1 00:00:05,520 --> 00:00:07,640 >>THANK YOU FOR 2 00:00:07,640 --> 00:00:10,680 ATTENDING THE SECOND OF FOUR 3 00:00:10,680 --> 00:00:13,880 MEETINGS FOR THE BIOMARKERS OF 4 00:00:13,880 --> 00:00:16,280 NUTRITION FOR DEVELOPMENT 5 00:00:16,280 --> 00:00:17,440 KNOWLEDGE INDICATING FOR THE 6 00:00:17,440 --> 00:00:18,000 BOND-KIDS PROJECT. 7 00:00:18,000 --> 00:00:19,840 I'M DREW BREEMER. 8 00:00:19,840 --> 00:00:21,960 ON BEHALF OF THE EUNICE KENNEDY 9 00:00:21,960 --> 00:00:22,640 SHRIVER NATIONAL INSTITUTE OF 10 00:00:22,640 --> 00:00:24,400 CHILD HEALTH AND HUMAN DEVELOP. 11 00:00:24,400 --> 00:00:26,680 IT'S MY PLEASURE TO EXTEND 12 00:00:26,680 --> 00:00:28,000 PROFOUND THANKS AND GRATITUDE TO 13 00:00:28,000 --> 00:00:33,520 THE FEDERAL AND NON-FEDERAL 14 00:00:33,520 --> 00:00:35,560 MEMBERS WHO HELPED SHAPE THE 15 00:00:35,560 --> 00:00:36,640 MEETING SERIES AS WELL AS THE 16 00:00:36,640 --> 00:00:38,040 WORKING GROUP CHAIRS AND 17 00:00:38,040 --> 00:00:38,320 MEMBERS. 18 00:00:38,320 --> 00:00:40,200 ALL HAVE PUT IN COUNTLESS HOURS 19 00:00:40,200 --> 00:00:41,640 OF TIME ON THE PROJECT AND WE'LL 20 00:00:41,640 --> 00:00:45,840 BE HEARING FROM WORKING GROUP 2 21 00:00:45,840 --> 00:00:46,120 TODAY. 22 00:00:46,120 --> 00:00:49,120 YOU'VE BEEN DOING THIS AMIDST 23 00:00:49,120 --> 00:00:51,280 YOUR DAY JOBS AND THE CHALLENGE 24 00:00:51,280 --> 00:00:52,240 OF THE PANDEMIC. 25 00:00:52,240 --> 00:00:56,240 I'D LIKE TO THANK MY COLLEAGUES 26 00:00:56,240 --> 00:01:01,120 AND RECOGNIZE DAN RADDEN AS THE 27 00:01:01,120 --> 00:01:01,760 ORGANIZER. 28 00:01:01,760 --> 00:01:08,760 THIRD, I'D LIKE TO THANK ALISON 29 00:01:08,760 --> 00:01:10,280 FOR HER AND HER TEAM. 30 00:01:10,280 --> 00:01:12,560 THIS COULD NOT HAPPEN WITHOUT 31 00:01:12,560 --> 00:01:13,120 HER. 32 00:01:13,120 --> 00:01:17,760 AND DELIGHTED TO HAVE JENNY 33 00:01:17,760 --> 00:01:19,760 WILSON AND FINALLY OUR CONTRACT 34 00:01:19,760 --> 00:01:22,000 AND TECHNICAL AND A.V. TEAMS FOR 35 00:01:22,000 --> 00:01:23,320 WORKING WITH US TO MAKE THE 36 00:01:23,320 --> 00:01:24,840 DISCUSSIONS AVAILABLE TO THE 37 00:01:24,840 --> 00:01:25,120 PUBLIC. 38 00:01:25,120 --> 00:01:27,280 SHE SERIES OF WORK MEETING THE 39 00:01:27,280 --> 00:01:28,680 CULMINATION OF HOURS OF 40 00:01:28,680 --> 00:01:30,560 PREPARATION AND DISCUSSION AND 41 00:01:30,560 --> 00:01:32,840 AS DAN WILL EXPLAIN, ARE MEANT 42 00:01:32,840 --> 00:01:33,840 TO TAKE A DEEP DIVE IN THE 43 00:01:33,840 --> 00:01:35,040 NUTRITIONAL NEEDS AND ASSESSMENT 44 00:01:35,040 --> 00:01:38,840 OF SCHOOL-AGED CHILDREN. 45 00:01:38,840 --> 00:01:39,440 I EXPECT ANOTHER FANTASTIC 46 00:01:39,440 --> 00:01:41,760 SESSION TODAY. 47 00:01:41,760 --> 00:01:44,320 IT'S MY PLEASURE TO INTRODUCE 48 00:01:44,320 --> 00:01:47,600 DAN RADEN THE ORGANIZER OF THE 49 00:01:47,600 --> 00:01:48,000 BOND-KIDS PROJECT. 50 00:01:48,000 --> 00:01:49,680 TAKE IT AWAY. 51 00:01:49,680 --> 00:01:53,800 >> HI, EVERYBODY. 52 00:01:53,800 --> 00:01:56,040 WELCOME BACK TO BOND-KIDS. 53 00:01:56,040 --> 00:01:57,840 IT'S THE SECOND IN THE SERIES OF 54 00:01:57,840 --> 00:01:59,600 FOUR WORKSHOPS. 55 00:01:59,600 --> 00:02:05,040 I'LL DESCRIBE THE WORKSHOPS ARE 56 00:02:05,040 --> 00:02:25,760 PART -- THIS WAS INITIATED FROM 57 00:02:25,760 --> 00:02:31,600 COLLEAGUES IN THE FIELD AND THE 58 00:02:31,600 --> 00:02:33,800 USDA AND THE LONDON SCHOOL OF 59 00:02:33,800 --> 00:02:36,560 HYGIENE TROPICAL MEDICINE WHO 60 00:02:36,560 --> 00:02:38,800 LEADS A CONSORTIUM ON NUTRITION 61 00:02:38,800 --> 00:02:40,360 FOR SCHOOL-AGED CHILDREN. 62 00:02:40,360 --> 00:02:44,400 ONE OF THE REAL KEY ISSUES HERE 63 00:02:44,400 --> 00:02:47,040 IS THAT THESE PROGRAMS AND 64 00:02:47,040 --> 00:02:48,760 THERE'S LOTS OF THEM 65 00:02:48,760 --> 00:02:49,840 DOMESTICALLY AND INTERNATIONALLY 66 00:02:49,840 --> 00:02:51,600 TO PROVIDE NUTRITIONAL SUPPORT 67 00:02:51,600 --> 00:02:55,240 TO KIDS, DO A PRETTY GOOD JOB AT 68 00:02:55,240 --> 00:02:58,040 DELIVERING THE SERVICES. 69 00:02:58,040 --> 00:02:59,600 BUT WE ARE LESS SUCCESSFUL AT 70 00:02:59,600 --> 00:03:00,320 MEASURING THE IMPACT OF THOSE 71 00:03:00,320 --> 00:03:07,000 SERVICES. 72 00:03:07,000 --> 00:03:08,720 WE'RE TRYING TO DEFINE THE NEED 73 00:03:08,720 --> 00:03:10,800 AND IMPACT. 74 00:03:10,800 --> 00:03:13,000 ON THIS CARTOON EXEMPLIFIES OUR 75 00:03:13,000 --> 00:03:14,680 APPROACH TO THIS PROJECT AND TO 76 00:03:14,680 --> 00:03:29,200 ALL THE PROJECTS THAT WE DO WE 77 00:03:29,200 --> 00:03:31,280 RECOGNIZE THE NEED FOR BALANCE. 78 00:03:31,280 --> 00:03:32,600 WE'RE AN EXTRAMURAL RESEARCH 79 00:03:32,600 --> 00:03:34,120 PROGRAM SO THERE'S A HEAVY 80 00:03:34,120 --> 00:03:36,000 EMPHASIS ON RESEARCH BUT WE ALSO 81 00:03:36,000 --> 00:03:38,200 RECOGNIZE WE LIVE IN THE REAL 82 00:03:38,200 --> 00:03:40,640 WORLD AND THE FINDINGS OF THEE 83 00:03:40,640 --> 00:03:41,960 THIS RESEARCH AND THE -- THIS 84 00:03:41,960 --> 00:03:43,120 RESEARCH AND THE EVIDENCE 85 00:03:43,120 --> 00:03:45,040 GENERATED NEEDS TO BE TRANSLATED 86 00:03:45,040 --> 00:03:47,800 IN A MEANINGFUL, EQUITABLE WAY 87 00:03:47,800 --> 00:03:48,640 TO HELP SUPPORT PROGRAM'S 88 00:03:48,640 --> 00:03:51,600 EFFORTS TO IMPROVE THE HEALTH 89 00:03:51,600 --> 00:03:53,280 AND WELL BEING OF THE POPULATION 90 00:03:53,280 --> 00:03:59,200 BOTH IN THE U.S. AND ABROAD. 91 00:03:59,200 --> 00:04:00,920 OUR BASIC ASPIRATIONS THE 92 00:04:00,920 --> 00:04:02,800 PROJECT HAS BEEN TO PROVIDE 93 00:04:02,800 --> 00:04:04,600 SUPPORT TO THOSE AGENCIES AND 94 00:04:04,600 --> 00:04:05,880 ORGANIZATIONS AND THE COMMUNITY 95 00:04:05,880 --> 00:04:08,320 INVOLVED IN PROVIDING 96 00:04:08,320 --> 00:04:09,720 NUTRITIONAL SUPPORT TO 97 00:04:09,720 --> 00:04:10,280 SCHOOL-AGED CHILDREN. 98 00:04:10,280 --> 00:04:12,000 WE'RE HOPING DO THAT BY ENGAGING 99 00:04:12,000 --> 00:04:14,520 THE ORGANIZATIONS THAT ARE 100 00:04:14,520 --> 00:04:14,960 EVOLVED. 101 00:04:14,960 --> 00:04:18,800 YOU MENTION THE SCIENTIFIC 102 00:04:18,800 --> 00:04:20,080 STEERING COMMITTEE AND U.S. AND 103 00:04:20,080 --> 00:04:23,360 DOMESTICALLY AND CIVIL SOCIETY 104 00:04:23,360 --> 00:04:26,200 HAS BEEN INVOLVED IN THIS 105 00:04:26,200 --> 00:04:26,440 ACTIVITY. 106 00:04:26,440 --> 00:04:27,200 THE TECHNICAL EXPERTISE 107 00:04:27,200 --> 00:04:28,720 REPRESENTED BY THE WORKING GROUP 108 00:04:28,720 --> 00:04:31,200 MEMBERS AND SPEAKERS YOU'LL BE 109 00:04:31,200 --> 00:04:33,160 HEARING FROM. 110 00:04:33,160 --> 00:04:35,200 OUR GOAL IS TO IDENTIFY THE 111 00:04:35,200 --> 00:04:38,280 EVIDENCE, WHAT IT IS WE KNOW AND 112 00:04:38,280 --> 00:04:40,000 WHAT IT IS WE DON'T KNOW AND USE 113 00:04:40,000 --> 00:04:41,400 THAT EVIDENCE AND MOVE IT 114 00:04:41,400 --> 00:04:43,680 FORWARD BOTH FROM A 115 00:04:43,680 --> 00:04:45,040 TRANSLATIONAL AND ADAPTATIONAL 116 00:04:45,040 --> 00:04:46,120 POINT OF VIEW AND THE 117 00:04:46,120 --> 00:04:47,080 DEVELOPMENT OF A RESEARCH AGENDA 118 00:04:47,080 --> 00:04:50,920 TO ADDRESS GAPS. 119 00:04:50,920 --> 00:04:52,200 TO BE CLEAR WHAT WE'RE NOT DOING 120 00:04:52,200 --> 00:04:54,920 IS NOT DEVELOPING GUIDELINES OR 121 00:04:54,920 --> 00:04:56,800 RECOMMENDATIONS OR MAKING 122 00:04:56,800 --> 00:04:57,200 POLICY. 123 00:04:57,200 --> 00:04:59,640 WE ARE SUPPORTING THROUGH THE 124 00:04:59,640 --> 00:05:01,080 GENERATION OF EVIDENCE AND 125 00:05:01,080 --> 00:05:03,360 KNOWLEDGE THOSE AGENCIES, 126 00:05:03,360 --> 00:05:06,960 ORGANIZATIONS THAT DO BOTH IN 127 00:05:06,960 --> 00:05:09,880 THE U.S. 128 00:05:09,880 --> 00:05:12,280 THE TITLE IS BOND-KIDS. 129 00:05:12,280 --> 00:05:14,280 THE BOND PIECE THE REASON WE'RE 130 00:05:14,280 --> 00:05:15,840 USING THE BOND PLATFORM IS 131 00:05:15,840 --> 00:05:17,280 BECAUSE FOR THOSE THAT MAY NOT 132 00:05:17,280 --> 00:05:19,400 BE FAMILIAR WITH BOND, IT'S A 133 00:05:19,400 --> 00:05:21,560 PROJECT THAT STARTED IN 2010 AS 134 00:05:21,560 --> 00:05:23,800 A COLLABORATION BETWEEN US AND 135 00:05:23,800 --> 00:05:26,200 THE BILL AND MELINDA GATES 136 00:05:26,200 --> 00:05:29,040 FOUNDATION AND THE OFFICE OF 137 00:05:29,040 --> 00:05:36,040 DIETARY SUPPLEMENTS AT NIH AND 138 00:05:36,040 --> 00:05:45,640 THE OFFICE OF NUTRITIONAL 139 00:05:45,640 --> 00:05:45,920 PARTNERS. 140 00:05:45,920 --> 00:05:48,080 THE GOAL IS TO DEVELOP 141 00:05:48,080 --> 00:05:52,200 DOCUMENTATION WHAT AND HOW TO 142 00:05:52,200 --> 00:05:53,400 ASSESS NUTRITIONAL STATUS AND 143 00:05:53,400 --> 00:05:56,840 WHAT DO WE NEED CONSIDER IN 144 00:05:56,840 --> 00:06:01,360 ASSESSING NUTRITIONAL STATUS AND 145 00:06:01,360 --> 00:06:04,280 RECOGNIZING THE IT NUTRITIONAL 146 00:06:04,280 --> 00:06:07,480 THE BOND ARE RESPONSIVE TO THE 147 00:06:07,480 --> 00:06:11,440 USER GROUPS WHETHER BENCH SIDE 148 00:06:11,440 --> 00:06:15,160 OR CLINICIAN AND IN A PRIMARY, 149 00:06:15,160 --> 00:06:20,680 SECONDARY, TERTIARY CARE SETTING 150 00:06:20,680 --> 00:06:24,800 AND THOSE RESPONSIBLE FOR THE 151 00:06:24,800 --> 00:06:26,960 EVALUATION OF THE PROGRAMS AND 152 00:06:26,960 --> 00:06:29,360 POLICY MAKERS AND SUCH. 153 00:06:29,360 --> 00:06:30,360 THEY ALL HAVE DIFFERENT NEEDS 154 00:06:30,360 --> 00:06:33,200 AND CONSUME THE DATA AND USE THE 155 00:06:33,200 --> 00:06:35,080 DATA AND USE THE ASSESSING 156 00:06:35,080 --> 00:06:35,960 METHODOLOGIES SO THE BOND 157 00:06:35,960 --> 00:06:37,480 PLATFORM IS INTENDED TO BE 158 00:06:37,480 --> 00:06:38,160 RESPONSIVE TO THE NEEDS OF ALL 159 00:06:38,160 --> 00:06:48,400 THOSE COMMUNITIES. 160 00:06:48,400 --> 00:06:51,400 THE SECOND PIECE OF THE TITLE IS 161 00:06:51,400 --> 00:06:52,800 KNOWLEDGE INDICATING DIETARY 162 00:06:52,800 --> 00:06:53,080 SUFFICIENCY. 163 00:06:53,080 --> 00:06:54,960 THAT WOULD IMPLY WHAT WE'RE 164 00:06:54,960 --> 00:07:00,120 DOING IS TAKING THE TRADITIONAL 165 00:07:00,120 --> 00:07:01,800 APPROACH TO MEASURING WHAT 166 00:07:01,800 --> 00:07:05,520 PEOPLE EAT AND YOU MAY MEASURE 167 00:07:05,520 --> 00:07:11,040 SOME ASPECT OF THEIR NUTRITIONAL 168 00:07:11,040 --> 00:07:12,480 STATUS BIO CHEMICALLY OR 169 00:07:12,480 --> 00:07:16,440 OTHERWISE AND IN FACT WE 170 00:07:16,440 --> 00:07:17,520 RECOGNIZE NUTRITIONAL 171 00:07:17,520 --> 00:07:18,400 SUFFICIENCY IS A MORE 172 00:07:18,400 --> 00:07:21,160 COMPLICATED SET OF ISSUES. 173 00:07:21,160 --> 00:07:23,200 WE TAKE AN ECOLOGICAL APPROACH 174 00:07:23,200 --> 00:07:25,680 AND WE MEAN THE SET OF 175 00:07:25,680 --> 00:07:27,280 RELATIONSHIPS BETWEEN A COMPLEX 176 00:07:27,280 --> 00:07:28,960 BIOLOGICAL SYSTEM IN THIS CASE 177 00:07:28,960 --> 00:07:30,920 THE SCHOOL-AGED CHILD, AND THEIR 178 00:07:30,920 --> 00:07:31,920 ENVIRONMENT. 179 00:07:31,920 --> 00:07:33,680 WE DIVIDE THAT ENVIRONMENT INTO 180 00:07:33,680 --> 00:07:34,760 INTERNAL AND EXTERNAL. 181 00:07:34,760 --> 00:07:37,640 THE INTERNAL IS THE BIOLOGY AND 182 00:07:37,640 --> 00:07:39,760 NUTRITIONAL AND HEALTH AND 183 00:07:39,760 --> 00:07:41,000 GENETICS, ETCETERA, THE SPECIFIC 184 00:07:41,000 --> 00:07:43,840 FUNCTIONAL DOMAINS OF INTEREST. 185 00:07:43,840 --> 00:07:49,160 THOSE WERE COVERED LAST WEEK. 186 00:07:49,160 --> 00:07:53,000 THE EXTERNAL ENVIRONMENT THIS 187 00:07:53,000 --> 00:07:54,400 NEEDS TO BE DETERMINED AND 188 00:07:54,400 --> 00:07:58,000 RECOGNIZING WE LIVE IN A 189 00:07:58,000 --> 00:07:58,720 COMPLICATED, COMPLEX ENVIRONMENT 190 00:07:58,720 --> 00:08:01,720 AND THE ACKNOWLEDGEMENT OF THAT 191 00:08:01,720 --> 00:08:03,440 ENVIRONMENT IS NECESSARY IN 192 00:08:03,440 --> 00:08:04,560 ORDER TO DEVELOP CONTEXT 193 00:08:04,560 --> 00:08:07,120 SPECIFIC APPROACHES AND THAT'S 194 00:08:07,120 --> 00:08:08,360 WHAT WE'LL BE HEARING ABOUT 195 00:08:08,360 --> 00:08:08,640 TODAY. 196 00:08:08,640 --> 00:08:10,360 NEXT SLIDE. 197 00:08:10,360 --> 00:08:12,520 THIS IS A REPRESENTATION OF OUR 198 00:08:12,520 --> 00:08:13,960 VIEW OF THE ENVIRONMENT AND 199 00:08:13,960 --> 00:08:15,640 TAKING A MORE HOLISTIC VIEW AND 200 00:08:15,640 --> 00:08:17,480 NOT JUST TALKING ABOUT THE 201 00:08:17,480 --> 00:08:20,320 PHYSICAL ENVIRONMENT BUT THE 202 00:08:20,320 --> 00:08:21,280 ENVIRONMENT WRIT LARGE WE'LL 203 00:08:21,280 --> 00:08:25,400 HEAR ABOUT TODAY. 204 00:08:25,400 --> 00:08:27,160 WE ALSO RECOGNIZE THAT THE 205 00:08:27,160 --> 00:08:30,400 REASON FOR THESE PROGRAMS TO 206 00:08:30,400 --> 00:08:32,800 SUPPORT NUTRITIONAL CARE OF 207 00:08:32,800 --> 00:08:34,120 SCHOOL-AGED CHILDREN IN MANY 208 00:08:34,120 --> 00:08:35,120 CASES THERE'S PROBLEMS WITH THE 209 00:08:35,120 --> 00:08:35,960 FOOD SYSTEM. 210 00:08:35,960 --> 00:08:38,640 THE FOOD SYSTEM NEEDS TO BE 211 00:08:38,640 --> 00:08:40,200 ACKNOWLEDGED AND THE FOOD SYSTEM 212 00:08:40,200 --> 00:08:46,000 REPRESENTS ITS OWN ECOLOGY AND 213 00:08:46,000 --> 00:08:50,000 REPRESENTED BY ISSUES AND THE 214 00:08:50,000 --> 00:08:53,120 PHYSICAL ENVIRONMENT AND SOCIAL, 215 00:08:53,120 --> 00:08:54,800 DEMOGRAPHIC CHOICES PEOPLE MAKE, 216 00:08:54,800 --> 00:08:57,880 ETCETERA. 217 00:08:57,880 --> 00:09:02,600 SO WHEN YOU PUT THESE SO IT 218 00:09:02,600 --> 00:09:12,960 MAKES NUTRITIONAL ECOLOGY IN 219 00:09:12,960 --> 00:09:13,920 SCHOOL-AGED CHILDREN AND HOW CAN 220 00:09:13,920 --> 00:09:15,960 WE SET UP IN EFFORT TO EXPLORE 221 00:09:15,960 --> 00:09:17,960 THE VARIOUS ASPECTS OF THIS 222 00:09:17,960 --> 00:09:27,160 COMPLEX SET OF RELATIONSHIPS. 223 00:09:27,160 --> 00:09:31,040 SO THE ISSUE OF SCHOOL-AGED 224 00:09:31,040 --> 00:09:33,400 CHILDREN IS A COMPLICATED WIN. 225 00:09:33,400 --> 00:09:35,720 WE'RE TALKING AGES 5 TO 19 WITH 226 00:09:35,720 --> 00:09:36,560 DUE RECOGNITION OF THE 227 00:09:36,560 --> 00:09:39,800 IMPORTANCE OF THE PRECURSOR OF 228 00:09:39,800 --> 00:09:42,400 THE PREGNANCY THROUGH THE FIRST 229 00:09:42,400 --> 00:09:45,040 FEW YEARS OF LIFE AND 230 00:09:45,040 --> 00:09:45,800 PREDISPOSES CHILDREN TO THINGS 231 00:09:45,800 --> 00:09:46,440 LATER IN LIFE. 232 00:09:46,440 --> 00:09:50,320 OUR FOCUS IS GOING TO BE ON THE 233 00:09:50,320 --> 00:09:53,400 DEVELOPMENT STAGES FROM 5 TO AGE 234 00:09:53,400 --> 00:09:54,160 19. 235 00:09:54,160 --> 00:09:56,600 EACH OF THE WORKING GROUPS IN 236 00:09:56,600 --> 00:09:58,000 THE BOND-KIDS PROJECT DIVIDE 237 00:09:58,000 --> 00:10:02,520 THEIR WORK INTO THREE SORT OF 238 00:10:02,520 --> 00:10:04,920 FUNDAMENTAL PERIODS PRE AND 239 00:10:04,920 --> 00:10:08,200 POST-PUBESCENT ADOLESCENCE AND 240 00:10:08,200 --> 00:10:10,800 RECOGNIZE THE IMPORTANCE OF THE 241 00:10:10,800 --> 00:10:13,880 FOOD SYSTEM. 242 00:10:13,880 --> 00:10:17,040 THE GOAL IS WE'RE TAKE AN 243 00:10:17,040 --> 00:10:19,440 ECOLOGICAL APPROACH TO ADDRESS 244 00:10:19,440 --> 00:10:20,200 THE NEEDS OF SCHOOL-AGED 245 00:10:20,200 --> 00:10:22,000 CHILDREN AND FOCUS ON HOW YOU 246 00:10:22,000 --> 00:10:27,640 ASSESS THE FUNCTIONAL IMPACT. 247 00:10:27,640 --> 00:10:28,800 NUTRITIONAL ASSESSMENT IS 248 00:10:28,800 --> 00:10:30,360 MEASURED BY SOMEONE'S STATUS. 249 00:10:30,360 --> 00:10:33,040 USUALLY WHETHER IT'S DIETARY 250 00:10:33,040 --> 00:10:35,920 INTAKE OR BIO CHEMICAL MAYBE THE 251 00:10:35,920 --> 00:10:38,480 STATUS AND BASED ON A 252 00:10:38,480 --> 00:10:40,200 STATISTICAL CUT-OFF MAKE 253 00:10:40,200 --> 00:10:41,040 DECISIONS WHETHER THEY'RE 254 00:10:41,040 --> 00:10:41,880 ADEQUATE OR NOT. 255 00:10:41,880 --> 00:10:43,200 THAT TELLS YOU SOMETHING ABOUT 256 00:10:43,200 --> 00:10:46,000 THE RELATIONSHIP BETWEEN WHAT 257 00:10:46,000 --> 00:10:46,880 THEY'RE EATING AND WHAT'S 258 00:10:46,880 --> 00:10:49,000 HAPPENED BUT IT DIDN'T TELL YOU 259 00:10:49,000 --> 00:10:50,400 MUCH ABOUT TO THE FUNCTIONAL 260 00:10:50,400 --> 00:10:53,000 IMPLICATIONS AND THE IMPACT OF 261 00:10:53,000 --> 00:10:54,560 THAT STATUS ON AN INDIVIDUAL'S 262 00:10:54,560 --> 00:10:55,800 HEALTH AND DEVELOPMENT. 263 00:10:55,800 --> 00:10:57,400 THAT'S WHAT WE'RE FOCUSSED ON 264 00:10:57,400 --> 00:10:58,120 HERE. 265 00:10:58,120 --> 00:11:00,120 THAT'S OUR GOAL IN PHASE 1 IS TO 266 00:11:00,120 --> 00:11:01,640 COVER THOSE KINDS OF ISSUES AND 267 00:11:01,640 --> 00:11:04,560 COVER THE INTERNAL AND EXTERNAL 268 00:11:04,560 --> 00:11:06,560 ENVIRONMENT AND ALSO INCLUDE AN 269 00:11:06,560 --> 00:11:09,000 APPRECIATION OF HOW TO ASSESS 270 00:11:09,000 --> 00:11:11,360 AND PUT THOSE THINGS TOGETHER IN 271 00:11:11,360 --> 00:11:17,040 AN ASSESSMENT BATTERY AND AGAIN 272 00:11:17,040 --> 00:11:18,360 GETTING BACK TO BALANCE WE 273 00:11:18,360 --> 00:11:20,200 RECOGNIZE THE IMPORTANCE OF 274 00:11:20,200 --> 00:11:21,480 TRANSLATION AND THE FOURTH 275 00:11:21,480 --> 00:11:23,000 WORKING GROUP YOU'LL HEAR ABOUT 276 00:11:23,000 --> 00:11:26,400 ON MARCH 25 WILL COVER THAT. 277 00:11:26,400 --> 00:11:28,400 THIS IS INTENDED NOT TO BE A 278 00:11:28,400 --> 00:11:28,640 ONE-OFF. 279 00:11:28,640 --> 00:11:31,800 THIS IS INTENDED TO BE THE FIRST 280 00:11:31,800 --> 00:11:33,240 IN WHAT WILL HOPEFULLY BE A 281 00:11:33,240 --> 00:11:34,560 SERIES OF ACTIVITIES IN 282 00:11:34,560 --> 00:11:36,240 COLLABORATION WITH OUR PARTNERS 283 00:11:36,240 --> 00:11:39,680 AT THE LONDON SCHOOL AND SCHOOL 284 00:11:39,680 --> 00:11:41,600 MEALS COALITION LED BY THE WORLD 285 00:11:41,600 --> 00:11:47,160 FOOD PROGRAM TO TAKE WHAT WE 286 00:11:47,160 --> 00:11:54,600 LEARNED HERE AND TEST IT AND 287 00:11:54,600 --> 00:11:56,760 IMPLEMENT IT AND SEE HOW IT 288 00:11:56,760 --> 00:11:58,280 MIGHT WORK. 289 00:11:58,280 --> 00:12:00,200 THIS IS A QUICK 290 00:12:00,200 --> 00:12:01,880 CONCEPTUALIZATION OF THE 291 00:12:01,880 --> 00:12:02,560 STRUCTURE OF THE PROJECT. 292 00:12:02,560 --> 00:12:04,600 DREW MENTIONS OUR PARTNERS WITH 293 00:12:04,600 --> 00:12:14,520 OUR ACADEMY FROM NUTRITION 294 00:12:14,520 --> 00:12:17,200 DIETETICS AND THE SECRETARY OF 295 00:12:17,200 --> 00:12:19,480 HHD AND THE MEMBERS ARE 296 00:12:19,480 --> 00:12:24,640 AVAILABLE AND U.S. GOVERNMENT 297 00:12:24,640 --> 00:12:27,000 AGENCIES INVOLVED IN PROGRAMS 298 00:12:27,000 --> 00:12:29,440 PROVING SUPPORT TO CHILDREN AND 299 00:12:29,440 --> 00:12:31,160 WHO AND UNICEF AND THE WORLD 300 00:12:31,160 --> 00:12:32,120 FOOD PROGRAM AND ON THE THE 301 00:12:32,120 --> 00:12:36,960 ACTUAL WORKING GROUPS THAT ARE 302 00:12:36,960 --> 00:12:38,240 DOWN IN THE WEEDS GETTING WORK 303 00:12:38,240 --> 00:12:39,920 DONE YOU'LL HEAR FROM TODAY. 304 00:12:39,920 --> 00:12:46,280 THIS IS HOW WE -- I PUT THIS 305 00:12:46,280 --> 00:12:54,440 TOGETHER ORGANIZATIONAL LY THE 306 00:12:54,440 --> 00:12:58,040 VEN DIAGRAM AND YOU'LL SEE THE 307 00:12:58,040 --> 00:13:00,200 OVERLAY ON THE RELATIONSHIPS AND 308 00:13:00,200 --> 00:13:03,760 NUTRITIONAL STATUS. 309 00:13:03,760 --> 00:13:05,600 ALL THOSE WILL THEN BE TAKEN BY 310 00:13:05,600 --> 00:13:11,000 WORK GROUP 3, THE ASSESSMENT 311 00:13:11,000 --> 00:13:14,120 GROUP AND WORK GROUP 4 WILL 312 00:13:14,120 --> 00:13:17,080 FOCUS ON THE PATIENT ACTIVITY. 313 00:13:17,080 --> 00:13:20,240 THAT'S A THUMB NAIL SKETCH OF 314 00:13:20,240 --> 00:13:22,760 WHAT WE'RE TRYING TO DO AND IT'S 315 00:13:22,760 --> 00:13:26,760 COMPLICATES ISSUES AND WE HAVE 316 00:13:26,760 --> 00:13:31,880 DR. MARIE BLACK WHO'S DONE A 317 00:13:31,880 --> 00:13:32,720 TREMENDOUS AMOUNT OF WORK AND 318 00:13:32,720 --> 00:13:33,720 I'LL TURN IT OVER. 319 00:13:33,720 --> 00:13:45,200 THANK YOU VERY MUCH. 320 00:13:45,200 --> 00:13:51,800 >> THANK YOU, VERY MUCH, DAN. 321 00:13:51,800 --> 00:14:11,880 I'M DELIGHTED TO BE HERE AND A 322 00:14:11,880 --> 00:14:13,160 CERTAINLY THANK NICHD WITH DREW 323 00:14:13,160 --> 00:14:18,000 AND DAN AND COMPANY AND THE 324 00:14:18,000 --> 00:14:20,400 ACADEMY FOR NUTRITION AND 325 00:14:20,400 --> 00:14:21,680 DIETETICS FOR THEIR 326 00:14:21,680 --> 00:14:23,240 COLLABORATION AND THANK YOU FOR 327 00:14:23,240 --> 00:14:23,840 PARTICIPATING IN OUR WORKSHOP 328 00:14:23,840 --> 00:14:25,920 TODAY. 329 00:14:25,920 --> 00:14:29,600 THE OBJECTIVES ARE FOR US TO 330 00:14:29,600 --> 00:14:31,480 SHARE THE INFORMATION ON WHERE 331 00:14:31,480 --> 00:14:32,600 WE ARE IN TERMS OF THE 332 00:14:32,600 --> 00:14:35,200 ENVIRONMENT AND WE WOULD LIKE 333 00:14:35,200 --> 00:14:38,000 VERY MUCH TO HAVE THIS BE AN 334 00:14:38,000 --> 00:14:38,560 INTERACTIVE ASSOCIATION. 335 00:14:38,560 --> 00:14:41,400 WE HAVE ALLOCATED SOME TIME FOR 336 00:14:41,400 --> 00:14:45,120 DISCUSSION AND SO WE'RE LOOKING 337 00:14:45,120 --> 00:14:48,920 FORWARD TO HAVING YOU JOIN US. 338 00:14:48,920 --> 00:14:53,000 LET ME INTRODUCE THE WORK GROUP 339 00:14:53,000 --> 00:14:53,320 2. 340 00:14:53,320 --> 00:14:58,080 YOU CAN SEE WE ARE EIGHT MEMBERS 341 00:14:58,080 --> 00:15:01,080 AND BETH WHO IS THE 342 00:15:01,080 --> 00:15:02,520 REPRESENTATIVE FROM THE ACADEMY 343 00:15:02,520 --> 00:15:04,920 FOR NUTRITION AND DIETETICS 344 00:15:04,920 --> 00:15:07,000 KEEPS US ORGANIZED AND GOING AND 345 00:15:07,000 --> 00:15:11,160 KEEPS US ALL IN GOOD SPIRIT. 346 00:15:11,160 --> 00:15:14,880 THERE ARE FOUR MEMBERS WHO WILL 347 00:15:14,880 --> 00:15:16,280 PRESENT PRESENTATIONS TODAY AND 348 00:15:16,280 --> 00:15:18,280 THE OTHERS WHO CONTRIBUTED TO 349 00:15:18,280 --> 00:15:20,640 ALL OF OUR PRESENTATIONS AND ALL 350 00:15:20,640 --> 00:15:23,680 OF OUR WORK SO WE'RE VERY 351 00:15:23,680 --> 00:15:30,200 EXCITED TO BE JOINING YOU TODAY. 352 00:15:30,200 --> 00:15:36,440 SO THIS IS TO TELL YOU WHAT OUR 353 00:15:36,440 --> 00:15:39,440 MISSION IS WE'RE LOOKING AT THE 354 00:15:39,440 --> 00:15:42,240 CHILD AND ADOLESCENT ENVIRONMENT 355 00:15:42,240 --> 00:15:44,880 5 TO 19 AND OUR TASK IS TO LOOK 356 00:15:44,880 --> 00:15:47,240 AT HOW THE ENVIRONMENT RELATE TO 357 00:15:47,240 --> 00:15:51,120 THEIR NUTRITIONAL ECOLOGY. 358 00:15:51,120 --> 00:15:54,200 AS DAN TALKED ABOUT IT CONSISTS 359 00:15:54,200 --> 00:15:55,400 OF VARIOUS ENVIRONMENTS. 360 00:15:55,400 --> 00:15:56,600 CHILDREN SPEND A TREMENDOUS 361 00:15:56,600 --> 00:15:58,120 AMOUNT OF THEIR HOMES, THEY 362 00:15:58,120 --> 00:16:00,640 SLEEP, EAT AND ENGAGE IN MANY 363 00:16:00,640 --> 00:16:00,960 ACTIVITIES. 364 00:16:00,960 --> 00:16:04,240 THEY'RE ALSO IN SCHOOL WHERE 365 00:16:04,240 --> 00:16:07,760 THEY LEARN, THEY PARTICIPATE, 366 00:16:07,760 --> 00:16:12,600 MAYBE EVEN GRADUATE AND MANY 367 00:16:12,600 --> 00:16:13,720 ACTIVITIES AND NUTRITION IMPACTS 368 00:16:13,720 --> 00:16:15,880 THESE ACTIVITIES AND SPEND TIME 369 00:16:15,880 --> 00:16:17,400 WHERE THEY PLAY AND WORK AND SEE 370 00:16:17,400 --> 00:16:19,280 THE MANY INTERCONNECTIONS THEY 371 00:16:19,280 --> 00:16:20,160 HAVE IN THE COMMUNITY. 372 00:16:20,160 --> 00:16:22,760 BUT IT'S NOT ONLY THESE THREE 373 00:16:22,760 --> 00:16:24,400 ENVIRONMENTS WHAT WE HAVE 374 00:16:24,400 --> 00:16:25,680 LEARNED IS THAT THE ENVIRONMENTS 375 00:16:25,680 --> 00:16:28,520 ARE CONNECTED TO ONE ANOTHER. 376 00:16:28,520 --> 00:16:31,520 THERE ARE MANY CONNECTIONS IN 377 00:16:31,520 --> 00:16:33,360 THIS COMPLEX SYSTEM. 378 00:16:33,360 --> 00:16:36,160 THEY VARY BY THE CHILDREN'S AGE. 379 00:16:36,160 --> 00:16:38,200 THE EXPERIENCES OF A 5-YEAR-OLD 380 00:16:38,200 --> 00:16:41,160 ARE QUITE DIFFERENT FROM AN 381 00:16:41,160 --> 00:16:42,840 11-YEAR-OLD OR FROM A 382 00:16:42,840 --> 00:16:43,160 19-YEAR-OLD. 383 00:16:43,160 --> 00:16:47,440 SO AS WE MOVE FORWARD AND LOOK 384 00:16:47,440 --> 00:16:49,800 AT THE CHILDREN AND WHAT THEY'RE 385 00:16:49,800 --> 00:16:52,520 DEVELOPMENT LOOKS LIKE WE CAN 386 00:16:52,520 --> 00:16:54,520 SEE THERE ARE MANY COMPONENTS OF 387 00:16:54,520 --> 00:16:55,640 CHILDREN'S DEVELOPMENT. 388 00:16:55,640 --> 00:16:58,720 THERE'S THEIR COGNITION, THEIR 389 00:16:58,720 --> 00:17:00,840 SOCIO EMOTIONAL DEVELOPMENT, 390 00:17:00,840 --> 00:17:03,000 DIETARY INTAKE, DISEASE RISK, 391 00:17:03,000 --> 00:17:04,680 PHYSICAL ACTIVITY, SCHOOL 392 00:17:04,680 --> 00:17:07,920 PERFORMANCE AND ALL OF THESE ARE 393 00:17:07,920 --> 00:17:09,200 INFLUENCED BY NUTRITION. 394 00:17:09,200 --> 00:17:12,360 THAT'S NOT ONLY THE FOOD THAT 395 00:17:12,360 --> 00:17:14,320 THEY EAT BUT THE EATING BEHAVIOR 396 00:17:14,320 --> 00:17:16,440 AND THE CONTEXT IN WHICH 397 00:17:16,440 --> 00:17:17,440 NUTRITION OCCURS. 398 00:17:17,440 --> 00:17:20,320 SO AGAIN, THAT CONTRIBUTES TO 399 00:17:20,320 --> 00:17:22,600 THE COMPLEXITY AND IT VARIES BY 400 00:17:22,600 --> 00:17:24,240 THE CHILDREN'S AGE. 401 00:17:24,240 --> 00:17:25,760 AGAIN, DIFFERENT FOR 5-YEAR-OLD 402 00:17:25,760 --> 00:17:29,960 FROM A 19-YEAR-OLD. 403 00:17:29,960 --> 00:17:31,560 MOVING FORWARD THIS IS A SLIDE 404 00:17:31,560 --> 00:17:36,960 FOR THOSE WHO PARTICIPATED LAST 405 00:17:36,960 --> 00:17:38,880 WEEK, AS MICHAEL SAID NEITHER HE 406 00:17:38,880 --> 00:17:40,440 NOR I CAN DO A PRESENTATION 407 00:17:40,440 --> 00:17:41,720 WITHOUT INCLUDING THIS SLIDE. 408 00:17:41,720 --> 00:17:44,160 THIS IS BECAUSE THIS ILLUSTRATES 409 00:17:44,160 --> 00:17:47,280 WHAT BRAIN DEVELOPMENT LOOKS 410 00:17:47,280 --> 00:17:50,400 LIKE AND YOU CAN SEE DRAWN A BOX 411 00:17:50,400 --> 00:17:53,400 AROUND THE FIRST 1,000 DAYS 412 00:17:53,400 --> 00:17:55,720 BEGINNING AT CONCEPTION AND 413 00:17:55,720 --> 00:17:58,000 CONTINUING UP TO AGE 2. 414 00:17:58,000 --> 00:18:01,160 SO 9 MONTHS OF CONCEPTION, 24 415 00:18:01,160 --> 00:18:05,160 MONTHS POST AFTER DELIVERY, 33 416 00:18:05,160 --> 00:18:07,960 MONTHS MULTIPLIED BY 30 IS A 417 00:18:07,960 --> 00:18:09,800 THOUSAND DAYS AND THERE'S A 418 00:18:09,800 --> 00:18:11,240 TREMENDOUS AMOUNT OF BRAIN 419 00:18:11,240 --> 00:18:12,080 DEVELOPMENT THAT HAPPENS DURING 420 00:18:12,080 --> 00:18:13,600 THAT TIME. 421 00:18:13,600 --> 00:18:15,800 WHEN WE STUDY CHILDREN LATER IN 422 00:18:15,800 --> 00:18:18,480 LIFE WE HAVE TO CONSIDER THE 423 00:18:18,480 --> 00:18:20,360 SUBSEQUENTLY WE'RE BUILDING ON 424 00:18:20,360 --> 00:18:22,400 WHAT HAPPENED DURING THOSE FIRST 425 00:18:22,400 --> 00:18:24,280 THOUSAND DAYS. 426 00:18:24,280 --> 00:18:27,440 THOSE ARE INFLUENCED BY TIMING 427 00:18:27,440 --> 00:18:32,520 OF MANY ASPECTS OF DEVELOPMENT 428 00:18:32,520 --> 00:18:33,960 INCLUDING NUTRITION. 429 00:18:33,960 --> 00:18:36,040 NOW, IF WE LOOK I'VE DRAWN BOXES 430 00:18:36,040 --> 00:18:40,480 AROUND THE AREA THAT YOU'RE 431 00:18:40,480 --> 00:18:42,080 STUDYING THE ELEMENTARY AGE 432 00:18:42,080 --> 00:18:45,000 CHILD IS FROM 5 TO 11. 433 00:18:45,000 --> 00:18:47,600 AND THEN WE HAVE THE EARLY 434 00:18:47,600 --> 00:18:49,720 ADOLESCENT IN GREEN, THAT'S FROM 435 00:18:49,720 --> 00:18:52,600 ABOUT 11 TO 12 TO ABOUT 15 OR 436 00:18:52,600 --> 00:18:52,760 SO. 437 00:18:52,760 --> 00:18:54,920 THEN THE MID TO UPPER ADOLESCENT 438 00:18:54,920 --> 00:18:58,120 FROM 16 TO 19. 439 00:18:58,120 --> 00:19:00,440 YOU CAN SEE THAT THEIR BRAIN 440 00:19:00,440 --> 00:19:02,320 DEVELOPMENT IS CONTINUING 441 00:19:02,320 --> 00:19:03,600 CERTAINLY DURING THAT TIME. 442 00:19:03,600 --> 00:19:06,160 BUT IT BUILDS ON WHAT HAS 443 00:19:06,160 --> 00:19:07,840 HAPPENED EARLIER IN LIFE. 444 00:19:07,840 --> 00:19:11,240 SO IT'S IMPORTANT TO CONSIDER 445 00:19:11,240 --> 00:19:14,800 THAT DEVELOPMENT IS PROGRESSING 446 00:19:14,800 --> 00:19:16,520 THAT IT IS -- THERE'S A 447 00:19:16,520 --> 00:19:18,480 TRAJECTORY THAT'S OCCURRING AND 448 00:19:18,480 --> 00:19:21,320 THIS STILL A VERY FORMATIVE TIME 449 00:19:21,320 --> 00:19:23,200 TO HELP CHILDREN DEVELOP HABITS 450 00:19:23,200 --> 00:19:24,760 THAT WILL STAY WITH THEM 451 00:19:24,760 --> 00:19:26,000 THROUGHOUT THEIR LIVES. 452 00:19:26,000 --> 00:19:27,600 WHEN I SHOW THIS SLIDE I ALWAYS 453 00:19:27,600 --> 00:19:29,840 ASK PEOPLE TO FIND THEIR OWN AGE 454 00:19:29,840 --> 00:19:30,840 ON THE SLIDE. 455 00:19:30,840 --> 00:19:32,840 CAN SEE INITIALLY IT GOES UP BY 456 00:19:32,840 --> 00:19:35,520 MONTHS AND THEN GOES UP BY 457 00:19:35,520 --> 00:19:35,800 YEARS. 458 00:19:35,800 --> 00:19:37,960 SO AS WE FIND OUR AGE ON THIS 459 00:19:37,960 --> 00:19:41,360 SLIDE, WHAT'S GOING ON IN OUR 460 00:19:41,360 --> 00:19:41,640 BRAINS. 461 00:19:41,640 --> 00:19:42,760 WELL, NOT MUCH JUST TRYING TO 462 00:19:42,760 --> 00:19:49,880 KEEP THINGS TOGETHER. 463 00:19:49,880 --> 00:19:51,720 THIS ILLUSTRATES HOW CHILDREN 464 00:19:51,720 --> 00:19:53,840 LEARN, HOW CHILDREN INTERACT AND 465 00:19:53,840 --> 00:19:57,840 IT IS A WHAT WE CALL A 466 00:19:57,840 --> 00:19:59,400 RECIPROCAL OR A RESPONSIVE 467 00:19:59,400 --> 00:19:59,680 PROCESS. 468 00:19:59,680 --> 00:20:02,400 SO LET'S SEE HOW IT MIGHT WORK. 469 00:20:02,400 --> 00:20:04,560 AS AN EXAMPLE, WE'RE USING A 470 00:20:04,560 --> 00:20:06,520 CHILD AND WE'RE USING A MOTHER 471 00:20:06,520 --> 00:20:08,920 BUT IT COULD WORK WITH A FATHER. 472 00:20:08,920 --> 00:20:11,320 IT COULD WORK WITH A FRIEND. 473 00:20:11,320 --> 00:20:16,720 IT COULD WORK WITH A DOG. 474 00:20:16,720 --> 00:20:18,600 IT CAN WORK WITH MANY ASPECTS OF 475 00:20:18,600 --> 00:20:19,840 THE ENVIRONMENT AND LOOKS LIKE 476 00:20:19,840 --> 00:20:20,040 THIS. 477 00:20:20,040 --> 00:20:21,400 THE CHILD DOES SOMETHING AND THE 478 00:20:21,400 --> 00:20:23,720 MOTHER THEN SEES WHAT THE CHILD 479 00:20:23,720 --> 00:20:26,800 HAS DONE, HEARS IT AND REACTS TO 480 00:20:26,800 --> 00:20:28,160 IT AND THEN THE CHILD REACTS TO 481 00:20:28,160 --> 00:20:29,560 WHAT THE MOTHER HAS DONE AND 482 00:20:29,560 --> 00:20:31,800 THEN THE MOTHER REACT TO WHAT 483 00:20:31,800 --> 00:20:36,040 THE CHILD HAS DONE AND SO ON AND 484 00:20:36,040 --> 00:20:37,320 SO ON. 485 00:20:37,320 --> 00:20:40,040 THIS RECIPROCITY, THIS BACK AND 486 00:20:40,040 --> 00:20:41,200 FORTH ILLUSTRATE THE 487 00:20:41,200 --> 00:20:43,720 INTERACTIONS WE ALL HAVE. 488 00:20:43,720 --> 00:20:44,840 SOMETIMES THIS IS REFERRED TO AS 489 00:20:44,840 --> 00:20:46,720 SERVE AND RETURN. 490 00:20:46,720 --> 00:20:49,280 WHAT IT ILLUSTRATES IS IT'S NOT 491 00:20:49,280 --> 00:20:50,000 STATIC. 492 00:20:50,000 --> 00:20:52,000 THE ASPECTS OF CHILDREN'S 493 00:20:52,000 --> 00:20:53,720 DEVELOPMENT AND OF THEIR 494 00:20:53,720 --> 00:20:54,960 INTERACTIONS ARE NOT STATIC. 