Developing a Self-Management System
for Adolescent Healthy Lifestyles
West Virginia School Health
Technical Assistance Center
 The place to go for resources, technical assistance and
training related to school-based health centers, schoolbased behavioral health programs and school-based oral
health programs in West Virginia.
 Has been assisting school-based health programs since
West Virginia’s initiative began in 1994.
History of MU’s Work on Adolescent
Self-Management
 Literature search on chronic disease self management
principles applied to adolescents
 Social marketing tool: Nemours Foundation 5-2-1-0 message
 5 servings of fruits and vegetables a day, 2 hours or less
of screen time, 1 hour of physical activity and none, or
almost none, of sugary drinks
 Created our own tool to facilitate adoption of healthy
behaviors
 Paper tool 
 Touch screen
Outcomes Examples
 The percent of enrolled students who reduce their BMI
from above the 85th percentile to less than 85th
percentile.
 The percent of enrolled students who increase their daily
intake of fruits and vegetables.
 The percent of enrolled students who increase their
physical activity time.
Obesity Treatment Guidelines
 The AMA, HRSA and CDC convened an Expert
Committee and produced:
 “Appendix: Expert Committee
Recommendations on the Assessment,
Prevention, and Treatment of Child and
Adolescent Overweight and Obesity”
 Released on June 6, 2007
 http://www.ama-
assn.org/ama1/pub/upload/mm/433/ped_obesity_recs.pd
f
Treatment
Recommendations
Step 1 - Assessment & Prevention through SBHCs
Action Step
Expert Recommendations
Proposed Activity
Assess all children
yearly for obesity




Accurately measure height and weight
Calculate BMI
Plot BMI on BMI growth chart
Measure blood pressure





Make a weight
category diagnosis
using BMI
percentile
Take a focused
family history







<5% = Underweight
5-84% = Healthy Weight
85-94% = Overweight
95-98% = Obese
Obesity
Type 2 diabetes
Cardiovascular disease (hypertension,
cholesterol)
Early deaths from heart disease




Coordinate BMI screening
Measure height and weight
Calculate BMI
Screen for Acanthosis Nigricans
Measure blood pressure and diagnose
hypertension- NHLBI recommendations
Plot BMI on BMI growth chart
Make a weight category diagnosis
category using BMI percentile
Family health history: cholesterol,
asthma, smoking, diabetes,
overweight, myocardial infarction,
bypass, angioplasty, catheterization or
death from heart disease
Clinical Management Progression
Weekly
Week 1:
Screen for obesity
Baseline ASM questionnaire
Conduct laboratory tests as indicated
Week 2: Visit, ASM check in
Week 3: Visit, ASM check in
Week 4: Visit ASM check in
Month 2
Visit, ASM check in
Month 3
Visit, ASM check in
Month 4
Visit, ASM check in
End of year
Student wrap up
Final ASM questionnaire
Conduct laboratory tests as indicated
http://wdn.ipublishcentral.net/www_aap_org/viewinside/6974624460157
Adolescent Self Management Software
Three (3) surveys which include:
 Healthy Lifestyles – Based on 5210 clinical guidelines.
 CRAFFT – Screening for substance abuse.
http://www.ceasar-boston.org/clinicians/crafft.php
 Risk Assessment - similar to GAPS, but modified for use in
WV SBHCs.
Positive Behavioral Support
Techniques
Risk Assessment
 Based on the Guidelines for Adolescent Prevention
Services Survey, but modified for use in WV School-Based
Health Centers.
 Can be modified for use with Middle School-aged students.
 Includes questions pertaining to
 Oral Health
 Safety
 Self-Harm
 Goal Setting
 Sexual Activity
Allows students to set goals
for improvement.
Tools/Resources
http://livewell.marshall.edu/asm/
 ASM Software
 User instructions
 Provider instructions
 SBHC Obesity Tx Recommendation Summary
 5210 Pediatric Obesity Clinical Decision Support Chart
(suggested purchase)
http://wdn.ipublishcentral.net/www_aap_org/viewinside/6974624460157
Marshall University Contact Information for
Self-Management Tools
Richard Crespo, PhD, Professor
Mary Grandon, PA-C
Robert C. Byrd Center for Rural Health
Marshall University School of Medicine
Phone: 304-691-1193
Email: crespo@marshall.edu
Phone and Fax: 304-206-7362
Email: grandon@marshall.edu
Stephanie Montgomery
Phone: (304) 634-1008
Email: smontgom@marshall.edu
ASM Software Developed by:
CodeBusters, LLC