ASTPHND DNPA (O) Update June 10, 2007

ASTPHND DNPA (O) Update June 10, 2007

Update on the Division of Nutrition, Physical Activity, and Obesity

Update on the Division of Nutrition, Physical Activity, and Obesity

Maternal and Child Nutrition Branch

Chronic Disease Nutrition Branch

Physical Activity and Health Branch

Associate Director for Science

Communication Team Associate Director for Policy and Planning

Admin Services/ Resource

ManagementOffice of the Director

DNPA Organizational StructureDNPA Organizational Structure

Deputy Director

NPAO Team

Integrated InputIntegrated Input

• Feedback from:– Staff– States– Expert Panel– Division Directors– Center Leadership– Other partners

• Feedback from:– Staff– States– Expert Panel– Division Directors– Center Leadership– Other partners

DNPA(O) Vision and MissionDNPA(O) Vision and Mission

Vision:A world where regular physical activity, good

nutrition, and healthy weight are part of everyone's life.

Mission:Lead strategic public health efforts to prevent

and control obesity, chronic disease, and other health conditions through regular physical activity and good nutrition.

Vision:A world where regular physical activity, good

nutrition, and healthy weight are part of everyone's life.

Mission:Lead strategic public health efforts to prevent

and control obesity, chronic disease, and other health conditions through regular physical activity and good nutrition.

GoalsGoals

Increase health-related physical activity through population-based approaches.

Improve those aspects of dietary quality most related to population burden of chronic disease and unhealthy child development.

Decrease prevalence of obesity through prevention of excess weight gain and maintenance of healthy weight loss.

Increase health-related physical activity through population-based approaches.

Improve those aspects of dietary quality most related to population burden of chronic disease and unhealthy child development.

Decrease prevalence of obesity through prevention of excess weight gain and maintenance of healthy weight loss.

Strategic Priorities

Strengthen relationships with all state, territorial and tribal health departments so that we are partners in promoting physical activity, nutrition, and obesity prevention and control.

Develop and implement a research agenda that supports public health practice.

Develop and implement an agenda that clarifies and defines strategic public health leadership in obesity prevention and control.

Strategic Priorities

Prioritize, initiate and improve linkages within CDC to align and disseminate consistent public health recommendations and promising practices.

Develop an agenda for addressing health disparities in physical activity, nutrition, and obesity prevention and control.

Seek new and creative approaches to integrate nutrition and physical activity initiatives for obesity prevention and control.

Strategic Priorities Linked to Vision, Mission, Goals

Strategic Priorities Linked to Vision, Mission, Goals

DNPA Staff

Div. Dirs.

Expert Panel

Center Leadership

VMG

Service Science-Program

Leadership Linkages Disparities Integration

Proposed DNPA Functional Model

Long-Range Planning

Research

Program Development and Technical

Assistance

Surveillance

Policy Analysis

Admin./ Clerical Services

Leadership, Management & Accountability

Training

Partnerships and External

Relations

Translation & Dissemination

Proposed DNPAO Organizational Structure

Physical Activity Branch

Proposed Team Structure:• Research Team• Surveillance Team• Guidelines Development &

Recommendations Team

Nutrition Branch

Proposed Team Structure:• Research & Surveillance

Team• Surveillance Systems Team• Guidelines Development &

Recommendations Team• International Unit (M/M)

Obesity Prevention & Control Branch

Proposed Team Structure:• Research & Surveillance

Team• Guidelines Development

and Recommendations Team

Associate Director for Science

Program Development & Evaluation Branch

Proposed Team Structure:• Technical Assistance &

Consultation Team• Program Development

Team• Evaluation Team

Associate Director for Translation and Dissemination

Associate Director for Policy and Planning

Program Resource ManagementOffice of the Director

Summary of Considerations to be Achieved by Organizational Design

Summary of Considerations to be Achieved by Organizational Design

1. Raise priority, scope, and visibility of obesity efforts2. Maintain identity of the health promotion aspects of

nutrition and physical activity3. Prioritize coordination of cross-unit activities within

division and for relations outside of division4. Raise visibility of translation and dissemination activities5. Retain the skills of the communication team within the

division6. Raise priority of state program services and improve

coordination and cohesiveness of these services in the division

1. Raise priority, scope, and visibility of obesity efforts2. Maintain identity of the health promotion aspects of

nutrition and physical activity3. Prioritize coordination of cross-unit activities within

division and for relations outside of division4. Raise visibility of translation and dissemination activities5. Retain the skills of the communication team within the

division6. Raise priority of state program services and improve

coordination and cohesiveness of these services in the division

New DevelopmentsNew Developments

PA GuidelinesFruits and Veggies: More Matters

Strategies to Increase Fruit and Vegetable Consumption

Strategies to Increase Fruit and Vegetable Consumption

Early exposure

Fruit and vegetable program

Access

Community gardens and farmers markets

Competitive pricing

Stealth interventions (Garden Market)

Early exposure

Fruit and vegetable program

Access

Community gardens and farmers markets

Competitive pricing

Stealth interventions (Garden Market)

New DevelopmentsNew Developments

Medical settings • Release of Expert Panel recommendations • NICHQ Network

Schools• Revision of the 1994 PA and Nutrition Guidelines• White paper on BMI screening in schools• Monitor adherence to Alliance agreement

