mass in motion - commonwealth conversations: public healthjan 11, 2012 · 8 new mass in motion...
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Mass in Motion Cheryl Bartlett, RN
Director, Bureau of Community Health and Prevention
Public Health CouncilJanuary 11, 2012
2
Mass in Motion: Eat Better, Move More
Multifaceted state initiative•
Call to Action report
•
Governor’s Executive Order 509
•
BMI regulation
•
School Nutrition Regulation
•
Public information campaigns
•
Municipal wellness grants
•
Worksite initiative
•
Website–
Info on physical activity and nutrition–
Calendars–
Blogs–
Links to state and local resources
MA Healthy Transportation Compact
Promote “Healthy, Livable and Sustainable Communities”
through land use, transportation and public health policies and initiatives
Promote and encourage walking, bicycling and transit through state policies and programs
Ensure “Complete Streets”
design approach that provides
appropriate accommodation of pedestrians and bicycles in all transportation and development projects that use federal or state funds, or that require state permits
Use Health Impact Assessments as a tool to promote healthy transportation goals
Health Impact Assessment Project
Goal
Further develop the relationship between land-use, transportation and health outcomes at the local level using Mass in Motion
and the Massachusetts Healthy
Transportation Compact
as key foundations for the
initiative
CDC Heath Impact Assessment Grant (3 years) - $175,446
RWJ/Pew HIA pilot for Grounding McGrath
Key Partners
State Agencies
MassDOT
Energy and Environmental Affairs
Housing and Community Development
Elder Affairs
Trade Associations
Boards of Health
Health Officers
Municipal Officials
Planning Directors
Regional Planning Agencies
Communities
Mass in Motion
others
Health Impact Assessment Project
Selecting HIAs
Prioritize housing, transportation and/or land-use projects taking place in Mass in Motion communities
Opportunities to build health in all policies and projects
Work with partners
Trainings
Regionally based trainings
Partnership with Regional Planning Agencies and trade associations
Select project for focus of HIA and training
New Inter-Agency Partnerships
Commissioners of DPH, Department of Agriculture Resources and Department of Conservation & Recreation signed a resolution to develop a joint action plan to promote healthy living.
A working group of senior managers will be meeting later in January.
New Inter-Agency Partnerships
The DPH-DCR-DAR partnership will focus on building state and local partnerships to encourage use of state parks for activity and promote access to healthy Massachusetts grown food.
New Inter-Agency Partnerships
An example of this partnership is mapping existing Walking Clubs (people 50+) and locations of DCR parks.
Cross promotional activities can be planned to encourage more walking.
ChopChop
Massachusetts
Partnership with ChopChop, the Fun Family Cooking Magazine, to produce a monthly e-
newsletter.
Launched Dec 20th
at
event with Governor.
Available in English and Spanish.
ChopChop Massachusetts
Mass in Motion Municipal Wellness & Leadership Grants
A public-private partnership supporting cities and towns
Using CDC recommended evidenced based strategies for community change
Initiating or expanding policy, systems, and environmental change approaches to:
•
Promote availability of affordable healthy food
•
Support healthy food and beverage choices
•
Create safe communities that support physical activity
Funding Partners
Blue Cross/Blue Shield of Massachusetts
Blue Cross/Blue Shield of Massachusetts Foundation
The Boston Foundation
Harvard Pilgrim Health Care Foundation
MetroWest Health Foundation
Tufts Health Plan Foundation
0 10 20 30Miles
LegendMass In Motion Communities
SpringfieldTri-town(Lee, Lenox, Stockbridge)
Fitchburg
Worcester
Northborough Gloucester
RevereEverett
DorchesterWeymouth
Brockton
Fall River
New Bedford
Franklin
FundedCommunities
New funding that expands Mass in Motion
Community Transformation Grant ( 5 years) -
$1,574,982 (Middlesex)
8 new Mass in Motion programs and 1 current Mass in Motion program
Community Transformation Grant ( 5 years) -
$1,505,006 (8 county)
8 new Mass in Motion programs and 3 current Mass in Motion programs
CORD (4 years) -
$1,743,442 (New Bedford and Fitchburg)
With this expansion, we now have Mass in Motion initiatives in 53 municipalities and every county in the Commonwealth.
