5-2-1-0!
These are numbers you will be seeing more of in the near future. In October, Governor Kim Reynolds announced the 5-2-1-0 Healthy Choices Count campaign. This is an educational campaign to promote healthy eating and active living for children and families in our state. The campaign promotes the daily recommendations of 5- servings of fruits and vegetables, 2- hours or less of recreational screen time, 1- hour of physical activity, and 0-sugary drinks and more water. The campaign is supported by the Iowa Department of Public Health and the Healthiest State Initiative. It is well known that children with healthy habits learn better, feel better, and have a decreased risk for chronic medical conditions (such as obesity, diabetes, liver disease, and cardiovascular disease). The 5-2-1-0 campaign is evidence-based, and has been utilized successfully in many other places across United States. It is endorsed by the American Academy of Pediatrics and National Head Start Association.
This nationally-recognized campaign makes healthy eating and active living fun and easy to remember. We all know education is just one piece of the puzzle. The key is to make healthy choices easier through changes in environment and public policies. The campaign also provides technical support to communities make the environmental and policy changes. IDPH has funded 4 communities as pilot sites to offer targeted technical support for this multi-setting community approach. These sites include Malvern, Dubuque, West Union, and Mt. Pleasant. The councils of governments in these regions are facilitating this work.
Evidence for Multi-setting Approach:
The Institute of Medicine has identified the importance of using a multi-setting approach to prevent and address the chronic medical condition of obesity. They recommend coordinated efforts to make environmental and policy changes across communities. Iowa’s 5-2-1-0 Healthy Choices Count Campaign is modeled after the 5210 Let’s Go! program, developed by and used in Maine for the last 10 years. Maine’s program has resulted in improved healthy behaviors in Maine's pediatric population and stabilized increasing rates of obesity. Their program involves messaging and technical support in six settings: school, childcare, out-of-school, healthcare, workplace, and communities. Closer to home, the Northeast Iowa Food and Fitness Initiative under the leadership of Ann Mansfield has been engaged in communities in multi-setting efforts and utilized 5-2-1-0 messaging. Their recently published work has demonstrated significant improvement in student growth parameters in northeast Iowa communities.
The United Way of Central Iowa brought the campaign to central Iowa in 2015, and in the last 2 years has supported a community stakeholder coalition called Well Kids of Central Iowa. In addition they have provided technical support in a variety of settings including childcare, before and after school, schools, and most recently health care. After the majority of Iowa counties identified nutrition and physical activity as a major public health issues in their communities, the Iowa Department of Public Health identified and began promotion of the 5-2-1-0 campaign statewide. Additionally, the Healthiest State Initiative Community Health Improvement Committee brought together state-wide stakeholders who identified the need for a common message and chose 5-2-1-0 as the message to unite the multiple efforts across the state.
Bringing the 5-2-1-0 Message to Life in Iowa
Great work is being done in the early childcare and school communities by programs such as the Iowa Department of Education’s Action for Healthy Kids, Pick-a-Better-Snack, NAPSACC, and CATCH. These efforts are making healthier choices easier for Iowa’s youth. Wellmark’s Healthy HomeTown Program is providing technical support for communities and workplaces who desire to make changes in their environments and policies. Rallying around the common 5-2-1-0 message only amplifies the impact of these great programs. The 5-2-1-0 Healthy Choices Count campaign serves to connect multiple community efforts facilitating strengthened programs through collaboration.
5-2-1-0 Health Care
As health care providers, we have an important role to play both inside and beyond our clinic walls. We have strong relationships with our patients and their families and so are uniquely positioned to partner with them to encourage and support healthy behavior changes. Furthermore, as experts in our community on the long-term benefits of healthy choices we can be impactful community advocates.
5-2-1-0 Health Care is a program to provide tools healthcare providers and their clinic staff in contributing to state-wide 5-2-1-0 Healthy Choices Count efforts. The United Way of Central Iowa program began as pilot in the last year with support from Wellmark and Hy-Vee. IMS is supporting a statewide pilot of the program in 2018. These programs are offered at no cost to clinics. For the United Way supported pilot, eleven clinics across five health systems in central Iowa have become registered 5-2-1-0 Health Care sites by committing to working toward three goals: 1) connecting with the community by displaying posters in their waiting rooms and exam rooms; 2) accurately weighing and measuring and recording BMIs on patients; and 3) having respectful conversations about health behaviors utilizing the Healthy Habits questionnaire at all well child checks for children ages 2 to 18. To be a registered site clinics commit to working toward some or all of these goals. If successful in accomplishing all three goals, the clinics are recognized as a 5-2-1-0 Health Care Sites of Distinction. The posters and stickers to endorse the message are provided to clinics and an annual survey is required.
Individualized technical support and additional optional trainings on a variety of topics are available through the program. These optional trainings include topics such as “Best Practices for Accurately Weighing and Measuring Pediatric Patients.” We all know behavior change is not easy and addressing topics like BMI and its connection to chronic health conditions can be sensitive and difficult to discuss with patients. To help additional trainings were developed “Addressing Weight Stigma to Reduce its Impact on Patient Care” as well as “Motivational Interviewing and Brief Action Planning to Efficiently and Effectively Engage Patients in Behavior Change.” Furthermore, note templates and dot phrases to facilitate documentation in the electronic medical records, tools to effectively connect families to community resources, and individualized support to providers who wish to advocate in their communities are provided if desired.