495 00:20:54,960 --> 00:20:57,800 THEY ARE DEPENDENT ON WHAT HAS 496 00:20:57,800 --> 00:21:00,000 HAPPENED BEFORE, WHAT THEY HAVE 497 00:21:00,000 --> 00:21:03,120 PERCEIVED AND THEN THEY INTERACT 498 00:21:03,120 --> 00:21:06,120 WITH THE ENVIRONMENT THAT THEN 499 00:21:06,120 --> 00:21:08,800 RECEIVES THEIR INTERACTION. 500 00:21:08,800 --> 00:21:10,640 IT'S A BACK AND FORTH PROCESS. 501 00:21:10,640 --> 00:21:13,520 NOW, WHEN WE LOOK AT THAT AND 502 00:21:13,520 --> 00:21:16,040 LOOK AT CHILDREN'S DEVELOPMENT, 503 00:21:16,040 --> 00:21:18,800 THE CHILDREN ARE CONSTANTLY 504 00:21:18,800 --> 00:21:20,040 LEARNING AND PERCEIVING WHAT IS 505 00:21:20,040 --> 00:21:22,680 HAPPENING AROUND THEM. 506 00:21:22,680 --> 00:21:25,160 AND SOMETIMES WE FORGET THESE 507 00:21:25,160 --> 00:21:26,600 KINDS OF THINGS, WE'RE 508 00:21:26,600 --> 00:21:28,440 INTERESTED IN MEASURING THEIR 509 00:21:28,440 --> 00:21:30,440 COGNITION AND SOCIO EMOTIONAL 510 00:21:30,440 --> 00:21:32,560 DEVELOPMENT BUT IT'S IMPORTANT 511 00:21:32,560 --> 00:21:34,800 ALSO TO RECOGNIZE HOW THIS 512 00:21:34,800 --> 00:21:39,480 DEVELOPMENT AND HOW WHAT GOES ON 513 00:21:39,480 --> 00:21:42,760 AROUND THEM HOW CHILDREN ARE 514 00:21:42,760 --> 00:21:43,040 PERCEIVING. 515 00:21:43,040 --> 00:21:44,320 FOR EXAMPLE, BODY SIZE. 516 00:21:44,320 --> 00:21:46,320 THERE'S STIGMA ATTACHED WITH 517 00:21:46,320 --> 00:21:46,880 BODY SIZE. 518 00:21:46,880 --> 00:21:49,520 MOST STIGMA IS ASSOCIATED WITH 519 00:21:49,520 --> 00:21:50,600 BEING OVERWEIGHT. 520 00:21:50,600 --> 00:21:55,240 WELL, WHAT DO WE LEARN ABOUT 521 00:21:55,240 --> 00:21:56,760 CHILDREN'S PERCEPTION OF 522 00:21:56,760 --> 00:21:58,040 OVERWEIGHT OR THE STIGMA 523 00:21:58,040 --> 00:21:58,840 ASSOCIATED WITH IT? 524 00:21:58,840 --> 00:21:59,960 WE LEARN THERE'S CONSEQUENCES. 525 00:21:59,960 --> 00:22:02,160 THOSE CONSEQUENCES ARE OFTEN NOT 526 00:22:02,160 --> 00:22:05,560 VERY POSITIVE FOR CHILDREN'S 527 00:22:05,560 --> 00:22:06,560 DEVELOPMENT. 528 00:22:06,560 --> 00:22:08,680 THINGS LIKE BINGE EATING, SOCIAL 529 00:22:08,680 --> 00:22:10,960 ISOLATION, AVOIDANCE OF HEALTH 530 00:22:10,960 --> 00:22:12,400 CARE, DECREASING PHYSICAL 531 00:22:12,400 --> 00:22:13,640 ACTIVITY AND INCREASE IN WEIGHT 532 00:22:13,640 --> 00:22:14,920 GAIN. 533 00:22:14,920 --> 00:22:16,520 SO IT'S IMPORTANT TO UNDERSTAND 534 00:22:16,520 --> 00:22:18,240 HOW CHILDREN PERCEIVE THINGS. 535 00:22:18,240 --> 00:22:20,920 WE'LL BE TALKING LATER TODAY 536 00:22:20,920 --> 00:22:23,000 ABOUT FOOD INSECURITY. 537 00:22:23,000 --> 00:22:27,400 BUT WHAT WE LEARN IS FOOD 538 00:22:27,400 --> 00:22:28,600 INSECURITY IS SOMETHING CHILDREN 539 00:22:28,600 --> 00:22:29,840 ALSO RECOGNIZE. 540 00:22:29,840 --> 00:22:31,680 MOST STUDIES WHERE WE LOOKED AT 541 00:22:31,680 --> 00:22:34,840 KIDS FROM 8 OR 9 UPWARDS AND WE 542 00:22:34,840 --> 00:22:37,960 LEARN THAT CHILDREN DO 543 00:22:37,960 --> 00:22:38,960 UNDERSTAND WHEN THEY DON'T HAVE 544 00:22:38,960 --> 00:22:41,200 ENOUGH FOOD. 545 00:22:41,200 --> 00:22:42,920 THEY HAVE A COGNITIVE AWARENESS, 546 00:22:42,920 --> 00:22:45,200 EMOTIONAL AWARENESS AND ASSUME 547 00:22:45,200 --> 00:22:46,360 SOME RESPONSIBILITY FOR MANAGING 548 00:22:46,360 --> 00:22:47,200 FOOD AND RESOURCES. 549 00:22:47,200 --> 00:22:50,880 SO THIS IS NOT ONLY A HOUSEHOLD 550 00:22:50,880 --> 00:22:52,720 PHENOMENON, IT IMPACTS 551 00:22:52,720 --> 00:22:53,800 CHILDREN'S PERCEPTIONS. 552 00:22:53,800 --> 00:22:55,720 THEN THERE'S THE ISSUE OF 553 00:22:55,720 --> 00:22:56,200 EQUITY. 554 00:22:56,200 --> 00:22:57,200 EQUITY GUIDES WHAT WITH ARE 555 00:22:57,200 --> 00:22:59,040 THINKING ABOUT IN TERMS OF THE 556 00:22:59,040 --> 00:22:59,800 ENVIRONMENT AND IN TERMS OF THE 557 00:22:59,800 --> 00:23:02,320 WHOLE PROJECT. 558 00:23:02,320 --> 00:23:07,040 CHILDREN ARE AWARE OF INEQUITIES 559 00:23:07,040 --> 00:23:08,160 FROM THE GET GO. 560 00:23:08,160 --> 00:23:09,320 FOR THOSE WOULD ARE PARENTS 561 00:23:09,320 --> 00:23:11,000 YOU'LL RECOGNIZE ONE OF 562 00:23:11,000 --> 00:23:13,680 CHILDREN'S FIRST WORDS IS MINE. 563 00:23:13,680 --> 00:23:14,440 THEY RECOGNIZE WHAT IS YOURS AND 564 00:23:14,440 --> 00:23:16,640 WHAT IS MINE. 565 00:23:16,640 --> 00:23:20,640 AND THEY WANT WHAT IS MINE. 566 00:23:20,640 --> 00:23:22,360 NOW, WE SEE DEVELOPMENTALLY 567 00:23:22,360 --> 00:23:24,800 CHILDREN BECOME MORE AND MORE 568 00:23:24,800 --> 00:23:26,200 SOPHISTICATED ABOUT EQUITY AND 569 00:23:26,200 --> 00:23:29,360 FROM ABOUT AGES 7 AND 8, THEY 570 00:23:29,360 --> 00:23:31,280 CAN RECTIFY INEQUITIES. 571 00:23:31,280 --> 00:23:34,000 THEY CAN CHANGE INEQUITIES. 572 00:23:34,000 --> 00:23:35,440 SO EQUITY HAS BEEN AN IMPORTANT 573 00:23:35,440 --> 00:23:38,400 COMPONENT OF WHAT WE THINK ABOUT 574 00:23:38,400 --> 00:23:40,240 AND USEFUL TO RECOGNIZE THAT 575 00:23:40,240 --> 00:23:42,360 CHILDREN THINK ABOUT THIS AS 576 00:23:42,360 --> 00:23:42,560 WELL. 577 00:23:42,560 --> 00:23:45,680 THE DRAWING AT THE BOTTOM 578 00:23:45,680 --> 00:23:47,920 ILLUSTRATES AN EXAMPLE OF 579 00:23:47,920 --> 00:23:48,160 EQUITY. 580 00:23:48,160 --> 00:23:50,480 YOU GET THE RESOURCES THAT YOU 581 00:23:50,480 --> 00:23:51,840 NEED DEPENDING ON YOUR SIZE IN 582 00:23:51,840 --> 00:24:04,320 THIS EXAMPLE. 583 00:24:04,320 --> 00:24:06,200 AS WE THINK ABOUT VARIABILITY 584 00:24:06,200 --> 00:24:08,440 AND IMPACT ON CHILDREN AND THIS 585 00:24:08,440 --> 00:24:09,920 IS RECENT INFORMATION FROM 586 00:24:09,920 --> 00:24:11,600 UNICEF FROM THE STATE OF THE 587 00:24:11,600 --> 00:24:13,880 WORLD CHILDREN AND SEE 588 00:24:13,880 --> 00:24:15,280 APPROXIMATELY 1 IN 3 CHILDREN 589 00:24:15,280 --> 00:24:18,960 UNDER AGE 5 ARE EXPERIENCING ONE 590 00:24:18,960 --> 00:24:20,960 OF THESE CONDITIONS. 591 00:24:20,960 --> 00:24:27,600 SO UNDER NUTRITION LEADS TO POOR 592 00:24:27,600 --> 00:24:31,360 GROWTH AND INFECTION AND 593 00:24:31,360 --> 00:24:33,320 COGNITION AND POOR EARNING 594 00:24:33,320 --> 00:24:34,760 POTENTIAL AND OVERWEIGHT 595 00:24:34,760 --> 00:24:40,320 CONTRIBUTES TO MULTIPLE HEALTH 596 00:24:40,320 --> 00:24:42,000 PROBLEMS, CARDIO VASCULAR 597 00:24:42,000 --> 00:24:43,600 PROBLEMS AND DIABETES AND 598 00:24:43,600 --> 00:24:45,000 IMPACTS EVERY SYSTEM AND AMONG 599 00:24:45,000 --> 00:24:47,680 CHILDREN IT INCREASES THE RISK 600 00:24:47,680 --> 00:24:50,040 OF LIFE LONG OBESITY. 601 00:24:50,040 --> 00:24:51,360 THEN THERE'S HIDDEN HUNGER. 602 00:24:51,360 --> 00:24:56,960 YOU HEARD SOME ABOUT LAST WEEK. 603 00:24:56,960 --> 00:24:59,000 MICRONUTRITION AND SKIN IMPACT 604 00:24:59,000 --> 00:25:02,040 AND IMMUNITY AND POOR HEALTH. 605 00:25:02,040 --> 00:25:03,480 THERE'S MANY DIRECT CONSEQUENCES 606 00:25:03,480 --> 00:25:07,600 THAT COME FROM THESE. 607 00:25:07,600 --> 00:25:10,920 NOW, IF WE LOOK AT THE 608 00:25:10,920 --> 00:25:13,600 PREVALENCE OF OVERWEIGHT OF 609 00:25:13,600 --> 00:25:18,840 OBESITY IN E.U COUNTRIES WE SEE 610 00:25:18,840 --> 00:25:20,840 IN THE U.S. OVERWEIGHT 49% AND 611 00:25:20,840 --> 00:25:23,800 JAPAN IS 15%. 612 00:25:23,800 --> 00:25:26,800 THIS IS LOOKING AT ONE SET OF 613 00:25:26,800 --> 00:25:27,800 COUNTRIES AND WE SEE OVERWEIGHT 614 00:25:27,800 --> 00:25:28,640 IS AN ISSUE. 615 00:25:28,640 --> 00:25:34,880 MOVING ON, IF WE LOOK AT LOW AND 616 00:25:34,880 --> 00:25:36,840 MIDDLE INCOME COUNTRIES WE SEE A 617 00:25:36,840 --> 00:25:40,720 HUGE INCREASE IN OVERWEIGHT FROM 618 00:25:40,720 --> 00:25:41,120 2010. 619 00:25:41,120 --> 00:25:43,720 IF WE LOOK SPECIFICALLY AT 620 00:25:43,720 --> 00:25:46,000 CHILDREN FROM 5-19, THERE WE CAN 621 00:25:46,000 --> 00:25:49,120 SEE THERE'S BEEN A DRAMATIC 622 00:25:49,120 --> 00:25:50,520 INCREASE IN OVERWEIGHT. 623 00:25:50,520 --> 00:25:54,760 SO NUTRITION IS CERTAINLY 624 00:25:54,760 --> 00:25:55,200 IMPACTING CHILDREN. 625 00:25:55,200 --> 00:25:58,000 THE BOTTOM LINE THE YELLOW LINE 626 00:25:58,000 --> 00:26:00,800 REPRESENTS CHILDREN UNDER 5 WHO 627 00:26:00,800 --> 00:26:01,400 ARE ALSO INCREASING IN 628 00:26:01,400 --> 00:26:05,480 PREVALENCE. 629 00:26:05,480 --> 00:26:07,400 MOVING FORWARD THIS IS CHINA AND 630 00:26:07,400 --> 00:26:12,200 WHAT WE SEE IN CHINA THE 631 00:26:12,200 --> 00:26:15,440 ENORMOUS PURPLE OVERWEIGHT FROM 632 00:26:15,440 --> 00:26:17,720 1995 TO 2015. 633 00:26:17,720 --> 00:26:19,440 THE OTHER TWO LINES REPRESENT 634 00:26:19,440 --> 00:26:22,120 THINNESS AND STUNTING WHICH HAVE 635 00:26:22,120 --> 00:26:23,520 GONE DOWN TO SOME EXTENT. 636 00:26:23,520 --> 00:26:25,600 WE QUAN SEE THE ISSUES THAT 637 00:26:25,600 --> 00:26:28,560 WE'RE TALKING ABOUT ARE CLEARLY 638 00:26:28,560 --> 00:26:34,960 GLOBAL. 639 00:26:34,960 --> 00:26:40,160 NOW, TO MOVE FORWARD WE WANTED 640 00:26:40,160 --> 00:26:42,880 TO SEE HOW FOOD SYSTEMS WERE 641 00:26:42,880 --> 00:26:53,120 ORGANIZED AND LOOKED AT THE 642 00:26:53,120 --> 00:26:55,400 INNOCENTI FRAMEWORK AND THIS IS 643 00:26:55,400 --> 00:27:01,240 DONE BY UNICEUNICEF, WE SEE FOUR 644 00:27:01,240 --> 00:27:07,000 DETERMINATES IN THE FOOD SYSTEM. 645 00:27:07,000 --> 00:27:14,480 WE CAN SEE INTERNAL, EXTERNAL 646 00:27:14,480 --> 00:27:17,280 FOOD ENVIRONMENT AND FOOD SUPPLY 647 00:27:17,280 --> 00:27:19,920 AND RELATIONSHIP OF THE FOOD 648 00:27:19,920 --> 00:27:22,000 GIVER AND ADOLESCENTS. 649 00:27:22,000 --> 00:27:23,280 THAT'S A COMPLEX SYSTEM. 650 00:27:23,280 --> 00:27:24,560 THERE'S EVEN MORE. 651 00:27:24,560 --> 00:27:29,400 NOW, IF WE LOOK AT THE DRIVERS 652 00:27:29,400 --> 00:27:31,520 THAT IMPACT THE FOOD SYSTEM WE 653 00:27:31,520 --> 00:27:34,680 CAN SEE THERE ARE EVEN MORE 654 00:27:34,680 --> 00:27:35,040 INVOLVED. 655 00:27:35,040 --> 00:27:37,200 THERE'S DEMOGRAPHIC FACTORS AND 656 00:27:37,200 --> 00:27:39,920 INNOVATIVE AND TECHNOLOGICAL 657 00:27:39,920 --> 00:27:42,600 FACTORS AND SOCIAL AND CULTURAL 658 00:27:42,600 --> 00:27:45,600 FACTORS AND THEN THE BIO 659 00:27:45,600 --> 00:27:46,640 PHYSICAL FACTORS INCLUDING 660 00:27:46,640 --> 00:27:49,280 THINGS LIKE CLIMATE CHANGE. 661 00:27:49,280 --> 00:27:51,160 IT'S BECOME MUCH MORE 662 00:27:51,160 --> 00:27:52,600 COMPLICATED THAN WE MIGHT HAVE 663 00:27:52,600 --> 00:27:53,800 INITIALLY REALIZED. 664 00:27:53,800 --> 00:27:55,600 MOVING FORWARD WE REALIZED IN 665 00:27:55,600 --> 00:27:57,200 ORDER TO MEET THE TASK WE HAVE 666 00:27:57,200 --> 00:28:00,200 BEEN ASSIGNED OF LINKING THE 667 00:28:00,200 --> 00:28:03,000 ENVIRONMENT WITH NUTRITIONAL 668 00:28:03,000 --> 00:28:04,800 ECOLOGY, WE NEED SOME HELP. 669 00:28:04,800 --> 00:28:07,240 WE NEED TO BE INFORMED BY SOCIAL 670 00:28:07,240 --> 00:28:08,200 ECOLOGICAL MODEL. 671 00:28:08,200 --> 00:28:11,000 WE NEED TO UNDERSTAND THE 672 00:28:11,000 --> 00:28:11,960 FUNCTIONAL COMPONENTS OF 673 00:28:11,960 --> 00:28:14,320 CHILDREN IN ADOLESCENTS. 674 00:28:14,320 --> 00:28:16,480 WE HAVE TO HAVE A DEVELOPMENTAL 675 00:28:16,480 --> 00:28:18,200 PERSPECTIVE AND HAVE TO CONSIDER 676 00:28:18,200 --> 00:28:18,920 EQUITY IN THIS. 677 00:28:18,920 --> 00:28:22,600 SO WE HAVE BEEN WORKING ON A 678 00:28:22,600 --> 00:28:23,880 CONCEPTUAL MODEL AND THIS IS 679 00:28:23,880 --> 00:28:24,280 WHERE WE ARE. 680 00:28:24,280 --> 00:28:27,880 SO THE IDEA OF THIS IS THAT IT 681 00:28:27,880 --> 00:28:31,280 REPRESENTS SOME OF THE SYSTEMS 682 00:28:31,280 --> 00:28:32,880 THAT WE NEED TO INVESTIGATE IN 683 00:28:32,880 --> 00:28:36,400 ORDER TO LOOK AT THE LINKS AND 684 00:28:36,400 --> 00:28:38,480 MEASUREMENTS OF ENVIRONMENT ON 685 00:28:38,480 --> 00:28:40,200 CHILDREN'S NUTRITIONAL EQUALITY. 686 00:28:40,200 --> 00:28:41,640 YOU CAN SEE IN THE FRAMEWORK AT 687 00:28:41,640 --> 00:28:44,600 THE BOTTOM THERE'S A DEVELOPMENT 688 00:28:44,600 --> 00:28:47,080 PERSPECTIVE AND WE'RE FOCUSSING 689 00:28:47,080 --> 00:28:48,160 ON THE 5-19. 690 00:28:48,160 --> 00:28:54,000 YOU CAN SEE THE PUZZLE PIECES 691 00:28:54,000 --> 00:28:57,040 THAT REPRESENT THE CHILDREN'S 692 00:28:57,040 --> 00:28:58,200 FUNCTION AND THEY NEED 693 00:28:58,200 --> 00:28:59,440 DEVELOPMENT IN ALL THESE AREAS. 694 00:28:59,440 --> 00:29:02,040 YOU CAN SEE THAT IT'S HEAVILY 695 00:29:02,040 --> 00:29:03,760 INFLUENCED BY THE FAMILY BUT ON 696 00:29:03,760 --> 00:29:06,320 THE OUTER LAYER IS THE 697 00:29:06,320 --> 00:29:09,240 ENVIRONMENT THAT ARE INTERTWINED 698 00:29:09,240 --> 00:29:10,240 AND CONNECTED. 699 00:29:10,240 --> 00:29:11,320 THIS IS GUIDING OUR THOUGHTS AS 700 00:29:11,320 --> 00:29:13,960 WE MOVE FORWARD. 701 00:29:13,960 --> 00:29:16,520 SO IN ORDER TO HAVE HELP IN 702 00:29:16,520 --> 00:29:19,200 DOING THIS WE LAID OUT THIS 703 00:29:19,200 --> 00:29:19,480 WORKSHOP. 704 00:29:19,480 --> 00:29:22,840 WE'VE INVITED THREE PEOPLE WHO 705 00:29:22,840 --> 00:29:25,400 HAVE EXPERTISE IN ENVIRONMENTAL 706 00:29:25,400 --> 00:29:27,600 SYSTEMS TO ASSIST US. 707 00:29:27,600 --> 00:29:33,160 SO THE FIRST IS ROSS HAMMOND A 708 00:29:33,160 --> 00:29:34,560 DISTINGUISHED PROFESSOR FROM 709 00:29:34,560 --> 00:29:36,560 WASH-U AND ALSO THE DIRECTOR OF 710 00:29:36,560 --> 00:29:38,840 THE CENTER ON SOCIAL DYNAMICS 711 00:29:38,840 --> 00:29:42,040 AND POLICY AT TO THE BROOKINGS 712 00:29:42,040 --> 00:29:45,600 INSTITUTE. 713 00:29:45,600 --> 00:29:49,080 THEN WE HAVE CHRIS TINA ECONOMOS 714 00:29:49,080 --> 00:29:50,480 THE DEAN FOR RESEARCH STRATEGY 715 00:29:50,480 --> 00:29:53,480 AND THE NEW BALANCE CHAIR IN 716 00:29:53,480 --> 00:29:56,000 CHILDHOOD NUTRITION AT TUFTS. 717 00:29:56,000 --> 00:30:00,400 THEN WE HAVE HILARY SELIGMAN A 718 00:30:00,400 --> 00:30:04,400 PROFESSOR AT THE UNIVERSITY OF 719 00:30:04,400 --> 00:30:07,080 CALIFORNIA SAN FRANCISCO AND 720 00:30:07,080 --> 00:30:10,680 HEADS THE NUTRITION AND OBESITY 721 00:30:10,680 --> 00:30:14,040 POLICY RESEARCH AND EVALUATION 722 00:30:14,040 --> 00:30:14,280 NETWORK. 723 00:30:14,280 --> 00:30:19,600 THEN WE HAVE FOUR MEMBERS OF OUR 724 00:30:19,600 --> 00:30:33,360 TEAM AND KRISTI, EBI AND LORRENN 725 00:30:33,360 --> 00:30:37,640 RICHIE AND THEN AMY CAROL SCOTT 726 00:30:37,640 --> 00:30:41,480 AND JAYNA MARKLAND DAVE WILL 727 00:30:41,480 --> 00:30:42,640 DISCUSS ISSUES OF EQUITY AND 728 00:30:42,640 --> 00:30:45,040 WE'LL HAVE QUESTIONS AND ANSWERS 729 00:30:45,040 --> 00:30:47,320 THROUGHOUT AND THEN WE'LL HAVE 730 00:30:47,320 --> 00:30:53,600 SOME REACTIONS FROM THE WORK 731 00:30:53,600 --> 00:30:55,000 GROUPS AS WELL AS ANYONE ELSE 732 00:30:55,000 --> 00:30:57,280 WHO WOULD LIKE TO REACT. 733 00:30:57,280 --> 00:31:00,000 THESE ARE QUESTIONS DAN POSED 734 00:31:00,000 --> 00:31:02,600 AND HOW THE PRESENTATIONS FIT 735 00:31:02,600 --> 00:31:08,080 WITH THE INTERNAL ONES LAST WEEK 736 00:31:08,080 --> 00:31:09,840 AND HOW WILL THE ENVIRONMENT BE 737 00:31:09,840 --> 00:31:11,400 INTEGRATED INTO WORK GROUPS 3 738 00:31:11,400 --> 00:31:13,120 AND 4 AND ARE THERE ASPECTS OF 739 00:31:13,120 --> 00:31:14,520 THE ENVIRONMENT THAT SHOULD BE 740 00:31:14,520 --> 00:31:16,360 INCREASED OR DECREASED AND WHAT 741 00:31:16,360 --> 00:31:20,640 DR. -- WHAT ARE THE KEY 742 00:31:20,640 --> 00:31:21,200 RESEARCH PRIORITIES. 743 00:31:21,200 --> 00:31:23,760 I LEAVE YOU WITH THE KEY 744 00:31:23,760 --> 00:31:30,960 INTRODUCTION AND ASK FLORIDA 745 00:31:30,960 --> 00:31:31,600 COMMENTS OR QUESTIONS AND THEN 746 00:31:31,600 --> 00:31:32,160 WE WILL MOVE ON TO THE NEXT 747 00:31:32,160 --> 00:31:33,520 SPEAKERS. 748 00:31:33,520 --> 00:31:34,480 I THANK YOU VERY MUCH AND WE'LL 749 00:31:34,480 --> 00:31:39,040 STOP SHARING. 750 00:31:39,040 --> 00:31:42,960 WE HAVE TWO OR THREE MINUTES IF 751 00:31:42,960 --> 00:31:44,600 ANYONE HAS A COMMENT OR QUESTION 752 00:31:44,600 --> 00:31:54,280 THAT YOU WOULD LIKE TO MAKE. 753 00:31:54,280 --> 00:31:56,760 I SEE NONE. 754 00:31:56,760 --> 00:32:00,280 OKAY, I WILL INTRODUCE OUR FIRST 755 00:32:00,280 --> 00:32:02,880 SPEAKER WHO IS ROSS HAMMOND. 756 00:32:02,880 --> 00:32:05,440 ROSS WILL BE TALKING ABOUT 757 00:32:05,440 --> 00:32:07,120 COMPLEX SYSTEMS AND GIVING AN 758 00:32:07,120 --> 00:32:08,120 OVERVIEW. 759 00:32:08,120 --> 00:32:34,520 ROSS, I TURN IT OVER TO YOU. 760 00:32:34,520 --> 00:32:37,240 >> QUICKLY, I NEEDED TO SAY AT 761 00:32:37,240 --> 00:32:38,840 THE OUTSET THOUGH I HAVE A 762 00:32:38,840 --> 00:32:40,240 NUMBER OF POLICY ADVISORY GOALS 763 00:32:40,240 --> 00:32:43,040 IN THIS SPACE WE'RE TALKING 764 00:32:43,040 --> 00:32:47,640 TODAY, NOTHING I SAY TODAY 765 00:32:47,640 --> 00:32:49,800 SHOULD BE CONSTRUED TO THESE 766 00:32:49,800 --> 00:32:51,760 BODIES MERELY MY OWN THOUGHTS. 767 00:32:51,760 --> 00:32:54,880 I WANT TO START TACKLING THE 768 00:32:54,880 --> 00:32:56,200 ISSUE OF COMPLEXITY MAUREEN DID 769 00:32:56,200 --> 00:32:58,200 A GOOD JOB OF COVERING ALREADY 770 00:32:58,200 --> 00:33:00,600 SO I WON'T GO IN MUCH DETAIL. 771 00:33:00,600 --> 00:33:04,760 I LIKE TO PUT UP THE PICTURE 772 00:33:04,760 --> 00:33:07,000 FROM A DIAGRAM FROM THE U.K. 773 00:33:07,000 --> 00:33:10,960 IT'S A SYSTEMS MAP OF OBESITY. 774 00:33:10,960 --> 00:33:13,520 I PURPOSELY MADE IT TOO IT SMALL 775 00:33:13,520 --> 00:33:15,120 TO LOOK AT THE DETAILS AND I 776 00:33:15,120 --> 00:33:17,880 WANT TO POINT OUT THREE THINGS. 777 00:33:17,880 --> 00:33:20,080 THIS IS A SYSTEM WHICH DRIVES 778 00:33:20,080 --> 00:33:22,200 OBESITY AS AN OUTCOME. 779 00:33:22,200 --> 00:33:25,080 EACH BOX WITH A WORD IS A 780 00:33:25,080 --> 00:33:26,920 MEASURABLE FACTOR THAT PLAYS A 781 00:33:26,920 --> 00:33:29,480 ROLE IN OBESITY AS AN OUTCOME 782 00:33:29,480 --> 00:33:32,720 AND EACH ARROW IS AN 783 00:33:32,720 --> 00:33:34,160 EVIDENCE-BASED CAUSAL 784 00:33:34,160 --> 00:33:36,720 RELATIONSHIP AND ONE KEY 785 00:33:36,720 --> 00:33:38,720 IMPLICATION IS USING METH 786 00:33:38,720 --> 00:33:40,560 LOGICAL TOOLS THAT REQUIRE US TO 787 00:33:40,560 --> 00:33:43,400 REQUIRE FACTORS ARE INDEPENDENT 788 00:33:43,400 --> 00:33:45,560 WON'T WORK WELL BECAUSE IT'S 789 00:33:45,560 --> 00:33:47,080 DEEPLY INTERDEPENDENT AND NOTICE 790 00:33:47,080 --> 00:33:49,960 THE SECTORS AND SCALES INVOKED 791 00:33:49,960 --> 00:33:51,640 IN THE MAP SOME WE HEARD AND 792 00:33:51,640 --> 00:33:53,320 I'LL TALK FURTHER ABOUT. 793 00:33:53,320 --> 00:33:56,080 THE THIRD I WANT YOU TO TAKEAWAY 794 00:33:56,080 --> 00:33:58,800 FROM THIS IS THERE'S DIFFERENT 795 00:33:58,800 --> 00:34:01,920 ACTS INVOLVED IN THIS SYSTEM WHO 796 00:34:01,920 --> 00:34:07,200 CAN BE VERY DIVERSE FROM EACH 797 00:34:07,200 --> 00:34:11,200 OTHER AS WELL AS MANY COMPLEX 798 00:34:11,200 --> 00:34:14,000 AND THERE'S THE IDEA OF 799 00:34:14,000 --> 00:34:14,280 ADAPTATION. 800 00:34:14,280 --> 00:34:17,880 THAT IT VERY FEW THINGS ARE 801 00:34:17,880 --> 00:34:21,000 CONSTANT AND THERE'S CONSTANT 802 00:34:21,000 --> 00:34:21,840 ADJUSTMENT TO CHANGING DYNAMICS 803 00:34:21,840 --> 00:34:23,480 IN THE SYSTEM. 804 00:34:23,480 --> 00:34:27,200 THE IMPLICATIONS OF THIS KIND OF 805 00:34:27,200 --> 00:34:28,040 COMPLEXITY OR SCIENCE AND POLICY 806 00:34:28,040 --> 00:34:29,520 IN NUTRITION IS A SEARCH FOR 807 00:34:29,520 --> 00:34:32,000 SOME KIND OF SINGLE INDEPENDENT 808 00:34:32,000 --> 00:34:34,880 CAUSE OF MANY OUTCOMES WE CARE 809 00:34:34,880 --> 00:34:36,840 ABOUT WHETHER UNDER NUTRITION, 810 00:34:36,840 --> 00:34:40,760 UNDER NUTRITION, ETCETERA IS 811 00:34:40,760 --> 00:34:42,840 PROBABLY NOT A FRUITFUL REQUEST 812 00:34:42,840 --> 00:34:45,000 AND STANDARD TOOLS TRYING TO 813 00:34:45,000 --> 00:34:45,960 ISOLATE DRIVERS MAY HAVE LIMITED 814 00:34:45,960 --> 00:34:46,800 USE FOR US. 815 00:34:46,800 --> 00:34:49,120 THE SECOND IS THERE MAY BE NO 816 00:34:49,120 --> 00:34:50,600 SINGLE SOLUTION TO THESE 817 00:34:50,600 --> 00:34:50,960 PROBLEMS. 818 00:34:50,960 --> 00:34:52,480 IT FITS ALL INDIVIDUAL 819 00:34:52,480 --> 00:34:55,040 CIRCUMSTANCES AND CONTEXT AND WE 820 00:34:55,040 --> 00:34:56,560 SOMEHOW NEED POLICY SOLUTIONS 821 00:34:56,560 --> 00:34:59,120 SUFFICIENTLY BROAD TO SPEAK TO 822 00:34:59,120 --> 00:35:03,200 MANY PARTS OF THIS COMPLEX MAP I 823 00:35:03,200 --> 00:35:04,200 SHOWED AS WELL AS SUFFICIENTLY 824 00:35:04,200 --> 00:35:06,080 COMPLEX SPECIFIC TO ACCOUNT FOR 825 00:35:06,080 --> 00:35:06,720 DIFFERENT CIRCUMSTANCES THAT WE 826 00:35:06,720 --> 00:35:07,600 FACE. 827 00:35:07,600 --> 00:35:11,360 AND FINALLY, WE NEED TO SOMEHOW 828 00:35:11,360 --> 00:35:13,000 HAVE COORDINATED INTERVENTIONS 829 00:35:13,000 --> 00:35:15,160 TO TAKE THESE DYNAMICS AND 830 00:35:15,160 --> 00:35:17,000 ADAPTATION INTO ACCOUNT. 831 00:35:17,000 --> 00:35:19,560 THERE'S SOME NICE QUOTES HERE AT 832 00:35:19,560 --> 00:35:21,400 THE TOP FROM A REPORT FROM THE 833 00:35:21,400 --> 00:35:26,120 ACADEMIES ON ACCELERATED 834 00:35:26,120 --> 00:35:27,400 PROGRESS AND OBESITY PREVENTION 835 00:35:27,400 --> 00:35:29,080 WE WERE INVOLVED IN AND THE 836 00:35:29,080 --> 00:35:31,080 SECOND ONE FROM A DIFFERENT 837 00:35:31,080 --> 00:35:32,400 ACADEMIES REPORT STRESSING THE 838 00:35:32,400 --> 00:35:34,600 IDEA OF MULTIPLE LEVELS OF 839 00:35:34,600 --> 00:35:36,600 SECTORS AND THINKING ABOUT 840 00:35:36,600 --> 00:35:38,280 ADAPTATIONS YOU THINK ABOUT LONG 841 00:35:38,280 --> 00:35:40,800 RUN EFFECTS NOT JUST SHORT-RUN 842 00:35:40,800 --> 00:35:41,000 EFFECTS. 843 00:35:41,000 --> 00:35:43,000 THIS IS OF COURSE HARD TO DO. 844 00:35:43,000 --> 00:35:44,000 COMPLEX SYSTEM TOOLS CAN HELP US 845 00:35:44,000 --> 00:35:46,560 AND WHAT I WANT TO DO TO GIVE AN 846 00:35:46,560 --> 00:35:49,040 OVERVIEW OF HOW THE TOOLS HAVE 847 00:35:49,040 --> 00:35:51,080 BEEN VIEWED AND WHAT THE TOOLS 848 00:35:51,080 --> 00:35:52,600 ARE AND HOW THEY MAYBE USED IN 849 00:35:52,600 --> 00:35:54,080 THE FUTURE IN MY 15 MINUTES IS 850 00:35:54,080 --> 00:35:57,120 TO REFER YOU TO TWO SPECIFIC 851 00:35:57,120 --> 00:35:57,400 ARTICLES. 852 00:35:57,400 --> 00:35:59,800 THE FIRST IS PUBLISHED IN 2009 853 00:35:59,800 --> 00:36:01,840 AND THE FIRST ATTEMPT TO REALLY 854 00:36:01,840 --> 00:36:04,680 LAY OUT A RESEARCH AGENDA USING 855 00:36:04,680 --> 00:36:06,360 COMPLEX SYSTEMS IN OBESITY 856 00:36:06,360 --> 00:36:06,640 RESEARCH. 857 00:36:06,640 --> 00:36:09,320 THE SECOND IS 10 YEARS LATER IN 858 00:36:09,320 --> 00:36:11,600 2019 A REVIEW AND META-ANALYSIS 859 00:36:11,600 --> 00:36:13,800 OF ALL THE USES OF COMPLEX 860 00:36:13,800 --> 00:36:16,480 SYSTEMS TOOLS TO DATE TO STUDY 861 00:36:16,480 --> 00:36:18,600 THINGS RELATED TO DIET. 862 00:36:18,600 --> 00:36:20,880 BOTH PAPERS SHARE IN COMMON 863 00:36:20,880 --> 00:36:22,400 THREE THEMES I WANT TO HIGHLIGHT 864 00:36:22,400 --> 00:36:24,240 IN MY ALLOTTED TIME TODAY. 865 00:36:24,240 --> 00:36:27,520 THE FIRST IS THE IMPORTANCE OF 866 00:36:27,520 --> 00:36:29,400 STUDYING APPROPRIATELY CONTEXT. 867 00:36:29,400 --> 00:36:30,960 THERE MANY KINDS OF CONTEXTS. 868 00:36:30,960 --> 00:36:36,080 WE OFTEN THINK OF THE PHYSICAL 869 00:36:36,080 --> 00:36:37,320 ENVIRONMENT WHERE FOOD IS LOCATE 870 00:36:37,320 --> 00:36:38,920 AND OUR ACCESS OCCURS AND 871 00:36:38,920 --> 00:36:41,360 THERE'S SOCIAL ENVIRONMENTS AS 872 00:36:41,360 --> 00:36:43,200 SHOWN IN THE DIAGRAM FROM A 873 00:36:43,200 --> 00:36:44,160 PAPER ON THE RIGHT. 874 00:36:44,160 --> 00:36:45,760 AND ONE OF THE KEY IDEAS THAT 875 00:36:45,760 --> 00:36:47,720 HAS EMERGED FROM THE COMPLEX 876 00:36:47,720 --> 00:36:49,800 SYSTEMS APPROACH TO THE TOPIC OF 877 00:36:49,800 --> 00:36:54,520 NUTRITION IS THIS IDEA OF 878 00:36:54,520 --> 00:36:54,800 TAILORING. 879 00:36:54,800 --> 00:36:56,200 WE HAVE TO TAILER OUR 880 00:36:56,200 --> 00:37:00,160 INTERVENTIONS TO ASPECT OF 881 00:37:00,160 --> 00:37:06,120 CONTEXT IN ORDER TO CREATE 882 00:37:06,120 --> 00:37:08,760 CHANGE AND PRECISION PREVENTION 883 00:37:08,760 --> 00:37:09,920 AND THINK OF NOT ONLY THE KINDS 884 00:37:09,920 --> 00:37:12,000 OF TREATMENTS WE DO IN MEDICINE 885 00:37:12,000 --> 00:37:13,200 THAT ARE INDIVIDUALIZED BUT THE 886 00:37:13,200 --> 00:37:14,600 KINDS OF PREVENTION WE'D LIKE TO 887 00:37:14,600 --> 00:37:17,040 DO THAT IN MANY CASES ARE 888 00:37:17,040 --> 00:37:18,600 PARTICULARIZED NOT TO 889 00:37:18,600 --> 00:37:21,000 INDIVIDUALS BUT TO CONTEXTS LIKE 890 00:37:21,000 --> 00:37:22,480 COMMUNITIES WE'LL HEAR ABOUT A 891 00:37:22,480 --> 00:37:23,840 BIT LATER. 892 00:37:23,840 --> 00:37:26,280 THE SECOND THING THAT'S ON MY 893 00:37:26,280 --> 00:37:28,000 LIST IS THE IMPORTANCE OF SOCIAL 894 00:37:28,000 --> 00:37:29,280 ENVIRONMENTS AND SO THERE'S 895 00:37:29,280 --> 00:37:31,600 QUITE A FEW PAPERS IN PARTICULAR 896 00:37:31,600 --> 00:37:33,240 THAT DELVE INTO THIS IDEA OF 897 00:37:33,240 --> 00:37:35,920 SOCIAL CONTEXT AS BEING CRITICAL 898 00:37:35,920 --> 00:37:39,040 FOR OUTCOMES IN NUTRITION AND 899 00:37:39,040 --> 00:37:39,360 OBESITY. 900 00:37:39,360 --> 00:37:40,360 THERE'S ONE PAPER IN PARTICULAR 901 00:37:40,360 --> 00:37:42,480 HERE THAT I WANT TO HIGHLIGHT 902 00:37:42,480 --> 00:37:44,040 SINCE I KNOW YOU'RE VERY 903 00:37:44,040 --> 00:37:45,480 INTERESTED IN A LIST OF PAPERS 904 00:37:45,480 --> 00:37:47,760 AND REFERENCES YOU CAN USE TO 905 00:37:47,760 --> 00:37:49,320 DELVE FURTHER THAN I CAN GO TO 906 00:37:49,320 --> 00:37:52,000 IN MY 15 MINUTES, THIS PAPER 907 00:37:52,000 --> 00:37:54,600 LAYS OUT A SPECIFIC MECHANISM 908 00:37:54,600 --> 00:37:57,040 FOR SOCIAL INFLUENCE AMONG 909 00:37:57,040 --> 00:37:58,880 ADOLESCENTS THAT SHAPES DIET 910 00:37:58,880 --> 00:38:01,200 BEHAVIOR AND HAS A LOT OF THE 911 00:38:01,200 --> 00:38:06,320 CRITICAL SUPPORT USED IN OTHER 912 00:38:06,320 --> 00:38:09,520 PAPERS SINCE THEN. 913 00:38:09,520 --> 00:38:12,360 AND THERE'S THE LIFE COURSE 914 00:38:12,360 --> 00:38:12,640 PERSPECTIVE. 915 00:38:12,640 --> 00:38:15,240 AND I WANT TO HIGHLIGHT ANOTHER 916 00:38:15,240 --> 00:38:20,000 PAPER I THINK MAY BE OF INTEREST 917 00:38:20,000 --> 00:38:25,040 TO YOU THAT IS A PAPER ABOUT 918 00:38:25,040 --> 00:38:25,760 PREFERENCES WHERE FOOD COMES 919 00:38:25,760 --> 00:38:28,760 FROM AND HELP UNDERSTAND ONE OF 920 00:38:28,760 --> 00:38:30,880 THE MYSTERIES IN THIS SPACE 921 00:38:30,880 --> 00:38:33,160 WHICH IS SYSTEMATIC REVIEWS TRY 922 00:38:33,160 --> 00:38:36,280 TO LINK FEATURES OF THE FOOD 923 00:38:36,280 --> 00:38:41,960 ENVIRONMENT AS AN OUTCOME BY A 924 00:38:41,960 --> 00:38:43,480 MIXED FIXTURE AND THIS PAPER AND 925 00:38:43,480 --> 00:38:45,920 OTHERS THAT BUILD ON IT LATE OU 926 00:38:45,920 --> 00:38:47,200 ONE PERSPECTIVE ON WHY THAT 927 00:38:47,200 --> 00:38:48,480 MIGHT BE AND IT'S NOT TODAY'S 928 00:38:48,480 --> 00:38:49,440 ENVIRONMENT WHICH IS MOST 929 00:38:49,440 --> 00:38:51,760 IMPORTANT FOR TODAY'S BEHAVIOR, 930 00:38:51,760 --> 00:38:53,880 BUT EARLIER ENVIRONMENTS THAT 931 00:38:53,880 --> 00:38:55,720 SHAPED PREFERENCES WHICH HAVE 932 00:38:55,720 --> 00:38:57,600 STICKY AND WHICH ARE STILL 933 00:38:57,600 --> 00:38:58,880 GOVERNING A LOT OF BEHAVIOR 934 00:38:58,880 --> 00:38:59,080 TODAY. 935 00:38:59,080 --> 00:39:01,400 AND I DON'T HAVE TIME TO GO IN 936 00:39:01,400 --> 00:39:03,000 THE DETAILS OF THE PAPER BUT I'D 937 00:39:03,000 --> 00:39:06,160 BE HAPPY TO IN Q&A OR OFFLINE. 938 00:39:06,160 --> 00:39:07,840 THIS PAPER ABOUT WHERE 939 00:39:07,840 --> 00:39:12,800 PREFERENCES COME FROM HAS BEEN A 940 00:39:12,800 --> 00:39:14,400 WHOLE LINE OF WORK AND THERE'S 941 00:39:14,400 --> 00:39:16,240 POLICY IN THE LANCET PAPER HERE 942 00:39:16,240 --> 00:39:18,960 I HAVE ABOUT HOW POLICIES MIGHT 943 00:39:18,960 --> 00:39:20,760 ACTUALLY BE DESIGNED TO SHAPE 944 00:39:20,760 --> 00:39:21,800 FOOD PREFERENCES MOVING FORWARD 945 00:39:21,800 --> 00:39:23,040 FOR A WHOLE GENERATION OF 946 00:39:23,040 --> 00:39:25,360 CHILDREN AND WHAT IT MEANS TO 947 00:39:25,360 --> 00:39:27,440 TAKE THE LIFE COURSE PERSPECTIVE 948 00:39:27,440 --> 00:39:29,200 PREFERENCE SERIOUSLY AND MANY 949 00:39:29,200 --> 00:39:32,000 ATTEMPTS TO REFINE AND TEST THE 950 00:39:32,000 --> 00:39:34,560 MODEL OF HOW THE PREFERENCES 951 00:39:34,560 --> 00:39:36,160 FORM THROUGH THINGS LIKE COHORT 952 00:39:36,160 --> 00:39:37,880 STUDIES AS SHOWN HERE AS PART OF 953 00:39:37,880 --> 00:39:39,520 THE ECHO PROGRAM AT NIH THAT I 954 00:39:39,520 --> 00:39:43,480 ALSO PARTICIPATE IN. 955 00:39:43,480 --> 00:39:44,960 THE THIRD THEME IN BOTH THE 956 00:39:44,960 --> 00:39:47,960 PAPERS I HIGHLIGHT IN THE 957 00:39:47,960 --> 00:39:49,360 BEGINNING IS A REAL EMPHASIS ON 958 00:39:49,360 --> 00:39:56,520 HOW WE SCALE AND SUSTAIN 959 00:39:56,520 --> 00:40:03,120 INTERVENTIONS TO CHANGE THE 960 00:40:03,120 --> 00:40:05,240 NUTRITION ECOLOGY AND THERE'S A 961 00:40:05,240 --> 00:40:06,840 BROADER SYSTEM AND WE SAW NICE 962 00:40:06,840 --> 00:40:12,960 VIEWS OF QUA THAT -- WHAT THAT 963 00:40:12,960 --> 00:40:14,800 CONSISTS OF AND THERE'S MORE ON 964 00:40:14,800 --> 00:40:19,480 THE LANCET REPORT AND IN THE 965 00:40:19,480 --> 00:40:25,720 NICE REPORT ON THE FOOD SYSTEM 966 00:40:25,720 --> 00:40:29,400 AND TRIES TO TALK ABOUT THE 967 00:40:29,400 --> 00:40:30,840 RESISTANCE AND I THINK THINKING 968 00:40:30,840 --> 00:40:33,240 ABOUT THE BROADER SYSTEM IS 969 00:40:33,240 --> 00:40:35,400 IMPORTANT BECAUSE INTERVENTIONS 970 00:40:35,400 --> 00:40:37,800 FOCUSSED WITH BLINDERS ON PART 971 00:40:37,800 --> 00:40:39,200 OF THE SYSTEM OFTEN DON'T WORK 972 00:40:39,200 --> 00:40:40,520 OUT AS PLANNED BECAUSE THEY'RE 973 00:40:40,520 --> 00:40:42,200 NOT TAKING INTO ACCOUNT THE 974 00:40:42,200 --> 00:40:43,480 REACTION OF OTHER PARTS OF THE 975 00:40:43,480 --> 00:40:46,160 SYSTEM THAT ACTUALLY SHAPE WHAT 976 00:40:46,160 --> 00:40:47,400 THE IMPACT OF THE INTERVENTION 977 00:40:47,400 --> 00:40:47,680 WILL BE. 978 00:40:47,680 --> 00:40:50,720 THE OTHER PART OF THIS IS 979 00:40:50,720 --> 00:40:53,120 THINKING ABOUT WHAT IT MEANS TO 980 00:40:53,120 --> 00:40:54,400 TAILOR INTERVENTIONS TO CONTEXT 981 00:40:54,400 --> 00:41:00,720 IN A WAY THAT ALLOWS THEM TO BE 982 00:41:00,720 --> 00:41:07,400 SUSTAINABLE AND I WORKED WITH 983 00:41:07,400 --> 00:41:11,400 KRIS ECONOMSO AND WE LOOKED AT 984 00:41:11,400 --> 00:41:13,800 THE UP STREAM PART OF DESIGNING 985 00:41:13,800 --> 00:41:14,600 INTERVENTIONS TO THINK WHAT DOES 986 00:41:14,600 --> 00:41:16,600 THE COMMUNITY LOOK LIKE IN WHICH 987 00:41:16,600 --> 00:41:17,920 YOU'RE INTERVENING, WHAT'S THAT 988 00:41:17,920 --> 00:41:19,120 MEAN HOW TO FIELD THE 989 00:41:19,120 --> 00:41:20,800 INTERVENTION THAT WILL WORK AND 990 00:41:20,800 --> 00:41:22,360 HAVE SUSTAINABILITY IN THAT 991 00:41:22,360 --> 00:41:24,480 CONTEXT AND HOW CAN YOU USE A 992 00:41:24,480 --> 00:41:25,440 VARIETY OF COMPLEX SYSTEM TOOLS 993 00:41:25,440 --> 00:41:27,400 TO HELP YOU DO THAT. 994 00:41:27,400 --> 00:41:28,600 WHEN I TALK ABOUT COMPLEX 995 00:41:28,600 --> 00:41:32,560 SYSTEMS TOOLS I WANT TO QUICKLY 996 00:41:32,560 --> 00:41:34,400 SAY THERE ARE VERY MANY SUCH 997 00:41:34,400 --> 00:41:39,760 TOOLS IN THE METHODOLOGICAL 998 00:41:39,760 --> 00:41:40,240 TOOLB 999 00:41:40,240 --> 00:41:40,480 TOOLBOX. 