Transcript An Introduction to Nemours Health and Prevention Services

Leveraging Public and
Private Partnerships to
Promote Healthy
Children and Families
Mary Kate Mouser
Executive Director
Nemours Health and Prevention Services
April 6, 2013
Learning Objectives
At the end of the session, you will:
1. Understand the challenge we currently face in
promoting healthy weight for children
2. Be able to describe public and private
partnerships models to combat childhood
obesity in the community
3. Be able to identify specific achievements and
lessons learned brought about by these
partnerships
4. Apply this information to your work
2
Delaware Survey of Children’s Health
Q: What is the percentage of overweight and obese children
and youth ages 2-17 in Delaware?
40%
Q: What percentage of Delaware kids are drinking LESS than
two sugar sweetened beverages per week?
57.3%
Q: What is the average number of days per week Delaware
teens are getting 60+ minutes of physical activity?
4 days
Q: By age 2, an average child in Delaware has watched how
many hours of TV?
657 hours
3
Why Nemours?
Nemours exists to serve the needs of children
and families—within and outside of the
walls of our pediatric health care facilities.
4
Determinants of Health
100%
90%
80%
Quality health care 10%
Social/
environmental 20%
70%
60%
50%
Genetic 30%
40%
30%
20%
Behavior 40%
10%
McGinnis, J.M. et al. Health Affairs 2002;21(2):78-93
5
What is the Vision?
Safe communities,
neighborhoods
and buildings that
support active
living as part of
every day life.
6
What is the Vision?
Fresh, local, and
healthy food is
available and
affordable in all
communities and
neighborhoods.
7
What is the Vision?
Schools and child
care agencies
promote physical
activities and
incorporate them
throughout the day.
Schools and child
care agencies offer
and promote healthy
food and beverages
to students.
8
How We Work: In Partnership
 NHPS’ Mission: Working
with others to help
children live healthier
lives.
• Through partnerships we
create policy and system
changes that will change
the way children live,
learn and play
9
Partnerships
•
•
•
•
•
•
•
•
Schools and Districts
Child Care Centers
Community Health Centers
Delaware Colleges and
Universities
Statewide Advisory Councils
County Government in Sussex, Kent, and New
Castle
State and County Park System
State Government Agencies
10
Schools Can Be Physically Active Places
Back in the early days of NHPS, we surveyed
Delaware parents:
 84 percent of them said that inadequate physical
activity in children was a problem, AND
 95 percent said that schools have a role to play in
addressing childhood obesity.
11
Schools Can Be Physically Active Places
What schools want:
Physical activity that is easy to implement;
Physical activity that doesn’t detract from study;
Physical activity that doesn’t add costs.
12
Schools Can Be Physically Active Places
 Delaware HB 471 passed in 2006
– Called for a pilot program to implement150
min/week of physical education/activity
 Response:
– Partnered with Delaware Department of
Education to provide technical assistance and
evaluation for the pilot
 Result:
– Confirmation that it is possible to provide 150
minutes physical education/activity week
– Examples of how to do it
Schools Can Be Physically Active Places
 Delaware HB 372 passed in 2006
– Required fitness assessment in 4th, 7th, 9/10th
grades in all public and charter schools
 Response:
– Partnered with Delaware Department of
Education to analyze the FITNESSGRAM data
 Result:
– Delaware specific data showing that students
who are more physically fit have:
 Higher state test scores in reading and math
 Better attendance
14
Schools Can Be Physically Active
Places
As our work took off, schools were
now requesting more:
– Training and tools to
implement physical activity in
school
Response:
– NHPS applied for the Carol
M. White Physical Education
Program grant (US DOE)
– $1.2 million over 3 years
Make School A Moving Experience
Goal:
-150 minutes of moderate to vigorous
physical activity per week
Plan:
-Each school created their own
combination of:
 Physical education
 Classroom activities
 Recess activities
 Other adaptations to the schedule
16
Make School A Moving Experience
Results:
 74 public elementary schools (~72%) voluntarily
incorporated 150 minutes of physical activity into
the school week, many still continuing their work
 40,000+ students participated in increased
physical activity at school, annually
 2,000+ teachers/staff trained to provide physical
activity
 http://vimeo.com/nhps/morningaccouncements
17
Partnering with School Nurses
 We promote health—but some children have
sickness or health issues in school.
 Chronic conditions such as asthma, anaphylaxis,
Type I diabetes, epilepsy, obesity and mental health
concerns may impact the students ability to be in
school and ready to learn
 School nurses requested improved communication
with Nemours clinicians and access to health
information of their students/Nemours patients.
18
Partnering with School Nurses
Parent /
Guardian
Nemours
Provider
S
T
U
D
E
N
T
School
Nurse
19
Partnering with School Nurses
 A multi-disciplinary team was formed to
develop a way to facilitate the exchange of
medical/education information between
school nurses and Nemours clinicians.
 There were people who said “it couldn’t be
done” because of the rules and regulations
protecting student /patient privacy.
20
Partnering with School Nurses

A HIPAA / FERPA compliant
authorization form was designed
to obtain parental consent for the
exchange of information

