00:00:03:16 - 00:00:28:09 Unknown All right, everybody, let's go ahead and get started. Hi. Good afternoon or good morning, depending on where you are joining us from. I'm Janelle Gunn at CDC's Division of Nutrition, Physical Activity and Obesity. We're really pleased to have you here today for our seminar series that's going to focus on the early care and education setting and some new data and reports and stories from the field to share with you today. 00:00:28:19 - 00:00:48:03 Unknown So first, a few housekeeping things, as we get started, this Zoom seminar call is being recorded. If you are not comfortable being on a recorded call, we ask that you disconnect at this time. To have the best experience we encourage, we encourage you to use the Zoom webinar app or website to view slides to participate in today's meeting. 00:00:48:05 - 00:01:20:15 Unknown All participants will be muted. Following our presentations, we will have a question and answer session, so you don't need to wait to submit your questions. The Q&A box is open so any time, drop a question in the box. We will get to as many as we can with the time that we have allotted. If you're using the Zoom app or website, you can type a question by clicking on the Q&A icon found in the app. We will get through as many questions as we can, As part of our seminar series today, we have an outstanding panel for you covering the early care and education settings. 00:01:20:16 - 00:01:54:00 Unknown These cover from the national level, the local level, all kinds of good information. So let me introduce you to our panel. We have Kelly Dahl who is an epidemiologist in CDC's Division of Nutrition, Physical Activity, and Obesity. We have Diane Peck, ECE Coordinator of the Alaska Department of Health and the Physical Activity Nutrition Program. We have Vanessa Plourde-Smith, Professional Development Specialist at thread. Kelly Stader, Nutrition Coordinator for the Chronic Disease Prevention Program at the Wisconsin Department of Health. 00:01:54:02 - 00:02:06:23 Unknown And she is joined by Nigeria Nealy, Lactation Specialist and Technical Assistant for the African American Breastfeeding Network. And Tashawna Green-Wilson, Director at the Train Up a Child Learning Center. 00:02:06:23 - 00:02:14:18 Unknown So our agenda for this afternoon. First you’ll hear about newly released CDC ECE State Indicator Report. 00:02:14:20 - 00:02:32:12 Unknown Then we’ll go to Go NAPSACC in Alaska Statewide Technical Assistance Network. If you're asking what Go NAPSACC is, hold on. We'll get to that and they'll be followed by Wisconsin, the Breastfeeding Friendly Child Care Initiative. And then lastly, we'll wrap up with Q&A. 00:02:32:12 - 00:02:48:06 Unknown Why ECE or Early Care and Education settings? The study includes child care centers, family child care homes, preschool or pre-K programs, and Head Start programs. ECE can directly influence what children eat and drink and how active they are. 00:02:48:08 - 00:03:04:18 Unknown They build a foundation for healthy habits. About 12.5 million young children are cared for outside of the home at least once a week. This represents three out of five children in this age group, so the ECE setting is an outstanding place to reach children of this age group. 00:03:04:18 - 00:03:13:22 Unknown DNPAO leads activities to improve breastfeeding support, nutrition, and physical activity for children age 0 to 5 in care. 00:03:13:22 - 00:03:45:17 Unknown So currently DNPAO funds 35 recipients in both states and communities to work in the ECE setting. And we know that many other states and communities are also doing this important work. DNPAO encourages a triple-pronged approach to improve the ECE setting by supporting the ECE state system level work, work to help individual ECE programs improve their policies and practices, and efforts to support ECE providers aka child care teachers to implement best practices in their day to day work. 00:03:45:19 - 00:03:50:09 Unknown You'll hear about activities at all three of these levels throughout our presentation today. 00:03:50:09 - 00:03:58:09 Unknown Without any more ado, I would like to hand it over to my colleague Kelly Dahl to share some of the latest information from CDC. Kelly, 00:03:58:09 - 00:04:09:02 Unknown Thank you so much, Janelle. And hello, everyone. I am Kelly Dahl, an epidemiologist on DNPAO’s Early Care and Education team. 00:04:09:04 - 00:04:30:17 Unknown And we've had the privilege of collaborating with DNPAO recipients on ECE work for over a decade. Today, I look forward to sharing new resources that DNPAO has created to inform and strengthen healthy growth and obesity prevention efforts in the ECE setting. I'll be mainly focusing on what you see here, just the 2023 ECE State Indicator Report. 00:04:30:17 - 00:04:55:16 Unknown All right. So I will say it has been a busy month for us. So here are two new ECE products on the screen, both of which were just published earlier this week. And one of my colleagues will drop the links to both of these in the chat now. The indicator report on the left is the focus of today's call, but I wanted to briefly mentioned another new resource on the right, the ECE State Licensing Scorecard. 00:04:55:16 - 00:05:21:19 Unknown So the state licensing scorecards describe the extent to which state licensing regulations for child care centers incorporate obesity prevention standards. These were just newly revised with 2022 ratings, and DNPAO’s ECE team will be holding a webinar in December to share more about these scorecards and how they can be used in states that are in the process of licensing, updating their child care licensing regulations. 00:05:21:19 - 00:05:32:09 Unknown But for now, the reason we're all here, one of the reasons we'll move on to today's topic, which is the just released 2023 ECE State Indicator Report. 00:05:32:09 - 00:05:47:01 Unknown So the report presents information about what states are doing to promote healthy growth and prevent obesity in ECE settings. It describes state level policies and activities related to nutrition, physical activity, healthy growth and obesity prevention. 00:05:47:05 - 00:06:05:18 Unknown It also updates the State Indicator Report that DNPAO released in 2016 with more up to date results. The audience for the report includes many of those on today's call. Public Health practitioners ECE partners and providers, and DNPAO recipients. So we're happy to have you here today. 00:06:05:18 - 00:06:09:04 Unknown I'll start by describing the methods we use for data collection. 