April 12, 2013
Coordinated Chronic Disease Program Leads and Chronic Disease Directors:
Welcome to the Coordinated Chronic Disease Prevention and Health Promotion (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, firstname.lastname@example.org.
Features highlighted in this update include:
· Eye on Medicaid Expansion
· Co-Ops: What are they, and what are the challenges?
· New Research: How Education, Employment Affect Your Health
· Payment Reform: What’s the return on investment?
· Findings from the 2011-2012 National Survey of Children’s Health, April 16 (Webinar)
· Diabetes Self-Management Training Resources from the National Council on Aging (NCOA)
Heart Disease & Stroke:
· Self-Reported Hypertension and Use of Antihypertensive Medication Among Adults ---United States, 2005-2009
Nutrition, Physical Activity, and Obesity:
· Leadership at the Top: Working with State & Local Officials to Prioritize Walking into Transportation Planning, April 26 (Webinar)
· Harnessing the Power of Procurement to Improve Food Environments, April 18 (Webinar)
· Smart Growth America: The Best Complete Streets Policies of 2012
· Taking Action on the Proposed Call to Action on Walking, April 16 (Webinar)
· Strategies to Prevent Weight Gain Among Adults
· New! Serving up MyPlate Graphics for School Menus
· Tips from Former Smokers Campaign Resources from the National Networks
· Newly Updated: Tobacco Control Job Opportunities
· Save the Date: Harm Reduction Webinar from TCN AND CTFK, April 15 (Webinar)
· Engaging Tribes to Raise Tobacco Taxes, April 23 (Webinar)
· Public Comment Opportunity: Tobacco Retailer Training Programs
· FDA Announces that Nicotine Replacement Therapy Labels May Change New Publications
· Spotlight on E-Cigarettes: News and Resources from the TCN Members & Partners
· E-Cigarette Webinar from TCN and NALBOH, April 29 (Webinar)
EYE ON MEDICAID EXPANSION
When Medicaid expands to cover more Americans in 2014, hospitals are likely to see higher revenues from newly enrolled Medicaid beneficiaries, according to a new Urban Institute Real Time Policy Analysis. Find out how much hospitals have to gain. Also: Learn about the impact of expansion on veterans and immigrants, and keep up to date on all issues related to Medicaid.
CO-OPS: WHAT ARE THEY, AND WHAT ARE THE CHALLENGES?
When policy-makers decided not to include a public health insurance option in the Affordable Care Act, they compromised by adding the Consumer Operated and Oriented Plan (CO-OP) program to the law. Sponsored by consumer groups and other nonprofits, CO-OPs would aim to offer consumers more options in states where few health insurers cater to individuals and small businesses. A new policy brief reviews the challenges facing CO-OPs as they prepare for open enrollment in October.
NEW RESEARCH: HOW EDUCATION, EMPLOYMENT AFFECT YOUR HEALTH
When it comes to good health, socioeconomic factors like community safety and social support, education, and employment all matter–often to a greater degree than the medical care you receive. Two new issue briefs and infographics explore research linking education level and employment status to health.
PAYMENT REFORM: WHAT’S THE RETURN ON INVESTMENT?
Growing evidence that payment reform strategies can help control costs is spurring employer purchasers to switch from the fee-for-service model of paying for health care, which encourages high volume, to payment models that reward high-value care. A new set of briefs from the Robert Wood Johnson Foundation (RWJF) examine four promising approaches employers have adopted: population-based payment, patient-centered medical homes, high-intensity primary care, and bundled payment. The briefs offer lessons learned and tips for employers looking to reward high-quality health care and make more efficient use of health care dollars. Click here to read more.
FINDINGS FROM THE 2011-2012 NATIONAL SURVEY OF CHILDREN’S HEALTH, APRIL 16, 3:00PM
The Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB) is pleased to announce the next DataSpeak Web conference titled "Findings from the 2011-2012 National Survey of Children's Health (NSCH)."
Presentations will be made by:
· Christina Bethell, PhD, MBA, MPH, Director of the Child and Adolescent Health Measurement Initiative (CAHMI) at the OHSU School of Medicine, on how participants can jump start their use of the new NSCH data using the resources available on the Data Resource Center’s Web site.
· Stephen Blumberg, PhD, Associate Director for Science in the Division of Health Interview Statistics at the Centers for Disease Control and Prevention, on the methods and design behind the NSCH.
· Michael Kogan, PhD, Director of MCHB’s Office of Epidemiology and Research, who will present key findings from the new survey.
Click here to register for this event.
