Tennessee Creating Holistic Approaches for Diabetes Programs and Policies: A Public Health Approach

Transcription

1 Tennessee Creating Holistic Approaches for Diabetes Programs and Policies: A Public Health Approach Susan R. Cooper MSN, RN Commissioner Tennessee Department of Health Women in Government March 4, 2011

2 Adult Diabetes Source: Behavioral Risk Factor Surveillance System Survey

3 Children Born in the Year in 3 will develop Type 2 Diabetes That number is 1 in 2 if you are African American or Hispanic It is a preventable disease Our Vision: By 2018, Tennessee will be the first state in the nation where all children will graduate at a HEALTHY WEIGHT

4 Determinants of Health Access to Care (10%) Social/Environment (20%) Genetic (30%) Behavior (40%) McGinnis JM et al. Health Affairs 2002;21(2):78-93

5 Prevention Model Policies and Systems National, State, Local laws and policies Community Physical, social and cultural environment Organizations Schools, Worksites, faith based Relationships Family, peers, social networks Individuals Knowledge, beliefs, attitudes

6 Fundamentals of Initiatives Policies: Putting health in all policies. Programs: Putting policies into action by utilizing and building the evidence base. Partnerships: Building and succeeding together.

7 Health Diabetes Prevention and Health Improvement Act of 2006 Tennessee Physical Activity and Nutrition Plan: Eat Well, Move More Cover Tennessee Products: Risk assigned based on Age, Weight, and Tobacco Use TennCare: Policies support Weight Watchers and other Healthy Weight Programs for children and their parents Disease management contractuallyrequired Child and teen newsletters include information on healthy food choices and exercise

8 Education Coordinated School Health: Mandated for all school systems, Fully Funded (1 st State in nation to fully fund) Tennessee is one of 19 states with nutritional standards for school meals and snacks that are more strict than federal requirements. Tennessee is one of 27 states with nutritional requirements for foods sold in school vending machines or in school bake sales. Physical Education Requirements=90 minutes per week BMI or health information collected Health Education requirements

9 Transportation, Agriculture, Economic Development Safe Routes to Schools Under ARRA, building sidewalks with roads Farm to School Programs Three Star Communities

10 Project Diabetes Fundamental Goals Decrease the prevalence of overweight/obesity across the State to prevent or delay the onset of Type 2 diabetes and/or its consequences Educate the public about current and emerging health issues linked to diabetes Promote community, public-private partnerships to identify and solve regional health problems related to obesity and diabetes Advise and recommend policies and programs that support individual and community health improvement efforts Evaluate the effectiveness of improvement efforts/programs that address overweight, obesity, pre-diabetes and diabetes Disseminate best practices for diabetes prevention and health improvement

11 Journey to Better Health

12 Intervention Programs Cherokee Health Systems Change for Life Program October 2008 March 2009 Target = children at risk for diabetes Goal = prevention of diabetes among underserved children via an integrated primary care approach 2,885 well child checks 234 at risk children referred 106 children enrolled in program 40 enrollees rechecked at 3 months 45% decreased their BMI 33% ate more fruits; 23% ate more vegetables 35% increased their physical activity 38% decreased time spent watching TV

13 Intervention Programs St. Thomas Family Health Centers Healthy Lifestyles Program October 2008 June 2009 Target = adult diabetes patients Goal = reduce the severity of and complications due to diabetes through education, healthy lifestyle changes and regular exercise 238 diabetic patients enrolled 66% achieved an hemoglobin A1C less than % decreased their BMI by 5% 96% reported physical activity twice per week

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15 GoTryBeTN

16 gotrybetn.com

17 Step U.P. to Health Center for Diabetes Prevention & Health Promotion Board Cordell Hull Building, Tennessee Room Tuesday, May 28 th, 2008, 9am Collaborative Partners

18 Step U.P. to Health Where did stepping originate? West African Gumboot Dance Tribal dance of celebration Form of story telling Modern Use of Step 1940 s by H.B.G.L.O., aka Divine Nine Intricate Words and Movements Unity through competition Use within program Aerobic Physical Activity Team concept, discipline

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20 Step U.P. to Health Pilot Program, 2006 in East Nashville Built on N.S.S.A. step team foundation Reach 300 at risk youth, Increase s Physical Activity Execution of Strategic Health Curriculum Addresses Self Efficacy & Self Esteem Issues Support for Academic Excellence Teams in 15 community centers

21 GetFitTN.com GetFitTN is a statewide awareness program developed to address the rising epidemic of Type 2 diabetes and risk factors that lead to diabetes. Focused on educating both adults and children that Type 2 diabetes can be delayed or even prevented with modest lifestyle changes like increasing physical activity and a healthier diet. Fun, interactive health and fitness tools. Kids and Teachers Center Get Fit cookbook March to the Moon State employees walked approximately 155,000 miles in at 31 day period

22 GetFitTN.com

23 GetFitTN.com

24 GetFitTN.com

25 GetFitTN.com

26 Golden Sneaker Program Focus of Initiative Target population: 0-5 years of age, as there seems to be less emphasis on encouraging healthy behaviors in this group Goal: to enhance policy related to physical activity and nutrition within Tennessee s licensed child care facilities and target development of healthy living skills Encourages licensed child care facilities to voluntarily adopt policies relative to physical activity, media viewing, and ensuring appropriate feeding patterns for infants and children including breastfeeding, adequate portion sizes, adequate meal times and reward systems associated with food and activity Partnership between Department of Health, Department of Human Services, and Child Care Resource and Referral Centers

27 Golden Sneaker Initiative $100,000 grant received from National Governor s Association Goal: to enhance policy related to physical activity and nutrition within Tennessee s licensed child care facilities and target development of healthy living skills Encourages licensed child care facilities to voluntarily adopt policies relative to physical activity, media viewing, and ensuring appropriate feeding patterns for infants and children including breastfeeding, adequate portion sizes, adequate meal times and reward systems associated with food and activity Partnership between Department of Health, Department of Human Services, and Child Care Resource and Referral Centers

28 Diabetes Funding Funding Activities as of June 2009 Target Population Number of Grants Funding Level High Risk for Diabetes 10 $2 million Diabetes Management 15 $2.6 million Children or School Setting 20 $2.7 million

29 Outcomes 2009 data show, adult diabetes rate in Tennessee has fallen from 11.9 percent to 10% In 2008, 71.3% of diabetic adults in Tennessee reported checking their blood sugar daily, exceeding the Healthy People 2010 objective of 60% (#1 nationally) In 2008, 83.2% of diabetic adults in Tennessee reported having an annual hemoglobin A1C check, exceeding the Healthy People 2010 objective of 65% The percentage of adult Tennesseans who reported no physical activity during the past month decreased between 2005 and % to 28.9%

30 Modeling Behaviors Participated in hundreds of community events ranging in size from participants Partnerships with schools, business community, community and faith based organizations, county/city governments, other state agencies Every moment is a teachable, get fit moment Message is consistent: Start where you are everyone can do something Fitness can be fun Learnings: Most people want to do the right thing they just don t know how to get started Most people do not know the data must make it personal your child, grandchild, or student

31 The Future Lots of progress made, but we have a long way to go to better health Continue to focus on translating research into practice clinical and community preventive health recommendations Community based participatory research Communicate, coordinate, collaborate Develop a working strategic plan to address overweight and obesity Innovate, innovate, innovate!!!

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