1000 00:41:40,480 --> 00:41:41,520 THIS IS FROM A REPORT WHICH I 1001 00:41:41,520 --> 00:41:44,360 THINK IS STILL VERY RELEVANT IN 1002 00:41:44,360 --> 00:41:46,040 THINKING ABOUT THE MAIN TOOLS 1003 00:41:46,040 --> 00:41:47,480 PEOPLE USE THEY INCLUDE THINGS 1004 00:41:47,480 --> 00:41:52,840 LIKE SYSTEM DYNAMIC MODELLING, 1005 00:41:52,840 --> 00:41:55,080 AGENT-BASED MODELLING AND 1006 00:41:55,080 --> 00:42:01,200 THERE'S MANY SUCH TOOLS. 1007 00:42:01,200 --> 00:42:02,320 SOME ARE QUALITATIVE AND SOME 1008 00:42:02,320 --> 00:42:04,320 MAKE PREDICTIONS AN SOME USE 1009 00:42:04,320 --> 00:42:05,400 LOTS OF DATA. 1010 00:42:05,400 --> 00:42:06,880 SOME CAN WORK WITHOUT DATA TO 1011 00:42:06,880 --> 00:42:10,520 HELP US BUILD THEORY AND 1012 00:42:10,520 --> 00:42:11,000 HYPOTHESES. 1013 00:42:11,000 --> 00:42:13,640 IN GENERAL THE TOOLS GET USED SO 1014 00:42:13,640 --> 00:42:14,680 FAR IN PUBLIC HEALTH IN GENERAL 1015 00:42:14,680 --> 00:42:19,760 AND NUTRITION SPACE IN 1016 00:42:19,760 --> 00:42:24,320 PARTICULAR IN THERE'S IMPORTANT 1017 00:42:24,320 --> 00:42:24,760 WAYS. 1018 00:42:24,760 --> 00:42:28,200 FIRST, COMPUTATIONAL 1019 00:42:28,200 --> 00:42:29,080 LABORATORIES TO TAILOR NEW 1020 00:42:29,080 --> 00:42:31,880 POLICIES OR INTERVENTIONS AND 1021 00:42:31,880 --> 00:42:33,880 SIMULATING COUNTER FACTUALS 1022 00:42:33,880 --> 00:42:36,720 THINGS THAT HAVE NOT YET BEEN 1023 00:42:36,720 --> 00:42:38,400 OBSERVED IN THE WORLD TO PREDICT 1024 00:42:38,400 --> 00:42:39,600 HOW TO HE SYSTEM MAY CHANGE IF 1025 00:42:39,600 --> 00:42:41,240 YOU PERTURB IT AND BECOME A WAY 1026 00:42:41,240 --> 00:42:43,240 TO TEST POLICIES IN THE VIRTUAL 1027 00:42:43,240 --> 00:42:45,240 WORLD OF A COMPUTER TO IDENTIFY 1028 00:42:45,240 --> 00:42:47,080 THE MOST PROMISING ONES BEFORE 1029 00:42:47,080 --> 00:42:49,200 YOU FIELD SOMETHING LIKE AN RCT 1030 00:42:49,200 --> 00:42:51,360 IN THE REAL WORLD TO TEST OUT 1031 00:42:51,360 --> 00:42:56,360 THIS IS A POPULAR USE AND WIDELY 1032 00:42:56,360 --> 00:42:59,160 USED FOR EXAMPLE, INFECTIOUS 1033 00:42:59,160 --> 00:43:00,800 DISEASE MODELS DURING THE 1034 00:43:00,800 --> 00:43:03,600 PANDEMIC AND IN TOBACCO CONTROL 1035 00:43:03,600 --> 00:43:05,880 IT'S COMMON AND IT'S JUST 1036 00:43:05,880 --> 00:43:07,440 STARTING TO BE USED IN THE 1037 00:43:07,440 --> 00:43:09,280 NUTRITION SPACE BUT LOOKS 1038 00:43:09,280 --> 00:43:09,560 PROMPTING. 1039 00:43:09,560 --> 00:43:11,600 SECOND IS AS RETROSPECTIVE TOOLS 1040 00:43:11,600 --> 00:43:17,080 TO LOOK AT INTERVENTIONS ALREADY 1041 00:43:17,080 --> 00:43:20,800 DONE AND TRY TO UNDERSTAND WHAT 1042 00:43:20,800 --> 00:43:22,800 WORKED AND DIDN'T WORK AND HOW 1043 00:43:22,800 --> 00:43:24,640 DEPENDENCE OF CONTEXT MAY PLAY 1044 00:43:24,640 --> 00:43:25,920 OUT IN TRYING TO TRANSLATE OR 1045 00:43:25,920 --> 00:43:27,320 SCALE INTERVENTIONS. 1046 00:43:27,320 --> 00:43:28,640 THIS IS VERY MUCH WHAT THE 1047 00:43:28,640 --> 00:43:31,600 COMPACT INTERVENTION I TALKED 1048 00:43:31,600 --> 00:43:32,760 ABOUT EARLIER -- COMPACT STUDY 1049 00:43:32,760 --> 00:43:33,840 IS ABOUT. 1050 00:43:33,840 --> 00:43:35,760 THE THIRD USE OF THE MODELS 1051 00:43:35,760 --> 00:43:37,720 WHICH ENCOMPASSES THE KIND OF 1052 00:43:37,720 --> 00:43:42,800 MORE IDEOLOGICAL MODELS I TALKED 1053 00:43:42,800 --> 00:43:44,800 ABOUT EARLIER LOOK AT THE LIFE 1054 00:43:44,800 --> 00:43:46,960 COURSE OR SOCIAL INFLUENCE IN 1055 00:43:46,960 --> 00:43:48,200 OBESITY AND NUTRITION, THE GOAL 1056 00:43:48,200 --> 00:43:51,800 IS TO TRY TO IDENTIFY MECHANISMS 1057 00:43:51,800 --> 00:43:53,760 NOT DIRECTLY OBSERVABLE BUT 1058 00:43:53,760 --> 00:43:56,120 ACTUALLY REPRESENT THE DYNAMICS 1059 00:43:56,120 --> 00:43:57,560 THAT TRANSLATE SEQUENCE OF 1060 00:43:57,560 --> 00:44:00,400 EXPOSURES EXPERIENCED BY 1061 00:44:00,400 --> 00:44:01,920 INDIVIDUALS INTO OUTCOMES WE CAN 1062 00:44:01,920 --> 00:44:02,200 MEASURE. 1063 00:44:02,200 --> 00:44:04,080 WHAT WE OFTEN CAN'T DO IS 1064 00:44:04,080 --> 00:44:06,040 UNDERSTAND IN DETAIL WHAT THE 1065 00:44:06,040 --> 00:44:07,760 MECHANISM IN BETWEEN THAT 1066 00:44:07,760 --> 00:44:09,600 CONNECTS THE EXPOSURES TO THE 1067 00:44:09,600 --> 00:44:11,280 OUTCOMES LOOKS LIKE AND WHAT THE 1068 00:44:11,280 --> 00:44:12,600 DYNAMIC PROPERTIES ARE AND 1069 00:44:12,600 --> 00:44:15,280 MODELS ALLOWING US TO TEST 1070 00:44:15,280 --> 00:44:20,800 HYPOTHESES AND TO SEE WHICH ONES 1071 00:44:20,800 --> 00:44:23,120 HAVE THIS ABILITY TO CREATE 1072 00:44:23,120 --> 00:44:24,800 PATTERNS OF OUTCOMES OVER TIME 1073 00:44:24,800 --> 00:44:26,240 AND SPACE GIVEN INPUTS AND 1074 00:44:26,240 --> 00:44:31,040 EXPOSURES OVER TIME. 1075 00:44:31,040 --> 00:44:32,080 -- AND ACROSS INDIVIDUALS. 1076 00:44:32,080 --> 00:44:35,440 BY DOING THAT WE HOPE TO 1077 00:44:35,440 --> 00:44:36,440 IDENTIFY KEY LEVERAGE POINTS FOR 1078 00:44:36,440 --> 00:44:38,160 FUTURE INTERVENTION. 1079 00:44:38,160 --> 00:44:38,920 THERE'S MANY CHALLENGE INVOLVED 1080 00:44:38,920 --> 00:44:41,680 IN DOING THIS KIND OF WORK. 1081 00:44:41,680 --> 00:44:46,120 DATA CHALLENGES, ENGAGEMENT WITH 1082 00:44:46,120 --> 00:44:47,800 STAKEHOLDERS, TEAM BUILDING. 1083 00:44:47,800 --> 00:44:50,080 ONE CHALLENGE I WANT TO 1084 00:44:50,080 --> 00:44:52,040 HIGHLIGHT IN EXPANDING COMPLEX 1085 00:44:52,040 --> 00:44:53,080 SYSTEM TOOLS FURTHER IN THE 1086 00:44:53,080 --> 00:44:55,680 SPACE DESPITE MANY EXHORTATIONS 1087 00:44:55,680 --> 00:44:58,400 FROM THE NATIONAL ACADEMIES AND 1088 00:44:58,400 --> 00:45:00,120 MAJOR JOURNALS AND SO ON IS 1089 00:45:00,120 --> 00:45:01,120 THERE'S STILL A LIMITED AMOUNT 1090 00:45:01,120 --> 00:45:03,200 OF TRAINING IN HOW TO USE THE 1091 00:45:03,200 --> 00:45:05,080 TOOLS EFFECTIVELY AND HOW TO 1092 00:45:05,080 --> 00:45:06,400 BECOME EXPERT IN THEM AND 1093 00:45:06,400 --> 00:45:08,080 SCATTERED AROUND A HANDFUL OF 1094 00:45:08,080 --> 00:45:10,760 UNIVERSITIES AROUND THE COUNTRY. 1095 00:45:10,760 --> 00:45:11,600 I'M FORTUNATE ENOUGH TO BE AT 1096 00:45:11,600 --> 00:45:13,720 ONE OF THOSE AND WE NEED MORE OF 1097 00:45:13,720 --> 00:45:15,040 THIS KIND OF TRAINING IF WE'RE 1098 00:45:15,040 --> 00:45:21,080 GOING TO GROW USE OF THIS TOOL 1099 00:45:21,080 --> 00:45:25,800 SET MORE BROADLY AND I'LL LEAVE 1100 00:45:25,800 --> 00:45:29,480 YOU AND ALLOW TIME FOR QUICK Q&A 1101 00:45:29,480 --> 00:45:34,520 BECAUSE I HAVE TO LEAVE AND YOU 1102 00:45:34,520 --> 00:45:36,480 WITH THIS QUOTE WHICH ARGUES 1103 00:45:36,480 --> 00:45:37,920 THERE SHOULD BE TRAINING IN ALL 1104 00:45:37,920 --> 00:45:39,320 COMPLEX SYSTEM APPROACHES NOT 1105 00:45:39,320 --> 00:45:41,040 JUST IN ACADEMIA BUT IN THE 1106 00:45:41,040 --> 00:45:43,560 PRIVATE SECTOR AND IN GOVERNMENT 1107 00:45:43,560 --> 00:45:45,880 AGENCIES SUCH AS NIH AND THIS 1108 00:45:45,880 --> 00:45:47,960 SHOULD INCLUDE NOT ONLY SYSTEMS 1109 00:45:47,960 --> 00:45:49,280 RESEARCH DESIGN BUT FROM 1110 00:45:49,280 --> 00:45:53,400 ANALYTICAL METHODOLOGIES SUCH AS 1111 00:45:53,400 --> 00:45:56,600 MODELLING. 1112 00:45:56,600 --> 00:45:59,160 I'LL STOP THERE AND STOP SHARING 1113 00:45:59,160 --> 00:46:26,680 MY SCREEN. 1114 00:46:26,680 --> 00:46:29,200 >> THAT WAS AMAZING. 1115 00:46:29,200 --> 00:46:32,880 WE APPRECIATE HOW YOU WERE ABLE 1116 00:46:32,880 --> 00:46:35,080 TO EXPLAIN THE COMPLEX SYSTEMS 1117 00:46:35,080 --> 00:46:37,600 AND THE REFERENCE US ADDED TO 1118 00:46:37,600 --> 00:46:39,840 ENABLE US TO UNDERSTAND IT AENT 1119 00:46:39,840 --> 00:46:40,040 MORE. 1120 00:46:40,040 --> 00:46:44,000 WE REALIZED IN OUR NIRNL LOOK AT 1121 00:46:44,000 --> 00:46:45,480 THIS TASK THAT WE HAD TO LEARN 1122 00:46:45,480 --> 00:46:49,800 MORE ABOUT COMPLEX SYSTEMS. 1123 00:46:49,800 --> 00:46:52,280 IT WAS YOU COULD NOT USE A 1124 00:46:52,280 --> 00:46:54,280 SIMPLE LINEAR STRATEGY TO MEET 1125 00:46:54,280 --> 00:46:56,600 THE DEMANDS OF OUR TASK. 1126 00:46:56,600 --> 00:47:02,120 I THANK YOU VERY MUCH FOR DOING 1127 00:47:02,120 --> 00:47:03,680 THIS. 1128 00:47:03,680 --> 00:47:08,080 WE HAVE A Q&A SCHEDULED AT 1129 00:47:08,080 --> 00:47:08,360 11:20. 1130 00:47:08,360 --> 00:47:09,960 DO YOU REMAIN THAT LONG? 1131 00:47:09,960 --> 00:47:16,280 >> I'LL TRY TO BUT I MAY HAVE TO 1132 00:47:16,280 --> 00:47:23,440 DROP OFF I THOUGHT I'D PUT MY 1133 00:47:23,440 --> 00:47:24,720 E-MAIL ON THE SLIDE. 1134 00:47:24,720 --> 00:47:25,880 >> I'LL TAKE ADVANTAGE OF THE 1135 00:47:25,880 --> 00:47:28,400 TWO OR THREE MINUTES RAND ASK IF 1136 00:47:28,400 --> 00:47:29,840 SOMEONE HAS A QUESTION THEY'D 1137 00:47:29,840 --> 00:47:40,200 LIKE TO ASK. 1138 00:47:40,200 --> 00:47:41,920 I SEE DON BUNDY. 1139 00:47:41,920 --> 00:47:42,480 YOU'RE ON. 1140 00:47:42,480 --> 00:47:44,760 >> THANK YOU, MAUREEN AND ROSS 1141 00:47:44,760 --> 00:47:46,200 FOR A REALLY INTERESTING 1142 00:47:46,200 --> 00:47:46,520 PRESENTATION. 1143 00:47:46,520 --> 00:47:49,760 I WONDERED IF YOU COULD SHARE 1144 00:47:49,760 --> 00:47:51,840 EXAMPLES WITH US WHERE THAT KIND 1145 00:47:51,840 --> 00:47:53,400 OF DYNAMIC COMPLEX SYSTEMS 1146 00:47:53,400 --> 00:47:56,040 APPROACH IS BEING USED IN LOW 1147 00:47:56,040 --> 00:47:58,000 INCOME COUNTRIES OR MIDDLE 1148 00:47:58,000 --> 00:47:58,600 INCOME COUNTRIES? 1149 00:47:58,600 --> 00:48:00,880 WE'RE THINK WHERE WE GO NEXT 1150 00:48:00,880 --> 00:48:09,800 WITH SOME OF THIS THINKING. 1151 00:48:09,800 --> 00:48:12,960 >> THESE TOOLS CAN BE USED IN 1152 00:48:12,960 --> 00:48:15,800 THAT CONTEXT AND THE COMPACT 1153 00:48:15,800 --> 00:48:19,640 STUDY WORKED WITH A VARIETY OF 1154 00:48:19,640 --> 00:48:24,920 COMMUNITIES TRIED TO ADOPT THIS 1155 00:48:24,920 --> 00:48:29,960 APPROACH INCLUDING EXPLORATORY 1156 00:48:29,960 --> 00:48:34,120 WORK A COMPACT APPROACH AND THE 1157 00:48:34,120 --> 00:48:37,560 TOOLS IN NEW ZEALAND AND ALSO 1158 00:48:37,560 --> 00:48:39,400 WITH INDIGENOUS POPULATIONS IN 1159 00:48:39,400 --> 00:48:41,240 NORTH AMERICA I'D BE HAPPY TO 1160 00:48:41,240 --> 00:48:43,640 TALK FURTHER ABOUT WITH YOU IF 1161 00:48:43,640 --> 00:48:45,200 YOU'RE INTERESTED IN THAT. 1162 00:48:45,200 --> 00:48:50,040 ALSO THE KINDS OF MODELS WERE 1163 00:48:50,040 --> 00:48:51,480 USED PRETTY MUCH ACROSS THE 1164 00:48:51,480 --> 00:48:54,000 BOARD IN THE DEVELOPING WORLD TO 1165 00:48:54,000 --> 00:48:55,120 HELP MANAGE COVID AND DESIGN 1166 00:48:55,120 --> 00:49:02,440 POLICIES DURING THE PANDEMIC. 1167 00:49:02,440 --> 00:49:04,600 >> THE VERY MUCH. 1168 00:49:04,600 --> 00:49:07,600 I WAS MEANING IN THE TERMS OF 1169 00:49:07,600 --> 00:49:08,000 NUTRITIONAL -- 1170 00:49:08,000 --> 00:49:08,680 >> YES. 1171 00:49:08,680 --> 00:49:09,280 >> OKAY. 1172 00:49:09,280 --> 00:49:10,400 MAYBE WE CAN FOLLOW-UP. 1173 00:49:10,400 --> 00:49:10,960 THAT WOULD BE SUPER. 1174 00:49:10,960 --> 00:49:24,040 >> GREAT. 1175 00:49:24,040 --> 00:49:30,000 >> FOLLOWING ROSS WE'LL HAVE A 1176 00:49:30,000 --> 00:49:35,400 COLLEAGUE AND PARTNER IN CRIME 1177 00:49:35,400 --> 00:49:37,880 OF ROSS'S AND CHRISTINA, YOU'RE 1178 00:49:37,880 --> 00:49:43,520 UP. 1179 00:49:43,520 --> 00:49:45,920 >> I'M HAPPY TO FOLLOW ROSS. 1180 00:49:45,920 --> 00:49:47,080 WE'VE BEEN CLOSE COLLEAGUES FOR 1181 00:49:47,080 --> 00:49:52,040 A LONG TIME AND I'LL PIVOT TO 1182 00:49:52,040 --> 00:49:55,120 SHOW YOU HOW SOME OF THE WORK IS 1183 00:49:55,120 --> 00:49:55,720 OPERATIONALIZED IN THE REAL 1184 00:49:55,720 --> 00:49:56,320 WORLD AND THE RESEARCH WE'RE 1185 00:49:56,320 --> 00:50:09,200 DOING NOW. 1186 00:50:09,200 --> 00:50:13,320 I WAS ASKED TO SPEAK ABOUT SHAPE 1187 00:50:13,320 --> 00:50:16,560 UP SOMERVILLE RESEARCH ARE I DID 1188 00:50:16,560 --> 00:50:20,160 ALMOST 20 YEARS AGO AND SHOW YOU 1189 00:50:20,160 --> 00:50:22,880 HOW WE RESOLVED THE SCIENCE AND 1190 00:50:22,880 --> 00:50:25,200 STUDIED THE COMPLEX ECOLOGICAL 1191 00:50:25,200 --> 00:50:29,080 SYSTEMS CHILDREN ARE EMBEDDED 1192 00:50:29,080 --> 00:50:30,160 WITHIN AND A LOT OF TOOLS WE'RE 1193 00:50:30,160 --> 00:50:31,400 USING ARE WHAT ROSS JUST 1194 00:50:31,400 --> 00:50:31,680 DESCRIBED. 1195 00:50:31,680 --> 00:50:34,120 I'LL TRY TO MAKE THEM COME TO 1196 00:50:34,120 --> 00:50:35,680 LIFE IN ILLUSTRATIONS OF HOW 1197 00:50:35,680 --> 00:50:37,080 WE'RE WORK WITH COMMUNITIES 1198 00:50:37,080 --> 00:50:38,200 ACROSS THE COUNTRY TO STUDY 1199 00:50:38,200 --> 00:50:46,600 THESE COMPLEX SYSTEMS. 1200 00:50:46,600 --> 00:50:47,760 WE KNOW THERE'S BEEN AN 1201 00:50:47,760 --> 00:50:48,880 EVOLUTION IN TERMS OF THE 1202 00:50:48,880 --> 00:50:50,320 RESEARCH WE DO AND HOW WE 1203 00:50:50,320 --> 00:50:52,560 APPROACH IT IF WE THINK BACK, 1204 00:50:52,560 --> 00:50:54,400 30, 40 YEARS AGO WE WERE VERY 1205 00:50:54,400 --> 00:50:55,560 MUCH FOCUSSED ON INDIVIDUAL 1206 00:50:55,560 --> 00:50:56,760 BEHAVIOR CHANGE AND THOSE 1207 00:50:56,760 --> 00:51:02,400 APPROACHES WHERE WE COULD TREAT 1208 00:51:02,400 --> 00:51:06,400 PEOPLE ONE-ON-ONE AND IMPLEMENT 1209 00:51:06,400 --> 00:51:07,560 EVIDENCE-BASED STRATEGIES AND 1210 00:51:07,560 --> 00:51:09,000 THROWS IMPORTANT BUT WE CAN'T 1211 00:51:09,000 --> 00:51:10,720 REACH THE WORLD AND THEN THE 1212 00:51:10,720 --> 00:51:14,640 POLICY EVOLVED IN DEVELOPING A 1213 00:51:14,640 --> 00:51:16,080 SUITE OF ASSESSMENT TOOLS IN THE 1214 00:51:16,080 --> 00:51:17,200 REAL WORLD TO UNDERSTAND WHETHER 1215 00:51:17,200 --> 00:51:19,320 THE INTERVENTIONS WERE EFFECTIVE 1216 00:51:19,320 --> 00:51:20,880 OR NOT. 1217 00:51:20,880 --> 00:51:23,600 MANY WERE DONE ONE BY ONE AND 1218 00:51:23,600 --> 00:51:25,320 STARTED TO COME TOGETHER 25 1219 00:51:25,320 --> 00:51:32,440 YEARS AGO IN MULTI-LEVEL, 1220 00:51:32,440 --> 00:51:33,840 MULTI-SECTOR DESIGNS AND EXPECT 1221 00:51:33,840 --> 00:51:35,400 IT IN THAT CATEGORY AND THE 1222 00:51:35,400 --> 00:51:40,720 WHOLE OF SYSTEM SCIENCE 1223 00:51:40,720 --> 00:51:41,560 APPROACHES. 1224 00:51:41,560 --> 00:51:45,640 I'LL TRY TO ILLUSTRATE WHAT 1225 00:51:45,640 --> 00:51:47,080 TYPES OF POLICY SYSTEMS SHOULD 1226 00:51:47,080 --> 00:51:48,880 WE IMPLEMENT WITHIN COMMUNITIES 1227 00:51:48,880 --> 00:51:49,840 TO INFLUENCE NUTRITION AND 1228 00:51:49,840 --> 00:51:52,840 HEALTH. 1229 00:51:52,840 --> 00:51:54,880 WHO MAKES THAT HAPPEN HOW DO WE 1230 00:51:54,880 --> 00:51:57,360 DO THIS WITH A SYSTEMS APPROACH 1231 00:51:57,360 --> 00:51:58,520 AND EQUITY LENS AND HOW DO WE 1232 00:51:58,520 --> 00:52:03,720 APPROACH EVALUATION. 1233 00:52:03,720 --> 00:52:07,000 I'LL I'LL GO BACK TO SHAPE UP 1234 00:52:07,000 --> 00:52:11,520 SOMERVILLE AN APPROACH TO 1235 00:52:11,520 --> 00:52:12,680 PREVENT OBESITY BETWEEN 2002 AND 1236 00:52:12,680 --> 00:52:12,960 2005. 1237 00:52:12,960 --> 00:52:19,560 THIS WAS SET UP AS A THREE-YEAR 1238 00:52:19,560 --> 00:52:23,080 CONTROLLED TRIAL TO STUDY 1239 00:52:23,080 --> 00:52:28,000 1st-3rd GRADERS OUTSIDE BOSTON. 1240 00:52:28,000 --> 00:52:29,800 WE DESIGNED AN INTERVENTION TO 1241 00:52:29,800 --> 00:52:31,360 ADDRESS THE ENERGY GAP WHICH WE 1242 00:52:31,360 --> 00:52:33,560 KNOW CAUSES UNNECESSARY WEIGHT 1243 00:52:33,560 --> 00:52:35,280 GAIN AND OBESITY IN CHILDREN BY 1244 00:52:35,280 --> 00:52:36,560 IMPLEMENTING AND EVALUATE 1245 00:52:36,560 --> 00:52:37,600 PORTFOLIO OF EVIDENCE-BASED 1246 00:52:37,600 --> 00:52:38,640 STRATEGIES THROUGHOUT THE 1247 00:52:38,640 --> 00:52:38,960 COMMUNITY. 1248 00:52:38,960 --> 00:52:41,640 AND WE USED A MULTI-LEVEL 1249 00:52:41,640 --> 00:52:42,400 APPROACH, MEANING WE WORKED 1250 00:52:42,400 --> 00:52:43,680 BEFORE, DURING AND AFTER SCHOOL 1251 00:52:43,680 --> 00:52:46,920 IN THE HOME, THE COMMUNITY AT 1252 00:52:46,920 --> 00:52:48,520 LARGE INVOLVING MANY DIFFERENT 1253 00:52:48,520 --> 00:52:49,360 ORGANIZATIONS AND SECTORS THAT 1254 00:52:49,360 --> 00:52:49,880 YOU SEE. 1255 00:52:49,880 --> 00:52:52,360 THE GOALS OF THIS CITY WERE TO 1256 00:52:52,360 --> 00:52:54,600 EXAMINE THE EFFECTIVENESS OF 1257 00:52:54,600 --> 00:52:56,320 THIS MULTI-SECTOR, MULTI-LEVEL 1258 00:52:56,320 --> 00:53:00,200 MODEL ON THE PREVENTION OF 1259 00:53:00,200 --> 00:53:02,320 UNDESIRABLE WEIGHT GAIN IN 1260 00:53:02,320 --> 00:53:02,600 CHILDREN. 1261 00:53:02,600 --> 00:53:07,200 WE WANT TO PREVENT WEIGHT GAIN 1262 00:53:07,200 --> 00:53:09,040 BUT PREVENT THE UNNECESSARY 1263 00:53:09,040 --> 00:53:10,440 WEIGHT GAIN FROM OCCURRING. 1264 00:53:10,440 --> 00:53:16,400 AND THOUGHT AT THE TIME WE COULD 1265 00:53:16,400 --> 00:53:17,240 TRANSFORM ONE COMMUNITY AND 1266 00:53:17,240 --> 00:53:19,360 SOCIAL CHANGE AT THE NATIONAL 1267 00:53:19,360 --> 00:53:19,640 LEVEL. 1268 00:53:19,640 --> 00:53:21,520 THE PORTFOLIO OF INTERVENTIONS 1269 00:53:21,520 --> 00:53:24,640 THAT WE IMPLEMENTS WE'RE USING 1270 00:53:24,640 --> 00:53:25,400 EVIDENCE-BASED STRATEGIES WE 1271 00:53:25,400 --> 00:53:27,920 KNEW AT THE TIME TO BE EFFECTIVE 1272 00:53:27,920 --> 00:53:29,800 WHEN THEY WERE IMPLEMENTING ONE 1273 00:53:29,800 --> 00:53:33,880 BY ONE OR EVEN IN A PAIR AND 1274 00:53:33,880 --> 00:53:35,320 THERE HADN'T BEEN TRIALS WHERE 1275 00:53:35,320 --> 00:53:36,200 THESE THINGS WERE PUT TOGETHER 1276 00:53:36,200 --> 00:53:43,800 IN A LARGE PORTFOLIO. 1277 00:53:43,800 --> 00:53:47,080 WE KNOW ONE SINGLE STRATEGY IS 1278 00:53:47,080 --> 00:53:48,800 UNLIKELY TO WORK. 1279 00:53:48,800 --> 00:53:50,360 THIS SHOWS A LONG LIFT OF THE 1280 00:53:50,360 --> 00:53:52,080 KINDS OF THINGS WE DID 1281 00:53:52,080 --> 00:53:53,080 THROUGHOUT THE COMMUNITY. 1282 00:53:53,080 --> 00:53:57,280 AND TO BRING IT BACK TO THE 1283 00:53:57,280 --> 00:53:58,960 EVIDENCE BASED WE FOCUSSED ON HE 1284 00:53:58,960 --> 00:54:02,520 REDUCTION OF SUGAR-SWEETENED 1285 00:54:02,520 --> 00:54:05,480 BEVERAGES AND ENCOURAGED DIETARY 1286 00:54:05,480 --> 00:54:07,200 GUIDELINES, INCREASING PHYSICAL 1287 00:54:07,200 --> 00:54:08,760 ACTIVITY, FAMILY MEALS. 1288 00:54:08,760 --> 00:54:11,200 ALL THE THINGS WE KNOW IN THE 1289 00:54:11,200 --> 00:54:12,280 NUTRITION LITERATURE AT THE TIME 1290 00:54:12,280 --> 00:54:13,600 WERE IMPORTANT BUT NEED TO BE 1291 00:54:13,600 --> 00:54:15,600 BROUGHT INTO THE REAL WORLD AS 1292 00:54:15,600 --> 00:54:16,360 INTERVENTIONS THAT ARE PART OF 1293 00:54:16,360 --> 00:54:23,400 EVERYDAY LIFE. 1294 00:54:23,400 --> 00:54:24,960 WE SAW A DECREASE IN THE SCORE 1295 00:54:24,960 --> 00:54:26,000 AND THE INTERVENTION COMMUNITY 1296 00:54:26,000 --> 00:54:30,760 IS THE SECOND LINE FROM THE TOP. 1297 00:54:30,760 --> 00:54:32,480 CHILDREN WERE MEASURED AT FOUR 1298 00:54:32,480 --> 00:54:35,200 TIME POINTS BEFORE AND AFTER TWO 1299 00:54:35,200 --> 00:54:36,280 CONSECUTIVE SCHOOL YEARS. 1300 00:54:36,280 --> 00:54:38,760 THERE WAS A REDUCTION IN THE 1301 00:54:38,760 --> 00:54:41,000 SCORE COMPARED TO EACH CONTROL 1302 00:54:41,000 --> 00:54:46,160 INDIVIDUALLY OR THE COMBINED 1303 00:54:46,160 --> 00:54:50,200 CONTROLS THE ANALYSIS WE PLANNED 1304 00:54:50,200 --> 00:54:52,200 AND YOU'LL NOTE A RISE IN THE 1305 00:54:52,200 --> 00:54:55,360 SUMMER AND THIS SHOULDN'T BE 1306 00:54:55,360 --> 00:54:59,080 NEWS IF YOU LOOKED AT CHILDREN'S 1307 00:55:02,400 --> 00:55:03,520 UNSTRUCTURED SUMMERTIME BEHAVIOR 1308 00:55:03,520 --> 00:55:05,600 AND WHAT WE'RE SEEING FROM THE 1309 00:55:05,600 --> 00:55:07,480 PAST TWO YEARS IS MANY CHILDREN 1310 00:55:07,480 --> 00:55:10,000 EXPERIENCE TWO YEARS OF 1311 00:55:10,000 --> 00:55:15,040 UNSTRUCTURED ACTIVITY WHICH HAS 1312 00:55:15,040 --> 00:55:17,320 LED TO A SIGNIFICANT INCREASE IN 1313 00:55:17,320 --> 00:55:18,600 OBESITY ACROSS THE COUNTRY. 1314 00:55:18,600 --> 00:55:21,160 IN ADDITION TO BIOLOGY WE SAW 1315 00:55:21,160 --> 00:55:23,160 BEHAVIORAL CHANGE LIKE SUGARY 1316 00:55:23,160 --> 00:55:26,600 DRINK INTAKE AND SCREEN TIME 1317 00:55:26,600 --> 00:55:33,360 REDUCTION OF ACTIVITIES AND 1318 00:55:33,360 --> 00:55:36,200 SPILLOVER FROM PARENTS AND 1319 00:55:36,200 --> 00:55:39,480 OBESITY AND SAW CHANGES AT THE 1320 00:55:39,480 --> 00:55:41,400 COMMUNITY LEVEL. 1321 00:55:41,400 --> 00:55:45,280 THIS HAS BEEN SUSTAIN OVER TIME 1322 00:55:45,280 --> 00:55:47,400 AND THE STUDY DID INFORM 1323 00:55:47,400 --> 00:55:48,560 NATIONAL EFFORTS. 1324 00:55:48,560 --> 00:55:49,400 EQUALLY IMPORTANT WAS THE 1325 00:55:49,400 --> 00:55:54,560 ECONOMIC ANALYSIS I DID WITH 1326 00:55:54,560 --> 00:55:59,560 SOME HEALTH ECONOMISTS LOOKING 1327 00:55:59,560 --> 00:56:01,800 AT THE OVER TIME ROI. 1328 00:56:01,800 --> 00:56:03,120 WE KNOW PREVENTION TAKES TIME TO 1329 00:56:03,120 --> 00:56:04,640 REAP THE BENEFITS. 1330 00:56:04,640 --> 00:56:08,200 IN THIS CASE IT WAS ABOUT THE 1331 00:56:08,200 --> 00:56:11,200 SIX, SEVEN YEAR MARK WHERE IT 1332 00:56:11,200 --> 00:56:12,640 STARTED TO PAY BACK AND THE PAY 1333 00:56:12,640 --> 00:56:14,200 BACK WAS BIG AND IF WE WERE TO 1334 00:56:14,200 --> 00:56:15,600 LOOK AT PREVENTION AND BELIEVE 1335 00:56:15,600 --> 00:56:17,880 IT DOES TAKE TIME BUT IT'S 1336 00:56:17,880 --> 00:56:21,480 IMPORTANT AND THE PAY NOW, PAY 1337 00:56:21,480 --> 00:56:23,000 LATER MODEL AND WE'D ARGUE IT'S 1338 00:56:23,000 --> 00:56:24,000 WORTH THE INVESTMENT RIGHT NOW. 1339 00:56:24,000 --> 00:56:26,160 WHEN THE STUDY WAS OVER, WE 1340 00:56:26,160 --> 00:56:31,240 PIVOTED TO TRY TO UNDERSTAND 1341 00:56:31,240 --> 00:56:36,200 WHAT HAPPENED IT WAS A LINEAR 1342 00:56:36,200 --> 00:56:39,760 MODEL IN HOW TO ACCOMPLISH THIS 1343 00:56:39,760 --> 00:56:41,040 MULTI-LEVEL, MULTI-SECTOR 1344 00:56:41,040 --> 00:56:43,800 INTERVENTION AND I REALIZED IT 1345 00:56:43,800 --> 00:56:47,880 WASN'T LINEAR BUT A SYSTEM 1346 00:56:47,880 --> 00:56:53,000 OPERATING IN AN INTERACTIVE AND 1347 00:56:53,000 --> 00:56:54,400 THERE WERE FEEDBACK LOOPS OVER 1348 00:56:54,400 --> 00:56:56,600 TIME AND I NEEDED TO UNDERSTAND 1349 00:56:56,600 --> 00:57:02,000 WHAT WAS GOING ON AND I 1350 00:57:02,000 --> 00:57:05,080 CONTACTED A SYSTEM SCIENTIST AND 1351 00:57:05,080 --> 00:57:07,160 FROM THERE FORWARD I'VE BEEN 1352 00:57:07,160 --> 00:57:08,520 USING SYSTEM SCIENCE IN MY 1353 00:57:08,520 --> 00:57:08,800 APPROACH. 1354 00:57:08,800 --> 00:57:10,960 I'M SHOWING THE COMMUNITY AND 1355 00:57:10,960 --> 00:57:12,400 THE MICROSYSTEMS OR SECTORS 1356 00:57:12,400 --> 00:57:14,640 WITHIN A COMMUNITY THAT 1357 00:57:14,640 --> 00:57:19,600 ULTIMATELY INFLUENCES INDIVIDUAL 1358 00:57:19,600 --> 00:57:28,000 BIOLOGY AND HEALTH. 1359 00:57:28,000 --> 00:57:30,000 AND THIS IS IMPORTANT TO 1360 00:57:30,000 --> 00:57:33,800 UNDERSTAND SO WE COULD REPLICATE 1361 00:57:33,800 --> 00:57:35,560 THE MODEL AND THE GROUP WE 1362 00:57:35,560 --> 00:57:40,640 BROUGHT TOGETHER OF LEADERSHIP 1363 00:57:40,640 --> 00:57:42,920 IN THE COMMUNITY WAS THE DRIVING 1364 00:57:42,920 --> 00:57:44,200 FORCE OF INTERVENTION ACTIVITIES 1365 00:57:44,200 --> 00:57:45,480 AND WHAT CAUSED THE 1366 00:57:45,480 --> 00:57:47,000 IMPLEMENTATION TO BE SUCCESSFUL 1367 00:57:47,000 --> 00:57:50,280 AND SUSTAINED OVER TIME. 1368 00:57:50,280 --> 00:57:52,120 BEGAN TO THINK MORE ABOUT THE 1369 00:57:52,120 --> 00:57:53,680 PEOPLE BEHIND THE INTERVENTION 1370 00:57:53,680 --> 00:57:56,760 AND HOW WE DON'T OFTEN STUDY THE 1371 00:57:56,760 --> 00:57:58,760 UP STREAM GROUP OF STAKEHOLDERS 1372 00:57:58,760 --> 00:58:00,600 RESPONSIBLE FOR MAKING THIS 1373 00:58:00,600 --> 00:58:00,800 HAPPEN. 1374 00:58:00,800 --> 00:58:03,880 WE PIVOTED AS A RESULT OF 1375 00:58:03,880 --> 00:58:05,800 COMPACT THE TRIAL ROSS MENTIONED 1376 00:58:05,800 --> 00:58:11,360 WE WERE CO-P.I.s ON AND OUR WORK 1377 00:58:11,360 --> 00:58:21,800 NOW TO LOOK TOWARDS SYSTEM 1378 00:58:21,800 --> 00:58:23,480 THINKING AND ACKNOWLEDGE THE 1379 00:58:23,480 --> 00:58:25,800 COMPLEX AND BUILDS ON COMMUNITY 1380 00:58:25,800 --> 00:58:26,880 STRENGTH TO IMPROVE THE HEALTH 1381 00:58:26,880 --> 00:58:32,560 AND WELL BEING OF CHILDREN AND 1382 00:58:32,560 --> 00:58:32,960 FAMILIES. 1383 00:58:32,960 --> 00:58:34,920 THIS IS CALLED STAKEHOLDER 1384 00:58:34,920 --> 00:58:35,840 COMMUNITY DIFFUSION. 1385 00:58:35,840 --> 00:58:38,680 ON THE LEFT YOU SEE THE UP 1386 00:58:38,680 --> 00:58:44,360 STREAM CONSTRUCTS AND THE 1387 00:58:44,360 --> 00:58:46,560 MIDSTREAM CONSTRUCTS INCLUDING 1388 00:58:46,560 --> 00:58:48,400 POLICY PRACTICE AND SYSTEM 1389 00:58:48,400 --> 00:58:49,640 ENVIRONMENT AND TO DRIVE 1390 00:58:49,640 --> 00:59:00,320 POSITIVE CHILD HEALTH OUTCOMES. 1391 00:59:00,320 --> 00:59:02,160 WE TRIED TO ENGAGE ON THE 1392 00:59:02,160 --> 00:59:03,200 COALITION THEY'RE PART OF AND 1393 00:59:03,200 --> 00:59:05,600 THE EFFICACY OF THE WORK OF THAT 1394 00:59:05,600 --> 00:59:05,920 COALITION. 1395 00:59:05,920 --> 00:59:11,400 WE DO A LOT OF WORK UP STREAM 1396 00:59:11,400 --> 00:59:13,720 AND TO DIFFUSE THAT USING THEIR 1397 00:59:13,720 --> 00:59:15,160 SOCIAL NETWORKS AND ULTIMATELY 1398 00:59:15,160 --> 00:59:16,200 IMPACT POLICIES, SYSTEMS AND 1399 00:59:16,200 --> 00:59:17,760 ENVIRONMENT TO DRIVE POSITIVE 1400 00:59:17,760 --> 00:59:18,600 HEALTH OUTCOMES. 1401 00:59:18,600 --> 00:59:20,880 THIS MODEL IS REALLY IMPORTANT 1402 00:59:20,880 --> 00:59:22,320 BECAUSE MOST PEOPLE START WITH 1403 00:59:22,320 --> 00:59:23,680 POLICY SYSTEMS AND ENVIRONMENTS 1404 00:59:23,680 --> 00:59:26,400 AND EXPECT THE HEALTH OUTCOMES 1405 00:59:26,400 --> 00:59:27,840 TO CHANGE BUT WE WOULD ARGUE IF 1406 00:59:27,840 --> 00:59:29,720 YOU DON'T DO THIS UPSTREAM WORK 1407 00:59:29,720 --> 00:59:31,360 IT WON'T BE SUSTAIN OVER TIME 1408 00:59:31,360 --> 00:59:34,800 AND YOU WON'T IMPACT THE PEOPLE 1409 00:59:34,800 --> 00:59:36,520 IN THE COMMUNITY WHO ARE 1410 00:59:36,520 --> 00:59:46,480 ACTUALLY DOING THE IMPLEMENT -- 1411 00:59:46,480 --> 00:59:47,600 IMPLEMENTATIONS AND LOOK AT THE 1412 00:59:47,600 --> 00:59:50,880 DRIVERS AND STRUCTURES PREVENTED 1413 00:59:50,880 --> 00:59:51,920 FROM BEING POSITIVE FOR CHILDREN 1414 00:59:51,920 --> 01:00:00,240 IN THE FIRST PLACE. 1415 01:00:00,240 --> 01:00:01,720 YOU'LL SEE WHEN I ILLUSTRATE 1416 01:00:01,720 --> 01:00:02,760 THROUGH THE COMMUNITY WORK WE'RE 1417 01:00:02,760 --> 01:00:05,080 DOING NOW, THESE ARE THE KINDS 1418 01:00:05,080 --> 01:00:07,920 OF THINGS PEOPLE IN COMMUNITIES 1419 01:00:07,920 --> 01:00:12,560 WORK ON AND CARE ABOUT NUTRITION 1420 01:00:12,560 --> 01:00:14,320 AND HEALTHY BEHAVIOR BUT KNOW 1421 01:00:14,320 --> 01:00:20,000 YOU NEED TO LOOK AT ECONOMIC 1422 01:00:20,000 --> 01:00:22,320 DEVELOPMENT, RACISM AND 1423 01:00:22,320 --> 01:00:23,960 STRATEGIC PARTNERSHIPS. 1424 01:00:23,960 --> 01:00:27,800 WE WORK WITH THE STAKEHOLDER 1425 01:00:27,800 --> 01:00:29,240 GROUPS TO LOOK AT COMMUNITY 1426 01:00:29,240 --> 01:00:32,280 BASED SYSTEM DYNAMICS WHICH FIT 1427 01:00:32,280 --> 01:00:34,080 IN THE SUITE ROSS TALKED ABOUT 1428 01:00:34,080 --> 01:00:41,320 AND HAVE THEM MAP OUT WHAT 1429 01:00:41,320 --> 01:00:42,440 STARTS IN THE COMMUNITIES AND 1430 01:00:42,440 --> 01:00:45,000 MODEL WHAT'S HAPPENING. 1431 01:00:45,000 --> 01:00:47,840 YOU CAN SEE FROM THIS COUNTY IN 1432 01:00:47,840 --> 01:00:49,120 CLEVELAND AN ACTUAL MAP CREATED 1433 01:00:49,120 --> 01:00:51,520 TO IDENTIFY THE COMMUNITY AND 1434 01:00:51,520 --> 01:00:55,000 ENVIRONMENTAL FACTORS WITHIN 1435 01:00:55,000 --> 01:00:56,120 THIS PARTICULAR COMMUNITY THREE 1436 01:00:56,120 --> 01:01:00,720 ARE PRESENT AND INTERCON COCONNECTED 1437 01:01:00,720 --> 01:01:02,680 AND NEED TO BE WORKED ON TO 1438 01:01:02,680 --> 01:01:03,400 INFLUENCE BIOLOGY AT THE 1439 01:01:03,400 --> 01:01:03,800 INDIVIDUAL LEVEL. 1440 01:01:03,800 --> 01:01:05,240 I'M PULLING OUT FOR YOU THE 1441 01:01:05,240 --> 01:01:07,120 KINDS OF THINGS WITHIN A 1442 01:01:07,120 --> 01:01:07,920 COMMUNITY THAT WILL BE 1443 01:01:07,920 --> 01:01:09,920 IDENTIFIED THAT NEED TON 1444 01:01:09,920 --> 01:01:12,640 STUDIED, CHANGED, EVALUATED AND 1445 01:01:12,640 --> 01:01:15,000 SUSTAIN OVER TIME. 1446 01:01:15,000 --> 01:01:19,720 FOR EXAMPLE, BUILT ENVIRONMENT, 1447 01:01:19,720 --> 01:01:21,120 WALKABILITY, TOXIC STRESS LIKE 1448 01:01:21,120 --> 01:01:23,000 POVERTY AND TRAUMA AND FOOD 1449 01:01:23,000 --> 01:01:25,120 ACCESS FROM THE RETAIL AND 1450 01:01:25,120 --> 01:01:27,040 FARMER'S MARKET TO FOOD BANKS 1451 01:01:27,040 --> 01:01:32,480 AND SHELTERS, POLITICAL WILL AND 1452 01:01:32,480 --> 01:01:34,360 COST OF CHILDCARE AND SO ON. 1453 01:01:34,360 --> 01:01:35,920 THESE ARE ALL IMPORTANT TO MAKE 1454 01:01:35,920 --> 01:01:38,320 THE ENTIRE SYSTEM WORK AND YOU 1455 01:01:38,320 --> 01:01:38,960 CAN SEE HERE THEY'RE 1456 01:01:38,960 --> 01:01:40,600 INTERCONNECTED. 1457 01:01:40,600 --> 01:01:42,320 HOW DO WE MEASURE WHETHER OR NOT 1458 01:01:42,320 --> 01:01:44,560 WE'RE HAVING AN IMPACT? 1459 01:01:44,560 --> 01:01:47,320 THIS IS ONE EXAMPLE WHERE THEY 1460 01:01:47,320 --> 01:01:48,320 IDENTIFIED THESE VARIABLES AND 1461 01:01:48,320 --> 01:01:50,280 WE SET A PLAN FOR ACTION AND 1462 01:01:50,280 --> 01:01:52,040 OVER TIME THEY ACTUALLY 1463 01:01:52,040 --> 01:01:54,720 IDENTIFIED WHERE THEY WERE 1464 01:01:54,720 --> 01:01:59,080 MAKING THE MOST PROCESS AND 1465 01:01:59,080 --> 01:02:02,240 THAT'S HIGHLIGHTED IN THE FIRST 1466 01:02:02,240 --> 01:02:03,960 BOX HERE AND MODEST PROGRESS AND 1467 01:02:03,960 --> 01:02:05,960 THE LAST BOX SHOWS WHERE THEY 1468 01:02:05,960 --> 01:02:07,080 NEEDED MORE PROGRESS. 1469 01:02:07,080 --> 01:02:09,120 THIS ENABLED US TO MEASURE 1470 01:02:09,120 --> 01:02:11,360 WHETHER THESE THINGS ARE BEING 1471 01:02:11,360 --> 01:02:12,680 ADDRESSED AND WHETHER THEY 1472 01:02:12,680 --> 01:02:14,880 BELIEVE THEY'RE HAVING AN 1473 01:02:14,880 --> 01:02:15,320 IMPACT. 