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Improving Outcomes in Child [& Adult] Obesity Management W E CAN I MPACT THIS G LOBAL H EALTH P ROBLEM  Maggie Argentine, PhD, RN Professionally Certified.

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Presentation on theme: "Improving Outcomes in Child [& Adult] Obesity Management W E CAN I MPACT THIS G LOBAL H EALTH P ROBLEM  Maggie Argentine, PhD, RN Professionally Certified."— Presentation transcript:

1 Improving Outcomes in Child [& Adult] Obesity Management W E CAN I MPACT THIS G LOBAL H EALTH P ROBLEM  Maggie Argentine, PhD, RN Professionally Certified in Obesity Management, Prevention & Education ~ Helping Adults, Teens & Seniors achieve Optimal Health & Longevity Argentine Health PartnersSyracuse, NY June 5, 2015

2 Objectives 1.Relate current economic and best practice clinical evidence for obesity management and risk reduction in children & adolescents to each encounter with patients, families & communities of care. 2.Examine results of a provider-referred, multidisciplinary interventional pilot program for overweight/obese adolescents with co-morbidities to avoid pitfalls in management. 3.Identify 3 strategies in obesity management I can implement immediately, inclusive of tracking outcomes. Argentine Health PartnersSyracuse, NY June 5, 2015

3 Current Evidence GLOBAL MACRO LEVEL GLOBAL ECONOMIC LEVEL CLINICAL BEST PRACTICE Argentine Health PartnersSyracuse, NY June 5, 2015

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5 Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2011 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK PR GUAM NH MA RI CT NJ DE MD DC

6 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2012 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK NH MA RI CT NJ DE MD DC PR GUAM

7 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK NH MA RI CT NJ DE MD DC PR GUAM

8 Global Macro Evidenc e Argentine Health PartnersSyracuse, NY June 5, 2015

9 Economics Macro Level Evidence McKinsey Global Institute November 2014  Obesity global economic burden $ 2.0 trillion Argentine Health PartnersSyracuse, NY June 5, 2015

10 Economi c Macro Level Evidenc e McKinsey Global Institute, November 2014

11 Economic – Macro Level Evidence, McKinsey Global Institute, November 2014 Weight Management Programs Surgery Pharmaceuticals Sufficient Evidence Weight Change Workplace Wellness Parental Education Limited Evidence Weight Change Portion Control Sufficient Evidence Behavior Change

12 Interventional Pilot Program Results FIT KIDS OF MADISON COUNTY OVERVIEW & BACKGROUND PILOT STRUCTURE & PROCESS PILOT OUTCOMES PITFALLS & LESSONS LEARNED FKMC OHC & MADISON COUNTY FUTURES Argentine Health PartnersSyracuse, NY June 5, 2015

13 FKMC Overview Argentine Health PartnersSyracuse, NY June 5, 2015

14  community based, medically referred, interventional pilot program for overweight and/or obese children, ages 11-14 in Madison County, New York.  initially conceived: 6 week program evolved: two 12-week programs with same children & families  FKMC places the individual and family at the center of healthy initiatives, encircled by a supportive community of neighbors and professionals, mindful of what is needed to “help individuals and families thrive.”  Fit Kids of Arizona template, FKMC is unique to Madison County for 4 components: nutrition; fitness; counseling, habits & behavior; and social support FKMC Pilot Program – 2012-2014 Background

15 FKMC Pilot Program – Structure & Process Referral & Intake Medical Nutrition Fitness Counseling, Habits & Behavior Social Support Two 12 Week Programs Per Week: * 4 > 3 Fitness * 1 Nutrition * 1 Counseling, Habits & Behavior * End of Program Healthy Shared Dish Dinner & Awards Evaluation * Satisfaction * Attendance * Fitness Change * Medical Labs Improvement * Behavior

16 FKMC Pilot Program – Medical Intake

17 FKMC Pilot Program – Nutrition Intake

18 FKMC Pilot Program – Fitness Intake

19 FKMC Pilot Program – Counseling, H&B Intake

20 FKMC Pilot – Medical Outcomes

21 FKMC Pilot – Conclusions & Lessons Learned Scheduling Orientation Referrals Mixed ages of Kids System & Structure Communication Meetings Updates & Handoffs Timely completion Team Effectiveness Evidence-based Tools that capture all needed variables Simplicity Sharing Documentation Agency External – insurance Foundations Partners – in Kind Funding

22 FKMC OHC & Madison County Futures County-Wide Organizations Primary Support Entities Fit Kid Expert Team Fit Kid & Family County- Wide * OHC – Northern County - maintaining * ??? Southern County * Rural Health Council & Mad. Cty DOH * Colgate Upstate Institute  Referring Providers  Oneida Healthcare  Community Memorial Hospital Expert, Kid-Friendly, Evidence-Based:  Registered Dietician  Youth Credentialed Fitness Trainer  Counselor, Social-Worker  Program Coordinator  Researcher, Data Analyzer

23 Obesity Management STRATEGIES & TRACKING Argentine Health PartnersSyracuse, NY June 5, 2015

24 NIH Publication No. 12-7486A, October 2012 Recommendations based on Evidence Review Directed towards all primary pediatric care providers (pediatricians, family practitioners, nurses & NP, PA, and registered dieticians)

25 more than 1,000 citations from the published literature and is available at: http://www.nhlbi.nih.gov/health- pro/guidelines/current/cardiovascular-health-pediatric-guidelines/index.htmhttp://www.nhlbi.nih.gov/health- pro/guidelines/current/cardiovascular-health-pediatric-guidelines/index.htm

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27 Continued to next slide: Strength of Recommendations

28 Continued from previous slide: Strength of Recommendations

29 State of the Science & Strategies, Oct 2012 Risk Factor Development Family Hx Early Athersosclerotic CV Disease Nutrition & DietPhysical ActivityTobacco State of the Science & Strategies, Oct 2012 High Blood Pressure Lipids & Lipoproteins Overweight & Obesity Diabetes Mellitus & Other Predisposing Risk Factor Clustering & Metabolic Syndrome https://www.nhlbi.nih.gov/files/docs/peds_guidelines_sum.pdf https://www.nhlbi.nih.gov/files/docs/peds_guidelines_sum.pdf Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Summary Report, October 2012. NIH Publication No. 12-7486A, October 2012

30 Discussion & Conclusions AUDIENCE EXAMPLES WHERE TO GO FROM HERE MY OBESITY MANAGEMENT STRATEGIES Argentine Health PartnersSyracuse, NY June 5, 2015

31 StrategyTacticsOutcomes Tracking Resources Needed 1. 2. 3.


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