Anthem Blue Cross and Blue Shield is the trade name RightCHOICE Managed Care, Inc' RIT, Healthy Alli

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Responding to Missouris Childhood Obesity
Epidemic
Sharon C. Hoffarth, MD, MPH, FACPM
Anthem Blue Cross and Blue Shield is the trade
name RightCHOICE Managed Care, Inc. (RIT) ,
Healthy Alliance Life Insurance Company (HALIC)
and HMO Missouri, Inc. use to do business in most
of Missouri. RIT and certain affiliates
administer non-HMO benefits underwritten by HALIC
and HMO benefits underwritten by HMO Missouri,
Inc. RIT and certain affiliates only provide
administrative services for self-funded plans and
do not underwrite benefits. RIT, HMO Missouri,
Inc. and HALIC are independent licensees of the
Blue Cross and Blue Shield Association.
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Children and Obesity National

• Childhood obesity is a national public health
  crisis.
• The number of overweight children has doubled in
  the last 2 decades.
• 2004 - 17.1 of all children in our nation were
  overweight vs. 13.9 in 2000.1
• 1. Ogden CL, Carroll MD, Curtin LR, et. al.
  Prevalence of Overweight
• and Obesity in the Unites States,
  1999-2004. JAMA. 20062951549-1555

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Children and Obesity Missouri

• 18.6 percent of Missouri adolescents are
  overweight. The national average is 14 percent.
• 39.4 percent of Missouri students in a
  nutritional screening are either at risk for
  overweight or actually overweight.2

2. MO Dept. of Health and Senior Services data
collection. Available online at
www.dhss.mo.gov/Obesity/Childhood.html
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Domino Effect

• An overweight adolescent has a 70 percent chance
  of becoming and remaining an overweight adult.3
• Overweight adults are at greater risk for
• Heart disease Asthma
• Diabetes Arthritis
• Hypertension Certain cancers
• Premature death
• 3. The Surgeon Generals Call to Action to
  Prevent and Decrease Overweight and
• Obesity 2001. Forward from the Surgeon General,
  U.S. Department of health and Human
• Services. Available online http//www.surgeongene
  ral.gov/topics/obesity

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Physicians Role

• The Institute of Medicine notes that physicians
  are vital in diagnosing and treating childhood
  obesity.
• But there are barriers...

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Communication Shortfall

• U.S. Maternal and Child Health Bureau Study
• communication shortfall between physicians and
  families create barriers to addressing childhood
  obesity.
• recommends use of practical office aids to talk
  with parents and patients

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Lack of Access to Information

• Most physicians and families do not have access
  to tools and guidelines for identifying children
  at risk or who are struggling with weight
  problems.

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Accessing Information

• We wanted to help.

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Unprecedented Collaboration

• Blue Cross Blue Shield of Missouri Foundation
• Missouri Department of Health and Senior Services
• Missouri State Medical Association
• Missouri Chapter of the American Academy of
  Pediatrics
• Missouri Academy of Family Physicians
• Missouri Association of Osteopathic Physicians
  and Surgeons
• Missouri Nurses Association
• Collaborated to offer...

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Healthy Habits for Healthy Kids
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Tools for the Physician

• Physicians Reference Tool

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Healthy Habits Tools

• Physicians Reference Tool offers information
  about
• Prevention strategies
• Counseling and motivating families to change
• Decision Trees/Weight Management Strategies
• Assessment guidelines and growth charts
• Resources
• and it fits in a lab coat pocket!

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Healthy Habits Tools

• Body Mass Index (BMI) Wheel
• Body mass index (BMI) is a measurement based on
  height and weight as it relates to body fat.

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Tools to Share with Parents

• Healthy Habits for Healthy Kids

In English...
Or Spanish...
And available online!
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Tools to Share with Parents
Healthy Habits for Healthy Kids

• Parents Learn
• Where to start with their family physician.
• How to help children set realistic goals.
• How to talk with their families about nutrition
  and the physical activity.

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Satisfaction Survey

• Survey Results
• 2.6 response rate (210 out of
• 7700 practitioners)
• 93 indicated they intend to use the materials
• Only 30.5 currently monitor BMIs however
• 95 thought the BMI wheel will make it easier to
  calculate
• BMIs and screen for obesity

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Expand the Initiative Reaching Kids at School

• Question How do we get the message directly to
  school-aged kids?
• Answer Involve/engage kids on a daily basis

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Pilot School Wellness Program

• House Bill 568 Protection of Children
• Mandates selected school districts to establish a
  Model School Wellness Program
• Encourages healthy lifestyles including
  nutrition, physical activity and tobacco
  prevention
• Requires hands-on professional development and
  performance evaluation

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Pilot School Wellness Program

• Institute for Americas Health (IAH) received
  funding from Blue Cross Blue Shield of Missouri
  Foundation to implement Model Wellness Programs
• IAH I is a 501c3 organization
• Mission to enhance health of Americas youth
  through research and education
• Multidisciplinary, multi-media, interesting,
  intelligent and FUN

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Pilot School Wellness Program

• Funding is being used to
• implement wellness programs across Missouri
• 550,000 over a three year period
• distribute Healthy Habits for Health Kids guides
  (6,000 copies, to date)
• Saint Louis University Center for Outcomes
  Research will evaluate the program

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Pilot School Wellness Program

• IAHs Healthy School Solutions Model Wellness
  program
• Pilot program consistent with the Governors goal
  of public-private partnerships to address
  childhood obesity
• Standardsbased interventions
• Wellness, Academics and You (WAY)
• Grades K-5
• Science, Tobacco and You (STY)
• Grades 4-5

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Pilot School Wellness Program

• School district collaboration
• Affton
• Columbia
• Jefferson City
• Perryville
• Springfield
• All materials and on-site training included
• Program assessment

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Pilot School Wellness Program
Program Components
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Pilot School Wellness Program
Students enjoy creating their own WAY journals
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Pilot School Wellness Program

• Initial feed-back from teachers and students
  has been positive

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Missouri Council for Activity and Nutrition

• Missouri Council for Activity and Nutrition
  (MoCAN)
• Objective develop comprehensive plan to address
  overweight and obesity in Missouri through
  broad-based public/private partners
• Mission document economic impact and health
  implications, provide evidence-based
  recommendations for use by employers, schools,
  insurers, families, etc.

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Missouri Council for Activity and Nutrition

• Strategy
• Enhance prevention, treatment, management of
  weight through improved knowledge, skills and
  resources
• Task
• Create practical, easy to use resource health
  care professionals will embrace and use

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MoCAN Toolkit for Healthcare Professionals

• Result Healthcare Toolkit
• Encourage health care professionals to obtain
  and use BMI calculations
• Summarize and provide best practice
  recommendations related to obesity
• Screening/Assessment
• Treatment
• Additional resources
• Separate kits target child/adolescent obesity and
  adult obesity

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Together

• It is the responsibility of all of us to make
  a difference in the health and well-being of
  Missouris children.