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KA 703. Nutrition Education and Behavior (San Miguel County)

Plan Goal

Improve health of San Miguel County residents through healthy food choices, food preparation skills and food resource management. Includes state staff Martha Archuleta, Kari Bachman, Karen Halderson, K’Dawn Jackson, Carmen Moreno, Lourdes Munoz and Linda

Situation Statement

Good nutrition is essential to improve and maintain health. Five of the leading causes of death including heart disease, cancer, stroke, diabetes and hypertension have links to diet. Obesity and overweight population presently affects a large population of San Miguel County adults. These individuals are at an increased risk of illness from hypertension, lipid disorders, type 2 diabetes,(San Miguel County adult population includes 2,149 or 10% of the population,) coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and certain cancers. The costs attributable to obesity-related disease nationally approaches $13 billion annually (NIH). In San Miguel County, it is estimated that ________are spent annually on adult obesity attributable medical expenditures (New Mexico Department of Health). New Mexico has one of the highest rates of poverty in the nation with 18.4% of New Mexicans living below poverty, San Miguel fits in at 23.3% or 6,790 of all children fall into that category.(US Bureau of the Census, 2000). Low income populations face numerous problems associated with inadequate nutrition.High medicaid bill are associated with many of San Miguel County's cases. Children do not eat enough to sustain health and to grow and develop at optimal levels. Even more commonly, individuals make poor food choices, which can lead to chronic disease problems such as obesity, diabetes, and heart disease. Although benefits such as Food Stamps and WIC provide vital resources to some of those in need of food assistance, this resource is often not maximized. This is often due to recipients’ lack of knowledge of the relationships between health and four areas: basic nutrition, food safety, food preparation, and food resource management. In addition, many limited-resource individuals do not receive the encouragement and reinforcement needed to put such knowledge into practice. Education can help low income families and individuals maximize their resources to improve their nutritional status. TANIF recipients in San Miguel County account for 381, (1.3%). While Food StamP Recipients includ 2,149 or (7.2%) from 2003 NM Statistics. Youth as well as adults should be targeted so nutrition related disease and obesity can be prevented. Nationally, overweight in children has tripled in the last 20 years and San Miguel County is no exception,both high school students are overweight or at risk for overweight medical problems. Low-income children between 2-5 years of age who participate in federally-funded nutrition programs are overweight or at risk for overweight (New Mexico Department of Health). Many San Miguel County children below the age of 18 live in poverty. This number has grown over the last 10 years. Reaching San Miguel County youth early in life with effective nutrition education will promote the adoption of healthy eating and food management practices. Establishing healthy habits early in life can have life long benefits in optimal health and disease prevention. Further, children are an ideal target for nutrition education in terms of habits being more amenable to change than later in life. Key tools for use in nutrition education by Extension include USDA’s MyPyramid, Dietary Guidelines for Americans (2005), and the Nutrition Facts Label. Diabetes: Of the leading chronic diseases, diabetes is a particular concern in San Miguel County. About 2,197 (10%) of San Miguel County residents have diabetes, although large number do not know they have the disease. Hispanics are two times more likely to be diagnosed with diabetes. If left untreated and uncontrolled, diabetes can result in serious complications: blindness, amputations, kidney disease, stroke, heart disease and death. There is no cure for diabetes, but it can be controlled and complications can be prevented or at least delayed. Simple changes, such as healthier food choices and adding regular physical activity can have a significant effect on the health and well-being of people with diabetes. Extension has long taught these principles to the general population. Because of the current collaboration between Extension, New Mexico Department of Health’s Diabetes Control Program and the Joslin Diabetes Center, Extension can effectively reach San Miguel County residents with or at risk for diabetes.

Target Audience and Actions

San Miguel County consumers, including individuals, families, youth, seniors, residents particularly limited resource audiences of San Miguel County. General Nutrition, with special focus on those with or at high risk for diabetes. Activities General Nutrition: ICAN adult series classes (Targets low income adults, focus is on healthy food choices, food preparation skills, food resource management, food safety and physical activity) ICAN youth series classes (Targets low income youth, focus is on healthy food choices, food preparation skills, food safety and physical activity) Fit Families series classes (Targets overweight children and their families, focus is on healthy food choices, physical activity and feeling positive) Coordinated Approach to Child Health (Targets elementary school children, focus is on nutrition education in the classroom and increase physical activity throughout the school day) Diabetes: Kitchen Creations Diabetes Cooking Schools series classes (Focus is on healthy food choices including balancing low and high carbohydrate foods and food preparations skills) On the Road to Living Well with Diabetes classes (Focus is on medical tests important for diabetes management) Keep Moving, Keep Healthy with Diabetes (Focus is on increasing exercise in people with diabetes)

Short-Term Objectives

80% of San Miguel County participants will increase knowledge of MyPyramid, Dietary Guidelines and Nutrition Facts Labels. 80% of San Miguel County participants will increase knowledge of healthy food choices. 80% of San Miguel County participants will increase knowledge of food preparation and meal planning. 80% ofSan Miguel County participants will increase knowledge of food resource management . 80% of San Miguel participants will increase knowledge of Diabetes Food Guide Pyramid and 50/50 method. 80% of San Miguel County participants will increase knowledge of medical tests important for diabetes management. 80% of San Miguel County participants will increase knowledge of importance of physical activity 60% of San Miguel County participants will plan to use MyPyramid, Dietary Guidelines and Nutrition Facts Labels to make food choices and plan meals. 60% of San Miguel County participants will plan to increase fruit and vegetable consumption. 60% of San Miguel County participants will plan to control portion sizes. 60% ofSan Miguel County participants will plan to adopt new food preparation and meal planning techniques. 60% of San Miguel County participants will plan to adopt new food resource management techniques. 60% of San Miguel County participants will plan to use the Diabetes Food Guide Pyramid and 50/50 method. 60% of San Miguel County participants will plan to get medical tests important for diabetes management. 80% of San Miguel County participants will plan to increase physical activity

Medium-Term Objectives

40% of San Miguel County participants will use MyPyramid, Dietary Guidelines and Nutrition Facts Labels to make food choices and plan meals one month after program participation. 40% of San Miguel County participants will increase fruit and vegetable consumption one month after program participation. 40% of San Miguel County participants will control portion sizes one month after program participation. 40% of San Miguel County participants will adopt new food preparation and meal planning techniques one month after program participation. 40% of San Miguel County participants will adopt new food resource management techniques one month after program participation. 40% of San Miguel County particpants will use the Diabetes Food Guide Pyramid and 50/50 method. 40% of San Miguel County participants will get medical tests important for diabetes management. 40% of San Miguel County participants will increase physical activity.

Long-Term Objectives

30% of San Miguel County participants will sustain adopted practices 3 years after program completion. 30% of San Miguel County participants will decrease their rates of chronic disease (obesity, cancer, heart disease).

Evaluation Plan

San Miguel County Participant knowledge and behavior surveys, diet records and activity logs for short and medium term objectives.