Building Healthy Change in Boston

Building Healthy Change in Boston


Boston Public Health Commission (BPHC) has many years of experience addressing preventable chronic diseases in the city of Boston, and obesity prevention is at its forefront. In Boston, almost half of first graders in Boston Public Schools and more than a third of high schoolers are either overweight or obese. These rates are even higher among youth of color and indicate the need to implement policy, systems and environmental (PSE) changes to address this issue beginning with early childhood.

In 2015, BPHC launched learning collaboratives to support early care and education (ECE) programs to implement practice and policy changes for childhood obesity prevention. Following the Let’s Move! Child Care goals, BPHC modeled the Nemours’ National Early Care and Education Learning Collaborative (ECELC) Project to implement learning collaboratives in the Boston community with the goal of making healthy and sustainable changes in ECE programs.

The ECELC Project, led by Nemours and funded by the Centers for Disease Control and Prevention, promotes healthy environments, policies and practices in ECE settings to address childhood obesity. The ECELC model includes five in-person Learning Sessions or trainings, action period tasks and individualized technical assistance. In Boston, participating center-based programs serving children birth to five worked to improve policies and practices related to healthy eating, physical activity, screen time and breastfeeding support.

Nemours’ goals aligned with those of the Boston Healthy Childcare Initiative and provided an excellent model for strengthening both internal and ECE program participants’ capacity to address childhood obesity.

How it worked

In the beginning, BPHC took the initiative to learn more about the Nemours ECELC model. Several conversations occurred with key staff at Nemours to address project implementation questions. With the resources available on the Let’s Move! Child Care website, they were able to access all the materials needed to implement learning collaboratives. The implementation guide provided trainers with step-by-step instructions on how to recruit, deliver the presentation, conduct activities, share parent resources and much more.
After having a clear understanding of the model, several center-based ECE programs were interviewed to determine interest and gather feedback about the model. With overwhelming positive results and high interest, they decided to move forward with implementation of learning collaboratives.


Using the ECELC Model to Enhance the Boston Community

Using the ECELC model as a guide, BPHC looked for ways to customize the learning collaboratives to meet the needs of their community. Working previously with ECE programs, previously established relationships allowed them to identify the best ways to implement learning collaboratives which would benefit their providers.

Similar to the ECELC model, BPHC provided incentives to participating programs. Each program received a $150 stipend, family-style dining materials, a USB flash drive containing all documents and resources shared with them during the Learning Sessions, and Continuing Education Credits (CEU’s). The incentives were used to assist in program recruitment and retention.

Meeting the Needs of the Programs Within the Curriculum

Interviews at the start of the process revealed that programs would be unable to provide staffing to attend all the suggested five in-person Learning Sessions due to responsibilities of staff at participating programs. BPHC decided to reduce the number of in-person Learning Sessions to three and one 90-minute webinar. After deciding to reduce the number of Learning Sessions, they revised the current ECELC curriculum to meet the programs’ interest and needs. Developing the webinar was a way to eliminate cancellations of sessions and low enrollment due to the timing of the Learning Sessions and potential weather conditions.

In the beginning, programs completed a poll to identify topic areas of interest. Breastfeeding and screen time were found to be the least favorable topics identified by the programs. BPHC used this information in order to develop the content for the webinar. Although these were the least desirable topic areas, there was a tremendous amount of positive response after the webinar.

In addition, BPHC collaborated with the BPHC Bureau of Child, Adolescent and Family Health to integrate trauma-informed principles into the curriculum. These principles focused on working with ECE programs to support resiliency in children and families exposed to violence and trauma. Working with this organization allowed for continued support for ECE programs after completion of the project.

Initially the BPHC had many concerns (e.g.: they thought the durations of the Learning Sessions might be too long and the participants would find the action periods overwhelming). However, after each learning session, the trainers realized that participants were engaged and happy to share the information with their colleagues.

What’s next?

The Boston Public Health Commission summarized their experience implementing the project as a positive one. With lessons learned and a successful round of collaboratives, the BPHC is gearing up to launch another round of collaboratives.


The National ECELC Project is currently funded by the Centers for Disease Control and Prevention (CDC) under a five-year Cooperative Agreement (1U58DP004102-01) to support states and localities in launching early care and education learning collaboratives focused on childhood obesity prevention. The views expressed in written materials or publications, or by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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