Creating Equal Opportunities for a Healthy Weight Workshop Summary (2013) / Chapter Skim
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5 Pathways to Obesity Prevention for Ethnic Minority and Low-Income Children and Adults in Primary Care
5 Pathways to Obesity Prevention for Ethnic Minority and Low-Income Children and Adults in Primary Care
Pages 49-60
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From page 49... ...
Accelerating Progress in Obesity Prevention calls for health care professionals to make obesity prevention part of routine preventive care and for insurers to cover obesity prevention, screening, diagnosis, and treatment. However, many barriers exist to achieving these objectives, and disadvantaged populations have difficulty accessing health care in general, much less health care emphasizing obesity prevention.
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From page 50... ...
STRATEGIES FOR HEALTH CARE PROVIDERS AND INSURERS IN OBESITY PREVENTION Summary of Remarks by William Dietz Relatively little is known about optimal approaches to preventing and treating obesity in primary care, Dietz stated. In the context of the health care system, obese individuals are an underserved group (Puhl and Brownell, 2003)
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From page 51... ...
. Treatment of extreme adult obesity in primary care practices using behavioral counseling, structured diets, and medications produced substantially greater weight loss than occurred in a control group (Ryan et al., 2010)
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From page 52... ...
Another promising model program Dietz noted was developed by ChildObesity180,1 which serves children in outof-school programs and emphasizes drinking water instead of sugarsweetened drinks, snacking on fruits and vegetables, and engaging in physical activity. A major challenge is to disseminate successful approaches, said Dietz, which requires the involvement of health care professionals.
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From page 53... ...
Training in behavior change, an understanding of how to work in teams, and the ability to link public health and clinical systems are the kinds of skills all health care providers are going to need to address not just obesity but other chronic conditions as well. "If we start early educating [medical]
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From page 54... ...
The program used the lay health leader model in which the leaders were the after-school teachers, who were trained by a behavioral psychologist and research staff and received continued support throughout the program. Burnet described how data were collected on site, including height, weight, BMI, and blood pressure for both the children and parents, along with self-reported measures of dietary intake and physical activity and knowledge, beliefs, and attitudes regarding nutrition and physical activity.
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From page 55... ...
When the Chicago White Sox baseball team and the University of Chicago formed a partnership to work on social marketing around childhood obesity, they used Power-Up as a cornerstone of the endeavor.3 At White Sox home games on Sundays, Power-Up All Stars booths at the park offer healthy nutrition and exercise activities, and children can go online to participate in related activities and earn prizes. Burnet provided several lessons drawn from her experience with Power-Up: The time and effort invested in building relationships pay off in engagement and sustainability.
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From page 56... ...
Burnet stated that the political environment in Chicago also has helped, in that the leadership of the city and of the Chicago Department of Public Health are keenly interested in obesity prevention. Burnet particularly emphasized the need to help organizations and surrounding communities find the resources to make such programs sustainable.
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From page 57... ...
A problem such as obesity, which has multifactorial origins, requires a multifactorial intervention, even in the primary care setting, said Buchholz. At the Upper Cardozo Health Center, such an intervention was created in 2008 by three physician assistants who adapted the Ways to Enhance Children's Activity and Nutrition (We Can!
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From page 58... ...
A new initiative to rank parks in Washington, DC, in terms of cleanliness, accessibility, exercise level, safety, and other measures, known as the DC Park Prescription program, enables providers to inform patients about opportunities for physical activity, Buchholz explained. Buchholz added that federally qualified health centers are an excellent platform for such programs, and the Affordable Care Act is about to greatly expand their role in the health care system.
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From page 59... ...
Unity Health Care sets aside a small budget for the program, and the DC Medicaid managed care organizations have been supportive. But the health care system will continue to evolve, driven partly by patient needs and partly by policy initiatives such as the Affordable Care Act, Buchholz noted, which will have implications for such programs.
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