00:06:09:06 - 00:06:38:23 Unknown The main data source for the report was a survey that DNPAO conducted in April through July of this year. So the data are quite recent. The survey was approved by OMB, then sent to one state agency point of contact in each state and D.C. who was familiar with the state's ECE obesity prevention activities. We received complete responses from 48 out of those 51 possible respondents for a response rate of 94%. 00:06:39:00 - 00:06:51:22 Unknown And I assume that there are perhaps many of those respondents on the call today. So we just wanted to express our appreciation to the respondents who took the time to fill out the survey on their state’s behalf. 00:06:52:11 - 00:07:16:23 Unknown The report also uses information from two publicly available data sources, which you can see here. So the on the left is the Achieving a State of a Healthy Weight licensing report. And on the right, are the Child Care Aware of America State Factsheets, both of which report 2022 data. And when you're looking at the report, it will note the sources that correspond with each indicator. 00:07:16:23 - 00:07:34:24 Unknown All right. So so now that I've described the sources for the data, we can really dive into what the report looks like and how you can use it. Once you understand the methodologies, strength and limitations, you can go to the tables like the one you see here on the slide to find your state's information. The results 00:07:35:04 - 00:08:00:02 Unknown The results are organized by topic area, like you can see along the top here in purple and you can find your state's row in the table and see how it's doing in each of those areas and how it compares to other states. Finally, there are six state success stories at the end of the report, and those show you what this work could look like in practice. 00:08:00:04 - 00:08:10:18 Unknown And we hope you could take inspiration from those states. It's it's really impressive work, just like the stories you're going to be hearing later from Wisconsin and Alaska speakers today. 00:08:10:18 - 00:08:24:05 Unknown All right. So the state indicator report results are organized around the framework you see here on the slide, which is called the Spectrum of Opportunities Framework for State Level Obesity Prevention Efforts in the ECE Setting, which is a mouthful. 00:08:24:06 - 00:08:36:05 Unknown But basically it shows nine areas of state ECE systems that can influence ECE policies, practices and environments for healthy growth, which are each of those colorful bubbles. 00:08:36:05 - 00:08:55:04 Unknown The State Indicator Report has 16 indicators total and they cover seven of these nine spectrum areas. So the seven with arrows there. And for the next few minutes we will kind of zoom in on each of these seven spectrum areas to explore reports, results. 00:08:55:04 - 00:09:23:06 Unknown So the first indicator is licensing. Licensing regulations describe the practices that all licensed ECE programs in a state must follow. For this reason, as you can imagine, incorporating regulations around nutrition, physical activity, breastfeeding, screen time into licensing has the potential to reach a large number of children that are in licensed care. And there's been significant progress in licensing since our first report came out in 2016 00:09:23:06 - 00:09:38:23 Unknown The 47 states increase the number of obesity prevention standards included in our licensing regulations, and states went from an average of six to an average of now 15 obesity prevention standards included in their licensing regs. 00:09:38:23 - 00:10:06:23 Unknown So the next indicator is the Child in Adult Care Food Program, or CACFP. CACFP is a federal program that provides reimbursement for nutritious meals and snacks in eligible ECE programs. These CACFP meal patterns undergo scientific review, and so requiring licensed ECE centers to follow those meal patterns means that they're going to be serving nutritious, pretty nutritious food. 00:10:07:00 - 00:10:28:07 Unknown So and you can also use CACFP really as an equity and food security lever for children in low resource areas. Our report found that 34 states require all licensed ECE centers to follow CACFP meal patterns regardless of whether their individual ECE center participates in CACFP. 00:10:28:07 - 00:10:34:21 Unknown And I love seeing other hearts receive CACFP. That's great. Our next indicator is Quality Rating and Improvement Systems. 00:10:34:21 - 00:11:03:14 Unknown Or QRIS. These are programs that set standards for high quality care and provide levels of achievement for programs to obtain and communicate their quality. 40 states and D.C. have QRIS systems. You could see some of their logos there on the screen. Iowa. Texas. North Dakota. And we found that 30 of the state QRIS programs include one or more obesity prevention standard. 00:11:03:22 - 00:11:33:23 Unknown Next is Professional Development. So ECE providers are skilled professionals that participate in regular training to improve their skills on a wide variety of child care topics. When pressed for professional development, trainings on healthy growth, nutrition and physical activity are available or even required in a state, providers can refine those skills and implement them in their programs. So 33 states had a training like this available for credit in their professional development registry. 00:11:33:23 - 00:12:05:21 Unknown Our next indicator is Recognition Programs. So these programs focus on a specific topic and recognize ECE programs that meet certain requirements around that topic. Such as outdoor learning or breastfeeding friendly ECEs. You can see some of these state recognition program logos on the slide. Colorado and Ohio. And we found that 30 states had a recognition program around a healthy weight topic, including six new states since the 2016 report. 00:12:05:23 - 00:12:16:20 Unknown I wanted to highlight today's speakers from Wisconsin will share about their Breastfeeding Friendly Child Care Initiative and feature an ECE center director whose program has received this recognition. 00:12:16:20 - 00:12:29:17 Unknown All right. The next indicators in the report are Interventions and Assessment Tools. Interventions are implemented at the ECE facility level and can help ECEs to improve their health policies and practices. 