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May 17, 2013

 

Chronic Disease Directors, Coordinated Chronic Program Mangers, Chronic Disease Leads, and Block Grant Coordinators:

 

Welcome to the Coordinated State Support Branch’s 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, bkwilliams@cdc.gov.

 

Features highlighted in this update include:

 

Cross-Cutting Updates:

·         Funding Opportunity Announcement: Tribal Public Health Capacity Building and Quality Improvement (CDC-RFA-OT13-1303)

·         Health Information Technology and Quality Improvement – Using an Electronic Health Record to Create Patient Problem Lists, May 17 (Webinar)

·         Essay Provides Recommendations for Health Departments in a Brave New World

·         Curbing Costs, Improving Quality

·         Tackling the Cost Conundrum

·         New Resource: Community Benefit State Law Profiles

 

Heart Disease:

·         Racial/Ethnic Disparities in the Awareness, Treatment, and Control of Hypertension – United States, 2003-2010

 

Nutrition, Physical Activity, and Obesity:

·         IOM Launch of Products to Support Healthy Weight Gain during Pregnancy

·         New Study: Better Recess May Equal A Better School Day

·         Obesity Prevention’s Real Benefits

·         Team Nutrition Releases Newly Updated Nutrition and Wellness Tips for Young Children: Provder Handbook for the Child and Adult Care Food Program

·         Study Finds Nearly All Food Products Advertised on Spanish-Language Kids Shows are Junk

·         USDA’s Economic Research Service: Disability is an Important Risk Factor for Food Insecurity

 

Tobacco:

·         Economic Evaluation for Public Health, June 13 & 18 (Webinar)

 

Community Health:

·         Community Health Workers and Your Health Center: The Time is Now

·         Communities Putting Prevention to Work (CPPW) Online Resource Center: New Products  Available

 

CROSS-CUTTING UPDATES

FUNDING OPPORTUNITY ANNOUNCEMENT: TRIBAL PUBLIC HEALTH CAPACITY BUILDING AND QUALITY IMPROVEMENT (CDC-RFA-OT13-1303)

CDC Tribal Support, housed in the Office for State, Tribal, Local and Territorial Support, is pleased to announce the availability of funds to strengthen and improve the infrastructure and performance of tribal public health agencies and tribal health systems through the provision of capacity building and quality improvement. Initiating tribal-specific programs will allow awardees to accelerate and expand the reach and health impact of tribal public health infrastructure. Tribal Support will fund federally recognized tribes in Priority Area 1 to develop disease interventions, build public health infrastructure, and cultivate community partnerships, and will fund a project evaluator in Priority Area 2 to conduct a program evaluation project. In order to reduce health concerns within AI/AN populations in federally recognized tribes, the program strategies for Priority Area 1 are: (1) to develop disease interventions; (2) to strengthen and build organizational infrastructure; and, (3) to cultivate community partnerships. Under Priority Area 2, the program strategy is to conduct monitoring and evaluation for all Priority Area 1 awardees for quality improvement, and to disseminate lessons learned. To be eligible to apply for this FOA, applicants must demonstrate significant experience and expertise in effectively and efficiently working in tribal communities to build tribal public health capacity (Priority Area 1) or evaluate program effectiveness (Priority Area 2).

 

Applications are due by 11:59 pm EST on July 15, 2013. See the full announcement  for this FOA—Tribal Public Health Capacity Building and Quality Improvement (CDC-RFA-OT13-1303)—for more information.

HEALTH INFORMATION TECHNOLOGY AND QUALITY IMPROVEMENT – USING AN ELECTRONIC HEALTH RECORD TO CREATE PATIENT PROBLEM LISTS, MAY 17, 2:00PM

This Webinar will focus on how safety net primary care providers can meaningfully use electronic health records (EHR) to create and maintain patient problem lists. Created by EHRs, patient problem lists are a core requirement of Meaningful Use. This function serves as a powerful tool for maintaining a patient’s medical history while also helping to engage patients to better track and manage their health care. Presenters will demonstrate how patient problem lists are created and maintained by EHRs, and share their strategies on how providers can use them for quality improvement and patient engagement. Staff from the U.S. Department of Health and Human Services will discuss the importance of patient problem lists in achieving Stage 1 and 2 of Meaningful Use. Click here to register.

 

Previous Health Resources and Services Administration (HRSA) Health IT and Quality Webinars can be accessed at the HRSA Health IT and Quality Webinar Web site. Questions for presenters are welcome prior to the event and may be emailed to healthit@hrsa.gov.

