ship ps4 h - cdc 1422 october 2015 final
TRANSCRIPT
Integrating Public Health into Clinical Systems - NDSUPrevention In The Primary Care Setting - October 15, 2015
Kristin Erickson, MS, APHN-BC, [email protected]
The Problem
Factors that influence Health
The Minnesota Solution Statewide Health Improvement Program
PartnerSHIP 4 Health
The Federal Solution CDC 1422 Community Wellness Grant
The Outcomes
Tonight’s Roadmap
The Problem: The “real” causes of
these deaths are behaviors that are preventable, such as tobacco use/exposure, poor diet, and sedentary living…
Obesity is epidemic in Minnesota.
• Nearly 2/3 of adults are overweight or obese
• Only one out of four adults eats enough fruits and vegetables
• Only slightly more than half of Minnesota adults get at least a moderate level of exercise
Percent of Minnesota Adults Obese
Tobacco continues to be a problem in Minnesota.
• 14.4% of adults smoke, and many others are subjected to secondhand smoke.
• Over a quarter of high school students used tobacco in the past 30 days. www.mnadulttobaccosurvey.org
What Influences Our Health?
• Socio-Ecological Model: – Individual: knowledge, attitudes,
beliefs
– Interpersonal: family, peers, social networks
– Organizational: employers, schools, etc.
– Community: social norms and standards
– Policy: a law, rule at an employer, college, or multi-unit housing
Where
we’v
e t
raditio
nally
spent
our
effort
s
What Influences Our Health?
• Socio-Ecological Model: – Individual: knowledge, attitudes,
beliefs
– Interpersonal: family, peers, social networks
– Organizational: employers, schools, etc.
– Community: social norms and standards
– Policy: a law, rule at an employer, college, or multi-unit housing
Where
we’v
e t
raditio
nally
spent
our
effort
sW
hat is
most e
ffectiv
e
2009 - present day
https://www.youtube.com/watch?v=SMymFKsix6A
Making the Healthy Choice the Easy Choice
Statewide Health
Improvement Program
(SHIP)
What is Policy Change?
• Policies include laws, ordinances, resolutions, mandates, regulations, or rules (both formal and informal)– Policy change includes the passing of
laws, ordinances, resolutions, mandates, regulations, or rules
– Example: organizational policy that allows the use of flex-time to accommodate physical activity
What is System Change?
• Systems impact all elements of an organization, institution, or system– Systems change impacts all elements
of an organization and often focuses on changing infrastructure within a school, park, worksite or healthcare setting
– Example: Implementation of the WHO 10 Steps to Successful Breastfeeding and becoming a baby-friendly hospital system
What is Environmental
Change?• The environment involves physical
or material elements of the economic, social, or physical environment– Environmental change is a change
made to the physical or material elements
– Example: Incorporating sidewalks, paths, and/or recreation areas into community design
Policy, systems, and environmental changes… supporting healthy individual behaviors…
How it
works
• work with schools to serve more locally grown produce
Rather than just telling kids about good
nutrition
• help employers build opportunities into the day
Rather than just telling people to get more
physical activity
• help college campuses become smoke-free
Rather than just telling students to avoid
second-hand smoke
PartnerSHIP 4 Health
Community and public health partners in Becker, Clay, Otter Tail and Wilkin counties working together to create an environment that supports improved health for all
Funded by the Statewide Health Improvement Program (SHIP) as well as multiple additional funding streams
Multiple funding streams• Statewide Health Improvement Program - SHIP
• SHIP Innovation
• CTG, CDC 1422 Community Wellness Grant
• ClearWay
• UCare
• Otto Bremer Foundation
• BCBS Foundation
• MN GreenCorps
• BCBS Center for Prevention
• NW Regional Sustainable Development
Walking Alongside Our Partners…
• Human Service Organizations
• Schools
• Worksites
• Communities
• Healthcare
• Childcare
Creating a Culture of Health
Environmental Changes
Policy Changes
System Changes
It Takes a Team
• Multi-agency, multi-county, multi-disciplinary staff• The right people doing the right work• Supported by decision-makers• Multiple funding partners
Complete Streets Active Transportation Safe Routes to School
Active School Day:
Active Recess and
Active Classrooms
Comprehensive School Physical Activity Programs:
Bike FleetWorksite Wellness
INCREASING PHYSICAL ACTIVITY FOR ALL
Worksite Wellness: Lactation Room
Farmers MarketsFresh Connect Food Hub
and Farm to School
Human Service Organizations
Community Gardens Healthy Food Pantry Donations
INCREASING HEALTHY FOOD ACCESS FOR ALL
Smoke-Free Multi-Housing Units
Clinical Guideline Implementation
Tobacco-Free Worksites and Secondary Campuses
Counter Marketing and Point of Sale
Increase Access to Tobacco Cessation Services
Smoke-free Childcare and Foster Care
DECREASING TOBACCO USE AND EXPOSURE
Encourage Clinical
Obesity and Tobacco
Guidelines
Encourage Worksite
Wellness to Foster Healthy Role Models
HEALTH CARE STRATEGY #1
ELEVEN PARTNERS Community Health
Service, Inc. (Migrant Health)
Family HealthCare Center (FQHC)
Orthopedic and Sports Physical Therapy, Inc.
