Steps for Change: Creating a Plan to Prevent Childhood Obesity

Early care and education (ECE) settings are critical places for obesity prevention efforts. When healthy eating and physical activity habits are acquired during the preschool years, they can last a lifetime. Before working through the steps, it is helpful to have a basic understanding of the Spectrum of Opportunities for obesity prevention in ECE settings.

Steps for Obesity Prevention in ECE Settings

As you plan new, or strengthen existing, state- or community-level efforts to promote healthy eating, physical activity, breastfeeding, and reduced screen time among children in ECE, it is advised to work through a series of action steps. The action steps listed below are sequential and cyclical, and are presented in the order that is most appropriate for states or communities who are new to this work. However, the best starting point for those already working in this area will be determined by the nature of their prior work and current partnerships.

  1. Assess and Strengthen Partnerships
  2. Complete a State Spectrum Profile and Identify Existing Equity Goals and Strategies
  3. Assess Efforts to Date
  4. Determine Feasibility of Opportunities and Consider Equity Goals
  5. Develop a Shared Action Plan and Logic Model
Step 1: Assess and Strengthen Partnerships

Partnerships — also called collaborations and coalitions — are the cornerstone of any successful endeavor to make changes within ECE settings. A partnership looking to address obesity in child care and early education settings should include key stakeholders, policy makers and advocates from diverse groups that support children, including:

  • state and local health departments
  • child care agencies (including the child care regulatory agency)
  • departments of education
  • Child and Adult Care Food Program (CACFP) and sponsoring organizations
  • nonprofit organizations
  • vocational schools, colleges and universities with early care and education-related degree/certificate programs
  • parents of children in ECE
  • ECE providers (family-home and center-based)

Most states have ongoing obesity prevention initiatives with established state-level partnerships, as well as a variety of ECE setting-focused collaborations, particularly through their child care agencies. A foundation for partnerships to address childhood obesity in ECE is likely already in place within your state — it’s just a matter of bringing these different groups together if they have not yet found connections.

Complete the Partnership Assessment Worksheet to identify who should be at the table for planning state efforts to address obesity prevention focused on the ECE setting. Identify both existing and potential partners from the ECE and public health arenas.

Step 2: Complete a State Spectrum Profile and Identify Equity Goals and Strategies

Once partners and stakeholders have been identified and engaged, they can help provide information needed to capture current and previous obesity prevention and health efforts targeting early care and education (ECE) settings. This information will help determine what is working well, identify gaps or areas for improvement, and identify lessons learned.

Use the State Spectrum Profile Worksheet to collect and summarize information about how well obesity prevention standards and implementation support are already embedded in your state or community’s ECE system. The worksheet is comprehensive and does not need to be completed all at once. Start with the partners who are already members of your stakeholder group.

Within your partnership group, it is important to understand the equity goals and considerations that inform each other’s work. Use the Equity Worksheet to document your key partners’ priorities, goals, and strategies pertaining to equity.

Step 3: Assess Efforts to Date

After completing the State Profile and Equity Worksheets, you can use the Spectrum of Opportunities Assessment Worksheet to evaluate obesity prevention efforts that are completed or currently underway in your state or community. The Assessment Worksheet will facilitate the process of identifying what work has been completed or is under way, what materials, resources, and persons are involved, time frame of work, evaluation results/plans, challenges and benefits, and known or expected equity impact. This worksheet is important because it can be used in later steps to determine feasibility of opportunities, and develop a shared action plan and logic model.

Assess ECE obesity prevention opportunities for children in your community by completing a Spectrum of Opportunities Assessment Worksheet.

Step 4: Determine Feasibility of Opportunities and Consider Equity Goals

At any given point in time, a variety of factors will influence whether a specific opportunity is truly a viable option to pursue. With input from your partners, assess the feasibility of pursuing new (or strengthen existing) opportunities based on a common set of factors. Use the Spectrum of Opportunities Rating Worksheet to identify new opportunities for consideration and current efforts that might be improved and to rate the feasibility of each to help develop consensus on what to pursue.

Taken together, the information gathered to complete the two Spectrum worksheets should help answer several key questions, such as:

  • What are the gaps in current policies and programs?
  • Are there fixed timelines or funding cycles that make an opportunity timely to pursue now? (For example, state licensing regulations may be up for review on a specific schedule, such as every five years.)
  • What resources are currently available or might be reasonably obtained in the near future? Is there one opportunity for change that requires the least amount of resources but may provide a big yield?
  • What is the political will in your state? Are some opportunities off-limits from the standpoint of current political and agency leadership?
  • Are key stakeholders more interested in making improvements focused on one specific area, such as breastfeeding, or are they willing to engage in changes that encompass nutrition, physical activity, breastfeeding and screen time reduction comprehensively?

Step 5: Develop a Shared Action Plan and Logic Model

Developing an action plan means turning ideas raised during the assessment process into reality. Action plans keep you on track and focused by:

  • Identifying objectives and timelines
  • Providing guidelines for achieving objectives
  • Monitoring progress and successes
  • Giving clear direction of tasks
  • Setting expectations for outcomes

It also identifies resources and responsible individuals, groups, or organizations, and describes how to evaluate the activity. Developing an action plan in concert with partners and stakeholders is a helpful way to solidify activities and identify personnel and financial resources which are important to initiating change in the early care and education arena.

Use the Action Plan Worksheet and sample logic model to create a plan that documents the efforts that will be pursued by each stakeholder in the immediate future and the efforts that are expected to be pursued in the long-term.