed.2016.10.017. Supplemental Appendix with strategy details available at: https://ars.els-cdn.com/content/image/1- s2.0-S0091743516303395-mmc1.docx

Suggested Citation

CHOICES Strategy Profile: Active School Day. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; December 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: New Opportunities for Healthy Afterschool Programs

Posted on October 19, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Providing school-age children in grades K-5 attending Title I public schools with free state-administered afterschool programs that include 80 minutes of physical activity, a healthy snack, academic enrichment, and homework assistance.

What population benefits?

Children in grades K-5 who experience low income and are not currently participating in afterschool programs but would if programs were available.

What are the estimated benefits?

Relative to not implementing the strategy
Increase moderate-to-vigorous physical activity and, in turn, promote healthy child weight.

What are the additional benefits?

Relative to not implementing the strategy
The costs of implementing this strategy could be offset by savings from…
↓ Decrease in time cost of parent, relative, and non-relative caregivers to provide care for children newly attending afterschool programming

What activities and resources are needed?

Activities Resources Who Leads?
Administer funding and coordinate afterschool programming • Time of federal and state directors to lead administration and funding of afterschool programs in each state
• Time of federal, state, and district coordinators to coordinate afterschool programming and funding		 Federal and state directors
Coordinate transportation for children attending afterschool programs • Time of district transportation coordinator School district transportation coordinator
Train afterschool program site directors and staff and school district food service directors to operate the afterschool programs Time of state physical activity training facilitator to lead annual trainings
• Time for afterschool program site directors and staff (teachers and paraprofessionals) to attend annual trainings
• Time for school district food service directors to attend annual trainings on operating a healthy afterschool snack program		 State physical activity training facilitator
Purchase physical activity curricula, equipment, and materials for operating afterschool programs • Cost of physical activity curricula and equipment
• Cost of afterschool program handbook provided to families		 School district coordinator
Provide afterschool snacks that meet USDA afterschool snack program guidelines from the National School Lunch Program or the Child and Adult Care Food Program • Cost of snacks School district food service director
Provide afterschool programming • Time of afterschool program site director
• Time of afterschool program staff (teachers and paraprofessionals)
• Time of school custodial staff to clean afterschool program space		 Afterschool program site director
Provide transportation home from afterschool programs • Cost of bus transportation School district transportation coordinator

FOR ADDITIONAL INFORMATION

Cradock AL, Barrett JL, Kenney EL, Giles CM, Ward ZJ, Long MW, Resch SC, Pipito AA, Wei ER, Gortmaker SL. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med. 2017 Feb;95 Suppl: S17-S27. doi: 10.1016/j.ypmed.2016.10.017. Supplemental Appendix with strategy details available at: https://ars.els-cdn.com/content/image/1- s2.0-S0091743516303395-mmc1.docx

Suggested Citation

CHOICES Strategy Profile: New Opportunities for Healthy Afterschool Programs. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; October 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Policy to Reduce TV Time in Early Care and Education Settings

Posted on September 22, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Policy to limit noneducational television time in licensed early care and education (ECE) programs to 30 minutes per week for young children ages 2-5.

What population benefits?

Children ages 2-5 who attend licensed early care and education programs.

What are the estimated benefits?

Relative to not implementing the strategy
Reduce child daily television time which can help promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Assess compliance with new policy to limit television time to no more than 30 minutes per week • Time for state licensor to assess compliance with new policy during monitoring visit
• Time for early care and education directors to participate in monitoring visit		 State early care and education licensing agency
Provide materials and equipment for promoting physical activity (such as CDs with activity-promoting music and templates for parent newsletters) • Time for state licensor to provide technical assistance related to policy to limit television time
• Time for early care and education directors to receive technical assistance related to policy		 State early care and education licensing agency
Produce educational materials about new policy for early care and education directors • Cost of educational materials State early care and education licensing agency
Strategy Modification

This strategy could be implemented at the state or local level through different mechanisms, including as a requirement for early care and education (ECE) programs participating in a state’s Quality Rating and Improvement System (QRIS) or as best practice recommendations for ECE providers issued by a local health department or via a resolution from a local board of health, alone or in combination with other health-related objectives. Using these mechanisms, the impact on health and the activities and resources needed to carry out the television time policy are expected to be similar, however the cost and reach may vary.

