BOX 6-2

Engaging Adult Health and Social Services Providers as Vehicles for Social Norm Changes

In 1999, the U.S. Department of Agriculture (USDA) funded a childhood obesity prevention initiative called Fit WIC to support and evaluate social and environmental approaches to preventing and reducing obesity in preschool children (USDA, 2005). California was one of the four state Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs that participated in the pilot program evaluation. The Fit WIC program, implemented through California WIC clinics and evaluated by the University of California at the Berkeley Center for Weight and Health (Crawford et al., 2004), compared six WIC sites (three of which served as intervention groups and three of which served as control groups) that participated in a pilot staff wellness intervention program to improve staff effectiveness in preventing childhood obesity. The intervention approaches focused primarily on supporting beneficial behaviors rather than on weight loss and on motivating staff members to eat healthfully and to be more physically active throughout the work day. Among the organizational changes at WIC sites were healthy food choices (e.g., fresh fruit or vegetables) when refreshments were served at meetings or celebrations and integrating 10-minute physical activity breaks into regular staff meetings or at certain times of the work day. Compared with the staff at the control site, the staff in the intervention group perceived greater support for their efforts to make healthful food choices available at the worksite and to engage in physical activity and reported substitutions in the types of foods served during meetings and the placement of a priority on physical activity in the workplace. Staff members at the intervention site were also more likely to counsel WIC participants to engage in physical activity with their children and reported that they believed that they had greater sensitivity in handling weight-related issues. This study underscores the potential reach of fitness promotion (Glasgow et al., 1999) in organizations serving high-risk groups, given the multiplier effect, that is, the positive influence of healthy provider behavior on clients.

SOURCES: Abramson et al. (2000); Frank et al. (2000); Lewis et al. (1986); Thompson et al. (2003).

Foundations

Foundations are active partners in many community-based obesity prevention efforts. As the funding sources for grantees at the community and grassroots levels, foundations may require that an evaluation plan be submitted with the grant application. For example, The California Endowment’s Healthy Eating/Active Communities (HEAC) initiative funds several community demonstration projects to implement programs promoting physical activity and healthful eating in six low-income communities



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