1474 01:02:15,320 --> 01:02:18,160 OBJECTIVELY WE USED VALIDATED 1475 01:02:18,160 --> 01:02:20,720 INSTRUMENT TO LOCK AT POLICY, 1476 01:02:20,720 --> 01:02:24,840 PRACTICES AND LOOK AT SCORES. 1477 01:02:24,840 --> 01:02:26,880 YOU'LL HEAR MORE COMING UP BUT 1478 01:02:26,880 --> 01:02:28,120 THIS IS ONE COMMUNITY WHERE THE 1479 01:02:28,120 --> 01:02:30,120 SCORE IMPROVED OVER TIME BY 1480 01:02:30,120 --> 01:02:32,960 OBJECTIVE MEASUREMENT AND YOU 1481 01:02:32,960 --> 01:02:36,640 CAN SEE THAT IT WAS SIGNIFICANT 1482 01:02:36,640 --> 01:02:39,480 INDICATING THE PSE CHANGES WERE 1483 01:02:39,480 --> 01:02:40,160 POSITIVELY MOVING. 1484 01:02:40,160 --> 01:02:42,040 WE ALSO LOOKED AT SOCIAL 1485 01:02:42,040 --> 01:02:42,480 NETWORKS. 1486 01:02:42,480 --> 01:02:43,640 BECAUSE WHAT'S IMPORTANT IS THE 1487 01:02:43,640 --> 01:02:45,320 DIFFUSION OF ALL THIS. 1488 01:02:45,320 --> 01:02:49,040 HOW ARE PEOPLE DIFFUSING THIS 1489 01:02:49,040 --> 01:02:50,560 KNOWLEDGE AND INFORMATION AND 1490 01:02:50,560 --> 01:02:51,080 IMPLEMENTATION OF THE 1491 01:02:51,080 --> 01:02:52,160 EVIDENCE-BASED STRATEGIES. 1492 01:02:52,160 --> 01:02:54,320 THIS IS AN EXAMPLE OF A 1493 01:02:54,320 --> 01:02:56,080 STAKEHOLDER NETWORK WITHIN A 1494 01:02:56,080 --> 01:02:57,720 COMMUNITY AT FIVE TIME POINTS 1495 01:02:57,720 --> 01:02:59,160 AND MEASURED THINGS LIKE THE 1496 01:02:59,160 --> 01:03:01,560 DISCUSSION NETWORK, FREQUENCY OF 1497 01:03:01,560 --> 01:03:03,120 CONNECTION, INFLUENCE ON EACH 1498 01:03:03,120 --> 01:03:05,840 OTHER AMONG OTHER SOCIAL NETWORK 1499 01:03:05,840 --> 01:03:07,720 VARIABLES THAT ARE OF INTEREST 1500 01:03:07,720 --> 01:03:09,680 TO US BUT THIS ILLUSTRATES FOR 1501 01:03:09,680 --> 01:03:12,920 YOU OVER TIME YOU CAN SEE THE 1502 01:03:12,920 --> 01:03:14,520 DIFFERENT TYPES OF CHANGES AND 1503 01:03:14,520 --> 01:03:17,080 THE GROWTH OF A NET WORK WE 1504 01:03:17,080 --> 01:03:18,640 OFTEN SEE WHICH IS THE GOAL TO 1505 01:03:18,640 --> 01:03:21,640 GET MORE PEOPLE PART OF THE 1506 01:03:21,640 --> 01:03:27,120 INTERVENTION. 1507 01:03:27,120 --> 01:03:31,720 AND YOU SEE THE WHOLE OF 1508 01:03:31,720 --> 01:03:33,520 COMMUNITY APPROACHES ARE 1509 01:03:33,520 --> 01:03:34,520 DIFFERENT AND LEVERAGE COMMUNITY 1510 01:03:34,520 --> 01:03:35,960 ASSETS AND BUILD CAPACITY AND 1511 01:03:35,960 --> 01:03:38,240 HELP WITH ENGAGEMENT AND WE HAVE 1512 01:03:38,240 --> 01:03:40,400 TO MEASURE THESE CONSTRUCTS AS 1513 01:03:40,400 --> 01:03:42,200 WELL AS THE MID STREAM AND DOWN 1514 01:03:42,200 --> 01:03:44,040 STREAM ASPECTS. 1515 01:03:44,040 --> 01:03:45,640 COORDINATION BETWEEN SECTORS 1516 01:03:45,640 --> 01:03:48,480 USING SYSTEM SCIENCE 1517 01:03:48,480 --> 01:03:51,320 METHODOLOGIES WHICH CAPTURES THE 1518 01:03:51,320 --> 01:03:52,120 COMPLEXITY. 1519 01:03:52,120 --> 01:03:52,880 IMPOSING ENVIRONMENTAL AND 1520 01:03:52,880 --> 01:03:55,080 POLICY INTERVENTIONS AND 1521 01:03:55,080 --> 01:03:56,640 EVALUATIONS NOT CONTEXT SPECIFIC 1522 01:03:56,640 --> 01:03:58,920 AND DEVELOPED WITH ENGAGEMENT 1523 01:03:58,920 --> 01:04:03,400 MAY NOT BE SUSTAINABLE. 1524 01:04:03,400 --> 01:04:04,440 REDUCING DISPARITIES REQUIRING 1525 01:04:04,440 --> 01:04:08,120 EQUITY ORIENTED DISPARITY 1526 01:04:08,120 --> 01:04:10,280 ADDRESS THE UNDERLYING 1527 01:04:10,280 --> 01:04:12,120 STRUCTURES AND DISADVANTAGES AND 1528 01:04:12,120 --> 01:04:14,520 ROSS ALSO EMPHASIZED FUTURE 1529 01:04:14,520 --> 01:04:16,920 LEADERS NEED THIS TYPE OF 1530 01:04:16,920 --> 01:04:17,680 INTERDISCIPLINARY TRAINING IF 1531 01:04:17,680 --> 01:04:19,080 WE'RE TO MAKE PROGRESS 1532 01:04:19,080 --> 01:04:21,520 INFLUENCING THE HEALTH OF 1533 01:04:21,520 --> 01:04:21,800 CHILDREN. 1534 01:04:21,800 --> 01:04:40,920 THANK YOU. 1535 01:04:40,920 --> 01:04:42,240 >> THANK YOU. 1536 01:04:42,240 --> 01:04:44,680 WE APPRECIATE THE EXAMPLES OF 1537 01:04:44,680 --> 01:04:49,720 SHAPE UP SOMERVILLE AND BEYOND. 1538 01:04:49,720 --> 01:04:52,880 THE NEXT SPEAKER WILL BE HILARY 1539 01:04:52,880 --> 01:04:54,320 AND SHE'LL TALK ABOUT HEALTH AND 1540 01:04:54,320 --> 01:04:54,920 ECONOMIC SYSTEMS. 1541 01:04:54,920 --> 01:04:57,040 >> DO WE HAVE TIME FOR 1542 01:04:57,040 --> 01:04:59,320 QUESTIONS, MAUREEN? 1543 01:04:59,320 --> 01:05:01,320 >> WELL, WE COULD HAVE TIME FOR 1544 01:05:01,320 --> 01:05:02,080 ONE QUESTION. 1545 01:05:02,080 --> 01:05:03,880 WE'RE TRYING TO KEEP ON THINGS, 1546 01:05:03,880 --> 01:05:05,640 DAN, BUT YES, IF YOU HAVE A 1547 01:05:05,640 --> 01:05:10,680 QUESTION OR SOMEONE ELSE HAS 1548 01:05:10,680 --> 01:05:16,520 TIME FOR ONE QUESTION, WE COULD 1549 01:05:16,520 --> 01:05:17,080 DO THAT. 1550 01:05:17,080 --> 01:05:21,360 >> MY QUESTION IS THIS THE TWO 1551 01:05:21,360 --> 01:05:24,200 PRESENTATIONS WE HEARD HAVE MADE 1552 01:05:24,200 --> 01:05:27,040 AN IMPORTANT CASE FOR DEVELOP 1553 01:05:27,040 --> 01:05:28,480 AND IMPLEMENTATION OF PROGRAMS 1554 01:05:28,480 --> 01:05:33,440 TO ADDRESS OUTCOME OF INTEREST. 1555 01:05:33,440 --> 01:05:36,720 THEY WERE LESS FOCUSSED ON 1556 01:05:36,720 --> 01:05:40,400 IMPACTING A PRE-EXISTING 1557 01:05:40,400 --> 01:05:40,640 PROGRAM. 1558 01:05:40,640 --> 01:05:42,240 CHRIS OR ROSS MIGHT WANT TO 1559 01:05:42,240 --> 01:05:42,680 RESPOND. 1560 01:05:42,680 --> 01:05:44,960 CHRIS MENTIONED SOME ASPECTS OF 1561 01:05:44,960 --> 01:05:46,800 THE WORK SHE'S DONE ON MEASURING 1562 01:05:46,800 --> 01:05:56,240 THE IMPACT OF THOSE PROGRAMS AND 1563 01:05:56,240 --> 01:05:57,400 LOOKING AT THE IMPACT OF 1564 01:05:57,400 --> 01:05:58,800 CHILDREN AND HOW DO WE APPLY 1565 01:05:58,800 --> 01:06:04,320 SYSTEMS APPROACHES TO THAT? 1566 01:06:04,320 --> 01:06:08,760 >> IT'S NOT A PROBLEM APPLY 1567 01:06:08,760 --> 01:06:11,880 THESE METHODOLOGIES AND I'LL 1568 01:06:11,880 --> 01:06:14,160 ROSS TALK ABOUT THE MODELLING 1569 01:06:14,160 --> 01:06:16,560 ASPECT BUT FROM THE SOCIAL 1570 01:06:16,560 --> 01:06:17,840 NETWORK AND ASPECT I'VE TALKED 1571 01:06:17,840 --> 01:06:20,120 ABOUT, YOU CAN DO THAT WITH AN 1572 01:06:20,120 --> 01:06:21,120 EXISTING PROGRAM. 1573 01:06:21,120 --> 01:06:21,960 WHAT I DIDN'T EMPHASIZE TODAY 1574 01:06:21,960 --> 01:06:23,680 BECAUSE I THINK THIS IS PART OF 1575 01:06:23,680 --> 01:06:29,480 OTHER WORKING GROUPS, WHAT ARE 1576 01:06:29,480 --> 01:06:30,920 THE SPECIFIC ENVIRONMENTAL 1577 01:06:30,920 --> 01:06:31,920 POLICY AND SYSTEM TOOLS YOU'RE 1578 01:06:31,920 --> 01:06:32,120 USING? 1579 01:06:32,120 --> 01:06:38,440 I ALOLUDED THOSE CAN BE USED WITH 1580 01:06:38,440 --> 01:06:49,520 AN EXISTING PROGRAM. 1581 01:06:49,520 --> 01:06:53,240 AND WE DID THAT 1582 01:06:53,240 --> 01:06:55,440 RETROSPECTIVELY -- ME MIGHT HAVE 1583 01:06:55,440 --> 01:06:56,400 HAD TO DROP OFF. 1584 01:06:56,400 --> 01:06:59,000 ROSS AND I PUBLISHED THAT 1585 01:06:59,000 --> 01:07:02,120 TOGETHER AS PART OF THE NIH 1586 01:07:02,120 --> 01:07:03,760 COMPACT TRIAL WHERE WE LOOKED AT 1587 01:07:03,760 --> 01:07:06,640 INTERVENTION HAVE BEEN DONE AND 1588 01:07:06,640 --> 01:07:08,600 TRYING TO UNDERSTAND WITH A 1589 01:07:08,600 --> 01:07:12,320 SYSTEM'S LENS, WHAT THEY 1590 01:07:12,320 --> 01:07:13,600 ACCOMPLISHED AND DONE AND USED 1591 01:07:13,600 --> 01:07:14,760 MODELLING AND ONE OF THOSE 1592 01:07:14,760 --> 01:07:17,320 PAPERS IS PUBLISHED AND ONE IS 1593 01:07:17,320 --> 01:07:18,840 ABOUT TO BE PUBLISHED. 1594 01:07:18,840 --> 01:07:20,720 YOU CAN COME INTO AN EXISTING 1595 01:07:20,720 --> 01:07:22,400 STUDY AND USE THE METHODOLOGY AS 1596 01:07:22,400 --> 01:07:22,680 WELL. 1597 01:07:22,680 --> 01:07:25,120 I THINK WHAT I WAS TRYING TO 1598 01:07:25,120 --> 01:07:29,520 EMPHASIZE WAS THE CONTEXT 1599 01:07:29,520 --> 01:07:32,760 SPECIFIC IMPORTANCE OF IMPLEMENT 1600 01:07:32,760 --> 01:07:34,200 POLICY SYSTEMS AND VARIETAL 1601 01:07:34,200 --> 01:07:35,200 INTERVENTIONS AND THE BEST WAY 1602 01:07:35,200 --> 01:07:37,400 TO DO THAT IS TO WORK FROM THE 1603 01:07:37,400 --> 01:07:48,120 COMMUNITY FROM THE BEGINNING. 1604 01:07:48,120 --> 01:07:50,800 >> THANK YOU VERY MUCH. 1605 01:07:50,800 --> 01:07:52,120 WE KNOW IT'S FASCINATE AND KNOW 1606 01:07:52,120 --> 01:07:54,600 MUCH OF WHAT HAS BEEN DONE HAS 1607 01:07:54,600 --> 01:07:56,840 NOT HAD THE IMPACT WE HOPED IT 1608 01:07:56,840 --> 01:07:57,040 WOULD. 1609 01:07:57,040 --> 01:07:59,120 OUR CHARGE IS TO DOCUMENT WHAT 1610 01:07:59,120 --> 01:08:04,720 HAS WORKED AND WHAT WE KNOW AND 1611 01:08:04,720 --> 01:08:09,760 DON'T KNOW YOU'RE HELPING THANE 1612 01:08:09,760 --> 01:08:09,920 WAY. 1613 01:08:09,920 --> 01:08:18,040 NEXT WE HAVE HILARY SELIGMAN. 1614 01:08:18,040 --> 01:08:19,120 >> THANK YOU FOR INVITING ME TO 1615 01:08:19,120 --> 01:08:27,960 TALK TODAY. 1616 01:08:27,960 --> 01:08:33,520 >> I'VE BEEN GIVEN A LARGE TOPIC 1617 01:08:33,520 --> 01:08:34,920 ON HEALTH AND ECONOMIC SYSTEMS 1618 01:08:34,920 --> 01:08:35,920 IN 12 MINUTES. 1619 01:08:35,920 --> 01:08:41,320 I'LL BRIEFLY TOUCH ON A FEW 1620 01:08:41,320 --> 01:08:43,560 IMPORTANT TOPICS AT THE END GIVE 1621 01:08:43,560 --> 01:08:46,720 YOU THOUGHTS ON RESEARCH 1622 01:08:46,720 --> 01:08:47,000 CONSTRUCTS. 1623 01:08:47,000 --> 01:08:48,560 I THINK ABOUT THIS THROUGH THE 1624 01:08:48,560 --> 01:08:56,560 LENS OF FOOD INSECURITY. 1625 01:08:56,560 --> 01:08:59,320 THE 20 NUMBERS FROM THE USDA 1626 01:08:59,320 --> 01:09:02,400 SHOW OVERALL IN THE U.S., FOOD 1627 01:09:02,400 --> 01:09:05,720 INSECURITY NUMBERS DID NOT 1628 01:09:05,720 --> 01:09:07,360 INCREASE BETWEEN DECEMBER 19 AND 1629 01:09:07,360 --> 01:09:08,320 DECEMBER 2020 IN THE MIDST OF 1630 01:09:08,320 --> 01:09:15,480 THE PANDEMIC. 1631 01:09:15,480 --> 01:09:16,920 A LOT OF THE POLICIES PUT IN 1632 01:09:16,920 --> 01:09:18,160 PLACE TO ADDRESS ECONOMIC 1633 01:09:18,160 --> 01:09:19,800 INSECURITY AND FOOD INSECURITY 1634 01:09:19,800 --> 01:09:21,440 WERE IMPACTFUL AND I THINK 1635 01:09:21,440 --> 01:09:23,120 THERE'S IMPORTANT LESSONS THERE. 1636 01:09:23,120 --> 01:09:27,400 THERE'S ALSO AN IMPORTANT LESSON 1637 01:09:27,400 --> 01:09:29,440 IN THE FACT THAT CHILD FOOD 1638 01:09:29,440 --> 01:09:34,560 INSECURITY TICKED UP AND I THINK 1639 01:09:34,560 --> 01:09:39,760 THAT IT EMPHASIZED THE HOUSEHOLD 1640 01:09:39,760 --> 01:09:44,080 IS AND HOW QUICKLY CHILDREN ARE 1641 01:09:44,080 --> 01:09:46,320 IMPACTED BY ECONOMIC AND INCOME 1642 01:09:46,320 --> 01:09:46,880 CHANGE. 1643 01:09:46,880 --> 01:09:54,400 THE SMALL INCREASES IN FOOD 1644 01:09:54,400 --> 01:09:56,280 INSECURITY ARE LARGER IN BLACK 1645 01:09:56,280 --> 01:10:01,000 AND BROWN HOUSEHOLDS AND THIS IS 1646 01:10:01,000 --> 01:10:03,760 A RECURRENT PATTERN WHERE 1647 01:10:03,760 --> 01:10:07,920 THEY'RE MORE SENSITIVE TO 1648 01:10:07,920 --> 01:10:12,600 ECONOMIC SHOCKS. 1649 01:10:12,600 --> 01:10:16,120 I'M A PHYSICIAN BY TRAINING. 1650 01:10:16,120 --> 01:10:19,160 I WANT TO EMPHASIZE ADVERSE 1651 01:10:19,160 --> 01:10:20,280 HEALTH OUTCOMES AMONG CHILDREN 1652 01:10:20,280 --> 01:10:25,800 AND I LISTED A NUMBER HERE. 1653 01:10:25,800 --> 01:10:26,680 WHAT IS INTERESTING IS ABOUT 1654 01:10:26,680 --> 01:10:29,200 THESE ARE TWO THINGS. 1655 01:10:29,200 --> 01:10:32,160 NUMBER ONE, EVEN VERY LOW LEVELS 1656 01:10:32,160 --> 01:10:35,080 OF FOOD INSECURITY WHAT WE CALL 1657 01:10:35,080 --> 01:10:36,920 MARGINAL FOOD INSECURITY IS 1658 01:10:36,920 --> 01:10:38,200 ASSOCIATED WITH POORER HEALTH 1659 01:10:38,200 --> 01:10:39,320 AMONG CHILDREN. 1660 01:10:39,320 --> 01:10:43,440 IT'S IMPORTANT THAT WE PREVENT 1661 01:10:43,440 --> 01:10:45,320 FOOT INSECURITY IN HOUSEHOLDS 1662 01:10:45,320 --> 01:10:46,880 AND EMPHASIZE THE RELATIONSHIPS 1663 01:10:46,880 --> 01:10:50,560 DON'T ONLY OCCUR BECAUSE OF 1664 01:10:50,560 --> 01:10:53,640 CHANGES IN DIETARY CHANGES. 1665 01:10:53,640 --> 01:10:55,440 IF WE LOOK AT THE ENTIRE 1666 01:10:55,440 --> 01:10:59,040 LITERATURE OF DIETARY INTAKE WE 1667 01:10:59,040 --> 01:11:01,400 SEE AN EXAMPLE FROM THIS 1668 01:11:01,400 --> 01:11:02,360 SYSTEMATIC REVIEW. 1669 01:11:02,360 --> 01:11:05,080 EACH DOT REPRESENTS A STUDY AND 1670 01:11:05,080 --> 01:11:08,680 THE STUDIES IF THE RED BOX 1671 01:11:08,680 --> 01:11:12,760 SHOWED AN ADVERSE IMPACT ON THE 1672 01:11:12,760 --> 01:11:14,920 NUTRIENT ARE, MACRO NUTRIENT 1673 01:11:14,920 --> 01:11:25,400 ASSOCIATED WITH FOOD INSECURITY. 1674 01:11:25,400 --> 01:11:27,520 THERE'S MANY OTHER PATHWAYS THAT 1675 01:11:27,520 --> 01:11:29,960 LINK FOOD INSECURITY TO POOR 1676 01:11:29,960 --> 01:11:30,960 HEALTH INCLUDING AMONG 1677 01:11:30,960 --> 01:11:32,240 HOUSEHOLDS WITH CHILDREN AND I 1678 01:11:32,240 --> 01:11:35,320 THINK IT'S IMPORTANT WE TAKE A 1679 01:11:35,320 --> 01:11:38,080 10,000 FOOT VIEW OF THIS AND 1680 01:11:38,080 --> 01:11:42,440 DON'T ONLY THINK OF DIETARY 1681 01:11:42,440 --> 01:11:46,480 INTAKE AS THE MECHANISM FOR 1682 01:11:46,480 --> 01:11:48,840 IMPACTING CHILDHOOD HEALTH AND 1683 01:11:48,840 --> 01:11:49,520 LONG-TERM OUTCOMES. 1684 01:11:49,520 --> 01:11:50,960 WITH THAT IN MIND I WANT TO GIVE 1685 01:11:50,960 --> 01:11:56,680 YOU THE LIST OF THINGS I THINK 1686 01:11:56,680 --> 01:12:02,440 HAVE AND THERE'S A POLICY 1687 01:12:02,440 --> 01:12:04,280 APPROACH IN THE U.S. AND 1688 01:12:04,280 --> 01:12:09,520 DECREASED RATES OF FOOD 1689 01:12:09,520 --> 01:12:12,920 ENSECURITY. 1690 01:12:12,920 --> 01:12:14,920 THEY INCLUDE SNAP, THE EARNED 1691 01:12:14,920 --> 01:12:18,320 INCOME TAX CREDIT, SCHOOL 1692 01:12:18,320 --> 01:12:21,440 BREAKFAST AND LUNCH PROGRAMS AND 1693 01:12:21,440 --> 01:12:24,040 WIC AND POLICIES FOR LOW-INCOME 1694 01:12:24,040 --> 01:12:24,320 HOUSEHOLDS. 1695 01:12:24,320 --> 01:12:36,360 THESE I THINK ARE CLEAR. 1696 01:12:36,360 --> 01:12:39,520 I THINK HAVE AN A SINGLE STUDY 1697 01:12:39,520 --> 01:12:46,320 OR OBSERVATIONAL STUDIES AND 1698 01:12:46,320 --> 01:12:47,880 THERE'S FOOD SERVICES AND THE 1699 01:12:47,880 --> 01:12:50,280 ADULT AND CHILD FOOD PROGRAM AND 1700 01:12:50,280 --> 01:12:54,000 FOOD THAT COMES FROM A NETWORK 1701 01:12:54,000 --> 01:13:01,640 OF FOOD BANKS AND PANTRIES AND 1702 01:13:01,640 --> 01:13:04,000 MEDICAID EXPANSION AND OTHER 1703 01:13:04,000 --> 01:13:05,840 PROGRAMS THAT WHICH ALLOW PEOPLE 1704 01:13:05,840 --> 01:13:08,240 TO SPEND MORE ON FOOD. 1705 01:13:08,240 --> 01:13:10,680 CASH TRANSFERS, WHICH ARE 1706 01:13:10,680 --> 01:13:12,120 GETTING INCREASED AND HOUSING 1707 01:13:12,120 --> 01:13:13,640 SUBSIDIES AND THEN I'LL TALK FOR 1708 01:13:13,640 --> 01:13:26,880 A MINUTE ABOUT FOOD AS MEDICINE. 1709 01:13:26,880 --> 01:13:28,880 WE LOOKED AT THE HEALTH OUTCOMES 1710 01:13:28,880 --> 01:13:30,560 AND OBESITY RATES IN THE 1711 01:13:30,560 --> 01:13:31,400 LONG-TERM. 1712 01:13:31,400 --> 01:13:36,520 THIS STUDY LOOKED AT THE ROLL 1713 01:13:36,520 --> 01:13:38,120 OUT AND LOOKED AT THE SNAP 1714 01:13:38,120 --> 01:13:39,840 PROGRAM IN THE 1970s AND 1715 01:13:39,840 --> 01:13:41,920 CHILDREN WHO HAD ACCESS TO SNAP 1716 01:13:41,920 --> 01:13:47,320 AND DIDN'T AND LOOKED AT THEIR 1717 01:13:47,320 --> 01:13:49,040 SNAP AVAILABILITY IN YOUR COUNTY 1718 01:13:49,040 --> 01:13:51,600 AS A CHILD HAD SIGNIFICANT 1719 01:13:51,600 --> 01:13:54,800 IMPACTS ON OBESITY RATES IN 1720 01:13:54,800 --> 01:13:59,960 ADULTHOOD AND POSITIVE AFFECTS 1721 01:13:59,960 --> 01:14:05,840 ON HIGH SCHOOL COMPLETION I WANT 1722 01:14:05,840 --> 01:14:07,600 TO MENTION FOOD MEDICINE 1723 01:14:07,600 --> 01:14:11,360 APPROACHES BECAUSE INCREASINGLY 1724 01:14:11,360 --> 01:14:12,840 IT WILL BE A SECTOR WHERE 1725 01:14:12,840 --> 01:14:14,960 CHILDREN ACCESS FOOD BUT NOT A 1726 01:14:14,960 --> 01:14:16,360 SECTOR WE TRADITIONALLY THINK OF 1727 01:14:16,360 --> 01:14:19,760 BEING ACCESS. 1728 01:14:19,760 --> 01:14:22,120 FOOD AS MEDICINE HAS BEEN 1729 01:14:22,120 --> 01:14:23,920 DEFINED AS THE INTEGRATION OF 1730 01:14:23,920 --> 01:14:25,760 THE FOOD AND NUTRITION 1731 01:14:25,760 --> 01:14:26,920 INTERVENTION IN CLOSE 1732 01:14:26,920 --> 01:14:27,720 COLLABORATION WITH THE HEALTH 1733 01:14:27,720 --> 01:14:29,160 CARE SYSTEM. 1734 01:14:29,160 --> 01:14:31,840 OFTEN, PARTICULARLY IN PEDIATRIC 1735 01:14:31,840 --> 01:14:33,720 POPULATIONS THE FOOD AS MEDICINE 1736 01:14:33,720 --> 01:14:35,000 INTERVENTIONS TARGET PEOPLE AT 1737 01:14:35,000 --> 01:14:43,920 HIGH RISK OF FOOD INSECURITY. 1738 01:14:43,920 --> 01:14:45,800 I WANTED TO CALL ATTENTION TO A 1739 01:14:45,800 --> 01:14:47,080 COUPLE PROGRAMS I THINK ARE 1740 01:14:47,080 --> 01:14:49,040 GAINING MOMENTUM PARTICULARLY IN 1741 01:14:49,040 --> 01:14:51,040 PEDIATRIC POPULATIONS. 1742 01:14:51,040 --> 01:14:54,320 AND THOSE WOULD BE THINGS LIKE 1743 01:14:54,320 --> 01:14:57,680 PRODUCE DESCRIPTION WHERE THE 1744 01:14:57,680 --> 01:15:00,520 PEDIATRICIAN OFFERS A DEBIT CARD 1745 01:15:00,520 --> 01:15:03,720 TO PURCHASE FRUITS AND 1746 01:15:03,720 --> 01:15:04,720 VEGETABLES, AND THERE'S EXAMPLES 1747 01:15:04,720 --> 01:15:07,200 OF MEDICALLY TAILORED GROCERIES 1748 01:15:07,200 --> 01:15:10,120 WHERE ARE HOUSEHOLDS TAKE HOME A 1749 01:15:10,120 --> 01:15:12,920 HEALTHY BAG OF GROCERIES. 1750 01:15:12,920 --> 01:15:15,120 AND THERE ARE ALSO MANY EXAMPLES 1751 01:15:15,120 --> 01:15:17,960 NOW OF HAVING PEOPLE ENROLLED 1752 01:15:17,960 --> 01:15:20,960 IN -- EMBEDDED IN HEALTH CARE 1753 01:15:20,960 --> 01:15:24,400 SYSTEMS TO HELP FAMILIES ENROLL 1754 01:15:24,400 --> 01:15:25,920 IN FEDERAL NUTRITION PROGRAMS 1755 01:15:25,920 --> 01:15:28,520 AND CLINICAL REFERRALS FROM THE 1756 01:15:28,520 --> 01:15:30,760 HEALTH CARE SECTOR ARE ALSO 1757 01:15:30,760 --> 01:15:46,240 CONSIDERED FOOD AS MEDICINE. 1758 01:15:46,240 --> 01:15:48,520 THIS CONCEPTUALIZE THE PROB AS 1759 01:15:48,520 --> 01:15:51,320 BEING LACK OF ACCESS TO 1760 01:15:51,320 --> 01:15:53,320 NUTRITION OPPOSED TO FOOD 1761 01:15:53,320 --> 01:15:55,800 INSECURITY WHICH MAY BE MORE 1762 01:15:55,800 --> 01:16:00,120 BROADLY UNDERSTOOD AS ACCESS TO 1763 01:16:00,120 --> 01:16:00,760 CALORIES WHICH IS FOOD 1764 01:16:00,760 --> 01:16:10,720 INSECURITY AS WELL. 1765 01:16:10,720 --> 01:16:13,440 THERE'S PHYSICAL AND SOCIAL, 1766 01:16:13,440 --> 01:16:16,000 ECONOMIC ASPECT TO FOOD MEETING 1767 01:16:16,000 --> 01:16:17,520 DIETARY NEEDS AND PREFERENCES 1768 01:16:17,520 --> 01:16:20,280 FOR AN ACTIVE HEALTHY LIFESTYLE. 1769 01:16:20,280 --> 01:16:24,120 THIS IS CONCEPTUALLY WHERE 1770 01:16:24,120 --> 01:16:25,800 PEOPLE ARE GOING WITH THE 1771 01:16:25,800 --> 01:16:28,080 NUTRITION INSECURITY MEASURE. 1772 01:16:28,080 --> 01:16:29,800 I THINK THERE'S LOTS OF 1773 01:16:29,800 --> 01:16:32,520 ADVANTAGES TO MAINTAINING FOOD 1774 01:16:32,520 --> 01:16:34,720 INSECURITY IN THE CONSTRUCT. 1775 01:16:34,720 --> 01:16:39,040 WE HAD MANY USE OF SURVEILLANCE 1776 01:16:39,040 --> 01:16:40,760 DATA AND PRETTY MATURE 1777 01:16:40,760 --> 01:16:42,680 LITERATURE ON THE DRIVERS AND 1778 01:16:42,680 --> 01:16:43,240 IMPLICATIONS. 1779 01:16:43,240 --> 01:16:48,920 ON THE OTHER HAND, NUTRITION AND 1780 01:16:48,920 --> 01:16:56,680 SECURITY AND THIS MAYBE BETTER 1781 01:16:56,680 --> 01:16:57,680 ALIGNED WITH PUBLIC HEALTH GOALS 1782 01:16:57,680 --> 01:16:59,840 AND THE NEXT STEP IS A CENSUS 1783 01:16:59,840 --> 01:17:10,480 FOR HOW IT'S DEFINED, MEASURED. 1784 01:17:10,480 --> 01:17:13,720 AND FIRST OF ALL, FOOD 1785 01:17:13,720 --> 01:17:15,320 INSECURITY IS UNDERSTOOD AS A 1786 01:17:15,320 --> 01:17:17,040 HOUSEHOLD MEASURE AND IT'S VERY 1787 01:17:17,040 --> 01:17:20,040 CONSISTENTLY DEFINED AND 1788 01:17:20,040 --> 01:17:23,680 MEASURED AND FOR SURVEILLANCE 1789 01:17:23,680 --> 01:17:26,320 STUDIES THE APPROPRIATE ITEM IS 1790 01:17:26,320 --> 01:17:30,760 THE HUNGER VITAL SIGN. 1791 01:17:30,760 --> 01:17:32,240 IT'S NOT CLEAR HOW IT'S TO BE 1792 01:17:32,240 --> 01:17:33,680 MEASURED BUT I THINK IT NEEDS TO 1793 01:17:33,680 --> 01:17:38,760 BE MEASURED AT THE INDIVIDUAL 1794 01:17:38,760 --> 01:17:41,160 LEVELS IN LOOKING AT NUTRIENT 1795 01:17:41,160 --> 01:17:43,600 NEEDS BUT THERE'S THOUGHTS OF 1796 01:17:43,600 --> 01:17:44,680 COMBINING MEASURES OF FOOD 1797 01:17:44,680 --> 01:17:47,280 INSECURITY AND DIETARY INTAKE TO 1798 01:17:47,280 --> 01:17:49,520 COME UP WITH SOME MEASURE OF 1799 01:17:49,520 --> 01:17:49,840 NUTRITION. 1800 01:17:49,840 --> 01:17:51,280 THEN THERE'S OTHER CONSTRUCTS I 1801 01:17:51,280 --> 01:17:58,960 THINK ARE WORTH THINKING ABOUT. 1802 01:17:58,960 --> 01:18:00,880 THE FIRST IS WHETHER THERE'S 1803 01:18:00,880 --> 01:18:02,560 SNAP AND SCHOOL LUNCH AND EITC 1804 01:18:02,560 --> 01:18:09,320 AND THE OTHER IS LOOKING AT 1805 01:18:09,320 --> 01:18:10,320 ENVIRONMENTAL OR OVERALL COUNTRY 1806 01:18:10,320 --> 01:18:13,520 WIDE ACCESS AND REACH OF PROVEN 1807 01:18:13,520 --> 01:18:16,080 PROGRAMS LIKE SNAP AND CITC AND 1808 01:18:16,080 --> 01:18:17,480 WHO IS UTILIZING THE PROGRAMS 1809 01:18:17,480 --> 01:18:19,200 AND WHO ISN'T ABLE TO UTILIZE 1810 01:18:19,200 --> 01:18:20,320 THE PROGRAMS. 1811 01:18:20,320 --> 01:18:22,160 HOW ARE THEY BEING SUPPORTED IN 1812 01:18:22,160 --> 01:18:23,600 THEIR COMMUNITIES THROUGH 1813 01:18:23,600 --> 01:18:24,680 IMPLEMENT AND MAINTENANCE 1814 01:18:24,680 --> 01:18:26,280 STRATEGIES AND FINALLY 1815 01:18:26,280 --> 01:18:28,400 PARTICULARLY IMPORTANT FOR 1816 01:18:28,400 --> 01:18:29,680 HOUSEHOLDS WITH CHILDREN IS HOW 1817 01:18:29,680 --> 01:18:32,200 WELL DOES THE STATE SUPPORT 1818 01:18:32,200 --> 01:18:36,080 ENROLLMENT IN MULTIPLE PROGRAMS 1819 01:18:36,080 --> 01:18:58,600 SIMULTANEOUSLY BECAUSE THE 1820 01:18:58,600 --> 01:18:59,120 BEARC 1821 01:18:59,120 --> 01:18:59,640 BUREAUCRATIC ISSUES HAVE 1822 01:18:59,640 --> 01:19:04,440 DIFFICULT. 1823 01:19:04,440 --> 01:19:11,520 >> IT'S NOT EASY TO AND ACCESS 1824 01:19:11,520 --> 01:19:21,880 SOME PROGRAMS YOU TALK ABOUT. 1825 01:19:21,880 --> 01:19:23,880 THE ISSUE IS BEING FOOD 1826 01:19:23,880 --> 01:19:25,840 INSECURITY IS AMAZING WE HAVE IN 1827 01:19:25,840 --> 01:19:29,120 THIS COUNTRY AND CERTAINLY 1828 01:19:29,120 --> 01:19:29,400 GLOBALLY. 1829 01:19:29,400 --> 01:19:39,920 DAN, DO YOU HAVE A QUESTION? 1830 01:19:39,920 --> 01:19:42,320 >> I HAVE TWO QUESTIONS IN 1831 01:19:42,320 --> 01:19:47,320 REGARD TO THE IMPACT OF CLIMATE 1832 01:19:47,320 --> 01:19:49,480 AND WONDER IF YOU HAVE DATA AND 1833 01:19:49,480 --> 01:19:55,640 WE TALKED ABOUT COVID'S IMPACT 1834 01:19:55,640 --> 01:19:58,280 AND IT DOES NOT CHANGE FOOD YIP 1835 01:19:58,280 --> 01:20:01,120 SECURITY BUT WE HAVE RAMPANT 1836 01:20:01,120 --> 01:20:03,240 FOOD INSECURITY NONETHELESS AND 1837 01:20:03,240 --> 01:20:04,920 CLIMATE GLOBALLY HAS BEEN 1838 01:20:04,920 --> 01:20:06,080 IDENTIFIED AS A MAJOR 1839 01:20:06,080 --> 01:20:10,240 CONTRIBUTOR TO HUNGER GLOBALLY 1840 01:20:10,240 --> 01:20:12,600 AND LEADS TO THE DEFINITION OF 1841 01:20:12,600 --> 01:20:17,440 FOOD INSECURITY WHEN YOU COMBINE 1842 01:20:17,440 --> 01:20:18,840 HUNGER AND FOOD INSECURITY AND A 1843 01:20:18,840 --> 01:20:21,600 REFLECTION OF CALORIE VERSUS 1844 01:20:21,600 --> 01:20:24,240 FOOD. 1845 01:20:24,240 --> 01:20:25,520 CAN YOU COMMENT ON THE 1846 01:20:25,520 --> 01:20:27,120 DIFFERENCE BETWEEN HUNGER AND 1847 01:20:27,120 --> 01:20:28,520 FOOD INSECURITY? 1848 01:20:28,520 --> 01:20:29,680 HUNGER IS INCREASING GLOBALLY 1849 01:20:29,680 --> 01:20:31,560 AND THE TWO PRIMARY COMPONENTS 1850 01:20:31,560 --> 01:20:37,920 OF THAT ACCORDING TO WHO IS 1851 01:20:37,920 --> 01:20:41,320 CONFLICT AND CLIMATE CHANGE. 1852 01:20:41,320 --> 01:20:43,320 ALSO, SPEAK ON THE IMPACT OF 1853 01:20:43,320 --> 01:20:43,680 CLIMATE. 1854 01:20:43,680 --> 01:20:46,520 >> LET ME START BY THE IMPACT OF 1855 01:20:46,520 --> 01:20:52,360 CLIMB -- CLIMATE CHANGE. 1856 01:20:52,360 --> 01:20:53,560 >> WE HAVE LOOKED AT FOOD 1857 01:20:53,560 --> 01:20:54,560 INSECURITY AND CLIMATE CHANGE. 1858 01:20:54,560 --> 01:20:56,440 WE HAVE DONE A LESS GOOD JOB I 1859 01:20:56,440 --> 01:20:57,320 THINK IN THE UNITED STATES 1860 01:20:57,320 --> 01:21:00,920 UNDERSTANDING THIS. 1861 01:21:00,920 --> 01:21:03,800 I THINK WE HAVE BEEN FORTUNATE 1862 01:21:03,800 --> 01:21:05,680 TO NOT THINK ABOUT IT FOR A LONG 1863 01:21:05,680 --> 01:21:06,800 TIME AND SUPPLY CHAIN 1864 01:21:06,800 --> 01:21:08,240 DISRUPTIONS IN THE U.S. AS PART 1865 01:21:08,240 --> 01:21:10,240 OF THE PANDEMIC HAVE I THINK 1866 01:21:10,240 --> 01:21:11,800 MADE MANY MORE PEOPLE REALIZE 1867 01:21:11,800 --> 01:21:14,040 HOW VUL FESHL OUR FOOD SYSTEM IS 1868 01:21:14,040 --> 01:21:20,120 AND THE EXTENT TO WHICH FOOD 1869 01:21:20,120 --> 01:21:22,040 INSECURE HOUSEHOLDS WILL BEAR 1870 01:21:22,040 --> 01:21:23,560 THE BRUNT OF CLIMATE CHANGE 1871 01:21:23,560 --> 01:21:23,880 INEQUITIES. 1872 01:21:23,880 --> 01:21:26,840 HOW WE UNDERSTAND THAT IN THE 1873 01:21:26,840 --> 01:21:28,600 CONTEXT OF FOOD INSECURITY IN 1874 01:21:28,600 --> 01:21:30,160 THE U.S. IS NOT WELL UNDERSTOOD 1875 01:21:30,160 --> 01:21:32,840 AT THIS POINT AND WE NEED MORE 1876 01:21:32,840 --> 01:21:34,760 INTERDISCIPLINARY RESEARCH ARERS 1877 01:21:34,760 --> 01:21:37,040 TO HELP THE FIELD BETTER ADDRESS 1878 01:21:37,040 --> 01:21:37,240 THAT. 1879 01:21:37,240 --> 01:21:38,600 THAT'S MY PERSONAL OPINION. 1880 01:21:38,600 --> 01:21:43,880 YOUR SECOND QUESTION IS ABOUT 1881 01:21:43,880 --> 01:21:46,360 HUNGER AND FOOD INSECURITY THERE 1882 01:21:46,360 --> 01:21:51,000 ARE OFFICIAL DEFINITIONS IN THE 1883 01:21:51,000 --> 01:21:53,280 DOUBLE SPACE BUT I'LL GIVE MY 1884 01:21:53,280 --> 01:21:54,720 OWN THOUGHTS WHY YOU GIVE FOOD 1885 01:21:54,720 --> 01:21:56,120 INSECURITY IN THIS CONTEXT. 1886 01:21:56,120 --> 01:21:58,880 I THINK OF THE TERM HUNGER AS 1887 01:21:58,880 --> 01:22:03,880 BEING A PHYSICAL SENSATION THAT 1888 01:22:03,880 --> 01:22:05,680 EVERYBODY EXPERIENCES WHEN THEY 1889 01:22:05,680 --> 01:22:09,680 LACK ACCESS TOED TO FOR ANY 1890 01:22:09,680 --> 01:22:09,920 REASON. 1891 01:22:09,920 --> 01:22:17,480 THE CONTEXT IT'S NOT THE FEELING 1892 01:22:17,480 --> 01:22:21,320 OF HUNGER, IT'S THE COPING 1893 01:22:21,320 --> 01:22:23,320 STRATEGIES PEOPLE ARE FORCED IT 1894 01:22:23,320 --> 01:22:25,040 USE IN ORDER TO AVOID THE 1895 01:22:25,040 --> 01:22:27,120 PHYSICAL SENSATION OF HUNGER. 1896 01:22:27,120 --> 01:22:31,280 CHANGING DIETARY INTAKE TO LESS 1897 01:22:31,280 --> 01:22:33,400 EXPENSIVE FOOD AND BINGE EATING 1898 01:22:33,400 --> 01:22:35,680 IN ANTICIPATION OF AN UPCOMING 1899 01:22:35,680 --> 01:22:36,760 FOOD SHORTAGE. 1900 01:22:36,760 --> 01:22:38,520 CONCENTRATING DIETARY INTAKE ON 1901 01:22:38,520 --> 01:22:40,080 A SMALL VARIETY OF FOODS. 1902 01:22:40,080 --> 01:22:41,920 THESE COPING STRATEGIES ARE 1903 01:22:41,920 --> 01:22:42,920 ADAPTIVE IN THE SHORT TERM AND 1904 01:22:42,920 --> 01:22:44,920 KEEP YOU FROM GOING HUNGRY BUT 1905 01:22:44,920 --> 01:22:47,480 THEY'RE MALADAPTIVE IN THE LONG 1906 01:22:47,480 --> 01:22:49,320 TERM BECAUSE THESE ARE THE 1907 01:22:49,320 --> 01:22:50,480 PATTERNS THAT EXPOSE PEOPLE TO 1908 01:22:50,480 --> 01:22:52,120 CHRONIC DISEASE. 1909 01:22:52,120 --> 01:22:54,320 ONE WAY I PERSONALLY LIKE THINK 1910 01:22:54,320 --> 01:22:55,840 ABOUT FOOD INSECURITY IS HUNGER 1911 01:22:55,840 --> 01:22:57,480 AND THE COPING STRATEGIES THAT 1912 01:22:57,480 --> 01:22:59,080 HOUSEHOLDS ENGAGE IN ORDER TO 1913 01:22:59,080 --> 01:23:01,560 AVOID THE PHYSICAL SENSATION OF 1914 01:23:01,560 --> 01:23:03,240 HUNGER, I PUT THOSE UNDER THE 1915 01:23:03,240 --> 01:23:14,920 UMBRELLA OF FOOD INSECURITY. 1916 01:23:14,920 --> 01:23:16,920 >> VERY COMPREHENSIVE RESPONSE. 1917 01:23:16,920 --> 01:23:19,600 >> CHRISTINE DO YOU HAVE A 1918 01:23:19,600 --> 01:23:19,920 QUESTION? 1919 01:23:19,920 --> 01:23:21,320 >> ONLY IF THERE AREN'T OTHERS. 1920 01:23:21,320 --> 01:23:32,680 THANKS, HILARY. 1921 01:23:32,680 --> 01:23:33,560 THERE'S TALK ABOUT ADOPTION AND 1922 01:23:33,560 --> 01:23:39,240 THE ABILITY TO MAINTAIN 1923 01:23:39,240 --> 01:23:40,800 PARTICIPATION IN THE PROGRAMS 1924 01:23:40,800 --> 01:23:42,520 YOU MIGHT KNOW THIS IS FOCUSSED 1925 01:23:42,520 --> 01:23:44,320 ON TRANSLATION AND 1926 01:23:44,320 --> 01:23:44,680 IMPLEMENTATION. 1927 01:23:44,680 --> 01:23:46,800 CAN YOU TALK ABOUT THE FACTORS 1928 01:23:46,800 --> 01:23:50,160 YOU'VE STUDIED OR RUN ARE INTO 1929 01:23:50,160 --> 01:23:51,120 WITH RESPECT TO DIFFERENTIAL 1930 01:23:51,120 --> 01:23:53,320 ADOPTION WHEN YOU LOOK AT THE 1931 01:23:53,320 --> 01:23:54,040 STRATIFICATION OF A POPULATION 1932 01:23:54,040 --> 01:23:59,200 AND WHAT WE CAN DO ABOUT THAT. 1933 01:23:59,200 --> 01:24:00,480 >> FIRST OF ALL, THANK YOU FOR 1934 01:24:00,480 --> 01:24:01,600 CALLING THAT OUT BECAUSE IT'S 1935 01:24:01,600 --> 01:24:03,600 IMPORTANT THE AVAILABILITY OF A 1936 01:24:03,600 --> 01:24:04,920 PROGRAM DOES NOT MEAN PEOPLE IN 1937 01:24:04,920 --> 01:24:10,360 THE COMMUNITY ARE ABLE TO ACCESS 1938 01:24:10,360 --> 01:24:13,280 IT AND I GIVE EXAMPLES OF THE 1939 01:24:13,280 --> 01:24:14,800 WAY I'VE SEEN THIS SHOW UP. 1940 01:24:14,800 --> 01:24:16,680 THERE'S ENORMOUS VARIABILITY 1941 01:24:16,680 --> 01:24:18,440 ACROSS STATES IN THE PERCENTAGE 1942 01:24:18,440 --> 01:24:21,240 OF PEOPLE ENROLLED AND WHEN YOU 1943 01:24:21,240 --> 01:24:25,920 ASK PEOPLE ABOUT THEIR 1944 01:24:25,920 --> 01:24:26,800 EXPERIENCES IN THE ENROLLMENT 1945 01:24:26,800 --> 01:24:30,320 OFFICE , A LOT OF WHAT COMES 1946 01:24:30,320 --> 01:24:31,880 THROUGH IS THE APPROACH IN SOME 1947 01:24:31,880 --> 01:24:34,040 OFFICES IS I WANT TO GET 1948 01:24:34,040 --> 01:24:35,160 EVERYBODY IN MY STATE ENROLLED 1949 01:24:35,160 --> 01:24:39,440 WHO IS ELIGIBLE FOR THIS PROGRAM 1950 01:24:39,440 --> 01:24:40,840 BECAUSE THIS PROGRAM IS FOR YOU 1951 01:24:40,840 --> 01:24:42,400 AND IN OTHER OFFICES THE 1952 01:24:42,400 --> 01:24:44,680 APPROACH SEEMS TO BE MORE ALONG 1953 01:24:44,680 --> 01:24:46,120 THE LINES OF I NEED TO FIND A 1954 01:24:46,120 --> 01:24:49,040 WAY TO KEEP YOU OUT OF THIS 1955 01:24:49,040 --> 01:24:49,280 PROGRAM. 