FOR ADDITIONAL INFORMATION

Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting television to reduce childhood obesity: cost-effectiveness of five population strategies. Child Obes. 2021 Oct;17(7):442-448. doi: 10.1089/chi.2021.0016.

Selected CHOICES research brief including cost-effectiveness metrics:

Grant T, Wiggins C, Shelson S, Cradock AL, Gortmaker SL, Pipito A, Kenney EL, Giles CM. Mississippi: State Regulations to Reduce Non-Educational Screen Time for Young Children in Licensed Care {Issue Brief}. Mississippi State Department of Health, Jackson, MS, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; April, 2017. Available at: https://choicesproject.org/publications/brief-state-regulations-screen-time-mississippi

Case S, Simpson K, Khan F, U’ren S, Giles C, Kenney EL, Flax CN, Gortmaker SL, Ward ZJ, Cradock AL. Oklahoma: Updated Requirements in Reaching for the Stars to Reduce Non-Educational Screen Time for Young Children in Family Child Care Homes {Issue Brief}. Oklahoma State Department of Health and Oklahoma State Department of Human Services, Oklahoma City, OK, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; October 2017. Available at: https://choicesproject.org/publications/brief-ece-screen-time-oklahoma

Pharis M, Lawman H, Root M, Dryden S, Wagner A, Bettigole C, Mozaffarian, RS, Kenney EL, Cradock AL, Gortmaker SL, Giles CM, Ward ZJ. Philadelphia, PA: Childcare Policies Can Build a Better Future {Issue Brief}. Philadelphia Department of Public Health, Philadelphia, PA, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; December 2017. Available at: https://choicesproject.org/publications/brief-screen-time-philadelphia

Hill AB, Mozaffarian RS, Barrett JL, Cradock AL. Detroit: Best Practice Guidelines for Healthy Childcare {Issue Brief}. Detroit Health Department and United Way for Southeastern Michigan, Detroit, MI, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; December 2019. Available at: https://choicesproject.org/publications/brief-ece-detroit

Suggested Citation

CHOICES Strategy Profile: Policy to Reduce TV Time in Early Care and Education Settings. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Program in Early Care and Education Settings to Reduce TV Viewing

Posted on September 22, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Program to reduce television viewing among young children ages 2-5 in licensed early care and education centers by training educators in an evidence-based curriculum and engaging families in reducing television time at home

What population benefits?

Children ages 2-5 attending licensed early care and education centers.

What are the estimated benefits?

Relative to not implementing the strategy
Reduce child daily television time which can help promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Train early care and education directors and staff on an evidence-based curriculum (Fit5Kids) to reduce television time • Time for state early care and education agency training consultant to prepare for and lead trainings
• Time for early care and education program directors and staff to attend trainings
• Travel costs		 State early care and education training consultant
Provide training materials for early care educators and administrators to engage children and families in reducing television time • Cost of training materials State government
Provide materials to children and families to promote reduced TV time • Cost of materials for children and families
• Cost of the book “The Berenstain Bears and Too Much TV”		 Early care and education programs

FOR ADDITIONAL INFORMATION

Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting television to reduce childhood obesity: cost-effectiveness of five population strategies. Child Obes. 2021 Oct;17(7):442-448. doi: 10.1089/ chi.2021.0016.

Suggested Citation

CHOICES Strategy Profile: Program in Early Care and Education Settings to Reduce TV Viewing. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Creating Healthier Early Care and Education Environments

Posted on September 22, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Improving nutrition, physical activity, & screen time policies & practices for children ages 3-5 by incorporating the Nutrition & Physical Activity Self-Assessment for Child Care (NAP SACC) Program into state’s Quality Rating and Improvement Systems (QRIS) for early care and education programs.

What population benefits?

Children ages 3-5 attending licensed early care and education programs that participate in their state’s Quality Rating and Improvement Systems (QRIS).

What are the estimated benefits?

