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Kristin Anderson, MD, MPH
Community Health and Prevention
Community Physicians Group
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CoC Prevention guideline Standard 4.1-Prevention
“Each calendar year, the cancer committee organizes and offers at least one cancer prevention program designed to reduce the incidence of a specific cancer type and targeted to meet the prevention needs of the community. Each prevention program is consistent with evidence-based national guidelines for cancer prevention.”
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Causes of Death, US, 2014 Number of deaths for leading causes of death:
Heart disease: 614,348
Cancer: 591,699
Chronic lower respiratory diseases: 147,101
-https://www.cdc.gov/nchs/fastats/deaths.htm
(accessed 6/16/17)
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Most Common Cancers Linked to Obesity* Bladder Cancer Breast Cancer* Colon and Rectal Cancer* Endometrial Cancer* Kidney Cancer* Leukemia Liver* Lung Cancer Melanoma Non-Hodgkin Lymphoma Pancreatic Cancer* Prostate Cancer Thyroid Cancer* -https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3 (accessed 6/16/17) -https://www.cancer.gov/types/common-cancers (accessed 6/16/17)
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Cancer and Prevention Mission, CMC
Your health—our commitment to you, from day one
Obesity
Impacts on health, community
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Where do we intervene? “Even if the entire U.S. population had access to excellent medical care — which it does not — only a small fraction of these deaths could be prevented. The single greatest opportunity to improve health and reduce premature deaths lies in personal behavior. In fact, behavioral causes account for nearly 40% of all deaths in the United States.”
http://www.nejm.org/doi/full/10.1056/NEJMsa073350#t=article
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Prevention USPSTF “The USPSTF recommends screening all adults for
obesity. Clinicians should offer or refer patients with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.”
B Recommendation
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Prevention CDC Community Guide “The Community Preventive Services Task Force recommends the creation of or enhanced access to places for physical activity to increase physical activity and improve fitness.”
-https://www.thecommunityguide.org/findings/physical-activity-creating-or-improving-places-
physical-activity
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How Do We Intervene? Increase Physical Activity
Community Based Partnerships Subcommittee Members
Missoula City County Health Department, Cancer Prevention Office
Missoula Parks and Recreation
American Cancer Society
CMC Marketing and Outreach
CMC Physical Therapy
CMC Nutrition
Physicians, CPG, Partnership
University of Montana, AHEC
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Intervention: Walk With a Doc
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First in Montana
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2015 Assessment Standard 4.1: Prevention
Date Contact Person Prevention Topic Type of Outreach # Served
6/18/2015 Dr. Kristin Anderson Obesity Walk with a Doc at Fort Missoula Trail 6
7/16/2015 Dr. Michelle Proper Obesity Walk with a Doc at McCormick Park 6
8/20/2015 Dr. Ryan Marshall Obesity Walk with a Doc Cancelled due
to Wildfire Smoke
9/24/2015 Dr. Kristin Anderson Obesity Official Walk with a Doc signed agreement
10/3/2015 Dr. Kristin Anderson Obesity Diva Day 1
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PDSA 2015 What not to do
Link it with local races
Underestimate the need for coordination
Underestimate the need for marketing
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2016 Assessment Susan, do you have this grid? I can’t find it in the
minutes-- Standard 4.1: Prevention
Date Contact Person Prevention Topic Type of Outreach # Served
1/23/2016 Dr. Kristin Anderson Obesity Walk with a Doc at Frost Fever 5k 6
4/19/2016 Family Practice Resident Obesity Walk with a Doc at the YMCA 2
9/28/2016 Dr. Kristin Anderson Obesity Walk with a Doc at Community Medical Center 8
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Where to focus for 2017?
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2017 Assessment • Partnership with University of Montana AHEC
• Martha Robertson, UM
• Phase 1, WWaD 2/17-5/17: Chose underserved and central location in Missoula: Milwaukee Trail
• Many people drove to location anyway
• Phase 2, WWaD/WWEase 5/17-10/17: Ft. Missoula, close to CMC
• As of 7/2017, 18 walks had been held with approximately 8-10 walkers
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If You Build It… February 2017, WWaD and National Parks and
Recreation Association(NPRA) approached us as a pilot site for NEW partnership between WWaD and Walk with Ease for arthritis management
Partners: CMC, UM AHEC, Missoula Parks and Recreation, NRPA
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New Partners
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Stronger Programming
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PDSA 2017 Enhance partnerships
Enhance assessment and further PDSA
Electronic assessment, apps, links to biomonitoring
New partners
VA
Montana University Systems Wellness Programs
Pharmacy at University of Montana
Other providers throughout the state
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Conclusions Obesity is our target for cancer prevention
Trusted partnerships have grown
Nationwide Pilot initiatives in place in Missoula for substantive obesity and cancer prevention