Resource Type: Tools & Guides

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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Strategy Profile: Counseling in WIC Visits to Reduce TV Viewing

Posted on August 9, 2023

Loving Mother Holding Newborn Baby At Home In Loft Apartment

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.

  • Incorporating television time counseling into required Special Supplemental Nutrition program for Women, Infants, and Children (WIC) certification visits among WIC participants with children ages 2-4 through the inclusion of relevant assessment items within the existing screening assessment tools regularly used by WIC clinical staff.

What population benefits?

Children ages 2-4 who participate in the WIC program.

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?
Coordinate planning and delivery of virtual training and educational materials for WIC clinicians and monitor program status • Time for National WIC Coordinator to coordinate and monitor the program National WIC Coordinator
Develop virtual training and educational materials for WIC clinicians • Time for national WIC agency staff to develop virtual training and educational materials National WIC Agency Staff
Add relevant assessment items to measure television viewing within tools, tracking, and monitoring systems regularly used by WIC clinicians • Time to update database, tools, and tracking systems State WIC Agency Information Systems Staff
Train WIC clinicians in using relevant screening tools and motivational interviewing techniques • Time for state WIC agency staff to prepare for and deliver trainings
• Time for state WIC clinicians to attend trainings		 State WIC Program Staff

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:

Adams B, Sutphin B, Looney R, Rollins N, Balamurugan A, Kim H, Bolton A, Reiner J, Barrett J, Gortmaker SL, Cradock AL. Arkansas: Women, Infants, and Children (WIC) Television Time Reduction {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-wic-st-arkansas

Suggested Citation

CHOICES Strategy Profile: Counseling in WIC Visits to Reduce TV Viewing. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; 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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Strategy Profile: Creating Healthier Afterschool Environments

Posted on October 6, 2022

Young boy eating a green apple

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.

  • Creating healthier afterschool environments is a strategy to improve nutrition and physical activity policies & practices through the Out of School Nutrition and Physical Activity (OSNAP) initiative for children in grades K-5 attending state-administered 21st Century Learning afterschool programs.

What population benefits?

Children in grades K-5 attending state-administered 21st Century Learning afterschool programs.

What are the estimated benefits?

Relative to not implementing the strategy
Increase vigorous physical activity and improve nutritional quality of snacks and beverages offered in afterschool programs, and, in turn, promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Issue regulations to improve nutrition and physical activity policies and practices in afterschool programs • Time to issue and communicate regulations State government
Provide training and technical assistance to regional Healthy Afterschool trainers on how to lead learning collaborative sessions • Time for state Healthy Afterschool coordinator to lead trainings
• Time for regional Healthy Afterschool trainers to be trained and receive technical assistance
• Travel costs
• Training material costs		 State healthy afterschool coordinator
Conduct regional learning collaboratives with afterschool program staff including training and technical assistance on goals and implementation activities • Time for regional Healthy Afterschool trainers to lead learning collaboratives and provide technical assistance
• Time for afterschool program staff to attend learning collaboratives and receive technical assistance
• Training material costs
• Travel costs		 Regional healthy afterschool trainer
Assess and implement actions to change program practices to meet Healthy Afterschool standards • Time for afterschool program staff to conduct program practice self-assessments and implement changes at their program
• Increase in food costs to provide snacks in compliance with nutrition standards to children attending Healthy Afterschool programs		 Afterschool program director
Develop CEU-accredited course for local program staff • Cost to create a CEU-accredited course State healthy afterschool coordinator
Provide educational materials and incentives to local program staff • Material and incentive costs State government
Monitor compliance to ensure afterschool programs are following programmatic requirements • Time for state monitoring and compliance staff to monitor compliance
• Travel costs		 State government monitoring and compliance staff
Establish a Healthy Afterschool recognition and monitoring website • Time to create and maintain website State government website developer
Strategy Modification

This strategy could be modified to benefit children who participate in out-of-school programs administered by other organizations (e.g., YMCA or Boys and Girls Club of America). With this modification, the activities necessary to carry out the voluntary recognition program may not be included (e.g., issuing regulations, creating a healthy afterschool nutrition website, and monitoring compliance). With this modification, the impact on health is expected to be similar, and the impact on reach and cost may vary.

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: Creating Healthier Afterschool Environments. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; May 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: Movement Breaks in the Classroom

Posted on October 6, 2022

Teacher leading a movement break in the classroom with young kids

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.

  • Movement Breaks in the Classroom is a strategy to promote physical activity during the school day by incorporating five-to-10-minute movement breaks in K-5 public elementary school classrooms. 

What population benefits?

 Children in grades K-5 attending public elementary schools. 

What are the estimated benefits?