Community Transformation Grants
Local policy and environmental change:Tobacco-free living/smokefree
housing
Healthy Eating/Active Living
Clinical Interventions
Three long-term outcomesReduce death and disability due to tobacco use by 5% in the implementation area.
Reduce the rate of obesity through nutrition and physical activity interventions by 5% in the implementation area.
Reduce death and disability due to heart disease and stroke by 5% in the implementation area.
Mass in Motion Community Activities to Increase Healthy Eating
Support implementation of school nutrition regulations
Promote healthy dining in restaurants
Promote access to healthy food in retail stores
Implement EBT system and/or use of SNAP and WIC vouchers at farmers markets
Promote access to healthy food including farmers markets and increase access to farmers market via affordable transportation modes
Conduct community food assessment to determine food deserts; present data and recommendations to city officials
Review zoning/land use policies for usage of vacant
parcels of land as community
gardens
Mass in Motion Community Activities to Increase Active Living
Implement a safe routes to school initiative
Establish a “complete streets”
policy
Incorporate health outcomes into master plan
Pass policy to require all new development include sidewalks
Zoning ordinance that requires site plans for commercial/industrial buildings require bicycle racks
Conduct walkability assessment and sidewalk review
Citywide collaboration re: snow clearance
Mass in Motion: Get Fit Gloucester!
Stephen Winslow, Get Fit Gloucester!
MiM
Assessment Tool Helps Build Community Partnerships
Gloucester / MiMCDC CHANGE Tool
•
5 Sector Assessment–
At‐Large–
Schools–
Workplaces–
Organizations–
Health Sector•
Community Action Plan
Lesson Learned:
Assessment Helps
Build Partnership
MiM
Partnerships Promote Broader Change
Gloucester•
City–
Community Development &
Health Depts.
•
School Department•
Addison Gilbert Hospital•
Farmer’s Market•
Food Pantry•
Pathways Headstart•
Senior Center•
The Trustees of Reservations•
Chill Zone – Youth Group•
Gorton’s
New•
Gloucester Fishermen’s
Athletic Association
•
Open Space Committee•
The Food Project•
WalkBoston
Lesson Learned:
Partner Agendas
Becomes a key part
of the MiM Agenda (and vice versa)
MIM Driven Dialogue Draws Investment
•
Sidewalks:–
$150,000 directly invested–
Additional Improvements–
Safe Routes to School–
$ 4 million Streetscape Project
•
Bicycles–
Bicycle Racks–
Sharrows
Mayor Carolyn Kirk
MiMMiM Funding for Project Staff Funding for Project Staff Leverages ResourcesLeverages Resources
1st
Open Space Plan in 13 years: Leveraged $250,000 to Improve Trail Access
Restore Newell Athletic Stadium: $3.5 million project –
10x use of current field
$2.0 million private donations /grants, $1.5 million local bonds
Lesson Learned:
Small Amount of
Strategic Funding
Has Been Able to
Leverage Many
Resources
MiM
Helps Plant Seeds to Promote Positive Change and Accomplish other MA DPH Goals
•
Burnham’s Garden–
Increased Safety of
Downtown Park
–
Eliminated Drinking and
Drugging spot
–
Grant Application for
Additional Recreation and
Safety Improvements
–
Featured Weekly on Local
Blog (60,000 views/mo)
Thank you!
Stephen WinslowSr. Project ManagerCity of Gloucester978‐281‐9781swinslow@gloucester‐ma.gov
New Bedford Mass in Motion
Dr. Pauline C. Hamel, NB Mass in Motion and
GNB Health Equity Initiative
Project Coordinator
New Bedford is on the Move!
