State and Local Initiative

About the Project:

Texas will be concentrating on both a statewide effort and, parallel to that, a community effort in Harlingen, Texas. To better recruit healthcare professionals, the Texas team developed an application process. Applicants were recruited through their professional and ethnic organizations as well as through personal connections and outreach to state agencies and organizations. Interested individuals filled out an online application aimed at determining their level of interest, their time commitment, and their role as a healthcare professional in their community. The Texas team selected applicants based on their ability to meet the above criteria and subsequently, formally invited to participate in the training.

Monthly Newsletter

May 2012 (PDF)

Success Stories:

- In Fort Bend, TX, trained advocate and school nurse Nellie Hartsell, RN, is working on a childhood obesity prevention strategy for her school. She approached her local Municipal Utility District (MUD) and asked if they would be willing to partner with her school to provide a 4- lane, asphalt surfaced track--and they agreed! The MUD agreed to donate $15,000 towards this project, which will begin in January 2012 and should be completed by March 2012. "Currently the students walk on a pebble track that is uneven and pitted with large holes throughout, and when it rains the track turns into a muddy mess," she said. "This new track will provide students, staff, and community members with a place where they will be able to walk or run safely!"

- Ms. Hartsell also plans to write a grant to her local education foundation in Fort Bend to inquire about funds for upgrading the school's soccer field, which is pitted with holes and wide cracks in the earth. "This funding would provide the means to resurface the field and get new nets and goals so children and the communtiy as a whole can have another place to participate in healthy activities," she said.

- Valerie Smith, MD, a trained Texas advocate turned core team member in the Dallas-Ft. Worth area, hosted a training in November 2011 in her hometown of Tyler, TX, that drew nearly 30 healthcare professioanls. “We had a great training with some excellent work plans developed,” said Dr. Valerie Smith. “One group is meeting [6 days after the training] to begin planning and implementing a running program in a local school district that will involve parents and the community!”

- Rocky Epstein, a trained Texas advocate, and his team participated in a few 2011 Fall Festivals in Austin to spread the word about their childhood obesity policies and strategies. “The parents and kids enjoyed hearing our ‘Sugar Shock’ [presentation] which included several drinks like soda, juice, water, and milk and small specimen cups which had the amount of sugar in each drink. Many were surprised at the amount of sugar in some of their favorite drinks.” The event was a huge success. “In total, we spoke to about 600-700 kids and parents at all 3 events.”

- A critical component of any sustainable improvement project is getting support from the entire system—a key strategy that Nellie Hartsell from Fort Bend has embraced. “Our parents are beginning to get involved and embrace our efforts at promoting wellness for our students,” she said. “Our cafeteria manager is working with me to encourage the students to select fruits and vegetables from the cafeteria line. And our coaching staff has applied for a grant [that will allow] students [to participate] in a fun jump rope program twice a week, with the goal of improving their cardiovascular endurance. ”


Customized Advocacy Resource Guide:

A customized version of the Be Our Voice guide has been developed to assist in training local advocates. Local government structures and processes, data, media resources, and other grantees specific to Texas are included. Download the Texas Advocacy Resource Guide (PDF). 

Key Data:

  • Obesity/Overweight prevalence: Approximately 42% of 4th graders in Texas are considered overweight while 39% of 8th graders and 36% of 11th graders are considered overweight. Additionally, 32% of children between 10-17 years of age are considered overweight. More state-wide data can be found here: NICHQ Obesity Factsheets--Texas
  • US/Mexico border data: 16-29% of children under 18 are living below the federal poverty level
  • Hispanic/Latino data: Mexican-American males age 12-19 have the highest prevalence of obesity (22.1%) compared 17.3% of white males.

Policy Focus:

The overall emphasis of all trainings will be on healthy eating and active living. Participants will be asked to focus on one of the 6 areas outlined by 5-2-1-0 - Healthy eating, screen time, active living, sugar-sweetened beverages, BMI screening, and breastfeeding, in either schools or communities. 


This is a project of the Texas Pediatric Society in partnership with the Texas Medical Association, the Texas Academy of Family Physicians, Live Smart Texas, the Department of State Health Services, the Texas Department of Agriculture, and the Partnership for a Healthy Texas. Additional local support is provided by Dell Children's Medical Center, Salud America and the University of Texas Health Science Center at San Antonio's Regional Academic Health Center, and Cook Children's Hospital.


Project Lead: Kimberly Avila Edwards, MD, FAAP; Mary Greene-Noble
Texas Pediatric Society
kaedwards@seton.org; mary.greene-noble@txpeds.org

NICHQ: Jenna Williams, Project Manager