00:12:29:19 - 00:12:58:08 Unknown For example, an intervention might have curriculums, materials and activities around physical activity in that ECE center. We found that 33 states promote one of these ECE interventions and there's also assessment tool. So these can work in tandem with interventions and help ECE programs kind of reflect, see where they're at and how they can improve. The most commonly reported assessment tool was GO NAP SACC. 00:12:58:10 - 00:13:12:18 Unknown You can see its logo there on the right. It's an evidence based intervention and assessment tool used in 23 states and our state speakers from Alaska, right after this, will share more about how they've implemented GO NAP SACC in their state. 00:13:13:01 - 00:13:39:23 Unknown All right. So our second to last spectrum area here is access to healthy environments through Farm to ECE. These initiatives include really a range of activities such as connections to local produce, nutrition education and hands on learning through gardening. And all of these activities can support ECE providers in serving nutritious food. There has been a lot of great work in this area. 00:13:40:00 - 00:14:02:21 Unknown 43 states reported supporting Farm to ECE activities at the state or local level, and you can see our success story on the site from Iowa. So those are embedded throughout the report. And Farm to ECE can be carried out at the state level but we did want to highlight that many survey respondents also highlighted Farm to ECE efforts occurring at the local level. 00:14:02:22 - 00:14:09:12 Unknown So if you're a local level person, there's definitely great work going on around the country. There. 00:14:09:12 - 00:14:29:14 Unknown All right. Our final spectrum area, it's a lot of numbers, but very exciting numbers. So our final spectrum area is Technical Assistance Networks, TA providers, Technical Assistance, TA, are trusted individuals that provide support to ECE providers in their state on a wide variety of topics. 00:14:29:16 - 00:14:48:07 Unknown And 39 state agencies have worked to improve their TA networks capacities around ECE healthy growth and obesity prevention topics. Later in this call, we'll have an opportunity to hear from TA providers in Alaska and Wisconsin that provide TA like this. 00:14:48:07 - 00:14:59:18 Unknown Okay. So those were all of our results related to those spectrum areas. But the report also includes additional information that might be relevant to those working on ECE efforts. 00:14:59:20 - 00:15:25:05 Unknown And that information is around Partnerships and Reach, which you can see here in the slide. So every state ECE system looks different, but there usually many different organizations and agencies involved. And we always hear we always say partnerships are key to the success of this work. So we asked our survey respondents to list the ECE partner agencies with whom they work. 00:15:25:07 - 00:16:00:08 Unknown Respondents reported an average of seven partners, and you could see a graph of the most common partners on the right. So it was led by Licensing, SNAP-Ed, Farm to ECE organizations, Child Care Resource and Referral agencies, and QRIS. We also included information on potential reach of state level activities. So the report includes the total number of ECE centers and homes in each state, as well as the total number of ECE slots for children in those centers and homes. 00:16:00:08 - 00:16:31:00 Unknown So those are the findings of the 2023 State Indicator Report at a very high level, but there's tons more info you can dig into in the report itself. And as you can see, there's a wide variety of exciting, sustainable ECE work occurring around the country. So depending on your state and your role, you can use these results to guide future ECE healthy weight efforts to educate decision makers about existing policies. 00:16:31:02 - 00:16:46:01 Unknown And if you are a DNPAO recipient, you can use these results to inform your SPAN, HOP, or REACH work. We are always looking to support those doing ECE work, so please reach out to our team if you have questions about the report or how to use it. 00:16:46:01 - 00:16:51:18 Unknown Okay, so on this slide you can see the contact email for the DNPAO Early Care and Education team. 00:16:51:18 - 00:17:13:14 Unknown It's ECD obesity at CDC. With that, thank you so much for your time. We hope the 2023 state indicator report will be a helpful resource. For those of you working on healthy weight efforts in your state. I will now pass it to Diane Peck to share about her team's work in Alaska. Thank you. 00:17:13:14 - 00:17:17:04 Unknown Thank you, Kelly. And hello, everyone. 00:17:17:04 - 00:17:49:18 Unknown I'm Diane. I work for the Alaska Department of Health, and I am joined today with my wonderful, amazing partner, Vanessa, who works with thread, which is Alaska's only child care resource and referral network. And today I'm going to talk about two of the spectrum of opportunities that Kelly mentioned Go NAPSACC, and how we have embedded that into our statewide technical assistance network. 00:17:49:18 - 00:18:23:23 Unknown So over the past four years, the Department of Health and thread have been working together to implement Go NAPSACC quality initiatives. And I'm going to let Vanessa talk a little bit more about that. I have some data, though, that I'd like to share with you. Over those four years, we've had 98 unique ECE programs that have completed one or more of the Go NAPSACC modules. There are seven modules in Go NAPSACC. 00:18:24:00 - 00:18:50:01 Unknown Collectively, they serve or have served almost 3500 children. They, the majority participate in CACFP. And compared to other states with Go NAPSACC, Alaska reaches a higher percentage of rural, military, and Native American Alaska Native tribal sites. 00:18:50:01 - 00:19:08:10 Unknown So we get a lot of really great data from Go NAPSACC and we can monitor all our different providers and the different modules that they're going through, as well as all the different practices that are in each of the module. 00:19:08:12 - 00:19:33:18 Unknown And this slide just shows kind of an overview overall and the data that shows that Go NAPSACC is making improvements in nutrition and physical activity. We see it in all seven modules. And we know that the different sites are writing the physical activity and nutrition policies and adopting those policies. 00:19:33:18 - 00:19:41:08 Unknown As I mentioned, this is a partnership and each partner brings a different things to the table. 00:19:41:10 - 00:20:22:05 Unknown So as the Department of Health, we provide the license or we pay for the license for Go NAPSACC from the University of North Carolina. We contract with thread to do the Go NAPSACC QIs as well as they do some other things too for us, like doing more physical activity and nutrition trainings. And they provide me with TA consultation around the ECEs because I'm not an expert in that, but we develop and provide new resources and purchase materials like physical activity and Farm to ECE equipment. 