mass in motion kids community-clinical partnerships to reduce childhood obesity a partnership...
TRANSCRIPT
Mass in Motion KidsCommunity-Clinical Partnerships to
Reduce Childhood Obesity
A partnership between the Massachusetts Department of Public Health, the cities of Fitchburg and New Bedford, the
National Initiative for Children’s Health Care Quality, and Harvard University
Childhood Obesity is Not Randomly Distributed Among our Communities
Childhood Obesity and Median Household Income, 2010-2011(N = 172 local and regional academic School Districts, 100 or more students
screened, all 4 grades reported)
0
5
10
15
20
25
30
35
40
45
50
$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000 $140,000 $160,000 $180,000
Median Household Income (2005-2009 American Community Survey, US Census Bureau)
% O
ve
rwe
igh
t o
r O
be
se
Ch
ildre
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Socioeconomic Factors
Changing the Contextto make individuals’ default
decisions healthy
Long-lasting Protective Interventions
ClinicalInterventions
Counseling & Education
LargestImpact
SmallestImpact
Examples
Poverty, education, housing, inequality
Immunizations, brief intervention, cessation treatment, colonoscopyFluoridation, trans fat, smoke-free laws, tobacco tax
Rx for high blood pressure, high cholesterol, diabetes
Eat healthy, be physically active
CDC “Health Impact Pyramid”
Mass in Motion: Eat Better, Move More
Multifaceted state initiative• Call to Action report• Governor’s Executive Order 509• BMI regulation• School Nutrition Standards• Public information campaigns• Municipal wellness grants• Worksite initiative• Website
– Info on physical activity and nutrition– Calendars– Blogs– Links to state and local resources
Division of Nutrition, Physical Activity and Obesity
Obesity Prevention & Control Branch
Massachusetts San Diego Texas
Evaluation Center University of Houston
Fitchburg
New Bedford
CDC Funded Childhood Obesity Research Demonstration (CORD) Project
Overall Approach
Build on successful Mass in Motion Approach Enhance connections between sectors Maintain the focus on evidence-based strategies
– Policies – Systems– Environmental changes
5 Key Target Behaviors
1. Decrease in children’s consumption of sugar-sweetened beverages
2. Decrease in screen time & TVs in children’s bedrooms
3. Increase in children’s moderate & vigorous physical activity
4. Substitution of empty-calories/nutrient poor foods with fruits and vegetables
5. Increase in children’s sleep quality & duration
Project OverviewIndividual/
FamilySystem Community
Health Care AssessmentCoachingCoordinated support
Obesity Learning Collaborative to improve quality of care
CHWs & physician champion link w/ local Mass in Motion initiative
Schools/ After schools
Motivates students/parents to eat better, move more
Policy & practice changes w/I 2 school systems
Implementation will link with Mass in Motion community initiatives
Child care I Am Moving, I Am Learning promotes physical activity & healthy food choices
NAP SACC supports policy, practice change in child care sites
Training of child care licensing staff to include elements in licensing visits
Community Support for activity groups, healthier decision making
Environment & policy change focused on increased activity and increased access to healthy food
Youth-driven media campaign to change community norms.Environment & policy change
Primary Care: Primary Prevention
ActivitiesGoal: Prevention of childhood obesity.
•Efforts targeting the entire population•Healthy weight as well as overweight & obese children
•Obesity Learning Collaborative•Be Our Voice Advocacy•EMR Best Practice Alerts•Patient education materials•Improve the healthfulness of the health center
Primary Care: Secondary Prevention
ActivitiesGoal: Prevent disease progression and development of comorbidities and complications
•Efforts focus on overweight & obese children
•EMR decision support tools for obesity management•Healthy Weight Clinics•Community Health Worker support of overweight/obese children and their families
Schools and After Schools
Activities
Elementary & Middle Schools
•Eat Well, Keep Moving, Planet Health– Curriculum and materials– Staff training
•Wellness champion•Fitness equipment•Support for wellness plan•Student survey during BMI measurement (4th & 7th grades)
Afterschool •Food and Fun–Curriculum–Support for environment changes
Child Care and Early Education
Activities
NAP SACC •Complete self-assessment for center•Set goals to improve nutrition and physical activity•Receive training, resources and materials from Mentors
I am Moving, I am Learning
• Receive training on –↑ physical activity –↓sugar-sweetened beverages and calorically dense foods–↑Fruit and vegetable consumption
• Educate staff and parents on IM/IL practice
Women, Infants, and Children (WIC) Nutrition Program
Activities
WIC •Complete readiness for change assessment•Receive training, resources, and materials •Obesity Learning Collaborative•Be Our Voice Advocacy
Community Interventions
Building on foundation of Mass in Motion Evidenced-based strategies focused on policy,
system and environmental change Creating environments that support healthy living
Media campaign Youth empowerment approach Will be developed in collaboration with schools to
integrate school efforts into community approaches
Mass in Motion as a Foundation
Enhance community action plans Focus on evidenced-based strategies that have the
largest impact on the 5 obesity related behaviors, eg, IOM’s 2009 Local Government Actions to Prevent Childhood Obesity
Ensure coordination and integration of the multiple sectors at the local level
Special role of the Physician Champion and the Community Health Worker in clinical sites
Engage champions from all sectors in community-wide efforts
Proposed MiM Kids Community Activities
Fitchburg 1. Implement at least 2 environmental changes at Big Field/Green Acres to increase physical activity
2. Increase healthy options among park vendors3. Market Basket grocery stores will implement at least 1 change
promoting healthy eating, with focus on fresh fruits and vegetables and healthy beverages
4. Fitchburg will adopt Complete Streets policy, including Safe Routes to Schools and Parks
5. Increase sustainability of Fun N Fitchburg
New Bedford
1. Increase the number of restaurants in NB from 0 to 5 that offer healthy childrens’ options
2. Increase number of corner stores from 0 to 3 that participate in MiM New Bedford Healthy Corner Store Initiative
3. Increase the number of elementary and middle schools from 0 to 3 that have well established and consistently active Safe Routes to School programs