 

ESSAY PROVIDES RECOMMENDATIONS FOR HEALTH DEPARTMENTS IN A BRAVE NEW WORLD

The Association of State and Territorial Health Officials (ASTHO) Prevention Policy Committee member Chris Maylahn, New York's Senior Deputy Gus Birkhead, along with co-author David Fleming, MD, published an essay in Preventing Chronic Disease that identifies three priority areas where action can lead to real change in health department programs and practices, despite limited financial resources in states, which would substantially improve the health of Americans.

 

A coordinated care approach to maximize existing opportunities includes (1) identifying minimum health services for chronic disease prevention programs, (2) improving the surveillance of chronic disease, and (3) utilizing evidence-based practices.

 

Source: Maylahn C, Fleming D, Birkhead G. Health Departments in a Brave New World. Prev Chronic Dis. 2013;10:130003. Click here for full text access.

 

CURBING COSTS, IMPROVING QUALITY

Four new analyses on health care costs, supported by RWJF, outline strategies for achieving a sustainable rate of spending, at the same time bolstering the quality of care

  • A report from the Engleberg Center for Health Care Reform at the Brookings Institution suggests system-wide reforms to Medicare, Medicaid, and private insurance markets and exchanges could save the U.S. $300 billion in the next 10 years, and $1 trillion in the next 20 years.
  • The Partnership for Sustainable Health Care presents five consensus recommendations, ranging from shedding the fee-for-service payment system to rewarding states that slow the growth in spending with some of the savings.
  • The National Commission on Physician Payment Reform takes a close look at how physicians are paid.
  • A report by the Bipartisan Policy Center recommends ways to move America's health care system from a system driven by volume of care to one that places a premium on quality and value.

 

TACKLING THE COST CONUNDRUM

Is the slowing growth of health care expenditures temporary or lasting? New RWJF-supported research answers the question, explores cost drivers, and presents ideas for making Medicare sustainable. Read four studies on health care costs and spending featured in the May issue of Health Affairs.

 

NEW RESOURCE: COMMUNITY BENEFIT STATE LAW PROFILES

The Hilltop Institute's Hospital Community Benefit Program has just released a new online resource: the Community Benefit State Law Profiles. The profiles are a compilation of hospital community benefit laws and regulations across the United States, analyzed in the context of the Affordable Care Act's community benefit framework. They include data on tax exemptions that most states make available to nonprofit hospitals.

Readers can access this information through a new interactive map, or see a summary table for side-by-side comparisons of different state policies. A companion issue brief, "Hospital Community Benefits after the ACA: The State Law Landscape," presents the profiles' findings and begins the analysis of each state's community benefit landscape and its significance in the context of national health reform.

 

HEART DISEASE & STROKE

RACIAL/ETHNIC DISPARITIES IN THE AWARENESS, TREATMENT, AND CONTROL OF HYPERTENSION – UNITED STATES, 2003-2010

Hypertension is a leading cause of cardiovascular disease and affects nearly one third of U.S. adults (1,2). Because the risk for cardiovascular disease mortality increases as blood pressure increases, clinical recommendations for persons with stage 2 hypertension (systolic blood pressure [SBP] ≥160 mmHg or diastolic blood pressure [DBP] ≥100 mmHg) include a more extensive treatment and follow-up regime than for those with stage 1 hypertension (SBP 140–159 mmHg or DBP 90–99 mmHg) (3). Although racial/ethnic disparities in the prevalence of hypertension have been well documented (4); ethnic disparities in the awareness, treatment, and control within blood pressure stages have not. To examine racial/ethnic disparities in awareness, treatment, and control of high blood pressure by hypertension stages, CDC analyzed data from the National Health and Nutrition Examination Survey (NHANES) for the period 2003–2010. This report describes the results of that analysis, which indicated that the proportion of Mexican-Americans and blacks with stage 1 and stage 2 hypertension was greater than for whites.* Among those with stage 1 hypertension, treatment with medication was significantly lower for Mexican-Americans compared with their non-Hispanic counterparts. Although treatment among persons with stage 2 hypertension did not differ by race/ethnicity, less than 60% of those with stage 2 hypertension were treated with medication. More efforts are needed to reduce barriers to accessing health care and low-cost medication, as well as increasing clinicians' hypertension treatment knowledge and adherence to clinical guidelines. Read full text.