Relative to not implementing the strategy
Promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Train early care and education health professionals to work with early care and education programs • Time of state training consultant to train early care and education health professionals
• Time of early care and education health professionals to be trained		 State QRIS administrators
Provide consultation to early care and education program directors and staff for conducting self-assessments of program policies and practices, completing action plans, and implementing changes to improve nutrition, physical activity, and screen time environments in programs • Time of early care and education health professionals to provide consultation to early care and education programs
• Time of early care and education program directors and staff to participate in consultation		 Early care and education health professionals
Provide materials and equipment for implementing NAP SACC program • Cost for GO NAP SACC online license
• Physical activity equipment costs		 State QRIS administrators
Implement changes in early care and education programs to improve nutrition, physical activity, and screen time environments • Time of early care and education program directors to implement changes Early care and education program directors
Improve nutritional quality of meals served in early care and education programs • Food costs for improving nutritional quality of meals Early care and education program directors
Monitor compliance with NAP SACC program • Time of state-level QRIS Administrators to monitor compliance State QRIS administrators
Strategy Modification

In states where NAP SACC is already being implemented, the strategy could be modified to focus on increasing the number of early care and education programs that participate in NAP SACC. With this modification, the cost for the GO NAP SACC online license would not be needed, since it is a fixed annual cost paid per state (i.e., it does not depend on the number of participating programs). With this modification, the impact on health is expected to be similar, and the impact on reach and cost would vary according to the number of programs reached.

FOR ADDITIONAL INFORMATION

Gortmaker SL, Wang YC, Long MW, Giles CM, Ward ZJ, Barrett JL, Kenney EL, Sonneville KR, Afzal AS, Resch SC, Cradock AL. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Aff (Millwood). 2015 Nov;34(11):1932-9. doi: 10.1377/hlthaff.2015.0631. Supplemental Appendix with strategy details available at: https://www.healthaffairs.org/doi/suppl/10.1377/hlthaff.2015.0631/ suppl_file/2015-0631_gortmaker_appendix.pdf

Selected CHOICES research brief including cost-effectiveness metrics:

Adams B, Sutphin B, Betancourt K, Balamurugan A, Kim H, Bolton A, Barrett J, Reiner J, Cradock AL. Arkansas: Creating Healthier Child Care Environments: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) in the Quality Rating Improvement System (QRIS) {Issue Brief}. Arkansas Department of Health, Little Rock, AR, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; May 2021. Available at: https://choicesproject.org/publications/brief-napsacc-arkansas

Kenney EL, Giles CM, Flax CN, Gortmaker SL, Cradock AL, Ward ZJ, Foster S, Hammond W. New Hampshire: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) Intervention {Issue Brief}. New Hampshire Department of Health and Human Services, Concord, NH, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; October 2017. Available at: https:// choicesproject.org/publications/brief-napsacc-intervention-new-hampshire

Suggested Citation

CHOICES Strategy Profile: Creating Healthier Early Care and Education Environments. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Fast-Food Restaurant Calorie Labeling (2018)

Posted on September 21, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Require fast-food chain restaurants with 20 or more locations nationally to list calories for standard menu items on in-store and drive-thru menu boards along with succinct statements concerning suggested daily caloric intake (implemented in 2018).

What population benefits?

All youth and adults ages 2 years and older.

What are the estimated benefits?

Relative to not implementing the strategy
Decrease daily energy intake and, in turn, promote healthy weight.

What activities and resources are needed?

Activities Resources Who Leads?
Manage rollout of restaurant calorie menu labeling and communicate policy change to restaurant chains • Time of Food and Drug Administration to manage rollout Food and Drug Administration
Review rule requirements • Time for legal analyst to review rule requirements

 

 Restaurant chain
Analyze nutrient content for each menu item • Cost of analyzing menu items by entering recipes in a nutrition database Restaurant chain
Replace menus and menu boards to comply with policy • Cost of designing new menus (if applicable)
• Cost of menu and menu board replacement		 Restaurant chain
Monitor compliance with menu labeling policy • Time of public health department inspectors to monitor compliance Local public health department

FOR ADDITIONAL INFORMATION

Dupuis R, Block JP, Barrett JL, Long MW, Petimar J, Ward ZJ, Kenney EL, Musicus AA, Cannuscio CC, Williams DR, Bleich SN, Gortmaker SL. Cost-Effectiveness of Calorie Labeling at Large Fast-Food Chains Across the U.S. Am J Prev Med. 2024 Jan 66(1):128-137. doi:10.1016/j.amepre.2023.08.012.