1956 01:24:49,280 --> 01:24:51,520 AND THAT APPROACH -- THAT 1957 01:24:51,520 --> 01:24:53,920 DIFFERENCE IN APPROACH SEEMS TO 1958 01:24:53,920 --> 01:24:55,800 BE A VERY PROFOUND DRIVER WHEN 1959 01:24:55,800 --> 01:24:58,680 WE TALK TO COMMUNITY MEMBERS 1960 01:24:58,680 --> 01:25:00,440 AROUND WHETHER PEOPLE ARE 1961 01:25:00,440 --> 01:25:02,200 ACTUALLY COMPLETING THE PROCESS 1962 01:25:02,200 --> 01:25:04,040 FOR SNAP OR WIC OR WHATEVER 1963 01:25:04,040 --> 01:25:04,320 ELSE. 1964 01:25:04,320 --> 01:25:07,440 IT IS THE CULTURE AND THE 1965 01:25:07,440 --> 01:25:09,280 OFFICE. 1966 01:25:09,280 --> 01:25:12,160 IT'S THE BUREAUCRATIC HURDLES 1967 01:25:12,160 --> 01:25:15,120 AND THE COMMUNITY FEELING AND 1968 01:25:15,120 --> 01:25:17,400 STIGMA AND ALL INCLUDING USDA 1969 01:25:17,400 --> 01:25:21,400 OVER THE HAS DEVOTED TIME AND 1970 01:25:21,400 --> 01:25:22,960 ATTENTION TO BUT WE NEED THOSE 1971 01:25:22,960 --> 01:25:25,240 ON THE GROUND APPROACHES TOO SO 1972 01:25:25,240 --> 01:25:27,800 MAKE SURE THE CHANGES AND 1973 01:25:27,800 --> 01:25:29,080 ADVANCEMENTS AND ADOPTION 1974 01:25:29,080 --> 01:25:29,760 STRATEGIES ARE REACHING THE 1975 01:25:29,760 --> 01:25:39,000 PEOPLE WHO ARE ELIGIBLE. 1976 01:25:39,000 --> 01:25:41,960 >> THANK YOU, THIS IS WHERE I 1977 01:25:41,960 --> 01:25:44,680 THOUGHT ABOUT THE MESSAGES 1978 01:25:44,680 --> 01:25:46,400 AROUND ADOPTION BUT NEGATIVE 1979 01:25:46,400 --> 01:25:47,520 MESSAGES TRAVEL AS FAST IF NOT 1980 01:25:47,520 --> 01:25:48,360 FASTER. 1981 01:25:48,360 --> 01:26:01,760 >> EXACTLY. 1982 01:26:01,760 --> 01:26:04,240 >> I CAN'T HELP BUT THINKING OF 1983 01:26:04,240 --> 01:26:06,080 THE WHOLE APPROACH AND THE 1984 01:26:06,080 --> 01:26:12,200 NEGATIVE ASPECTS IN SOME 1985 01:26:12,200 --> 01:26:17,520 COMMUNITIES YOU TALK ABOUT ARE 1986 01:26:17,520 --> 01:26:22,720 THERE AND HOW TO SO JUST MAKING 1987 01:26:22,720 --> 01:26:28,600 A POLICY AVAILABLE BUT MAKE IT 1988 01:26:28,600 --> 01:26:36,600 ACCESSIBLE IS A MORE COMPLICATED 1989 01:26:36,600 --> 01:26:38,560 ISSUE THAN WE REALIZE. 1990 01:26:38,560 --> 01:26:40,160 THIS IS AMAZING. 1991 01:26:40,160 --> 01:26:41,680 I DON'T SEE OTHER QUESTIONS. 1992 01:26:41,680 --> 01:26:43,840 WE'RE ON TIME. 1993 01:26:43,840 --> 01:26:48,360 YOU FOLKS ARE INCREDIBLE. 1994 01:26:48,360 --> 01:26:49,120 WE'RE HALFWAY THROUGH THE 1995 01:26:49,120 --> 01:26:53,120 SESSION AND HAVE A FIVE-MINUTE 1996 01:26:53,120 --> 01:26:55,000 BREAK 1997 01:26:55,000 --> 01:27:13,720 >> WE'LL RESUME NOW. 1998 01:27:13,720 --> 01:27:15,440 >> I APPRECIATE ALL THE EARLIER 1999 01:27:15,440 --> 01:27:15,760 PRESENTATIONS. 2000 01:27:15,760 --> 01:27:17,880 THEY WERE OUTSTANDING. 2001 01:27:17,880 --> 01:27:22,280 I WANT TO STEP BACK AND TAKE THE 2002 01:27:22,280 --> 01:27:23,040 BROADEST POSSIBLE PERSPECTIVE. 2003 01:27:23,040 --> 01:27:26,120 THERE'S A BROAD RANGE OF CHANGES 2004 01:27:26,120 --> 01:27:30,920 GOING ON NOT JUST CLIMATE CHANGE 2005 01:27:30,920 --> 01:27:31,960 BUT OTHER CHANGES THAT WILL 2006 01:27:31,960 --> 01:27:33,640 AFFECT THE DISCUSSIONS TODAY AND 2007 01:27:33,640 --> 01:27:35,320 IN THE WORKING GROUPS. 2008 01:27:35,320 --> 01:27:41,320 THERE'S A FRAMING CALL PLANETARY 2009 01:27:41,320 --> 01:27:42,880 BOUNDARIES LOOKING AT CHANGES 2010 01:27:42,880 --> 01:27:44,280 AROUND THE WORLD AS A RESULT OF 2011 01:27:44,280 --> 01:27:49,280 HUMAN ACTIVITIES. 2012 01:27:49,280 --> 01:27:54,880 YOU CAN SEE NOTICE RED ZONE AND 2013 01:27:54,880 --> 01:27:56,600 PHOSPHORUS FROM AGRICULTURE AND 2014 01:27:56,600 --> 01:27:59,280 GENETIC DIVERSITY AND THEY'LL 2015 01:27:59,280 --> 01:28:07,520 ALL AFFECT THE QUALITY AND QUAN 2016 01:28:07,520 --> 01:28:11,360 QUANTITY OF FOOD IN THE FUTURE. 2017 01:28:11,360 --> 01:28:12,800 THIS SHOWS CHANGES IN GLOBAL 2018 01:28:12,800 --> 01:28:13,560 TEMPERATURE CHANGE FROM 1850 TO 2019 01:28:13,560 --> 01:28:19,440 2020. 2020 01:28:19,440 --> 01:28:20,160 CLEAR PATTERN. 2021 01:28:20,160 --> 01:28:21,720 WE HAVE CHANGE THE CLIMATE. 2022 01:28:21,720 --> 01:28:24,280 IT'S UNEQUIVOCAL AND THE CHANGES 2023 01:28:24,280 --> 01:28:26,440 WILL IN SOME WAYS ACCELERATE IN 2024 01:28:26,440 --> 01:28:28,680 THE COMING DECADES. 2025 01:28:28,680 --> 01:28:30,680 THE REASON I'M TALKING ABOUT 2026 01:28:30,680 --> 01:28:32,120 THIS IS THERE ARE MULTIPLE 2027 01:28:32,120 --> 01:28:34,560 ELEMENTS OF THE FOOD SYSTEM THAT 2028 01:28:34,560 --> 01:28:36,080 ARE CLIMATE SENSITIVE. 2029 01:28:36,080 --> 01:28:38,080 THIS IS NOT A COMPLETE LIST BUT 2030 01:28:38,080 --> 01:28:40,080 IT GIVES YOU A SENSE OF THE WIDE 2031 01:28:40,080 --> 01:28:42,640 RANGE OF ISSUES THAT ARE OF 2032 01:28:42,640 --> 01:28:47,880 CONCERN IN TERMS OF FOOD 2033 01:28:47,880 --> 01:28:53,640 INSECURITY AND MEASURES THAT 2034 01:28:53,640 --> 01:28:56,080 NEED TO BE TAKEN TO MAKE SURE WE 2035 01:28:56,080 --> 01:28:58,520 HAVE ADEQUATE YIELD, ACCESS AND 2036 01:28:58,520 --> 01:29:00,360 BE ABLE TO TRANSPORT OUR FOOD TO 2037 01:29:00,360 --> 01:29:08,680 THE END USE. 2038 01:29:08,680 --> 01:29:10,600 WHEN WE LOOK WORLD WIDE 65% OF 2039 01:29:10,600 --> 01:29:14,120 THE CALORIES IN THE WORLD COME 2040 01:29:14,120 --> 01:29:18,200 FROM WHEAT AND RICE. 2041 01:29:18,200 --> 01:29:23,080 THIS SHOWS INTEMPERATE AND 2042 01:29:23,080 --> 01:29:25,040 TROPICAL AREAS AND THE RED AND 2043 01:29:25,040 --> 01:29:28,720 BLUE HAVE TO DO WITH DIFFERENT 2044 01:29:28,720 --> 01:29:30,840 ASSUMPTIONS OF ADAPTATION OF OUR 2045 01:29:30,840 --> 01:29:32,280 AGRICULTURAL SYSTEMS AND IN THE 2046 01:29:32,280 --> 01:29:35,360 U.S. WE'LL MOSTLY BE FINE BUT 2047 01:29:35,360 --> 01:29:38,520 THE SMALL INCREASE OR DECREASE 2048 01:29:38,520 --> 01:29:42,880 IN WHEAT YIELDS BUT MOSTLY WE'LL 2049 01:29:42,880 --> 01:29:43,200 BE FINE. 2050 01:29:43,200 --> 01:29:45,120 WE MAY HAVE TO MOVE TO NEW 2051 01:29:45,120 --> 01:29:46,440 LOCATIONS BUT WE'LL HAVE THE 2052 01:29:46,440 --> 01:29:48,560 WEATHER PATTERNS THAT WILL BE 2053 01:29:48,560 --> 01:29:49,960 SUPPORTIVE FOR ADEQUATE WHEAT 2054 01:29:49,960 --> 01:29:50,360 YIELDS. 2055 01:29:50,360 --> 01:29:51,280 THE TROPICS ARE A COMPLETELY 2056 01:29:51,280 --> 01:29:55,640 DIFFERENT STORY. 2057 01:29:55,640 --> 01:29:57,520 ANY INCREASE IN LOCAL MAIN 2058 01:29:57,520 --> 01:30:04,880 TEMPERATURE TRULT -- RESULTS IN 2059 01:30:04,880 --> 01:30:06,120 LOWER CROP YIELD. 2060 01:30:06,120 --> 01:30:08,000 THE TWO FIGURES SHOW ON THE LEFT 2061 01:30:08,000 --> 01:30:11,960 A RANGE OF CLIMATE MODELS MAKING 2062 01:30:11,960 --> 01:30:22,680 DIFFERENT KINDS OF ASSUMPTIONS 2063 01:30:22,680 --> 01:30:25,440 AND SEE A DECLINE IN CROP YIELDS 2064 01:30:25,440 --> 01:30:27,360 AND ON THE RIGHT SHOWING THIS 2065 01:30:27,360 --> 01:30:29,040 TRANSLATES DIRECTLY TO STUNTING. 2066 01:30:29,040 --> 01:30:32,280 THE PROJECTIONS FOR STUNTING IN 2067 01:30:32,280 --> 01:30:35,880 2030 AND 2050 IRREGARDLESS OF 2068 01:30:35,880 --> 01:30:36,920 ASSUMPTIONS ABOUT DEVELOPMENT, 2069 01:30:36,920 --> 01:30:41,080 WHAT CAN HAPPEN AS WE DEVELOP 2070 01:30:41,080 --> 01:30:42,840 FURTHER, HOPEFULLY ALONG A 2071 01:30:42,840 --> 01:30:43,960 SUSTAINABLE DEVELOPMENT PATHWAY 2072 01:30:43,960 --> 01:30:45,880 WE'LL SEE AN INCREASE IN 2073 01:30:45,880 --> 01:30:46,640 STUNTING IN CHILDREN UNDER THE 2074 01:30:46,640 --> 01:30:56,080 AGE OF 5. 2075 01:30:56,080 --> 01:30:56,840 THERE'S ONE GLOBAL ASSESSMENT 2076 01:30:56,840 --> 01:30:59,360 THAT ESTIMATED MORTALITY DUE TO 2077 01:30:59,360 --> 01:31:00,880 CLIMATE CHANGE IN ABOUT 2030 2078 01:31:00,880 --> 01:31:06,880 WHICH IS VERY CLOSE NOW. 2079 01:31:06,880 --> 01:31:13,840 YOU CAN SEE THE RISKS VARY QUITE 2080 01:31:13,840 --> 01:31:15,680 A BIT WITH THE BIGGEST RISK FROM 2081 01:31:15,680 --> 01:31:16,680 UNDER NUTRITION. 2082 01:31:16,680 --> 01:31:18,840 THE EVIDENCE SINCE THEN HAS BEEN 2083 01:31:18,840 --> 01:31:20,120 GROWING THE RISK FOR UNDER 2084 01:31:20,120 --> 01:31:26,880 NUTRITION ARE VERY HIGH. 2085 01:31:26,880 --> 01:31:31,080 THIS IS FROM THE 2086 01:31:31,080 --> 01:31:32,160 INTERGOVERNMENTAL PANEL ON 2087 01:31:32,160 --> 01:31:33,320 CLIMATE CHANGE. 2088 01:31:33,320 --> 01:31:35,040 I'M NOT SURE WHY IT'S NOT 2089 01:31:35,040 --> 01:31:36,880 SHOWING AND HOPEFULLY YOU CAN 2090 01:31:36,880 --> 01:31:39,080 SEE NORTH AMERICA. 2091 01:31:39,080 --> 01:31:40,360 I HAD IT OUTLINED EARLIER BUT IT 2092 01:31:40,360 --> 01:31:48,000 DIDN'T WORK. 2093 01:31:48,000 --> 01:31:50,160 YOU CAN SEE FOOD SCARCITY 2094 01:31:50,160 --> 01:31:53,120 INCREASING IN SOME PLACES AN 2095 01:31:53,120 --> 01:31:57,400 SIMILAR WITH AGRICULTURE AND 2096 01:31:57,400 --> 01:31:59,960 CROP PRODUCTION AND THERE'S 2097 01:31:59,960 --> 01:32:04,920 LIVESTOCK AND INCREASES AND 2098 01:32:04,920 --> 01:32:06,640 DECREASES IN AQUA CULTURE AND 2099 01:32:06,640 --> 01:32:08,600 THEY HAVE IMPACTS ON HUMAN 2100 01:32:08,600 --> 01:32:19,400 HEALTH AND WELL BEING. 2101 01:32:19,400 --> 01:32:21,400 HERE'S CONCLUSIONS FROM THE 2102 01:32:21,400 --> 01:32:23,400 REPORT ON FOOD SECURITY. 2103 01:32:23,400 --> 01:32:26,800 FIRST IS PRESSURE ON FOOD 2104 01:32:26,800 --> 01:32:27,920 PRODUCTION AND ACCESS. 2105 01:32:27,920 --> 01:32:29,680 SECOND IS ABOUT THE INCREASES 2106 01:32:29,680 --> 01:32:35,040 AND FREQUENCY INTENSITY AND 2107 01:32:35,040 --> 01:32:40,040 SEVERITY OF CLIMATE CHANGE AND 2108 01:32:40,040 --> 01:32:42,160 INCREASING EVIDENCE CLIMATE IS 2109 01:32:42,160 --> 01:32:43,880 WEAKENING SOIL HEALTH AND 2110 01:32:43,880 --> 01:32:47,280 SERVICES AND INCREASING PRESSURE 2111 01:32:47,280 --> 01:32:52,120 IN DISEASES AND UNDERLYING FOOD 2112 01:32:52,120 --> 01:32:52,440 PRODUCTIVITY. 2113 01:32:52,440 --> 01:32:56,280 THERE'S LOTS OF RISK TO HEALTH 2114 01:32:56,280 --> 01:32:59,400 AND ALSO TO FOOD PRODUCTION AND 2115 01:32:59,400 --> 01:33:02,960 RELATED TO EXTREME EVENTS BUT 2116 01:33:02,960 --> 01:33:05,360 ALSO INCREASING PRESSURE FROM 2117 01:33:05,360 --> 01:33:10,960 HEAT INDUCED PRODUCTIVITY 2118 01:33:10,960 --> 01:33:11,280 LOSSES. 2119 01:33:11,280 --> 01:33:19,080 THERE'S HEALTH RISKS AND 2120 01:33:19,080 --> 01:33:20,160 SYSTEMS-BASED APPROACHES ARE 2121 01:33:20,160 --> 01:33:31,640 CRITICAL. 2122 01:33:31,640 --> 01:33:32,800 THIS IS TO SYNTHESIZE THE RISK 2123 01:33:32,800 --> 01:33:34,640 FROM A VARIETY OF SYSTEMS. 2124 01:33:34,640 --> 01:33:38,320 WHEN YOU LOOK AT THE FIGURE, THE 2125 01:33:38,320 --> 01:33:40,280 ZERO LINE IS PRE-INDUSTRIAL. 2126 01:33:40,280 --> 01:33:44,520 THE REPORT WAS PUBLISHED THROW 2127 01:33:44,520 --> 01:33:47,440 YEARS AGO AND THE TEMPERATURE 2128 01:33:47,440 --> 01:33:49,320 HAD INCREASED ABOUT ONE DEGREE 2129 01:33:49,320 --> 01:33:54,280 AND WE'RE 1.1 DEGREE 2130 01:33:54,280 --> 01:33:54,680 PRE-INDUSTRIAL. 2131 01:33:54,680 --> 01:33:57,560 THE COLORS IN THE FIGURE WHEN IN 2132 01:33:57,560 --> 01:34:00,000 WHITE SHOWS NO CHANGE IN DRY 2133 01:34:00,000 --> 01:34:01,400 LAND WATER SCARCITY. 2134 01:34:01,400 --> 01:34:03,400 WHEN IT TURNS TO YELLOW IT MEANS 2135 01:34:03,400 --> 01:34:04,560 THERE'S BEEN A CHANGE AND THE 2136 01:34:04,560 --> 01:34:09,480 CHANGE IS AT LEAST PARTIALLY 2137 01:34:09,480 --> 01:34:10,640 ATTRIBUTABLE TO CLIMATE CHANGE. 2138 01:34:10,640 --> 01:34:12,800 RED MEANS THE RISK IS HIGH AND 2139 01:34:12,800 --> 01:34:15,920 PURPLE IS VERY HIGH WITH THE 2140 01:34:15,920 --> 01:34:21,840 POSSIBILITY OF IRREVERSABILITY 2141 01:34:21,840 --> 01:34:27,280 WE CALL THEM THE FLYING M INING EMBERS 2142 01:34:27,280 --> 01:34:29,680 AND WHERE WILL WE SEE THE 2143 01:34:29,680 --> 01:34:30,560 PRESSURE POINTS SHIFT AS 2144 01:34:30,560 --> 01:34:42,600 TEMPERATURES CONTINUE TO RISE. 2145 01:34:42,600 --> 01:34:45,240 AND FOOD PRODUCTION WILL BE 2146 01:34:45,240 --> 01:34:46,760 AFFECTED SEVERELY WITH 2147 01:34:46,760 --> 01:34:53,720 ADDITIONAL COMPLOIMENT CHANGE. 2148 01:34:53,720 --> 01:35:00,680 THERE'S -- CLIMB CHANGE. 2149 01:35:00,680 --> 01:35:02,280 ON THE LEFT YOU SEE ELEMENTS 2150 01:35:02,280 --> 01:35:04,040 INCLUDED IN MANY MODELS AND ON 2151 01:35:04,040 --> 01:35:05,120 THE RIGHT SOME OF THE MANY 2152 01:35:05,120 --> 01:35:06,800 ELEMENTS NOT INCLUDED. 2153 01:35:06,800 --> 01:35:11,800 WHICH GIVES AN OVERALL SENSE 2154 01:35:11,800 --> 01:35:17,640 THAT PROBABLY THE PROJEBBPROJECTIONS 2155 01:35:17,640 --> 01:35:19,760 AND OPTIMISTIC AND THE RISK IS 2156 01:35:19,760 --> 01:35:21,440 HIGHER WITH LESS WARMING THAN 2157 01:35:21,440 --> 01:35:23,000 WHAT WE'RE PROJECTING RIGHT NOW. 2158 01:35:23,000 --> 01:35:24,880 ONE OF THE EXAMPLES IS EXTREME 2159 01:35:24,880 --> 01:35:28,280 WEATHER AND CLIMATE EVENTS. 2160 01:35:28,280 --> 01:35:32,120 THE MAP ON THE LEFT SHOWS THE 2161 01:35:32,120 --> 01:35:33,280 NUMBER OF YEARS WITH FREQUENT 2162 01:35:33,280 --> 01:35:34,680 HOD HOT DAYS AND ON THE RIGHT AN 2163 01:35:34,680 --> 01:35:39,360 EXAMPLE OF THE REDUCTION IN 2164 01:35:39,360 --> 01:35:43,040 HARVEST DURING THE 2003 EUROPEAN 2165 01:35:43,040 --> 01:35:44,880 HEATWAVE THAT KILLED ABOUT 2166 01:35:44,880 --> 01:35:51,440 70,000 PEOPLE. 2167 01:35:51,440 --> 01:35:53,880 THE OTHER ASPECT IS IT'S NOT 2168 01:35:53,880 --> 01:35:56,120 JUST EXTREME EVENTS AND 2169 01:35:56,120 --> 01:36:01,520 PRECIPITATION BUT ALSO CARBON 2170 01:36:01,520 --> 01:36:02,360 DIOXIDE ITSELF. 2171 01:36:02,360 --> 01:36:04,400 ALL PLANT HAVE MECHANISMS TO 2172 01:36:04,400 --> 01:36:07,080 TAKE CARBON DIOXIDE IN FROM THE 2173 01:36:07,080 --> 01:36:09,080 ATMOSPHERE AND BREAK IT A PART. 2174 01:36:09,080 --> 01:36:11,880 85% OF OUR PLANT USE ONE 2175 01:36:11,880 --> 01:36:12,760 PARTICULAR PATHWAY, BIO 2176 01:36:12,760 --> 01:36:14,200 CHEMISTRY OF IT MEANS IT'S 2177 01:36:14,200 --> 01:36:16,880 CALLED A C3 PATHWAY. 2178 01:36:16,880 --> 01:36:19,840 THIS INCLUDES WHEAT, RICE, 2179 01:36:19,840 --> 01:36:21,960 BARLY, POTATO, SPINACH, TREES 2180 01:36:21,960 --> 01:36:30,480 AND GRASSES. 2181 01:36:30,480 --> 01:36:33,240 WHAT HAPPENS IS THE PLANT HAS 2182 01:36:33,240 --> 01:36:34,320 MORE CARBON. 2183 01:36:34,320 --> 01:36:36,720 YOU MAY HAVE READ IN THE 2184 01:36:36,720 --> 01:36:39,440 RIGHT-WING MEDIA, CO2 IS PLANT 2185 01:36:39,440 --> 01:36:41,880 FOOD AND TRUE AND C3 PLANT ARE 2186 01:36:41,880 --> 01:36:43,880 SOMEWHAT DEFICIENT IN CARBON SO 2187 01:36:43,880 --> 01:36:45,360 WHEN THEY HAVE MORE CARBON THEY 2188 01:36:45,360 --> 01:36:46,640 DO GROW MORE. 2189 01:36:46,640 --> 01:36:49,880 THERE'S TWO CONSEQUENCES. 2190 01:36:49,880 --> 01:36:52,040 ONE, PLANT HAVE A LOT MORE 2191 01:36:52,040 --> 01:36:53,440 CARBOHYDRATES IN THEM. 2192 01:36:53,440 --> 01:36:55,440 THE OTHER IS BECAUSE YOU'RE 2193 01:36:55,440 --> 01:36:57,040 CHANGING THE BALANCE OF CARBON 2194 01:36:57,040 --> 01:37:01,840 AND NITROGEN THERE'S A 10% 2195 01:37:01,840 --> 01:37:04,080 REDUCTION IN PROTEIN AND 30% 2196 01:37:04,080 --> 01:37:05,960 REDUCTION IN B VITAMINS BECAUSE 2197 01:37:05,960 --> 01:37:09,360 THEY'RE ALSO NITROGEN-BASED 2198 01:37:09,360 --> 01:37:10,920 COMPOUNDS AND BECAUSE WHEN C3 2199 01:37:10,920 --> 01:37:13,480 PLANT HAVE MORE CARBON, THEY'RE 2200 01:37:13,480 --> 01:37:15,480 MORE WATER EFFICIENT SO THEY 2201 01:37:15,480 --> 01:37:17,520 DRAW LESS MICRONUTRIENTS FROM 2202 01:37:17,520 --> 01:37:19,880 THE SOIL AND OVERALL FROM THE 2203 01:37:19,880 --> 01:37:21,880 EXPERIMENTS DONE, MICRONUTRIENTS 2204 01:37:21,880 --> 01:37:23,680 DECLINE ABOUT 5%. 2205 01:37:23,680 --> 01:37:28,800 THIS INCLUDES IRON AND ZINC. 2206 01:37:28,800 --> 01:37:30,840 THERE'S ABOUT 1.5 BILLION WOMEN 2207 01:37:30,840 --> 01:37:32,680 AND GIRLS AROUND THE WORLD WITH 2208 01:37:32,680 --> 01:37:35,240 IRON DEFICIENCY ANEMIA AND WHAT 2209 01:37:35,240 --> 01:37:36,760 COULD BE THE CONSEQUENCES OF THE 2210 01:37:36,760 --> 01:37:38,760 CHANGES TO THE NUTRITIONAL 2211 01:37:38,760 --> 01:37:41,480 CAUGHT OF OUR CROPS WITH HIGHER 2212 01:37:41,480 --> 01:37:42,520 CO2 ARE IN THE HUNDREDS OF 2213 01:37:42,520 --> 01:37:49,320 MILLIONS OF PEOPLE. 2214 01:37:49,320 --> 01:37:52,320 IT'S NOT JUST THAT CHANGE. 2215 01:37:52,320 --> 01:37:53,720 WE HEARD ABOUT FOOD AS MEDICINE. 2216 01:37:53,720 --> 01:37:55,600 WE HEARD ABOUT THE CHANGE IN THE 2217 01:37:55,600 --> 01:37:57,600 CARBON NITROGEN RATIO. 2218 01:37:57,600 --> 01:38:01,680 THERE'S CHANGES SUCH AS WHEN YOU 2219 01:38:01,680 --> 01:38:05,000 HAVE HIGHER SOIL TEMPERATURE YOU 2220 01:38:05,000 --> 01:38:06,880 HAVE HIGHER ARSENIC IN RICE AND 2221 01:38:06,880 --> 01:38:08,120 OTHER COMPOUNDS IN PLANT AND 2222 01:38:08,120 --> 01:38:10,440 DON'T FORGET IT'S NOT JUST 2223 01:38:10,440 --> 01:38:12,280 HUMANS THAT EAT PLANT BUT 2224 01:38:12,280 --> 01:38:14,840 LIVESTOCK AND THERE'S GROWING 2225 01:38:14,840 --> 01:38:16,400 EVIDENCE HERE IN THE U.S. WITH 2226 01:38:16,400 --> 01:38:21,320 HIGHER CO2 CONCENTRATIONS, 2227 01:38:21,320 --> 01:38:24,080 GRASS-FED CATTLE ARE BECOMING 2228 01:38:24,080 --> 01:38:25,360 INCREASINGLY PROTEIN STRESSED 2229 01:38:25,360 --> 01:38:26,000 LIKELY BECAUSE OF THE CHANGES IN 2230 01:38:26,000 --> 01:38:29,600 THE GRASS. 2231 01:38:29,600 --> 01:38:32,440 SO WHEN WE THINK OF CLIMATE 2232 01:38:32,440 --> 01:38:33,880 CHANGE I HOPE EVERYBODY THINKS 2233 01:38:33,880 --> 01:38:36,120 ABOUT CHILDREN. 2234 01:38:36,120 --> 01:38:37,120 85% OF THE CLIMATE CHANGE RISK 2235 01:38:37,120 --> 01:38:40,880 ARE IN CHILDREN AND I HOPE YOU 2236 01:38:40,880 --> 01:38:41,240 THINK OF KIDS. 2237 01:38:41,240 --> 01:38:54,360 THANK YOU. 2238 01:38:54,360 --> 01:38:57,080 >> THANK YOU, THAT WAS AMAZING 2239 01:38:57,080 --> 01:38:57,920 AND ALSO FRIGHTENING TO THINK 2240 01:38:57,920 --> 01:39:05,440 ABOUT. 2241 01:39:05,440 --> 01:39:08,000 HOW DO WE MEASURE THIS? 2242 01:39:08,000 --> 01:39:11,440 ARE THERE ASPECTS ONE CAN 2243 01:39:11,440 --> 01:39:13,280 MEASURE BEYOND THE HEAT 2244 01:39:13,280 --> 01:39:18,640 TEMPERATURE WHICH IS AMAZING HOW 2245 01:39:18,640 --> 01:39:20,080 MUCH THAT'S CHANGED? 2246 01:39:20,080 --> 01:39:21,520 AS WE THINK ABOUT WHAT TO DO 2247 01:39:21,520 --> 01:39:23,680 ABOUT IT AND HOW DO WE CONTINUE 2248 01:39:23,680 --> 01:39:31,720 TO MONITOR WHAT'S HAPPENING? 2249 01:39:31,720 --> 01:39:34,160 >> EXCELLENT QUESTION. 2250 01:39:34,160 --> 01:39:37,880 ON THE AGRICULTURE SIDE THEY 2251 01:39:37,880 --> 01:39:41,280 THERE'S A CONSORTIUM THE IT 2252 01:39:41,280 --> 01:39:42,840 AGRICULTURAL MODELLING 2253 01:39:42,840 --> 01:39:44,080 INTERCOMPARISON PROGRAMS WITH 2254 01:39:44,080 --> 01:39:45,440 ABOUT 1,000 PARTNERS AROUND THE 2255 01:39:45,440 --> 01:39:48,040 WORLD AND TRYING TO UNDERSTAND 2256 01:39:48,040 --> 01:39:49,320 HOW CURRENT CHANGES IN 2257 01:39:49,320 --> 01:39:51,160 TEMPERATURE AND EXTREME EVENTS 2258 01:39:51,160 --> 01:39:52,840 IS AFFECTING CROP YIELDS. 2259 01:39:52,840 --> 01:39:54,680 THERE'S FROM MY PERSPECTIVE A 2260 01:39:54,680 --> 01:39:56,360 VALLEY OF DEATH BECAUSE WE DON'T 2261 01:39:56,360 --> 01:39:57,360 THEN HAVE THE MEASUREMENTS OF 2262 01:39:57,360 --> 01:40:02,760 WHAT THAT MEANS FOR PEOPLE. 2263 01:40:02,760 --> 01:40:04,880 WE ALSO DON'T HAVE GOOD 2264 01:40:04,880 --> 01:40:05,680 MEASUREMENTS OF THE QUALITY OF 2265 01:40:05,680 --> 01:40:06,320 THE CROPS. 2266 01:40:06,320 --> 01:40:08,040 WE KNOW HOW MUCH IS BEING 2267 01:40:08,040 --> 01:40:08,600 PRODUCED. 2268 01:40:08,600 --> 01:40:09,480 WE HEARD A BIT ABOUT THE 2269 01:40:09,480 --> 01:40:11,400 ECONOMICS AND INCENTIVES WITHIN 2270 01:40:11,400 --> 01:40:12,560 THE U.S. FOR HOW MUCH YOU 2271 01:40:12,560 --> 01:40:13,880 PRODUCE, NOT THE QUALITY OF WHAT 2272 01:40:13,880 --> 01:40:15,000 YOU PRODUCE. 2273 01:40:15,000 --> 01:40:20,440 AND WE HAVE VERY FEW 2274 01:40:20,440 --> 01:40:22,920 MEASUREMENTS OF THE QUALITY AND 2275 01:40:22,920 --> 01:40:25,200 EVEN IN THE U.S. WE HAVE 2276 01:40:25,200 --> 01:40:26,160 OCCASIONAL NUTRITIONAL SURVEYS 2277 01:40:26,160 --> 01:40:27,400 BUT WE'RE NOT TRACKING THIS WELL 2278 01:40:27,400 --> 01:40:33,440 AT ALL. 2279 01:40:33,440 --> 01:40:35,400 WHERE YOU OF WE KNOW THERE'S 2280 01:40:35,400 --> 01:40:36,560 CONSEQUENCES FOR OUR FOOD AND 2281 01:40:36,560 --> 01:40:37,200 VERY LITTLE IS BEING MEASURED IN 2282 01:40:37,200 --> 01:40:49,280 THE SPACE. 2283 01:40:49,280 --> 01:40:51,280 >> CHRIS, ARE YOU AWARE OF 2284 01:40:51,280 --> 01:40:52,440 EFFORTS. 2285 01:40:52,440 --> 01:40:53,680 WE HAVE A SYSTEM IN THE UNITED 2286 01:40:53,680 --> 01:40:56,520 STATES AND IN MANY PLACES AROUND 2287 01:40:56,520 --> 01:40:58,560 THE WORLD WHERE WE MEASURE 2288 01:40:58,560 --> 01:41:00,400 DIETARY EXPOSURE AND WE USE 2289 01:41:00,400 --> 01:41:02,400 EXISTING DATABASES FOR NUTRIENT 2290 01:41:02,400 --> 01:41:08,200 COMPOSITION OF FOODS. 2291 01:41:08,200 --> 01:41:10,640 THERE'S BEEN SOME EFFORTS TO 2292 01:41:10,640 --> 01:41:12,480 LOOK AT CHANGES IN THE FOOD 2293 01:41:12,480 --> 01:41:14,200 SYSTEM AS WE LOOK TO THE 2294 01:41:14,200 --> 01:41:16,600 DATABASE BUT AT THIS POINT I 2295 01:41:16,600 --> 01:41:18,720 DON'T THINK USDA IS DOING THIS. 2296 01:41:18,720 --> 01:41:21,560 I THINK THERE'S BEEN SOME 2297 01:41:21,560 --> 01:41:23,080 EFFORTS THAT FOA LOOKED AT THIS. 2298 01:41:23,080 --> 01:41:27,080 ARE YOU AWARE OF EFFORTS TO LOOK 2299 01:41:27,080 --> 01:41:32,280 AT THE CHANGE IN THE FOOD 2300 01:41:32,280 --> 01:41:35,440 COMPOSITION TABLES FOR THE 2301 01:41:35,440 --> 01:41:35,680 CLIMATE? 2302 01:41:35,680 --> 01:41:40,880 >> NO, THAT NEEDS TO BE DONE. 2303 01:41:40,880 --> 01:41:44,000 PEOPLE ASK AND ASK HOW MUCH RICE 2304 01:41:44,000 --> 01:41:46,200 DO YOU DO EVERY DAY AND WE DON'T 2305 01:41:46,200 --> 01:41:48,480 KNOW HOW REFLECTIVE THE LOOK-UP 2306 01:41:48,480 --> 01:41:51,320 TABLES ARE FOR WHAT PEOPLE ARE 2307 01:41:51,320 --> 01:41:53,200 CONSUMING TODAY BASED ON 2308 01:41:53,200 --> 01:41:56,720 PARTICULARLY THE CO2 RESPONSE. 2309 01:41:56,720 --> 01:41:58,240 AND THESE ARE FIELD EXPERIMENTS 2310 01:41:58,240 --> 01:42:00,560 WITH HIGHER CONCENTRATIONS OF 2311 01:42:00,560 --> 01:42:01,960 CO2 AT THE MOMENT IT LOOKS LIKE 2312 01:42:01,960 --> 01:42:04,680 THE RELATIONSHIP IS LINEAR 2313 01:42:04,680 --> 01:42:08,920 BETWEEN CO2 AND MICRONUTRIENT 2314 01:42:08,920 --> 01:42:11,240 PROTEIN AND VITAMIN CONTENT 2315 01:42:11,240 --> 01:42:13,440 WHICH SUGGESTS OUR FOOD SUPPLY'S 2316 01:42:13,440 --> 01:42:16,440 ALREADY BEEN AFFECTED. 2317 01:42:16,440 --> 01:42:19,320 WHAT OUR GRANDPARENTS ATE 2318 01:42:19,320 --> 01:42:20,480 PROBABLY HAD HIGHER NUTRITION 2319 01:42:20,480 --> 01:42:21,880 THAN WHAT WE'RE EATING TODAY BUT 2320 01:42:21,880 --> 01:42:23,440 WE DON'T KNOW AND NOBODY'S 2321 01:42:23,440 --> 01:42:25,280 STEPPING FORWARD YET TO DO THOSE 2322 01:42:25,280 --> 01:42:41,880 KINDS OF ANALYSES. 2323 01:42:41,880 --> 01:42:45,080 >> THERE'S VECTOR BORN DISEASES 2324 01:42:45,080 --> 01:42:45,840 AND INFLAMMATORY CONDITIONS. 2325 01:42:45,840 --> 01:42:52,200 YOU MIGHT BE AWARE OF THIS IS 2326 01:42:52,200 --> 01:42:57,240 THERE DEVELOPMENT PERSPECTIVE ON 2327 01:42:57,240 --> 01:43:11,280 CHILDREN AND WE NEED TO LOCK AT 2328 01:43:11,280 --> 01:43:13,360 THE VARIOUS AREAS OF FUNCTION. 2329 01:43:13,360 --> 01:43:14,920 AND NEURAL DEVELOPMENT AND THE 2330 01:43:14,920 --> 01:43:16,480 STRESS ASSOCIATED WITH CLIMATE 2331 01:43:16,480 --> 01:43:18,200 AND THE IMPACT ON NEURAL 2332 01:43:18,200 --> 01:43:22,960 DEVELOPMENT IN CHILDREN IS 2333 01:43:22,960 --> 01:43:29,840 ANOTHER THING WE MAY NIGEED TO 2334 01:43:29,840 --> 01:43:31,960 THINK ABOUT MEASURING. 2335 01:43:31,960 --> 01:43:33,680 >> I AGREE THIS IS AN AREA WHERE 2336 01:43:33,680 --> 01:43:39,240 WE CAN ALL OUT WHAT SHOULD BE 2337 01:43:39,240 --> 01:43:40,200 MEASURED AND WHAT'S AVAILABLE SO 2338 01:43:40,200 --> 01:43:43,200 WE'RE MORE OF AWARE OF THE 2339 01:43:43,200 --> 01:43:45,080 POTENTIAL CONSEQUENCES. 2340 01:43:45,080 --> 01:43:47,080 >> I'LL START WITH A DISCLAIMER, 2341 01:43:47,080 --> 01:43:49,520 DAN, THIS IS ABSOLUTELY NOT YOUR 2342 01:43:49,520 --> 01:43:49,720 FAULT. 2343 01:43:49,720 --> 01:43:52,760 THERE'S ALMOST NO FUNDING FOR 2344 01:43:52,760 --> 01:43:53,080 RESEARCH. 2345 01:43:53,080 --> 01:43:55,480 EVERYBODY COMPLAINS THERE'S NOT 2346 01:43:55,480 --> 01:43:57,080 ENOUGH RESEARCH FUNDING IN 2347 01:43:57,080 --> 01:43:58,160 CLIMATE HEALTH. 2348 01:43:58,160 --> 01:43:59,880 THE NIH BUDGET ON CLIMATE CHANGE 2349 01:43:59,880 --> 01:44:03,560 AND HEALTH HAS BEEN RUNNING AT 2350 01:44:03,560 --> 01:44:05,200 0.02 TO 0.04 OF THE BUDGET. 2351 01:44:05,200 --> 01:44:14,200 >> I FEEL YOU. 2352 01:44:14,200 --> 01:44:17,240 PRESIDENT BIDEN PUT SOME IN THE 2353 01:44:17,240 --> 01:44:20,880 BUDGET BUT IT'S STILL 0.2%. 2354 01:44:20,880 --> 01:44:28,360 >> IT'S LARGELY ON FOOD NOT 2355 01:44:28,360 --> 01:44:32,400 NUTRITIONAL HEALTH. 2356 01:44:32,400 --> 01:44:39,680 >> MY UNDERSTANDING IS THE $110 2357 01:44:39,680 --> 01:44:41,240 MILLION. 2358 01:44:41,240 --> 01:44:42,520 WE ARE REALLY CONCERNED ABOUT 2359 01:44:42,520 --> 01:44:44,440 THIS THOSE WHO WORK IN CLIMATE 2360 01:44:44,440 --> 01:44:46,440 CHANGE AND HEALTH AND, MAN, WE 2361 01:44:46,440 --> 01:44:49,560 JUST NEED WAYS TO START 2362 01:44:49,560 --> 01:44:51,800 ANSWERING THESE QUESTIONS. 2363 01:44:51,800 --> 01:44:55,200 >> THESE ARE HUGE ISSUES. 2364 01:44:55,200 --> 01:44:58,760 THANK YOU FOR AN ENLIGHTENING 2365 01:44:58,760 --> 01:44:59,080 DISCUSSION. 2366 01:44:59,080 --> 01:45:01,880 NEXT WE HAVE THE DIRECTOR OF THE 2367 01:45:01,880 --> 01:45:04,360 NUTRITION POLICY INSTITUTE AND 2368 01:45:04,360 --> 01:45:06,600 COOPERATIVE EXTENSION NUTRITION 2369 01:45:06,600 --> 01:45:10,000 SPECIALIST AT UNIVERSITY OF 2370 01:45:10,000 --> 01:45:10,920 CALIFORNIA IN THE AGRICULTURE 2371 01:45:10,920 --> 01:45:11,400 AND NATURAL RESOURCES. 2372 01:45:11,400 --> 01:45:30,440 THANK YOU. 2373 01:45:30,440 --> 01:45:32,880 >> THERE'S ENVIRONMENTAL FACTORS 2374 01:45:32,880 --> 01:45:33,680 IN RELATIONSHIP TO CHILD 2375 01:45:33,680 --> 01:45:34,680 NUTRITION AND HEALTH. 2376 01:45:34,680 --> 01:45:40,280 YOU CAN SEE ON THE NEXT SLIDE AN 2377 01:45:40,280 --> 01:45:41,120 ENORMOUS CHALLENGE IS THERE'S 2378 01:45:41,120 --> 01:45:46,240 MANY FACTORS WHICH RELATE TO 2379 01:45:46,240 --> 01:45:48,240 WHERE SEARCH PLAY AND LEARN AND 2380 01:45:48,240 --> 01:45:52,600 THESE RANGE AS YOU KNOW FROM THE 2381 01:45:52,600 --> 01:45:55,160 BIG KEY POLICIES AND THE FEDERAL 2382 01:45:55,160 --> 01:45:56,440 ASSISTANCE PROGRAM TO FACTORS AT 2383 01:45:56,440 --> 01:46:02,160 MORE LOCAL, STATE OR COMMUNITY 2384 01:46:02,160 --> 01:46:04,680 LEVELS FOR SCHOOLS AND CHILDCARE 2385 01:46:04,680 --> 01:46:06,000 SETTINGS TO INDIVIDUAL 2386 01:46:06,000 --> 01:46:07,800 ORGANIZATIONS SUCH AS FOOD BANKS 2387 01:46:07,800 --> 01:46:13,360 AND PANTRIES AND AS OUR SYSTEM 2388 01:46:13,360 --> 01:46:15,080 SCIENCE FOLKS TALKED ABOUT, 2389 01:46:15,080 --> 01:46:17,200 THERE'S INTERACTIONS ACROSS ALL 2390 01:46:17,200 --> 01:46:19,480 THESE LEVELS AND BETWEEN THE 2391 01:46:19,480 --> 01:46:21,200 INDIVIDUAL PROGRAMS AND 2392 01:46:21,200 --> 01:46:25,920 ENVIRONMENTAL FACTORS WITHIN 2393 01:46:25,920 --> 01:46:32,920 LEVELS AND THE FACT THERE'S SO 2394 01:46:32,920 --> 01:46:36,120 MANY FACTORS BEGS THE QUESTION, 2395 01:46:36,120 --> 01:46:37,520 HOW CAN WE MEASURE QUANTIFY, 2396 01:46:37,520 --> 01:46:38,920 COMPARE AND RANK ALL THE 2397 01:46:38,920 --> 01:46:41,200 DIFFERENT ENVIRONMENTAL 2398 01:46:41,200 --> 01:46:41,440 EXPOSURES? 2399 01:46:41,440 --> 01:46:44,440 AND I WILL ARGUE THAT THERE'S 2400 01:46:44,440 --> 01:46:45,480 MUCH WORK REMAINS TO BE DONE BUT 2401 01:46:45,480 --> 01:46:47,520 I WANT TO SHARE A FEW EFFORTS 2402 01:46:47,520 --> 01:46:48,280 THAT HAVE TRIED TO ADDRESS THIS 2403 01:46:48,280 --> 01:46:53,720 CHALLENGE. 2404 01:46:53,720 --> 01:46:55,480 THE NEXT SLIDE SHOWS WHAT I'LL 2405 01:46:55,480 --> 01:46:56,920 HIGHLIGHT SOME EVOLVING 2406 01:46:56,920 --> 01:46:58,880 APPROACHES THAT HAVE BEEN USED 2407 01:46:58,880 --> 01:47:00,040 TO MEASURE EXTERNAL 2408 01:47:00,040 --> 01:47:01,160 ENVIRONMENTAL FACTORS IN 2409 01:47:01,160 --> 01:47:03,400 RELATION TO NUTRITION AND HEALTH 2410 01:47:03,400 --> 01:47:08,720 AMONG SCHOOL-AGED CHILDREN. 2411 01:47:08,720 --> 01:47:11,960 THE DIFFERENT STUDIES FOLLOW AND 2412 01:47:11,960 --> 01:47:17,520 BUILD ON EACH OTHER FIRST IS THE 2413 01:47:17,520 --> 01:47:20,640 KAISER PERMANENTE PROGRAM WITH 2414 01:47:20,640 --> 01:47:22,760 SIX STATES WITH AN IDEA OF 2415 01:47:22,760 --> 01:47:24,680 TRACKITRACK 2416 01:47:24,680 --> 01:47:26,600 ING WHAT WAS GOING ON AND 2417 01:47:26,600 --> 01:47:30,880 SPEAKING TO DAN'S COMMENTS ABOUT 2418 01:47:30,880 --> 01:47:33,840 EXISTING PROGRAMS, POLICIES AND 2419 01:47:33,840 --> 01:47:34,400 ENVIRONMENTAL FACTORS. 2420 01:47:34,400 --> 01:47:36,120 THE NATIONAL COMMUNITY STUDIO 2421 01:47:36,120 --> 01:47:40,840 INVOLVED RETROSPECTIVE DATA 2422 01:47:40,840 --> 01:47:43,480 SELECTION AND 130 DIVERSE 2423 01:47:43,480 --> 01:47:44,080 COMMUNITIES IN THE 2424 01:47:44,080 --> 01:47:46,520 U.S. INCLUDING ONE LIKE SHAPE UP 2425 01:47:46,520 --> 01:47:47,400 SOMERVILLE AND OTHERS TO 2426 01:47:47,400 --> 01:47:49,840 UNDERSTAND WHAT THEY WERE DOING 2427 01:47:49,840 --> 01:47:55,000 ON THE GROUND AND RELATE THAT TO 2428 01:47:55,000 --> 01:47:59,840 CHILD HEALTH AND FINALLY THE 2429 01:47:59,840 --> 01:48:11,960 CALIFORNIA HEALTHY KIDS STUDIES. 2430 01:48:11,960 --> 01:48:13,440 THEY GATHERED INFORMATION ON 2431 01:48:13,440 --> 01:48:15,840 ENVIRONMENTAL CHANGES AS THEY 2432 01:48:15,840 --> 01:48:17,400 WERE OCCURRING USING INTERVIEWS 2433 01:48:17,400 --> 01:48:23,200 AND SURVEYS OF STAKEHOLDERS AND 2434 01:48:23,200 --> 01:48:30,120 PARTNERS THEY WERE INTERVIEWED 2435 01:48:30,120 --> 01:48:32,680 AND LOOKED AT BMI MEASUREMENTS 2436 01:48:32,680 --> 01:48:44,120 AND BODY MASS INDEX. 2437 01:48:44,120 --> 01:48:45,880 THEY CREATED A POPULATION DOSE. 2438 01:48:45,880 --> 01:48:49,240 FOR EACH POLICY OR ENVIRONMENTAL 2439 01:48:49,240 --> 01:48:55,120 FACTORS DOCUMENTED AND COMPUTED 2440 01:48:55,120 --> 01:48:58,000 AS A PRODUCT OF REACH TIMES 2441 01:48:58,000 --> 01:49:00,200 STRENGTH AND IT'S THE PERCENT OF 2442 01:49:00,200 --> 01:49:03,040 CHILDREN TOUCHED BY A PARTICULAR 2443 01:49:03,040 --> 01:49:05,080 ENVIRONMENTAL FACTOR AND THE 2444 01:49:05,080 --> 01:49:08,880 STRENGTH IS AN ESTIMATE OF THE 2445 01:49:08,880 --> 01:49:10,000 EFFECT SIZE ON EACH REACH. 