Mass in Motion Kids Community-Clinical Partnerships to Reduce Childhood Obesity A partnership between the Massachusetts Department of Public Health, the cities of Fitchburg and New Bedford, the National Initiative for Children’s Health Care Quality, and Harvard University

Childhood Obesity is Not Randomly Distributed Among our Communities

CDC “Health Impact Pyramid” Examples Largest Impact Smallest Eat healthy, be physically active Counseling & Education Clinical Interventions Rx for high blood pressure, high cholesterol, diabetes Long-lasting Protective Interventions Immunizations, brief intervention, cessation treatment, colonoscopy The goal of mass in motion kids is to reduce the prevalence of obesity among 2-12 year old children. The interventions are focused on several levels of the health impact and links different sectors for long-lasting effect Changing the Context to make individuals’ default decisions healthy Fluoridation, trans fat, smoke-free laws, tobacco tax Socioeconomic Factors Poverty, education, housing, inequality

Mass in Motion: Eat Better, Move More Multifaceted state initiative Call to Action report Governor’s Executive Order 509 BMI regulation School Nutrition Standards Public information campaigns Municipal wellness grants Worksite initiative Website Info on physical activity and nutrition Calendars Blogs Links to state and local resources Mass in Motion was launched in 2009. a Massachusetts state initiative to promote healthy living through a multi-faceted approach.

Childhood Obesity Research Demonstration (CORD) Project CDC Funded Childhood Obesity Research Demonstration (CORD) Project Division of Nutrition, Physical Activity and Obesity Obesity Prevention & Control Branch Massachusetts San Diego Texas Evaluation Center University of Houston Fitchburg New Bedford

Overall Approach Build on successful Mass in Motion Approach Enhance connections between sectors Maintain the focus on evidence-based strategies Policies Systems Environmental changes

5 Key Target Behaviors Decrease in children’s consumption of sugar-sweetened beverages Decrease in screen time & TVs in children’s bedrooms Increase in children’s moderate & vigorous physical activity Substitution of empty-calories/nutrient poor foods with fruits and vegetables Increase in children’s sleep quality & duration

Project Overview Individual/ Family System Community Health Care Assessment Coaching Coordinated support Obesity Learning Collaborative to improve quality of care CHWs & physician champion link w/ local Mass in Motion initiative Schools/ After schools Motivates students/parents to eat better, move more Policy & practice changes w/I 2 school systems Implementation will link with Mass in Motion community initiatives Child care I Am Moving, I Am Learning promotes physical activity & healthy food choices NAP SACC supports policy, practice change in child care sites Training of child care licensing staff to include elements in licensing visits Support for activity groups, healthier decision making Environment & policy change focused on increased activity and increased access to healthy food Youth-driven media campaign to change community norms. Environment & policy change

Primary Care: Primary Prevention Activities Goal: Prevention of childhood obesity. Efforts targeting the entire population Healthy weight as well as overweight & obese children Obesity Learning Collaborative Be Our Voice Advocacy EMR Best Practice Alerts Patient education materials Improve the healthfulness of the health center

Primary Care: Secondary Prevention Activities Goal: Prevent disease progression and development of comorbidities and complications Efforts focus on overweight & obese children EMR decision support tools for obesity management Healthy Weight Clinics Community Health Worker support of overweight/obese children and their families

Schools and After Schools Activities Elementary & Middle Schools Eat Well, Keep Moving, Planet Health Curriculum and materials Staff training Wellness champion Fitness equipment Support for wellness plan Student survey during BMI measurement (4th & 7th grades) Afterschool Food and Fun Curriculum Support for environment changes

Child Care and Early Education Activities NAP SACC Complete self-assessment for center Set goals to improve nutrition and physical activity Receive training, resources and materials from Mentors I am Moving, I am Learning Receive training on ↑ physical activity ↓sugar-sweetened beverages and calorically dense foods ↑Fruit and vegetable consumption Educate staff and parents on IM/IL practice

Women, Infants, and Children (WIC) Nutrition Program Activities WIC Complete readiness for change assessment Receive training, resources, and materials Obesity Learning Collaborative Be Our Voice Advocacy

Community Interventions Building on foundation of Mass in Motion Evidenced-based strategies focused on policy, system and environmental change Creating environments that support healthy living Media campaign Youth empowerment approach Will be developed in collaboration with schools to integrate school efforts into community approaches

Mass in Motion as a Foundation Enhance community action plans Focus on evidenced-based strategies that have the largest impact on the 5 obesity related behaviors, eg, IOM’s 2009 Local Government Actions to Prevent Childhood Obesity Ensure coordination and integration of the multiple sectors at the local level Special role of the Physician Champion and the Community Health Worker in clinical sites Engage champions from all sectors in community-wide efforts

Proposed MiM Kids Community Activities Fitchburg Implement at least 2 environmental changes at Big Field/Green Acres to increase physical activity Increase healthy options among park vendors Market Basket grocery stores will implement at least 1 change promoting healthy eating, with focus on fresh fruits and vegetables and healthy beverages Fitchburg will adopt Complete Streets policy, including Safe Routes to Schools and Parks Increase sustainability of Fun N Fitchburg New Bedford Increase the number of restaurants in NB from 0 to 5 that offer healthy childrens’ options Increase number of corner stores from 0 to 3 that participate in MiM New Bedford Healthy Corner Store Initiative Increase the number of elementary and middle schools from 0 to 3 that have well established and consistently active Safe Routes to School programs

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