00:20:22:07 - 00:20:33:01 Unknown And then we also have communications like a listserv, a blog site, social media, and we share a lot of that with our partners. 00:20:33:01 - 00:20:52:01 Unknown So I'm going to pass it on to Vanessa. Thank you, Diane. And I'm honored to be here today from Alaska. In addition to being a professional development specialist here at thread, which is, as Diane mentioned, is the CCR&R for Alaska. 00:20:52:03 - 00:21:22:11 Unknown I was an early educator. I ran my own family child care for almost 20 years. So I've been in early education in some facet the majority of my my life. So Learn and Grow is what our are QRIS system is in Alaska. With that we provide administrative support, consultation, business support, onboarding, coaching, as well as a lot of statewide training. 00:21:22:13 - 00:21:36:21 Unknown We've been doing a lot of hybrids recently and now we're stepping more into that face to face. So we're really excited about that. And again, more professional development and funding for the ECE community. 00:21:36:21 - 00:21:51:07 Unknown Some of the aspects of our partnership and working with Go NAPSACC has been really exciting because the evolution of it, we've really looked at what are we doing well and what things can we shift every fiscal year. 00:21:51:09 - 00:22:26:15 Unknown As Diane mentioned, we reach out to the whole state and try and really support those programs family, childcare, group, home and center base that are low income in rural locations as well as in diverse types of ECE groups. We provide training not only for Go NAPSACC, but for all educators that goes under physical fitness, nutrition, gardening, Farm to ECE, and the like. 00:22:26:15 - 00:22:49:12 Unknown So one of the exciting things I love about Go NAPSACC is that we're really able to share the data in Spanish and English to providers throughout our state, as well as using some of that information and creating trainings and events for those that are part of Go NAPSAC as well as those that are just in our community. 00:22:50:01 - 00:23:24:22 Unknown I'd like to just share a quick story, because I think it's important to know kind of the faces of who gets this support. We work with educators all over and we decided to use a cohort network system so that really brings the groups together. It not only provides the effective and time saving because educators don't have a lot of time, they're overworked, they're super busy, and we want to make sure they're supported and the benefits are there. 00:23:24:24 - 00:24:01:20 Unknown So we work as a group. They not only learn from that cohort, but they build relationships which supports them as well as their children and families that they care for. One of the educators that I worked with in a center not only completed her QI, which just required two modules and some training, but all of her staff decided to participate on their own to learn a little bit more about breastfeeding, about farm to table, about outdoor play and expand of their learning and their professional growth. 00:24:01:20 - 00:24:25:24 Unknown And so that was on their own and it really supports their programs in addition to updating their policies to add some of these things in there and have better communication tools with their families that they care for. So I'd like to hand it over to Kelly and and thank you so much. 00:24:25:24 - 00:24:27:08 Unknown Thank you, Vanessa. 00:24:27:08 - 00:24:28:23 Unknown So my name is Kelli Stader. 00:24:28:23 - 00:24:38:20 Unknown I work for the Wisconsin Department of Health Services and I'm here with my community partners today to talk about Wisconsin's Breastfeeding Friendly Child Care Initiative. 00:24:38:20 - 00:24:48:14 Unknown So our recognition program was built on Wisconsin's Ten Steps to Breastfeeding Friendly Child Care Centers Toolkit, which was created almost 15 years ago. 00:24:48:14 - 00:25:12:03 Unknown And for a few years it was just kind of a standalone guide. But back in 2012, we decided to build that into a training and some technical assistance and resources so that we could start recognizing programs as breastfeeding friendly. And we started that work in one county who had a really strong local breastfeeding coalition but then built that out statewide over the next few years. 00:25:12:05 - 00:25:39:13 Unknown One thing I really wanted to highlight is that we've always emphasized the importance of having this be a collaborative partnership really from the ground up. So we have breastfeeding content experts on one side who might be coming from a local health department, a WIC agency, a local breastfeeding coalition. But then we pair that with our child care experts, which in this case is usually coming from our child care resource and referral agencies which are regional in Wisconsin. 00:25:39:15 - 00:26:08:09 Unknown So the roles of each of those side can look different depending on what community we're talking about. But we've always really emphasized how important that relationship is, knowing that each side really brings something unique to the table. Our program includes a training for a child care providers assessments, including specifically the Go NAPSACC breastfeeding and infant feeding, self assessment, and then technical assistance for the child care programs to help them meet those ten steps. 00:26:08:11 - 00:26:33:20 Unknown Childcare providers can receive continuing education credit or taking our training, and for a lot of the technical assistance that they might receive throughout this process. Breastfeeding Friendly is also linked to our QRIS system, which is called YoungStar in Wisconsin. And so providers can help to meet their rating criteria, both under our health and well-being section of YoungStar, as well as family engagement. 00:26:33:20 - 00:26:54:18 Unknown So over the last decade, we've had various funding streams help support this work. When we started, it was under a previous iteration of the SPAN funding from CDC in 1305, if you've been around that long. And now we're back to having SPAN funding, which will help support this work moving forward. Years ago, we received some funding from Race to the Top. 00:26:54:18 - 00:27:28:06 Unknown If that's a a funding source that you're familiar with, more on the child care side. In recent years, we received funding from our Maternal and Child Health Title Five block grant, and that's really helped support capacity throughout our local health departments to work on this. And then as you might imagine, each local community that works on this might do their own fundraising or grant writing or seeking local donations if they're looking for things like equipment or other incentives that might help a child care program move through this process. 