2446 01:49:10,000 --> 01:49:15,680 AND THE WAY THEY DID THAT IN 2447 01:49:15,680 --> 01:49:17,280 THIS PARTICULAR STUDY WAS BASED 2448 01:49:17,280 --> 01:49:19,000 ON STUDIES THAT EVALUATED 2449 01:49:19,000 --> 01:49:24,240 SIMILAR ENVIRONMENTAL CHANGES 2450 01:49:24,240 --> 01:49:31,040 USUALLY THEY IMPUTED AN EFFECT 2451 01:49:31,040 --> 01:49:31,240 SIZE. 2452 01:49:31,240 --> 01:49:33,120 THIS IS A WAY TO COMBINE AND 2453 01:49:33,120 --> 01:49:35,360 COMPARE ENVIRONMENTAL STRATEGIES 2454 01:49:35,360 --> 01:49:38,600 THAT EXIST CROSS SETTINGS USING 2455 01:49:38,600 --> 01:49:40,840 A COMMON YARD STICK. 2456 01:49:40,840 --> 01:49:46,680 LET ME PUT THIS INTO CONTEXT BY 2457 01:49:46,680 --> 01:49:50,000 GIVING YOU AN EXAMPLE. 2458 01:49:50,000 --> 01:49:51,880 THE NEXT STEP IS TO LOOK AT 2459 01:49:51,880 --> 01:49:54,520 STRATEGY TARGET THE SAME 2460 01:49:54,520 --> 01:49:54,840 OUTCOME. 2461 01:49:54,840 --> 01:49:57,680 THE EXAMPLE I PICKED SHOWS 2462 01:49:57,680 --> 01:49:58,960 MULTIPLE STRATEGIES FOR 2463 01:49:58,960 --> 01:50:02,760 CERTAINLY VEGETABLE INTAKE ALONG 2464 01:50:02,760 --> 01:50:05,040 WITH EACH STRATEGY AND SPECIFIC 2465 01:50:05,040 --> 01:50:06,080 DOSE SCORE IN THEIR REACH AND 2466 01:50:06,080 --> 01:50:11,040 STRENGTH AND DOSE. 2467 01:50:11,040 --> 01:50:12,480 AND THE TOTAL POPULATION DOSE IS 2468 01:50:12,480 --> 01:50:13,440 THE SUM OF THE INDIVIDUAL DOSES 2469 01:50:13,440 --> 01:50:19,280 ADDED TOGETHER. 2470 01:50:19,280 --> 01:50:20,680 RESEARCHERS FOUND IT WORKED 2471 01:50:20,680 --> 01:50:22,440 PRETTY WELL AND IMPROVED CHILD 2472 01:50:22,440 --> 01:50:23,680 NUTRITION OUTCOMES IN MANY 2473 01:50:23,680 --> 01:50:27,760 SPACES BUT NOT SO WELL IN 2474 01:50:27,760 --> 01:50:28,200 OTHERS. 2475 01:50:28,200 --> 01:50:30,640 FOR EXAMPLE IT WORKS PRETTY WELL 2476 01:50:30,640 --> 01:50:35,880 IN FOOD AND VEGETABLE INTAKE BUT 2477 01:50:35,880 --> 01:50:41,680 NOT SUGARY BEVERAGES. 2478 01:50:41,680 --> 01:50:50,160 WHY IS THAT? 2479 01:50:50,160 --> 01:50:53,600 IN THE HEALTHY COMMUNITY STUDY 2480 01:50:53,600 --> 01:50:54,920 INCLUDING SHAPE UP SOMERVILLE 2481 01:50:54,920 --> 01:51:00,760 AND RANDOMLY SELECTED ONES, DATA 2482 01:51:00,760 --> 01:51:04,240 ON POLICY AND ENVIRONMENT WAS 2483 01:51:04,240 --> 01:51:06,520 COLLECTED RETROSPECTIVELY AND 2484 01:51:06,520 --> 01:51:08,880 STRUCTURED INTERVIEWS AND 2485 01:51:08,880 --> 01:51:14,480 SURVEYS, WE ALSO DID 2486 01:51:14,480 --> 01:51:15,000 OBSERVATIONS. 2487 01:51:15,000 --> 01:51:18,040 AND LOOKING AT HOW MUCH TIME 2488 01:51:18,040 --> 01:51:23,560 THEY ATE AND WHAT WAS THEIR 2489 01:51:23,560 --> 01:51:30,680 ACCESS TO FOODS AND POLICY 2490 01:51:30,680 --> 01:51:32,080 DOCUMENTS WERE WE VIEWED. 2491 01:51:32,080 --> 01:51:38,640 IN THIS LARGE STUDY THERE WERE 2492 01:51:38,640 --> 01:51:46,320 SOME COST PROHIBITIVE TO LOOK AT 2493 01:51:46,320 --> 01:51:50,320 THE POLICIES AND STRATEGIES 2494 01:51:50,320 --> 01:51:50,760 DOCUMENTED. 2495 01:51:50,760 --> 01:51:56,360 INSTEAD EACH WAS CODE ON 2496 01:51:56,360 --> 01:51:59,480 ATTRIBUTE 2497 01:51:59,480 --> 01:52:04,680 ATTRIBUTES FOR THE SCORE. 2498 01:52:04,680 --> 01:52:05,680 THEY LOCKED AT HOW MANY CHILDREN 2499 01:52:05,680 --> 01:52:13,360 WERE TOUCHED AND THE DURATION 2500 01:52:13,360 --> 01:52:19,760 HOW LONG OR HOW OFTEN AND WHAT 2501 01:52:19,760 --> 01:52:25,840 BEHAVIORAL STRATEGY WAS USED WAS 2502 01:52:25,840 --> 01:52:27,720 THERE INFORMATION AND SCORES 2503 01:52:27,720 --> 01:52:30,240 WERE 0 TO 1 AND ACROSS THE 10 2504 01:52:30,240 --> 01:52:37,720 YEARS FOR THE COMMUNITY. 2505 01:52:37,720 --> 01:52:43,760 AND LOOKING AT FOR THE 2506 01:52:43,760 --> 01:52:49,360 COMMUNITIES AND FOR THE STUDY 2507 01:52:49,360 --> 01:52:58,600 PERIOD THIS SHOWS THE MEAN 2508 01:52:58,600 --> 01:53:02,880 INTENSITY SCORE AND THE LAST 2509 01:53:02,880 --> 01:53:08,680 YEAR AND THE SCORE START OUT 2510 01:53:08,680 --> 01:53:10,120 RELATIVELY LOW AT ABOUT 12 2511 01:53:10,120 --> 01:53:15,160 INCREASING TO ABOUT 35 IN THE 2512 01:53:15,160 --> 01:53:22,000 FINAL YEAR LUOOKING AT THE 2513 01:53:22,000 --> 01:53:23,200 ENVIRONMENTAL FACTORS AND THE 2514 01:53:23,200 --> 01:53:29,280 PATTERNS CHANGED QUITE AENT. 2515 01:53:29,280 --> 01:53:34,960 SOME INCREASES AND THAT WAS 2516 01:53:34,960 --> 01:53:36,600 QUITE A RISE FROM MAX OF 80 IN 2517 01:53:36,600 --> 01:53:38,960 THE HIGHEST COMMUNITIES AT THE 2518 01:53:38,960 --> 01:53:40,240 TOP TO ABOUT 10 IN THE 2519 01:53:40,240 --> 01:53:45,360 COMMUNITIES AT THE LOW END. 2520 01:53:45,360 --> 01:53:46,520 THE NEXT SHOWS THE RELATIONSHIP 2521 01:53:46,520 --> 01:53:51,800 BETWEEN THE INTENSITY SCORES AND 2522 01:53:51,800 --> 01:53:54,240 ONE OUTCOME WE MEASURED BODY 2523 01:53:54,240 --> 01:53:56,200 MASS INDEX AND IT REPRESENTS THE 2524 01:53:56,200 --> 01:53:58,640 COMMUNITY'S BMI FROM THE LOWEST 2525 01:53:58,640 --> 01:54:02,320 TO THE HIGHEST INTENSITY SCORE 2526 01:54:02,320 --> 01:54:06,040 VALUE AFTER ADJUSTING FOR THE 2527 01:54:06,040 --> 01:54:06,520 SOCIO DEMOGRAPHIC 2528 01:54:06,520 --> 01:54:13,480 CHARACTERISTICS. 2529 01:54:13,480 --> 01:54:14,680 WE FOUND COMMUNITY EFFORT WAS 2530 01:54:14,680 --> 01:54:20,480 ASSOCIATED WITH A DECREASE IN 2531 01:54:20,480 --> 01:54:24,280 BMI FOR CHILDREN SCHOOL AGED AND 2532 01:54:24,280 --> 01:54:25,880 INTERPRETATION OF THE BLACK LINE 2533 01:54:25,880 --> 01:54:27,760 GOING DOWN THE MIDDLE IS A 2534 01:54:27,760 --> 01:54:28,880 COMMUNITY WHERE TO CHANGE FROM 2535 01:54:28,880 --> 01:54:30,440 HAVING THEIR LOWEST INTENSITY 2536 01:54:30,440 --> 01:54:33,320 SCORE TO THE HIGHEST INTENSITY 2537 01:54:33,320 --> 01:54:40,240 SCORE WE WOULD PREDICT THE CHILD 2538 01:54:40,240 --> 01:54:48,680 BMI WOULD DECREASE YOU CAN SEE 2539 01:54:48,680 --> 01:54:52,280 ALL BE IT, AN INCREASE IN 2540 01:54:52,280 --> 01:54:56,320 INTENSITY WAS ASSOCIATED WITH AN 2541 01:54:56,320 --> 01:54:58,160 DECREASE IN BMI. 2542 01:54:58,160 --> 01:55:00,840 WE FOUND A TEMPORAL RELATIONSHIP 2543 01:55:00,840 --> 01:55:02,640 AND IT WON'T SURPRISE YOU BUT 2544 01:55:02,640 --> 01:55:05,760 THE BMI CHANGE WAS CONSIDERED 2545 01:55:05,760 --> 01:55:08,280 OVER THE TWO YEARS PRIOR TO THE 2546 01:55:08,280 --> 01:55:12,440 BMI MEASURE AND THOSE SCORES 2547 01:55:12,440 --> 01:55:15,280 THAT WERE OVER A TWO-YEAR 2548 01:55:15,280 --> 01:55:20,480 DURATION AND TAKE TIME TO 2549 01:55:20,480 --> 01:55:22,480 OBSERVE AN IMPACT. 2550 01:55:22,480 --> 01:55:24,360 AND THIS IS WITH RESPECT TO 2551 01:55:24,360 --> 01:55:28,600 CHANGES IN THE CHILD'S 2552 01:55:28,600 --> 01:55:28,880 ENVIRONMENT. 2553 01:55:28,880 --> 01:55:30,320 THE NEXT SLIDE SHOWS THE TRENDS 2554 01:55:30,320 --> 01:55:32,720 WERE NOT THE SAME FOR ALL 2555 01:55:32,720 --> 01:55:35,440 POPULATIONS OF CHILDREN. 2556 01:55:35,440 --> 01:55:37,000 WE TALKED ABOUT CONTEXT AND 2557 01:55:37,000 --> 01:55:37,240 EQUITY. 2558 01:55:37,240 --> 01:55:42,240 WHAT WE OBSERVED WAS THAT 2559 01:55:42,240 --> 01:55:43,800 OVERALL THERE WAS A SIGNIFICANT 2560 01:55:43,800 --> 01:55:44,360 RELATIONSHIP BETWEEN WHAT 2561 01:55:44,360 --> 01:55:45,920 COMMUNITIES DID AND IMPACT ON 2562 01:55:45,920 --> 01:55:48,960 BMI AND HIGHER INTENSITY SCORES 2563 01:55:48,960 --> 01:55:52,640 WERE SIGNIFICANTLY RELATED FOR 2564 01:55:52,640 --> 01:55:53,880 NON-HISPANIC WHITE CHILDREN. 2565 01:55:53,880 --> 01:55:56,760 THAT BAR IN THE DARK BLUE WERE 2566 01:55:56,760 --> 01:55:58,680 NOT SIGNIFICANT THOUGH THEY WENT 2567 01:55:58,680 --> 01:56:00,200 IN THE SAME DIRECTION FOR BLACK 2568 01:56:00,200 --> 01:56:01,280 CHILDREN THE RED LINE FOR 2569 01:56:01,280 --> 01:56:04,280 HISPANIC CHILDREN AND THE GREEN 2570 01:56:04,280 --> 01:56:07,960 LINE AND GREATER CHANGES WITH 2571 01:56:07,960 --> 01:56:10,120 PARENTS WITH HIGHER EDUCATION 2572 01:56:10,120 --> 01:56:11,960 THAN WITH LOWER EDUCATION AGAIN 2573 01:56:11,960 --> 01:56:13,480 SUGGESTING THE SAME POLICIES AND 2574 01:56:13,480 --> 01:56:16,760 ENVIRONMENTS IN THE WAY WE 2575 01:56:16,760 --> 01:56:17,760 MEASURED THEM STILL END UP 2576 01:56:17,760 --> 01:56:18,640 HAVING THE SAME RESULT ARE FOR 2577 01:56:18,640 --> 01:56:23,040 THE CHILDREN. 2578 01:56:23,040 --> 01:56:50,240 -- RESULTS FOR THE CHILDREN. 2579 01:56:50,240 --> 01:56:51,880 THERE'S EDUCATION WITH POLICY OR 2580 01:56:51,880 --> 01:56:55,080 OTHER SUPPORT ARE LIKELY TO 2581 01:56:55,080 --> 01:56:57,640 ACHIEVE BEHAVIOR CHANGE AND 2582 01:56:57,640 --> 01:57:00,400 THERE'S SOME LESSONS SHARED WITH 2583 01:57:00,400 --> 01:57:02,880 US IN SHAPE UM SOMERVILLE AND 2584 01:57:02,880 --> 01:57:07,400 THERE WAS A TARGET BEHAVIOR THAT 2585 01:57:07,400 --> 01:57:12,440 IS THE WHAT AND THAT IS BASED ON 2586 01:57:12,440 --> 01:57:16,920 THE ASSUMPTION THAT BEHAVIORS IS 2587 01:57:16,920 --> 01:57:20,800 BETTER THAN RECOGNIZE DIETS ARE 2588 01:57:20,800 --> 01:57:24,440 MADE UP OF MANY FACTORS NOT 2589 01:57:24,440 --> 01:57:29,880 IMPACTING ONE WILL SOLVE ALL OF 2590 01:57:29,880 --> 01:57:32,960 OUR PROBLEMS. 2591 01:57:32,960 --> 01:57:36,880 WE FOUND THAT A HIGHER DOSE OR 2592 01:57:36,880 --> 01:57:38,960 INTENSITY WAS ASSOCIATED WITH 2593 01:57:38,960 --> 01:57:41,400 INCREASED CONSUMPTION OF LOWER 2594 01:57:41,400 --> 01:57:45,160 FAT OVER WHOLE MILK AND THERE 2595 01:57:45,160 --> 01:57:48,280 WERE LOWER INTAKE OF UNHEALTHY 2596 01:57:48,280 --> 01:57:54,640 ITEMS LIKE SUGARS AND SUGARY 2597 01:57:54,640 --> 01:57:55,400 DRINKS. 2598 01:57:55,400 --> 01:57:59,480 WE OBSERVED HIGHER INTAKE OF 2599 01:57:59,480 --> 01:58:06,160 HEALTHIER ITEMS LIKE FOODS AND 2600 01:58:06,160 --> 01:58:07,880 VEGETABLES AND WE HAVE UP TO 10 2601 01:58:07,880 --> 01:58:10,600 YEARS OF DATA AS THE OPTIMAL 2602 01:58:10,600 --> 01:58:13,080 PERIOD FOR DIETARY CHANGE. 2603 01:58:13,080 --> 01:58:14,880 WE FOUND ABOUT FOUR YEARS WAS 2604 01:58:14,880 --> 01:58:17,920 NECESSARY FOR BMI CHANGES AND WE 2605 01:58:17,920 --> 01:58:23,880 FOUND FOR DIETARY IMPACTS WAS 2606 01:58:23,880 --> 01:58:43,680 ABOUT SIX YEAR AND THE MAPS 2607 01:58:43,680 --> 01:58:45,200 CHRISTINA SHARED WITH US IN THE 2608 01:58:45,200 --> 01:58:47,280 CALIFORNIA HEALTHY KIDS STUDY WE 2609 01:58:47,280 --> 01:58:50,280 LET THE DATA DO THE TALKING 2610 01:58:50,280 --> 01:58:51,320 RATHER THAN DEFINE ENVIRONMENTAL 2611 01:58:51,320 --> 01:58:57,200 FACTORS. 2612 01:58:57,200 --> 01:58:59,520 WE APPLIED NOVEL METHODS 2613 01:58:59,520 --> 01:59:05,200 COMBINING REDIMENSION -- 2614 01:59:05,200 --> 01:59:10,880 DIMENSION AND WITH THE HEALTHY 2615 01:59:10,880 --> 01:59:14,280 COMMUNITY TEAM AND WE RECENTLY 2616 01:59:14,280 --> 01:59:18,560 OBTAINED NIH FUNDING TO LOOK AT 2617 01:59:18,560 --> 01:59:21,840 THE DATA ADAPTIVE APPROACHES AND 2618 01:59:21,840 --> 01:59:24,280 USE GRADIENT BOOSTING MACHINES 2619 01:59:24,280 --> 01:59:29,880 AND WHILE I DON'T HAVE FINDINGS 2620 01:59:29,880 --> 01:59:35,480 YET WE'RE HOPEFUL WE'LL HAVE A 2621 01:59:35,480 --> 01:59:37,480 LOT OF LEARNING TO SHARE ABOUT 2622 01:59:37,480 --> 01:59:47,680 THE DATA AND SCIENCE APPROACHES. 2623 01:59:47,680 --> 01:59:52,280 THE LESSONS LEARNED ARE THE DOSE 2624 01:59:52,280 --> 01:59:53,720 CONCEPT AND ASSESSMENT IS USEFUL 2625 01:59:53,720 --> 01:59:55,680 FOR CAPTURING POLICY AND 2626 01:59:55,680 --> 01:59:56,960 ENVIRONMENTAL EXPOSURES. 2627 01:59:56,960 --> 01:59:59,400 WE CAN DO THESE THINGS 2628 01:59:59,400 --> 02:00:01,680 RETROSPECTIVELY BUT PEOPLE'S 2629 02:00:01,680 --> 02:00:06,480 MEMORY ARE -- MEMORIES FADE AND 2630 02:00:06,480 --> 02:00:07,920 IT'S HARD TO FIND IN THOSE 2631 02:00:07,920 --> 02:00:10,200 ENVIRONMENTS WE KNOW ARE THE 2632 02:00:10,200 --> 02:00:12,160 WINDOW OF INFLUENCE. 2633 02:00:12,160 --> 02:00:14,320 CLUSTERING THE DOSE AND ING ON 2634 02:00:14,320 --> 02:00:18,600 EXPOSED CHILDREN MAY HELP 2635 02:00:18,600 --> 02:00:19,840 MEASURE IMPACTS. 2636 02:00:19,840 --> 02:00:23,480 LONGER ASSESSMENTS ARE BETTER 2637 02:00:23,480 --> 02:00:24,800 THAN SHORTER. 2638 02:00:24,800 --> 02:00:30,400 AND WE CAN'T JUST MEASURE WHAT'S 2639 02:00:30,400 --> 02:00:57,120 GOING ON HERE AND WE ARE GOING 2640 02:00:57,120 --> 02:01:03,240 TO TRY TO UNDERSTAND WHY THHEALTHY 2641 02:01:03,240 --> 02:01:08,080 VARIATION WE SAW THE DIFFERENCES 2642 02:01:08,080 --> 02:01:10,080 AND THOSE FACTORS CAN STILL BE 2643 02:01:10,080 --> 02:01:13,640 EXPLORED AND FINALLY WE'RE 2644 02:01:13,640 --> 02:01:14,720 HOPING SYSTEM SCIENCE APPROACHES 2645 02:01:14,720 --> 02:01:18,560 WILL HELP US NOT RELY SO MUCH ON 2646 02:01:18,560 --> 02:01:22,600 SCORING AND SOME OF THE 2647 02:01:22,600 --> 02:01:24,280 ASSUMPTIO 2648 02:01:24,280 --> 02:01:24,560 ASSUMPTIONS. 2649 02:01:24,560 --> 02:01:27,040 I WANT TO SHOW AND ACKNOWLEDGING 2650 02:01:27,040 --> 02:01:31,840 THE MANY WONDERFUL COLLEAGUES 2651 02:01:31,840 --> 02:01:36,240 INVOLVED IN THIS WORK AND ADDED 2652 02:01:36,240 --> 02:01:38,280 REFERENCES TO ALL MY SLIDES BUT 2653 02:01:38,280 --> 02:01:40,720 THEY'RE ALL THERE IN CASE YOU 2654 02:01:40,720 --> 02:01:42,200 HAVE MORE QUESTIONS AND DIG 2655 02:01:42,200 --> 02:01:44,000 DEEPER INTO THAT INFORMATION. 2656 02:01:44,000 --> 02:01:45,800 AND WITH THAT I'LL TURN IT BACK 2657 02:01:45,800 --> 02:01:46,800 OVER TO MAUREEN. 2658 02:01:46,800 --> 02:01:58,440 THANKS, MAUREEN. 2659 02:01:58,440 --> 02:02:01,280 >> THANK YOU, THAT WAS AMAZING. 2660 02:02:01,280 --> 02:02:02,960 IT'S INNOVATIVE AND PROMISING TO 2661 02:02:02,960 --> 02:02:05,080 LOOK AT THE WAY THAT YOU HAVE 2662 02:02:05,080 --> 02:02:07,280 BEEN ABLE TO LOCK AT 2663 02:02:07,280 --> 02:02:10,680 RETROSPECTIVE AND THEN 2664 02:02:10,680 --> 02:02:12,960 PROSPECTIVE EVALUATIONS OF THE 2665 02:02:12,960 --> 02:02:18,080 IMPACT OF THESE ENVIRONMENTAL 2666 02:02:18,080 --> 02:02:26,280 POLICIES. 2667 02:02:26,280 --> 02:02:27,280 INSPIRING TALK. 2668 02:02:27,280 --> 02:02:28,960 QUITE INNOVATIVE. 2669 02:02:28,960 --> 02:02:33,360 NEXT WE HAVE AN INTERESTING CASE 2670 02:02:33,360 --> 02:02:36,920 STUDY DONE BY AMY CAROL SCOTT AT 2671 02:02:36,920 --> 02:02:38,160 DREXEL UNIVERSITY IN 2672 02:02:38,160 --> 02:02:40,120 PHILADELPHIA AND SHE'S GOING TO 2673 02:02:40,120 --> 02:02:42,560 BE TALKING ABOUT THE WEST 2674 02:02:42,560 --> 02:02:43,400 PHILADELPHIA PROMISE 2675 02:02:43,400 --> 02:03:12,360 NEIGHBORHOOD MODEL. 2676 02:03:12,360 --> 02:03:15,800 >> I'LL ATTEMPT TO APPLY THE 2677 02:03:15,800 --> 02:03:17,360 APPROACH AND DIG DEEPLY IN THE 2678 02:03:17,360 --> 02:03:18,680 COMMUNITY CONTEXT AND MULTIPLE 2679 02:03:18,680 --> 02:03:20,600 LEVELS THROUGHOUT THE CITY OF 2680 02:03:20,600 --> 02:03:20,920 PHILADELPHIA. 2681 02:03:20,920 --> 02:03:26,320 THIS SAY -- IS A FEDERALLY 2682 02:03:26,320 --> 02:03:27,480 CENTERED INITIATIVE AND TO 2683 02:03:27,480 --> 02:03:28,600 REFLECT ON THE CHALLENGES AND 2684 02:03:28,600 --> 02:03:29,880 OPPORTUNITIES THAT OCCUR WHEN 2685 02:03:29,880 --> 02:03:31,400 ATTEMPTING TO EVALUATE THESE 2686 02:03:31,400 --> 02:03:34,280 KINDS OF FEDERALLY FUNDED 2687 02:03:34,280 --> 02:03:35,680 INITIATIVES NOT SPECIFICALLY SET 2688 02:03:35,680 --> 02:03:40,360 UP TO ACHIEVE OR MEASURE SYSTEMS 2689 02:03:40,360 --> 02:03:40,600 CHANGE. 2690 02:03:40,600 --> 02:03:47,120 IT'S FUNDED BY THE 2691 02:03:47,120 --> 02:03:51,480 U.S. DEPARTMENT OF EDUCATION LED 2692 02:03:51,480 --> 02:03:53,240 BY DREXEL UNIVERSITY AND 2693 02:03:53,240 --> 02:03:54,800 KNITTING TOGETHER SYSTEMS OF 2694 02:03:54,800 --> 02:03:58,800 SUPPORT IN WEST PHILLY USING A 2695 02:03:58,800 --> 02:03:59,400 CRADLE TO CAREER OPPORTUNITY 2696 02:03:59,400 --> 02:04:02,440 MODEL. 2697 02:04:02,440 --> 02:04:04,600 WE RECEIVE ABOUT $6 MILLION A 2698 02:04:04,600 --> 02:04:07,720 YEAR AND EVERY YEAR THE FUNDS 2699 02:04:07,720 --> 02:04:09,560 HAVE TO BE APPROVED BY CONGRESS. 2700 02:04:09,560 --> 02:04:14,240 WE'RE CURRENTLY IN A 18-MONTH 2701 02:04:14,240 --> 02:04:16,480 NO-COST EXTENSION DUE TO COVID 2702 02:04:16,480 --> 02:04:17,240 FOCUSSED ON ANALYSIS AND 2703 02:04:17,240 --> 02:04:17,640 DISSEMINATION. 2704 02:04:17,640 --> 02:04:19,200 I HAVE NO RESULTS TO SHARE TODAY 2705 02:04:19,200 --> 02:04:21,480 BUT INSTEAD WAS ASKED TO SHARE 2706 02:04:21,480 --> 02:04:22,920 OUR EVALUATION DESIGN AND 2707 02:04:22,920 --> 02:04:24,600 CHALLENGES AND OPPORTUNITIES. 2708 02:04:24,600 --> 02:04:26,480 THE STAFF AT PROMISE 2709 02:04:26,480 --> 02:04:28,080 NEIGHBORHOOD AND DREXEL DON'T 2710 02:04:28,080 --> 02:04:29,080 RUN PROGRAMMING. 2711 02:04:29,080 --> 02:04:31,120 WE RUN WITH EXPERTS IN THE FIELD 2712 02:04:31,120 --> 02:04:35,520 AND COMMUNITY AT SCHOOLS TO FUND 2713 02:04:35,520 --> 02:04:36,680 AND SUPPORT THEIR WORK AND LOOK 2714 02:04:36,680 --> 02:04:39,000 AT THE WHOLE CHILD APPROACH TO 2715 02:04:39,000 --> 02:04:42,800 IDENTIFY THE PROGRAMS WE SUPPORT 2716 02:04:42,800 --> 02:04:44,560 FOCUSSING NOT ON BUILDING STAND 2717 02:04:44,560 --> 02:04:47,280 ALONE PROGRAMS BUT SYSTEMS TO 2718 02:04:47,280 --> 02:04:52,560 LINK IN LEVERAGE TO EACH OTHER 2719 02:04:52,560 --> 02:04:54,120 MORE EFFECTIVELY. 2720 02:04:54,120 --> 02:04:56,320 WHAT IS A PLACE-BASED INITIATIVE 2721 02:04:56,320 --> 02:04:58,840 IT'S MULTI-SECTORIAL, EDUCATION 2722 02:04:58,840 --> 02:05:02,880 HELP, HOUSING, ECONOMICS, IT'S 2723 02:05:02,880 --> 02:05:04,160 MULTI-LEVEL AT THE COMMUNITY 2724 02:05:04,160 --> 02:05:05,240 NEIGHBORHOOD, SCHOOL, MUNICIPAL 2725 02:05:05,240 --> 02:05:05,880 GOVERNMENT LEVEL. 2726 02:05:05,880 --> 02:05:10,880 WHAT YOU SEE ON THE LEFT HERE IS 2727 02:05:10,880 --> 02:05:15,840 THE AREA WE FOCUS ON WEST PHILLY 2728 02:05:15,840 --> 02:05:19,240 NEIGHBORHOOD. 2729 02:05:19,240 --> 02:05:20,640 IT'S PREDOMINANTLY AFRICAN 2730 02:05:20,640 --> 02:05:24,480 AMERICAN AND HALF THE FOLKS LIVE 2731 02:05:24,480 --> 02:05:25,800 UNDER THE FEDERAL POVERTY LEVEL 2732 02:05:25,800 --> 02:05:27,640 AND AN AREA WITH TREMENDOUS 2733 02:05:27,640 --> 02:05:29,480 ASSETS OR PROMISE INCLUDING A 2734 02:05:29,480 --> 02:05:31,280 FABRIC OF CIVIC AND 2735 02:05:31,280 --> 02:05:32,600 COMMUNITY-BASED ORGANIZATIONS WE 2736 02:05:32,600 --> 02:05:34,280 WORK CLOSELY WITH IN PROMISE 2737 02:05:34,280 --> 02:05:38,240 NEIGHBORHOOD. 2738 02:05:38,240 --> 02:05:41,120 IT'S SURROUNDED BY MANY MEDS, 2739 02:05:41,120 --> 02:05:44,800 PENN HOSPITAL AND IT'S AN 2740 02:05:44,800 --> 02:05:45,480 OVERSTUDIED COMMUNITY THAT NOT 2741 02:05:45,480 --> 02:05:48,080 ONLY MISTRUSTS THE INSTITUTIONS 2742 02:05:48,080 --> 02:05:52,480 BUT SEES THEM AS DRIVERS OF 2743 02:05:52,480 --> 02:05:53,560 GENTRIFICATION AND DISPLACEMENT, 2744 02:05:53,560 --> 02:06:06,000 RIGHTFULLY SO. 2745 02:06:06,000 --> 02:06:08,120 THIS IS A HUD NEIGHBORHOOD AND 2746 02:06:08,120 --> 02:06:12,640 ANOTHER OBAMA INITIATIVE. 2747 02:06:12,640 --> 02:06:16,480 THERE'S GRANT GOALS WE DISTILLED 2748 02:06:16,480 --> 02:06:19,160 INTO THESE FIVE ALL INTERRELATED 2749 02:06:19,160 --> 02:06:20,640 AND THE NUTRITION AND FOOD 2750 02:06:20,640 --> 02:06:22,880 ACCESS PROGRAMS FALL WITHIN THIS 2751 02:06:22,880 --> 02:06:23,080 ONE. 2752 02:06:23,080 --> 02:06:25,440 CHILDREN AND FAMILIES THRIVE IN 2753 02:06:25,440 --> 02:06:26,160 HEALTHY, SAFE AND STABLE 2754 02:06:26,160 --> 02:06:30,120 COMMUNITIES. 2755 02:06:30,120 --> 02:06:33,680 IT'S BASED ON THE ZONE MODEL AND 2756 02:06:33,680 --> 02:06:35,520 HAS COALITION AND COLLABORATION 2757 02:06:35,520 --> 02:06:40,240 APPROACH AND THERE'S A BACKBONE 2758 02:06:40,240 --> 02:06:41,360 ORGANIZATION AND COMMON AGENDA 2759 02:06:41,360 --> 02:06:43,240 FOR CHANGE AND SHARED 2760 02:06:43,240 --> 02:06:45,000 MEASUREMENT AND MUTUALLY 2761 02:06:45,000 --> 02:06:46,320 REINFORCING ACTIVITIES AND OPEN 2762 02:06:46,320 --> 02:06:57,600 AND CONTINUOUS COMMUNICATIONS. 2763 02:06:57,600 --> 02:07:05,680 THIS IS AN A MIX OF PHILADELPHIA 2764 02:07:05,680 --> 02:07:07,280 ORGANIZATIONS AND HEALTH CARE 2765 02:07:07,280 --> 02:07:08,720 DELIVERY ORGANIZATIONS AND WEST 2766 02:07:08,720 --> 02:07:09,560 PHILLY COMMUNITY ORGANIZATION 2767 02:07:09,560 --> 02:07:10,280 AND CIVIC ORGANIZATIONS AND 2768 02:07:10,280 --> 02:07:17,080 PARENT ORGANIZATIONS. 2769 02:07:17,080 --> 02:07:19,360 WE CAN SEE THAT WE'RE REQUIRED 2770 02:07:19,360 --> 02:07:21,880 TO COLLECT AND SHOW 2771 02:07:21,880 --> 02:07:27,080 POPULATION-LEVEL CHANGE ON 15 2772 02:07:27,080 --> 02:07:30,760 REQUIRED ARE INDICATORS AND WE 2773 02:07:30,760 --> 02:07:32,960 MAP THEM ON THE SOCIAL 2774 02:07:32,960 --> 02:07:33,720 DETERMINATES OF HEALTH AND 2775 02:07:33,720 --> 02:07:35,360 THEY'RE HOUSED AT OUR SCHOOL OF 2776 02:07:35,360 --> 02:07:38,120 PUBLIC HEALTH AND TO PROVIDE A 2777 02:07:38,120 --> 02:07:41,280 FRAMEWORK HOW TO ANALYZE AND 2778 02:07:41,280 --> 02:07:43,080 RECORD THE DATA AND EVERYTHING 2779 02:07:43,080 --> 02:07:44,080 IS IN PARTNERSHIPS WITH THESE 2780 02:07:44,080 --> 02:07:49,520 COMMUNITIES. 2781 02:07:49,520 --> 02:07:53,800 AND I'LL TRY TO DO THIS QUICKLY 2782 02:07:53,800 --> 02:07:54,920 AND HIT THE HIGHLIGHTS. 2783 02:07:54,920 --> 02:07:56,680 FIRST IS OUR PRIMARY DATA 2784 02:07:56,680 --> 02:07:57,360 COLLECTION AT SCHOOL AND 2785 02:07:57,360 --> 02:07:59,480 NEIGHBORHOOD LEVELS AND THESE 2786 02:07:59,480 --> 02:08:01,680 ARE TO COLLECT REQUIRED GIFTS AS 2787 02:08:01,680 --> 02:08:03,160 WELL AS CO-CREATED MEASURES WITH 2788 02:08:03,160 --> 02:08:03,880 OUR PARTNERS. 2789 02:08:03,880 --> 02:08:07,160 THE SECOND IS A LONGITUDINAL 2790 02:08:07,160 --> 02:08:08,720 DATA SYSTEM THAT'S CHILD 2791 02:08:08,720 --> 02:08:10,560 CENTERED AND THE STRATEGY 2792 02:08:10,560 --> 02:08:12,840 REQUIRED BY THE DEPARTMENT OF ED 2793 02:08:12,840 --> 02:08:14,680 TO EVALUATE THE SUCCESS OF THE 2794 02:08:14,680 --> 02:08:16,520 MULTIPLE SYSTEMS OF SUPPORT. 2795 02:08:16,520 --> 02:08:18,080 THE THIRD SAY TRACKING SYSTEM WE 2796 02:08:18,080 --> 02:08:20,160 ADDED TO ENSURE WE'RE ALSO 2797 02:08:20,160 --> 02:08:22,240 TRACKING PROGRESS AND OUTCOMES 2798 02:08:22,240 --> 02:08:23,400 OF INDIVIDUAL PROGRAMS AND A 2799 02:08:23,400 --> 02:08:25,760 SYSTEMS LEVEL INTERVENTION. 2800 02:08:25,760 --> 02:08:26,800 FOUR, IS ANOTHER EVALUATION 2801 02:08:26,800 --> 02:08:28,760 STRATEGY WE ADDED TO CAPTURE 2802 02:08:28,760 --> 02:08:30,320 CONNECTS BETWEEN EXISTING 2803 02:08:30,320 --> 02:08:31,880 PROGRAMS AND SYSTEMS THAT SERVE 2804 02:08:31,880 --> 02:08:34,000 CHILDREN AND FAMILIES IN WEST 2805 02:08:34,000 --> 02:08:36,280 PHILADELPHIA AND FIVE, WE BUILD 2806 02:08:36,280 --> 02:08:38,280 A COMMUNITY-BASED PARTICIPATORY 2807 02:08:38,280 --> 02:08:43,520 MODEL TO ALL ASPECTS OF OUR WORK 2808 02:08:43,520 --> 02:08:49,160 TO BUILD TRUST AND AUTHENTIC 2809 02:08:49,160 --> 02:08:51,440 ENGAGE MANY AND DEMOCRATIZE 2810 02:08:51,440 --> 02:08:55,400 ACCESS INTO OUR DATA 2811 02:08:55,400 --> 02:08:57,480 INFRASTRUCTURE. 2812 02:08:57,480 --> 02:09:00,400 AND WE HAVE OUR ANNUAL SCHOOL 2813 02:09:00,400 --> 02:09:02,880 CLIMATE SURVEY TO WHICH WE ADDED 2814 02:09:02,880 --> 02:09:05,760 MEASURES STARTING IN 2017 2815 02:09:05,760 --> 02:09:07,880 INCLUDING OUR FRUIT AND 2816 02:09:07,880 --> 02:09:08,600 VEGETABLE CONSUMPTION MEASURES 2817 02:09:08,600 --> 02:09:10,280 AND PROVIDE SUPPORT FOR 2818 02:09:10,280 --> 02:09:10,880 OUTREACH, RECRUITMENT AND 2819 02:09:10,880 --> 02:09:12,480 ADMINISTRATION OF THE SURVEYS 2820 02:09:12,480 --> 02:09:15,040 WITH PARENTS AT OUR SEVEN 2821 02:09:15,040 --> 02:09:17,720 SCHOOLS WE SUPPORT GIVE LOW 2822 02:09:17,720 --> 02:09:18,960 RESPONSE RATE AMONG PARENT 2823 02:09:18,960 --> 02:09:19,960 SURVEYS WHICH I'VE SEEN IN YOUR 2824 02:09:19,960 --> 02:09:22,680 SCHOOL DISTRICTS AS WELL. 2825 02:09:22,680 --> 02:09:24,080 OUR NEIGHBORHOOD SURVEY DESIGN 2826 02:09:24,080 --> 02:09:28,880 IS A LONGITUDINAL COHORT DESIGN 2827 02:09:28,880 --> 02:09:34,440 AND ADDRESS S ARE STRATIFIED DUE 2828 02:09:34,440 --> 02:09:36,440 TO PROVISION OF IMMUNIZATION OR 2829 02:09:36,440 --> 02:09:37,680 ENROLLMENT IN THE PUBLIC SCHOOL 2830 02:09:37,680 --> 02:09:43,680 SYSTEM AND ADDRESSES ARE 2831 02:09:43,680 --> 02:09:45,600 RANDOMIZED. 2832 02:09:45,600 --> 02:09:49,040 WE HAVE 2018, 2019 AND 2021 2833 02:09:49,040 --> 02:09:52,040 WE'RE WRAPPING UP AND HAD AN 2834 02:09:52,040 --> 02:09:52,880 ADDITIONAL PHONE COVID SURVEY 2835 02:09:52,880 --> 02:09:58,000 CONDUCTED IN SUMMER AND FALL OF 2836 02:09:58,000 --> 02:09:59,240 2020. 2837 02:09:59,240 --> 02:10:07,400 ALL ELIGIBLE HOUSEHOLDS IN WEST 2838 02:10:07,400 --> 02:10:10,200 PHILADELPHIA ARE INCLUDED AND 2839 02:10:10,200 --> 02:10:11,160 ADDITIONAL SURVEY INCLUDING 2840 02:10:11,160 --> 02:10:13,440 HEALTH, HOUSING, SAFETY, POLICE 2841 02:10:13,440 --> 02:10:14,160 INTERACTIONS, EDUCATION, 2842 02:10:14,160 --> 02:10:16,880 EMPLOYMENT, PERCEPTIONS OF THE 2843 02:10:16,880 --> 02:10:18,280 NEIGHBORHOOD BUILT ENVIRONMENT, 2844 02:10:18,280 --> 02:10:20,160 SOCIAL COHESION AND AVAILABILITY 2845 02:10:20,160 --> 02:10:21,080 OF RESOURCES AND ASSETS IN THE 2846 02:10:21,080 --> 02:10:29,200 COMMUNITY. 2847 02:10:29,200 --> 02:10:31,920 OUR MODEL IS TO TRAIN AS 2848 02:10:31,920 --> 02:10:32,200 SURVEYORS. 2849 02:10:32,200 --> 02:10:33,760 THEY'RE THE ONLY ONES WHO CAN 2850 02:10:33,760 --> 02:10:35,920 WALK DOOR TO DOOR, KNOCK ON THE 2851 02:10:35,920 --> 02:10:38,120 DOOR AND ACTUALLY INCENTIVIZE 2852 02:10:38,120 --> 02:10:38,800 FOLKS TO PARTICIPATE IN OUR 2853 02:10:38,800 --> 02:10:43,000 SURVEY. 2854 02:10:43,000 --> 02:10:45,760 MANY HAVE BEEN PROMOTED TO OTHER 2855 02:10:45,760 --> 02:10:47,440 POSITIONS WITHIN THE PROMISE 2856 02:10:47,440 --> 02:10:52,280 NEIGHBORHOOD INITIATIVE. 2857 02:10:52,280 --> 02:10:55,320 TO SHARE SOME OF OUR NEW TRIGS 2858 02:10:55,320 --> 02:10:59,880 RELATED MEASURES AND THE RECENT 2859 02:10:59,880 --> 02:11:02,880 WAVE YOU SEE THERE'S LOW DAILY 2860 02:11:02,880 --> 02:11:04,880 SERVINGS OF FRUIT AND VEGETABLES 2861 02:11:04,880 --> 02:11:05,960 AMONG CHILDREN AND CAREGIVERS 2862 02:11:05,960 --> 02:11:08,680 AND LOW ENCOURAGEMENT FOR FRUIT 2863 02:11:08,680 --> 02:11:13,520 AND VEGETABLE CONSUMPTION AND WE 2864 02:11:13,520 --> 02:11:15,080 SEE THERE'S A VERY HIGH REPORT 2865 02:11:15,080 --> 02:11:18,160 ING OF UNHEALTHY EATING LIKE 2866 02:11:18,160 --> 02:11:19,000 SUGARY BEVERAGES AND YOU SEE THE 2867 02:11:19,000 --> 02:11:21,880 SECOND FROM THE BOTTOM FROM THE 2868 02:11:21,880 --> 02:11:23,400 SCHOOL DATA THAT A LOW 2869 02:11:23,400 --> 02:11:27,440 PERCENTAGE OF FRUIT AND 2870 02:11:27,440 --> 02:11:28,440 VEGETABLE CONSUMPTION THROUGH 2871 02:11:28,440 --> 02:11:30,360 THE SCHOOL SURVEY AND LASTLY I'D 2872 02:11:30,360 --> 02:11:31,800 LIKE TO POINT OUT OUR HIGH 2873 02:11:31,800 --> 02:11:33,240 SECURITY RATE. 2874 02:11:33,240 --> 02:11:37,520 THIS IS ONLY 19% IN WAVE 1 AND 2875 02:11:37,520 --> 02:11:44,000 HEALTH STUDY IN WAVE 2 AND JUMP 2876 02:11:44,000 --> 02:11:48,200 JUMPED TO MORE THAN DOUBLE 2877 02:11:48,200 --> 02:11:50,920 DURING COVID AND THESE ARE 2878 02:11:50,920 --> 02:11:51,960 HOUSEHOLDS SUSCEPTIBLE TO THE 2879 02:11:51,960 --> 02:11:53,800 GLOBAL SHOCK OF THE PANDEMIC. 2880 02:11:53,800 --> 02:11:55,640 OUR INTEGRATED SYSTEM WAS 2881 02:11:55,640 --> 02:11:57,480 INTENDED TO INTEGRATE A VARIETY 2882 02:11:57,480 --> 02:12:02,720 OF CHILD-FAMILY HOUSEHOLD 2883 02:12:02,720 --> 02:12:03,880 PROGRAMS AND SCHOOL AND 2884 02:12:03,880 --> 02:12:04,680 NEIGHBORHOOD INFORMATION 2885 02:12:04,680 --> 02:12:05,720 TOGETHER OVER TIME TO UNDERSTAND 2886 02:12:05,720 --> 02:12:10,080 EACH CHILD'S HOLISTIC NEEDS FOR 2887 02:12:10,080 --> 02:12:10,760 CARE AND COORDINATION AS WELL AS 2888 02:12:10,760 --> 02:12:12,080 EVALUATE IMPACTS OF THE 2889 02:12:12,080 --> 02:12:13,480 INITIATIVE OVER TIME. 2890 02:12:13,480 --> 02:12:16,360 THIS IS THE BACKBONE OF 2891 02:12:16,360 --> 02:12:17,200 EVALUATING PROGRAMMING AS 2892 02:12:17,200 --> 02:12:18,720 REQUIRED BY THE DEPARTMENT OF 2893 02:12:18,720 --> 02:12:19,040 ED. 2894 02:12:19,040 --> 02:12:20,640 YOU CAN SEE HERE THE LEVELS ARE 2895 02:12:20,640 --> 02:12:21,880 IN THE CIRCLES. 2896 02:12:21,880 --> 02:12:23,600 THE DATA SOURCES IN THE ARROWS 2897 02:12:23,600 --> 02:12:25,280 AND OF COURSE NOT ALL OF THESE 2898 02:12:25,280 --> 02:12:27,000 ARE NESTED SO NEATLY WITHIN EACH 2899 02:12:27,000 --> 02:12:31,120 OTHER AS THERE'S PROGRAMS AT THE 2900 02:12:31,120 --> 02:12:33,000 SCHOOL LEVEL AND ONLY PROGRAMS 2901 02:12:33,000 --> 02:12:36,680 AT THE SCHOOL LEVEL NOT NESTED 2902 02:12:36,680 --> 02:12:39,640 THAT WAY AND ONLY A THIRD ATTEND 2903 02:12:39,640 --> 02:12:43,200 A SCHOOL IN THEIR NEIGHBORHOOD 2904 02:12:43,200 --> 02:12:52,640 MAKE IT CHALLENGING. 2905 02:12:52,640 --> 02:12:54,880 AND IT'S NOT YET BEEN REALIZED 2906 02:12:54,880 --> 02:12:57,160 IN THE SIX NO-COST EXTENSION 2907 02:12:57,160 --> 02:12:58,040 YEAR. 2908 02:12:58,040 --> 02:13:00,320 WE'VE BEEN NEGOTIATING AND 2909 02:13:00,320 --> 02:13:02,240 CONSENSUS BUILDING AROUND 2910 02:13:02,240 --> 02:13:05,280 PRIORITIES, GOALS, PROCESSES, 2911 02:13:05,280 --> 02:13:07,440 DATA USE AGREEMENTS AND 2912 02:13:07,440 --> 02:13:13,080 LIABILITY ISSUES. 2913 02:13:13,080 --> 02:13:14,640 THE DATA SOURCES COME FROM 2914 02:13:14,640 --> 02:13:16,200 CHILDREN AND FAMILIES INCLUDING 2915 02:13:16,200 --> 02:13:17,080 BEHAVIORAL HEALTH, PUBLIC HEALTH 2916 02:13:17,080 --> 02:13:20,480 AND HUMAN SERVICES, HOMELESSNESS 2917 02:13:20,480 --> 02:13:22,880 SERVICES AND CORRECTIONS. 2918 02:13:22,880 --> 02:13:23,880 THERE'S ALL KINDS OF TECHNICAL 2919 02:13:23,880 --> 02:13:27,600 CAPACITY AND TIME ISSUES AND 2920 02:13:27,600 --> 02:13:29,400 LOGISTICS OF DATA GENERATION AND 2921 02:13:29,400 --> 02:13:30,880 SHARING AND SECURITY ISSUES AND 2922 02:13:30,880 --> 02:13:32,440 LEGAL PARAMETERS AROUND DATA 2923 02:13:32,440 --> 02:13:34,080 SHARING AND DATA PRIVACY 2924 02:13:34,080 --> 02:13:34,360 CONCERNS. 