This form also reinforces the role
of the school nurse as part of the
care team
Information Shared:
•
Treatment –example: care plans
•
Non-treatment – example:
immunizations, lead levels, TB
screenings
•
Education – example:
attendance, medication
compliance, frequency at nurse’s
office
•
Nemours Providers can access
the form at this link:
http://teamshare/patient/proj/pcfor
ms/Delaware%20Valley%20Form
s/Forms/AllItems.aspx
21
Current Districts/Charters Participating
School Districts (19/19)
Charters (12/22)




















Charter School of Wilmington

DE College Prep Academy

Kuumba Academy

Moyer Academy

Newark Charter

Reach Academy

Sussex Academy of Art/Science

Thomas Edison Charter

Gateway Lab School

Prestige Academy

East Side Charter

Odyssey
Appoquinimink
Brandywine
Caesar Rodney
Cape Henlopen
Capital
Christina
Colonial
Delmar
Indian River
Lake Forest
Laurel
Milford
New Castle County Vo-Tech
Polytech
Red Clay
Seaford
Smyrna
Sussex Tech
Woodbridge
Benefits
 Improved communication across the continuum of care /
minimize miscommunication
 Provider access to School Nurse’s clinical input and
assessment
 Possible reduction in the need to contact the provider office
for routine information
 Recognition of School Nurse as part of the care team
 Greater efficiency by School Nurses in accessing student
medical information allowing them to reinforce instructions
given to families and better coordinate the care provided in
the school environment
 Improved health outcomes for patients/students
Healthy Child Care Settings
Changes in policy set the stage:

A partnership with the Department of
Education led to new nutrition guidelines
for food served in licensed child care
settings

A partnership with the Office of Child Care
Licensing led to new regulations for
healthy eating and physical activity
24
Healthy Child Care Settings
 Best Practices Guide
-
-
NHPS collaborated with the Delaware Child and Adult Care Food Program
(CACFP) to co-author, Best Practices for Healthy Eating: A Guide to Help
Children Grow Up Healthy embodying the Nemours 5-2-1-Almost None
message
Provides recommended action steps
Endorsed by the USDA
 Child Care Learning Collaborative
-
28 centers completed 5 sessions
Receive insight, experience from 4 pilot site champions
Receive hands-on techniques to imbed physical activity
into the day, increase fruits and vegetables on the menu,
and receive parental support for healthy foods brought
into the center
25
Healthy Child Care Settings
Results of Work
• Healthy eating practices
increased
• Physical activity practices
increased
• Increases in provider
knowledge about nutrition and
physical activity
• Changes in centers’ written
nutrition and physical activity
policies
• Changes in center practices
• Supports to keep the
regulations strong
26
National Partnership:
Let’s Move! Child Care
 Goal: Create strong practice change in child care
settings across the country to improve healthy
eating, physical activity and screen time behaviors
for children
 External Partners: Office of the First Lady,
Domestic Policy Council, CDC, Administration for
Children and Families, Child Care Aware of
America, University of North Carolina, Healthy
Kids, Healthy Future Steering Committee
Healthy Child Care Settings:
It Takes Time
Child Care Learning Collaborative
Provider Workshops
CACFP Trainings/Team Nutrition Trainings
Child Care Pilots
2006
2007
2008
2009
2010
2011
2012
Healthy Kids Healthy Future
Steering Committee
Let’s Move! Child
Care
Nat’l Provider
Collaboratives
DE Institute for Excellence in Early
Childhood
CACFP Regulations in Effect
Office of Child Care Licensing Rules for Healthy Eating and Physical Activity in Effect
Healthier Vending and Concessions

May 20, 2010 Governor
Markell’s Executive Order #19:
Established a Council on Health
Promotion and Disease
Prevention

“In carrying out its charge, the
Council shall endeavor to
ensure that the State, as an
employer, set the standard for
workplace health promotion and
disease prevention, including
healthy foods in vending
machines, physical activity
opportunities, and health
promotion benefits to state
employees and their families”
Healthier Vending and Concessions
Nemours developed a guide
to healthier vending and
Concessions, with the easy to
use “go, slow and whoa:
terminology.
30
Munch Better in the Great Outdoors
Munch Better in the First State
31
Partnerships for Healthy Vending
State Parks
Policy
2010
State
Buildings
Pilot
2012
AI duPont
and
Nemours
Facilities
Currently
32
Lessons Learned
• Prevention is not the top priority on
everyone’s agenda
 Need to make sure our partners’
priorities are connected to our
priorities
 Listening is key: acknowledge barriers
and find solutions
 Share results: national groups were
interested in Delaware child care work
• Community is dynamic and changing: be
ready to adapt
33
Collaboration=Increased Impact
Multiple partners, multiple strategies and
commitment add up to increased impact
34
An Ambitious
Goal
• Creating healthy, active
environments will take the
combined efforts of entire
communities
• The health of future generations
is at stake
35
Mary Kate Mouser
Executive Director
Nemours Health & Prevention Services
252 Chapman Road, Suite 200
Newark, DE 19702
[email protected]
36