DIABETES SELF-MANAGEMENT TRAINING RESOURCES FROM THE NATIONAL COUNCIL ON AGING (NCOA)
The National Council on Aging (NCOA) Web site features a variety of resources specific to Medicare's Diabetes Self-Management Training benefit, including a comprehensive toolkit, FAQs, Webinars, and tip sheets. Several of these resources focus on use of the Stanford Diabetes Self-Management Program as part of an expanded (ADA-recognized or AADE-accredited) diabetes self-management education program that meets the requirements for Medicare reimbursement. Click here to visit the Web site. The following resources may be of particular interest to state health departments:
· Obtaining Diabetes Self-Management Accreditation and Medicare Reimbursement: What States Need to Know (Webinar recording)
· How to Work with a Federally Qualified Health Center (tip sheet)
HEART DISEASE & STROKE
SELF-REPORTED HYPERTENSION AND USE OF ANTIHYPERTENSIVE MEDICATION AMONG ADULTS ---UNITED STATES, 2005-2009
Hypertension affects one third of adults in the United States (1) and is a major risk factor for heart disease and stroke (2). A previous report found differences in the prevalence of hypertension among racial/ethnic populations in the United States; blacks had a higher prevalence of hypertension, and Hispanics had the lowest use of antihypertensive medication (3). Recent variations in geographic differences in hypertension prevalence in the United States are less well known (4). To assess state-level trends in self-reported hypertension and treatment among U.S. adults, CDC analyzed 2005–2009 data from the Behavioral Risk Factor Surveillance System (BRFSS). The results indicated wide variation among states in the prevalence of self-reported diagnosed hypertension and use of antihypertensive medications. In 2009, the age-adjusted prevalence of self-reported hypertension ranged from 20.9% in Minnesota to 35.9% in Mississippi. The proportion reporting use of antihypertensive medications among those who reported hypertension ranged from 52.3% in California to 74.1% in Tennessee. From 2005 to 2009, nearly all states had an increased prevalence of self-reported hypertension, with percentage-point increases ranging from 0.2 for Virginia (from 26.9% to 27.1%) to 7.0 for Kentucky (from 27.5% to 34.5%). Overall, from 2005 to 2009, the prevalence of self-reported hypertension among U.S. adults increased from 25.8% to 28.3%. Among those reporting hypertension, the proportion using antihypertensive medications increased from 61.1% to 62.6%. Increased knowledge of the differences in self-reported prevalence of hypertension and use of antihypertensive medications by state can help in guiding programs to prevent heart disease, stroke, and other complications of uncontrolled hypertension, including those conducted by state and local public health agencies and health-care providers. Read full text.
NUTRITION, PHYSICAL ACTIVITY, AND OBESITY
LEADERSHIP AT THE TOP: WORKING WITH STATE & LOCAL OFFICIALS TO PRIORITIZE WALKING INTO TRANSPORTATION PLANNING, APRIL 26, 11:00AM (PT)
America Walks is hosting the fourth webinar in the six-part All Things Walking series.
This webinar will showcase the efforts underway in the great state of Tennessee to make walking a major priority in transportation planning. Register
- Top officials in the Tennessee transportation community will talk about how walking and walkability are being integrated into transportation planning in Tennessee.
- Find out why the Tennessee Department of Transportation (TDOT), a multi-modal agency, has won numerous awards for its innovation and dedication to transportation and provides one of the best transportation systems in the country
- Learn about City of Nashville's transportation planning and the integration of walking programs.
About this Webinar Series
This webinar is the 4th in a series on "All Things Walking," that includes webinars, telephone discussion forums, on-line technical resources, community-based workshops, and customized technical assistance designed to empower local communities to implement walking strategies and interventions in their communities.
HARNESSING THE POWER OF PROCUREMENT TO IMPROVE FOOD ENVIRONMENTS, APRIL 18, 1:00PM (ET)
Please attend the next webinar in a series exploring important topics in public health law.
- Dorothy Miller, J.D., M.P.H., Research Scientist, PolicyLab
- Quang Dang, J.D., Senior Staff Attorney and Technical Assistance Legal Director, ChangeLab Solutions
- Roberta Friedman, Sc.M., Director of Public Policy and Obesity, Yale Rudd Center
- Kathleen Noonan, J.D., Co-Director, PolicyLab
Procurement – the process through which goods are purchased – is a powerful tool that government leaders can use to promote policy and healthy food goals. Many leaders in public health, business and government may not be aware of the opportunities they have to promote policy change through procurement policies and laws. This webinar presents an overview of procurement, including a causal diagram that highlights key points of influence and impact for leaders. Dorothy Miller from PolicyLab will present an overview of procurement and highlights from PolicyLab's recent research. Quang Dang from ChangeLab Solutions will discuss best contracting practices related to procurement and vending. Roberta Friedman from the Rudd Center will discuss linkages between procurement and optimal defaults. Kathleen Noonan from PolicyLab will moderate the panel.