January 11, 2012
A Success Story CDC, Capacity Building, & Community Action Plans
•
Board of Health Resolution/ Master Plan 2020
•
Adoption of School Wellness Policies–
Physical Activity: Safe Routes to School;
Walking
–
Nutrition: School Lunches; After School Programs
•
Healthy Dining New Bedford (2011‐12)
•
South Coast Pathways–
New Bedford‐Fall River Bike Ride (11/2010)
–
South Coast Bike Summit (2/2011)
–
Regional & Local Bicycle Committees (ongoing)
•
Groundwork South Coast:
Letter of Intent/Application
A Success Story
•
Integration of Health Equity/Social Determinants of Health
into Mass in Motion initiatives–
Prevention for Health Caucus; Sen. Chandler, Rep. Lewis
–
SouthCoast Legislative Breakfasts: Mark Fenton
Southcoast by Design (10/10); Food for Thought (10/11)
•
Policy Link: Equity Summit 2011: Healthy Communities,
Strong Regions, A Prosperous America; Detroit, MI (11/2011)
•
American Public Health Assn Annual Conference presenter;
Healthy Communities promote Healthy Minds and Bodies:
“History, Public Health and Hip Hop: Moving Toward a
Healthier Community” in Washington, DC (11/2/2011)
•
Childhood Obesity Research Demonstration Project
(CORD): Launch with Dr. Lauren Smith, P.I. (11/21/11)
Communication, Policy, Systems, and Environmental Strategies in Action
•
SAFE ROUTES TO SCHOOL, Mass RIDES–
Fed, State & City officials, Mayor Lang, Schools, New Bedford Police, Health Dept., St. Luke’s, parents and children
–
International Walk to School Day–
SRTS Annual Forum, Newton, MA
30
HHS R.Adm
Michael Milner
at Roosevelt MS
Lincoln Elem School
Mayor Lang and School Committee members
Mass in Motion and Community Engagement
Healthy Dining New Bedford
New Bedford Mass in MotionMayor’s Office
New Bedford Health DepartmentNB Economic Development Council
Southcoast Health SystemLocal Restaurants
______
Promotional materials created incollaboration with
Boston University AdLab
Healthy Dining New Bedford
Good for you.
Good for New Bedford.
GNB Health Equity Initiative: Our Time is Now !
•Build capacity to increase cancer screenings/outreach•Promote health equity and eliminate health disparities•Enhance/strengthen the identity of Community Health Workers
10/5/11
Health Communication, Awareness and Promotion
Questions?
Dr. Pauline C. Hamel, Project CoordinatorNew Bedford Mass in Motion
&
GNB Health Equity Initiative
Adjunct Faculty, Boston University
508‐380‐7775 <[email protected]>
Thank You!
Mass in Motion
Community-Clinical Partnerships to Reduce Childhood Obesity
Dr. Lauren Smith
Medical Director, MDPH
A partnership between the City of New Bedford, the Massachusetts Department of Public Health, the
National Initiative for Children’s Health Care Quality, and Harvard University
Childhood Obesity Research Demonstration Project
$6,275,000 over 4 years
MA one of 3 sites selected by CDC
Only project lead by a state health department
Joint project with experienced partners
Harvard School of Public Health
Department of Population Medicine, Harvard Medical School
National Initiative for Children’s Healthcare Quality
Overall Approach
Build on successful Mass in Motion approach
Enhance connections between sectors
Maintain the focus on evidence-based strategies
Policies
Systems
Environmental changes
Aims of the Project
Decrease the number and percentage of children, aged 2-12 years who are obese or overweight, especially low income or minority children
Decrease the prevalence of chronic disease associated with unhealthy eating and lack of physical activity
Division of Nutrition, Physical Activity and Obesity
Obesity Prevention & Control Branch
Massachusetts San Diego Texas
Evaluation Center University of Houston
Fitchburg
New Bedford
CDC Funded Childhood Obesity Research Demonstration (CORD) Project
Changes we want to see: 5 Key Targets
1.
Decrease in childrens’
consumption of sugar- sweetened beverage
2.
Increase childrens’
moderate & vigorous physical activity
3.
Decrease in screen time & TV’s
in children’s bedrooms
4.
Increase childrens’
sleep duration & quality
5.
