YEAH Presentation (2)
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- Childhood obesity rates in Idaho have more than tripled over the past 30 years, with over 30% of school-aged children classified as overweight or obese. - St. Luke's has established two models - a clinical model and community model called YEAH! - to address this issue through lifestyle change programs, nutrition education, and physical activity. - St. Luke's is working to standardize the YEAH! program, establish collaborations to take a system-wide approach, and explore funding opportunities to ensure long-term sustainability of childhood obesity prevention and intervention efforts.
YEAH Presentation (2)
- 1. A Multi-Disciplinary Approach to Childhood Obesity
- 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
- 3. 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
- 4. 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.
- 5. 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
- 6. 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
- 7. 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
- 8. 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.
- 9. Objective 1: Program Standardization EBP/Outcomes and Standardization EBP/Outcomes and Standardization Medical Director/CHOICE Medical Director/CHOICE Work Group LeadsWork Group Leads Regional ManagersRegional Managers Program TeamProgram 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.
- 10. Objective 2: Childhood Obesity Collaborative Collaborative Partners: 1.Healthcare Providers 2.Payors 3.Policy Makers 4.Community/State Agencies 5.Schools/Educators 6.Families/Caregivers 7.Community Partners 8.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.
- 11. Outcomes Data Objective 2: Childhood Obesity Collaborative Framework Health Care Providers Schools/Educators Family/Care Givers Policy Makers Community Kids Community Agencies Payors Funding Community Partners
- 12. Case Studies Program Sustainability 1.Health System Support 2.Payor Reimbursement Models 3.Endowment/Philanthropy 4.Sustaining Partnerships 5.Events 6.Grant Funding 7.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
- 13. 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.
- 14. •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
- 15. 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
- 16. Be Well Now! Family Festival
- 17. 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.
- 19. St. Luke’s YEAH! Program http://www.youtube.com/watch?v=SGflW-P0ilQ
- 20. Find Out More About the YEAH! Program www.stlukesonline.org/childrens