Maternal and Child Health Public Health Across the Lifespan October, 2005

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Maternal and Child HealthPublic Health
Acrossthe Lifespan October, 2005

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• Health Resources And Services Administration
• Maternal And Child Health Bureau
• Peter C. Van Dyck, MD, MPH

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MCH BUREAU
TVIS AND OTHER DATA
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TVIS Keyword Search Obesity
State Priority Needs 15 States with 17 Priority
Needs Identified (FY 2003 Annual Reports/FY 2005
Applications) 34 States with 41 Priority Needs
Identified (FY 2004 Annual Reports/FY 2006
Applications Preliminary Data) State
Performance Measures 21 States with 25
Performance Measures (FY 2003 Annual Reports/FY
2005 Applications FY 2004 Annual Reports/FY
2006 Applications Preliminary Data)
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The 9 Health Systems Capacity Indicators

• 09C) The ability of States to monitor overweight
  or obesity among children and youth (as reported
  in the 2003 Annual Block Grant Report)

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The 9 Health Systems Capacity Indicators

• YRBS
• 47 of 59 States participate
• 35 (60) sample size is large enough for
  statewide estimates
• 12 (20) sample size too small
• 12 (20) do not participate

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The 9 Health Systems Capacity Indicators

• Pediatric Nutrition Surveillance System
• 40 of 59 States participate
• 36 (61) sample size is large enough for
  statewide estimates
• 4 (7) sample size too small
• 19 (32) do not participate

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The 9 Health Systems Capacity Indicators

• WIC Nutrition Survey
• 53 of 59 States participate
• 48 (81) sample size is large enough for
  statewide estimates
• 5 (9) sample size too small
• 6 (10) do not participate

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MCH BUREAU
MCHB ACTIVITIES
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MCHB Cross-Division Nutrition Committee

• MCHB nutrition strategic plan focuses on four
  major areas
• Breastfeeding promotion and support
• Overweight/obesity prevention and healthy
  lifestyle promotion
• Public health nutrition leadership and training
• Coordination and collaboration with federal,
  state and local partners

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Breastfeeding Support

• Systems support
• Liaison to the U.S. Breastfeeding committee
• Strategic plan for breastfeeding in the U.S.
• National breastfeeding coalition workshop (2006)
• Expert work group meetings (MCHB and CDC)
• Oral health and breastfeeding
• Safe and appropriate use of human milk
  substitutes for the breastfed infant in the U.S

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Breastfeeding Support

• Hospital Support
• Baby Friendly Hospital Project
• Identification of barriers to implementing the
  TEN Steps to Successful Breastfeeding.
• Work site support
• Development of a Best Start Social Marketing
  program to provide breastfeeding support to
  employers and women returning to work/school.

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Breastfeeding Support

• Provider Support
• Academy of Breastfeeding Medicine
• Development of protocols and support for annual
  meeting.
• AAP Breastfeeding Promotion in Physicians Office
  Practices (BPPOP Phase III)
• 3-year program to initiate and sustain
  system-wide changes in breastfeeding management
  at the national, state and community levels.
• Builds on 1997-2000 and 2001-2004 programs.

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Breastfeeding Support BPPOP III

• Focuses on educating and supporting future and
  practicing physicians and health care
  professionals in culturally effective
  breastfeeding promotion and support directed at
  achievement of Healthy People 2010 goals.
• Developing breastfeeding curriculum for medical
  residency training programs.
• http//www.aap.org/advocacy/bf/bppopIII.htm

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Overweight and Obesity

• Proposed in the MCHB Nutrition Strategic Plan is
  the funding of interdisciplinary training for
  health providers working as a team to 1) treat
  pediatric overweight/obesity and 2) develop
  prevention programs.
• Maternal obesity is also an area of interest.
  Task order was awarded in September to the
  National Academy of Sciences to support a
  Workshop on the Impact of Pregnancy Weight on
  Child and Maternal Health.

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Impact of Pregnancy Weight on Child and Maternal
Health Workshop

• Purpose Convene a two-day workshop to describe
  what is known about recent trends in maternal
  weight prior to, during, and after pregnancy, and
  the impact of maternal weight on the health of
  mothers and their children (up to 12 months of
  age.)
• Project Period 12 months (Summary Report that
  analyzes and synthesizes the workshop
  deliberations will be submitted at the completion
  of the project.)

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Impact of Pregnancy Weight on Child and Maternal
Health Workshop

• Research Questions
• What research and databases describe the
  distribution of maternal weight (prior to,
  during, and after pregnancy) among different
  populations of women in the U.S.?
• What research and databases inform our
  understanding of the effects of different weight
  patterns (including underweight and overweight)
  during pregnancy on maternal and child health
  outcomes (up to 12 months)?

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Impact of Pregnancy Weight on Child and Maternal
Health Workshop

• Research Questions (continued)
• What research has been conducted to describe the
  individual, community, and health care system
  factors that impede or foster compliance with
  recommended gestational weight guidelines (prior
  to, during, and after pregnancy.)
• What opportunities exist for Title V MCH Programs
  to build on this knowledge to help childbearing
  women achieve and maintain recommended weight
  (prior to, during, and after pregnancy.)

