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February 15, 2013



Coordinated Chronic Disease Program Leads and Chronic Disease Program Directors:

Welcome to the Coordinated Chronic Disease Prevention and Health Promotion Program’s (CCDP) weekly update featuring news, tools, and resources that may be useful for your state-based chronic disease prevention and health promotion efforts. 


Should you have any questions about the update, please feel free to contact Branalyn Williams,


Features highlighted in this update include:

Cross-Cutting Updates:

·        Epidemic Intelligence Service (EIS) 2013: Call for Position Descriptions (Deadline: March 1)

·        What Is Your State Doing to Prevent Injuries?

·        New Children’s Electronic Health Record Format Announced

·        Technical Assistance: Key to Increasing Quality with Electronic Health Records

·        Oregon Health Insurance Experiment Earns Prestigious Research Award


Heart Disease & Stroke:

·        Health Resources and Services Administration: Using an HER and Quality Data to Improve Hypertension, February 22 (Webinar)


Nutrition, Physical Activity, and Obesity:

·        More Mothers are Breastfeeding

·        CDC Releases Steps to Wellness Toolkit

·        Lower-Calorie Foods: It’s Just Good Business

·        New CDC Infographic: Go Light When You Grab a Bite

·        USDA Farm to School Grants

·        USDA Summer Feeding Program



·        New Publications

·        Study: California Saved $134B in Health Costs Thanks to Tobacco Control Program

·        Alert: Reynolds Puts Renewed Push on (Ineffective) Right Decisions Right Now Program

·        American Indian Public Health Disparities – Regional Differences in Health, February 21 (Webcast)

·        Upcoming Earned Media Opportunities

·        Summer Research Training Institute for American Indian and Alaska Native Health Professionals, Portland, Oregon, June 10-27



DEADLINE: MARCH 1, 2013, 5:00PM (ET)

The Epidemic Intelligence Service (EIS) is seeking position descriptions (PDs) for placement of EIS officers.  PDs from CDC CIOs, local/state health departments, or other federal agencies are welcomed.  PDs must adequately describe the opportunity for epidemiology training during the majority of the 2-year assignment.


EIS officers are expected to be shielded from administrative and other responsibilities that interfere with their learning and practice of epidemiology. The EIS program will consider assignment quality and training opportunities when reviewing submitted PDs.

The EIS program is launching online PD submission. All PDs must be submitted through the website. Go to  

The primary supervisor is responsible for creating and submitting a PD.  Once saved and submitted, the PD will be reviewed by your CIO's Epidemiology Advisory Committee (EAC) representative.  The EIS program will only access and review PDs that are approved, then submitted by the EAC representative. 


For additional information, please contact CAPT Rachel Avchen, 404-498-6110,



Millions of injuries could be prevented each year if more states adopted additional research-based injury prevention policies, and if programs were fully implemented and enforced. That's the key finding of a new report, "The Facts Hurt," by the Trust for America’s Health and the Robert Wood Johnson Foundation. Injuries are the third leading cause of death nationally, and the leading cause of death for Americans between the ages of 1 and 44. Check out our interactive map to find state-by-state injury death rates and learn how states score on 10 key indicators of steps they can take to prevent injuries, and read the report.



The benefits of electronic health records (EHRs) may become more widely available to children through an EHR format for children's health care announced today by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare & Medicaid Services (CMS).

Growing use of EHRs continues to improve the quality and safety of health care in the United States, but many existing EHR systems are not tailored to capture or process health information about children. The EHR format for children's health care announced today includes recommendations for child-specific data elements such as vaccines and functionality that will enable EHR developers to broaden their products to include modules tailored to children's health.  Read full press release.



A new study published in Health Affairs by Weill Cornell Medical College in collaboration with the Primary Care Information Project (PCIP) shows evidence that high levels of technical assistance and longer use of an electronic health record (EHR) are key for improving quality measures.
Primary findings concluded that a minimum of nine months of EHR use combined with eight or more technical assistance visits from PCIP were necessary to have a significant impact on quality measures including breast cancer screening, retinal exam and urine testing for diabetes patients, chlamydia screening for women, and colorectal cancer screening. No significant improvements were found among practices that used an EHR for up to two years with minimal to no technical support from PCIP.


The study is one of few examining the effect of EHRs on quality of care in small practices serving disadvantaged populations. Quality measures were based on specifications from thirteen insurers and generated by linking multi-payer New York State medical claims for years 2007-2010 to data shared from small practices in the PCIP network. The final sample included 5,005 physicians, 360 from the PCIP network, and over 57,000 measure observations.


