TABLE 2.

Healthy Eating, Active Communities (HEAC) Program Expected Outcomes, Midpoint Achievements, and Midpoint Community Exposure to the Program, by Children's Environment: California, 2007–2008

Children's Environment	Expected Outcomes	Midpoint Achievements	Midpoint Exposure
Schools     Goal: Increase healthy eating and physical activity during the school day	Adopt and implement state nutrition standards district-wide for a la carte food and beverages solda Adopt and implement district-wide policies that ensure students receive mandated number of minutes of PE Engage parents and families as advocates for healthier food and physical activity	Implemented state nutrition standards (all sites) Trained classroom teachers on physical activity and hired PE specialists Adhered to state requirement for PE minutes and expanded class time Used technical assistance and resources from public health departments and health care sector to accomplish goals Parents involved in changing food and physical activity environments through participation in wellness policy committees	11 school districts 885 000 elementary, middle, and high school students 769 000 students exposed to intensive PE interventions
After school     Goal: Increase healthy eating and physical activity in after-school programs	Adopt and implement SB 12, SB 965,a or other policies that make healthy foods accessible in after-school sites Adopt and implement policies that promote physical activity on a regular basis Parents and youth engaged as advocates for healthier food and physical activity in after-school settings	Secured state after-school funding Hired after-school coordinator Included physical activity in “higher learning” (academic) after-school sites Introduced SPARK physical activity curriculum in after-school programs	14 after-school programs 7000 enrolled participants 3900 after-school sites statewide required to adopt HEAC strategies, adhere to state nutrition standards, and document nutrition and physical activity environments
Neighborhood     Goal: Increase children's and families' opportunities for healthy eating and physical activity in neighborhoods	Policies and programs lead to improved access to affordable, quality, healthy food Policies and programs lead to improved access to physical activity opportunities Residents develop increased policy advocacy capacity	Created “healthy check-out lines” (Wal-Mart, Smart & Final) Convinced convenience stores to sell produce and healthier foods Improved parks and advocated for updated park equipment and programming Improved walkability and bikability around schools; creating complete streets policies	470 000 residents in 6 HEAC communities have been exposed to HEAC food retail interventions
Health care     Goal: Engage local health care systems in diabetes and obesity prevention	Health care spokespersons are testifying at school board meetings, planning commission meetings, and city council meetings Promotorasb have a prominent role as health liaisons with the community Health care providers incorporate obesity prevention into well-child visits Health care agencies have organizational policies that promote healthy eating and physical activity	Trained, educated, and recruited physicians and promotorasb for obesity prevention and policy advocacy Implemented weight management programs such as KP Kids and Kidshape Developed county vending policies and healthy hospital policies (all sites) Changed clinical practices to include BMI charting and obesity prevention messages Implemented policy for drug representatives to provide healthy foods to health care practices	More than 300 health care providers have been exposed to HEAC clinical training and community programs on childhood obesity prevention
Marketing and advertising     Goal: Discourage or eliminate local-level advertising and marketing of unhealthy foods and beverages and inactivity in school, after-school, and neighborhood settings, and encourage regulatory action to reduce advertising to children	Reduce or eliminate neighborhood-level marketing to children Local marketing is assessed, and youth are active in advocating for reducing marketing of unhealthy foods Tell parents how some businesses market unhealthy food and physical activity to children	Included ban on unhealthy food marketing within district wellness policies Engaged youth in assessing marketing environments in schools and local stores Worked to get healthy advertising into new stadium Soda-free summer campaign	276 students have been engaged in HEAC youth leadership programs, conducting assessments and reporting on food and physical activity environments

Note. PE = physical education; BMI = body mass index.

^aIn 2005, California passed laws setting minimum nutritional standards for a la carte food and beverages sold on school campuses. Law SB 12 sets standards for all competitive foods sold on public school campuses for grades K–12. For food items, fat content is not to exceed 35% of calories, saturated fat content is not to exceed 10% of calories, and sugar content is not to exceed 35% of total weight of food. SB 965 sets standards for beverages sold on public school campuses for grades K–12. Beverages allowed for sale at middle and high schools are fruit drinks made of 50% or more fruit juice with no added sweetener; water; milk products; and certain electrolyte replacement beverages.

^bPromotoras are outreach workers in Hispanic communities who are responsible for raising awareness of health and educational issues.