Recommended Actions for Childhood Obesity Prevention and Treatment

results of research, planning and community forums

Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission

Missouri Council on Activity and NutritionChanging the Future of Childhood Obesity:Aligning and Amplifying Statewide Efforts

April 21, 2015 | Columbia, MO

Sarah Hampl, MDChildren’s Mercy Hospitals & Clinics

Kansas Cityshampl@cmh.edu

Denise Wilfley, PhDWashington University

St. Louiswilfleyd@psychiatry.wustl.edu

Chairpersons

Subcommittee Purpose1. Review the issue of childhood obesity, the evidence for effective

approaches to prevent and treat, Missouri's current approaches, and the gaps in services and resources.

2. Compile recommendations to create a comprehensive approach that includes access to treatment in Missouri that will fill identified gaps and decrease prevalence of obesity.

3. Present the report and recommendations to the Missouri Children's Service Commission which will in turn, inform the Governor and General Assembly.

Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission

Project Timeline

February 2014 Subcommittee held inaugural meeting

March-April Prepared outline for report

May-Aug Compiled preliminary recommendationsMeetings and conference calls

Sept-Oct Held public hearing(s) for input on recommendations - 122 people attendedSpringfield (Sept 19), St. Louis (Sept 29), Columbia (Oct 1), Kansas City (Oct 7)

Oct-Nov Subcommittee meeting and conference calls,

incorporated feedback, prepared executive summary

December Present draft to Children's Services Commission

Jan-Mar 2015 Finalize report and release to stakeholders

Graciela Couchonnal, PhDHealth Care Foundation of Greater Kansas City

Ann Davis, PhD, MPH, ABPPCenter for Children’s Healthy Lifestyles and Nutrition University of Kansas Medical Center

Dawnavan Davis, PhDKC Blue Cross Blue Shield

Johanna B. DerdaAmerican Academy of Pediatrics, Missouri Chapter

Meredith Dreyer Gillette, PhDChildren’s Mercy Hospitals and Clinics, Kansas City

Janet E. Farmer, PhDUniversity of Missouri School of Health Professions

Sarah Hampl, MD, FAAP, Co-ChairChildren’s Mercy Hospitals and Clinics, Kansas City

Megan Klenke, MSWChild Care Aware of Missouri, St. Louis

Timothy Kling, MD, FACOGMissouri HealthNetMissouri Department of Social Services

Deborah Markenson, MS, RDWeighing In, Children’s Mercy Hospitals and Clinics, Kansas City

Ann McCormack, MPH, RDBureau of Community Food and Nutrition AssistanceMissouri Department of Health and Senior Services

Donna Mehrle, MPH, RD, LDMissouri Council for Activity & Nutrition (MOCAN)University of Missouri Extension

Samar Muzaffar, MD, MPHMissouri HealthNetMissouri Department of Social Services

L. Carol Scott, PhDChild Care Aware of Missouri, St. LouisMember of Children’s Services Commission

Pat Simmons, MS, RD, LDMissouri Department of Health and Senior Services

Amy Stringer Hessel, MSWMissouri Foundation for Health

Aneesh Tosh, MDUniversity of Missouri School of Medicine

Denise Wilfley, PhD, Co-ChairWashington University in Saint Louis

subcommittee members

project staffEric S. Armbrecht, PhDAngela Lima, MBA, RD, LD

Emily Meissen-Sebelius, MSW Stephanie SegerAllison Yee, MPH

THANK YOUHealth Care Foundation of Greater Kansas City

& Missouri Foundation for HealthFunds provided by the Health Care Foundation of Greater Kansas City

and Missouri Foundation for Health have been used to support writing, research, meeting facilitation and public forums per direction of

the volunteer members of the Subcommittee for Childhood Obesity.

Public Forum HostsSpringfield-Greene County Department of Health

Missouri Foundation for Health

Columbia-Boone County Department of Public Health

Kansas City Health Department

Rationale and Context• Over the past 30 years, obesity rates have more than doubled for

children and quadrupled for adolescents

• 1 in 3 children are overweight or obese– much higher for children with Medicaid

• Obesity as co-morbidity increases costs for other childhood conditions*– 30% higher: analysis of MoHealthNet claims in 2012

– Obesity co-morbidity with: asthma (42%), depression (50%), diabetes (54%), hypertension (80%)

• Serious, direct health consequences during childhood and beyond

• Research shows that adult obesity originates in childhood

• Given current trends, Missouri will spend $12 billion annually on obesity-related healthcare by 2030

Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission

* Edison, Greever-Rice et al 2014

At the onset of this project, Subcommittee members agreed to develop just a few priority action items

for recommendation to the Children’s Services Commission.

The Subcommittee sought to develop recommendations that were consistent with these four guidelines:

Statewide. potential to achieve statewide reach

Impactful. supported by evidence

Actionable. by state legislature or government agencies

Feasible. reasonable to achieve in two years

guidelines

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Types of Recommended Actions

1. Prevention

2. Treatment

3. Infrastructure

Subcommittee on Childhood ObesityState of Missouri Children’s Services Commission

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Recommended Actions for Childhood Obesity Prevention and Treatment

Update child care licensing rules to align with the latest evidence on nutrition, physical activity, and screen time.

Train and support child care professionals to meet new standards.

prevention early childhood

Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Recommended Actions for Childhood Obesity Prevention and Treatment

prevention schools

Establish an Office for Student Wellness to maintain expectations for health and physical education curricula.

Modify school accreditation by creating and maintaining a health and wellness component. Train and support school staff to implement best practices and school wellness policies related to nutrition, physical activity and physical education.

Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Recommended Actions for Childhood Obesity Prevention and Treatment

treatment reimbursement

Reimburse licensed professionals with specialized training in evidence-based weight reduction programs through all Medicaid plans. Reimburse services provided in health care or community settings for children with a

body mass index (BMI) at or above the 85th percentile.

Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Recommended Actions for Childhood Obesity Prevention and Treatment

infrastructure centers of excellence

Establish Centers of Excellence across Missouri to provide evidence-based weight management services; coordinate access to treatment; train health care providers, school staff,

and others about screening, treatment options, and referral coordination; and train health care and community agencies on prevention strategies.

Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO

State of Missouri Children’s Services Commission Subcommittee on Childhood Obesity

Recommended Actions for Childhood Obesity Prevention and Treatment

infrastructure commission

Establish a Commission on Child Health and Wellness to oversee implementation of the Subcommittee’s recommendations, study effectiveness of obesity prevention strategies, and provide an ongoing forum for education and future actions.

Missouri Council for Activity and Nutrition | April 21, 2015 | Columbia, MO

Next Steps

Thank You