Anna Corona, MPH, CPH
Program Analyst, Child and Adolescent Health
When I was a WIC senior nutritionist, I regularly worked with families, caregivers, and parents of children and youth with special health care needs (CYSHCN) – work that I found rewarding, but that also left me wishing I could do more. In particular, I wished there was more I could provide in terms of nutrition advice and best practices for children with special nutrition needs. Fortunately, some states and the federal government have launched initiatives to give front line health care workers the skills and resources to do just that.
Leaders from Wisconsin and Washington showcased their efforts last month at the 2018 AMCHP Annual Conference, in a session called "Building Community Capacity to Support Nutrition Services for CYSHCN," which enticed me because of my experience in WIC (the federal Special Supplemental Nutrition Program for Women, Infants, and Children).
Peggy Helm-Quest (MSEd, MHA-PH) of Wisconsin and Joan Zerzan, (MS, RD) of Washington discussed the histories of developing systematic CYSHCN training for nutritionists across their states. The Wisconsin WIC CYSHCN Nourishing Special Needs Network aims to improve access to nutrition services and supports for infants and children with birth defects and other special health care needs by increasing the capacities of dieticians in WIC to serve these populations through a mentorship-style program. Similarly, Washington built a statewide capacity-building Nutrition Network to improve the ability of nutritionists to address the special nutrition needs of CYSHCN. Washington built its program by utilizing four capacity-building processes: 1) a bottom-up organization approach, 2) a top-down organization approach, 3) building partnerships, and 4) a community organizing approach.
Implementing such innovative and inclusive nutrition strategies throughout our public health work is of utmost importance for the maternal and child health populations we serve. On the national level, the U.S. Department of Health and Human Services recently included decreasing childhood obesity as one of its top three public health priorities. In support of that priority, the department's Health Resources and Services Administration funded the Children's Healthy Weight Collaborative Improvement and Innovation Network (CHW CoIIN) project, which is led by the Association of State Public Health Nutritionists (ASPHN). The goal of the CHW CoIIN is to increase the proportion of children and young adults (ages birth to 21) who fall within a healthy weight range. It does that by helping the 13 states selected to join the CoIIN (represented in the graphic below) adopt evidence-based or evidence-informed policies and practices related to nutrition, physical activity, and breastfeeding.
States Participating in the CHW CoIIN
This graphic depicts states selected to participate in the CHW CoIIN's year one workstreams, which focus on breastfeeding and physical activity. Each workstream includes two groups: one which receives monthly technical assistance and the other which receives a more intensive level of support from experts on the CHW CoIIN's steering committee.
The heightened focus on including nutrition-related strategies in public health programming is crucial to the health of families. Sandy Perkins, MS, RD/LD, who serves as the CHW CoIIN's project coordinator and the program development director at ASPHN, emphasized the importance of this work when she said, "Childhood obesity rates have leveled off in recent years but still remain really high, which is why it is important that we utilize innovative nutrition strategies through the CHW CoIIN to find new and unique ways to increase the number of children at a healthy weight."
The prioritization of improving the proportion of children who are at a healthy weight at both federal and state levels of government demonstrates a clear and much-needed commitment to a public health epidemic that our country has struggled with for decades.
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