Lake Region Healthcare, Essentia Health, Sanford Health, and Perham Health Clinics
Local Public Health Departments
HEALTH CARE STRATEGY
Five Partners
• Essentia Health St. Mary’s in Detroit Lakes
• Lake Region Healthcare in Fergus Falls
• Perham Health in Perham
• St. Francis in Breckenridge
• Essentia Health and Sanford Health in Fargo-Moorhead
Participate with Local Hospitals in their
Community Health Needs Assessment and Strategic
Planning Process
Health Care Strategy #2
• Minnesota bent the curve and outperformed nearby states• Significant health care savings linked to 60,000 more Minnesotans at a healthy weight
U.S. and Regional Obesity Rates
Data source: CDC Behavioral Risk Factor Surveillance System
http://www.health.state.mn.us/news/pressrel/2015/ship042015.html
Initial Results:Minnesota Alone Trims Obesity Rates Among Upper Midwest States
FUNDING TO PREVENT OBESITY, DIABETES, AND HEART DISEASE AND STROKE
The Minnesota Department of Health (MDH) received new Centers for Disease Control & Prevention (CDC) funding to support local communities to improve health.
PartnerSHIP 4 Health is one of FOUR selected communities to receive funding targeted for cross-cutting, creative approaches that can positively impact the health of residents, especially those with the greatest health needs.
The key components and strategies of this grant enhance communities’ current efforts through the Statewide Health Improvement Program (SHIP), The Minnesota Accountable Health Model or SIM, and Health Care Homes.
Four Components - Fifteen Strategies – 11/15 related to healthcare
Improve the Quality of Health Systems, Care Systems, and Care Delivery for People w/Hypertension and Pre-Diabetes Disparities
2.1 Increase electronic health records (EHR) adoption and the use of health information
technology (HIT) to improve performance (e.g., implement advanced Meaningful
Use data strategies to identify patient populations who experience CVD-related
disparities)
2.2 Increase the institutionalization and monitoring of aggregated/standardized quality
measures at the provider level (e.g., use dashboard measures to monitor
healthcare disparities and implement activities to eliminate healthcare disparities)
2.3 Increase engagement of non-physician team members (i.e., nurses, pharmacists,
nutritionists, physical therapists and patient navigators/community health workers)
in hypertension management in community health care systems
2.4 Increase use of self-measured blood pressure monitoring tied with clinical support
2.5 Implement systems to facilitate identification of patients with undiagnosed
hypertension and people with prediabetes
Link Clinical and Community Resources to Support Heart Disease, Stroke and Type 2 Diabetes Prevention
2.6 Increase engagement of CHWs (such as Community Paramedics) to
promote linkages between health systems and community
resources for adults with high blood pressure and adults with
prediabetes or at high risk for type 2 diabetes
2.7 Increase engagement of community pharmacists in the provision of
medication-self management for adults with high blood pressure
2.8 Implement systems to facilitate bi-directional referral between
community resources and health systems, including lifestyle change
programs (e.g., EHRs, 800 numbers, 211 referral systems, etc.)
• Washington, D.C., September 21, 2015 – At 27.6 percent, Minnesota now has the 36th highest adult obesity rate in the nation, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).
• Across the country, rates increased in five states (Kansas, Minnesota, New Mexico, Ohio and Utah) and remained stable in the rest.
• Minnesota’s increase in 2014 comes despite investments in the very areas advocated by the Trust organization and the Robert Wood Johnson Foundation, which co-released Monday’s report.
• Minnesota’s Statewide Health Improvement Program, or SHIP, has spent nearly $100 million since 2009 on projects to get people to eat better, exercise more and smoke less.
http://healthyamericans.org/reports/stateofobesity2015/release.php?stateid=MNhttp://healthyamericans.org/reports/stateofobesity2015/http://stateofobesity.org/http://www.startribune.com/minnesota-one-of-five-states-with-more-obese-adults-in-2014/328583361/
Current Outcomes: September 2015 DataObesity Rates Remain High