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From her desk at Public Health – Seattle & King County, Adrienne Dorf, MPH, RD, sees every child care setting as an opportunity for obesity prevention. She has influenced healthy child care environments for the past 12 years in King County. Currently, she holds two key roles: nutrition consultant for the Child Care Health Program and lead for the child care component of King County’s Community Transformation Grant (CTG), a partnership with Seattle Children’s Hospital.
With a background as a pediatric clinical dietitian, she worked for WIC and then the Washington State Department of Health in maternal and child health. “When the county’s Child Care Health program nutrition position came open,” she says, “I saw the opportunity to do population-based work through the providers, while also addressing the needs of individual children. I saw the need for both.”
In her 12 years with King County, Adrienne has seen how changes in policies and practices can impact children’s lives. “Of course it is always a challenge asking providers to make changes, considering the expense and need for staff training,” she says. But recent initiatives like Communities Putting Prevention to Work (CPPW) generated notable success stories. According to Adrienne, “CPPW did that with Farm to Child Care projects. The providers were excited and the children wanted to eat the kale right out of the basket. The project translated into providers offering healthier food on menus and getting children more excited about fruits and vegetables.” Some providers also switched to 1% low-fat milk from 2% milk.
Adrienne notes that CPPW also showed an impact with physical activity in child care settings. “I’ve seen the centers do more with physical activity by adding movement to music,” she says. “Some providers also realized that having a play set in the yard was not enough to encourage children to be active. It’s better when children have a moveable object, like a ball, rather than a jungle gym. It is all about new knowledge contributing to changes in practice.”
Adrienne plans to continue building state and local capacity for child care health through online and in-person provider trainings. The City of Seattle will organize cooking workshops to support farm to child care initiatives, and the County’s recent Community Transformation Grant will support one-on-one consulting with dozens of providers in Seattle and South King County.
To make it easier for parents to find health promoting child care, Adrienne works with partners to develop stronger state licensing regulations (WACs) for child care homes and centers. “Schools get a lot of attention,” she notes. “But by the time kids get to school, they are already overweight, so let’s take the opportunity of thinking about child care and all of the associated opportunities for obesity prevention.” She cites data collected by the Washington Department of Health and the Office of the Superintendent of Public Instruction showing that children had academic challenges when they also had health risk factors (being overweight, drinking three sugary drinks per day, and less than one hour of physical activity per day). “We are trying to help state leaders see the connection between children being healthy -- not overweight -- and being ready to learn,” she says. “We need to start on the statewide policy level, then engage the trainers, and finally the providers.”
State Legislators did not adopt Bill 1784 this year to require the Washington Department of Early Learning “to consider the prevention of childhood obesity when adopting rules relating to physical activity, screen time, and nutritional standards for all early learning programs.” In an encouraging step, the House Committee on Early Learning & Human Services scheduled a work session following the legislative session, giving health advocates the opportunity to inform the committee on the need for stronger regulations.
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Featured: March 2013
Child care advocates in Washington