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

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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

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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 ObesityObesity 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

ActivitiesElementary & 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

ActivitiesNAP 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

ActivitiesWIC •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

Poster

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