Relative to not implementing the strategy

Increase students’ moderate-to-vigorous physical activity levels and, in turn, promote healthy child weight. 

What activities and resources are needed?

Activities Resources Who Leads?
Identify and compile materials and content for training and implementation • Time for physical activity coordinator to identify and compile materials/content to train teachers
• Time for physical activity coordinator to develop a movement break library to support teachers with implementation		 Physical activity coordinator
Recruit schools and coordinate training • Time for physical activity coordinator to communicate and plan training activities with schools Physical activity coordinator
Train classroom teachers in movement breaks • Time for physical activity coordinator to provide training
• Time for classroom teachers to attend trainings		 Physical activity coordinator
Materials and equipment provided to teachers to implement movement breaks • Material costs School districts or local government

FOR ADDITIONAL INFORMATION

The Community Preventive Services Task Force. Physical Activity: Classroom-based Physical Activity Break Interventions. The Community Guide. 2021:8. Available at: https://www.thecommunityguide.org/findings/physical-activity-classroom-based-physical-activity-break-interventions

Selected CHOICES research brief including cost-effectiveness metrics:

Carter J, Greene J, Neeraja S, Bovenzi, M, Sabir M, Carter S, Bolton AA, Barrett JL, Reiner JR, Cradock AL. Boston, MA: Movement Breaks in the Classroom {Issue Brief}. Boston Public Schools, Boston Public Health Commission, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; August 2022. Available at: https://choicesproject.org/publications/brief-movement-breaks-boston

Good N, Bolton AA, Barrett JL, Reiner JF, Cradock AL. Massachusetts: Movement Breaks in the Classroom {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-movement-breaks-ma

Suggested Citation

CHOICES Strategy Profile: Movement Breaks in the Classroom. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; October 2022.

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: Sugary Drink Excise Tax

Posted on April 28, 2022

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.

  • A sugary drink excise tax is an excise tax assessed on manufacturers, bottlers, and/or distributors of sugary drinks based on the size of the sugary beverage distributed to consumers. This profile is specific to a sugary drink excise tax of 1 cent or 2 cents per ounce.

What population benefits?

All youth and adults ages 2 years and older.

What are the estimated benefits?

Relative to not implementing the strategy
Reduce sugary drink purchases and consumption, and, as a result, promote healthy weight.

What are the additional benefits?

Relative to not implementing the strategy
↓ Decrease in tooth decay
↓ Decrease in diabetes incidence

The costs of implementing this strategy could be offset by savings from…
↓ Decrease in dental costs

What activities and resources are needed?

Activities Resources Who Leads?
Administer the excise tax • Time for government tax agent to administer tax, including notifying taxpayers, updating systems and forms, processing tax statements, and conducting audits Government tax agency and staff
Prepare tax statements and comply with audits • Time for private industry accountant to prepare tax submissions and comply with audits Private industry accountant
Strategy Modification

Some state and local health agencies added to this strategy the costs of developing and implementing communications campaigns to further promote the tax among distributors and the public. This would require additional time to develop and distribute communication materials and the additional cost of materials.

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 reports including cost-effectiveness metrics:
Gouck J, Whetstone L, Walter C, Pugliese J, Kurtz C, Seavey-Hultquist J, Barrett J, McCulloch S, Reiner J, Garrone M, Cradock AL, Gortmaker S. California: A Sugary Drink Excise Tax. 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; March 2021. Available at: https://choicesproject.org/publications/report-california-sugary-drink-excise-tax/

McKinnon A, Ward Z, Barrett J, Cradock AL, Resch S, Flax C, and Gortmaker S. Utah: Sugary Drink Tax. Salt Lake County Health Department, Salt Lake City, UT, 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/report-utah-sugary-drink-tax

Suggested Citation

CHOICES Strategy Profile: Sugary Drink Excise Tax. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; May 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: Electronic Decision Support for Pediatric Medical Providers

Posted on April 28, 2022

Toddler girl laughing while doctor examines

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 recognition and recommended management of obesity among children ages 6-12 through electronic decision supports for pediatric medical providers during well-child visits.

What population benefits?

Children ages 6-12 years old with obesity (BMI>95th percentile) who are being seen by primary care providers with fully-functioning electronic health records systems.

What are the estimated benefits?

Relative to not implementing the strategy
Increase nutrition and physical activity health-promoting behaviors and, as a result, promote healthy child weight.

What activities and resources are needed?