Medical settings • Release of Expert Panel recommendations • NICHQ Network

Schools• Revision of the 1994 PA and Nutrition Guidelines• White paper on BMI screening in schools• Monitor adherence to Alliance agreement

New DevelopmentsNew Developments

Worksites• CDC Healthier worksite initiative (cdc.gov/hwi)• Obesity cost calculator - validation• Community Guide recommendations• Impact of interventions on costs

Communities• Early assessment project• Measures project• Guide chapter on obesity• Capture community successes

Worksites• CDC Healthier worksite initiative (cdc.gov/hwi)• Obesity cost calculator - validation• Community Guide recommendations• Impact of interventions on costs

Communities• Early assessment project• Measures project• Guide chapter on obesity• Capture community successes

CDC Projects Related to Worksites CDC Projects Related to Worksites

Community Guide Recs

Promising Practices

Translate Findings

Focus groups

Disseminate

Develop Cost

CalculatorEvaluate

Develop Toolkits

Implement

Evaluate

New DevelopmentsNew Developments

Worksites• CDC Healthier worksite initiative (cdc.gov/hwi)• Obesity cost calculator - validation• Community Guide recommendations• Impact of interventions on costs

Communities• Early assessment project• Measures project• Guide chapter on obesity• Capture community successes

Worksites• CDC Healthier worksite initiative (cdc.gov/hwi)• Obesity cost calculator - validation• Community Guide recommendations• Impact of interventions on costs

Communities• Early assessment project• Measures project• Guide chapter on obesity• Capture community successes

Lessons from Tobacco ControlLessons from Tobacco Control

Surveillance – advocacy and policy

Comprehensive, multidimensional

Efficacy and effectiveness research

Advocacy frames the issue

Funded programs

Explicit, measurable goals and objectives

Threshold spending

Local initiatives fed national action

Surveillance – advocacy and policy

Comprehensive, multidimensional

Efficacy and effectiveness research

Advocacy frames the issue

Funded programs

Explicit, measurable goals and objectives

Threshold spending

Local initiatives fed national action

Arkansas Act 1220 (2003)Arkansas Act 1220 (2003)

Universal BMI measurements in schoolsCME courses for primary care providersChild Health Advisory CommitteeLocal parent advisory committeesLimited vending machines accessDisclosure of contract information with

beverage companies30’ physical activity/dayEducation for cafeteria workers

Universal BMI measurements in schoolsCME courses for primary care providersChild Health Advisory CommitteeLocal parent advisory committeesLimited vending machines accessDisclosure of contract information with

beverage companies30’ physical activity/dayEducation for cafeteria workers

Changes in BMI in ArkansasChanges in BMI in Arkansas

Category Year 1 Year 2 Year 32003-4 2004-5 2005-6

Overweight 20.9% 20.8% 20.4%At risk 17.2% 17.2% 17.1%Healthy weight 60.1% 60.1% 60.6%Underweight 1.8% 1.9% 1.9%

Total students 348,710 372,369371,082

All available data for years 1 & 2, and all data received by 6/14/06 for year 3 analysis

Category Year 1 Year 2 Year 32003-4 2004-5 2005-6

Overweight 20.9% 20.8% 20.4%At risk 17.2% 17.2% 17.1%Healthy weight 60.1% 60.1% 60.6%Underweight 1.8% 1.9% 1.9%

Total students 348,710 372,369371,082

All available data for years 1 & 2, and all data received by 6/14/06 for year 3 analysis

Successful Community-based Interventions for Children

Successful Community-based Interventions for Children

El Paso Texas (Paso del Norte Health Foundation)Somerville MassachusettsColac (Australia)EPODE (Ensemble Prevenons L’Obesite des Enfants – Fleurbaix Laventie, FR)

El Paso Texas (Paso del Norte Health Foundation)Somerville MassachusettsColac (Australia)EPODE (Ensemble Prevenons L’Obesite des Enfants – Fleurbaix Laventie, FR)

Paso del Norte El Paso Project Paso del Norte El Paso Project

CATCH in elementary schools (Coordinated Approach to Child Health) Bike/walk pathsWalk El PasoQue Sabrosa Vida

CATCH in elementary schools (Coordinated Approach to Child Health) Bike/walk pathsWalk El PasoQue Sabrosa Vida

Changes in the Prevalence of Overweight: Paso del Norte El Paso Project

Changes in the Prevalence of Overweight: Paso del Norte El Paso Project

2001-02 2004-054th grade 26% 23%8th grade 19% 15%

2001-02 2004-054th grade 26% 23%8th grade 19% 15%

Strategies to Improve Community Interventions

Strategies to Improve Community Interventions

• Local surveillance• Common indicators – outcome and

community level; proximal and distal• Links with academic centers for design,

evaluation, and technical assistance• Early assessment• Mechanism(s) to share knowledge and

experience

• Local surveillance• Common indicators – outcome and

community level; proximal and distal• Links with academic centers for design,

evaluation, and technical assistance• Early assessment• Mechanism(s) to share knowledge and

experience

A National Convergence Around Healthy Eating, Active Living?

A National Convergence Around Healthy Eating, Active Living?

StateObesity Summits Alliance for a

Healthier Generation

Food and FitnessInitiative

(WK Kellogg Fndtn)

HEAC(California Endowment)

Health in the Balance(IOM)

ALbD and HEbD (RWJF)

KP’s HEAL Initiative

YMCASteps to aHealthier US