November 2, 2015

CU at the HELM of healthy habits in southern Colorado

CSPH's Healthy Eaters, Lifelong Movers program benefits students, schools and communities

By Cathy Beuten | CU system

Healthy Eaters, Lifelong Movers

Elaine Belansky is encouraged. Nowadays when she visits K-12 schools in southern Colorado, she sees self-service salad bars, fruits and vegetables near the front of the lunch line, new drinking fountains, expanded opportunities for physical activity and no vending machines.

Belansky, associate professor of community and behavioral health and director of the Rocky Mountain Prevention Research Center, and her colleagues are ensuring children in Colorado’s San Luis Valley and southeast Colorado develop healthy habits early on that will last them a lifetime.

“My favorite changes are the ones made to the physical environment because those are the ‘gifts that keep on giving,’” Belansky said. “We’ve seen new outdoor basketball courts, walking paths, playground markings for hopscotch and other games. Those are all changes that students can benefit from year after year.”

Since 2010, the Healthy Eaters, Lifelong Movers (HELM) program, through the Colorado School of Public Health at the CU Anschutz Medical Campus, has partnered with schools and communities throughout southern Colorado to help to create school-specific plans that guide students to healthier lifestyles.

“We use a university-community partnership approach,” Belansky said.

“The university brings the latest research to schools and the schools bring knowledge of their community and a keen understanding of what will work.”

HELM has two components: Assess, Identify, Make-it-happen (AIM) and the Physical Education Academy. In five years, the programs have resulted in more than 150 healthy changes through AIM and a 31 percent increase in students’ physical activity levels through the PE Academy. Because of this success, the Colorado Health Foundation, which initially funded the HELM program in 2010, renewed its funding in 2013.

AIM Taskforce

“Rural communities are incredible places,” Belansky said. “People work together to leverage limited resources and help those in need. Rural communities have a lot to offer children because of the caring adults who devote so much of their time and energy into sustaining their communities.

“But rural communities are struggling economically and on most health indicators. Poverty, isolation and lack of access to health care are just some of the challenges these communities face.”

In nearly all of the counties in the San Luis Valley, between 28 percent and 37 percent of children live in poverty; in most of the other southeast Colorado counties, between 21 percent and 28 percent of children live in poverty, collectively making that area the poorest in the state. Research by the Mayo Clinic found that U.S. citizens who live in the most poverty-dense counties are those most prone to obesity. More than 23 percent of the state’s children ages 2 to 14 are overweight and obese and, as of 2007, Colorado’s childhood obesity rate was the second-fastest rising in the nation.

That’s where HELM comes in, assisting 73 schools in southeastern Colorado and 46 schools in the San Luis Valley.

“In AIM, we present a ‘menu of best practices’ to schools and they decide which changes to put in place,” Belansky said. “The program increases access to healthy food and decreases access to unhealthy food because of schools’ willingness to incorporate fruits and vegetables into the breakfast and lunch programs, daily snacks, salad bars and classroom parties. Healthy eating is a key behavior related to preventing obesity and chronic disease.”

The PE Academy provides rural schools with the SPARK curriculum, equipment, training and personalized support from site coordinators. “In the PE Academy, we teach teachers how to implement the SPARK curriculum in their school to ensure students are getting the most out of their time in physical education,” she said.

Belansky applauded the southern Colorado schools’ willingness to incorporate brain boosters in classrooms, add more minutes to recess and equipment to the playground, and discontinue the practice of keeping students from recess because of poor behavior or missed work. However, she said there is more progress to be made in these areas.

Health Kids

“In addition to maintaining a healthy weight, physical activity is considered to be an important behavior related to academic performance,” Belansky said. “Studies show that when students are moving, their brain activity lights up and they perform better on tests.”

HELM offers a website that any school in Colorado can use to find resources to help make their school a healthier place at

The university conducts regular literature reviews to identify evidence-based practices schools can put in place to increase opportunities for students to be physically active and eat healthy foods during the school day.

“We find research studies that rigorously test changes schools can make to their environment, practices or policies to increase physical activity and/or healthy eating,” Belansky said, noting, for example, some studies show that having balls, jump ropes, hula hoops and other equipment available at recess leads to higher activity levels.

“Other studies show that when lunchroom staff place fruits and vegetables in the front of the lunch line, consumption increases,” she said. “And another body of research shows that certain physical education curricula, such as SPARK, lead to higher levels of physical activity and greater enjoyment of physical education.”

HELM is an ongoing partnership between Belansky’s team, the schools and communities. Her team meets with PE teachers in their gym every month throughout the school year to help them implement the curriculum and highly effective instructional practices, she said.

Belansky oversees the AIM program. Her associate Nick Cutforth, a professor at the University of Denver in the Morgridge College of Education and an adjunct faculty member at the Colorado School of Public Health, oversees the PE Academy.

Healthy Eaters, Lifelong Movers

“We also work with local public health agencies across southeastern Colorado. And, we have community steering committees for both locations,” she said. “Those school representatives meet with us quarterly to advise us on the program and to ensure that our activities meet the needs of the community.”

HELM schools complete an online tool called the School Environment and Policy Survey. They then receive a tailored report showing them which evidence-based practices they have fully, partially, or not at all in place. 

“We use a stoplight approach: red if the best practice is not in place, yellow if partially in place and green if fully in place,” she said.

“For example, the national recommendation is for elementary students to receive 150 minutes of PE each week. Very few rural schools meet that recommendation. The goal is to have ‘green’ on every best practice, but that takes a lot of time and resources too.”

Lack of time and resources are not the only obstacles the program, schools and communities face. Staff turnover at the schools and community concerns that increased time at recess leaves less time in the classroom create their own challenges.

Yet HELM is getting results, the partnership is growing and schools and communities are benefiting.

“When schools are health-promoting places, students learn better and can be physically healthy,” Belansky said. “This saves communities health care costs and prepares the next generation of adults to be strong, healthy and successful.”