Mass in Motion Kids
Community-Clinical Partnerships to
Reduce Childhood Obesity
A partnership between the Massachusetts Department of
Public Health, the cities of Fitchburg and New Bedford, the
National Initiative for Children’s Health Care Quality, and
Harvard University
Childhood Obesity is Not
Randomly Distributed Among our Communities
Childhood Obesity and Median Household Income, 2010-2011
(N = 172 local and regional academic School Districts, 100 or more students
screened, all 4 grades reported)
50
% Overweight or Obese Children
45
40
35
30
25
20
15
10
5
0
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
Median Household Income (2005-2009 American Community Survey, US Census Bureau)
$180,000
CDC “Health Impact Pyramid”
Examples
Smallest
Impact
Counseling
& Education
Clinical
Interventions
Long-lasting
Protective Interventions
Rx for high blood
pressure, high
cholesterol, diabetes
Changing the Context
Immunizations,
brief intervention,
cessation
treatment,
colonoscopy
Fluoridation, trans
fat, smoke-free
laws, tobacco tax
Socioeconomic Factors
Poverty, education,
housing, inequality
to make individuals’ default
decisions healthy
Largest
Impact
Eat healthy, be
physically active
Mass in Motion: Eat Better, Move More
Multifaceted state initiative
•
•
•
•
•
•
•
•
Call to Action report
Governor’s Executive Order 509
BMI regulation
School Nutrition Standards
Public information campaigns
Municipal wellness grants
Worksite initiative
Website
–
–
–
–
Info on physical activity and nutrition
Calendars
Blogs
Links to state and local resources
CDC Funded
Childhood Obesity Research Demonstration (CORD) Project
Division of Nutrition,
Physical Activity and Obesity
Obesity Prevention & Control Branch
Evaluation Center
University of Houston
Massachusetts
San Diego
Fitchburg
New Bedford
Texas
Overall Approach



Build on successful Mass in Motion Approach
Enhance connections between sectors
Maintain the focus on evidence-based strategies
– Policies
– Systems
– Environmental changes
5 Key Target Behaviors
1.
2.
3.
4.
5.
Decrease in children’s consumption of sugarsweetened beverages
Decrease in screen time & TVs in children’s
bedrooms
Increase in children’s moderate & vigorous
physical activity
Substitution of empty-calories/nutrient poor
foods with fruits and vegetables
Increase in children’s sleep quality & duration
Project Overview
Individual/
Family
System
Community
Health Care
Assessment
Coaching
Coordinated
support
Obesity Learning
Collaborative to improve
quality of care
CHWs & physician
champion link w/ local
Mass in Motion initiative
Schools/
After
schools
Motivates
students/parents
to eat better, move
more
Policy & practice changes
w/I 2 school systems
Implementation will link
with Mass in Motion
community initiatives
Child care
I Am Moving, I Am
Learning promotes
physical activity &
healthy food
choices
NAP SACC supports
policy, practice change in
child care sites
Training of child care
licensing staff to include
elements in licensing
visits
Community
Support for activity
groups, healthier
decision making
Environment & policy
change focused on
increased activity and
increased access to
healthy food
Youth-driven media
campaign to change
community norms.
Environment & policy
change
Primary Care: Primary Prevention
Activities
Goal: Prevention of childhood obesity.
•Efforts targeting the
entire population
•Healthy weight as
well as overweight &
obese children
•Obesity Learning Collaborative
•Be Our Voice Advocacy
•EMR Best Practice Alerts
•Patient education materials
•Improve the healthfulness of the
health center
Primary Care: Secondary Prevention
Activities
Goal: Prevent disease progression and development of
comorbidities and complications
•Efforts focus on •EMR decision support tools for
overweight &
obesity management
obese children •Healthy Weight Clinics
•Community Health Worker support of
overweight/obese children and their
families
Schools and After Schools
Activities
Elementary &
Middle Schools
Afterschool
•Eat Well, Keep Moving, Planet Health
– Curriculum and materials
– Staff training
•Wellness champion
•Fitness equipment
•Support for wellness plan
•Student survey during BMI measurement
(4th & 7th grades)
•Food and Fun
–Curriculum
–Support for environment changes
Child Care and Early Education
Activities
NAP SACC
•Complete self-assessment for center
•Set goals to improve nutrition and physical
activity
•Receive training, resources and materials
from Mentors
I am Moving, • Receive training on
–↑ physical activity
I am
–↓sugar-sweetened beverages and calorically
Learning
dense foods
–↑Fruit and vegetable consumption
• Educate staff and parents on IM/IL practice
Women, Infants, and Children (WIC)
Nutrition Program
Activities
WIC
•Complete readiness for change assessment
•Receive training, resources, and materials
•Obesity Learning Collaborative
•Be Our Voice Advocacy
Community Interventions

Building on foundation of Mass in Motion
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
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Evidenced-based strategies focused on policy,
system and environmental change
Creating environments that support healthy living
Media campaign


Youth empowerment approach
Will be developed in collaboration with schools to
integrate school efforts into community approaches
Mass in Motion as a Foundation

Enhance community action plans

Focus on evidenced-based strategies that have the
largest impact on the 5 obesity related behaviors,
eg, IOM’s 2009 Local Government Actions to
Prevent Childhood Obesity
Ensure coordination and integration of the
multiple sectors at the local level


Special role of the Physician Champion and the
Community Health Worker in clinical sites
Engage champions from all sectors in
community-wide efforts

Proposed MiM Kids Community Activities
Fitchburg
1.
2.
3.
4.
5.
New
Bedford
1.
2.
3.
Implement at least 2 environmental changes at Big Field/Green
Acres to increase physical activity
Increase healthy options among park vendors
Market Basket grocery stores will implement at least 1 change
promoting healthy eating, with focus on fresh fruits and
vegetables and healthy beverages
Fitchburg will adopt Complete Streets policy, including Safe
Routes to Schools and Parks
Increase sustainability of Fun N Fitchburg
Increase the number of restaurants in NB from 0 to 5 that offer
healthy childrens’ options
Increase number of corner stores from 0 to 3 that participate in
MiM New Bedford Healthy Corner Store Initiative
Increase the number of elementary and middle schools from 0
to 3 that have well established and consistently active Safe
Routes to School programs
Poster
Booklet
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