Replacement of calorically-dense or nutritionally poor foods with fruits and vegetables
Project Overview: 3 Levels of Intervention in 4 Domains
Individual/Family System CommunityHealth Care:Practice change initiative (High Five for Kids)
AssessmentCoachingCoordinated support
Obesity Learning Collaborative to improve quality of care
CHWs and physician champion link w/ local Mass in Motion initiative
Child Care: Nutritionist mentors support implementation of 2 linked interventions
I Am Moving, I Am Learning promotes daily physical activity and health food choices
NAP SACC supports policy, practice change in child care sites
Training of child care licensing staff to include elements in licensing visits
School: 3 evidenced based interventions
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
Community: Local Mass in Motion coalition initiatives
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
Programs Implementation
CHC InterventionOne large CHC per site reaching approx 20,000 patients/year34% of patients at 100% poverty
Childcare 6 childcare sites per community
School/after school
Minimum of 30 elementary/middle schools and afterschool programs Reach at least 12,000 students in grades K‐7
Community
18,000 children ages 2‐12 across communitiesAll elementary schools
Intervention communities:
Fitchburg
and New Bedford
Evaluation
CHC cohortIntervention sites only400 children per intervention CHC assessed at baseline, 1‐
and 2‐year follow‐up Measure 5 target behaviors, parent satisfaction with health care, utilization of servicesCHC surveillance
Intervention + control sitesExtract child BMI from EMR records at baseline, 1‐
and 2‐year follow‐up (N=8000)
Community
surveillance
Intervention + control sites baseline and 2‐yr follow‐upWIC: BMI records and 5 target behaviors (N=2300) Schools: BMI (gr. 1,4,7) and behaviors (gr. 4, 7) N=4050
Intervention communities:
Fitchburg
and New Bedford
Control community: ?
Outcomes
Main outcomesDecreases in BMI
5 key targets
Decrease in sugar
sweetened beverages
Decrease in screen time
Increase in physical
activity
Improvements in sleep
Replacement of empty
calories w/ fruits &
vegetables
Additional outcomesIncreased parent satisfaction with and utilization of health care services
Cost effectiveness of program
Community‐level policy change
CHC Intervention
Healthy weight clinicsEMR alerts RegistryClinician toolkits CHW inclusionClinic environmentLearning collaborativeAdvocacy training
Childcare I am moving/I am learning
NAP SACC assessment of environment and policy
School/after schoolPlanet HealthFood and FunEat well/Keep moving
CommunityLed by MiM coalitionsYouth driven social marketing campaignSafe Routes to School
Reducing Childhood Obesity In New Bedford
Community Health Centers: Primary Prevention
Goal: Prevention of child obesity
Activities
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
Community Health Centers: Secondary Prevention
Goal: Prevent disease progression and development of comorbidities
and complications
Activities
Efforts focus on overweight and 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 Afterschools
Goal: Prevention of child obesity
Target population ActivitiesElementary Schools Eat Well, Keep Moving
Curriculum and materials
Staff training
Middle School Planet HealthCurriculum, lesson plans, materials
Integrated in to core subjects
Staff training
Afterschool Food and FunCurriculum
Support for environment changes
Child Care and Early Education Goal: Prevention of child obesity
ActivitiesNAP 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
Community Interventions
Building on foundation of Mass in Motion
Evidenced-base strategies focused on policy, system and environment change
Creating environments to support healthy living
Media campaign
Youth empowerment approach
Developed in collaboration with schools to integrate school efforts into community approaches
Mass in Motion as Foundation
Enhance Community Action Plans to focus on evidence based strategies that have largest impact on the five obesity related behaviors
•IOM’s 2009 Local Government Actions to Prevent Childhood Obesity
Ensure coordination and integration of the multi-sectors at the local level
•Special role of the Community Health Workers
Engage champions from all sectors in community-wide efforts
Mass in Motion: Community Clinical
Partnerships to Reduce Childhood ObesitySteering
Committee
L. Smith, MDPHChair
Community Intervention
TeamL. Ojamaa,MDPH
Clinical Intervention
TeamE. Taveras, DPM
School and After School Intervention
TeamK. Davison, HSPH
Evaluation & DataAnalysis TeamK. Davison, HSPH
Communication Campaign Team
S. Moses, HSPH
MDPHHSPHDPM
NICHQ
Project Manager
J. Kwass, MDPH
Mass in Motion Coalition
CoordinatorsM. Giannetti, FitchburgP. Hamel, New Bedford
Mass in Motion Coalition Members
Questions?