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Impact of Pregnancy Weight on Child and Maternal
Health Workshop

• Research Questions (continued)
• What future research and data collection efforts
  could improve the efforts of Title V programs to
  support women from different racial and ethnic
  backgrounds in their efforts to comply with
  recommended weight gain guidelines and to improve
  their maternal health.
• The review conducted for this project will help
  lay the foundation for a potential future study
  to reexamine the pregnancy weight gain guidelines
  for different groups of women.

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Child And Adolescent Overweight And Obesity

• Needs assessment conducted to determine current
  practices of pediatricians, nurses and dietitians
  in the assessment and treatment of childhood
  overweight and obesity (MCHB, CDC, NCEMCH, and
  ILSI)
• - Findings published as a Supplement to the
  Journal Pediatrics (July 2002)

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Child And Adolescent Overweight And Obesity

• Expert Panel Convened in February 2005 to Develop
  Recommendations for the Assessment, Prevention
  and Treatment of Child and Adolescent
  Overweight/Obesity (MCHB, CDC and AMA). Several
  key professional organizations serve as the
  Executive Committee for this effort.
• Four Papers to be Published
• 1. Prevention 3. Treatment
• 2. Assessment 4. Overall Summary

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National Business Group on Health

• MCHB nutrition staff serve on the Obesity
  Institute, an initiative that encourages members
  to
• Network with other corporate leaders to raise
  awareness about the health and cost consequences
  of obesity.
• Identify and test solutions to obesity that have
  a positive return on investment.
• Advance health plans and vendors efforts to
  implement solutions.

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National Business Group on Health

• With MCHB support, developed An Employer Toolkit
  for Addressing Overweight Among Employees and
  Their Children.
• Toolkit includes
• Issue Brief
• PowerPoint Presentation
• Family Fact Sheets
• Tip Sheets

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Innovative Approaches To Promoting a Healthy
Weight in Women

• Purpose
• to develop creative, innovative approaches that
  are effective in reducing the prevalence of
  overweight/obesity in women
• Efforts must target women in communities with
  limited access to preventive health services,
  particularly women of color, who are
  disproportionately affected by this risk factor

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Innovative Approaches to Promoting a Healthy
Weight in Women

• Approaches must be substantive in nature and
  incorporate nutrition, physical activity and
  health/wellness components
• Must also link women, when appropriate, with
  Title V/other relevant services to provide
  comprehensive care

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Innovative Approaches Promoting a Healthy Weight
in Women

• 7 Grantees approximately 150,000/yr. for 3
  yrs., funding began September 2004 and May 2005
• Texas State University, San Marcos, TX
• NorthEast Ohio Neighborhood Health Services,
  Cleveland, OH
• Holyoke Health Center, Holyoke, MA

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Innovative Approaches Promoting a Healthy Weight
in Women

• Funded May 2005
• Mariposa Community Health Center, Nogales, AZ
• Orange County Health Department, Orlando, FL
• Bad River Band of Lake Superior Chippewa Indians,
  Odanah, WI
• Christiana Care Health Services, Inc.,
  Wilmington, DE

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Innovative Approaches to Promoting a Healthy
Weight in Women

• New Competition for FY 2006
• Number of awards three (3)
• Total Amt. of Funding 450,000 per award
  maximum per year is 150,000
• Duration three (3) years
• Contact Lisa.king_at_hrsa.hhs.gov
• https//apply.grants.gov/forms_apps_idx.html

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MCH Nutrition Leadership

• Development of a National Nutrition Blueprint for
  Action (MCHB, NIH, CDC, ASTPHND)
• Blueprint for Action. Nutrition and Physical
  Activity Cornerstones of a Healthy Lifestyle
• Stakeholder consensus document that brings focus
  and urgency to critical goals and strategies that
  will frame nutrition and physical activity for
  the future.

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Blueprint for Action Nutrition and Physical
Activity Cornerstones of a Healthy Lifestyle

• Umbrella document that can be adapted to
  reflect local and state needs
• Document to use at all levels to educate decision
  makers on priority actions.
• Document that fosters joint efforts for greater
  impact with well-utilized resources.

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Blueprint for Action Nutrition and Physical
Activity Cornerstones of a Healthy Lifestyle

• Initial Meeting (April 2004)
• Participants included nutrition and physical
  activity experts representing public and
  non-profit organizations.
• Second Meeting (April 2005)
• Document expected to be released in 2006

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The Maternal and Child Health Training Program

• Supports Nutrition Discipline Training in
• Public Health
• Pediatrics
• FY 2005 Profile
• Fund 7 MCH Centers of Excellence in Nutrition
• Grant Awards Range from 120,000 to 210,000 Per
  Year
• Collaborative Project of all 7 grantees will
  focus on developing a website, which will make
  obesity-related materials, such as prepared
  PowerPoint presentations, available to the Title
  V programs.

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Coordination and Collaboration

• Commitment for coordination with all other major
  childrens programs-- WIC, Medicaid, SCHIP, Head
  Start, early intervention programs

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Contact
Peter C. van Dyck, M.D., M.P.H. HRSA/MCHB http/
/mchb.hrsa.gov/