You may qualify for CLE credit. ASLME is an approved provider of continuing legal education credits in several states. ASLME will also apply for CLE credits in other states upon request.
Each webinar is free and open to all interested parties. Secure your spot by registering here. Information about webinar procedures will be distributed to all registrants before the event.
Series Is Presented in Partnership by: American Society of Law Medicine and Ethics (ASLME); Network for Public Health Law; and Public Health Law Research Program
SMART GROWTH AMERICA: THE BEST COMPLETE STREETS POLICIES OF 2012
In 2012, 125 cities, states and regions passed policies to make streets safer and more convenient for everyone who uses them.
These communities are part of the growing movement to create Complete Streets, and the movement is stronger today than ever before.
There are now 488 Complete Streets policies in place across the country at all levels of government. That’s a remarkable achievement.
Ten policies from 2012 stand out as leaders in the Complete Streets field. The communities have gone the distance to craft exceptional policy language—and your community might be one of them.
See the top 10 best Complete Streets policies in the country >>
The National Complete Streets Coalition examined each policy passed last year and scored them based on 10 elements of ideal policy language.
The annual ranking is intended in part to celebrate the communities that have done exceptional work in the past year, as well as to give other communities an example to follow in writing their own Complete Streets policies.
In addition to the annual rankings, the new report also contains tips and tools for communities interested in creating a Complete Streets policy of their own. Read the full report today >>
TAKING ACTION ON THE PROPOSED CALL TO ACTION ON WALKING, APRIL 16, 11:00AM (PT)
You'll get help on how to effectively share your comments with the Surgeon General to shape walking in America! Public Comment period ends April 30.
This is your opportunity to make your voice heard! Help shape walking in America by giving input on the Surgeon General's proposed call to action on walking: Walking as a Way for Americans to Get the Recommended Amount of Physical Activity for Health. Join America Walks, the Centers for Disease Control and Prevention (CDC), and Kaiser Permanente for this webinar and discussion. Register Now!
- Make your voice count. Learn how to make the most of your message to the Surgeon General through the Federal Register.
- Get support for your detailed comments on the Surgeon General's proposed call to action on walking.
- Become familiar with resources and on line technical assistance from Kaiser Permanente and America Walks
- Prepare your questions in advance. You can submit when registering. Q & A session will follow presentations.
- Joan Dorn, MD is the Team Lead for Physical Activity and Health Branch within the Division of Physical Activity, Nutrition at the Centers for Disease Control and Prevention
- Tyler Norris, MDiv. serves as Vice President, Total Health Partnerships at Kaiser Permanente, a role that includes leading KP's integrated physical activity and active transportation initiatives.
- Scott Bricker is the Executive Director of America Walks, a national non-profit organization focused on Making America a Great Place to Walk.
For more information, please contact webinar moderator Yolanda Savage-Narva, ysavage-narva[at]americawalks.org.
STRATEGIES TO PREVENT WEIGHT GAIN AMONG ADULTS
Objectives. Adults tend to gain weight progressively through middle age. Although the average
weight gain is 0.5 to 1 kg per year, this modest accumulation of weight can lead to obesity over
time. We aimed to compare the effectiveness, safety, and impact on quality of life of strategies to
prevent weight gain among adults. Self-management, dietary, physical activity, orlistat and
combinations of these strategies were considered.
Data sources. We searched MEDLINE®, Embase®, the Cochrane Central Register of Controlled
Trials, CINAHL®, and PsycINFO® through June 2012 for published articles that were potentially
eligible for this review.
Review methods. Two reviewers independently reviewed titles, abstracts, and articles, and
included English-language articles that reported on maintenance of weight or prevention of
weight gain among adults. Studies targeting a combination of weight loss with weight
maintenance or weight loss exclusively were considered to be outside of the scope of this review.