Suggested Citation

CHOICES Strategy Profile: Fast-Food Restaurant Calorie Labeling (2018). CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: More Movement in Early Care and Education Settings

Posted on September 15, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Policy to promote physical activity among children ages 3-5 in licensed early care and education (ECE) programs by requiring training for early care educators in the provision of structured physical activity opportunities using an evidence-based curriculum.

What population benefits?

Children ages 3-5 who attend licensed early care and education programs.

What are the estimated benefits?

Relative to not implementing the strategy
Increase children’s moderate-to-vigorous physical activity levels and, in turn, promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Train early care and education program directors and staff on evidence-based strategies and curricula (Hip Hop to Health Jr.) to provide physical activity instruction • Time for State Early Care and Education Agency Training Consultant to prepare for and lead training
• Time for early care and education program directors and staff to attend training
• Travel costs		 State early care and education training consultant
Provide materials and equipment for promoting physical activity (such as CDs with activity-promoting music and templates for parent newsletters) • Cost of materials and equipment Early care and education programs (or local government)
Assess compliance with new policy to provide training and physical activity opportunities • Time for state licensor to assess compliance with policy during monitoring visit State early care and education agency monitoring and compliance staff

FOR ADDITIONAL INFORMATION

Cradock AL, Barrett JL, Kenney EL, Giles CM, Ward ZJ, Long MW, Resch SC, Pipito AA, Wei ER, Gortmaker SL. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med. 2017 Feb;95 Suppl: S17-S27. doi: 10.1016/j.ypmed.2016.10.017. Supplemental Appendix with strategy details available at: https://ars.els-cdn.com/ content/image/1-s2.0-S0091743516303395-mmc1.docx

Suggested Citation

CHOICES Strategy Profile: More Movement in Early Care and Education Settings. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Reducing Exposure to Unhealthy Food and Beverage Advertising

Posted on September 15, 2023

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Reducing exposure to unhealthy food and beverage advertising is a strategy to eliminate the tax deductibility of television advertising costs for nutritionally poor foods and beverages advertised to children and adolescents ages 2-19.

What population benefits?

All youth and adolescents between the ages of 2 and 19.

What are the estimated benefits?

Relative to not implementing the strategy
Reduce exposure to unhealthy food and beverage advertising on television and, in turn, promote healthy weight.

What activities and resources are needed?

Activities Resources Who Leads?
Process tax statements and conduct audits • Time for the state tax administrator to process tax statements and conduct audits State tax administrator
Prepare tax statements and participate in audits • Time for a private company tax accountant to prepare tax statements and participate in audits Private company tax accountant

FOR ADDITIONAL INFORMATION

Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting television to reduce childhood obesity: cost-effectiveness of five population strategies. Child Obes. 2021 Oct;17(7):442-448. doi: 10.1089/chi.2021.0016.

Suggested Citation

CHOICES Strategy Profile: Reducing Exposure to Unhealthy Food and Beverage Advertising. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Home Visits to Reduce TV Time

Posted on September 15, 2023

Mom and daughter meeting with counselor at home, while daughter is looking at a handheld screen

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Home visits to reduce TV time is a program to disseminate a screen time managing device to families through a home visiting program to reduce screen time among children ages 4-7.

What population benefits?

Children ages 4-7 with BMI >75th percentile who receive home visits.

What are the estimated benefits?

Relative to not implementing the strategy
Reduce child daily television time which can help improve dietary intake and, in turn, promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Coordinate the training rollout • Time for the director to coordinate the trainings Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program
Train community health workers who would implement the program • Time for community health workers to receive trainings
• Travel costs
• Material costs		 Home Visiting Program Coordinator
Train registered nurses about referring children to home visits to reduce screen time • Time for registered nurses to receive trainings
• Travel costs		 Home Visiting Program Coordinator
Purchase program materials • TV control device cost
• Posters cost
• Incentives for children cost		 Home Visiting Programs
Coordinate patient referrals and provide counseling during home visits • Time for registered nurses to recruit and refer patients
• Time for community health workers to implement		 Community health center registered nurses & community health workers
Strategy Modification

Some state and local health agencies added to this strategy by teaching about parental controls on other screen devices (e.g., tablets, smart phones, etc.). This could help parents limit all types of screen time for their children, not just on the television. This would require additional training and materials for families.

