What is already known on this topic?Evidence is growing that strategies to improve physical activity and nutrition should focus on community-based approaches to improve health, especially in rural communities.What is added by this report?The High Obesity Program helped to increase access to healthier foods for more than 1.5 million people and increase access to physical activity for nearly 1.6 million people. More than 100 communities implemented policy, systems, and environmental changes that enhanced places for physical activity, and 88 priority communities increased access to healthier foods.What are the implications for public health practice?Public health strategies aiming to improve healthy food and physical activity access should consider working with nontraditional partners and using community-based participatory approaches to engage communities. AbstractThe burden of obesity and other chronic diseases negatively affects the nation's health, businesses, economy, and military readiness. The prevalence is higher in certain geographic locations. Be-
Background Breastfeeding is the optimal method for infant feeding. In the United States, 81.1% of mothers initiate breastfeeding; however, only 44.4% and 22.3% of mothers are exclusively breastfeeding at 3 and 6 months, respectively. Research aim The Centers for Disease Control and Prevention provides guidance and funding to state health departments to support strategies to improve breastfeeding policies and practices in the hospital, community, and worksite settings. In 2010, the Hawaii State Department of Health received support from the Centers for Disease Control and Prevention to launch the Baby-Friendly Hawaii Project (BFHP) to increase the number of Hawaii hospitals that provide maternity care consistent with the Ten Steps to Successful Breastfeeding and increase the rate of women who remain exclusively breastfeeding throughout their hospital stay. Methods For this article, we examined the BFHP’s final evaluation report and Hawaii breastfeeding and maternity care data to identify the role of the BFHP in facilitating improvements in maternity care practices and breastfeeding rates. Results Since 2010, 52 hospital site visits, 58 trainings, and ongoing technical assistance were administered, and more than 750 staff and health professionals from BFHP hospitals were trained. Hawaii’s overall quality composite Maternity Practices in Infant Nutrition and Care score increased from 65 (out of 100) in 2009 to 76 in 2011 and 80 in 2013, and Newborn Screening Data showed an increase in statewide exclusive breastfeeding from 59.7% in 2009 to 77.0% in 2014. Conclusion Implementation and findings from the BFHP can inform future planning at the state and federal levels on maternity care practices that can improve breastfeeding.
Context Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels. Objective For this project, we identified state-level farmers market activities completed with CDC’s DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state. Design and Participants We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words “farm,” “market,” “produce market,” and “produce stand.” State data with at least one state-level farmers market action present were then coded for the presence of itemized activities. Results Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices. Implications for Policy & Practice Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land-use policies, can be adopted as methods for farmers market policy and practice work. Conclusion The activities identified in this study can inform future planning at the state and federal levels on environment, policy, and systems approaches that improve the food environment through farmers markets.
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