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Sometimes Innovation of a Public Health Program Lies Not Only in Its Premise, But in Its Execution

By Las Cruces (NM) Mayor Ken D. Miyagishima
October 21, 2013

Statewide, more than one third (36.8 percent) of New Mexico’s third-graders are overweight or obese – but that statistic, while clearly in and of itself a cause for concern, doesn’t tell the fully story.

That’s why when I was elected, I made children’s health in general, and childhood obesity prevention in particular, one of my top public health priorities. And I, in short order presented with an opportunity to take action – shortly after my election, I was approached by and met with officials from the New Mexico Department of Health, to discuss the childhood obesity problem and to work collaboratively to develop strategies to reverse the trend. It was from those conversations that the “Mayor’s 5-2-1-0 Fitness and Nutrition Challenge” was born. The Challenge has been, from its outset, based on the best available science – the length of the program, 21 days, was chosen because research has shown that this is the average length of time it takes an individual to change a particular bad habit and replace it with a good one, which is the overall goal of the Challenge. And third grade children were chosen as the primary target demographic for the program because, I and my health officials believed, they’re old enough to comprehend the nature of the “challenge,” while still young enough to make lifestyle changes more easily than older children. In mid-2008, we presented our program to the Las Cruces Public School System (I felt that the program would be most easily delivered in the school setting, where they’d have a captive audience, so to speak), and received approval to implement the program at each of the public elementary schools.

What sets the Las Cruces program apart from the rest is its execution. The specific elements of the “Mayor’s 5-2-1-0 Fitness and Nutrition Challenge” are as simple as they are effective. During the school year, I travelled to each elementary school within the Las Cruces Public School System, and made a presentation to the school’s third grade students. I first have a photo taken of with each third grade class. I then tell the students that each of them will be receiving an autographed copy of the photo, to remind them not only of the day the mayor came to their class to speak to them personally, but of the importance of the presentation. I show the children a blank Mayor’s Award Certificate, as well as my special “Mayor’s Coin,” and ask whether they would like to win a certificate and coin. I then use plastic fruits and vegetables to ask whether the children know what they are. The children love calling out the name of each item and identifying whether it’s a fruit or vegetable. I ask the children to name other fruits and vegetables, not included in my bowl. I explain that the reason I want to make sure they are familiar with fruits and vegetables is because, for the next 21 days, I issue a challenge to them. I then explain in detail the four components of the 5-2-1-0 Challenge. As the I noted, once the children’s groans die down, I point out several types of physical activity that they can engage in, instead of spending time in front of a screen, as well as acceptable drinks, fruits and vegetables they can consume and enjoy. Soon, the children realize that adhering to the challenge won’t as painful as they initially thought it’d be.

At the end of the presentation, I reiterate what each of the numbers stand for. Each teacher is given a booklet where each child would record their 5-2-1-0 selections. An important aspect of the program is that each child’s page is to be signed by her/his parent – reinforcing the notion that the entire family will support the child’s effort to complete the challenge. The teachers are also given a blank certificate and a coin to display in their classrooms, as an added incentive and reminder to the students.

Since the launch of the program in the 2007-2008 school year, I have personally issued the Challenge to nearly 12,000 third grade students. The “Mayor’s 5-2-1-0 Fitness and Nutrition Challenge” has gained statewide and national recognition; even more rewarding to me is the fact that the program has been implemented by mayors in other cities in the state.

For more information contact: Carolyn Horner; 575-636-7227;