Transcript Changing the Landscape to Prevent Childhood Obesity

Changing the Landscape to
Prevent Childhood Obesity
Kansas City’s Childhood Obesity
Collaborative-Weighing In
KC Capacity Inventory
20
18
16
Trends and Healthy People
HP
Targets
202010% 
14
12
10
8
6
HP
2010 
to 5%
4
2
0
NHANES I
NHANES II
2-5
6-11
NHANES III
12-19
NHANES 200306
Past Year Activities and
Accomplishments
• Published 11 Weighing In updates
• Hosted and expanded quarterly meeting attendance
by 62%
• Increased number on e-mail list by 42%
• Launched WI Website - (www.kcweighingin.org)
• Conducted Member Survey
• Updated Strategic Plan
• Aligning Working Group and compiling action plans
• Adopted Operations Guide for Weighing In November 2010.
Past Year Activities and
Accomplishments, cont.
• Conducted review of capacity to address childhood
obesity
• Compiled inventory of assets and resources
• Compiled report for recommendations for population
groups—pregnancy, breastfeeding, early childhood
and school-age and infrastructure supports
• Secured funding for core operations through 2013
• Competed in pool of 200 applications to become
designated as one of 10 Healthy Weight Collaborative
Teams—representing Region VII
Childhood Obesity Prevention
Capacity
• Conducted inventory of current capacity
• Population based
– Prenatal
– Early Childhood
– School-age
• Identified current and sustainable capacity,
information needs and priorities
KC
Collaboratives
Addressing
Childhood
Obesity
Greater KC Food Policy
Coalition
KC
Childhood
Obesity
Collaborative
-Weighing In
Building a
Healthier
Heartland
Mother and Child Health
Coalition
Agencies by Population Group
Prenatal
Mother and Child Health Coalition
0-5 years
KC Childhood Obesity CollaborativeWeighing In
Mid America Regional Council (MARC)Head Start
Mother and Child Health Coalition
K-12
Alliance for a Healthier Generation
Energy Balance for Kids
Junior League of Kansas City, MO
Kansas Coordinated School Health
KC Childhood Obesity CollaborativeWeighing In
PE4Life
Score 1 for Health
General
Blue Cross/Blue Shield
Children’s Mercy Family Health Partners
Greater Kansas City Food Policy Coalition
Health Care Foundation of Greater KC
Independence City Health Department
Jackson County Health Department
Kansas City Health Department
KC Healthy Kids
Menorah Legacy Foundation
Mid America Coalition on Health Care
Mid America Regional Council (MARC)
Public Health Department-Unified
Government of Wyandotte
Regional Office-US Department of Health
and Human
University of Kansas
University of Missouri-Extension
YMCA of Greater Kansas City
Information
What you want:
1. What is effective
2. Obesity prevalence data
3. Programs and efforts in my area
Distribution opportunities
• Half have constituent newsletters
• All had websites
• One-third used social media
• All willing to distribute information on
childhood obesity
Number of Programs by Strategies
Community Strategies to Prevent Obesity
CDC Recommended Community Strategy Categories
Promote the availability of affordable healthy food & beverages
Encourage communities to organize for change
Create safe communities that support physical activity
Encourage physical activity or limit sedentary activity among
children and youth
Support healthy food and beverage choices
Encourage breastfeeding
Total Programs within CDC Recommended Strategies
Other Strategies
Schools-based programs
Research based efforts
Screening and treatment
Education programs and other activities
Early childhood and infant focused programs
Funding support
Total Programs within Other Strategies
Total Programs
Programs
by Strategy
%
9
7
6
3
1
0
26
14
8
9
6
6
4
47
73
36%
64%
Agencies with which
Interviewees (N=25) Collaborated
School(s)/School Districts
KC Healthy Kids
Building a Better Heartland
Food Policy Coalition
Weighing In
Children’s Mercy Hospital and Clinics
Mother and Child Health Coalition
Local Public Health Agency
University of Kansas
Mo Council on Activity and Nutrition (MoCAN)
MU Extension
Beans and Greens Program
Number of Percent
times
reported
11
44%
10
40%
7
28%
6
24%
6
24%
6
24%
6
24%
5
20%
4
16%
4
16%
