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A Multi-Disciplinary Approach to Childhood Obesity

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Page 1: YEAH Presentation (2)

A Multi-Disciplinary Approach to Childhood Obesity

Page 2: YEAH Presentation (2)

Startling Statistics

•Childhood obesity has more than tripled over the past 30 years.

•A 2008-09 school year BMI assessment of Idaho students in all odd grades 1 through 11 found that overall, 30.5% of the Idaho school children in the sample were classified as overweight or obese.

•The study found that significantly more boys were obese than girls.

•Idaho has a projected obesity rate of 53% by 2030.

•Predicted annual economic obesity related costs in Idaho are expected to reach $1.5 billion by 2018.

Source:*Idaho Department of Health and Welfare*Trust for America's Health and the Robert Wood Johnson Foundation

Page 3: YEAH Presentation (2)

Two Models For Best Results

The best predictor for long-term success is prevention and early intervention.

Our Community Health Needs Assessment identifies weight management as a high priority need.•With more than 30% of our school aged children classified as overweight or obese, population health needs to be addressed at pre-school age to help positively influence habit forming behavior.

•By engaging children, we routinely see very positive health changes in the parents.

Population Health and Community Need

Page 4: YEAH Presentation (2)

Yeah! Making a Difference

Yeah! began four years ago as part of the BrightPath Network, and was funded through a two year Pacific Source grant. The initial program has since expanded to become part of St. Luke’s Children’s.

Page 5: YEAH Presentation (2)

Two Models For Best Results

Yeah! Clinical Model:•Requires a health care provider referral•Children ages 5-16 years of age•BMI > 95% (AAP definition)•Readiness to change and commitment are key•16 week program•Lifestyle change versus weight loss focus

Two Models for Best Outcomes

Page 6: YEAH Presentation (2)

Clinic YEAH! Program Overview

Clinic Team: Pediatrician, Nurse Coordinator, Physical Therapist, Social Worker, Dietitian and Exercise Physiologist

Clinic Visits:Initial/1 month/3 month/12 month

• Baseline data measurements include: weight, height, waist circumference, blood pressure, fitness testing, Peds QL• Goal setting• Physical Activity class weekly• Nutrition class every other week

Clinical Model Components

Page 7: YEAH Presentation (2)

Community Program Components

Yeah! Community Model:•Requires a health care provider referral•Children ages 5-16 years of age•BMI > 85% (AAP definition)•Readiness to change and commitment key indicators•8 week program•Lifestyle change versus weight loss focus

Page 8: YEAH Presentation (2)

A System Wide Initiative

We have set three objectives to ensure we can replicate the program across the health system: producing outcomes, collaborating with others and addressing sustainability for the future.

Page 9: YEAH Presentation (2)

Objective 1: Program Standardization 

EBP/Outcomes and Standardization

Medical Director/CHOICE

Work Group Leads

Regional Managers

Program Team

Plan to meet Objective:

1.Develop standardized processes, procedures and curriculum for Yeah!

medical and community programs.

2.Approved program material will be distributed to all Yeah! program

provider sites.

3.Workgroup leaders to provide shared decision making for process to review,

suggest changes and/or modifications to program.

4.Medical Director to review, approve, or make recommendation to ensure

evidence based practice is utilized.

5.Registry of participants to be developed so data can be tracked, analyzed

and reported for outcomes.

6.Program changes and modifications must be approved by the Medical

Director.

7.Standard review process will be lead by Medical Director with CHOICE

council members annually.

Page 10: YEAH Presentation (2)

Objective 2: Childhood Obesity Collaborative 

Collaborative Partners:

1.Healthcare Providers2.Payors3.Policy Makers4.Community/State Agencies5.Schools/Educators6.Families/Caregivers7.Community Partners8.Funding/Philanthropy

Plan to Meet Objective:

1.Review CHOICE membership, identifying key

stakeholder/agencies who many need to be represented.

2.Identify collaborative objectives and approach to childhood

obesity initiative.

3.Draft a plan to create desired areas of strategic impact

(school programs, daycare facilities, WIC, other state and local

agencies), then identify representatives who may have the

best influence to move the metric.

4.Using shared decision making, identify timelines, metric

development, and anticipated results.

