Evidence-level

Promising (About evidence-level criteria)

Description

The rural counties of Lincoln, East Linn, and rural Benton lie in the northwest part of Oregon. Economic recovery from the 2008 recession has been slow, and unemployment figures have fallen below pre-recession rates. The area's poverty has had direct effects on their children. Childhood obesity is a common problem in the region, particularly for children ages 11 and 13 years of age. Local data from 2017 shows that 30% of children in Linn County qualified as obese, over 25% of children in Benton County, and nearly 23% of children in Lincoln County identified as obese.

As rural areas tend to have fewer health, community, and financial resources, it is difficult for local families to access services that address obesity. In the years leading up to the project, the number of physical education (PE) classes declined, and nutrition programs were nonexistent, both of which are contributing factors to the area's high childhood obesity rates.

In 2012, the national Coordinated Approach to Child Health (CATCH) program was adopted by the Coast to Cascades Community Wellness Network (CCCWN) and by Samaritan Health Services to address the rising obesity epidemic. Dubbed the "Coast to Cascades CATCH program," it focused on teaching 2 of the 4 curriculum components: nutrition and physical education.

View this video to see how CATCH is being used at the Samaritan Early Learning Center, Neighbors for Kids, and Pioneer Elementary School.

Each county developed its own Childhood Obesity Partnership that merged into one consortium to provide regionally-informed input. As part of the current funding cycle, CATCH programming expanded to include culinary education. Because of that, the program name changed to Coast to Cascades C.H.E.F. (Culinary Health Education and Fitness) program. Each county is still assigned a coordinator who serves as a liaison between project management, the consortium, and individual sites.

Partners of the C.H.E.F. Program include:

• College of Osteopathic Medicine Pacific-Northwest
• Alsea School District Lebanon School District
• Lincoln County School District
• Monroe School District
• Oregon State University-Linus Pauling Institute
• Food Share of Lincoln County
• Planting Seeds of Change
• Samaritan Health Services
• Samaritan Lebanon Community Hospital

The first CATCH program was funded by the Federal Office of Rural Health Policy's Rural Health Care Services Outreach Grant Program from 2012-2015. The current C.H.E.F. program is funded on behalf of the CCCWN by the Federal Office of Rural Health Policy's Rural Health Network Development Grant through 2020 under Samaritan Lebanon Community Hospital.

The current cycle of funding expands CATCH programming to 11 additional sites to include middle schools and to implement culinary education classes throughout Lincoln, East Linn, and rural Benton counties.

Services offered

The consortium still offers the following CATCH programs through their C.H.E.F. program:

CATCH for Schools (in-school, K-8) equips schools with materials to teach healthy behaviors in the classroom, PE classes, the cafeteria, and the home

• CATCH Kids Club (afterschool, K-8) provides nutrition manuals to include scripted teaching lessons for instructors and also includes games, songs, nutritional facts, recipes, handouts, and letters home in both English and Spanish
• CATCH Early Childhood (preschool) includes fun, hands-on activities, such as classroom-based gardening and lively dance/music activities

CATCH programs include the following components:

• CATCH PE Activity Kits – a guidebook and activity box that holds 300+ cards with cardio, aerobic games, muscular strength, endurance, flexibility, and cool-down activity ideas.
• CATCH Kids Club Nutrition Manual – features lessons incorporating stories, rhymes, games, and songs. Handouts, nutritional facts, posters, and food label information are part of the teaching aids. Letters to parents written in English and Spanish reinforce positive behavior at home.
• Community Events – outreach events held annually at every CATCH site or school district.
• Physical Activity – the course requires 150 minutes of physical activity per week from each participant. Activities such as CATCH physical activity breaks, school recess, and PE classes count toward the minutes.
• Tasting Tables – offers samples of fruit or vegetable that are prepared in different ways and voted on by the kids. The food changes every month and is often used in school lunchrooms, CATCH snack time, and during special events.

The C.H.E.F. culinary education portion includes the following programs:

Cooking Matters – Founded by Share Our Strength, Cooking Matters classes are designed to provide hands-on cooking experiences for youth, children and families. The main goal is to help low-income families learn how to eat healthier for less cost.

Fresh Grown Cooking Classes – The Linus Pauling Institute Healthy Youth Program within Oregon State University developed this curriculum. The goal is to provide equitable opportunities to eat healthy, nourishing foods and to have the tools and resources needed to grow and prepare these foods.

Results

C.H.E.F. partners continue to see overall success in reaching the program's objectives and in positively impacting children's health. Although the programs are mid-way through the second evaluation, results include the following:

• More school cafeterias and afterschool programs have started offering healthier food options.
• To date in the current cycle, 3,487 children have been directly impacted through CATCH initiatives.
• With the addition of 11 new schools, the number of CATCH sites in Lincoln, East Linn, and rural Benton Counties has increased to 40.
• Increase from 42% to 55% in the total amount of time that CATCH participants spent in moderate to vigorous physical activity, surpassing the 50% recommended rate from the Department of Health and Human Services.
• Offered 24 culinary education courses across the region, reaching 436 adult and children participants.
• Trained 61 volunteers and medical students to deliver culinary education courses.

Challenges

• Partner organization and readiness was one of the most significant barriers in the first year of the current funding cycle. Of the 11 sites identified to become CATCH sites in the grant application, only 7 were prepared to begin with training and implementation. Staff changes, retirements, or additional programs being added to their schedules were among the main reasons.
• The capacity to deliver the original number of cooking courses resulted in a revision to the work plan. It was decided that the staffing and schedule of partner agencies could feasibly accomplish 69 classes, rather than 77. However, the original projected number of participants could still be attained.

Replication

C.H.E.F partners admit that one of their program's greatest accomplishments has been the support from local communities. They offer some advice to others interested in starting their own programs:

• Be willing to supply all equipment and provide as much training as possible for program staff and school leaders. Train a champion who can serve as an internal advocate for nutrition education, physical activity, and healthy living, and ensures the continuation of the program.
• Pursue the training of more than one CATCH champion at each site in order to mitigate leadership attrition due to staff turnover or relocation within the district.
• Leverage the support from regional leaders and community health advocates to coordinate community activities aimed at preventing childhood obesity.
• Coordinate and enhance health-promoting activities in your community and schools to carry on the momentum started by CATCH programs.
• Continue to submit equipment requests to local funders and apply for new federal grant opportunities that would enhance your program.
• Partnerships brought a high level of success with existing programs that have proven track records of reaching specific populations and community classes.
• Collaboration with Western University College of Osteopathic Medicine, Pacific Northwest to train medical students in delivery of cooking classes achieves both efficacy in class delivery for participants as well as expands medical student's experience with lifestyle medicine.

Tools used:

• Go, Slow, Whoa concepts were implemented during school and afterschool CATCH programs.
• An intensive study of the physical activity aspect of the CATCH program was conducted by an evaluation assistant, Daniel Roberson, a graduate student from Oregon State University. The study was successfully completed in 2014 and the thesis is available upon request.

To view more details about the culinary health education programs utilized, visit:

• Linus Pauling Institute's Healthy Youth Program, CHEF Project
• Cooking Matters

To view more details about the national and Lincoln, East Linn, and rural Benton Counties CATCH programs, visit:

• The National CATCH Library

Contact Information

JoAnn Miller, Director – Community Health Promotion
Samaritan Health Services
541.768.7330
jomiller@samhealth.org