3
13%
3
13%
Setting
School
Priorities
Neighborhood
Community-Region
Other
Focus
General
Provide technical
assistance and resource
supports
Support after school
programs
Launch and maintain
school-based programs,
Secure school district
support
Conduct youth
empowerment program
Change school
environments and policies
Conduct school-based
screenings and refer at risk
for weight management
treatment
Provide counseling for
overweight/ obese children
and their families
Support neighborhood
based initiatives
Increase community
mobilization on HE/AL
Conduct adult and youth
HE/AL programs
Conduct nutrition education
Establish school gardens
Provide nutrition counseling
Increase access to local,
affordable healthy food
Document impact of
physical activity levels on
academic success
Increase physical activity
opportunities
Add walking trails
Advocate for livable streets
and improved parks
Promote use of walking
trails
Increase community
gardening
Healthy Eating (HE)
Active Living (AL)
Create sustainable
corridors
Support linkage between
schools and worksites/
corporate support
Work to align activities
Increase and strengthen
community health planning
Collaborate with others on
HE/AL activities
Provide technical
assistance and resource
supports
Establish enforceable policy
Support Head Start and
child care initiatives
Educate employers on
health plan design
Collect and analyze data
Increase public awareness
of problem and solution
Market services and
provide rationale for use
Seek and maintain funding
to support activities
Survive tight times
Educate and provide
resources to healthcare
professionals
Provide health coaching
Advocate for insurance
coverage for weight
management services
Improve access to local
foods
Promote purchase of local
foods in institutions
Expand Beans and Greens
program
Establish Food Policy
Coalition
Change mindset on use of
fresh fruits and vegetables
Support Metro Green Trail
System
Anticipated Changes
Align and increase
collective efforts (8)
Become more effective
(6)
Keep childhood obesity
prevention as ongoing
priority (4)
Shift from program to
policy & environment
focus (2)
Adapt based on health
care
reform
Not sure
(2) (3)
Population Recommendations
• Healthy weight pregnancies
• Infants and Early Childhood
• School-age
Build on our
current capacity
and assets
General Recommendations
• Information Needs
• Capacity to Track Childhood
Obesity Indicators
• Consistent messaging
• Systems Approach
• Governance Framework
• Treatment
School-age Recommendations
Highlights
• 44 % collaborate with schools
• 10 interviewees had schoolspecific programs
• 15 of all 75 programs/initiatives
for schools
What’s happening on a broader
scale
• New insights regarding what is
effective to support healthy
school environment
Healthy Hunger Free Kids Act, 2010
• USDA will set nutrition standards for all foods
regularly sold during school day
• Funding to meet updated nutritional standards
• Supports local farm to school networks, school
gardens, local foods
• Expands access to drinking water
• Standards for local wellness policies
• Increase number eligible—direct certification
• Universal meal access in high poverty
communities
School Recommendations
 Compile list of agencies
serving schools-build on
current rich capacity
 Bi-state policy inventory
 Collaborate on 1-2 priorities
regionally for action plan to
support implementation of
Healthy Hunger Free Kids Act,
2010
 Link with broader community
efforts
 Position paper
 Consistent Messages
Breastfeeding-Everyone
Supports
• White House Task Force on
Childhood Obesity
• Healthy People 2020 Goals
• Surgeon General-Call to
Action
• Healthy Hunger Free Kids
Act, 2010
• Health Care Reform
• Centers for Disease Control
and Prevention
Breastfeeding rate at 6 months
(CDC Report Card-2010)
US: 44.3%
KS: 41.0
MO: 35.1
Strive to have Kansas City
Hospital(s) on the Baby
Friendly Designation Map:
http://www.babyfriendlyusa.org/en
g/03.html
Much more ….
Pregnant women
Mothers’ pre-conception
weight and weight gain
during pregnancy are two of
the most important prenatal
determinants of childhood
obesity.