Page 11: YEAH Presentation (2)

Outcomes Data

Objective 2: Childhood Obesity Collaborative Framework  

Health Care Providers

Schools/Educators

Family/Care Givers

Policy MakersCommunity Kids

Community Agencies

Payors

Funding Community Partners

Page 12: YEAH Presentation (2)

Case Studies

Program Sustainability

1.Health System Support2.Payor Reimbursement Models3.Endowment/Philanthropy4.Sustaining Partnerships5.Events6.Grant Funding7.Private Donations

Plan to meet Objective:

1.Business case development that identifies key drivers for

long-term sustainability and successful program outcomes.

2.Work with foundation to write case statement for Yeah!

campaign.

3.Identify potential sustaining partner opportunities,

appropriate communication channels, and full approval to

contact.

4.Create outcomes plan/case studies to present to payors for

consideration for preventative health assistance.

5.Identify key events that lend to generating program

awareness and sustainability of program.

6.Continue to identify appropriate grant funding opportunities

to supplement funding needs.

Objective 3: Program Sustainability

Page 13: YEAH Presentation (2)

Case Studies

What do Our Outcomes Show?

Understanding participants are undergoing normal growth, and change in BMI through normal childhood and adolescent growth, the following physical/physiological measures showed statistically significant differences from baseline as a result of participation in our YEAH! Program: · Waist size at 6 and 12 months· Blood pressure at 6 months· Resting heart rate at 6 months· Distance run and 50 foot shuttle at 6 months Several fitness measures, step, squat, crunches, pushups, back extension, all also statistically significantly improved at 6 months. A Pediatric Quality of Life tool was implemented containing questions relating to the participants’ and parents’ perceptions of physical, emotional, social and school-related issues which combine to generate an overall score. For the participant (child), all parameters improved at six months and only school narrowly missed statistical significance at 12 months (p = 0.58), attesting to the lasting effect on a child’s self-image. Parents perceptions were also statistically significantly positive at six and 12 months except for questions relating to physical attributes, a somewhat interesting discrepancy.

Page 14: YEAH Presentation (2)

•The Childhood Obesity Initiative Council for Excellence (CHOICE) has been established to create a consistent, collaborative approach across our areas of impact, and determine a road map for the program’s future. This collaborative effort includes many community agencies and partners; including, Central District Health, Department of Health and Welfare, State Department of Education, Idaho Association for the Education of Young People and many others.

•We continue to explore all funding opportunities through philanthropy, sustaining events, and hope to soon work with payors to identify new reimbursement models for these types of programs.

In Progress, and On the Horizon

Page 15: YEAH Presentation (2)

We held our First Annual Childhood Obesity Conference and Family Wellness Festival on April 13, 2013

Items of note:•Dr. David Katz, a renowned childhood obesity expert, keynoted the conference. He is the Editor-in-Chief of the Childhood Obesity Journal, and is the founding director of Yale University's Prevention Research Center.

•Dr. Katz also was the featured guest for a leadership dinner that convened mayors, educators, policy makers, community advocates and health care leaders.

•Mayor Bieter led a walk as part of his Mayor’s Challenge to highlight activity and walkable space in our community.

•The festival hosted more than 2000 people who actively engaged in healthy, fun activity.

Childhood Obesity Conference and Wellness Festival

Page 16: YEAH Presentation (2)

Be Well Now! Family Festival

Page 17: YEAH Presentation (2)

YEAH! Summer Camp

St. Luke’s hosted its first YEAH! summer camp at Bogus Basin. The event was held from Aug. 12-16.

Items of note:

•During the camp, 18 area youth participated in a variety of healthy activities that culminated in a three-mile hike. For many participants this was the first time they had gone to a camp.

•Student volunteers in the group One Stone volunteered to serve as camp counselors.

•The event wouldn’t have been possible without partners in the community including Bogus Basis, City of Boise and Wal-Mart.

•At the conclusion of camp Wal-Mart presented a check for $25,000 to help continue funding the YEAH! program.

Page 18: YEAH Presentation (2)

YEAH! Summer Camp

Page 19: YEAH Presentation (2)

St. Luke’s YEAH! Program

http://www.youtube.com/watch?v=SGflW-P0ilQ

Page 20: YEAH Presentation (2)

Find Out More About the YEAH! Program

www.stlukesonline.org/childrens