25 Years of CATCH with Dr. Steve Kelder and Peter Cribb

www.CATCHUSA.org

We are an international leader in conducting research and providing programs that promote healthy living for children, their families and communities. Our work fosters improved health behaviors among youth, influences policy and environmental change to support healthy living, and advances professional education and community service. Our vision: Healthy children in a healthy world

About our Center

www.msdcenter.org

CATCH YouTube

Coordinated Approach To Child Health (CATCH)

Classroom Curriculum

Food Service

Physical Education

Family

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! Russell V. Luepker, MD Cheryl L. Perry, PhD University of Minnesota Minneapolis

Philip R. Nader, MD University of California San Diego

Guy S. Parcel, PhD University of Texas Health Science Center Houston

Larry S. Webber, PhD Tulane University School of Public Health and Tropical Medicine New Orleans

CATCH Main Trial Sites

Where we began…

Where we are today!

• Reduced total fat and saturated fat content of school lunches

• Increased MVPA during P.E. classes • Improved students’ self-reported eating

and physical activity behaviors • Effects persisted over three years without

continued intervention • Reduced prevalence of obesity in El Paso trial

CATCH Main Trial, 1996 Results and Major Outcomes

Luepker R, et al (1996). JAMA, 275(10), 768-76. Nader P, et al (1999). Arch Pediatr Adolesc Med, 153(7), 695-704. Coleman et al (2005). Arch Peciatric Adolesc Med, 159, 217-224.

Diffusion of Innovation Good ideas do not sell themselves! Everett Rogers, The Diffusion of Innovations, 1995 “Understanding, evaluation, acceptance, social/economic/political constraints, adaptation to specific situations, time, money, and the expertise of change agents all influence the adoption of an innovation.”

Characteristics of Innovations

•  Relative advantage: degree innovation is perceived as better than the idea it supersedes

•  Compatibility: degree innovation is consistent with existing values, past experiences, and needs of potential adopters

•  Complexity: degree innovation is perceived as difficult to understand and use.

•  Trialability: degree innovation may be experimented with on a limited basis

•  Observeability: degree results of an innovation are visible to others

Steven H Kelder, PhD MPH

25 Years of CATCH: Diffusion of an Innovation

We Are Here

Institutionalization ♦  Continued implementation ♦  Continued training ♦  Policy

Implementation ♦  Training; in-person & web ♦  Fidelity; continuing education ♦  Champion; Coordination Kit Adoption

♦  Decision to use ♦  Commitment to implement ♦  Teacher/admin support Dissemination

♦  Knowledge ♦  Awareness ♦  Readiness to adopt

Diffusion of Innovation

TDH Dissemination 1998-2006 2200+ schools

RWJ Policy 2005-2008 150 schools Harris County 2005-2007 430 schools

Dell CATCH 2006-2010 97 schools

Dell CATCH MS 2009-2012 700 schools

CATCH Florida 2010-2011 600 schools

CKC New Jersey 2009-2012 400 YMCA programs

CATCH Tx RGK 2011-2013 300 schools

CATCH Dallas RGK 2011-2013 35 schools

CATCH Early Childhood 2012+ 200 JCC

CKC Canada 2007+ 350 YMCA sites

CATCH Health Habits/OASIS 2011+ 18 US cities

Dissemination examples

•  Identifying opinion leaders and change agents •  State Board of Education support •  Policy requirements; Texas Education Code •  Foundation/community support •  Training, professional development, coordination

toolkit •  Personal visits/calls; On-line materials •  Partnering with state & local organizations •  Conference presentations; shoe leather •  Re-invention •  Media and recognition

Diffusion: What Worked?