Click here for temporary access to the full article.



The groundbreaking Oregon Health Insurance Experiment is the 2013 winner of the prestigious Health Services Research (HSR) Impact Award, presented by AcademyHealth.

The study is unique because researchers were able to compare the outcomes of two randomly selected groups: uninsured, low-income adults selected by lottery for Medicaid coverage, and those who weren’t selected. One year later, the group selected by lottery had lower out-of-pocket medical costs and medical debt and better self-reported physical and mental health, but higher health care utilization, than the other group. Read the brief.







In recognition of "National Heart Month,” in February, this webinar will focus on how safety net providers can utilize health information technology (HIT) to improve health outcomes in patients with hypertension. Hypertension is a significant risk factor that contributes to major health complications, including cardiovascular disease, a leading cause of death in the United States. Hypertension control is a core clinical quality measure in the Meaningful Use incentive program and also a priority within the National Quality Strategy, Healthy People 2020, and the U.S. Department of Health and Human Services’ "Million Hearts” campaign.  Presenters for this webinar are safety net providers from rural inpatient and community health center settings, who will share their best practices for helping patients control their hypertension. Register:


·        Christopher H. Tashjian, MD

Ellsworth Medical Clinic, Ellsworth, Wisconsin


·        Sarah Woolsey, MD

Health Insight, Salt Lake City, Utah


Questions for presenters are welcome ahead of the event and may be emailed to




African American mothers need more support


Across all groups, the percentage of mothers who start and continue breastfeeding is rising, according to a report released today by the Centers for Disease Control and Prevention (CDC).  From 2000 to 2008, mothers who started breastfeeding increased more than 4 percentage points. During that same time, the number of mothers still breastfeeding at six months jumped nearly 10 percentage points, from 35 percent in 2000 to nearly 45 percent in 2008.


In addition to increases among all groups, gaps in breastfeeding rates between African American and white mothers are narrowing.  The gap narrowed from 24 percentage points in 2000 to 16 percentage points in 2008.


"Breastfeeding is good for the mother and for the infant – and the striking news here is, hundreds of thousands more babies are being breastfed than in past years, and this increase has been seen across most racial and ethnic groups,” said CDC Director Tom Frieden, M.D., M.P.H.  "Despite these increases, many mothers who want to breastfeed are still not getting the support they need from hospitals, doctors, or employers. We must redouble our efforts to support mothers who want to breastfeed.”


While gaps continue to narrow among groups, more targeted strategies to increase breastfeeding support for African American mothers are still needed. To address this, CDC is currently funding Best-Fed Beginnings, a project that provides support to 89 hospitals, many serving minority and low income populations, to improve hospital practices that support breastfeeding mothers. CDC has also recently awarded funds to six state health departments to develop community breastfeeding support systems in communities of color.

To better understand breastfeeding trends and differences among African American, white and Hispanic infants born from 2000 to 2008, CDC analyzed National Immunization Survey data from 2002–2011. Other key findings of the report include:

·        From 2000 to 2008, breastfeeding at six and twelve months increased significantly among African American, white and Hispanic infants.

·        While numbers are rising across all groups, all mothers need more support to continue breastfeeding since less than half of mothers are breastfeeding at six months (45 percent) and less than a quarter of mothers (23 percent) are breastfeeding at twelve months.

·        Although rates of breastfeeding at six months increased by more than 13 percent among African American mothers, this group still had the lowest rates of breastfeeding duration, indicating that they still need more, targeted support.


For more information about CDC efforts to improve support for breastfeeding mothers, specifically hospital practices to support breastfeeding, visit For a video clip of the MMWR report on progress in increasing breastfeeding and reducing racial/ethnic differences, please visit


Many working American adults struggle to stay fit and active.  Because many of us spend most of the day at work, the workplace is a logical place to encourage physical activity. CDC’s new tool kit, Steps to Wellness: A Guide to Implementing the 2008 Physical Activity Guidelines for Americans in the Workplace  provides employers with easy and understandable steps on how to get employees moving.


This tool kit includes ideas and suggestions on how employers can create a wellness culture in the workplace by introducing physical activity programs. Work site wellness programs may improve employees’ health, which can result in greater productivity. 