00:27:28:08 - 00:27:53:21 Unknown I wanted to point out our partnership with the Wisconsin Technical College System. So our breastfeeding training is part of their infant toddler development curriculum for their early childhood degree program. So this is a way we're reaching childcare providers before they even, you know, launch into their career, which is exciting. Our local capacity and engagement has obviously shifted over time for both on the breastfeeding side as well as the childcare side. 00:27:53:22 - 00:28:19:13 Unknown But I think we've really tried to stay flexible in our process to help with sustainability. We definitely don't have statewide reach with our recognition program, but that means we still have lots of opportunity for expansion and for really thinking about where we want to target our efforts in terms of who we want to reach. A few other things I wanted to mention and how we just have been trying to prioritize equity throughout the last ten years. 00:28:19:15 - 00:28:45:23 Unknown We've always encouraged our communities to really think about which child care programs in their area are serving families who might need the most support when it comes to breastfeeding sustainability. We updated our training back in 2021 in an effort to have more inclusive language and to include more information for our childcare providers on understanding things like historical trauma related to breastfeeding in certain populations. 00:28:45:24 - 00:29:09:22 Unknown We want the providers to understand that, you know, every family is coming to this breastfeeding journey from a different place and might need different types of support, but really showing them the role that they can play and being part of that support system. Our training and resources are available in both English and Spanish. And then the last thing I wanted to point out before I hand it over to Nigeria is a more recent funding opportunity. 00:29:09:22 - 00:29:18:06 Unknown We've been able to provide to the African American Breastfeeding Network in Milwaukee. But I will let Nigeria talk more about that. 00:29:18:06 - 00:29:39:10 Unknown Hello, everyone. I'm Nigeria Nealy. I am a Lactation Specialist and Technical Assistant with the African-American Breastfeeding Network. A little bit more about AABN is that we just celebrated 15 years of addressing maternal fetal health outcomes in champion breastfeeding among minorities. 00:29:39:12 - 00:30:16:11 Unknown One way that we do that is that we host community breastfeeding gatherings, which are monthly breastfeeding classes that are offered in-person and virtually, free to our community. And we basically talk about breastfeeding, offer breastfeeding resources and information, as well as offer prenatal and post-partum support to our clients. Another way is that we just certified 17 community based doulas, so we're now able to offer free doula support to the families that we serve. 00:30:16:13 - 00:30:47:10 Unknown I heard a lot of talk about partnerships and we know how important partnerships are. So another way that we increase our efforts and magnify our work is through our partnerships. Our partnership in particular, in particular with 4C For Children, which is a nonprofit community based organization here in Milwaukee who are a leader in early care and education. They provide training and classes to new and existing child care programs. 00:30:47:12 - 00:31:23:03 Unknown They also are a resource for families that are looking for child care programs who have accreditation and or a higher star rating. So our partnership with them allowed us to identify childcare programs that were looking to offer breastfeeding services to their families and also looking to increase their ratings. And we were able to offer this training, this was a two hour in-person training at 4C For Children on May 30th, where we identified five child care programs who were interested. 00:31:23:05 - 00:31:54:04 Unknown We did use the Wisconsin Breastfeeding Coalition curriculum, and we also introduced them to the breastfeeding and infant feeding module for Go NAPSACC. We did wrap up our completion ceremony, and I'm happy to announce that we were able to celebrate all five of our breastfeeding champions. One of our star childcare programs are able to join us today. Her name is Tashawna, so I'm going to go ahead and pass it over to her. 00:31:54:04 - 00:31:56:00 Unknown Good afternoon, everyone. 00:31:56:00 - 00:32:20:23 Unknown I'm a family childcare program in Milwaukee County, and I was fortunate to be part of this program because my daughter was actually having a baby who the program allowed me to kind of go over to her how important breastfeeding was and to be able to kind of balance out her life, to be able to breastfeed. 00:32:20:24 - 00:32:31:06 Unknown Just been as young as she was. And my grandbaby now is six weeks and she's been breast feeding since the womb. So I'm so excited about this. 00:32:31:06 - 00:32:47:21 Unknown So one of the things about being able to promote breastfeeding to families in Milwaukee County is that being part of different, smaller organizations, I talk about it and I'll also tell them how important it is for brain development for that child not being able to be sick. 00:32:47:23 - 00:33:06:15 Unknown Just the importance of how important it is and being able to work a job and still be able to breastfeed. So my daughter is able to get a space behind me that we use that she's able to actually come in to breastfeed in here. So you just kind of missed her to pump. She actually breastfeeds and pump back in the room here. 00:33:06:15 - 00:33:30:19 Unknown And it's just for her to be able to do this. So that was an awesome experience. Go NAPSACC, it started off rough for me, y'all, with Go NAPSACC, it started off rough. But with the help of Nigeria, we worked out the kinks. And I'm actually honest to say, all of my staff was able to enter play part in this and we all took the training together. 00:33:30:19 - 00:33:58:15 Unknown So it was awesome because my, again, my daughter had no idea I breastfed years ago but she had no idea on what to do, got together and we just got rated, which is so awesome. We made our five stars last week, so we just got rated last week for five stars. And I'm the young lady who came out to rate our program seeing our breath but breastfeeding bookbinder and she was like, what is in this binder? 