Valerie Minor, RN, MSN., Christa Ice, Ph.D., & Shannon Holland, MA.

1. Valerie Minor, Associate Director CARDIAC, will introduce the CARDIAC project 2. Christa Ice will present findings from the past year of CARDIAC and give examples of CARDIAC research projects 3. Shannon Holland, Executive Director WVOM, will talk about the Schools on the Move grants

The West Virginia CARDIAC Project Coronary Artery Risk Detection In Appalachian Communities “To reduce cardiovascular disease, diabetes, and other chronic illnesses in West Virginia through research and intervention in children.”

1998: 3 counties 2012: 55 counties

W.A.Neal, MD …there was a famous pediatric cardiologist. He saved and improved the quality of the lives of hundreds of sick children.

In 1995, the WV age adjusted death rate from heart disease was 21% higher than the national average.

Something had to be done. But the grown-ups just didn’t seem to be getting it.

Now, this was not just your average “run of the mill” famous pediatric cardiologist. He was a deep thinker! Hold that thought.

The postman delivered letters that invited lots of people (including the famous pediatric cardiologist and a cranky nurse) to a meeting.

Lfdoas lfoei ad ald da ll ldjpe fj j erd lfoe d 0p aod ap apo A[a aeipf apoia’p d ka adl k

“Geez, you’re the worst focus group I’ve ever seen.” Geez, you’re the worst focus group I’ve ever seen.”

The cranky nurse didn’t like focus groups with all talk and no action and said so as she introduced herself to the group.

The famous pediatric cardiologist agreed. He decided to introduce himself to the cranky nurse.

W.Neal, MD And there are 2 others who can make this happen… So over lunch at the meeting, the famous pediatric cardiologist talked to the cranky nurse. He told her about his bright idea and about 2 other people...

WVU SOM Department of Pediatric Cardiology

And you will do community service projects…

CDC Benedum Foundation Department of Pediatrics Foundation Compton Nutrition Chair American Heart Association … and the givers gave… Private contributions

WE CARDIAC …and the legislature gave…

And the famous pediatric cardiologist said, “This is good.”

Many of the same people Remains community based Able to focus on CARDIAC alone So far, so good!

1) Active consent 5 th grade (CARDIAC Kid) 1) Family history 2) BMI 3) Blood pressure 4) Acanthosis Nigricans 5) Fasting lipid profile 2) Eight county active consent research program 3) Passive consent 2 nd grade (CARDIAC TOO)

County and state results for 5 th grade are available on our website: Since 1998, we’ve screened over 81,156 5 th graders! In : counties were screened schools 3. 4,780 students parents

Among those 4,780 screened: 18.7% were overweight 27.8% were obese 20.3% had high blood pressure 23.5% had abnormal lipids (high TC and/or low HDL) 3.9% had Acanthosis Nigricans Of those with AN, 62.1% had high insulin Many of the students screened do not realize they need medical attention! Parents can call our toll-free hotline with questions. Parents are contacted if their child should seek immediate medical attention.

Since 2005, over 50,082 2 nd graders have been screened During : 41 counties participated 8,591 students 15.7% were overweight 24.5% were obese 2% had Acanthosis Nigricans

Screened 868 kindergartners 17.2% were overweight 13.6% were obese 0.7% had Acanthosis Nigricans Screened 97 8 th graders 19.8% were overweight 26% were obese 6.2% had Acanthosis Nigricans

Validate a Model for Reducing and Preventing Obesity in WV School Aged Children 3 year project following students in 6 th, 7 th, and 8 th grades In collaboration with Marshall University regarding School Based Health Centers Funded by The Claude Worthington Benedum Foundation Compared school-based health centers to a physician office-based model

Evaluation and program develop of Greenbrier CHOICES, an integrated adolescent health promotion program on the physical activity, fitness, and dietary behaviors of middle school students. Screening 6 th, 7 th, and 8 th grade students In Greenbrier County middle schools As part of the Clinical Component of the Carol M. White Physical Education Program (PEP) Grant

With the discontinuation of WVRHEP in the school year, CARDIAC hired experienced Area Coordinators If you are currently a school nurse participating in the CARDIAC Project, please see our booth, pick up screening results, and say hi to your Area Coordinator! If you have any questions regarding CARDIAC screening of 2 nd or 5 th grade students, please feel free to talk to them!

One of the biggest questions we get is what can we do with these CARDIAC results to improve child health in WV? Area Coordinators will start implementing or facilitating intervention efforts in their areas in We will generally only be screening passive consent 2 nd grade and active consent 5 th grade schools We value the expertise of the School Nurses and we request that they participate in the screening

These results are extremely important for families, who might not realize cardiovascular risk starts in young children They are also important for state and nationwide research implications. CARDIAC in the state news: Kate Long with the Charleston Gazette:

Nationwide CARDIAC research in the news: 1) 2012 AHA EPI-NPAM Science News: Sam Gidding, MD, FAHA and Christa Ice, PhD. CV Risk Factors and Rurality in Appalachian Children 2) Ms. Ritchie’s 2010 article: Universal versus targeted blood cholesterol screening among Appalachian youth: The CARDIAC project. Pediatrics. 126, ) Dr. Cottrell’s 2011 article: Metabolic abnormalities in children with asthma. American Journal of Respiratory and Critical Care Medicine. 183,

20,266 Subjects Tested (5 th Graders) 14,468 met NCEP screening Guidelines (71.4%) 5,798 did not meet NCEP Screening guidelines (28.6%) 170 warrant pharmacologic tx (1.2% of those who met NCEP guidelines) (1.7% of those who did not Meet NCEP guidelines) 98 warrant pharmacologic tx

Results Summary: Mid-sized metro areas consistently presented with the worst outcomes (BP, BMI, cholesterol) All areas/counties have high rates of cardiovascular risk! Data from

Obesity is defined as BMI ≥95 th percentile Data includes over 81,000 participants National average is ~20% All counties have prevalence above the national average

Take steps to improve West Virginia children’s health! Here are a few ways you can help: Ask parents and schools to participate in the CARDIAC Project Encourage state legislators to continue supporting child health initiatives, such as healthy school meals and obesity screening Volunteer with local, community-based health initiatives, such as school gardens Become a role model: Follow Have your cholesterol and blood pressure checked.

