Performance Improvement 2010. Address Nutrition, Obesity and Self-Care


The Centers for Disease Control and Prevention (CDC) studied programs promoting nutrition, physical activity and obesity.  Researchers found that funded states increased staff, leveraged funds and built partnerships.  States developed programs led by a strong core staff of highly qualified managers and physical activity and nutrition coordinators.  These strong core teams were backed by other key staff, including epidemiologists, evaluators, and worksite coordinators.  The programs developed plans which helped to put all partners on the same page and set priorities for activities of interest.  States developed strategic plans and implemented more than 250 interventions.  Communities and schools were the most popular settings; states also implemented interventions elsewhere including worksites, childcare facilities, hospitals and healthcare facilities, and faith-based organizations.  States that received more funding implemented interventions in more settings.  For every $1 of CDC funding, states leveraged $2 of support.  A range of public and private partnerships contributed to state capacity-building, state plan development and implementation, and program dissemination, enabling states to extend their reach and activities in ways that would not have been feasible without partners.  States with more active partnerships leveraged five times as much funding for obesity prevention. (9225)

Researchers for CDC developed a new method to identify promising practices for promoting healthy weight among employees at small and medium-sized worksites.  This promising worksite practice, supported by field-based, aggregate data showed: (1) no weight gain and a positive change in at least one related behavior marker (for example, physical activity or dietary pattern) or biomedical marker (for example, lower blood pressure or serum cholesterol concentrations) in employees who had normal weight, or (2) sustained weight loss in employees who were overweight or obese.  An evaluation method was developed that could rapidly assess worksite strategies that helped employees attain and maintain a healthy body weight.  The evaluation helped the agency create a website that provides employers a centralized resource of free evidence-based tools to plan, build, promote and assess employee obesity prevention and control programs. (9226)

The Institute of Medicine defined patient self-management support programs as those which provide "education and supportive interventions by health care staff to increase patients' skills and confidence in managing their health, including regular assessment of progress and problems, goal setting, and problem-solving support." Researchers conducted a literature survey to better understand what must be considered when buying or building patient self-management support programs.  The literature provided evidence that patient support programs should facilitate positive change in patient's behavior, fit well with where the support program is administered (either within or outside the primary care setting), and provide coaching in addition to patient education. (9033

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