Trials of interventions and observational studies of approaches with at least 1 year of follow-up
with a weight outcome were included. Data were abstracted on measures of weight, adherence,
obesity-related outcomes, safety, and quality of life. The timepoints of interest for weight
outcomes were: 1 year, 2 years, 5 years, and the last reported timepoint after 5 years. For the
other outcomes, we abstracted data only from the last reported timepoint on or after 1 year. We
selected a meaningful difference threshold in addition to a statistically significant threshold
(p<0.05) for the outcomes. A meaningful between group difference was defined as 0.5 kg of
weight, 0.2 units of BMI (based on a 0.5-kg change for an individual with a BMI of 27), or 1 cm
of waist circumference per year of follow-up. We considered an intervention or approach
effective if the difference between groups met the meaningful between group difference
threshold and was statistically significant. We qualitatively synthesized the studies by
population, intervention, and outcome.
Results. We included 58 publications (describing 51 studies) involving 555,783 patients. Two
interventions may be effective compared with no intervention at preventing weight gain with
moderate strengths of evidence: workplace interventions having individual and environmental
components and exercise performed at home by women with cancer. Potentially effective
interventions with low strength of evidence include a clinic-based program to teach heart rate
monitoring, a combination intervention for mothers of young children, small group sessions to
educate college women, and physical activity among individuals at risk of cardiovascular disease
and diabetes. Potentially effective approaches described in observational studies having low
strength of evidence include eating meals prepared at home among college graduates and less
television viewing among individuals with colorectal cancer. When reported, adherence to
interventions tended to be below 80 percent. There were no adverse events among the few trials
that reported on adverse events. Trial study quality tended to be poor due to knowledge of the
intervention by the study personnel who measured the weight of the participants or lack of
reporting on this item. This lack of blinding of the outcome assessor along with inclusion of
studies that were not designed to prevent weight gain resulted in a low strength of evidence for
the majority of comparisons.
Conclusions. The literature provides some, although limited, evidence about interventions and
approaches that may prevent weight gain. Although there is not strong evidence to promote a
particular weight gain prevention strategy, there is no evidence that not adopting a strategy to
prevent weight gain is preferable.
Hutfless S, Maruthur NM, Wilson RF, Gudzune KA, Brown R, Lau B, Fawole OA, Chaudhry ZW, Anderson CAM, Segal JB. Strategies to Prevent Weight Gain Among Adults Comparative Effectiveness Review No. 97. (Prepared by The Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2007-10061-I.) AHRQ Publication No. 13-EHC029-EF. Rockville, MD: Agency for Healthcare Research and Quality; March 2013. www.effectivehealthcare.ahrq.gov.
NEW! SERVING UP MYPLATE GRAPHICS FOR SCHOOL MENUS
Jazz up your elementary school meal menus and encourage healthy choices with these free graphics from Team Nutrition. Download Graphics at: http://teamnutrition.usda.gov/graphics.html
Connect Nutrition Messages in the Cafeteria With Serving Up MyPlate Classroom Lessons:
TIPS FROM FORMER SMOKERS CAMPAIGN RESOURCES FROM THE NATIONAL NETWORKS
The CDC’s new Tips From Former Smokers ads feature additional population groups (American Indian/Alaska Native and LGBT communities [lesbian, gay, bisexual, and transgender]) that were not featured in the first campaign. Please see below for communications and resources about the campaign from the National Networks for Tobacco Control and Prevention. TCN members are encouraged to contact the National Networks to learn more about how to work with them to leverage the campaign and address tobacco-related disparities.
The National Networks are collecting stories from former smokers who have been impacted by smoking-related diseases and disabilities and come from communities experiencing tobacco related disparities. Click here to see the stories on the National Networks website. Do you or anyone you know have a story to share? The National Networks would love to hear from you! Click here to fill out an online form to share your story.
SAVE THE DATE: HARM REDUCTION WEBINAR FROM TCN AND CTFK, APRIL 15, 1:00PM (ET)
As you may have seen or heard, the tobacco industry has been busy promoting harm reduction in states and trying to enlist states to help them with that effort through various proposals. These proposals include promoting smokeless tobacco as less harmful than smoking, taxing smokeless tobacco at lower rates and diverting tobacco prevention funding to study or implement harm reduction approaches. The tobacco control community needs to be prepared to respond.
On Monday, April 15th, from 1-2:30pm EDT, the Tobacco Control Network (TCN) will present the first of a two-part webinar series on harm reduction issues. This first webinar will focus on the state harm reduction proposals, and provide tools and messages to counter the industry. The second webinar will discuss electronic cigarettes; more information about that one will be sent at a later date.
The April 15th webinar will feature speakers from the Tobacco Control Legal Consortium, Oklahoma Tobacco Settlement Endowment Trust, the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Lung Association, and the American Heart Association. Topics will include a review of the science related to harm reduction, what’s happening in states, OK’s experience with harm reduction proposals, a new toolkit with useful materials for advocates, and strategies you can use to oppose harm reduction proposals in your state.