Because of High Rates of Child Obesity, CATCH was Translated into Policy

Source: Hoelscher et al., 2009; Hoelscher et al., 2004; Kelder et al., 2009; Barroso et al., 2009; Hoelscher et al., 2011

•  Senator Jane Nelson –  SB 19 (2001) modeled after CATCH in action –  Sought input from SPAN and CATCH policy

research –  Continued to support and strengthen

coordinated school health policies •  Texas Comptroller Susan Combs

–  As commissioner for the Texas Department of Agriculture, Combs initiated a standard series of foods served at schools

–  2007, Combs provided funding for implementation of SB 42 in low-income middle schools to purchase PE and nutrition materials and equipment

Campus Team – Program

Champion

Physical Education

Nutrition Services

Classroom Education

Family Education

After School

Activity Breaks

CATCH Model for Implementation – an example

•  53% – Number of Texas districts with

elementary schools trained in CATCH •  46%

– Number of Texas districts with middle schools trained in CATCH

•  1 Million – CATCH reach to Texas students

•  25 – Number of years since initial CATCH trial

•  15,000 –  Estimated number of CATCH trained

schools

CATCH by the Numbers

Determinants of CATCH Implementation Success "  Administrative support

–  State Agencies (Education, Agriculture, Health) –  School District Administration (PE, Nutrition, Health Education) –  School Campus (Principal, Asst Principal, Teachers)

"  On-site CATCH Champion –  Attendance at training –  CATCH Team: Physical Education, Nurse, School Food Service,

Classroom teacher, Counselor –  Recognition across the board

"  Parent Teacher Association; Parent Teacher Organization "  Neighborhood and larger community support "  Policy support

What's associated with better outcomes in CATCH schools?

•  Environment –  number of CATCH meetings, –  CATCH committee activity rating, –  whether school participated in

weekday themed events, –  whether participated in 1 or more of 5

named CATCH activities, –  participated in CATCH kick-off week, –  number of WOW days (teacher-led

physical activity), –  number of morning announcements

in the last month, and –  extent to which CATCH activities are

coordinated with staff).

•  Classroom activities –  teacher attended CATCH training, –  number of CATCH lessons taught, –  number of health lessons taught, –  whether teacher coordinated classroom

activities to align with CATCH, and –  student report of CATCH lessons.

•  Parent communication –  level of parent communication, and –  whether CATCH materials were sent

home. •  Cafeteria

–  extent to which good meal practices were followed, and

–  promotion activities for healthy foods.

It’s About Sustainability

•  Campus guide to CATCH implementation – focuses efforts on common initiatives throughout the school year.

•  Designed to coordinate health messages and activities across the component areas.

CATCH Coordination Toolkit

•  Provides resources that support campus wide implementation.

Discussion/Comment

CATCH Us Making the Healthy

Choice the Easy Choice!

Create a Healthy Environment

Create a Healthy Environment

Be a Healthy Role Model

Healthy Messaging: Teacher Shirts

Healthy Messaging: Student Shirts

Sample Monthly Menu

Posting Nutrition Information

Jared encouraging healthy habits

Cafeteria Tours

CATCH Coordination: Art Dept.

CATCH Coordination: Nurse Dept.

CATCH Coordination: Classroom

CATCH Coordination: Child Nutrition

CATCH Coordination: Campus Activities

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Community

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Retail Partner Reinforcement

•  Support the Coordinated School Health/CATCH Team

•  Model healthy behaviors •  It takes EVERYONE working together!

Let’s Make the Healthy Choice Easy!

CATCH Early Childhood: Physical Activity

CATCH Early Childhood: Lessons

•  What part did each of you play during the early days of catch?

•  Who were the main investigators from each site?

•  Did you know, or think that this was going to be a special program?

•  Did you think it would still be going strong after 25 years?

•  What did you decide to do after the early research project was over?

Your questions – The early years…

•  What makes this program different from others?

•  What is the importance of having a proven/evidenced-based program?

•  Why has The University of Texas stayed dedicated to CATCH?

•  How supportive has the Michael & Susan Dell Center for Healthy Living been?

Your questions – About CATCH

•  We have seen “statewide” dissemination of the program now (Florida, SC, Texas) why do you think that is?

•  How did CATCH Kids Club (CKC) come along? •  What is the importance of CKC now? •  How did CEC come along? •  Can you tell us about what other organizations

are doing with the program? •  How does CATCH work with other organizations/

programs?

Your questions – Years of progress

•  What kind of growth do you see for CATCH? •  You have a new website and newsletter and this

“group” that works together, tell us about that. •  What role will Jared and the Jared foundation

play in disseminating/promoting CATCH? •  Do you see a bright future for CATCH? Why?

Your questions – The future of CATCH