NHPS Policy and Advocacy

Advocating for Change

Nemours Health & Prevention Services (NHPS) believes changing policies and practices, and even cultural norms, is necessary to build healthy communities and promote healthy behaviors. NHPS is working with community partners and coalitions to catalyze changes in places where children live, learn and play – schools, child care centers, primary care practices and the built environment.

At the same time, we are embarking on a multi-year, statewide public awareness campaign designed to create the demand for change and promote policy and practice changes in the environments that play a vital role in the development of Delaware’s children.

The initial area of emphasis is childhood obesity prevention through the promotion of healthy lifestyles. The centerpiece of this effort is the 5-2-1-Almost None message, which calls for:

• Eating at least five servings of fruits and vegetables a day
• Spending no more than two hours a day in front of a screen (TV, video games, recreational computer time)
• Getting at least one hour of physical activity a day
• Drinking almost no sugary beverages, like sodas and sports drinks

In the spring of 2010, the article "A Statewide Strategy to Battle Child Obesity in Delaware" appeared in the Health Affairs journal, detailing the NHPS efforts to reduce childhood obesity in Delaware.

Abstract:

In 2006, approximately 37 percent of Delaware’s children were overweight or obese. To combat Delaware’s childhood obesity epidemic, Nemours, a leading child health care provider, launched a statewide program to improve child health. The “social-ecological” strategy reaches beyond clinical encounters to promote better health and behavior at multiple levels. Early results show that the initiative halted the increase in the prevalence of overweight and obese children, since no statistically significant change occurred during the two-year span between administrations of the Delaware Survey on Children’s Health. The initiative also spurred increased knowledge of healthy eating and awareness of the need for increased physical activity in school, child care, and primary care settings.

Policy Briefs on Child Health Issues

Nemours Health and Prevention Services has produced the following briefs outlining our position on issues affecting children’s health in Delaware.

Delaware Policy Should Ensure Physical Activity in Elementary Schools
Recent studies show the importance of schools implementing physical activity and the strong connection between physical fitness and student success.  The 2008 Physical Activity Guidelines for Americans and the 2010 Dietary Guidelines for Americans recommend that children be active for 60 minutes or more each day.  The Institute of Medicine (IOM) recommends that children accumulate a minimum of 60 minutes of moderate to vigorous physical activity daily and that schools ensure that all students particulate in a minimum of 30 minutes of moderate to vigorous physical activity during the school day.  A statewide policy to ensure 150 minutes of moderate to vigorous physical activity will enable Delaware to join 12 other states that promote children’s health and academic achievement with policies ensuring sufficient physical activity during the school day.

Why Delaware Should Maintain Nutrition Regulations for Child Care
Delaware’s regulations for child care, which specify nutritional requirements for food prepared and served by child care providers and food supplied by parents and guardians, are meant to ensure that while in care, all children receive the healthy foods and beverages they need for their growth and development.  Delaware is not unique in regulating the quality of all food served in child care; several other states regulate nutrition in the child care sector in this manner as well.

Delaware’s Child Care Regulations Promote Healthy Child Development
Delaware's child care providers play an important role in nurturing the physical and emotional health of our state's youngest and most vulnerable residents.  The First State's child care regulations are nationally recognized for their sound requirements to promote young children's healthy development.  Collaboration among public, private and nonprofit organizations has made possible the establishment of child care regulations that teach healthy lifestyles to our youngest children and serve as a model for other states.

The Need to Increase Participation in Delaware’s School Breakfast Program
Breakfast improves student learning and may contribute to healthier weights.  Delaware can increase participation in school breakfast through a variety of mechanisms.  These strategies and the importance of school breakfast, especially for low-income students, are explained in this brief.

Counties and Municipalities in Delaware Can Develop Complete Streets to Combat Childhood Obesity
Complete streets - roadways designed and operated to enable safe access for pedestrians, bicyclist, motorists and mass transit users of all ages/abilities - encourage physical activity. A growing body of research finds that children are more physically active if they can walk or bike from home and school, which can help combat childhood obesity.

Improving Children’s Health Through Delaware Child Care Policy
Child care centers in Delaware play a vital role in teaching the importance of healthy eating and physical activity. Nemours Health and Prevention Services seeks to improve the standards and funding of the Delaware Stars for Early Success system regarding nutrition and physical activity.

New Expert Recommendations for Prevention and Treatment of Childhood Obesity in Primary Care
This policy brief describes recommendations on prevention, evaluation, and treatment of childhood obesity. It was recently released by a national expert committee made up of representatives from 15 professional organizations. Additionally, it outlines actions steps for Delaware stakeholders in pediatric health. 

Improving Children’s Social and Emotional Health through Delaware Child Care Policy
The brief outlines the importance of the childcare setting in the development of a child's social and behavioral health, as well as the new Delaware Stars for Early Success quality rating and improvement system for early care facilities.

Increasing Physical Activity for Students in Delaware Schools
Physical activity is an important part of a child’s day. Studies have reported 150 minutes of physical activity or education a week contributes to higher test scores and reduced discipline incidents.

Families Want Information to Make Healthy Choices: Why We Need Menu Labeling in Delaware
Most parents do not realize which items on a menu are packed with calories. Parents need to know how many calories their children are consuming. NHPS advocates chain restaurants with menus (those with more than 10 outlets nationally) to list calories, saturated fat, carbohydrates, and sodium next to each menu item.

Why Delaware Schools Should Continue to Assess Student Physical Fitness
Recent studies have used FITNESSGRAM data to demonstrate important linkages between fitness and academic achievement, disciplinary data, and absenteeism. The FITNESSGRAM is an essential tool in fighting childhood obesity in Delaware.

The Need to Measure Effectiveness of Childhood Obesity Prevention Efforts: The Healthy Eating and Physical Activity Index
The Healthy Eating and Physical Activity Index (HEPA), recently developed by Nemours Health and Prevention Services, uses statistical methods to aggregate a range of physical activity and healthy eating behaviors and the environmental supports for them (such as the walkability of a community or access to fresh fruits and vegetables).

Connecting Delaware Students to Local Foods: Why Delaware Needs a Farm to School Program
Delaware should establish a Farm to School Program in the Department of Agriculture. Such a program would provide the necessary infrastructure to increase the number of participating farmers and schools and potentially attract grant funding for special projects.

Investment in Parks and Recreation is Necessary for Children's Health
Parks and recreation facilities can provide a safe, fun, accessible and convenient location for physical activity for children and families.  This brief summarizes data on Delaware residents' recreation use and preferences and highlights the importance of investing in parks and recreation to support healthy lifestyles.

The Advantages of Providing Mental Health Services in the Primary Care Setting
This paper provides a rationale for integrating social and emotional
development and mental health services in primary care as well as
strategies for helping to ensure the effectiveness of this co-location.