Early childhood
Development is more rapid
during these early years
than at any other time after
birth, and young children’s
early experiences are “built
into their bodies,” affecting
neural, metabolic, and
behavioral systems in ways
that can influence the risk
for obesity, health, and wellbeing through the life span.
…and still more.
• Information Needs
– Track Childhood
Obesity Indicators
– Communicationimpressive untapped
capacity for
coordinated
communication
• Systems Approach
– Childhood obesity is a
large complex, multisector issue
• Treatment
Greater Kansas City Obesity
Collaborative
HWC Phase One Teams
Kansas City is one of ten
teams nationally selected
to participate in the
Healthy Weight
Collaborative-created by
the Affordable Care Act
and supported through the
Prevention and Public
Health Fund
Region 1: Massachusetts
Region 2: New York
Region 3: Virginia
Region 4: Florida
Region 5: Ohio
Region 6: Arkansas
Region 7: Missouri-Greater Kansas City Obesity Collaborative
Region 8: Montana
Region 9: California
Region 10: Washington
Who We Are
Community Organizations
• Deborah Markenson, MS, RD,
LD
Team Leader
Primary Care
Weight Management Services,
Children’s Mercy Hospital
816-234-9223 [email protected]
– Sarah Hampl, MD
– Kerri Wade, PNP-BC
– Shelly Summar, MSEd, RD, LD
Children’s Mercy Family Health
Partners:
Public Health
KC Childhood Obesity CollaborativeWeighing In
» Greg Hanley, FACHE, MBA
» Beth McElwain, RD, LD, MPH
YMCA:
» Gail Vessels
KC Healthy Kids:
» Gretchen Kunkel, MBA, MHA
» Erika Devore, MS, RD, LD
KC (MO) Health Department
– Clyde Bolton, BGS, MSA
– Christine Riederer, PhD
HWC Model for Improvement
AIM:
What are we trying to
accomplish?
MEASURES: How will we know if a change
is an improvement?
CHANGE: What changes can we make that
Act
Plan
will result in improvement?
Study
Do
Primary
Care
Public
Health
Community
Healthier Children and Families in Kansas
City
Kansas City HWC Target
Population
• Children 2-5 years of age
•
•
Targeted lower income zip code areas of
Kansas City
Preliminary targeted area:
N – Missouri River
W – Kansas State Line
E – 435 (N-S)
S – 435 (E-W)
Overweight + Obesity Rates
Adult = 63.1%
(2007-Jackson Co BRFSS)
Young Children = 30.7%
(2009-Jackson Co PedNSS)
CMH primary care clinic =
27.7%
(2010, 2-5 year olds)
CMH Primary Care Clinic-32.6%
(2010, 2-12 year olds)
Baseline Data on Target
Population
Children Mercy Hospital Primary Care
Clinic 2-5 year old Well Child Clinic
(2010, n=4838)
2-5 year olds with BMI≥85th percentile
Percentage for 2-5 yr
olds with BMI≥85th %ile
27.7
-African Americans
40.4
-Hispanic
25.9
-Caucasian
20.7
-Medicaid recipients
85.7
-Commercial insurance
5.6
-Uninsured
8.0
Preliminary Targeted Changes for
KC
PUBLIC HEALTH: Review, strengthen, and reinforce nutrition and physical
activity standards in inspected child care facilities
COMMUNITY: Increase the number of settings that
reinforce consistent message on feeding practices for
children 2-5
State
Collaboration
Increase proportion of
primary care providers assessing,
counseling and scheduling follow-up with
families with children with BMI ≥85.
PRIMARY CARE:
CMFHP
Child Care Settings
Head Start
YMCA
Metropolitan
Official Health
Agencies of the
KC Area
Community Centers
WIC Clinics
Safety Streets
Assess and Diagnose
Counsel
Follow-up
…we’ll keep you posted on what works and doesn’t work.
STAY TUNED….
…we present at a national meeting 9/13-15/11 and would love your
thoughts and questions.
WE WELCOME YOUR
COMMENTS AND
SUGGESTIONS….