00:33:58:15 - 00:34:14:15 Unknown And I kind of had her out on the front because I have a new parent that are being enrolled really soon. So that's kind of question is should she breastfeed? So giving her a lot of information on it. Thanks again to Nigeria and the whole coalition with the information I have been given. So she was just looking in the book. 00:34:14:15 - 00:34:39:00 Unknown And she knew nothing about this. And this is actually one of the people that rate. So I gave her some of your information Ms. Nigeria. So she may be reaching out, but she knew nothing about this. So it's been a very wonderful wonderful, wonderful, wonderful partnership. And with everything that Ms. Nigeria and have done for my program. So thank you guys, I’ve truly appreciated this. 00:34:39:02 - 00:35:04:01 Unknown And we're still learning as we grow. So it's been an honor to be part of it. And I’ll pass it back over to Ms.. Kelli. Thank you so much Tashawna. I'm really grateful you could join us today. The last thing I just wanted to mention for Wisconsin is that our breastfeeding friendly child care work really happens under the umbrella of Healthy Early, which is our statewide partnership that supports healthy eating physical activity for early childhood. 00:35:04:01 - 00:35:30:10 Unknown And it has been around since 2007. So Healthy Early has really restructured itself over the last year or two to try to transition our decision making power over to community leaders and to child care providers themselves to really make those decisions of where our state should go in terms of how we're supporting the ECE system. So Dellvery Blackwell, who's the Executive Director of AABN, is one of those Healthy Early leaders who's helping us with that work. 00:35:30:10 - 00:35:32:12 Unknown So I just wanted to highlight that 00:35:32:12 - 00:35:55:10 Unknown and I'll leave it with and thank you for your time, and I think I am passing it back to Janelle for Q&A. You are a thank you. What an outstanding panel. I’d like to thank all of our panelists for sharing their great information with us this afternoon. We're going to move into a portion of Q&A so I can ask the panelists to please turn their cameras back on so we can have some Q&A. 00:35:55:10 - 00:36:39:16 Unknown We might be able to take a few more questions if you haven't submitted yours yet on the Q&A button at the bottom of your Zoom box and we'll get started. And Diane, the first question is for you. Do you use Go NAPSACC to address any other areas of the spectrum of opportunities? yes, we do, actually. We we also have a breastfeeding welcome tier for child care statewide recognition program and we do use Go NAPSACC in that one of the activities that the site has to do is to do the breastfeeding and infant feeding self assessment and then score a certain percentage on that. 00:36:39:18 - 00:37:27:08 Unknown As Vanessa mentioned, we're working with QRIS to try to embed Go NAPSACC into that probably as one of the menu options of things that they can choose from to complete to become recognized in QRIS. We definitely work closely with CACFP and even some of the CACFP trainers and sponsors have become Go NAPSACC TA consultants. And I think that's was kind of shown in the number of CACFP participants that have gone through Go NAPSACC and then the professional development Go NAPSACC has been approved. 00:37:27:10 - 00:37:54:17 Unknown We have it's called SEED. And Vanessa, I don't know what SEED stands for, but it is the continuing education. And so those who go through Go NAPSACC or take the wonderful online trainings that they have now, they can get some of the professional development, continuing education hours. Thank you. Tashawna, let me ask you the next question and Nigeria might have some to add here. 00:37:54:17 - 00:38:16:06 Unknown So the question is we know how difficult it can be for child care providers to meet all of the requirements and regulations on top of providing quality care to children. So how do you find the time and capacity to become breastfeeding friendly with an already busy schedule and large workload? I got a great answer. My life is revolved around the work that I'm doing, so I do a lot of stuff. 00:38:16:06 - 00:38:38:23 Unknown Actually, I'm just being persistent with it and some days I'm up later than other days I'll be honest. And so I just stay persistent with a lot of things that I do. I don't like starting something and don't finish it. So just I have late nights. I was up late last night, but I have some late nights and I just continue to move through a lot of prayer. 00:38:38:23 - 00:39:10:22 Unknown Thank you. Nigeria, any additional thoughts on this one? I would definitely say that is the passion. And as you guys can see with Tashawna, her dedication and passion, it really just gave me energy and light to really see how important our work is. So when you have providers like Tashawna, who are, you know, they really want to improve, they really are passionate about the families that they serve and they want to offer the best quality. 00:39:10:24 - 00:39:16:19 Unknown It just gives us a reason to do the work that we do. So 00:39:16:19 - 00:39:34:05 Unknown Kelly Stader, this questions for you, but I'm thinking, Diane, you might have something to add, too. So the question is, what are some suggestions translating these programs or initiatives to smaller states that have less capacity and fewer resources for this work? That's $1,000,000 question. 00:39:34:11 - 00:40:01:20 Unknown But I will say, I mean, I wouldn't call Wisconsin very large and I would say we have pretty limited capacity in funding. So I don't want to give off the impression that we've been, you know, swimming in funding all these years because we haven't. I mean, I do think what the when I was mentioning kind of the braided funding piece, I guess that's one piece I can highlight of we lost our CDC funding back in 2018. 00:40:02:01 - 00:40:26:12 Unknown So that was, you know, the the SPAN funding. So for those five years, that was a huge loss. And that's where we really turned to our Maternal and Child Health funds and got more involved with the Title Five block grant, who was able to step in and kind of fill a little of what we lost. And now that we have CDC funding back, we want to make sure we're keeping, you know, multiple funding streams so we can keep that capacity going. 