Activities Resources Who Leads?
Oversee and implement electronic decision support for pediatric medical providers • Time for health system project coordinator to develop content for website, project dissemination plan, and training materials Health system project coordinator
Modify electronic health record system to prompt providers to recognize and manage obesity at clinics • Time for electronic health record system staff to update electronic health record system Electronic health record system staff
Develop and maintain a website to share local nutrition and physical activity resources to support healthy behaviors • Time to develop and maintain the website Health system website developer
and staff
Train in motivational interviewing and electronic health system changes and provide performance feedback to primary care providers • Time for health system project coordinator and/ or electronic health records system manager to lead trainings and to provide performance feedback to primary
care providers
• Time for primary care providers to attend trainings
• Training material costs
• Food costs to offer with trainings		 Health system project
coordinator, electronic health records system manager,
practice coach, and/or operations
manager
Develop and deliver direct-to-parent communications • Time for the health systems project coordinator to develop content for communications materials for families
• Costs for printing and mailing materials		 Health systems project coordinator
Additional time in clinics by primary care providers • Additional time for primary care clinicians to spend with patients in office Primary care clinicians
Material costs for primary care offices • Costs for printing posters to be displayed in primary care offices Health system
Strategy Modification

Some state and local health agencies replaced parent mailings with text messages, following a strategy modification that was shown to be effective in a research study. In the text messaging scenario, this strategy could reach children ages 2-12 and we estimate BMI would decrease (-0.3 units or about -1.24 lbs for a 9-year-old of average height). If a text messaging platform already exists in clinics, this could be less expensive than parent mailings.

FOR ADDITIONAL INFORMATION
Sharifi M, Franz C, Horan CM, Giles C, Long M, Ward Z, Resch S, Marshall R, Gortmaker S, Taveras E. Cost-Effectiveness of a Clinical Childhood Obesity Intervention. Pediatrics. 2017; 140(5): e20162998.

Selected CHOICES research brief including cost-effectiveness metrics:
Moreland J, Rosen J, Kraus E, Reiner J, Gortmaker S, Giles C, Ward Z. Denver: Study of Technology to Accelerate Research (STAR) {Issue Brief}. Denver Public Health and Denver Health, Denver, CO, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; July 2018. Available at: https://choicesproject.org/publications/brief-star-denver

Suggested Citation

CHOICES Strategy Profile: Electronic Decision Support for Pediatric Medical Providers. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; April 2022.

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: Safe Routes to School

Posted on April 28, 2022

Kids crossing street with crossing guard

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.

  • Safe Routes to School is a program that supports the use of physically active modes of transportation to and from school, and aims to help children in grades K-8 safely walk and bicycle to school through infrastructure improvements, education, enforcement, and promotional activities.

What population benefits?

Children in grades K-8 who switch from passive to active travel to school after their school adopts an active transport program.

What are the estimated benefits?

Relative to not implementing the strategy
Increase 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 driving, parking, and vehicle ownership and operation costs
↓ Decrease in travel time for families using their own vehicles for transportation
↓ Decrease in pedestrian and bicycle injuries and vehicle crash costs
↓ Decrease in air, greenhouse gas, water, and noise pollution costs

What activities and resources are needed?

Activities Resources Who Leads?
Oversee implementation of Safe Routes to School program • Time for Safe Routes to School coordinator(s) to oversee and manage implementation of the program
• Time for Safe Routes to School committee to select and provide guidance on projects, including advise and award grants, provide technical assistance to programs, communicate between Safe Routes to School programs and partners, and advocate for programs		 Safe Routes to School coordinator(s) and committee members
Attend Safe Routes to School committee meetings • Time for Safe Routes to School committee members to attend meetings
• Travel costs for Safe Routes to School committee members		 Safe Routes to School committee members
Improve infrastructure around schools • Infrastructure project costs Local government or other organization and schools
Adopt key components of Safe Routes to School Framework (e.g., education, encouragement, equity, enforcement, and evaluation) • Non-infrastructure project costs Local government or other organization and schools

FOR ADDITIONAL INFORMATION

Selected CHOICES research brief including cost-effectiveness metrics:
McCulloch SM, Barrett JL, Reiner JF, Cradock AL. Wisconsin: Safe Routes to School {Issue Brief}. Wisconsin Department of Health Services, Division of Public Health, Madison, WI, & East Central Wisconsin Regional Planning Commission, Menasha, WI 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-safe-routes-to-school-wisconsin/

Reiner J, Barrett J, Giles C, Cradock AL. Houston: Safe Routes to School {Issue Brief}. Houston Health Department, Houston, TX 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-srts-houston-tx

Pelletier J, Reiner J, Barrett J, Cradock AL, Giles C. Minnesota: Safe Routes to School (SRTS) {Issue Brief}. Minnesota Department of Health (MDH), St. Paul, MN, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; March 2019. Available at: https://choicesproject.org/publications/brief-saferoutes-to-school-minnesota

Suggested Citation

CHOICES Strategy Profile: Safe Routes to School. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; April 2022.

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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