 

NUTRITION, PHYSICAL ACTIVITY, AND OBESITY

IOM LAUNCH OF PRODUCTS TO SUPPORT HEALTHY WEIGHT GAIN DURING PREGNANCY

We are happy to announce the launch of a new home for the pregnancy weight gain guidelines dissemination products on the Institute of Medicine website: www.iom.edu/healthypregnancy. The website includes a link to the interactive web-based infographic, as well as information on downloading and ordering hard copies of the patient and provider booklets, poster, and other products related to the guidelines.

 

NEW STUDY: BETTER RECESS MAY EQUAL A BETTER SCHOOL DAY

A well-organized and active recess has the potential to drive better student behavior, health, and learning, according to a new study from Mathematica Policy Research and the John W. Gardner Center at Stanford UniversityRead the research.

 

The randomized control trial looked at the impact of Playworks, a national nonprofit that provides safe, healthy recess and other playtime at low-income elementary schools in 22 cities nationwide. Schools with Playworks programs experienced:

  • Less bullying and exclusionary behavior at recess;
  • Students engaging in more vigorous physical activity; and
  • Kids returning to class ready to learn and teachers needing less time to transition to learning activities. 

Learn more about the specific findings.

"Playworks gets results. I’ve seen it firsthand, and a growing body of evidence now shows that, when it comes to changing schools for the better, recess and play may be one of the most powerful and underutilized tools we have." —Risa Lavizzo-Mourey, MD, MBA, President and CEO of RWJF

 

OBESITY PREVENTION’S REAL BENEFITS

When the Congressional Budget Office (CBO) estimates the costs of proposed federal legislation, it does so over a 10-year time frame. But when it comes to tallying up the costs and savings attributable to obesity prevention efforts, the CBO approach misses billions of dollars in potential savings over the long haul, according to a report by the RWJF-supported Campaign to End Obesity. The campaign recommends widening the window from 10 to 75 years

 

TEAM NUTRITION RELEASES NEWLY UPDATED NUTRITION AND WELLNESS TIPS FOR YOUNG CHILDREN: PROVIDER HANDBOOK FOR THE CHILD AND ADULT CARE FOOD PRORAM

Just in time for Food Allergy Awareness Week and National Physical Fitness and Sports Month, this
popular new tool for child care providers is now even better! This revised version includes minor clarifications and improvements based upon feedback from program stakeholders.

 

The handbook, a joint effort from USDA's Team Nutrition and the Department of Health and Human Services (HHS), helps child care providers create healthier environments for the 2 though 5 year-old children in their care. Along with the nutrition, physical activity, and screen time tip sheets, the handbook's supplements cover additional important topics: choking prevention and food allergies. Supplement B, "Care for Children With Food Allergies," is even more comprehensive in this newly revised version and is a vital tool for all child care facilities. The helpful "Resources" section of the handbook has also been updated and expanded. The handbook is available to download now from the Team Nutrition Resource Library: www.teamnutrition.usda.gov.

STUDY FINDS NEARLY ALL FOOD PRODUCTS ADVERTISED ON SPANISH-LANGUAGE KIDS SHOWS ARE JUNK

"Spend a little time watching children’s TV programs and you’ll see lots of commercials for high-fat, sugary foods that health officials don’t want you or your kids to eat. Watch Spanish-language programming and you’ll see even more.” -- Rob Waters, Forbes.com

 

What happens when 84 percent of the foods that young kids see advertised on TV are for products that are downright unhealthy? And when those foods are promoted by their favorite cartoon characters? It’s a recipe for bad health that may last a lifetime, causing diabetes, heart disease and a host of other conditions.

 

So say the authors of a newly released study on junk-food marketing on Spanish-language TV. As Prevention Institute’s Rob Waters reports in his latest Forbes column, the research, funded by the Robert Wood Johnson Foundation, found Latino children are being bombarded with commercials for junk foods, sugary drinks and fast-food restaurants.

 

Experts agree that junk food is a huge contributor to skyrocketing rates of diabetes, high blood pressure and even strokes. Food and beverage companies spend nearly $2 billion a year promoting unhealthy foods to kids virtually everywhere they go. Since many Latino children live in families where both parents work, and in neighborhoods where it’s unsafe to play outside, "television is the only supervision available,” said Xavier Morales, executive director of Latino Coalition for a Healthy California. "They become a captive audience for food marketers.”

