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​​​​​​​​​​​State Physical Activity and Nutrition (SPAN)

Pennsylvania is one of 16 states awarded the Centers for Disease Control and Prevention's State Physical Activity and Nutrition (SPAN) grant. SPAN is a five-year grant that supports state investments to improve nutrition and support safe and accessible physical activity. Through 2023, the department will increase:

  • breastfeeding support in birthing facilities and communities;
  • the availability of healthy foods in hospitals and community settings;
  • the implementation of nutrition and physical activity standards in early care and education systems; and
  • the number of places that implement community planning and transportation interventions to support safe and accessible physical activity


Through the work of the SPAN grant, the department is implementing breastfeeding interventions that address maternity care practices in birthing facilities and continuity of care.

Maternity Care Practices

The department, in partnership with the Pennsylvania Chapter, American Academy of Pediatrics (PA AAP), started the Keystone 10 Initiative in 2015. The comprehensive program engages Pennsylvania birthing facilities to implement 10 steps that will support birthing families. Under the SPAN program, birthing facilities:

  • receive technical assistance when implementing the 10 steps;
  • have access to 15 hours of breastfeeding curriculum, in-person and online;
  • participate in regional collaborative meetings; and
  • join a webinar on a relevant breastfeeding topic.

There are currently 84 hospitals and birth centers throughout Pennsylvania participating in Keystone 10.

Continuity of Care

To strengthen continuity of care and community breastfeeding support, the department has partnered with the Pennsylvania Chaper of the American Academy of Pediatrics (PA AAP) to implement the Educating Physicians in their Communities, Breastfeeding Education, Support and Training (EPIC BEST). EPIC BEST:

  • provides the latest evidence-based research and information on breastfeeding and how to best support breastfeeding mothers;
  • is presented by a local physician and International Board Certified Lactation Consultant to sites in pediatric, family medicine, obstetric-gynecological and community settings; and
  • is available both on-site and online.

More than 3,700 healthcare professionals have been trained with EPIC BEST.

Health care professionals who are interested in learning more about supporting breastfeeding should refer to The Surgeon General's Call to Action to Support Breastfeeding and The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.

For more information on breastfeeding, please contact

Food Service Guidelines

The department is strengthening food service guidelines in worksite and community settings through the SPAN grant. Adopting food service guidelines will increase the availability of healthy foods to employees and community members.

Food Service Guidelines in Community Settings

The department is partnering with the Erie County Department of Health to support the implementation of food service guidelines in Erie County. Utilizing the Centers for Disease Control and Prevention's Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities, Erie County is working to:

  • convene a food service guideline workgroup within their Food Policy Council;
  • educate stakeholders on food service guidelines policy options; and
  • adopt food service guidelines in community settings.

For more information on Food Service Guidelines in Community Settings, please contact

Food Service Guidelines in the Commonwealth

The department has developed a diverse stakeholder's workgroup of state agencies to implement food service guidelines in the commonwealth. The workgroup will utilize the Centers for Disease Control and Prevention's Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities to:

  • establish goals, assess the current food service environment and develop a work plan;
  • identify policy options; and
  • adopt food service guidelines in the commonwealth.

For more information on Food Service Guidelines in the commonwealth, please contact

Good Food, Healthy Hospitals

The department has partnered with the Philadelphia Department of Public Health and The Common Market to implement the Good Food, Healthy Hospitals program. The program began in Philadelphia in 2015. Currently, 20 hospitals in Philadelphia participate in the program. Four health systems in other areas of Pennsylvania are expected to be recruited in the coming year.

Participating hospitals and health systems:

  • receive technical assistance on nutritional analysis, menu planning and implementing food service guidelines;
  • adopt food service guidelines to create healthier food environments;
  • pledge to increase the availability of healthy foods in cafeterias, vending, catering, patient meals and purchased foods; and
  • convene as a task force twice a year to collaborate and share with other participating hospitals.

Facilities interested in learning more about food service guidelines should refer to the U.S. Department of Health and Human Services' Food Service Guidelines for Federal Facilities and the Centers for Disease Control and Prevention's Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities.