2925 02:13:34,360 --> 02:13:35,400 AS A RESULT WE STILL DO NOT HAVE 2926 02:13:35,400 --> 02:13:37,240 A FULL IDEA. 2927 02:13:37,240 --> 02:13:39,080 WE ARE COMPLETING A 2928 02:13:39,080 --> 02:13:41,760 DEMONSTRATION PROJECT WITH THE 2929 02:13:41,760 --> 02:13:43,800 FIVE-YEAR BIRTH COHORT AND 2930 02:13:43,800 --> 02:13:44,880 THINGS HAVE WORKED QUITE WELL 2931 02:13:44,880 --> 02:13:46,280 AND WE'RE LOOKING TO LAUNCH INTO 2932 02:13:46,280 --> 02:13:50,680 A ONE-TIME INTEGRATION TOO THE 2933 02:13:50,680 --> 02:13:51,280 DATA TO EVALUATE PROMISE 2934 02:13:51,280 --> 02:13:53,520 NEIGHBORHOOD AND HOPE THAT WILL 2935 02:13:53,520 --> 02:13:58,920 ALLOW US TO WORK WITH OUR 2936 02:13:58,920 --> 02:14:01,320 COLLEAGUES TO DO MORE SYSTEMS 2937 02:14:01,320 --> 02:14:04,000 MODELLING WITH OUR DATA. 2938 02:14:04,000 --> 02:14:05,280 ALSO WANT TO LET YOU KNOW 2939 02:14:05,280 --> 02:14:08,000 BRIEFLY WE HAD TO BUILD OUR OWN 2940 02:14:08,000 --> 02:14:11,440 INFORMATION PORTAL TO LINK 2941 02:14:11,440 --> 02:14:14,000 INFORMATION BETWEEN SERVICE 2942 02:14:14,000 --> 02:14:14,680 PROVIDERS AND TRACK PROGRAM 2943 02:14:14,680 --> 02:14:16,080 PROGRESS AND OUTCOMES OVER TIME. 2944 02:14:16,080 --> 02:14:20,320 WE ALSO CREATED OUR OWN TA WAS 2945 02:14:20,320 --> 02:14:23,320 VETTED BY OUR SURVEYORS. 2946 02:14:23,320 --> 02:14:25,880 THIS IS WITH BOOTS ON THE GROUND 2947 02:14:25,880 --> 02:14:27,040 COMMUNITY MEMBER VERIFIED 2948 02:14:27,040 --> 02:14:28,640 RESOURCES WE MAKE AVAILABLE IT 2949 02:14:28,640 --> 02:14:30,600 ALL OF THE PROGRAMS AND 2950 02:14:30,600 --> 02:14:32,560 PROVIDERS OF SERVICES THAT WE 2951 02:14:32,560 --> 02:14:33,040 FUND THROUGH PROMISE 2952 02:14:33,040 --> 02:14:35,000 NEIGHBORHOOD AND WE LINK THESE 2953 02:14:35,000 --> 02:14:44,080 ALL TOGETHER THROUGH THE PIP. 2954 02:14:44,080 --> 02:14:46,560 OUR FOOD SECURITY CHALLENGES ARE 2955 02:14:46,560 --> 02:14:54,240 DELIVERED WITHIN THE BACKDROP OF 2956 02:14:54,240 --> 02:14:58,800 VIOLENCE INTERVENTION STRATEGIES 2957 02:14:58,800 --> 02:15:01,160 AND FOOD RESOURCES ARE THE MOST 2958 02:15:01,160 --> 02:15:02,280 COMMON RESOURCES ASKED FOR BY 2959 02:15:02,280 --> 02:15:04,920 OUR COORDINATOR WHICH IS OUR 2960 02:15:04,920 --> 02:15:06,960 MAIN SYSTEMS LEVEL INTERVENTION. 2961 02:15:06,960 --> 02:15:09,560 THINK OF A COMMUNITY HEALTH 2962 02:15:09,560 --> 02:15:11,720 WORKER MODEL EXTENDING FROM A 2963 02:15:11,720 --> 02:15:12,880 COLLECTIVE IMPACT MODEL OF 2964 02:15:12,880 --> 02:15:13,440 VARIOUS SYSTEMS. 2965 02:15:13,440 --> 02:15:17,000 YOU'LL SEE A LISTING OF BOTH 2966 02:15:17,000 --> 02:15:20,920 INDIVIDUAL LEVEL AND ALSO SCHOOL 2967 02:15:20,920 --> 02:15:22,080 AND NEIGHBORHOOD LEVEL NUTRITION 2968 02:15:22,080 --> 02:15:23,080 AND FOOD SECURITY RELATED 2969 02:15:23,080 --> 02:15:26,200 STRATEGIES HERE. 2970 02:15:26,200 --> 02:15:28,360 YOU'LL SEE A LOT OF THESE ARE 2971 02:15:28,360 --> 02:15:30,760 LINKING TOGETHER FOOD AND 2972 02:15:30,760 --> 02:15:32,320 NUTRITION RESOURCES INTO 2973 02:15:32,320 --> 02:15:34,760 EXISTING STRATEGIES AND 2974 02:15:34,760 --> 02:15:36,040 ADVOCATING FOR THINGS LIKE FOOD 2975 02:15:36,040 --> 02:15:37,280 DISTRIBUTION SITES. 2976 02:15:37,280 --> 02:15:39,720 WHEN COVID HIT IT BECAME CLEAR 2977 02:15:39,720 --> 02:15:41,000 THERE WAS NOT SUFFICIENT FOOD 2978 02:15:41,000 --> 02:15:42,120 DISTRIBUTION WITHIN THIS 2979 02:15:42,120 --> 02:15:42,400 COMMUNITY. 2980 02:15:42,400 --> 02:15:45,440 IN FACT, OUR OUTREACH MANAGER 2981 02:15:45,440 --> 02:15:46,960 WAS DISTRIBUTING FOOD ON HIS 2982 02:15:46,960 --> 02:15:49,080 FRONT PORCH FOR A LONG PERIOD OF 2983 02:15:49,080 --> 02:15:50,680 TIME ADVOCATING FOR AND CREATING 2984 02:15:50,680 --> 02:15:54,640 NEW FOOD DISTRIBUTION SITES AND 2985 02:15:54,640 --> 02:15:55,280 WINTERIZE EXISTING FOOD 2986 02:15:55,280 --> 02:15:57,040 DISTRIBUTION INFRASTRUCTURE. 2987 02:15:57,040 --> 02:15:58,760 I DO WANT TO MENTION FOR A 2988 02:15:58,760 --> 02:16:01,720 SECOND THAT WE DID BUILD IN AN 2989 02:16:01,720 --> 02:16:02,680 ORGANIZATIONAL NETWORK SURVEY. 2990 02:16:02,680 --> 02:16:04,040 THIS WAS NOT REQUIRED BY THE 2991 02:16:04,040 --> 02:16:06,080 DEPARTMENT OF ED BUT WE FOUND IT 2992 02:16:06,080 --> 02:16:08,080 VERY IMPORTANT TO UNDERSTAND HOW 2993 02:16:08,080 --> 02:16:09,280 SYSTEMS -- HOW INDIVIDUAL 2994 02:16:09,280 --> 02:16:10,120 PROGRAMS AND SYSTEMS OF SUPPORT 2995 02:16:10,120 --> 02:16:14,400 ARE CONNECTED TO EACH OTHER BY 2996 02:16:14,400 --> 02:16:17,080 CATEGORY AND BY NETWORKS. 2997 02:16:17,080 --> 02:16:20,640 SO ONE OF THE NETWORKS WE TOOK A 2998 02:16:20,640 --> 02:16:22,200 LOOK AT WAS HOW THEY LOOKED AT 2999 02:16:22,200 --> 02:16:23,480 EACH OTHER AND COORDINATION AND 3000 02:16:23,480 --> 02:16:24,280 STRATEGIC PLANNING AND 3001 02:16:24,280 --> 02:16:29,560 COLLABORATION AND DATA SHARING. 3002 02:16:29,560 --> 02:16:34,680 LASTLY, OUR DATA DISSEMINATION 3003 02:16:34,680 --> 02:16:36,800 AND USING DATA BOARDS AND 3004 02:16:36,800 --> 02:16:38,120 DEMOGRAPHIC BRIEFS, 3005 02:16:38,120 --> 02:16:39,480 PRESENTATIONS AND COMMUNITY TOWN 3006 02:16:39,480 --> 02:16:42,360 HALL MEETINGS AND ALSO DATA 3007 02:16:42,360 --> 02:16:42,640 REQUESTS. 3008 02:16:42,640 --> 02:16:45,080 WE WILL PROVIDE WHAT DATA WE ARE 3009 02:16:45,080 --> 02:16:47,400 ALLOWED TO PROVIDE GIVEN OUR 3010 02:16:47,400 --> 02:16:49,960 VARIOUS IRB AND DATA USE 3011 02:16:49,960 --> 02:16:50,920 AGREEMENTS INCLUDING FOR 3012 02:16:50,920 --> 02:16:52,680 EXAMPLE, THE MANY HUNDREDS OF 3013 02:16:52,680 --> 02:16:54,520 COMMUNITY INDICATORS THAT WE 3014 02:16:54,520 --> 02:16:56,240 DEVELOPED IN OUR ROLE AS THE 3015 02:16:56,240 --> 02:16:59,480 PHILADELPHIA LOCAL DATA UNIT 3016 02:16:59,480 --> 02:16:59,800 INTERMEDIARY. 3017 02:16:59,800 --> 02:17:05,200 ANY OF OUR CIVIC OR COMMUNITY 3018 02:17:05,200 --> 02:17:07,160 PARTNERS WHO REQUEST THESE DATA 3019 02:17:07,160 --> 02:17:11,880 IS MADE AVAILABLE TO THEM. 3020 02:17:11,880 --> 02:17:13,520 WHAT ARE THE CHALLENGES OF THIS 3021 02:17:13,520 --> 02:17:14,360 KIND OF WORK? 3022 02:17:14,360 --> 02:17:16,400 FIRST IS THE GRANT SUPPORTS AND 3023 02:17:16,400 --> 02:17:18,760 REPORTING REQUIREMENTS ARE BASED 3024 02:17:18,760 --> 02:17:21,480 ON TRADITIONAL THINK OF GRANT 3025 02:17:21,480 --> 02:17:23,400 IMPACTS. 3026 02:17:23,400 --> 02:17:29,760 THEY'RE STILL REQUIRING ARE -- 3027 02:17:29,760 --> 02:17:35,400 REQUIRE ARE 3028 02:18:07,120 --> 02:18:14,840 -- WE'RE INTEGRATING SYSTEMS AND 3029 02:18:14,840 --> 02:18:16,000 INFORMATION CLOEOLLECTED FROM THE 3030 02:18:16,000 --> 02:18:17,960 SAME FAMILY AND IT'S EASIER TO 3031 02:18:17,960 --> 02:18:20,280 REQUEST DATA FOR RESEARCH THAN 3032 02:18:20,280 --> 02:18:22,080 PROVIDING HOLISTIC SUPPORT FOR 3033 02:18:22,080 --> 02:18:27,360 KIDS AND THAT'S JUST NOT JUST OR 3034 02:18:27,360 --> 02:18:27,640 EQUITABLE. 3035 02:18:27,640 --> 02:18:29,880 AND INCORPORATES PROGRAM 3036 02:18:29,880 --> 02:18:31,200 MONITORING AND OTHER TRACKING 3037 02:18:31,200 --> 02:18:32,200 DATA SYSTEMS THAT DON'T SPEAK 3038 02:18:32,200 --> 02:18:33,600 WELL TO EACH OTHER AND THERE'S 3039 02:18:33,600 --> 02:18:36,360 ALSO THE CHALLENGE OF LINKING 3040 02:18:36,360 --> 02:18:37,480 LOTS OF SMALL DATA FROM PROGRAMS 3041 02:18:37,480 --> 02:18:39,960 TO BIG DATA. 3042 02:18:39,960 --> 02:18:42,280 AND NO REALLY GOOD PRACTICAL 3043 02:18:42,280 --> 02:18:46,560 HISTORY OR MODELS TO DO THIS. 3044 02:18:46,560 --> 02:18:47,880 THERE'S ALSO COMPLEXITY 3045 02:18:47,880 --> 02:18:49,280 PROCEDURES REQUIRED BY PROMISE 3046 02:18:49,280 --> 02:18:50,040 NEIGHBORHOODS, SCHOOL DISTRICT 3047 02:18:50,040 --> 02:18:53,280 TO CITIES, DREXEL, THE VARIOUS 3048 02:18:53,280 --> 02:18:54,600 PROGRAMS THAT CHALLENGED A LOT 3049 02:18:54,600 --> 02:18:57,360 OF INTEGRATION AND ADOPTION OF 3050 02:18:57,360 --> 02:18:57,520 OUR. 3051 02:18:57,520 --> 02:19:01,360 I PORTAL AND LASTLY I'LL SAY THE 3052 02:19:01,360 --> 02:19:02,360 TRADITIONAL FUNDING TIME LINES 3053 02:19:02,360 --> 02:19:04,360 DOES NOT ALLOW FOR POPULATION 3054 02:19:04,360 --> 02:19:05,480 LEVEL CHANGE. 3055 02:19:05,480 --> 02:19:08,640 YOU CAN'T CHANGE SYSTEMS OF 3056 02:19:08,640 --> 02:19:10,160 SYSTEMIC RACISM IN FIVE YEARS 3057 02:19:10,160 --> 02:19:12,200 AND CHANGE NEEDS TO HAPPEN AT 3058 02:19:12,200 --> 02:19:13,720 THE HOUSEHOLD SCHOOL, 3059 02:19:13,720 --> 02:19:14,720 NEIGHBORHOOD AND SYSTEMS LEVELS 3060 02:19:14,720 --> 02:19:16,280 BEFORE WE'LL SEE ANY KIND OF 3061 02:19:16,280 --> 02:19:16,880 POPULATION CHANGE IN COMMUNITIES 3062 02:19:16,880 --> 02:19:19,400 LIKE THIS. 3063 02:19:19,400 --> 02:19:22,400 SO THE METHODS AND INDICATORS 3064 02:19:22,400 --> 02:19:23,800 EVALUATING THESE MULTI-LEVEL S 3065 02:19:23,800 --> 02:19:27,360 NEED TO FOCUS ON DETECTING THESE 3066 02:19:27,360 --> 02:19:28,800 PROCESS AND SYSTEMS CHANGES 3067 02:19:28,800 --> 02:19:30,240 BEFORE EXPECTING TO SEE 3068 02:19:30,240 --> 02:19:31,720 SIGNIFICANT AND SUSTAINABLE 3069 02:19:31,720 --> 02:19:32,680 CHANGE AMONG CHILDREN AND YOUTH 3070 02:19:32,680 --> 02:19:39,720 AT THESE DIFFERENT LEVELS. 3071 02:19:39,720 --> 02:19:51,000 THAT IS IT. 3072 02:19:51,000 --> 02:19:51,680 >> THANK YOU. 3073 02:19:51,680 --> 02:19:53,280 YOU ARE VERY BRAVE FOR 3074 02:19:53,280 --> 02:19:57,120 UNDERTAKING SUCH AN ENORMOUS 3075 02:19:57,120 --> 02:19:57,840 TASK. 3076 02:19:57,840 --> 02:19:59,080 I WAS DELIGHTED TO HAVE HEARD 3077 02:19:59,080 --> 02:20:01,120 MORE ABOUT THE PROCESSES AND 3078 02:20:01,120 --> 02:20:02,080 METHODS AND HOW YOU THOUGHT 3079 02:20:02,080 --> 02:20:03,680 ABOUT IT. 3080 02:20:03,680 --> 02:20:05,080 OF COURSE WE'RE ANXIOUS TO THINK 3081 02:20:05,080 --> 02:20:08,240 ABOUT THE OUTCOME BUT IT WAS 3082 02:20:08,240 --> 02:20:09,680 WONDERFUL TO BE ABLE TO HEAR 3083 02:20:09,680 --> 02:20:11,360 METHODS YOU USED IN SOME OF THE 3084 02:20:11,360 --> 02:20:11,960 CHALLENGES SO THANK YOU VERY 3085 02:20:11,960 --> 02:20:15,280 MUCH. 3086 02:20:15,280 --> 02:20:27,400 THE NEXT SPEAKER THAT WE HAVE IS 3087 02:20:27,400 --> 02:20:31,240 JAYNA DAVE FROM THE BAYLOR 3088 02:20:31,240 --> 02:20:32,280 COLLEGE OF MEDICINE AND TALK 3089 02:20:32,280 --> 02:21:29,280 ABOUT ISSUES OF EQUITY. 3090 02:21:29,280 --> 02:21:33,080 >> CAN YOU HEAR ME NOW? 3091 02:21:33,080 --> 02:21:35,080 >> YES, PERFECT. 3092 02:21:35,080 --> 02:21:36,520 >> I'LL GIVE AN OVERVIEW OF 3093 02:21:36,520 --> 02:21:39,320 EQUITY AND RELATED CONCEPTS AND 3094 02:21:39,320 --> 02:21:43,280 WHY THEY'RE IMPORTANT WHEN WE 3095 02:21:43,280 --> 02:21:46,800 LOOK AT CHILD HEALTH. 3096 02:21:46,800 --> 02:21:48,640 SO HEALTH EQUITY IS PROVIDING 3097 02:21:48,640 --> 02:21:50,080 EVERY PERSON WITH THE SAME 3098 02:21:50,080 --> 02:21:52,160 OPPORTUNITY TO STAY HEALTHY FOR 3099 02:21:52,160 --> 02:21:54,320 COPE WITH DISEASE IN CRISIS 3100 02:21:54,320 --> 02:21:55,080 REGARDLESS OF THE SOCIAL 3101 02:21:55,080 --> 02:21:57,880 ECONOMIC CONDITIONS, RACE, 3102 02:21:57,880 --> 02:21:59,720 GENDER, AGE, SOCIAL STATUS, 3103 02:21:59,720 --> 02:22:02,000 ENVIRONMENT AND ANY OTHER SOCIAL 3104 02:22:02,000 --> 02:22:06,120 DETERMINATED FACTORS. 3105 02:22:06,120 --> 02:22:08,120 SOME STEPS WHEN WE TALK ABOUT 3106 02:22:08,120 --> 02:22:13,360 HEALTH EQUITY INCLUDE HEALTH 3107 02:22:13,360 --> 02:22:13,960 DISPARI 3108 02:22:13,960 --> 02:22:14,600 DISPARITIES, SOCIAL DETERMINATES 3109 02:22:14,600 --> 02:22:15,360 OF HEALTH AND DIFFERENCES IN 3110 02:22:15,360 --> 02:22:17,880 HEALTH OUTCOMES AND CAUSES AMONG 3111 02:22:17,880 --> 02:22:22,080 GROUPS OF PEOPLE AND ACHIEVING 3112 02:22:22,080 --> 02:22:23,440 HEALTH EQUITY AND REDUCING 3113 02:22:23,440 --> 02:22:26,680 HEALTH DISPARITIES ESPECIALLY IN 3114 02:22:26,680 --> 02:22:27,840 CHILDREN IS A MAJOR PUBLIC 3115 02:22:27,840 --> 02:22:28,400 HEALTH GOAL. 3116 02:22:28,400 --> 02:22:31,880 THE SOCIAL FACTORS THAT FLOUNCE 3117 02:22:31,880 --> 02:22:36,520 HEALTH CARE AND HEALTH OUTCOMES 3118 02:22:36,520 --> 02:22:37,680 ARE THE SOCIAL DETERMINATES OF 3119 02:22:37,680 --> 02:22:38,960 HEALTH AND THESE ARE THE 3120 02:22:38,960 --> 02:22:41,640 CONDITIONS WHERE PEOPLE ARE 3121 02:22:41,640 --> 02:22:44,520 BORN, LIVE OR AN AGE. 3122 02:22:44,520 --> 02:22:46,120 ACCORDING TO WHO, THESE 3123 02:22:46,120 --> 02:22:48,840 CIRCUMSTANCES ARE SHAPED BY THE 3124 02:22:48,840 --> 02:22:52,640 DISTRIBUTION OF MONEY, POWER AND 3125 02:22:52,640 --> 02:22:53,440 RESOURCES GLOBAL AND NATIONAL 3126 02:22:53,440 --> 02:22:57,880 AND LOCAL LEVELS. 3127 02:22:57,880 --> 02:23:02,280 NOW, THE UNFAIR AND AVOIDABLE 3128 02:23:02,280 --> 02:23:03,280 DIFFERENCES IN HEALTH STATUS 3129 02:23:03,280 --> 02:23:05,880 SEEN WITHIN POPULATIONS AND 3130 02:23:05,880 --> 02:23:08,720 WITHIN COUNTRIES IS WHAT HAS 3131 02:23:08,720 --> 02:23:09,920 HELPED INEQUITIES AND SOCIAL 3132 02:23:09,920 --> 02:23:10,680 DETERMINATES OF HEALTH HAVE 3133 02:23:10,680 --> 02:23:11,920 MOSTLY RESPONSE ARABLE FOR THE 3134 02:23:11,920 --> 02:23:22,480 HEALTH INEQUITIES. 3135 02:23:22,480 --> 02:23:25,320 THIS IS INCLUDED AS ONE OF THE 3136 02:23:25,320 --> 02:23:27,760 OVER ARCHING GOALS FOR THE 3137 02:23:27,760 --> 02:23:29,040 DECADE AND THE SOCIAL 3138 02:23:29,040 --> 02:23:30,760 DETERMINATES OF HEALTH APPROACH 3139 02:23:30,760 --> 02:23:35,680 BASICALLY INCORPORATES IN DEPTH 3140 02:23:35,680 --> 02:23:41,480 ANALYSES OF GROWING AND STUDYING 3141 02:23:41,480 --> 02:23:42,160 CHIERNZ ENVIRONMENT AND ADDRESS 3142 02:23:42,160 --> 02:23:44,880 THE ROOT CAUSE IN ADDITION TO 3143 02:23:44,880 --> 02:23:46,960 THE INDIVIDUAL AND COMMUNITY 3144 02:23:46,960 --> 02:23:47,360 BEHAVIORS. 3145 02:23:47,360 --> 02:23:49,280 IT'S A MULTI-SECTORIAL APPROACH 3146 02:23:49,280 --> 02:23:59,040 BY DEFINITION ITSELF. 3147 02:23:59,040 --> 02:23:59,520 ADDITIONALLY, WHO ALSO 3148 02:23:59,520 --> 02:24:04,160 EMPHASIZES THE CONCEPT OF SOCIAL 3149 02:24:04,160 --> 02:24:05,120 DETERMINATES OF HEALTH AND HAVE 3150 02:24:05,120 --> 02:24:07,520 A REPORT PUBLISHED BACK IN 2008 3151 02:24:07,520 --> 02:24:16,520 I THINK ON IT. 3152 02:24:16,520 --> 02:24:17,840 THERE ARE A FEW MEASURES FOR 3153 02:24:17,840 --> 02:24:18,520 SOCIAL DETERMINATES OF HEALTH 3154 02:24:18,520 --> 02:24:20,800 THAT HAVE BEEN PUBLISHED. 3155 02:24:20,800 --> 02:24:24,080 ONE IS PROTOCOL FOR RESPONDING 3156 02:24:24,080 --> 02:24:26,080 TO AND ASSESSING EXPERIENCES BY 3157 02:24:26,080 --> 02:24:28,480 THE NATIONAL ASSOCIATION OF 3158 02:24:28,480 --> 02:24:30,160 COMMUNITY HEALTH CENTERS. 3159 02:24:30,160 --> 02:24:32,480 AND IT ALIGNS WITH THE HEALTHY 3160 02:24:32,480 --> 02:24:36,280 PEOPLE 2020 PRIORITIES AND IS 3161 02:24:36,280 --> 02:24:37,880 AVAILABLE ON DIFFERENT 3162 02:24:37,880 --> 02:24:38,480 ELECTRONIC ELECTRONIC HEALTH 3163 02:24:38,480 --> 02:24:43,800 RECORD PLATFORMS. 3164 02:24:43,800 --> 02:24:45,600 THIS PARTICULAR TOOL LOOKS AT 3165 02:24:45,600 --> 02:24:49,280 SOCIAL DEMOGRAPHICS, HOUSING 3166 02:24:49,280 --> 02:24:50,840 STATUS, HOUSING STABILITY, 3167 02:24:50,840 --> 02:24:53,920 EDUCATION, EMPLOYMENT, STRESS, 3168 02:24:53,920 --> 02:24:55,400 INSURANCE, INCOME, MATERIAL 3169 02:24:55,400 --> 02:24:57,080 SECURITY INCLUDING MONEY AND 3170 02:24:57,080 --> 02:24:58,600 RESOURCE ARE WHICH ALSO INCLUDE 3171 02:24:58,600 --> 02:25:02,640 THE FOOD, TRANSPORTATION, SOCIAL 3172 02:25:02,640 --> 02:25:05,920 INTEGRATION OF SUPPORT AND 3173 02:25:05,920 --> 02:25:06,880 SEASONAL WORK. 3174 02:25:06,880 --> 02:25:08,600 THE OTHER TOOL THAT IS AVAILABLE 3175 02:25:08,600 --> 02:25:13,680 IS THE HEALTH RELATED SOCIAL 3176 02:25:13,680 --> 02:25:15,720 NEEDS SCREENING TOOL BY THE 3177 02:25:15,720 --> 02:25:16,480 ACCOUNTABLE HEALTH COMMUNITY 3178 02:25:16,480 --> 02:25:19,080 CENTER FOR MEDICARE AND MEDICAID 3179 02:25:19,080 --> 02:25:19,360 SERVICES. 3180 02:25:19,360 --> 02:25:21,280 IT WAS DEVELOPED TO ADDRESS 3181 02:25:21,280 --> 02:25:22,960 CRITICAL GAP BETWEEN CRITICAL 3182 02:25:22,960 --> 02:25:25,640 AND COMMUNITY SERVICES. 3183 02:25:25,640 --> 02:25:28,640 WE LOOK AT HOUSING INSTABILITY, 3184 02:25:28,640 --> 02:25:31,440 FOOD INSECURITY, TRANSPORTATION 3185 02:25:31,440 --> 02:25:32,240 NEEDS, UTILITY NEEDS AND 3186 02:25:32,240 --> 02:25:36,560 INTERPERSONAL SAFETY. 3187 02:25:36,560 --> 02:25:39,120 THERE IS ANOTHER TOOL CALLED THE 3188 02:25:39,120 --> 02:25:40,560 PATIENT REPORT THE OUTCOMES 3189 02:25:40,560 --> 02:25:46,960 QUALITY OF LIFE WHICH WHICH 3190 02:25:46,960 --> 02:25:47,840 BASICALLY ASKS WHICH OF THE 3191 02:25:47,840 --> 02:25:49,240 FOLLOWING REPRESENTS YOUR SINGLE 3192 02:25:49,240 --> 02:25:50,680 BIGGEST CONCERN RIGHT NOW AND 3193 02:25:50,680 --> 02:25:53,040 THE BIGGEST CONCERNS INCLUDED 3194 02:25:53,040 --> 02:25:54,920 ARE PERSONAL RELATIONSHIPS, 3195 02:25:54,920 --> 02:25:56,600 MONITORING HEALTH, EMOTIONAL 3196 02:25:56,600 --> 02:26:02,000 HEALTH, MONEY, HEALTH BEHAVIORS, 3197 02:26:02,000 --> 02:26:03,360 MEDICINE, GETTING HEALTH CARE 3198 02:26:03,360 --> 02:26:04,240 WORK, PHYSICAL HEALTH OR ANY 3199 02:26:04,240 --> 02:26:07,120 OTHER CONCERN. 3200 02:26:07,120 --> 02:26:11,680 AND THEY ASK ABOUT THE DIFFERENT 3201 02:26:11,680 --> 02:26:14,200 PROBLEMS AROUND MEDICINE AND 3202 02:26:14,200 --> 02:26:14,680 GETTING HEALTH CARE AND 3203 02:26:14,680 --> 02:26:21,480 INSURANCE. 3204 02:26:21,480 --> 02:26:23,720 ANOTHER CONCEPT WHEN WE TALK 3205 02:26:23,720 --> 02:26:25,480 ABOUT HEALTH EQUITY IS 3206 02:26:25,480 --> 02:26:26,880 ENVIRONMENT JUSTICE THE FAIR 3207 02:26:26,880 --> 02:26:28,760 TREATMENT AND ENROLLMENT OF ALL 3208 02:26:28,760 --> 02:26:30,480 PEM REGARDING OF RACE AND 3209 02:26:30,480 --> 02:26:32,560 NATIONAL ORIGIN OR INCOME WITH 3210 02:26:32,560 --> 02:26:38,160 RESPECT TO THE DEVELOPMENT, 3211 02:26:38,160 --> 02:26:39,240 IMPLEMENT OF ENFORCEMENT OF 3212 02:26:39,240 --> 02:26:41,920 LAWS, REGULATIONS AND POLICIES. 3213 02:26:41,920 --> 02:26:43,760 WHAT WE MEAN BY MEANINGFUL 3214 02:26:43,760 --> 02:26:48,800 ENROLLMENT IS ACTIVE ENGAGEMENT 3215 02:26:48,800 --> 02:26:50,800 OF PEOPLE IN HER DECISION-MAKING 3216 02:26:50,800 --> 02:26:53,920 ACTIVITIES THAT MAY AFFECT THEIR 3217 02:26:53,920 --> 02:26:56,520 ENVIRONMENT OR THEIR HEALTH 3218 02:26:56,520 --> 02:26:58,600 THREW APPROACHES AND THIS CAN BE 3219 02:26:58,600 --> 02:27:00,200 DONE USING APPROACHES SUCH AS 3220 02:27:00,200 --> 02:27:02,680 COMMUNITY ENGAGED RESEARCH OR 3221 02:27:02,680 --> 02:27:08,280 COPR. 3222 02:27:08,280 --> 02:27:09,760 WE SPOKE ABOUT FOOD INSECURITY 3223 02:27:09,760 --> 02:27:13,880 AND I THINK FOOD SECURITY AND 3224 02:27:13,880 --> 02:27:16,080 ENVIRONMENTAL JUSTICE ARE SOCIAL 3225 02:27:16,080 --> 02:27:19,400 MOMENTS BOTH INTERESTED IN 3226 02:27:19,400 --> 02:27:21,760 EQUITY AND JUSTICE AND 3227 02:27:21,760 --> 02:27:23,360 SYSTEM-WIDE FACTORS AND SHARED A 3228 02:27:23,360 --> 02:27:27,040 CONCERN FOR ISSUES OF DAILY LIFE 3229 02:27:27,040 --> 02:27:30,040 AND THE NEED TO ESTABLISH 3230 02:27:30,040 --> 02:27:31,160 EMPOWERMENTS BY COMMUNITY AND 3231 02:27:31,160 --> 02:27:31,800 EMPOWERMENT STRATEGIES. 3232 02:27:31,800 --> 02:27:34,160 IN BOTH OF THESE MOVEMENTS HAVE 3233 02:27:34,160 --> 02:27:39,400 ALREADY BEGUN TO RESHAPE THE 3234 02:27:39,400 --> 02:27:41,080 SUSTAINABLE FOOD SYSTEM HOWEVER, 3235 02:27:41,080 --> 02:27:43,400 THE COMMUNITY FOOD SECURITY AND 3236 02:27:43,400 --> 02:27:46,160 ENVIRONMENTAL JUSTICE IS STILL 3237 02:27:46,160 --> 02:27:50,440 REMAINING AS SEPARATE MOMENTS 3238 02:27:50,440 --> 02:27:53,240 INDICATING INCOMPLETE COURSES IN 3239 02:27:53,240 --> 02:27:54,680 RESHAPING AGENDAS AND JOINING 3240 02:27:54,680 --> 02:27:59,080 THESE MOVEMENTS THROUGH 3241 02:27:59,080 --> 02:27:59,920 EMPOWERMENT AND LEVEL ANALYSES 3242 02:27:59,920 --> 02:28:01,800 WE HEARD SOME THROUGH THE CASE 3243 02:28:01,800 --> 02:28:04,520 STUDIES TODAY WOULD ENHANCE THE 3244 02:28:04,520 --> 02:28:05,640 DEVELOPMENT OF A MORE POWERFUL 3245 02:28:05,640 --> 02:28:08,160 AND INTEGRATED APPROACH. 3246 02:28:08,160 --> 02:28:13,160 AND SOME OF THESE EFFORTS WOULD 3247 02:28:13,160 --> 02:28:15,840 INCLUDE MAKING COMMUNITY FOOD 3248 02:28:15,840 --> 02:28:17,920 PRODUCTION AND COMMUNITY 3249 02:28:17,920 --> 02:28:25,480 DEVELOPMENT AND PLANNING. 3250 02:28:25,480 --> 02:28:31,360 AND WITH IMBALANCES IN THE FOOD 3251 02:28:31,360 --> 02:28:33,600 SYSTEMS ARE MAJOR DRIVERS OF 3252 02:28:33,600 --> 02:28:34,600 NUTRITION INEQUITIES AND CAN 3253 02:28:34,600 --> 02:28:38,280 RESTRICT ACCESS OR PROMOTE 3254 02:28:38,280 --> 02:28:39,840 LOW-QUALITY DIETS. 3255 02:28:39,840 --> 02:28:42,600 WE ALL KNOW THE FOOD ENVIRONMENT 3256 02:28:42,600 --> 02:28:44,680 WHERE CONSUMERS MAKE DECISIONS 3257 02:28:44,680 --> 02:28:52,280 IS INEQUITABLE FOR MANY WITH 3258 02:28:52,280 --> 02:29:00,480 ADVERTISING AND QUALITY OF FOOD. 3259 02:29:00,480 --> 02:29:03,360 AND THE INEQUITIES PROVIDE AN 3260 02:29:03,360 --> 02:29:04,520 INTEGRATED RESPONSE AT TO THE 3261 02:29:04,520 --> 02:29:05,920 GLOBAL AND NATIONAL LEVELS 3262 02:29:05,920 --> 02:29:07,360 BRINGING TOGETHER THE CAPACITY 3263 02:29:07,360 --> 02:29:11,280 OF MULTIPLE SECTORS AND AN 3264 02:29:11,280 --> 02:29:11,920 EQUITY-SENSITIVE APPROACH TO 3265 02:29:11,920 --> 02:29:13,760 FOOD SYSTEMS THAT DELIVERS 3266 02:29:13,760 --> 02:29:16,040 HEALTHY DIETS WOULD SEEK TO 3267 02:29:16,040 --> 02:29:18,000 REDUCE INEQUITIES AS WELL AS 3268 02:29:18,000 --> 02:29:19,960 DIRECTLY ADDRESS FOOD 3269 02:29:19,960 --> 02:29:20,920 AVAILABILITY, ACCESSIBILITY AND 3270 02:29:20,920 --> 02:29:21,640 PRICE IN LOCAL FOOD 3271 02:29:21,640 --> 02:29:26,560 ENVIRONMENTS. 3272 02:29:26,560 --> 02:29:29,640 SO ADDRESSING HEALTH DISPARITIES 3273 02:29:29,640 --> 02:29:31,360 IN GENERAL AS MAUREEN STARTED 3274 02:29:31,360 --> 02:29:33,320 TALKING ABOUT IT EARLIER THIS 3275 02:29:33,320 --> 02:29:38,200 MORNING, IT'S GROUNDED IN SOCIAL 3276 02:29:38,200 --> 02:29:42,040 AND ECOLOGICAL MODEL WHICH ALSO 3277 02:29:42,040 --> 02:29:44,360 SUPPORTS THE FRAMEWORK THAT 3278 02:29:44,360 --> 02:29:46,880 WE'RE USING FOR THE WORK. 3279 02:29:46,880 --> 02:29:51,640 AND I WON'T TALK TOO MUCH ABOUT 3280 02:29:51,640 --> 02:30:00,280 THIS BUT I WOULD WANT TO SAY 3281 02:30:00,280 --> 02:30:01,080 INTERSECTI 3282 02:30:01,080 --> 02:30:03,520 INTERSECTIONITY SHAPE HOW CHANGE 3283 02:30:03,520 --> 02:30:05,520 AND THESE ARE IMPORTANT IN 3284 02:30:05,520 --> 02:30:07,960 IDENTIFYING POINTS OF 3285 02:30:07,960 --> 02:30:10,760 INTERVENTIONS TO IMPROVE HEALTH 3286 02:30:10,760 --> 02:30:12,320 BEHAVIORS. 3287 02:30:12,320 --> 02:30:15,720 INTERSECTIONAL ITY 3288 02:30:15,720 --> 02:30:18,440 INTERSECTIONALITY, ARE RACE, 3289 02:30:18,440 --> 02:30:23,280 CLASS, GENDER GEOGRAPHY AND AGE 3290 02:30:23,280 --> 02:30:25,880 AND INTERACT TO FORM UNIQUE 3291 02:30:25,880 --> 02:30:28,360 MEANS AND COMPLEX EXPERIENCES 3292 02:30:28,360 --> 02:30:31,840 WITHIN THE WEN GROUPS AND SOEFTZ 3293 02:30:31,840 --> 02:30:32,480 AND SHAPES ADAPTATION PROCESSES 3294 02:30:32,480 --> 02:30:37,320 TO OUTCOMES AND IN ORDER TO 3295 02:30:37,320 --> 02:30:40,480 BETTER ASSESS AND ADDRESS 3296 02:30:40,480 --> 02:30:42,880 INEQUALITIES ASSOCIATED WITH 3297 02:30:42,880 --> 02:30:44,880 POLICIES AND PROGRAMS FOR 3298 02:30:44,880 --> 02:30:46,680 ADAPTATION AND SOCIAL ECOLOGICAL 3299 02:30:46,680 --> 02:30:47,480 CHANGE AND ADDRESS THESE. 3300 02:30:47,480 --> 02:30:54,600 BEFORE I END I WANTED TO HAVE 3301 02:30:54,600 --> 02:30:55,440 RECOMMENDED PRACTICES FOR 3302 02:30:55,440 --> 02:30:58,680 MEASUREMENT OF HEALTH 3303 02:30:58,680 --> 02:31:00,000 DISPARITIES OR HEALTH INEQUITIES 3304 02:31:00,000 --> 02:31:02,840 AND SOCIAL DETERMINATES OF 3305 02:31:02,840 --> 02:31:03,120 HEALTH. 3306 02:31:03,120 --> 02:31:05,680 AND THESE INCLUDE ASSESSING THE 3307 02:31:05,680 --> 02:31:07,440 DIFFERENCES IN HEALTH AND ITS 3308 02:31:07,440 --> 02:31:10,800 DETERMINATES THAT ARE ASSOCIATED 3309 02:31:10,800 --> 02:31:13,200 WITH THE SOCIAL POSITION AND 3310 02:31:13,200 --> 02:31:14,760 ASSESSING SOCIAL AND STRUCTURAL 3311 02:31:14,760 --> 02:31:16,080 DETERMINATES OF HEALTH AND 3312 02:31:16,080 --> 02:31:18,880 CONSIDERING MULTIPLE LEVELS OF 3313 02:31:18,880 --> 02:31:19,160 MEASUREMENT. 3314 02:31:19,160 --> 02:31:22,880 THE RATIONALE FOR GROUPS TO BE 3315 02:31:22,880 --> 02:31:23,160 COMPARED. 3316 02:31:23,160 --> 02:31:27,000 SHOULD WE SIMULTANEOUSLY 3317 02:31:27,000 --> 02:31:29,120 CLASSIFY SOCIAL STATUSES AND 3318 02:31:29,120 --> 02:31:33,040 EVALUATING THE IMPACT OF PUBLIC 3319 02:31:33,040 --> 02:31:34,840 POLICIES ADDRESSING SOCIAL 3320 02:31:34,840 --> 02:31:36,920 DETERMINATES OF HEALTH 3321 02:31:36,920 --> 02:31:38,920 INEQUITIES OVER TIME TO SEE IF 3322 02:31:38,920 --> 02:31:46,920 THE IMPACT IS SUSTAIN OVER TIME. 3323 02:31:46,920 --> 02:31:48,960 THOUGH MUCH IS UNDERSTOOD ABOUT 3324 02:31:48,960 --> 02:31:51,800 THE SOCIAL DETERMINATES OF 3325 02:31:51,800 --> 02:31:53,680 HEALTH IN SHAPING THE HEALTH OF 3326 02:31:53,680 --> 02:31:54,760 THE POPULATIONS WE AS RESEARCH 3327 02:31:54,760 --> 02:31:57,160 ARERS NEED TO CONTINUE TO 3328 02:31:57,160 --> 02:31:58,640 ADVANCE UNDERSTANDING THE 3329 02:31:58,640 --> 02:32:02,280 PATHWAYS THROUGH WHICH WE 3330 02:32:02,280 --> 02:32:14,240 OPERATE ON HEALTH OUTCOMES. 3331 02:32:14,240 --> 02:32:17,320 THERE'S STILL WE NEED TO LEARN 3332 02:32:17,320 --> 02:32:18,320 ON SOCIAL DETERMINATES OF HEALTH 3333 02:32:18,320 --> 02:32:19,760 ON GLOBAL AND NATIONAL LEVELS. 3334 02:32:19,760 --> 02:32:25,720 WITH THAT I WILL END. 3335 02:32:25,720 --> 02:32:42,200 >> THANK YOU. 3336 02:32:42,200 --> 02:32:44,280 THANK YOU FOR TALKING ABOUT 3337 02:32:44,280 --> 02:32:46,560 THESE INEQUITIES AND WE KNOW 3338 02:32:46,560 --> 02:32:48,120 ISSUES OF INEQUITY INFLUENCE 3339 02:32:48,120 --> 02:32:51,000 ACCESS THAT EVEN IF WE HAVE 3340 02:32:51,000 --> 02:32:53,680 AVAILABLE FOOD SERVICES OR 3341 02:32:53,680 --> 02:32:56,800 AVAILABLE ASPECTS OF NUTRITION 3342 02:32:56,800 --> 02:32:58,880 AND ACCESS CAN BE IMPLEMENTED BY 3343 02:32:58,880 --> 02:33:05,720 THE INEQUITIES THAT HAVE GONE 3344 02:33:05,720 --> 02:33:05,880 ON. 3345 02:33:05,880 --> 02:33:07,040 AND IT'S IMPORTANT TO CONSIDER 3346 02:33:07,040 --> 02:33:12,400 THAT AS WE CONSIDER HOW THE 3347 02:33:12,400 --> 02:33:14,840 ENVIRONMENT RELATES TO 3348 02:33:14,840 --> 02:33:16,480 CHILDREN'S NUTRITIONAL ECOLOGY. 3349 02:33:16,480 --> 02:33:17,920 I HAVE TO THANK THE SPEAKERS FOR 3350 02:33:17,920 --> 02:33:18,480 STAYING ON TIME. 3351 02:33:18,480 --> 02:33:22,920 WE NOW HAVE AN OPPORTUNITY TO 3352 02:33:22,920 --> 02:33:24,480 ASK QUESTIONS AND MAKE COMMENTS. 3353 02:33:24,480 --> 02:33:30,840 I SAID IN THE BEGINNING DAN HAS 3354 02:33:30,840 --> 02:33:41,800 ASKED ABOUT TALK ABOUT TE 3355 02:33:41,800 --> 02:33:46,600 DRIVERS OF NUTRITION ECOLOGY 3356 02:33:46,600 --> 02:33:50,080 THAT ARE CONSIDERED AND HOW THAT 3357 02:33:50,080 --> 02:33:52,240 INFORMS THE MEASUREMENT AND WORK 3358 02:33:52,240 --> 02:33:53,480 GROUP 4 THEN CONSIDERS SOMETHING 3359 02:33:53,480 --> 02:33:56,560 ABOUT THE TRANSLATION. 3360 02:33:56,560 --> 02:33:57,920 WE'LL OPEN THE FLOOR AND IF YOU 3361 02:33:57,920 --> 02:34:02,760 WOULD LIKE IT MAKE A COMMENT, 3362 02:34:02,760 --> 02:34:04,040 RAISE YOUR HAND AND WHEN TALKING 3363 02:34:04,040 --> 02:34:09,880 IT WOULD BE HELPFUL TO TURN ON 3364 02:34:09,880 --> 02:34:13,280 YOUR VIDEO TO HAVE A SOMEWHAT 3365 02:34:13,280 --> 02:34:14,960 PERSON TO PERSON EXCHANGE. 3366 02:34:14,960 --> 02:34:16,680 CONNIE, I SEE YOUR HAND UP. 3367 02:34:16,680 --> 02:34:17,680 >> CAN YOU HEAR IS THE 3368 02:34:17,680 --> 02:34:19,080 >> YES, I CAN. 3369 02:34:19,080 --> 02:34:21,080 >> VERY GOOD. 3370 02:34:21,080 --> 02:34:22,920 SO THANK YOU FOR THIS EXCELLENT 3371 02:34:22,920 --> 02:34:23,200 WORKSHOP. 3372 02:34:23,200 --> 02:34:26,240 I THINK YOU MANAGED THE TIMING 3373 02:34:26,240 --> 02:34:28,360 OF YOUR PRESENTATIONS BETTER 3374 02:34:28,360 --> 02:34:31,040 THAN WE DID TRYING TO CRAM ALL 3375 02:34:31,040 --> 02:34:38,160 THE BIOLOGY INTO A SIMILAR TIME 3376 02:34:38,160 --> 02:34:39,400 FRAME TO I APPRECIATE THE 3377 02:34:39,400 --> 02:34:39,960 DISCUSSION. 3378 02:34:39,960 --> 02:34:41,400 WHAT I'D LIKE TO SEE, YOU DID A 3379 02:34:41,400 --> 02:34:45,600 GREAT JOB THE WHOLE GROUP ON 3380 02:34:45,600 --> 02:34:49,560 EXPRESSING THE COMPLEXITY AND 3381 02:34:49,560 --> 02:35:01,680 THE SYSTEMS APPROACH AND LET'S 3382 02:35:01,680 --> 02:35:04,640 SAY WHAT OUR FINDS ARE FOR 3383 02:35:04,640 --> 02:35:08,200 EVALUATING EFFICACY OF SOME 3384 02:35:08,200 --> 02:35:12,160 SCHOOL INTERVENTION OR A 3385 02:35:12,160 --> 02:35:12,880 SCHOOL-AGED CHILDREN 3386 02:35:12,880 --> 02:35:14,160 INTERVENTION WHICH I THINK THE 3387 02:35:14,160 --> 02:35:19,400 BIGGEST ONE IS SCHOOL LUNCH AND 3388 02:35:19,400 --> 02:35:21,040 BREAKFAST, THAT SORT OF THING. 3389 02:35:21,040 --> 02:35:22,520 LET'S SAY IT'S FOUND THERE'S 3390 02:35:22,520 --> 02:35:26,240 SOME DEFICIENCY IN A SCHOOL OR 3391 02:35:26,240 --> 02:35:28,360 REGION OR WHATEVER. 3392 02:35:28,360 --> 02:35:36,160 WHAT ARE THE PATHWAYS FROM THAT? 3393 02:35:36,160 --> 02:35:38,040 IN THE U.S. I KEEP THINKING THE 3394 02:35:38,040 --> 02:35:40,680 MAIN STRATEGY IS TO MAKE SURE WE 3395 02:35:40,680 --> 02:35:42,440 GET A THIRD OF THE DIETARY 3396 02:35:42,440 --> 02:35:49,640 GUIDELINES IN EACH OF THE MEALS 3397 02:35:49,640 --> 02:35:52,200 BUT THEN GIVING THE NUTRIENTS TO 3398 02:35:52,200 --> 02:35:55,320 SOME COOL OR REGENTS IDENTIFIED 3399 02:35:55,320 --> 02:35:58,160 IT HAS SOME PROB OR DEFICIENCY I 3400 02:35:58,160 --> 02:36:03,440 DON'T EVER HEAR OF OKAY, THERE'S 3401 02:36:03,440 --> 02:36:06,000 A MICRONUTRIENT SUPPLEMENTATION 3402 02:36:06,000 --> 02:36:06,400 IN THE U.S. 3403 02:36:06,400 --> 02:36:08,120 I KNOW I HEAR ABOUT THEM 3404 02:36:08,120 --> 02:36:11,080 INTERNATIONALLY BUT I DON'T KNOW 3405 02:36:11,080 --> 02:36:12,520 WHO DECIDES THAT. 3406 02:36:12,520 --> 02:36:15,800 WHO MAKES IT HAPPEN. 