FOR ADDITIONAL INFORMATION

Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting television to reduce childhood obesity: cost-effectiveness of five population strategies. Child Obes. 2021 Oct;17(7):442-448. doi: 10.1089/chi.2021.0016.

Selected CHOICES research brief including cost-effectiveness metrics:

Carter S, Bovenzi M, Sabir M, Bolton AA, Reiner JR, Barrett JL, Cradock AL, Gortmaker SL. Boston, MA: Home Visits to Reduce Screen Time {Issue Brief}. Boston Public Health Commission, Boston, MA, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; February 2023. Available at: https://choicesproject.org/publications/brief-home-visits-screen-time

Suggested Citation

CHOICES Strategy Profile: Home Visits to Reduce TV Time. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; September 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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Strategy Profile: Promoting Water Consumption in Schools

Posted on August 30, 2023

School-aged girl drinking water from a reusable water bottle

The information in this resource is intended only to provide educational information. This profile describes the estimated benefits, activities, resources, and leadership needed to implement a strategy to improve child health. This information can be useful for planning and prioritization purposes.

  • Promoting increased water consumption among elementary and middle school students (grades K-8) with the installation of chilled drinking water dispensers in school cafeterias with viable plumbing in schools that participate in the National School Lunch Program.

What population benefits?

Children in grades K-8 attending schools with viable plumbing that participate in the National School Lunch Program.

What are the estimated benefits?

Relative to not implementing the strategy
Increase the availability of safe, free drinking water in schools. In turn, this would increase child water consumption and promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Purchase and install chilled water dispensers • Staffing resources necessary for installing water dispensers
• Costs associated with purchasing water dispensers		 School personnel
Deliver training to school food service directors in cleaning and maintaining the chilled water dispensers • Time to develop online training and materials
• Time for food service directors to access and attend online training		 School district food service staff
Maintain and clean water dispensers • Time for food service staff to clean water dispensers
• Cost of water dispenser filter replacement
• Time for food service staff to replace filters		 School food service staff
Increase utilities and disposable cup usage • Cost of incremental increase in water and electricity usage
• Cost of increased disposable cup usage		 Schools
Test lead levels in drinking water and remediate issues • Cost of lead testing and remediation for school drinking water Schools
Conduct administrative review related to drinking water • Time for the school district food service director to participate in administrative review
• Time for the National School Lunch Program administrator to conduct administrative review		 State government
Strategy Modification

Some state and local health agencies added to this strategy the costs of developing and disseminating educational materials on water consumption to further encourage water consumption among students. This would require additional time to develop and disseminate the educational materials and the additional cost of the educational materials.

FOR ADDITIONAL INFORMATION
Kenney EL, Cradock AL, Long MW, Barrett JL, Giles CM, Ward ZJ, Gortmaker SL. CostEffectiveness of Water Promotion Strategies in Schools for Preventing Childhood Obesity and Increasing Water Intake. Obesity. 2019;27(12):2037-2045. doi:10.1002/oby.22615.

Selected CHOICES research brief including cost-effectiveness metrics:
Gouck J, Whetstone L, Walter C, Pugliese J, Kurtz C, Seavey-Hultquist J, Barrett J, McCulloch S, Reiner J, Cradock AL. California: Improving Drinking Water Equity and Access in California Schools {Issue Brief}. California Department of Public Health, Sacramento, CA, the County of Santa Clara Public Health Department, San Jose, CA, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; December 2021. Available at: https://choicesproject.org/publications/brief-water-schools-california

McCulloch SM, Barrett JL, Reiner JF, Cradock AL. Massachusetts: Water Dispensers in Schools {Issue Brief}. The CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; June 2023. Available at: https://choicesproject.org/publications/brief-water-dispensers-ma

Suggested Citation

CHOICES Strategy Profile: Promoting Water Consumption in Schools. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; April 2022; revised August 2023.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose. The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

Adapted from the TIDieR (Template for Intervention Description and Replication) Checklist

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