There are limited lines for the teleconference and webinar, so we would appreciate it if colleagues in the same office can participate using one line.
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ENGAGING TRIBES TO RAISE TOBACCO TAXES, APRIL 23, 3:00PM (ET)
This webinar, presented by the National Native Network, will feature speaker Vanessa Tibbitts, Oglala Lakota, Program Manager for the Northern Plains Tribal Tobacco Technical Assistance Center at the Great Plains Tribal Chairmen’s Health Board. By the end of this presentation, participants will be able to identify and apply at least one method to engage tribal communities to raise tribal tobacco taxes and will be able to differentiate between state and tribal tobacco taxes. Space is limited. Click here to reserve your webinar seat. Registered participants will receive a confirmation email containing information about joining the Webinar.
PUBLIC COMMENT OPPORTUNITY: TOBCCO RETAILER TRAINING PROGRAMS
Comments due: April 26, 2013
The FDA is seeking comments on its recently released draft guidance related to tobacco retailer training programs. The draft guidance contains information about the various elements that should be covered in a training program. This is an opportunity for states to provide any experience and expertise you may have with regard to developing and implementing tobacco retailer training programs. I really want to encourage you to respond if you have information pertaining to these programs. You are the experts in the field and FDA can really benefit from hearing about your experience. Click here to read the notice in the Federal Register and to submit a comment, or go to regulations.gov and search for Docket No. FDA–2010–D–0350. Click here for the draft guidance document.
FDA ANNOUNCES THAT NICOTINE REPLACEMENT THERAPY LABELS MAY CHANGE
FDA’s Center for Drug Evaluation and Research (CDER) announced that labels on over-the-counter nicotine replacement therapy products can be changed to allow consumers to use them longer and at the same time as other nicotine-containing products. Related materials include: summary of FDA actions, Consumer update, FDA’s full announcement in the Federal Register, statement from the Campaign for Tobacco-Free Kids.
- Data: Quarterly update to smoke-free policy lists and maps - Americans for Nonsmokers’ Rights. Click here to view all the lists, or click here for the newest list on smokefree multi-unit housing laws. Did you expect to see your new law included, but don't see it on the lists? That is either because the law is not yet in effect, or because the law didn't meet the smokefree list criteria for enclosed non-hospitality workplaces, restaurants, bars, and/or gambling venues to be 100% smokefree without exemptions. Still have questions? Please contact Laura Walpert at email@example.com. American Indian and Alaska Native sovereign tribal laws are not reflected in these lists and maps. But there are plenty out there! ANR is working with their partners to make sure these laws are collected to eventually create a database specific to laws in Native Communities. Please contact Holly Callahan for hard copies of these lists at 510/841-3032 or at firstname.lastname@example.org.
SPOTLIGHT ON E-CIGARETTES: NEWS AND RESOURCES FROM THE TCN MEMBERS & PARTNERS
Everyone seems to be talking about e-cigarettes right now. Sales of the products are continuing to increase, with the potential to overtake traditional cigarette sales in the next decade. FDA has warned of the potential health risks of the products and announced its intent to regulate them. E-cigarette retailers and users claim to be pitted against Big Tobacco as policies to regulate the products are introduced in several states. A former Surgeon General has even joined the board for one e-cigarette brand. To help you stay informed about this emerging issue, TCN has collected several resources from our members and partners on e-cigarettes:
Does your organization have a position statement or information about e-cigarettes that you’d like to share with other TCN members? Submit it to the TCN staff email@example.com. Looking for more information? TCN is planning two upcoming webinars on harm reduction and e-cigarettes. Please see below for details.
E-CIGARETTE WEBINAR FROM TCN AND NALBOH, APRIL 29, 3:00PM (ET)
The National Association of Local Boards of Health (NALBOH) and the Tobacco Control Network (TCN) will present this webinar on e-cigarettes as the second of a two-part webinar series on harm reduction issues. The first webinar on April 15th (see above for details) will focus on recent state harm reduction proposals, and provide tools and messages to counter the industry. This second webinar will feature speakers from the Tobacco Control Legal Consortium, Legacy, Americans for Nonsmokers' Rights, and Tacoma-Pierce County Health Department, WA. Please look for an upcoming save-the-date email with more details and a link to register.
Branalyn K. Williams, MPH
Coordinated State Support Branch
Division of Population Health
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
4770 Buford Hwy, NE, Mail Stop K-93
Atlanta, GA 30341
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