For more information on Good Food, Healthy Hospitals, please contact


 Content Editor ‭[2]‬

 Content Editor ‭[1]‬

Early Care and Education (ECE)

High-Impact Obesity Prevention Standards Integration

Centers for Disease Control and Prevention's Spectrum of Opportunities outlines a framework for how to incorporate nutrition and physical activity standards into statewide ECE systems such as:

  • quality rating improvement systems;
  • state professional development systems;
  • licensing;
  • statewide technical assistance networks;
  • state subsidy programs;
  • statewide recognition programs; and
  • others outlined in the CDC ECE opportunities framework.

This aims encourage states to focus on activities that impact all residents by making changes that have the potential to reach all legally operating ECE providers or the subset of providers statewide that are served under a particular ECE system component (e.g., all licensed providers; all providers participating in QRIS, and all providers accepting subsidy funds).

Nutrition and Physical Activity Standards for ECE refers to a subset of 47 high-impact obesity prevention standards included in the Caring for Our Children (4th Ed.) national health and safety standards. The subset of 47 high-impact standards were identified by an expert review panel and designated as Preventing Childhood Obesity standards. These standards, which include nutrition, breastfeeding, physical activity and screen time topics are published in Preventing Childhood Obesity in Early Care and Education Programs (2nd Ed.).

Pennsylvania (Pa.) is accomplishing this work through bi-monthly and annual meetings with a statewide stakeholder group, Keystone Kids Go! (KKG).  The collaborative workgroup has members from the Pa. departments of Health, Education, Human Services, Head Start State Collaboration Office, Pa. Chapter American Academy of Pediatrics Early Childhood Education Linkage System (ECELS), Office of Child Development and Early Learning (OCDEL), Penn State Better Kid Care (BKC), Penn State Cooperative Extension, Pa. Family Literacy, Pa. Nutrition Education Network and Tuscarora Intermediate Unit (TIU) and numerous community organizations representing ECE interests in the state. A full list of partners is available on the KKG website.

Child and Adult Care Food Program (CACFP) Participation in Pennsylvania: A Story Map

The Pennsylvania SPAN Program and Keystone Kids Go workgroup aims to support early childhood education programs that currently participate in CACFP and encourage more eligible programs to participate in an effort to increase access to nutritious meals and snacks and curb disparities in food access across Pennsylvania. The SPAN program implements early childhood education strategies to prevent childhood obesity. In this map, current CACFP participation in Pennsylvania in the context of food access and poverty is examined.

Implementation of Nutrition and Physical Activity Standards

Since 2009, Pennsylvania has supported the implementation of nutrition and physical activity standards in ECE environments throughout the state through the Pennsylvania Nutrition and Physical Activity Self-Assessment for Child Care (PA NAP SACC).  The PA NAP SACC mini-grant program currently supports up to 100 ECE programs annually with technical assistance, training, professional development and resources to make policy and practice changes that create healthier environments for staff and the children they care for.  Outcomes and best practices from past participants are searchable by subject area here.    

NAP SACC is an approved bonus points intervention to assist child care programs with achieving Quality Rating Improvement System (QRIS) and Keystone STAR 3 and 4 status.

For more information on ECE strategies, please contact

Physical Activity

The department has partnered with the Pennsylvania Downtown Center to provide funding and technical assistance to communities to develop plans or policies that better connect active modes of transportation with everyday destinations within the community through the SPAN grant and WalkWorks. Active modes of transportation include sidewalks, paths, bicycle routes and public transit while everyday destinations include homes, early care and education, schools, worksites, parks or recreation centers. To date, more than 30 communities have developed and adopted active transportation plans.

Everyday Destinations

Everyday destinations are places people can get to from where they live or work by walking, bicycling or using transit systems. These can include jobs, grocery stores, schools, libraries, parks, restaurants, cultural and natural landmarks or health care facilities. They are often desirable, useful and attractive. These can connect to activity-friendly routes that can make it safe and convenient for people of all abilities to walk, run, bike, skate or use wheelchairs.

For more information on community physical activity, please contact