Kristin Anderson, MD, MPH

Community Health and Prevention

Community Physicians Group

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.”

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)

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)

Cancer and Prevention Mission, CMC

Your health—our commitment to you, from day one

Obesity

Impacts on health, community

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

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

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

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

Intervention: Walk With a Doc

First in Montana

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

PDSA 2015 What not to do

Link it with local races

Underestimate the need for coordination

Underestimate the need for marketing

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

Where to focus for 2017?

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

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

New Partners

Stronger Programming

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

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