00:40:26:14 - 00:40:46:20 Unknown So that's always something to kind of piece things together. We Have to do that all the time in Wisconsin. But in terms of capacity at the local level, I think that's where we've tried to just be flexible. So it's an example of for a lot of times for a lot of years we've had our local health departments trying to support this work at the local level. 00:40:46:20 - 00:41:13:15 Unknown And obviously you all know what COVID did, health department capacity. And so I think that's where an example like Nigeria with African-American Breastfeeding Network comes in. How can we shift our attention to maybe these partners, you know, community based organizations we haven't been traditionally working with in this child care space? How can we bring them in and have them, you know, reach folks in a different way than we've been reaching them in the past through the health department lens? 00:41:13:15 - 00:41:42:03 Unknown So I think just trying to be as creative as possible and making it work and doing what you need to do, like Tashawna said of just figuring it out, we don't want this program to end, so you just have to figure it out. Thank you. Diane, any additional thoughts on this question? Yeah. You know, we are a small state, biggest in geography, smallest and not smallest of one of the smallest in population. 00:41:42:05 - 00:42:10:08 Unknown And I think partnerships, everything that Kelli said, plus the partnerships, I mean, there's no way we can do this alone. And so we have to have those partnerships. And that helps not only to do the work, but also then to help braid that funding that Kelli talked about. And yeah, you know, we do we are fortunate to have this SPAN but that's not the only thing that goes towards this effort that we're doing. 00:42:10:08 - 00:42:49:14 Unknown There are other sources of funding like where ever I can find it I'm trying to pull it in to purchase materials or develop things. And yeah, those partnerships are really important. Thank you. Vanessa, the next question is for you. Have you used Go NAPSACC in any other capacity as a childcare resource and referral specialist? I I've used it in so many different capacities outside of the QI, which has its regulations. I use a lot of the resources when I'm creating and presenting trainings. 00:42:49:16 - 00:43:16:06 Unknown We just did a Got Dirt so so how we can have gardening in Alaska during the winter, during the summer all year round and it was really hands on. So I use some of that literature out there as well as pulling some resources for my colleagues. So when they get questions in the field and they're not privy to the portal, then I'm able to share some of that information with them. 00:43:16:12 - 00:43:20:04 Unknown And it's it's been just a beautiful resource. 00:43:20:04 - 00:43:53:06 Unknown Thank you, Kelly Dahl, how were the single respondents per state identified and what instructions were given to them to help complete the survey? For example, who else they might need to engage to answer the questions? Good question. So we started with DNPAO recipients. If there was an ECE point of contact, if we knew, we knew they were at a state agency and also working on ECE. We also DNPAO has a list of Ambassador State contacts. 00:43:53:08 - 00:44:26:01 Unknown So we went there as well. And it was a combination because we did need them to be a state agency person and familiar with ECE activities in their state. It's a it's a really good question because, you know, like everyone's been saying about partnerships, the different agencies, there's there's not one person that knows everything in a state. So to the second part of the question, we did encourage the survey respondent to work with others that they knew in their state. 00:44:26:03 - 00:44:54:12 Unknown We gave them a good bit of time to complete the survey and we shared the PDF of the survey so they could see, you know, all the topics that were covered and if they didn't know something, they could reach out to someone in their state who would, before, you know, before going into the the little online survey collector. So that's how we identify those people and we hope they could work with others. 00:44:54:14 - 00:45:18:07 Unknown But I think it gets to another point about it. This is in the Indicator Report, but I just wanted to mention the Indicator Report is meant to be a jumping off point. I'm sure I can say there's probably information occurring in states that isn't captured in the report. So definitely, you know, please start with the Indicator Report, but then you might know of other activities in your state or there might be others who know of more. 00:45:18:07 - 00:45:22:00 Unknown So opting to go beyond that to. 00:45:22:00 - 00:45:51:19 Unknown Okay, thank you. Next question for Nigeria. What is your biggest barriers to implementing breastfeeding friendly care and a tip for success you’ve shared with other programs? I would definitely say time and resources with the five child care programs that we just completed, we were able to secure rocking chairs, boppy pillows, books, posters. 00:45:51:21 - 00:46:18:21 Unknown Like Tashawna said, she has a breastfeeding binder, so just to find the funding to get those resources because we know that an inviting environment can, you know, encourage someone to breastfeed. So when she has someone come to her center and they see all of these things, this information, then they start asking questions. So you really want to have that inviting environment. 00:46:18:23 - 00:46:48:21 Unknown One tip that I would give to other organizations is to try to reach out or find organization that is already working with child care programs. We were fortunate enough to work with 4Cs who was already working with child care programs. Tashawna was already working with people there that she trusted that were helping her with resources. So she knew that this was a good resource for her and that we would be there to help her either on our in or on their end. 00:46:48:21 - 00:46:53:12 Unknown So just that partnership of trust is what I would say 00:46:53:12 - 00:47:18:18 Unknown Kelli Stader, who are the key state level partners involved in supporting your recognition program there. So I, I think most important has been our relationship with our Department of Children and Families who kind of covers the child care system in our state. They have been part of this work since day one and have, kind of like Diane was saying, you know, the ECE world is not my expertise. 