Task Force on Obesity Progress Report Nancy F. Krebs, MD Co-Chair Task Force on Obesity Presented at the AAP-NCE, Oct 2005

[2003] [2004]

Background 2002 - # 1 prioritized resolution at Chapter Forum: “Comprehensive approach to obesity in children & adolescents” 2003 - “Prevention of Pediatric Overweight & Obesity” Policy Statement 2003 – AAP Strategic Plan: formation of Task Force on Obesity (TFOO) 2005 - Numerous activities at Section / Committee & Chapter levels

AAP Task Force on Obesity (est 2003) Co-Chairs NF Krebs (CON) RL Washington (COSMF) Gastroenterology W Cochran General Pediatrics S Hassink J Calabrese Adolescent medicine M Jacobson Media expertise D Shifrin Liaisons: W Dietz (CDC) V Hubbard (NIH)

AAP Task Force on Obesity (est 2003) Consultants Endocrinology F Kaufman Primary Care R Holmberg Pediatric Surgery T Inge Behavior change K Resnicow Schools/community H Taras Reimbursement M Schulman Special Advisor R Schwartz AAP Staff: Pamela Kanda, MPH Jeanne Lindros, MPH Cindy Pellegrini

AAP Task Force on Obesity (est 2003) Charge: direct the AAP’s policies on overweight and obesity Strategic priorities: Prevention Treatment Advocacy Reimbursement

Selected TFOO Objectives… Obj # 1: Child health professionals will… Make obesity prevention a part of every routine child health supervision visit; Be able to identify & treat children and their families who are overweight, including the related co-morbidities

Obj #1: Routine prevention, identification & treatment in the office Develop “Coding Fact Sheet” & “Strategy for Claim/Coverage Denials” Website posting – June ‘05 AAP News – August ’05 Develop document to identify best assessment, prevention & treatment approaches Collaborating with AMA, CDC, ADA, NIH, MCHB, et al, to develop consensus statement for revised guidelines – product mid-’06

Obj #1: Routine prevention, identification & treatment in the office Develop plan to hold motivational interviewing & behavior change workshops at NCE & CME courses Sessions at NCE – 2004, 2005, (2006) Workshops at SuperCME PediaLink obesity module Under construction – Dec 05 available Develop resource kit (aka “tool kit”) Under construction – early 2006

Selected TFOO Objectives… Obj # 2: Pediatricians will actively promote policies, programs, & interventions that support healthy active living by collaborating with… Other health care professionals Public health sector Schools Community-based organizations Employers

Obj #2: To promote policies & interventions by collaborations AAP representation/input Agency for Health Research & Quality (Jan 2004) Federal Trade Commission (July 2005) AMA disparities workshop (Nov 2003) American Heart Association (2003 + current) Shaping America’s Youth Obesity Summit (June 2004) Post list of slide presentations on AAP obesity web site (www.aap.org/obesity)

Obj #2: To promote policies & interventions by collaborations Facilitating local/chapter obesity initiatives CATCH grantees Health Tomorrow grantees Healthy People 2010 grantees CDC Grant: “Prevention of Obesity in School Health” Hold educational seminars & provide technical support to AAP chapters re advocacy in schools Develop a guide for community advocacy & collaboration (post online by Dec ’05)

Selected TFOO Objectives… Obj #3: Pediatricians will be recognized by insurers, employers & legislators as critical providers of health services on overweight/obesity prevention & treatment to all children Access to care/medical home AAP reimbursement committee Education on coding Legislation/policy development

Obj # 3: Recognition of pediatricians as critical providers of services for obesity [Develop “Coding Fact Sheet” & “Strategy for Claim/Coverage Denials”] Develop resource materials for chapters to educate payers on evaluation & treatment of obesity by pediatricians; “Backgrounder” for health insurance carriers Participate in payer conferences and work groups: ongoing Meet w/ national carriers to advocate for recognition of & reimbursement for obesity Dx code & reimbursement for preventive & treatment services: ongoing

Selected TFOO Objectives… Obj #4: AAP will collaborate with medical schools, residency & fellowship programs to integrate childhood obesity prevention & treatment into respective curricula.

Obj #4: Advocate for training on pediatric obesity prevention & treatment Identify key leaders & initiate discussions American Board of Pediatrics Pediatric Program Directors Section on Residents Identify & evaluate existing online curricula Reviewed UNC/Nutrition in Medicine CD ROM (for medical students) Position for federally supported training initiatives

Additional TFOO Activities Media & public information Facilitating local/chapter obesity initiatives Partnerships w/ private sector AAP Publications Update of AAP Policy Statement Review of relevant clinical reports, pamphlets Consumer book for parents (draft in review)

Summary Childhood overweight & obesity is a “mega issue” for children’s health & thus for AAP Priority in current AAP Strategic Plan & for AAP leadership at all levels: National: Committees/Sections Local: Districts & Chapters Individual practicing pediatricians Pediatric healthcare arena is an essential sphere of influence that must be involved in reversing the current trends