Recommended Actions for Childhood Obesity Prevention and Treatment
results of research, planning and community forums
Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission
Missouri Council on Activity and NutritionChanging the Future of Childhood Obesity:Aligning and Amplifying Statewide Efforts
April 21, 2015 | Columbia, MO
Sarah Hampl, MDChildren’s Mercy Hospitals & Clinics
Kansas [email protected]
Denise Wilfley, PhDWashington University
Chairpersons
Subcommittee Purpose1. Review the issue of childhood obesity, the evidence for effective
approaches to prevent and treat, Missouri's current approaches, and the gaps in services and resources.
2. Compile recommendations to create a comprehensive approach that includes access to treatment in Missouri that will fill identified gaps and decrease prevalence of obesity.
3. Present the report and recommendations to the Missouri Children's Service Commission which will in turn, inform the Governor and General Assembly.
Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission
Project Timeline
February 2014 Subcommittee held inaugural meeting
March-April Prepared outline for report
May-Aug Compiled preliminary recommendationsMeetings and conference calls
Sept-Oct Held public hearing(s) for input on recommendations - 122 people attendedSpringfield (Sept 19), St. Louis (Sept 29), Columbia (Oct 1), Kansas City (Oct 7)
Oct-Nov Subcommittee meeting and conference calls,
incorporated feedback, prepared executive summary
December Present draft to Children's Services Commission
Jan-Mar 2015 Finalize report and release to stakeholders
Graciela Couchonnal, PhDHealth Care Foundation of Greater Kansas City
Ann Davis, PhD, MPH, ABPPCenter for Children’s Healthy Lifestyles and Nutrition University of Kansas Medical Center
Dawnavan Davis, PhDKC Blue Cross Blue Shield
Johanna B. DerdaAmerican Academy of Pediatrics, Missouri Chapter
Meredith Dreyer Gillette, PhDChildren’s Mercy Hospitals and Clinics, Kansas City
Janet E. Farmer, PhDUniversity of Missouri School of Health Professions
Sarah Hampl, MD, FAAP, Co-ChairChildren’s Mercy Hospitals and Clinics, Kansas City
Megan Klenke, MSWChild Care Aware of Missouri, St. Louis
Timothy Kling, MD, FACOGMissouri HealthNetMissouri Department of Social Services
Deborah Markenson, MS, RDWeighing In, Children’s Mercy Hospitals and Clinics, Kansas City
Ann McCormack, MPH, RDBureau of Community Food and Nutrition AssistanceMissouri Department of Health and Senior Services
Donna Mehrle, MPH, RD, LDMissouri Council for Activity & Nutrition (MOCAN)University of Missouri Extension
Samar Muzaffar, MD, MPHMissouri HealthNetMissouri Department of Social Services
L. Carol Scott, PhDChild Care Aware of Missouri, St. LouisMember of Children’s Services Commission
Pat Simmons, MS, RD, LDMissouri Department of Health and Senior Services
Amy Stringer Hessel, MSWMissouri Foundation for Health
Aneesh Tosh, MDUniversity of Missouri School of Medicine
Denise Wilfley, PhD, Co-ChairWashington University in Saint Louis
subcommittee members
project staffEric S. Armbrecht, PhDAngela Lima, MBA, RD, LD
Emily Meissen-Sebelius, MSW Stephanie SegerAllison Yee, MPH
THANK YOUHealth Care Foundation of Greater Kansas City
& Missouri Foundation for HealthFunds provided by the Health Care Foundation of Greater Kansas City
and Missouri Foundation for Health have been used to support writing, research, meeting facilitation and public forums per direction of
the volunteer members of the Subcommittee for Childhood Obesity.
Public Forum HostsSpringfield-Greene County Department of Health
Missouri Foundation for Health
Columbia-Boone County Department of Public Health
Kansas City Health Department
Rationale and Context• Over the past 30 years, obesity rates have more than doubled for
children and quadrupled for adolescents
• 1 in 3 children are overweight or obese– much higher for children with Medicaid
• Obesity as co-morbidity increases costs for other childhood conditions*– 30% higher: analysis of MoHealthNet claims in 2012
– Obesity co-morbidity with: asthma (42%), depression (50%), diabetes (54%), hypertension (80%)
• Serious, direct health consequences during childhood and beyond
• Research shows that adult obesity originates in childhood
• Given current trends, Missouri will spend $12 billion annually on obesity-related healthcare by 2030
Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission
* Edison, Greever-Rice et al 2014
At the onset of this project, Subcommittee members agreed to develop just a few priority action items
for recommendation to the Children’s Services Commission.
The Subcommittee sought to develop recommendations that were consistent with these four guidelines:
Statewide. potential to achieve statewide reach
Impactful. supported by evidence
Actionable. by state legislature or government agencies
Feasible. reasonable to achieve in two years
guidelines
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Types of Recommended Actions
1. Prevention
2. Treatment
3. Infrastructure
Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Recommended Actions for Childhood Obesity Prevention and Treatment
Update child care licensing rules to align with the latest evidence on nutrition, physical activity, and screen time.
Train and support child care professionals to meet new standards.
prevention early childhood
Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Recommended Actions for Childhood Obesity Prevention and Treatment
prevention schools
Establish an Office for Student Wellness to maintain expectations for health and physical education curricula.
Modify school accreditation by creating and maintaining a health and wellness component. Train and support school staff to implement best practices and school wellness policies related to nutrition, physical activity and physical education.
Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Recommended Actions for Childhood Obesity Prevention and Treatment
treatment reimbursement
Reimburse licensed professionals with specialized training in evidence-based weight reduction programs through all Medicaid plans. Reimburse services provided in health care or community settings for children with a
body mass index (BMI) at or above the 85th percentile.
Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Recommended Actions for Childhood Obesity Prevention and Treatment
infrastructure centers of excellence
Establish Centers of Excellence across Missouri to provide evidence-based weight management services; coordinate access to treatment; train health care providers, school staff,
and others about screening, treatment options, and referral coordination; and train health care and community agencies on prevention strategies.
Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO
State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity
Recommended Actions for Childhood Obesity Prevention and Treatment
infrastructure commission
Establish a Commission on Child Health and Wellness to oversee implementation of the Subcommittee’s recommendations, study effectiveness of obesity prevention strategies, and provide an ongoing forum for education and future actions.
Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO
Next Steps
Thank You