 

RESEARCH SHOWS LATINO STUDENTS HAVE HIGH EXPOSURE TO UNHEALTHY SNACKS AT SCHOOL

Latino students are widely exposed to high-fat, high-sugar snacks and drinks sold in schools, but implementing stronger nutritional standards can yield healthier school snacks for this growing population at high risk of obesity, according to a new package of research materials released today by Salud America! The Robert Wood Johnson Foundation (RWJF) Research Network to Prevent Obesity Among Latino Children.

 

The new Salud America! "Healthier School Snacks & Latino Kids” research materials, which can be found at www.salud-america.org, include:

  • A research review with the latest science;
  • An issue brief (lay summary of the review);
  • An infographic; and
  • An animated video

 

This is the first of six new research material packages to be released over the summer by Salud America!, each of which will focus on a specific topic on Latino childhood obesity and highlight the issue, policy implications and future research areas.

 

The "Healthier School Snacks & Latino Kids” package highlights the fact that young people consume a high proportion of their daily calories at school.

 

"Research shows that access to unhealthy snack foods and beverages in schools has a disproportionately negative health influence among Latino students, and schools with a higher proportion of Latino students tend to have weaker policies regarding access to and nutritional values of these items,” said Amelie G. Ramirez, director of Salud America!, based at the Institute for Health Promotion Research at the UT Health Science Center at San Antonio.

 

"By 2050, 35 percent of young people in the U.S. will be Latino. Providing healthier school snacks and drinks can help make sure this growing population is healthy,” Ramirez said.

 

To learn more, visit www.salud-america.org.

 

NEW FROM USDA’S ECONOMIC RESEARCH SERVICE

TOPIC: FOOD & NUTRITION ASSISTANCE

Disability Is an Important Risk Factor for Food Insecurity

Disability has emerged as one of the strongest known factors in household food security. ERS found that a third of U.S. households with an adult unable to work due to disability were food insecure in 2009-10.

 

TOBACCO

ECONOMIC EVALUATION FOR PUBLIC HEALTH, JUNE 13 & 18, 1:00PM (ET)

These webcasts from the Michigan Public Health Training Center will describe key components of economic evaluation and illustrate using economic evaluation analysis tools in prioritizing and implementing prevention and treatment strategies.  ROI as an economic evaluation outcome in public health will be discussed. These webcasts will feature Michigan-specific data, but the subject matter is relevant to public health practitioners in other states. Click  for more details about this course and other free training opportunities from MPHTC.

 

COMMUNITY HEALTH

COMMUNITY HEALTH WORKERS AND YOUR HEALTH CENTER: THE TIME IS NOW

An article, available on the Northwest Regional Primary Care Association Web site, discusses the role of Community Health workers (CHWs) in community health centers, including:

·         Their roles in new models of care, such as the patient-centered medical home (PCMH) and Accountable Care Organization (ACO);

·         Current policy initiatives at the state and federal level to integrate CHWs into clinical care; and

·         Opportunities in state planning to promote employment of CHWs.

 

The article cites a CDC online course "Promoting Policy and Systems Change to Expand Employment of Community Health Workers (CHWs)”, which is available by clicking here. Click here to read the article.

COMMUNITIES PUTTING PREVENTION TO WORK (CPPW) ONLINE RESOURCE CENTER: NEW PRODUCTS AVAILABLE

The following new product by ChangeLab Solutions (CLS) was posted online recently for the CPPW Online Resource Center:

·         From the Ground Up: Land Use Policies to Protect and Promote Farmers’ Markets. This guide provides an overview of farmers’ market policy issues and community tested best practices, and was written for local government staff (planners, public health departments, etc.), elected officials, farmers’ market managers, food policy councils, and other stakeholders, to provide practical guidance and tools that can be customized to create more farmers’ market opportunities and to ensure their long-term viability. This product also features a set of complementary model land use policies for comprehensive plans.

 

The following new product was published recently by Joey Vrazel, of Leverage Consulting, in partnership with Community Initiatives. It is not hosted online yet; see the PDF attached:

·         Managing Change and Leading Through Transitions: A Guide for Community And Public Health Practitioners. This guide was developed to bridge the gap in offering specific information and assistance related to addressing change and sustaining community-level efforts, and providing an introductory resource on the topics for practitioners to draw from. This resource will help coalition leaders and local and state practitioners develop their foundational skills and maintain their place-based change efforts over time even through leadership changes. It reviews the sustainability of coalitions focused on policy, systems, and environmental improvements; offers lessons from the field capturing context and experiences; and provides specific principles and strategies to maintain momentum.