00:47:18:18 - 00:47:52:09 Unknown So having them in your back pocket, to kind of teach you all the things and answer all your questions is essential. And then likewise, our kind of membership umbrella organization for our CCR&R is called Supporting Families Together Association. So our partnership with them has also been essential. But then I could probably list, you know, 40 other organizations, our maternal and child health program, our state WIC program, Healthy Early I already mentioned, which is already a partnership of a million other organizations, Kids Forward, healthTIDE, our State Breastfeeding Coalition. 00:47:52:09 - 00:48:06:24 Unknown Our Department of Public Instruction is who houses our the CACFP program. So piecing all of those partners together, depending on what question we have or what need we have, has really just been key to keeping this going. 00:48:06:24 - 00:48:19:02 Unknown Thank you. Kelly Dahl, how have states use the State Indicator Report in the past? So the 2016 report was the first indicator report. 00:48:19:08 - 00:48:44:13 Unknown And you know, at that time probably the ECE system looked a little different. But we do know that folks were able to use the Indicator Report in several ways. They were able to first just kind of get a landscape assessment what was going on in their state, understand the pieces that they were less familiar with, and then use it to educate those in their state. 00:48:44:15 - 00:49:16:07 Unknown I think, you know, they could I know of states that said, well, look, see, you know, other states have a recognition program or you know, other states have this in their QRIS And it could be a motivator in that way when talking to decision makers. And then third, probably just to get inspiration to learn about what other states are doing and, you know, not have to reinvent wheel other time every time, but find a state that's similar to you, that's doing some things that you might be interested in doing. 00:49:16:11 - 00:49:46:15 Unknown And then a quick follow up. These states have to work in all areas of the spectrum of opportunities at once? Good question. No, although I think our speakers here have been giving great examples how they're connecting things. But no, not always. And I think in some states, you know, some states don't have a QRIS or some states, you know, certain areas just might not be as feasible or you might hit a wall. 00:49:46:17 - 00:50:00:03 Unknown And we've seen states have great success really diving into Farm to ECE and focusing in that area, etc.. So definitely got to see what makes the most sense for you, for your state and your time. 00:50:00:03 - 00:50:07:12 Unknown As we're wrapping up here, I want to ask our panelists if they want to leave our audience with any kind of final word or message. 00:50:07:14 - 00:50:12:12 Unknown So maybe we'll just go in the order that you all presented today. So, Diane 00:50:12:12 - 00:50:34:19 Unknown Yeah, I guess I would just say that and reiterate really what Kelly was saying is that there's so many different things that can be done to advance nutrition and physical activity. And again, finding those partners and trying to decide when and what your partners are passionate about and what they would like to do. 00:50:34:19 - 00:50:43:06 Unknown And then that can really just build that momentum to to do some amazing things in your state. 00:50:43:06 - 00:51:15:04 Unknown Thank you, Vanessa. I would just like to highlight our child care provider here and say that we really need to build those relationships as consultants and partners. We we need to listen and really lean in and listen of what would work for them, acknowledge their schedule, and maybe alter when we have conversations, maybe it's at nap time, maybe it's after hours, whatever might work and making it doable and feasible for them. 00:51:15:06 - 00:51:39:14 Unknown And I always leave my providers with a thought that there's no bad weather, just poorly dressed people. So get out and play and have a great time. Okay, that's great. Kelli Stader. I thought that was hard to follow. I'll just say, did it? I just thought that was great because I was and I mean, I was just going to build on what Kelly had just said about the spectrum of opportunities, too. 00:51:39:14 - 00:52:02:05 Unknown I feel like as a kind of a state person who is trying to think about the system as a whole, I think it's a great reference to just like always have in the back of your mind of, like you said, if you kind of hit a wall in one area, you have all these other ones to pick. So just kind of figure out over the years opportunities will come up in those different areas and if you can kind of layer them in one by one. 00:52:02:10 - 00:52:29:24 Unknown Now we feel like we have this system that's more sustainable and more comprehensive, but it takes time. And so just like you said, finding partners in each of those areas and kind of doing things one by one, Nigeria, I just want to say that I appreciate that all of us bring different expertise to the table and that we can take time to listen to one another and learn one another. 00:52:30:01 - 00:52:37:01 Unknown And, you know, we can just hone our skills so that we just become better and better as a team. 00:52:37:01 - 00:53:04:04 Unknown Tashawna. Something I didn't talk about, I'll leave you with. I am very, very pleased because my program does follow ECE as well too. So my children know how to plant some seeds and watch them come up. So this year was a great year for us because we planted kale, red cabbage, regular cabbage, brussel sprouts. 00:53:04:04 - 00:53:26:17 Unknown We did stuff we've never done before. So I need Farm to ECE to stay around whoever’s listening because it's awesome and it's very, very healthy for our children and especially children who have never experienced it. So they don't get it at home. But in the child care program they’re provided it, and organic right out the garden. Thank you, everybody. 00:53:26:19 - 00:53:50:16 Unknown That's great. And Kelly Dahl, I'm sorry. I realize I did the order wrong. So let me return it to, you. No, no problem. And just everything everyone said has really resonated with me and inspired me. So thank you to all the other speakers and thank you to everyone in attendance. We really hope that the new State Indicator Report can be a resource to you and helpful for you. 00:53:50:16 - 00:54:11:09 Unknown So just let us know and and good luck. Thank you. Thank you all. A big round of applause for our panel today. And thank you for our audience and joining us today for this important topic area. And we'll get you out of here just a couple of minutes early, encourage you to stand up and get a little physical activity before you join your next meeting. 00:54:11:09 - 00:54:14:10 Unknown So thank you all. We'll see you next year.