A simple basic program thatpromotes healthy food choices,behavior change, and lots of funand inexpensive activities.* What are healthy foods ?*Where, what, when to & not to eat* What are the risks of being overweight ?*What can I do everyday at home to have fun?
History• Launched in 2004 at GR Pediatrics• Focused on overweight asthmatics• Children 6 – 18 years of age * Only criteria- ready to make changes.• Twelve Week Program• Charged for book and program
Today’s ProgramCriteria > 85 % of BMI 8 – 16 years of age Committed Support Partner 7 weeks to dedicate to their child & the program Ready to make changes in their current lifestyle. Free / $10 Registration Fee
Goals Spread the Program by taking referrals or training Spread the same consistent evidenced based messages Reach as many children as possible with a BMI of > 85% Form a united front with sister community health centers in the fight against childhood obesity. Encourage “STEAM” program buy-in from community health centers Obtain health plan reimbursements for STEAM program attendees Plan to continue to make the program stronger in quality and outcomes with CHC collaboration.
Contributors/Community Support• Cherry St Health Services• Americorp• Holt Graphic Design• Health Plan of MI• Care Source Foundation• Spectrum Health Practices• U of M Research• John Ruedisuelli, Attorney• Dick’s Sporting Goods• Erin Dressander PT, MSPT• S.T.R.O.N.G.
What makes a child overweight? Genes contribute to weight problems, but family environment has the greatest impact on a child’s weight gain. On the other hand, the family environment also has the greatest impact on the child’s ability to lose weight, keep it off, and build a lifetime of healthy
Motivators Adults are motivated by challenges, titles, competition, prestige and $$$$. Kids are motivated by fun and competition.
– Prevention Plus Family visits with PCP Frequency individualized to family needs and risk factors - Monthly recommended Tailored Plan BMI Monitoring Use MI and cultural competency Focused messagingNo improvement in 3-6 months – Stage 2
- Structured Weight Management Family visits with PCP or health professional with training in weight management Visits can be individual or group. Include visits with dietician, exercise specialist, counselor. Include self monitoring, goal setting, rewards Frequency: monthly or individualized to family needs and risk factors.No improvement in 3-6 months – Stage 3
– Comprehensive, MultidisciplinaryMultidisciplinary team with experience in childhood obesity Behavior Change Goal Setting Self Monitoring Systematic measuring - Anthropometrics - Dietary logs - Fitness testing Frequency - often weekly group sessions for 12-24 weeks with follow up ( longer = better outcomes Monthly visit with PCPSeverely obese, multiple co-morbidities, adolescence – Stage 4
- Tertiary Care Intervention( For select children only when provided by experienced programs with established clinical or research protocols) Medications – sibutramine, orlistat Very-low-calorie diets Weight control surgery- gastric bypass or banding( not FDA approved for children but in clinical trials.
STEAM Program Structure Referrals from medical providers in the community Referrals promoted by brochures, fliers, presentations, web site, and collaboration efforts Meet for 2 hours, one day a week x 7 weeks Weekly weigh-in for child and support partner HW-making child accountable for goal setting, healthy food food choices, and exercise achievements Planned topics for presentations related to Behavior Modification ( Pediatrician/MSW), Nutrition (Registered Dietician), and exercise specialist ( CPT or higher level) Guest Presenters Graduation Prizes/Bikes Follow up at 1 month, 6 months, and one year New ideas from spread programs Uniqueness of STEAM - team will train and assist in spreading to other organizations the STEAM message of evidence based proven strategies.
Getting Started Thinking about starting a Childhood Obesity Program ? Started a Childhood Obesity Program, but would like to collaborate with your sister Community Health Centers to make your program better.Why start from scratch when STEAM is seasoned, structured, outcome focused, and experienced in successfully training new start up sites.
Who will you need?Your STEAM TEAM … Director/Coordinator Medical Provider / Mid Level / MSW Registered Dietician Exercise Specialist Technical Support ( Americorp ) Volunteers Guests
What will you need? Location Promotional Material / Plan List of Potential Participants Committed Team Program Plan / Outline Training if using “ STEAM” Administrative Assistance Community Support List of Available Community Resources
Healthy Habits/Healthy Weight7 Breakfast every week6 Home cooked meals per week5 Servings of fruits & Vegetables each day4 Ounces of 100% juice per day or less3 Servings of low fat dairy each day2 Hours or less of screen time each day1 Hour or more of physical activity each day
Registration Process Referrals from PCP Commitment Informational Fliers Registration Form ( in office) Support & Back up Support Partner Medical Provider Approval Form Fax paperwork to Program Coordinator Program Coordinator gathers info and sends out Welcome Letter. Coordinator meets with team & shares info Reminder calls are made to participants
STEAM Program Forms Registration Liability/Consent Form Welcome Letter Medical Provider Approval Forms Sample Fliers Pre/Post Surveys Provider Summary Forms Goal Sheets Food Charts Aerobic Exercise Forms Stretch Forms Training Manual Certificates of Achievement Much More …
Winter 2011 Post Program SurveySince starting the program … 100% eating 3-5 servings of fruits & vegetables daily Will you continue flex exercises -75% Yes, 25% Not sure Eating breakfast more frequently 100% Less junk food in the home 100% Eating smaller portion sizes 75% Yes , 25% No Able to Read food labels 75% Yes, 25% Same More active now 100% Drinking more water now 75 % Yes, 25% No Less Screen Time 75% Yes, 25% about the same Less intake of sweetened beverages 100% Yes
Budget Considerations Rent Prizes – most points ( depends on how many participants & options for prizes ) Administrative supplies & time ( copies, mailings, handouts, postage) Projector & Screen for power points for presenters. Presenter’s Props Examples of healthy snacks Program tools – balls, hula hoops, jump ropes, DVD player Scale, standometer Health Plan Reimbursements
Program RequirementsFollow required outline/topics/guidelinesUse standard forms so outcomes can be measuredPhysician ChampionProfessional/Qualified TeamProfessional GuestsAttend Training
What will STEAM do for you? Provide your medical providers with a referral source for your overweight patients. Provide additional income to make the program self supporting. Provide your patients with the basic knowledge to make healthier choices which will give the PCP leverage to build on. Provide a great team building experience for your participating staff. Provide you with an awesome program that allows you to be as creative as you wish without compromising program requirements. Provide you with a support group to make your program run smoothly and effectively.
Thank You• For your interest in Children struggling with obesity.• For continuing the successful childhood obesity programs you may have already running in your organizations• In advance, for your willingness to take the initiative to start a program of your own• For caring enough to be here today.
STEAM Program ContactRose RumballProgram DirectorCherry St Health Services330 Barclay Ave NESuite GL 2Grand Rapids, MI 495031-616-459-4314Roser@cherryhealth.com