According to one study, for every dollar spent on wellness programs, medical costs fell by $3.27 and costs associated with absenteeism fell by $2.73.  Physical activity is an important component of any comprehensive wellness program.
Steps to Wellness tool kit includes -
• A case for why businesses should create a culture that values physical activity
• Steps employees and their employers can take to promote, physical activity
• Tools and templates to help promote physical activities
• Other resources, including an overview of the 2008 Physical Activity Guidelines for Americans.


Restaurant chains that serve more lower-calorie foods and beverages have better business results, according to a study released today by the Hudson Institute. Between 2006 and 2011, chains that increased servings of lower-calorie options had better sales growth, larger increases in customer traffic, and stronger gains in total food and beverage servings than chains whose servings of lower-calorie options declined.


The report, Lower-Calorie Foods: It’s Just Good Business, analyzed 21 of the nation’s largest restaurant chains, including quick-service chains such as McDonald’s and Taco Bell, and sit-down chains such as Applebee’s and Olive Garden.


In 17 of the 21 chains, lower-calorie foods and beverages outperformed traditional items. In addition, chains that grew their sales of lower-calorie items saw a 10.9 percent increase in customer traffic, compared with a 14.7 percent decrease among chains whose servings of lower-calorie items declined. Read full report.



CDC is excited to announce the release of our fifth infographic that focuses on the connection between our busy lives and eating food away from home: Go Light When You Grab a Bite. CDC released Go Light to coincide with the time when many Americans have returned to our busy schedules and are challenged to stick to New Year’s resolutions.


The infographic outlines how Americans have shifted their food spending between 1960 and 2011 and the impact that eating four meals away from home – the number of meals the average American eats away from home each week – can have on our waistlines. It also includes simple solutions for eating healthier when we’re on the go.


Previous infographics have been overwhelming successes, being viewed by more than 32 million people and sparking a lot of conversation about screen time, healthy eating, and physical activity. Share Go Light with your partners and community to start a similar discussion around fitting healthy eating into our busy lives. The infographic is attached and also available at:



Across the country, an increasing number of schools and districts have begun to source more foods locally and to provide complementary educational activities to students that emphasize food, farming, and nutrition. This nationwide movement to enrich children’s bodies and minds while supporting local economies is often referred to as "farm to school.” The term encompasses efforts that bring local or regionally produced foods into school cafeterias; hands-on learning activities such as school gardening, farm visits, and culinary classes; and the integration of food-related education into the regular, standards-based classroom curriculum.


The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) established a federal Farm to School Program in order to assist eligible entities, through grants and technical assistance, in implementing farm to school programs that improve access to local foods in eligible schools. The USDA Food and Nutrition Service (FNS) is charged with implementing the Farm to School Program.

In this funding cycle, FNS anticipates awarding up to $5 million in grant funding to support efforts that improve access to local foods in eligible schools.


The RFA will be posted on USDA’s Farm to School website and available at


Important Dates:

·        February 6, 2013: Request for Applications Released

·        April 24, 2013 (Midnight EST): Proposals Due

·        October 2013: Awards Announced and Funds Available (Pending the Availability of Federal Funds)

Webinars to Learn More:

Three webinars will be offered so that grant applicants can learn more about this grant opportunity. To receive additional information about webinars, please be sure to sign up for the Farm to School E-Letter

·        March 5, 2013, 1:00 p.m. EST – Planning Grants

·        March 6, 2013, 1:00 p.m. EST – Implementation Grants

·        March 7, 2013, 1:00 p.m. EST – Support Service Grants



The USDA provides free or reduced price lunches to 22 million children during the school year through the National School Lunch Program (NSLP).  However, during summer break only 3 million of those students participate in a USDA summer feeding program.  You can be a game-changer by feeding more children nutritious meals during the summer and lowering the risk of hunger.

The Summer Food Service Program (SFSP) is a federally funded program administered by the States that helps fill the summer meal gap for low-income children by reimbursing organizations that serve children meals at feeding sites during summer months.  Schools, churches, recreation centers, playgrounds, parks, and camps can provide summer meals in neighborhoods with high percentages of low-income families, making a positive impact on the lives of hungry children.  These summer food sites are safe and familiar locations where children naturally gather during the summer.


The USDA, Food and Nutrition Service (FNS) is offering free webinars on SFSP, so you can learn more about how you can help your community feed children in need.  The webinars will review SFSP participation requirements, cover resources and tools available to help you get started, highlight successful programs and outreach practices from around the country, and provides an opportunity to have your questions answered by FNS Program experts. To register for our webinars, click here!