Become involved in statewide initiatives, such as the physical activity plan: Go to West Virginia on the Move for other great physical activity ideas: Partner with WVU Extension’s healthy lifestyle initiative:

Since 2004 Statewide non-profit Mission : To promote a physically active lifestyle for all West Virginians, by providing leadership, technical expertise, and collaboration with the goal of reducing the prevalence of chronic disease.

50 To help WV schools create and foster opportunities for comprehensive school physical activity that could not be developed without external funding. * *WV Physical Activity Plan - Priority Area 1: School-based Programs & Initiatives. Implement multi-year programs to provide resources and technical support for PK-12 schools seeking to establish comprehensive school physical activity programs. (ActiveWV Schools) Warwood School

51 Since 2005 Up to $5,000 Pre-K to 12 Public or private # of grants varies 5 to 11 Increase physical activity opportunities before, during or after school for students, staff and families Tunnelton-Denver Elementary (2011)

52 Walking Tracks Circuit Training & Hip Hope Dance Program Mobile PE Boxes Climbing Walls Family Fun Nights Cycling Clubs Kids Run Wild Program SPARK Training Summer Shape Up Challenge Williamstown Elementary 2009

Brandywine Elementary (Pendleton) - Walking Trail Increase physical activity most students receive by twenty minutes on a new walking trail. Activities include after-school family walking program in addition to before and during school programs. Fountain Primary School (Mineral) - On the Go Increase physical activity levels of students and community members through programs using paved walking track. Promote use before during and after school and increase community access. Marlowe Elementary (Berkeley) - Marlow is Walking around the World Increase student physical activity levels during the school day in addition to increasing levels for parents, staff and community weekly by creating walking clubs that will “walk around the world”. Point Harmony Elementary (Kanawha) - Point Harmony After-School Activity Program Increase physical activity levels and reduce screen time through after school clubs and integration of nature trail in school and community outdoor physical activity. Tucker County High School (Tucker) - Wheels for the Hills Create school based outdoor adventure club to foster a life-long enjoyment of outdoor recreation for students, staff and community through mountain biking. West Liberty Elementary (Ohio) - Heart of an Eagle Increase knowledge of moderate to vigorous physical activity using heart rate monitors through programming that includes best practices such as SPARK and Let’s Move! WV.

Total 39,281 Reported by Grant Contacts 2005 – 2011

Barbour Berkeley Boone Braxton Brooke Cabell Clay Fayette Gilmer Grant Greenbrier Hampshire Hancock Hardy Harrison Jackson Kanawha Lewis Lincoln Logan McDowell Marion Mason Mercer Mineral Mingo Monongalia Monroe Morgan Nicholas Ohio Pendleton Pocahontas Preston Putnam Raleigh Randolph Ritchie Roane Taylor Tucker Tyler Upshur Wayne Webster Wetzel Wirt Wood Wyoming Marshall Cal- houn Dodd- ridge Jefferson Pleas- ants Sum- mers 6 Grants 5 Grants 4 Grants 3 Grants 2 Grants 1 Grants Grants 2005 to grants in 30 counties Funding for Schools on the Move Program provided by WVU Children’s Hospital Foundation. Additional support from End Childhood Obesity Race (ECHO) and The CARDIAC Project.

Reported.. 58% leveraged more funding 36% obtained up to $5,000 27% obtained >$10, % received publicity 91% reached desired target audience 91% report SOM experience encouraged them to seek other funding or increased their grant writing capacity Bridge Elementary

“The sight of over 100 children staying after school and running happily on a trail that the school community built was the vision we hoped for… …[Children] are learning the basics of health through the activity and parents see it in action.” “…I have noticed that students that were not normally competitive in sports activities are very successful and enjoy using the climbing wall. “ “Through [this project] our school adopted an entire health and wellness initiative” Story from...parent : “They took a slow, trudging, injury prone, overweight work horse and turned her into a eager, peppy and healthy race horse who is forty pounds lighter. … that running club's last group was 180 kids out of an enrollment of 460 children, more than 1/3 of our school. Crazy amounts of kids are running here thanks …”

Thanks! WVU Children’s Hospital Foundation Additional support provided by The CARDIAC Project and End Childhood Obesity (ECHO) Race, Wheeling Initial program funding from The Benedum Foundation WVOM Board Members provide their expertise In-kind support from countless organizations who help spread the word

New Funding for Academic Year WVU Children’s Hospital Foundation Information on WVOM website by September 2012 List of previously funded projects – available now CARDIAC Area Coordinators role 59

First - Letter of Intent Form required Then - Application: Cover Sheet Committee List Narrative Need/Problem Statement Expected Outcomes Target Audience Intervention Description Evaluation. Outcomes Table Budget and Justification 2 Letters of Support

61 Proposals should support local initiatives that promote comprehensive approaches to youth physical activity: (a) Quality physical education (b) Alternative before, during or after school programs (c) Parent/community outreach (d) Staff/faculty wellness (e) Active transportation Tygarts Valley High School

62 Thanks for all you do to help … West Virginia Schools Get on the Move!

For Schools on the Move contact: Shannon Holland: For CARDIAC contact: Christa Ice: OR Valerie Minor