COD E R E D

Section 1. General RecommendationsTABLE 7. INVENTORY OF RECOMMENDATIONS ON GENERAL INTERVENTIONS FOR CHRONIC HEALTHCONDITIONSPolicy Reports Recommendations (Total studies = 75)Academic Performance-relatedClaimsCommunity-based● Advocate and support policies that promote “asthma friendly" communities andhomes and expand asthma control activities and interventions in high-riskpopulations particularly in low-income and minority populations. Establish diabetesprevention programs in high-risk communities that focus on the link between obesityand diabetes.● After school programs for elementary and teenage children run by local parks andrecreation departments, other public agencies, and privately-funded organizations.Head Start and childcare programs for the very young should be funded to ensurethat quality, evidenced- based physical activity is provided daily.● Establish zoning regulations that prohibit the sale of unhealthy food near schoolsas well as restrict placement and operating hours of restaurants near schools.Require hospitals and other health care facilities to sell only healthful foods.● Design or provide incentives to developers that build communities that promotehealthy eating and physical activity. Encourage location of grocery stores instead ofliquor stores in low-income neighborhoods, and increase healthy and competitivelypriced food choices. Promote communities where it’s easy and safe to walk and bike.Requirements for new schools to be sited and planned should include objectives toensure that students who live within one mile can safely walk or ride to school.School renovation funds and transportation funds should be allocated forimprovements to schools and transportation infrastructure that facilitate studentswalking to school. Building more trails and paths to encourage walking, jogging andcycling.● Commit all schools to participate inavailable child nutrition programs,including breakfast, lunch, afterschool snacks, child care andsummer food service.● Ensure there is staff and space forquality physical education.● Hire credentialed physicaleducation teachers for elementaryschools.● Institute a state subject matterproject for physical education andhealth and provide funding forschools to adopt evidence-basedphysical education programs andprovide incentive funding to teachersto prepare for the nationalprofessional board exam insecondary physical education andelementary physical education.● Educate families on disease risk factors, prevention and management. Encourageparents and caregivers to promote healthy eating patterns by offering nutritioussnacks, such as vegetables and fruits, low-fat dairy foods, and whole grains;encouraging children’s autonomy in self-regulation of food intake and settingappropriate limits on choices; and modeling healthy food choices.● Encourage community health workers to participate in diabetes prevention andtreatment programs.● Establish a pilot program to demonstrate the effectiveness of comprehensivecommunity-based initiatives focusing on obesity and type 2 diabetes in children andadolescents. Information about successful community projects for people withasthma should be made available to local officials.● The Legislature should requireschools to provide breakfast.● School districts should elect toinclude formal curriculum on physicalactivity and physical educationinstruction in kindergarten throughtwelfth grades. Teachers should begiven education and training on howto model physical activity behaviors.Health care access/delivery/coverage● Improve access to quality care and services utilization and culturally appropriateservices.● Increase the proportion of people with asthma who receive written asthmamanagement plans from their health care provider. Provide case-management tohigh-risk children.● Pediatricians should develop simple appraisal methods to enable schools/familiesand their health centers to identify when children are becoming obese.● Improve health coverage for uninsured or underinsured children withasthma/diabetes and expand insurance to preventive services. Ensure broaderaccess to asthma/diabetes medications and supplies. Expand the insurance benefitsto cover for preventive services and reimburse preventive community healthprofessionals.● Good public policy on asthma canincrease school attendance andeducational attainment. Asthmarelatedabsenteeism negativelyaffects children’s learning potential.● Poor asthma control often results intime away from school, work, sports,or other activities that affect thequality of life. Even if the individualwith asthma is able to attend work orschool, ongoing symptoms orE-40