3407 02:36:15,800 --> 02:36:18,800 SO DO YOU FOLLOW WHAT MY 3408 02:36:18,800 --> 02:36:22,760 INTEREST IS? 3409 02:36:22,760 --> 02:36:23,880 >> YES, THANK YOU. 3410 02:36:23,880 --> 02:36:25,480 >> I'M GOING TO MAKE A VERY 3411 02:36:25,480 --> 02:36:29,880 QUICK COMMENT AND THEN I'M GOING 3412 02:36:29,880 --> 02:36:33,880 TO ASK LORRENE TO ADDRESS THIS 3413 02:36:33,880 --> 02:36:36,400 ISSUE RELATED TO SCHOOL PROGRAMS 3414 02:36:36,400 --> 02:36:37,520 AND I GUESS MY QUICK COMMENT 3415 02:36:37,520 --> 02:36:39,800 WOULD SAY, WELL, WE HAVE HAD 3416 02:36:39,800 --> 02:36:42,480 THINGS LIKE THE HEALTHY 3417 02:36:42,480 --> 02:36:45,600 HUNGER-FREE KIDS ACT THAT HAVE 3418 02:36:45,600 --> 02:36:47,960 TRANSFORMED SCHOOL MEALS, FOR 3419 02:36:47,960 --> 02:36:49,960 EXAMPLE, AND FROM MY PERSPECTIVE 3420 02:36:49,960 --> 02:36:51,680 I THINK SOME OF THE 3421 02:36:51,680 --> 02:36:55,680 TRANSFORMATION HAS COME FROM THE 3422 02:36:55,680 --> 02:36:58,000 FEEDBACK THAT THEY'VE INCREASED 3423 02:36:58,000 --> 02:37:00,080 THE NUTRITIONAL CAUGHT OF SCHOOL 3424 02:37:00,080 --> 02:37:02,480 MEALS BUT THERE'S ALSO BEEN AN 3425 02:37:02,480 --> 02:37:06,480 EFFORT TO INCREASE THE ACCESS 3426 02:37:06,480 --> 02:37:07,560 THE PRESENTATION OF SCHOOL MEALS 3427 02:37:07,560 --> 02:37:08,200 AS WELL. 3428 02:37:08,200 --> 02:37:10,600 WHIL THE NUTRITION PART IS 3429 02:37:10,600 --> 02:37:11,440 INCREDIBLY IMPORTANT AND THAT IS 3430 02:37:11,440 --> 02:37:13,560 WHY WE'RE DOING IT, IT'S 3431 02:37:13,560 --> 02:37:14,960 RECOGNIZED THAT YOU HAVE TO PUT 3432 02:37:14,960 --> 02:37:16,840 THE OTHER PIECES IN PLACE TO 3433 02:37:16,840 --> 02:37:20,800 MAKE IT ACCESSIBLE TO THE 3434 02:37:20,800 --> 02:37:23,240 SCHOOLS TO THE YOUTH AND IT 3435 02:37:23,240 --> 02:37:25,640 THEY'RE WILLING TO PARTICIPATE 3436 02:37:25,640 --> 02:37:27,640 IN IT AND THAT'S WHERE SOME OF 3437 02:37:27,640 --> 02:37:29,880 THE ENVIRONMENTAL THINGS. 3438 02:37:29,880 --> 02:37:34,880 LET ME TURN TO LORENE. 3439 02:37:34,880 --> 02:37:37,560 >> WE CAN BUILD IT AND WE HAVE. 3440 02:37:37,560 --> 02:37:40,120 THE SCHOOL MEAL PROGRAMS ARE 3441 02:37:40,120 --> 02:37:40,880 QUITE WIDESPREAD. 3442 02:37:40,880 --> 02:37:43,240 ALMOST ALL SCHOOLS HAVE THEM AND 3443 02:37:43,240 --> 02:37:44,760 THE NUTRITION STANDARDS ARE 3444 02:37:44,760 --> 02:37:47,400 QUITE ROBUST AND CAN BE IMPROVED 3445 02:37:47,400 --> 02:37:48,880 ALWAYS BUT WE'VE MADE 3446 02:37:48,880 --> 02:37:50,440 SIGNIFICANT HEADWAY IN ENSURING 3447 02:37:50,440 --> 02:37:53,000 ALL SCHOOLS DELIVER MEALS THAT 3448 02:37:53,000 --> 02:37:54,520 ARE HEALTHY. 3449 02:37:54,520 --> 02:37:57,520 HOWEVER, IF YOU BUILD IT THEY 3450 02:37:57,520 --> 02:37:58,240 DON'T ALWAYS COME. 3451 02:37:58,240 --> 02:38:02,000 ONLY 60% OF KIDS PARTICIPATE IN 3452 02:38:02,000 --> 02:38:03,800 THE SCHOOL MEAL PROGRAMS 3453 02:38:03,800 --> 02:38:06,640 REGULARLY AND THE FACTORS SHE 3454 02:38:06,640 --> 02:38:08,040 ALLOWEDED TO WHICH BAN THE 3455 02:38:08,040 --> 02:38:09,760 TOPICS WE TALKED ABOUT IN THE 3456 02:38:09,760 --> 02:38:14,000 WORKSHOP ALL THE WAY FROM DANA'S 3457 02:38:14,000 --> 02:38:15,440 EXAMPLES OF EQUITY AND THERE'S 3458 02:38:15,440 --> 02:38:17,280 STIGMA ASSOCIATED WITH THOSE 3459 02:38:17,280 --> 02:38:22,360 SCHOOL MEALS AND PLACES THEY'RE 3460 02:38:22,360 --> 02:38:23,520 CONSIDERED MEALS AND WE HAVE ALL 3461 02:38:23,520 --> 02:38:27,680 THE OTHER FACTORS THAT WE 3462 02:38:27,680 --> 02:38:29,480 MEASURE AND HOW MUCH TIME DO 3463 02:38:29,480 --> 02:38:31,760 KIDS HAVE TO EAT, IS THERE A 3464 02:38:31,760 --> 02:38:34,200 PLACE FOR THEM TO SIT AND DO 3465 02:38:34,200 --> 02:38:39,040 THEY VALUE THAT MEAL, DO THEY 3466 02:38:39,040 --> 02:38:42,280 COME BRINGING A BUNCH OF OTHER 3467 02:38:42,280 --> 02:38:43,480 STUDENTS FROM HOME THAT COMPETE 3468 02:38:43,480 --> 02:38:48,160 WITH THE SCHOOL MEALS. 3469 02:38:48,160 --> 02:38:49,880 THERE'S DIFFERENT FACTORS IN 3470 02:38:49,880 --> 02:38:51,280 CALIFORNIA WE'RE WORKING TO 3471 02:38:51,280 --> 02:38:52,720 ADOPT A PRESCHOOL MEALS FOR ALL 3472 02:38:52,720 --> 02:38:57,800 THAT WILL HOPEFULLY ANSWER 3473 02:38:57,800 --> 02:39:00,840 QUESTIONS ABOUT ACCESS AND REE 3474 02:39:00,840 --> 02:39:04,200 REDUCING STIGMA AND YOU PROBABLY 3475 02:39:04,200 --> 02:39:09,720 KNOW AS WELL I DO OUR BIOLOGY WE 3476 02:39:09,720 --> 02:39:12,880 LOVE SUGAR, FAT AND SALT. 3477 02:39:12,880 --> 02:39:14,160 THAT'S WHAT KIDS IN THE UNITED 3478 02:39:14,160 --> 02:39:16,600 STATES ARE USED TO EATING WHEN 3479 02:39:16,600 --> 02:39:19,000 WE HAVE FOODS WITH LESS ADDED 3480 02:39:19,000 --> 02:39:25,920 SUGARS, FAT AND SALT IT'S HARD 3481 02:39:25,920 --> 02:39:26,280 ON THEIR PALATE. 3482 02:39:26,280 --> 02:39:28,960 THERE'S A LOT OF WE NEED TO 3483 02:39:28,960 --> 02:39:33,840 IMPLEMENT BEFORE EVERYBODY GETS 3484 02:39:33,840 --> 02:39:35,080 EXCITED ABOUT THE SCHOOL MEALS 3485 02:39:35,080 --> 02:39:37,480 AND QUALITY AND FRESHNESS AND 3486 02:39:37,480 --> 02:39:40,440 PRODUCING THOSE WITH DOLLARS. 3487 02:39:40,440 --> 02:39:42,040 EACH SCHOOL MEAL ONLY GETS 3488 02:39:42,040 --> 02:39:43,680 REIMBURSED FOR $2. 3489 02:39:43,680 --> 02:39:45,680 WE MAY HAVE TO THINK ABOUT THAT 3490 02:39:45,680 --> 02:39:55,880 AS A SOCIETY INVESTING MORE TO 3491 02:39:55,880 --> 02:39:58,560 GET MEALS OUT ON THAT BUDGET BUT 3492 02:39:58,560 --> 02:40:09,200 HOW DO WE MAKE THEM APPEALING. 3493 02:40:09,200 --> 02:40:11,680 >> THERE'S SOME RELATED WITH MY 3494 02:40:11,680 --> 02:40:14,480 RATES OF ANEMIA AND ARE THERE 3495 02:40:14,480 --> 02:40:18,720 PRATH WAYS TO SAY, OKAY, THERE'S 3496 02:40:18,720 --> 02:40:20,240 EXTRA ATTENTION NEEDED FOR THE 3497 02:40:20,240 --> 02:40:27,520 ONE NUTRIENT SOMEHOW? 3498 02:40:27,520 --> 02:40:30,280 >> DO THEY TAKE ON 3499 02:40:30,280 --> 02:40:32,920 SUPPLEMENTATION OF IRON AND 3500 02:40:32,920 --> 02:40:33,240 ANEMIA -- 3501 02:40:33,240 --> 02:40:39,360 >> NOT SCHOOL MEALS TAKE IT ON 3502 02:40:39,360 --> 02:40:40,760 BUT 3503 02:40:40,760 --> 02:40:47,640 >> THE ASSESSMENT --. 3504 02:40:47,640 --> 02:40:50,080 >> THIS CONVERSATION HAS GONE 3505 02:40:50,080 --> 02:40:51,640 FRON THE BEGINNING AND ARE WE 3506 02:40:51,640 --> 02:40:57,040 FOCUSSING ON SCHOOL-CENTRIC 3507 02:40:57,040 --> 02:40:59,400 PROGRAMS OR EFFORTS TO ASSESS 3508 02:40:59,400 --> 02:41:04,840 NUTRITION ON SCHOOL-AGED 3509 02:41:04,840 --> 02:41:05,560 CHILDREN. 3510 02:41:05,560 --> 02:41:09,280 THERE'S ISSUES RELATED TO WHAT 3511 02:41:09,280 --> 02:41:12,360 NUTRIENT MOST RESPONSIVE TO 3512 02:41:12,360 --> 02:41:15,320 SPECIFIC TYPES OF PROGRAMS THAT 3513 02:41:15,320 --> 02:41:16,480 MAY BE WORTHY TO CONSIDER FOR 3514 02:41:16,480 --> 02:41:18,600 ASSESSMENT. 3515 02:41:18,600 --> 02:41:21,720 IN TERMS OF THE PROGRAM THE 3516 02:41:21,720 --> 02:41:30,240 WRAP-AROUND [INAUDIBLE] -- MANY 3517 02:41:30,240 --> 02:41:32,080 KIDS WE'RE TALKING ABOUT 3518 02:41:32,080 --> 02:41:33,920 PARTICULARLY IN 3519 02:41:33,920 --> 02:41:39,680 NON-U.S. SETTINGS LOW-RESOURCE 3520 02:41:39,680 --> 02:41:43,880 SETTINGS ARE [INDISCERNIBLE] AND 3521 02:41:43,880 --> 02:41:45,840 THAT TO BE CONSIDERED AS WE 3522 02:41:45,840 --> 02:41:46,920 ASSESS IMPACT. 3523 02:41:46,920 --> 02:41:51,000 IT'S NOT JUST THE IMPACT OF WHAT 3524 02:41:51,000 --> 02:41:53,480 KIDS ARE RECEIVING IN THE SCHOOL 3525 02:41:53,480 --> 02:41:57,760 BUT TO TRULY ASSESS THE IMPACT 3526 02:41:57,760 --> 02:41:59,600 WE NEED TO RECOGNIZE THE 3527 02:41:59,600 --> 02:42:03,320 NUTRITIONAL BIOLOGY OF THE 3528 02:42:03,320 --> 02:42:03,560 CONTENT. 3529 02:42:03,560 --> 02:42:18,920 I THINK [INDISCERNIBLE] 3530 02:42:18,920 --> 02:42:20,040 [OFF MIC] 3531 02:42:20,040 --> 02:42:21,480 >> DAN, WE'RE LOSING YOUR VOICE. 3532 02:42:21,480 --> 02:42:23,480 >> WHAT PART DID YOU MISS? 3533 02:42:23,480 --> 02:42:26,000 >> IT WAS GETTING QUIET. 3534 02:42:26,000 --> 02:42:26,680 IT WAS GOING DOWN. 3535 02:42:26,680 --> 02:42:34,840 WE COULD NOT HEAR. 3536 02:42:34,840 --> 02:42:38,800 >> DID YOU HAVE ANOTHER COMMENT, 3537 02:42:38,800 --> 02:42:38,960 DAN? 3538 02:42:38,960 --> 02:42:43,080 IT WAS DAN, DON AND JAYNA. 3539 02:42:43,080 --> 02:42:43,680 DO YOU HAVE ANOTHER COMMENT, 3540 02:42:43,680 --> 02:42:54,880 DAN? 3541 02:42:54,880 --> 02:42:56,480 >> THERE WERE QUESTIONS OUTLINED 3542 02:42:56,480 --> 02:43:01,480 AND WE NEED TO HEAR FROM 3543 02:43:01,480 --> 02:43:15,920 [OFF MIC] 3544 02:43:15,920 --> 02:43:19,080 THERE WERE SPECIFIC FUNCTIONAL 3545 02:43:19,080 --> 02:43:19,320 OUTCOMES. 3546 02:43:19,320 --> 02:43:23,440 IN TERM OF OUR ABILITY TO FORM 3547 02:43:23,440 --> 02:43:30,280 GROUP 3 AND 4 I'D LIKE TO HEAR 3548 02:43:30,280 --> 02:43:30,720 FROM THEM. 3549 02:43:30,720 --> 02:43:33,400 >> WE'LL HAVE DON NEXT AND THEN 3550 02:43:33,400 --> 02:43:41,080 JAYNA AND THEN AMY. 3551 02:43:41,080 --> 02:43:43,800 >> I WANTED TO RESPOND. 3552 02:43:43,800 --> 02:43:51,400 THERE'S NOT UNLIKE THE OTHER 3553 02:43:51,400 --> 02:43:53,840 COUNTRIES, THERE'S NOT MANY 3554 02:43:53,840 --> 02:43:56,280 PROGRAMS THAT RESPOND TO 3555 02:43:56,280 --> 02:43:58,680 MICRONUTRIENT DEFICIENCIES IN 3556 02:43:58,680 --> 02:44:03,680 THE U.S. AND THERE ARE SOME 3557 02:44:03,680 --> 02:44:07,480 THROUGH INSURANCE BUT MOST THE 3558 02:44:07,480 --> 02:44:09,160 PROGRAMS ARE PROBABLY GEARED 3559 02:44:09,160 --> 02:44:15,680 TOWARDS OBESITY PREVENTION. 3560 02:44:15,680 --> 02:44:17,560 WHEN YOU LOOK AT SCHOOL PROGRAMS 3561 02:44:17,560 --> 02:44:19,520 THOUGH THEY DO HAVE THE 3562 02:44:19,520 --> 02:44:20,520 REQUIREMENTS, NUTRITION 3563 02:44:20,520 --> 02:44:21,520 REQUIREMENTS FOR SCHOOL MEALS 3564 02:44:21,520 --> 02:44:25,800 AND SO ON, I DON'T THINK THERE 3565 02:44:25,800 --> 02:44:29,920 IS A FOLLOW-UP ON MICRONUTRIENT 3566 02:44:29,920 --> 02:44:37,280 DEFICIENCIEIES AS MUCH AS FOR. 3567 02:44:37,280 --> 02:44:39,440 >> THE WIC PROGRAM RESPONDED TO 3568 02:44:39,440 --> 02:44:45,480 THE IRON DEFICIENCY AT ITS 3569 02:44:45,480 --> 02:44:47,640 FORMATION AND IS MORE DRIVEN 3570 02:44:47,640 --> 02:44:49,840 TOWARD THE NUTRIENT REQUIREMENTS 3571 02:44:49,840 --> 02:44:53,280 OF CHILDREN UP THROUGH AGE 5 BUT 3572 02:44:53,280 --> 02:44:54,880 THAT DOES NOT APPLY TO CHILDREN 3573 02:44:54,880 --> 02:44:59,080 IN THIS AGE GROUP. 3574 02:44:59,080 --> 02:45:00,680 THERE'S ALSO SOME OF THE FOOD AS 3575 02:45:00,680 --> 02:45:02,280 MEDICINE INTERVENTIONS THAT 3576 02:45:02,280 --> 02:45:06,800 WOULD BE ASSOCIATED WITH 3577 02:45:06,800 --> 02:45:08,160 PARTICULAR PROBLEMS THAT HILARY 3578 02:45:08,160 --> 02:45:11,440 SPOKE ABOUT IN HER TALK ON FOOD 3579 02:45:11,440 --> 02:45:12,720 INSECURITY. 3580 02:45:12,720 --> 02:45:15,280 NOW WE'LL GO TO DON AND I WOULD 3581 02:45:15,280 --> 02:45:16,720 ASK PEOPLE TO BE SOMEWHAT BRIEF 3582 02:45:16,720 --> 02:45:29,200 IS WE END ON TIME. 3583 02:45:29,200 --> 02:45:30,640 >> THANK YOU. 3584 02:45:30,640 --> 02:45:32,200 CONGRATULATIONS ON A SUPER GREAT 3585 02:45:32,200 --> 02:45:32,480 SESSION. 3586 02:45:32,480 --> 02:45:33,600 GREAT PRESENTATIONS. 3587 02:45:33,600 --> 02:45:35,760 I WANT TO RESPOND ON TWO ISSUES 3588 02:45:35,760 --> 02:45:47,400 IN TERMS OF WORK GROUP 2. 3589 02:45:47,400 --> 02:45:48,680 ONE IS AROUND THE COMPLEXITY OF 3590 02:45:48,680 --> 02:45:50,800 THE DYNAMICS AND THE LIFE COURSE 3591 02:45:50,800 --> 02:45:56,240 AND THAT COMES THROUGH AS A 3592 02:45:56,240 --> 02:45:59,360 CHALLENGE IN THE COMPLEXITY OF 3593 02:45:59,360 --> 02:46:02,080 THE INDICATORS WE'RE 3594 02:46:02,080 --> 02:46:05,720 CONSIDERING. 3595 02:46:05,720 --> 02:46:08,040 TALKING ABOUT METHODS AND WE 3596 02:46:08,040 --> 02:46:09,160 HAVE TO MEASURE A LOT OF THINGS 3597 02:46:09,160 --> 02:46:10,520 IF WE'RE GOING UNDERSTAND THIS. 3598 02:46:10,520 --> 02:46:19,360 THE EXAMPLES WERE GIVEN WHICH 3599 02:46:19,360 --> 02:46:25,880 WERE BRIL -- BRILLIANT IN 3600 02:46:25,880 --> 02:46:26,520 LOW-RESOURCED COMMUNITIES AND 3601 02:46:26,520 --> 02:46:30,720 PARTICULARLY WELL FUNDED 3602 02:46:30,720 --> 02:46:34,400 MONITORING METHODS IN CONTRAST 3603 02:46:34,400 --> 02:46:35,760 TO WHAT RESOURCE-POOR COUNTRIES 3604 02:46:35,760 --> 02:46:37,280 WOULD HAVE TO INVEST IN THIS 3605 02:46:37,280 --> 02:46:41,800 KIND OF MONITORING. 3606 02:46:41,800 --> 02:46:44,120 I THINK IT WOULD BE HELPFUL IF 3607 02:46:44,120 --> 02:46:46,160 WORKING GROUP 3 IN THINKING 3608 02:46:46,160 --> 02:46:48,120 ABOUT THIS ADDRESSES A KEY ISSUE 3609 02:46:48,120 --> 02:46:51,680 ABOUT HOW DO WE MINIMIZE THE 3610 02:46:51,680 --> 02:46:52,560 SCOPE AND COMPLEXITY WITHOUT 3611 02:46:52,560 --> 02:46:55,160 LOSING SITE OF THE NEED TO 3612 02:46:55,160 --> 02:47:03,480 EMBRACE COMPLEXITY. 3613 02:47:03,480 --> 02:47:05,600 I'M PUTTING THAT FORWARD AS A 3614 02:47:05,600 --> 02:47:05,880 CHALLENGE. 3615 02:47:05,880 --> 02:47:08,880 I'M CLEAR WE NEED TO MAKE THESE 3616 02:47:08,880 --> 02:47:11,160 MEASUREMENTS BUT HOW DO WE GET 3617 02:47:11,160 --> 02:47:13,680 TO AN OPTIMAL MINIMAL GROUP ON 3618 02:47:13,680 --> 02:47:14,000 THIS. 3619 02:47:14,000 --> 02:47:15,680 >> I HEAR YOU ASKING FOR A 3620 02:47:15,680 --> 02:47:16,680 BALANCE TO RESPECT THE 3621 02:47:16,680 --> 02:47:18,840 COMPLEXITY NOT IGNORE IT AS WE 3622 02:47:18,840 --> 02:47:21,520 HAVE IN OUR SILOED HISTORY BUT 3623 02:47:21,520 --> 02:47:22,320 WE CANNOT HAVE EVERYTHING RELATE 3624 02:47:22,320 --> 02:47:28,720 TO EVERYTHING. 3625 02:47:28,720 --> 02:47:31,760 >> THAT'S RIGHT AND FOR SOME 3626 02:47:31,760 --> 02:47:33,880 RESOURCED SETTINGS IT'S VITAL TO 3627 02:47:33,880 --> 02:47:35,280 STEP UP AND DO SOMETHING 3628 02:47:35,280 --> 02:47:36,280 IMPORTANT. 3629 02:47:36,280 --> 02:47:38,920 AND A MISSING PIECE BECAUSE DAN 3630 02:47:38,920 --> 02:47:44,720 ASKED US TO REFLECT ON THOSE I 3631 02:47:44,720 --> 02:47:46,160 THOUGHT IN THE PLANETARY 3632 02:47:46,160 --> 02:47:48,480 PRESENTATION ONE THING THAT WAS 3633 02:47:48,480 --> 02:47:50,240 WORTH EMPHASIZING IS FOOD 3634 02:47:50,240 --> 02:47:51,880 SYSTEMS DO ALLOW SOME CLIMATE 3635 02:47:51,880 --> 02:47:52,760 SENSITIVE IN THE WAY WHICH WE 3636 02:47:52,760 --> 02:47:57,960 RESPONSE TO SOME OF THESE IT 3637 02:47:57,960 --> 02:48:09,080 THINGS IN NEPAL WHERE WHAT WAS 3638 02:48:09,080 --> 02:48:11,480 USED IN SCHOOLS ROSE FROM 3 TO 3639 02:48:11,480 --> 02:48:15,480 28 WHEN LOCALLY SOURCED 3640 02:48:15,480 --> 02:48:17,880 MATERIALS WERE ENCOURAGED AS 3641 02:48:17,880 --> 02:48:18,960 PART OF IT. 3642 02:48:18,960 --> 02:48:21,400 THIS ROLLED BACK THE IDEA OF 3643 02:48:21,400 --> 02:48:26,520 FOOD PRODUCTION TO THE MORE 3644 02:48:26,520 --> 02:48:29,920 SUSTAINABLE BIO DIVERSITY 3645 02:48:29,920 --> 02:48:32,480 APPROACHES AND MORE CULTURALLY 3646 02:48:32,480 --> 02:48:34,160 APPROPRIATE APPROACH WHICH SEEMS 3647 02:48:34,160 --> 02:48:35,320 TO BE MORE RESPONSIVE TO 3648 02:48:35,320 --> 02:48:42,560 CLIMATE. 3649 02:48:42,560 --> 02:48:48,200 AND WE DON'T SEE DICHOTOMIES 3650 02:48:48,200 --> 02:48:51,400 VERY CLEARLY AND DISCUSSION OF 3651 02:48:51,400 --> 02:48:53,160 BANNING MEATS IN THE NORTH FOR 3652 02:48:53,160 --> 02:48:54,840 GOOD REASONS AND MEANWHILE WHEN 3653 02:48:54,840 --> 02:48:57,400 LOOKING AT LOW-RESOURCED 3654 02:48:57,400 --> 02:49:00,240 COUNTRIES, NUTRIENT DENSE 3655 02:49:00,240 --> 02:49:02,240 ANIMAL-SOURCED FOODS LIKE MILK 3656 02:49:02,240 --> 02:49:04,360 AND EGGS REMAIN VITALLY 3657 02:49:04,360 --> 02:49:05,240 IMPORTANT, ACTUALLY. 3658 02:49:05,240 --> 02:49:07,080 THAT KIND OF DISCUSSION I DON'T 3659 02:49:07,080 --> 02:49:08,480 THINK WE'VE CAPTURED AT THE 3660 02:49:08,480 --> 02:49:17,120 STAGE IN OUR DISCUSSIONS. 3661 02:49:17,120 --> 02:49:18,280 >> THANK YOU. 3662 02:49:18,280 --> 02:49:18,440 AMY. 3663 02:49:18,440 --> 02:49:20,600 >> I WANTED TO GO BACK TO THE 3664 02:49:20,600 --> 02:49:21,960 DISCUSSION THAT CONNIE HAD ABOUT 3665 02:49:21,960 --> 02:49:23,720 PROGRAMS AND ADOPTION OF 3666 02:49:23,720 --> 02:49:25,440 PROGRAMS AND THE COMMENT SUSAN 3667 02:49:25,440 --> 02:49:27,360 HAD HARKENING BACK TO HILARY'S 3668 02:49:27,360 --> 02:49:29,400 COMMENT ABOUT THE NEED TO MAKE 3669 02:49:29,400 --> 02:49:30,840 SURE PROGRAMS ARE SOCIALLY AND 3670 02:49:30,840 --> 02:49:36,320 CULTURALLY DRIVEN AND I WANT TO 3671 02:49:36,320 --> 02:49:40,320 SAY IN MY OWN EXPERIENCE AND 3672 02:49:40,320 --> 02:49:42,480 IT'S VERY DOMESTIC AND HYPER 3673 02:49:42,480 --> 02:49:44,920 LOCAL BUT IN TERMS OF IMPLEMENT 3674 02:49:44,920 --> 02:49:47,320 AND ALL OF US ARE THINKING ABOUT 3675 02:49:47,320 --> 02:49:50,200 METRICS AND MEASURES, COMMUNITY 3676 02:49:50,200 --> 02:49:53,160 ENGAGEMENT IN THE CULTURAL 3677 02:49:53,160 --> 02:49:56,560 LINGUISTIC CONTEXTUAL ADAPTATION 3678 02:49:56,560 --> 02:49:58,840 OF SUCCESSFUL PROGRAMS AND 3679 02:49:58,840 --> 02:49:59,400 INTERVENTIONS IS KEY. 3680 02:49:59,400 --> 02:50:03,400 AND THEIR ENGAGEMENT CAN HELP US 3681 02:50:03,400 --> 02:50:05,080 TO LIKE A PATIENT-CENTERED 3682 02:50:05,080 --> 02:50:07,240 OUTCOMES RESEARCH THINKING ABOUT 3683 02:50:07,240 --> 02:50:08,800 COMMUNITY-CENTERED OUTCOMES 3684 02:50:08,800 --> 02:50:11,480 RESEARCH APPROACH TO CO-CREATING 3685 02:50:11,480 --> 02:50:14,320 METRICS TO THOSE CO-CREATED OR 3686 02:50:14,320 --> 02:50:15,640 CO-TAILORED INTERVENTIONS TO 3687 02:50:15,640 --> 02:50:19,400 MAKE SURE THAT WE'RE DESIGNING 3688 02:50:19,400 --> 02:50:20,440 BOTH IMPLEMENT AND EVALUATION AT 3689 02:50:20,440 --> 02:50:23,280 THE SAME TIME IN THE MOST 3690 02:50:23,280 --> 02:50:25,280 SUCCESSFUL WAY.IN THE 3691 02:50:25,280 --> 02:50:27,280 COMMUNITIES I WORK WITH, PRIOR 3692 02:50:27,280 --> 02:50:29,520 FAILED NUTRITION, PHYSICAL 3693 02:50:29,520 --> 02:50:31,000 ACTIVITY, CHRONIC DISEASE 3694 02:50:31,000 --> 02:50:32,000 PREVENTION AND COMMUNITY 3695 02:50:32,000 --> 02:50:33,800 VIOLENCE PREVENTION PROGRAMS 3696 02:50:33,800 --> 02:50:36,400 JUST CONTINUE TO STIGMATIZE AND 3697 02:50:36,400 --> 02:50:37,800 RECREATE COMMUNITY-LEVEL TRAUMA 3698 02:50:37,800 --> 02:50:43,360 AND SO I THINK IT'S BOTH 3699 02:50:43,360 --> 02:50:46,520 ESSENTIAL TO THE EFFECTIVE ROLE 3700 02:50:46,520 --> 02:50:47,680 TO HEALTH EQUITY AND TO ALL OF 3701 02:50:47,680 --> 02:50:48,800 US TRYING TO DO THE WORK AND 3702 02:50:48,800 --> 02:50:50,200 MEASURE IT AND BE ABLE TO SHARE 3703 02:50:50,200 --> 02:50:52,200 BEST PRACTICES. 3704 02:50:52,200 --> 02:50:54,040 >> THANK YOU. 3705 02:50:54,040 --> 02:50:57,160 CAN I ASK A QUICK QUESTION AND I 3706 02:50:57,160 --> 02:51:04,520 HOPE I CAN ASK IN NOT TOO -- 3707 02:51:04,520 --> 02:51:06,600 NAIVE A WAY AND WHAT CHRISTINE 3708 02:51:06,600 --> 02:51:07,960 TALKED ABOUT EARLIER TODAY ALSO 3709 02:51:07,960 --> 02:51:13,680 IS HOW -- IT'S A QUESTION OF HOW 3710 02:51:13,680 --> 02:51:17,760 DO HAVE THE TOP-DOWN AND 3711 02:51:17,760 --> 02:51:19,040 BOTTOM-UP AND NOT BEING 3712 02:51:19,040 --> 02:51:20,040 SIMPLISTIC IN DOING THAT BUT YOU 3713 02:51:20,040 --> 02:51:23,720 HAVE THE STAKEHOLDERS OR THE 3714 02:51:23,720 --> 02:51:26,040 GOVERNMENTAL ASPECTS OF A 3715 02:51:26,040 --> 02:51:27,880 COMMUNITY INVOLVED AND YOU ALSO 3716 02:51:27,880 --> 02:51:32,680 THEN ARE RESPONSIVE TO THE 3717 02:51:32,680 --> 02:51:33,520 COMMUNITY LEVEL OR THE HOUSEHOLD 3718 02:51:33,520 --> 02:51:33,720 LEVEL. 3719 02:51:33,720 --> 02:51:38,520 HOW DO YOU GET BOTH OF THEM, IF 3720 02:51:38,520 --> 02:51:42,240 THEY ARE INVOLVED IN CREATING A 3721 02:51:42,240 --> 02:51:44,280 WHOLE SYSTEMS APPROACH OR HOW DO 3722 02:51:44,280 --> 02:51:47,240 YOU -- BECAUSE IT SOUNDS AS 3723 02:51:47,240 --> 02:51:50,280 THOUGH YOU'RE NEEDING BOTH OF 3724 02:51:50,280 --> 02:51:51,920 THEM. 3725 02:51:51,920 --> 02:51:53,080 >> IT'S VERY DIFFICULT. 3726 02:51:53,080 --> 02:51:58,440 IT HAS TO BE INTENTIONAL AND A 3727 02:51:58,440 --> 02:51:59,800 MODEL CAN DO THAT BY CENTERING 3728 02:51:59,800 --> 02:52:01,600 COMMUNITY VOICES AS IMPORTANT 3729 02:52:01,600 --> 02:52:05,720 AND ESSENTIAL EXPERTISE THAT 3730 02:52:05,720 --> 02:52:09,000 ADDS TO THE COLLECTIVE EXPERTISE 3731 02:52:09,000 --> 02:52:10,880 OF EVERYONE INVOLVED IN MAKING 3732 02:52:10,880 --> 02:52:12,240 THESE LARGE INITIATIVES HAPPEN. 3733 02:52:12,240 --> 02:52:15,800 AND YOU HAVE TO BE VERY 3734 02:52:15,800 --> 02:52:19,400 INTENTIONAL WITH TRUST BUILDING, 3735 02:52:19,400 --> 02:52:22,040 COMMUNICATION AND JARGON USE IN 3736 02:52:22,040 --> 02:52:23,160 THE BEGINNING AND SOMETIMES IT'S 3737 02:52:23,160 --> 02:52:26,240 AS SIMPLE AS LEVELLING THE 3738 02:52:26,240 --> 02:52:27,320 PLAYING FIELD AND MAKING SURE 3739 02:52:27,320 --> 02:52:29,160 FOLKS ARE APPROACHING THEIR 3740 02:52:29,160 --> 02:52:30,840 CONTRIBUTION TO THE WORK WITH 3741 02:52:30,840 --> 02:52:32,560 SOME CAPACITY BUILDING AND SOME 3742 02:52:32,560 --> 02:52:36,800 TERMINOLOGY DEFINITIONS SO FOLKS 3743 02:52:36,800 --> 02:52:38,440 WHO ARE TYPICALLY NOT POWERED, 3744 02:52:38,440 --> 02:52:40,040 MORE EMPOWERED TO CONTRIBUTE 3745 02:52:40,040 --> 02:52:41,080 THEIR EXPERTISE AND THOUGHTS. 3746 02:52:41,080 --> 02:52:43,920 IT'S COMPLEX BUT WE HAVE LOTS OF 3747 02:52:43,920 --> 02:52:46,840 LARGE FIELD FOCUSSED TO THIS AND 3748 02:52:46,840 --> 02:52:48,080 LOTS OF TOOL KITS AND BEST 3749 02:52:48,080 --> 02:52:50,240 PRACTICES. 3750 02:52:50,240 --> 02:52:53,480 >> THANKS, THANKS. 3751 02:52:53,480 --> 02:52:53,720 SARABH. 3752 02:52:53,720 --> 02:52:59,320 >> THANK YOU. 3753 02:52:59,320 --> 02:53:00,920 I WILL THANK YOU FOR THE 3754 02:53:00,920 --> 02:53:02,720 PRESENTATIONS AND 3755 02:53:02,720 --> 02:53:03,160 CONGRATULATIONS. 3756 02:53:03,160 --> 02:53:08,440 FROM THE WORK GROUP 3 3757 02:53:08,440 --> 02:53:11,000 PERSPECTIVE, WE HAVE ASSESSMENT 3758 02:53:11,000 --> 02:53:13,400 AND FOOD FOR THOUGHT AROUND HOW 3759 02:53:13,400 --> 02:53:15,680 TO BALANCE THE COMPLEXITY OF THE 3760 02:53:15,680 --> 02:53:17,080 THINGS WE MEASURE AND THE 3761 02:53:17,080 --> 02:53:23,760 FEASIBILITY OF WHAT CAN BE DONE. 3762 02:53:23,760 --> 02:53:25,600 HOPEFULLY WE'LL BE ABLE TO REACH 3763 02:53:25,600 --> 02:53:28,040 OUT TO YOUR GROUP AS WELL AS TRY 3764 02:53:28,040 --> 02:53:28,880 TO WORK ON THOSE STEPS OF 3765 02:53:28,880 --> 02:53:30,880 ASSESSMENTS. 3766 02:53:30,880 --> 02:53:31,120 THANK YOU. 3767 02:53:31,120 --> 02:53:37,120 >> WONDERFUL, THANK YOU. 3768 02:53:37,120 --> 02:53:37,840 >> RAPHAEL. 3769 02:53:37,840 --> 02:53:41,000 >> GOOD AFTERNOON. 3770 02:53:41,000 --> 02:53:44,560 A QUICK COMMENT ABOUT THE 3771 02:53:44,560 --> 02:53:47,280 SURVEILLANCE IN THE U.S. VERY 3772 02:53:47,280 --> 02:53:47,480 LIMITED. 3773 02:53:47,480 --> 02:53:53,080 THE ONLY SOURCE WE VERY IS THE 3774 02:53:53,080 --> 02:53:55,240 NHANES SURVEY AND TRYING TO LOOK 3775 02:53:55,240 --> 02:53:56,800 AT THE LOCATION OF 5-19. 3776 02:53:56,800 --> 02:54:00,800 WE WORK IN THAT AREA BUT OUR 3777 02:54:00,800 --> 02:54:03,880 PRIORITY IS THE FIRST 1,000 3778 02:54:03,880 --> 02:54:04,600 DAYS. 3779 02:54:04,600 --> 02:54:10,440 THE MOTHER AND THE KIDS. 3780 02:54:10,440 --> 02:54:12,160 THERE'S A SYSTEM LOOKING INTO 3781 02:54:12,160 --> 02:54:15,280 THIS WHEN YOU LOOK BACK TO THE 3782 02:54:15,280 --> 02:54:17,080 STATES IN THE U.S. AND 3783 02:54:17,080 --> 02:54:17,960 TERRITORIES AND TRIBES. 3784 02:54:17,960 --> 02:54:20,560 THERE'S NO DATA WHATSOEVER WE 3785 02:54:20,560 --> 02:54:21,240 CAN USE. 3786 02:54:21,240 --> 02:54:23,240 THIS IS A KEY AREA. 3787 02:54:23,240 --> 02:54:24,680 IF WE ARE GOING TO BE THINKING 3788 02:54:24,680 --> 02:54:27,920 ABOUT WHAT IS THE STATUS OF THE 3789 02:54:27,920 --> 02:54:35,280 SCHOOL CHILDREN 5-19 USING THE 3790 02:54:35,280 --> 02:54:40,280 SCHOOL AS FIRST WE NEED TO KNOW 3791 02:54:40,280 --> 02:54:40,640 THE SITUATION. 3792 02:54:40,640 --> 02:54:56,400 OVER. 3793 02:54:56,400 --> 02:54:59,400 >> I'LL RESPOND TO SOMETHING DON 3794 02:54:59,400 --> 02:55:06,680 SAID AND IF CHRISTIE WANTS TO 3795 02:55:06,680 --> 02:55:11,480 RESPOND WITH CLIMB AND HOME 3796 02:55:11,480 --> 02:55:12,880 SYSTEMS IT STILL DOESN'T ADDRESS 3797 02:55:12,880 --> 02:55:17,400 THE IT ISSUE OF CARBON DIOXIDE 3798 02:55:17,400 --> 02:55:18,000 IN THE ENVIRONMENT WHICH WILL 3799 02:55:18,000 --> 02:55:31,040 AFFECT QUALITY. 3800 02:55:31,040 --> 02:55:32,760 IT ASSESSES PROGRAMS OF SCHOOL 3801 02:55:32,760 --> 02:55:33,040 CHILDREN. 3802 02:55:33,040 --> 02:55:36,560 HOW DO WE ATTRIBUTE ASPECTS OF 3803 02:55:36,560 --> 02:55:37,600 THE CHILD'S ECONOMY TO IMPACT 3804 02:55:37,600 --> 02:55:42,280 EVALUATION. 3805 02:55:42,280 --> 02:55:44,480 WHILE IT'S IMPORTANT TO 3806 02:55:44,480 --> 02:55:47,080 UNDERSTAND THE PROGRAMS WE STILL 3807 02:55:47,080 --> 02:55:49,240 ARE NOT DISCUSSING THE IMPACT OF 3808 02:55:49,240 --> 02:55:50,520 THE CHILD ON THE CHILD. 3809 02:55:50,520 --> 02:55:52,680 WHETHER IT'S CLIMATE, IF YOU'RE 3810 02:55:52,680 --> 02:55:56,800 ASSESSING GOING BACK TO WORKING 3811 02:55:56,800 --> 02:55:59,360 GROUP ONE AND ASSESSING 3812 02:55:59,360 --> 02:56:01,200 NEUROLOGICAL OUTCOME OR IMMUNE 3813 02:56:01,200 --> 02:56:03,480 FUNCTION IF YOU DON'T CONSIDER 3814 02:56:03,480 --> 02:56:08,200 THE CHILD'S PHYSICAL ENVIRONMENT 3815 02:56:08,200 --> 02:56:09,760 YOU'LL FALSELY ATTRIBUTE TO A 3816 02:56:09,760 --> 02:56:12,520 LIMITED SET OF BARRIERS. 3817 02:56:12,520 --> 02:56:14,000 THE CHALLENGE STARTS WHAT 3818 02:56:14,000 --> 02:56:16,080 VARIABLE WE NEED TO INCLUDE IN 3819 02:56:16,080 --> 02:56:17,080 THIS ASSESSMENT BATTERY THAT 3820 02:56:17,080 --> 02:56:21,440 GETS A HANDLE ON THE IMPACT OF 3821 02:56:21,440 --> 02:56:23,400 THE PROGRAMS ON KIDS IN THE 3822 02:56:23,400 --> 02:56:26,640 ENVIRONMENT THEY LIVE IN. 3823 02:56:26,640 --> 02:56:34,240 AND THAT'S A FOCUS WITH THE 3824 02:56:34,240 --> 02:56:45,520 PROGRAMS ON THE CHILD AND IT WIZ 3825 02:56:45,520 --> 02:56:49,520 -- WAS MADE CLEAR US TO WE 3826 02:56:49,520 --> 02:56:50,520 DON'T KNOW THROUGH FOCUS ON THE 3827 02:56:50,520 --> 02:56:53,040 CHILD'S HEALTH AND DEVELOPMENT. 3828 02:56:53,040 --> 02:56:53,720 THAT'S WHAT WE NEED TO BE 3829 02:56:53,720 --> 02:56:54,040 FOCUSSED ON. 3830 02:56:54,040 --> 02:56:59,720 THANK YOU. 3831 02:56:59,720 --> 02:57:00,280 >> THANK YOU. 3832 02:57:00,280 --> 02:57:02,560 I THINK WE HAVE REACHED THE 3833 02:57:02,560 --> 02:57:02,960 HOUR. 3834 02:57:02,960 --> 02:57:07,280 SO I THANK YOU VERY MUCH FOR A 3835 02:57:07,280 --> 02:57:08,520 VERY RICH DISCUSSION. 3836 02:57:08,520 --> 02:57:10,240 I'VE CERTAINLY LEARNED A LOT AND 3837 02:57:10,240 --> 02:57:13,520 I THINK WHAT I WOULD SAY IS THAT 3838 02:57:13,520 --> 02:57:15,080 TO FOCUS ON THE CHILD WE 3839 02:57:15,080 --> 02:57:18,440 RECOGNIZE THE CHILD IS PART OF 3840 02:57:18,440 --> 02:57:20,040 THEIR COMMUNITY AND IT STARTS 3841 02:57:20,040 --> 02:57:22,320 WITH THEIR FAMILY AND IT EXTENDS 3842 02:57:22,320 --> 02:57:25,080 TO THE SCHOOL, TO THE COMMUNITY, 3843 02:57:25,080 --> 02:57:26,000 TO BEYOND THEM. 3844 02:57:26,000 --> 02:57:29,640 WE'VE AGREED TO TAKE A SOCIAL 3845 02:57:29,640 --> 02:57:31,680 ECOLOGICAL MODEL TO HELP US 3846 02:57:31,680 --> 02:57:33,240 UNDERSTAND THIS THAT EXTENDS 3847 02:57:33,240 --> 02:57:36,520 MULTI-LEVELS UP AND WE 3848 02:57:36,520 --> 02:57:38,240 RECOGNIZED HOW SOMETHING AS 3849 02:57:38,240 --> 02:57:41,200 STRONG AS CLIMATE HAS AN IMPACT 3850 02:57:41,200 --> 02:57:44,840 THAT COMES DOWN AND IMPACTS THE 3851 02:57:44,840 --> 02:57:46,440 FAMILY, THE FOOD SYSTEMS AND 3852 02:57:46,440 --> 02:57:49,360 IMPACTS THE CHILD. 3853 02:57:49,360 --> 02:57:52,080 WE CAN SEE FROM THE PANDEMIC HOW 3854 02:57:52,080 --> 02:57:52,920 SOMETHING AS A PANDEMIC 3855 02:57:52,920 --> 02:57:54,920 CERTAINLY HAD AN IMPACT AT THE 3856 02:57:54,920 --> 02:57:56,200 LEVEL OF THE CHILDREN. 3857 02:57:56,200 --> 02:57:58,760 WE HEARD TODAY PEOPLE TALKING 3858 02:57:58,760 --> 02:58:02,920 ABOUT NOT HAVING ACCESS TO 3859 02:58:02,920 --> 02:58:05,480 SCHOOL MEALS DURING THE PANDEMIC 3860 02:58:05,480 --> 02:58:09,000 AND WE HEARD THAT CHILDREN 3861 02:58:09,000 --> 02:58:11,400 GAINED WEIGHT DURING THE 3862 02:58:11,400 --> 02:58:12,520 PANDEMIC BECAUSE FOR SOME 3863 02:58:12,520 --> 02:58:14,360 REASONS, THE MULTIPLE REASONS 3864 02:58:14,360 --> 02:58:16,520 ONE, THEY DIDN'T HAVE THE 3865 02:58:16,520 --> 02:58:17,600 STRUCTURED ENVIRONMENT OF THE 3866 02:58:17,600 --> 02:58:18,920 SCHOOL NOR DID THEY ALWAYS HAVE 3867 02:58:18,920 --> 02:58:20,760 ACCESS TO THE SCHOOL MEALS. 3868 02:58:20,760 --> 02:58:21,520 WE SEE THE ENVIRONMENT DOES 3869 02:58:21,520 --> 02:58:24,200 REACH TO THE LEVEL OF THE CHILD 3870 02:58:24,200 --> 02:58:27,720 AND IF OUR ROLE IS TO THINK 3871 02:58:27,720 --> 02:58:29,320 ABOUT THAT ENVIRONMENT AND HOW 3872 02:58:29,320 --> 02:58:30,480 THAT REACHES THE LEVEL OF THE 3873 02:58:30,480 --> 02:58:32,280 CHILD AND HOW WE MEASURE IT AND 3874 02:58:32,280 --> 02:58:40,400 HOW WE MONITOR IT, I THANK THE 3875 02:58:40,400 --> 02:58:42,120 PRESENTERS TODAY THAT 3876 02:58:42,120 --> 02:58:46,960 REMEMBERIREMEMBEINDING 3877 02:58:46,960 --> 02:58:50,120 US THINK FROM A SILOED 3878 02:58:50,120 --> 02:58:51,920 PERSPECTIVE WON'T HELP CHILDREN 3879 02:58:51,920 --> 02:58:53,640 IN HOW PROGRAMS IMPACT THEM. 3880 02:58:53,640 --> 02:58:56,640 I'D LIKE TO THANK THE EXTERNAL 3881 02:58:56,640 --> 02:58:58,760 SPEAKERS WHO SPENT TIME WITH US 3882 02:58:58,760 --> 02:58:59,840 AS WELL AS THE INTERNAL 3883 02:58:59,840 --> 02:59:00,120 SPEAKERS. 3884 02:59:00,120 --> 02:59:01,320 THANK YOU VERY MUCH AND I 3885 02:59:01,320 --> 02:59:02,800 APPRECIATE THE DISCUSSION. 3886 02:59:02,800 --> 02:59:03,720 HAVE A WONDERFUL WEEKEND. 3887 02:59:03,720 --> 02:59:06,040 YOU CAN REACH OUT TO US THIS 3888 02:59:06,040 --> 02:59:08,560 SESSION HAS BEEN RECORDED. 3889 02:59:08,560 --> 02:59:09,920 AND SO YOU'RE WELCOME TO LISTEN 3890 02:59:09,920 --> 02:59:11,760 TO IT TO LOOK AT IT AGAIN AND 3891 02:59:11,760 --> 02:59:20,680 ALL THE BEST. 3892 02:59:20,680 --> 02:59:22,760 >> I WANT TO THANK EVERYONE AND 3893 02:59:22,760 --> 02:59:25,600 THANK THOSE FOR JOINING VIA THE 3894 02:59:25,600 --> 02:59:28,960 VIDEOCAST. 3895 02:59:28,960 --> 02:59:32,440 WE'RE CAPTURING COMMENTS AND WE 3896 02:59:32,440 --> 02:59:33,880 DO APPRECIATE INPUT FROM 3897 02:59:33,880 --> 02:59:35,040 EVERYONE AND A WANT TO BE 3898 02:59:35,040 --> 02:59:38,000 RESPECTFUL OF TIME AND I WISH 3899 02:59:38,000 --> 02:59:39,840 EVERYONE A WONDERFUL WEEKEND AND 3900 02:59:39,840 --> 02:59:41,360 STAY SAFE, BE WELL AND WE'LL SEE 3901 02:59:41,360 --> 02:59:42,520 YOU BACK NEXT FRIDAY. 3902 02:59:42,520 --> 03:00:14,280 >> THANK YOU, EVERYONE.