·        MMWR - Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness — United States, 2009–2011 - the smoking prevalence for adults with a mental illness is 70% higher than adults with no mental illness more attention to smoking prevention and cessation efforts is needed for those with mental illness.

·        Vital Signs brief - Adult smoking: Focusing on people with mental illnessthis reader-friendly brief highlights the findings in the MMWR with a graphic summary of the smoking statistics and what can be done to reduce tobacco use among people with mental illness


California’s tobacco prevention program saved $134 billion in health care costs over the last two decades, according to a new study published Wednesday about the smoking control program’s impacts in the most populous state. Read study.



The Campaign for Tobacco-Free Kids reports that Reynolds American (RAI—RJ Reynolds’s parent company) is up to its old tricks: putting a renewed push on promoting its Right Decisions Right Now (RDRN) youth tobacco prevention program. This time, they’ve managed to gain the support of the National Foundation for Women Legislators (NFWL), whose members may try to bring the RDRN program to schools in their districts. RAI’s website highlights the launch of RDRN in a digital, interactive format and the offer for free materials. And the NFWL (which has ties to the tobacco industry) recently passed a resolution that encourages every state to declare that evidence-based youth tobacco prevention education is a part of health education curriculums. A RAI press release promotes the endorsement.

Editor’s note: For more of the history behind RDRN and tobacco-industry supported "tobacco use prevention” materials, check out this Help Your Peers question from 2009 when Reynolds tried to introduce a Spanish-language RDRN curriculum in Puerto Rico.

CTFK agrees that every state should include evidence-based youth tobacco prevention education a part of its health education curriculum. But the RDRN program is not evidence-based, and the goal of the tobacco industry’s youth prevention programs is to convince policy makers to not enact policies and programs that actually reduce tobacco use.

The Campaign for Tobacco-Free Kids has resources to help you counter attempts to introduce industry programs like RDRN into your schools:


Take action: Please alert the schools in your community that women legislators or others might promote the use of this curriculum and ask them to reject its use by offering them these fact sheets on where to find legitimate tobacco prevention materials. If you hear that any schools have been contacted, contact CTFK so they can track whether this effort by RAI is getting any traction.



This live broadcast will address a number of relevant topics surrounding public health disparities and American Indian populations. Specifically, this broadcast will include a brief review of current American Indian Health Policies and a discussion of disparities that exist in health resources for American Indians. Speaker Donald K. Warne, MD, MPH will also review key health disparities that exist among and between American Indian populations as well as regional differences in health. Finally, Dr. Warne will present policy and program strategies intended to reduce the existing disparities. Click here to register.


From last month’s OSH Media Network discussion - earned media opportunities for February and March:



·        Heart Month/Valentine’s Day

o   Information about The Heart Truth and Million Hearts campaigns to combat smoking and other risk factors for heart disease

o   OSH material:  

§  OSH Love Your Heart feature

§  E-Cards and buttons

o   State example: Florida Heart Health Month media alert


·        Black History Month –

o   National African American Tobacco Prevention Network, - Delmonte Jefferson

§  The Resources tab on NAATPN site has a traveling wall that shows a timeline of major events that have impacted African American in tobacco control up until 2004; the timeline was recently updated to show events up until 2012.

§  Voices from the Village PSAs talk about decreasing smoking use in African American communities. The videos include commentary from prominent African Americans like actor/singer Harry Belafonte and legendary football player Jim Brown.

o   State example: Heritage Month Toolkit - North Carolina Health & Wellness Trust Fund




  • Women’s History Month
  • LGBT Health Awareness Month
  • National Poison Prevention Week - March 17-23 (sample news release from CDC)
  • Kick Butts Day - March 20  – Campaign for Tobacco-Free Kids - national day of activism that empowers youth to stand out, speak up and seize control against Big Tobacco; CTFK toolkit supports youth and event organizers in hosting events



The purpose of the Summer Research Training Institute for American Indian and Alaska Native Health Professionals is to meet the needs of professionals who work in diverse areas of American Indian and Alaska Native Health.   Information about the curriculum, travel, lodging, tuition, course descriptions and schedules are described here in the conference brochure.  This training event is supported with funds from the Native American Research Centers for Health Grant from NIH and IHS (U26IHS300415) and the Center for Healthy Communities, a CDC-funded Prevention Research Center grant at the Oregon Health & Science University (U48DP001937). For additional information, contact Tosha Zaback, Northwest Portland Area Indian Health Board, 503-416-3285 or