1. Family Health Division – Health Promotion Division Orange County Health Care Agency / Public Health Services Overweight Children: The Role of CHDP Providers in Prevention & Treatment July 2008

2. 2 Thanks to Support from: Child Health & Disability Prevention (CHDP) Program California Endowment – Healthy Eating, Active Communities (HEAC) County of Orange Health Care Agency (Complements CalOptima Fitastic Provider Training & CMA Foundation Toolkit)

3. 3 By the end of this lecture participants will be able to… Diagnose overweight and obesity using BMI % for age. Identify the weight goals for overweight children. Explain the staged approach to obesity treatment. Give brief, focused advice & referrals. Describe ways to improve the office and advocate for change.

4. 4 What’s in Your Office? Do you share BMI info with your patients? Do you assess & counsel patients on their eating and activity habits? Do you display posters or offer handouts? Do you make referrals to community resources? Does your staff model healthy habits? Do you provide support for nearby schools and programs?

5. 5 Topics Overview of childhood obesity Step 1 – Obesity prevention-Well Care Visits Assessment & Treatment guidelines Healthy lifestyle advice and counseling Step 2 – Prevention Plus visits Step 3 – Going Beyond Your Practice Environmental change and advocacy

6. 6 Step 3: Going Beyond Your Practice (Community & Advocacy) Addressing Childhood Obesity at Many Levels Making it easier to eat healthy foods and be active in our communities. (See Step 3, page 4)

7. 7 Can patients follow your advice? Schools, fast food sites and parks - Main St. in Santa Ana 13 Fast Food sites within ½ mile of Spurgeon High – OCDE Access Flags = Schools Circles = Fast Food Sites Green Space = Parks

8. 8 Food Supply & PA Opportunities Urban Design & Transportation Systems Media Legislation & Policy Framework for Childhood Obesity Prevention Environmental Change Schools Community Healthcare System The Child Home & Family Individual Change: Knowledge, Skills, Motivation Gail Woodward-Lopez UC Berkeley Center for Wt & Health

9. 9 Unique role of physicians and other health care providers You are viewed as experts for all aspects of health - Use medical expertise and credibility to act as a leader/advocate. You can play a key role in encouraging environmental changes in schools, worksites and communities. For example, physician/healthcare testimonies at school boards, or government hearings can be very powerful at influencing public opinion and change.

10. 10 Obesity prevention in schools Schools can… Provide PE and recess. Promote walking and biking to school. Offer healthy foods in school meals, vending machines, and fundraising efforts. Teach health curricula on nutrition & physical activity. You can… Be a guest speaker on “Career Day” or in a health class. Provide quotes/ info for a school newsletter. Write letters of support for grants and projects. Provide testimony to School Board on health-related policy.

11. 11 Obesity prevention in communities Communities can… Make healthy foods available and affordable at local grocery stores, farmers markets, and community gardens. Improve safety of and access to parks and paths. Implement pedestrian and bicycle friendly zoning. You can… Ask corner stores & vendor trucks to stock healthy foods. Install bike racks outside your clinic. Promote/ support your local farmers market. Ask Public Works to repair broken sidewalks by your clinic.

12. 12 Obesity prevention in the healthcare system Healthcare systems can… Enact standards for medical office visits – BMI screening, counseling and referral. Implement policy and environmental changes at health care facilities that promote physical activity and healthy eating. You can… Refer clients to physical activity programs in the community. Hang displays/posters in waiting rooms. Make healthy foods and beverages available in your clinic. Promote wellness activities for staff. Advocate for improved coverage and funding for obesity treatment

13. 13 Additional environments for obesity prevention Food supply & physical activity opportunities You can: Advocate for more grocery stores in low-income neighborhoods. Support parks and Joint-Use Agreements. Urban design & transportation systems You can: Conduct a “walk audit” around your clinic & share results with City staff. Media You can: Contact local TV station or newspaper about junk food ads targeting children. Legislation & policy You can: Share opinion with elected officials about proposed legislation affecting obesity prevention.

14. 14 Santa Ana providers helped promote 2007 “Walk to School” Campaign Sent letters to local school principals encouraging participation. Encouraged patients to participate in their schools’ events. Walked with kids on event day. Example… Walk to School Day, happens every October. Adults & children walk together to promote safety, health, & physical activity.

15. 15 Santa Ana providers helped promote 2007 “Walk to School” Campaign Spoke to the media about the importance of walking & walkable neighborhoods. Posted pedestrian safety yard signs outside clinic. Advocated to City for improvements (street design, better sidewalks, landscape, safety) Example cont…

16. 16 Summary - By the end of this lecture you will be able to… Diagnose overweight and obesity using BMI % for age. Identify the weight goals for overweight children. Explain the staged approach to obesity treatment. Give brief, focused advice & referrals. Describe ways to improve the office and advocate for change.

17. 17 In closing.. Evaluation forms Continuing education certificates Additional information and materials Thank you!