A Culture of Healthy Choices

Miriam (Mim) Gaines, MACT, RD, LD

Nutrition and Physical Activity Division

A Culture of Healthy Choices

Objectives

• Give a definition of wellness

• List venues to reach the public

• Name solutions to barriers in wellness policy, environmental and systems changes.

Wellness as Compared to Healthy Choices

A choice — A decision you make every day, every hour, every minute to move toward optimal health.A way of life — A lifestyle you design to achieve your highest potential for wellbeing.A process — An awareness that there is no endpoint, but that health and happiness are possible in each moment, here and now.

Overview of Adult Sickness

• Obesity• Mississippi #1• Alabama #2

• Hypertension• Diabetes• High Cholesterol• Cancer• Etc.

A Healthy Culture

Wellness Prevention in a

Treatment Medical Country

Healthy CultureWellness is an active process of ◦Becoming aware◦Making choices toward◦Having a more successful existence

Nutrition and Physical Activity Vision:

Alabamians of all ages to embrace a culture of healthy choices as their normal way

of life.

Six Dimensional Wellness Model Helps Determine Approaches

ADPH Uses Wellness Model for Healthy Approaches

Helping the culture change How actions fit into the model

Examples focus on low cost and grant funded methods

Wellness Model:

Social Dimension Encourages: Contributing to environment and

community welfare over selfish desires Living in harmony with others and our

environment rather than in conflict Addressing environmental health

concerns

Social Dimension

Recycle plasticsBrewton LowndesboroBureau retreatAfter school sitesEmployee

wellness program: selected areas to improve

Occupational DimensionEncourages:

Personal satisfaction and enrichment through work

Contributing unique gifts, skills, and talents to work for personal fulfillment

ADPH:

Intellectual Dimension

Encourages:Stretching and challenging mindsIdentifying potential problems and appropriate solutions instead of waiting, worrying

NPA:

Emotional Dimension

Encourages:◦Recognizing, being aware of, and accepting

feelings while acting responsibly ◦Being optimistic in life yet realistic ◦Coping effectively with stress

◦ADPH

Spiritual Dimension

Encourages: Searching for meaning and purpose of life Being tolerant of others beliefs Living each day consistent with personal values

and beliefs

NPA employee programs at work

Physical Dimension

• Encourages: Consuming foods and beverages that

enhance good health Moving more Discouraging the use of tobacco, drugs, and

excessive alcohol consumption Monitoring your own vital signs and

understand your body's warning signs

Proven Areas to Address Health

Increase fruit and vegetable consumption

Decrease sedentary activity

Increase physical activity

Breastfeeding

Physical Dimension Fun

Staff Gatherings Combine Several Components

Fun staff meetings help when raises are no where in site.

Combining ComponentsStatewide Promotes lifestyle

change Rewards weight-loss Starts in January 10-week contest Adults Operated at local level

through employers, hospitals, health departments, etc.

. 

SUPPORT TO MAKE CHANGES COMES FROM

The Environment, System, and Policies

Socio-Ecological ModelLooking Beyond the Individual

What Factors That Influence Your Wellness?

There is an interwoven relationship between the individual and their environment.

NPA Addresses Policy Opportunities

• State level policies• State employee policies• Public policies- state and local • Local policies• Academia K- PhD • Businesses• Faith community• Medical • Family

Example of Policy to Change Culture at Work:

Meeting Guidelines

Serve• Lower calorie and

lower fat foods• Fruits and vegetables

whenever possible• Small portions• Low-fat or fat-free

(skim) milk, 100% fruit or vegetable juice, water or calorie-free beverages

ADPH Meeting Guidelines

Serve foods • Baked• Broiled• Grilled• Steamed • Poached

• Limit serving size of high fat, high sugar, low fiber items

ADPH Meeting Guidelines:Physical Activity in Meetings

• Choose walkable

• Stretch breaks during meeting

• Overnight facilities offer areas or passes to local gyms

Meeting Guidelines Cont.A smoke-free environmentGo paperless when

possibleOpt for pitchers of water

instead of bottlesOpt for re-usable plates,

cups, and flatware rather than paper or plastic.

Choose environmentally friendly facilities

Leadership Skills Required for Culture Changes

Leadership skills as compared to hosting a party

1. Make sure guest have what they need…Provide tools, equipment, and support as

needed

2. Visit with everyone… Check on employees, network with partners

3. Be sure everyone feels included and welcomed

Team work and recognizing talents

Leadership Skills Required for Culture Changes

4. Listen carefully to the unspoken

Active listening and negotiating when needed

5. Make them want to come back

Have fun

6. Make them feel safe

Cover their backs

Lessons Learned and Leadership Skills Used While Trying to Create a Healthy Environment for the Culture Change

Overview: Vending machines will

provide 50% healthy choices in state agency buildings.

Snacks are clearly marked

Vendors to get reimbursed for any loss

Employees tasted foods before implementation.

Leadership Skills Used in Vending Project

Tools- Reports provided to partnersVisit- Worked with Rehab before

implementation on monthly basis, face to face meetings, minutes with next steps sent

Feeling included- Staff and partners asked direct questions with follow up

Unspoken- Tried to read between the linesFeel Safe- Asked for vendor’s input, NPA

staff reports

Leadership Lessons LearnedTools- Reports are not read or retainedVisit- Face to face worked well, but hard

to get people to come to the meetings; Rehab finance not at the table

Feeling included- Staff and partners versus the vendors

Unspoken- Vendors felt unrepresentedFeel Safe- NPA felt discourage

Leadership in Projects May Be Crisis Style Leadership

Vendors not paid timelyPrivate vendor for expansion requires

close follow up Negotiations changes ◦50% versus 30%

Expanding to Private and to Counties

Lessons Learned from Expansion Efforts

Baptist Hospital had smoother expansion with in house champions and strong administrative support

Gas topers- Public Health typical PR efforts versus general public

Private vendors are supportive, but follow up may be harder

Why Continue?

Train up the future generation that healthy eating is normal

Leadership Encourages Others to be Good Role Models

• Public Health Employees are role models.

• Who is in your world?

• Who influences you and your family – state or local authorities, health providers, church leaders, etc. ?

Think Wellness

“We are all faced with a series of great opportunities brilliantly disguised as impossible situations.”

Charles R. Swindoll