1. A Culture of Healthy
Choices
Miriam (Mim) Gaines, MACT, RD, LD
Nutrition and Physical Activity Division

2. 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.

3. 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.

4. Overview of Adult Sickness
• Obesity
• Mississippi #1
• Alabama #2
• Hypertension
• Diabetes
• High Cholesterol
• Cancer
• Etc.

5. A Healthy Culture
Wellness Prevention
in a
Treatment Medical
Country

6. Healthy Culture
 Wellness 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.

7. Six Dimensional Wellness Model
Helps Determine Approaches

8. 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

9. 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

10. Social Dimension
 Recycle plastics
 Brewton
 Lowndesboro
 Bureau retreat
 After school sites
 Employee
wellness program:
selected areas to
improve

11. Occupational
Dimension
 Encourages:
 Personal satisfaction and enrichment
through work
Contributing unique gifts, skills, and
talents to work for personal fulfillment
ADPH:

12. Intellectual Dimension
Encourages:
Stretching and challenging minds
Identifying potential problems and
appropriate solutions instead of
waiting, worrying
NPA:

13. Emotional Dimension
 Encourages:
◦ Recognizing, being aware of, and accepting
feelings while acting responsibly
◦ Being optimistic in life yet realistic
◦ Coping effectively with stress
◦ ADPH

14. 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

15. 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

16. Proven Areas to Address
Health
 Increase fruit and
vegetable
consumption
 Decrease
sedentary activity
 Increase physical
activity
 Breastfeeding

17. Physical Dimension Fun

18. Staff Gatherings Combine
Several Components
Fun staff meetings help
when raises are no
where in site.

19. Combining Components
.
 Statewide
 Promotes lifestyle
change
 Rewards weight-loss
 Starts in January
 10-week contest
 Adults
 Operated at local level
through
employers, hospitals,
health
departments, etc.

20. SUPPORT TO MAKE
CHANGES COMES FROM
The Environment, System,
and Policies

21. Socio-Ecological Model
Looking Beyond the Individual
What Factors That Influence Your Wellness?
There is an interwoven relationship between
the individual and their environment.

22. 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

23. Example of Policy to
Change Culture at Work:
Meeting Guidelines

24. ADPH 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

25. Serve foods
• Baked
• Broiled
• Grilled
• Steamed
• Poached
• Limit serving
size of high
fat, high
sugar, low fiber
items

26. ADPH Meeting Guidelines:
Physical Activity in Meetings
• Choose
walkable
• Stretch breaks
during meeting
• Overnight
facilities offer
areas or passes
to local gyms

27. Meeting Guidelines Cont.
 A smoke-free environment
 Go paperless when
possible
 Opt for pitchers of water
instead of bottles
 Opt for re-usable
plates, cups, and flatware
rather than paper or
plastic.
 Choose environmentally
friendly facilities

28. 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

29. 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

30. 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.

31. Leadership Skills Used in
Vending Project
 Tools- Reports provided to partners
 Visit- 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 lines
 Feel Safe- Asked for vendor’s input, NPA
staff reports

32. Leadership Lessons Learned
 Tools- Reports are not read or retained
 Visit- 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 unrepresented
 Feel Safe- NPA felt discourage

33. Leadership in Projects May Be
Crisis Style Leadership
 Vendors not paid timely
 Private vendor for expansion requires
close follow up
 Negotiations changes
◦ 50% versus 30%

34. Expanding to Private and to
Counties

35. 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

36. Why Continue?
Train up the future
generation
that healthy eating is
normal

37. 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. ?

38. Think Wellness
“We are all faced with a series of
great opportunities brilliantly
disguised as impossible
situations.”
Charles R. Swindoll