SCale Down Annual Update


With the release of the South Carolina Obesity Action Plan in the fall of 2014, a new phase of obesity prevention work began in our state.  The plan provides clear direction for focused action in multiple settings on a 5-year horizon.  To ensure that such action occurs, the SCale Down Initiative was launched in January 2015 to support this effort by engaging partners to achieve the objectives outlined in the Action Plan.  The SC Institute of Medicine and Public Health is convening the SCale Down initiative in partnership with the SC Department of Health and Environmental Control.  Over the past year, SCale Down has sought to eliminate duplication of efforts and better promote achieved successes by connecting and mobilizing stakeholders who are working to reduce and prevent obesity in the Palmetto State.

Since the launch of the South Carolina Obesity Action Plan and SCale Down, significant progress has been made in advancing the 74 objectives of the plan.  The dedication and collaborative spirit of key partners and stakeholders are the fundamental reasons for this success.  As a part of SCale Down, an Action Team (leadership) was established to provide guidance and strategic input to shape the direction of the initiative.  An Evaluation Team provides high-level oversight for evaluating and monitoring progress toward obesity reduction and prevention efforts, while SC Department of Health and Environmental Control monitors and maintains the data surveillance for the individual objectives included in the plan.  The five SCale Down workgroups (Child Care, Community, Health Care, Schools and Worksites) actively address the strategies and objectives in each setting of the plan and expand the reach of the Initiative through their partnership networks.

Considerable thanks goes to the nearly 100 partners who have come together to make SCale Down a success!  Their tireless efforts are making it possible to advance the policy, systems and environmental changes needed to turn the tide on obesity in our state.

A Year in Review

The Scale Down workgroups focus their efforts on achieving action plan objectives that target specific settings where South Carolinians interact most during the day.  This update highlights the activities and successes that have occurred during the first year.  A pdf document outlining the activities and successes of 2015 can be found here.

  • Identified 78 farmers’ markets and stands accepting Electronic Benefits Transfer (EBT) for the Supplemental Nutrition Assistance Program.
  • Identified 162 farmers’ markets and stands accepting Women Infants and Children’s (WIC) Farmers’ Market Nutrition Program vouchers.
  • Held two statewide meetings that highlighted efforts that improve access to healthy food for South Carolinians with limited financial resources – Farm & Fork Conference held on 10/22/14 and Food Access Summit held 9/16/15.
  • Established a baseline for the number of county comprehensive plans that include healthy eating and active living principles.  Two of 45 plans account for healthy eating principles and 12 of 45 plans account for active living principles.
  • Conducted active community environment assessments and developed community action plans in six counties.
  • SC School Boards Association adopted and distributed to 81 schools districts a model policy providing open community access to school recreational facilities.
  • Developed an action plan for open community use of school recreation areas.
  • Developed the “Mother Friendly Support” Toolkit to assist faith-based organizations with promoting and supporting a mother-friendly environment where moms can breastfeed their babies.
  • Developed a system for the donation of human breast milk to be used by very low birth weight infants (Mother’s Milk Bank of South Carolina).
  • Developed a web-based clearinghouse of resources and tools for faith-based organizations interested in addressing physical activity, nutrition, tobacco use and breastfeeding in their congregations and communities.


  • Completed the South Carolina Hospital Association’s Working Well comprehensive worksite assessment and provided action steps for improvement in 18 state agencies, including the 16 Governor’s cabinet agencies (A Healthier State Initiative).
  • Established a statewide worksite wellness advisory group to provide recommendations on frameworks, methods and key indicators to foster the development of worksite wellness initiatives among South Carolina employees.
  • Completed surveys in over 70 cross-sector worksites to assess current worksite wellness policies, activities and needs.

Health Care

  • Modified Electronic Health Records at nine federally qualified health centers to identify people at risk for developing Type 2 diabetes.
  • Completed an assessment of two health care practices participating in the Prescription for Parks pilot program.
  • Increased the number of hospitals designated as Baby Friendly hospitals from five to ten.
  • Held 11 continuing education trainings on the South Carolina Medical Association Childhood Obesity Taskforce Toolkit.  This toolkit promotes the 5- 2-1-0 message (5 fruits and vegetables a day, 2 hours or less of screen time a day, 1 hour or more of physical activity a day and no sugar sweetened beverages).
  • Increased the number of American Diabetes Association or American Association of Diabetes Educators accredited diabetes self-management programs from four to eight.
  • Increased the number of active diabetes prevention programs (DPP) sites from two to 24.


  • Increased schools participating in the Farm to School/Farm to Preschool program from 124 to 162.
  • Completed an assessment for implementing a statewide web-based fitness education, testing, reporting and data management system.
  • Established a statewide system for gathering and reporting student-level fitness data – FitnessGram.  FitnessGram is being implemented in 61 of 81 school districts in the state.
  • Increased the Supplemental Nutrition Assistance Program (SNAP) nutrition education programs in Bamberg, Fairfield, Marion, Lee and Orangeburg Counties.

Child Care  

Moving Forward

SCale Down has become the unifying link for obesity prevention efforts across the state by creating multiple opportunities for partners to connect and collaborate.  As the initiative moves into its second year, the many engaged partners anticipate continued progress on the collaborative work to advance the obesity action plan objectives and obesity prevention efforts in South Carolina.  Some of the activities and areas of focus planned for 2016 include:

  • Developing a South Carolina Healthy Community Designation.
  • Increasing the number of faith-based organizations implementing a “Mother Friendly Support” program.
  • Increasing the number of adult Medicaid patients that are offered, coded and billed for obesity services.
  • Increasing the number of the health care providers utilizing the South Carolina Medical Association’s Childhood Obesity Taskforce Toolkit.
  • Developing a South Carolina Worksite Wellbeing Assessment Tool.
  • Increasing the number of active diabetes prevention program sites in South Carolina.
  • Increasing the number of out-of-school time providers that achieve healthy eating and physical activity best practices.
  • Submitting nutrition and physical activity standards for group/family home providers to the South Carolina Department of Social Service ABC Quality Rating and Improvement program for consideration and adoption.

Connecting the Dots

2015 was an exciting and successful year for SCale Down, and 2016 looks to be even better!

As the lead facilitator of the SCale Down Initiative, The SC Institute of Medicine and Public Health looks forward to the continued support of multiple partners and stakeholders in the coming year and welcomes the opportunity to expand the initiative’s reach and message through new partnerships, associations and professional networks.

Together, we can make progress and move the needle to reduce the burden of obesity in our state!

To find out how you can become involved with SCale Down, please contact To learn more about the initiative, visit

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© 2015 South Carolina Institute of Medicine and Public Health