ASPHN Obesity Mini CoIIN Virtual Kick Off March 26, 2019

1. ASPHN Obesity Mini CoIINVirtual Kick OffMarch 26, 2019 Emia Oppenheim, PhD, Mphil, RD Public Health Nutrition Consultant ASPHN

2. Today’s Meeting • Introductions • Background- CoIIN process and aim • QI overview – backbone of CoIIN, PDSA, Driver, etc. • Key Dates and Deadlines Interest Forms – States thus far and questions • Basecamp – share site, key documents (info packet, current states, applications) • Next Webinar – April 23rd, 4-5pm (time change)

3. Introductions • ASPHN • CDC • NFSN

4. Alabama Molly Killman Director, Nutrition and Physical Activity Division, AL Department of Public Health (ASPHN member) Theresa Patterson Child Nutrition Program, AL State Department of Education, CACFP, Farm to Preschool Joan Wright Executive Director, AL Childcare Resource and Referral

5. Arizona Lori Masseur Early Childhood Education Director AZ Department of Education Jean Parlin Assistant, The Garden Kitchen, Pima County University of AZ, Cooperative Extension Tina Wegner Early Childhood Nutrition Supervisor Maricopa County Department of Public Health Hope Wilson Area Assistant Agent, Yavapai County University of AZ, Cooperative Extension

6. Colorado

7. Minnesota

8. Ohio Alison Patrick Program Manager Maternal & Child Health Cuyahoga County Board of Health Heidi Scarpitti Early Childhood Health Prog. Women & Family Health Services, OH Department of Health (ASPHN Member) Julie Stone Director of Professional Development, OH Head Start Association Ann Weidenbenner Program Manager Bureau of Healthy OH, OH Department of Health (ASPHN Member)

9. CoIIN - Collaborative Improvement and Innovation Network Provides tools and opportunities for participants to self-organize, partner, and coordinate to address complex issues creatively with knowledge sharing and networking. Key Elements of a CoIIN Self Selected Build and Strengthen Partnerships Coordinated Activity to Tackle Complex Issues Collaborative Learning to Innovate & Improve

10. Background: What is a CoIIN? Collaborative Improvement and Innovation Network (CoIIN)- provides tools for participants to self-organize, partner, and coordinate to address complex issues creatively with knowledge sharing and networking. Key Elements of a CoIIN Self Selected Build and Strengthen partnerships Coordinated activity to tackle complex issues Structured, collaborative learning to innovate & improve

11. 2019-20 ASPHN Obesity Mini CoIIN: Farm to ECE • Overarching Aim – improvements in the proportion of children ages 2-5 who fall within a healthy weight range • Technology based learning from each other and SMEs • Capitalize on each other’s skills and resources (internally and externally – ASPHN, CDC, PEG, NFSN) • Rapid cycle improvement using PDSAs • Strong Partnerships – strengthening coalitions • Annual In Person Meeting • 4K Seed Funding/state/year

12. ASPHN OBESITY MINI COIIN DRIVER DIAGRAM: 2019-20 FARM to ECE Measurable Aim Primary Drivers Secondary Drivers Change Ideas Communications materials for community partners to support farm to ECE Farm to ECE Communication and Messaging Increased number of early care and education (ECE) settings (independent physical address) conducting sustainable, comprehensive farm to ECE, by July 2020. Increased procurement and serving of local foods in the ECE setting Database of family engagement messaging and resources Professional Development: Technical Assistance (TA) and Training for Providers • Creation of online professional development for farm to ECE Creation of state TA system Policies/Systems Supporting farm to ECE Increased food and agricultural literacy into the content of ECE programming Alignment of CACFP, QRIS, ECCERs, Early Learning Standards, etc. with farm to ECE for State Funding or Incentives to Access Local Food Systems Mini Grant and TA for family child care providers Multisector state coalition and partnerships Increased edible gardens inside or outside ECE facilities Crosswalk of policy and/or system changes needed for farm to ECE Meaningful Family Engagement TedX/Statewide Workshop to build diverse coalition

13. Model for Improvement AIM Measures Ideas Series of testing “cycles”

14. Improvement requires change, but change does not always mean improvement.

15. The PDSA Cycle for Learning andImprovement Plan Act Small scale test Series of tests Wide-scale tests Implementation • Objective • Questions and • predictions (why) • Plan to carry out the cycle • (who, what, where, when) • Plan for data collection • Adopt, Adapt, • Abandon • What changes • are to be made? • Next cycle? Study Do • Complete the • analysis of the data • Compare data to • predictions • Summarize • what was • learned • Carry out the plan • Document problems • and unexpected • observations • Begin analysis • of the data

17. PDSA Examples – Ohio Pediatric Mini CoIIN PDSAs • ECE Licensing improvements – healthy eating and active living regulations in state law • Collaborative process to create crosswalk of recommendations PDSA 1 – 1 focus group, turnaround 1mo, revise PDSA 2 – 4 focus groups, turnaround 3mo, revise PDSA 3 – Implementation trial, pilot revisions, turnaround 6mo

18. A P S D D S P A A P S D A P S D Why test? Repeated use of PDSA cycle Changes That Result in Improvement Implementation of Change DATA Process measures and feedback on Cycle questions Wide-Scale Tests of Change Follow-up Tests Hunches Theories Ideas Very Small Scale Test

20. Test versus Task- both necessary but not same thing A Test: • Lets you predict an improvement • Provides quick feedback • Allows you to try something • Allows you to make changes • Helps identify what changes should be made A Task: • Vital behavior needed for the action to take place • Should be identifiable • Should be defined

21. Questions

22. State Team Expectations and Important Dates Monthly Team leads : CoIIN manager meet - before April 6th Monthly state team meetings – before April 19th QI & CoIIN process – 3-5 PDSA plans by April 22nd Monthly Webinars – active participation & surveys, next one April 23rd, 4-5pm Seed funding – budget draft by May 1 In person learning session information - April 1 ASPHN dues by June 11th Mini CoIIN In Person Learning Session, June 11-12

23. State Stipend • $4,000/state •  ASPHN can pay state agency or coalition team member organization – acting fiscal lead OR • ASPHN has a subcontract with state or grant award to state • Example allowable expenses: in-state meeting costs, CoIIN supplies, student stipend • To access funds, state submits draft to AC via Emia, May 1. Once that is approved, states finalize plan add short budget explanation.

24. June In-Person Learning Session • June 9-11, Annual ASPHN, June 11-12 Mini CoIIN • Location – Embassy Suites, Scottsdale, AZ; Use PHX • Logistics – arrive by 11 on the 11th, leave after 6:30pm • Theme: Partnerships and Quality Improvement Progressing State Farm to ECE Activities and Sustainability • Registration fee: $70 for Mini CoIIN (Annual ASPHN meeting $90) • Invitations, agendas, travel approval forms –April 1 • Reimbursement forms – return after travel/ 30d

25. Basecamp • Two sites – Combined and Individual state sites • Combined site –all states’ resources, networking between states, PDG B-5 applications • Individual State site – Minutes, agendas, PDSA cycle worksheets, budget info, or team leads to use for coalition info dissemination

26. Questions

27. Questions • CoIIN, QI, etc: Emia Oppenheim– emia@asphn.org • Financial: Cyndi Atterbury – cyndi@asphn.org • Farm to ECE: Lacy Stephens– lacy@farmtoschool.org