Multi-pronged program targets childhood obesity
Multi-pronged program targets childhood obesity
Health plan works with schools, communities
With an eye to improving the health of their members over the long term, BlueCross and BlueShield of Tennessee has taken aim at childhood obesity.
"The goal of our childhood obesity program is prevention. We approach the problem from multiple angles, involving the schools, community, and providers," says Ron Trammel, RN, CPHQ, regional nurse liaison for childhood obesity for the Chattanooga-based insurer.
About 32% of all children are overweight, adds Pamela Davis, RN, CCM, clinical coordinator for bariatric surgery at Baptist Metabolic Surgery Center of Baptist Hospital in Nashville, TN, and a member of the advisory board of the Obesity Action Coalition.
"We're seeing school-age children with hypertension and type 2 diabetes. This may be the first generation that doesn't outlive their parents," she says.
When Davis worked with a vascular surgeon, she frequently saw patients in their late 30s who were having limbs amputated as a result of diabetes.
"Now that we're seeing children who are 9 or 10 with type 2 diabetes, we can expect that in a few years it won't be uncommon for people 24 to 30 years old to need an amputation as a result of diabetes," she said.
In Tennessee, at least one of three children are overweight, due to poor lifestyle choices they or their parents have made, Trammel points out. Many families eat fast food predominately, in part because it's cheaper than eating a balanced diet, he adds.
"If they don't change their lifestyle habits, they are going to end up as obese adults with all the underlying health problems," he says.
Keeping in mind that providers are reluctant to talk with patients about weight problems, the health plan has created a childhood obesity kit for providers. The kit, available on-line, includes links to educational materials and other resources including body mass index calculators and clinical practice guidelines for the treatment of childhood obesity.
"The physicians can download educational materials for parents from the site and distribute them to families," Trammel says.
The health plan employs masters'-prepared nurses in each of their regions with duties that include education with physicians and community organizations.
The regional nurses have met with more than 200 health care providers to discuss childhood obesity, to encourage them to measure and record BMI, and to explain how to address it with parents.
"The Childhood Obesity Tool Kit contains pointers on how to approach the issue without making the parents mad. This simple message has made a lot of difference," says Nancy Alsgard, RN, managing director of medical clinical strategy.
The nurses also are available to PTAs and other community organizations to present the health plan's community outreach program to help families make lifestyle choices that can help their children maintain a healthy weight.
The presentation includes information about diet and physical activities and includes simple things families can do such as turning off the TV and computer and taking the children outdoors every day.
"We promote small, incremental changes in diet and activity, such as taking a walk as a family or reviving the practice of having the entire family sit down to a meal together," Trammel says.
In addition, the health plan has developed a 30-minute DVD presentation on diet and exercise that it has distributed to PTAs, doctors' offices, health departments, and employer groups across the state.
The company has developed WalkingWorks for Schools, based on the BlueCross Blue Shield Association's WalkingWorks program. Participants are asked to walk for at least five minutes each school day for 12 weeks.
"This is a formal program that gets kids out every day to walk around in the school yard. We have created rewards associated with it and had a huge response," Trammel says.
Students get a WalkingWorks wristband when they agree to participate and certificates for completing the program. Schools that reach their goals are designated "Extra Mile Schools" and receive a banner and recognition on the health plan's web site.
The health plan provides teachers with educational materials and suggestions for enhancing the program.
The company has worked on a statewide level to support legislation that regulates the type of snacks children have access to in vending machines at school and on a program in which school nurses track the body mass index of students.
Employer groups are beginning to recognize the importance of addressing the issue of childhood obesity and of working with the family as a whole, not just the employees, Alsgard says.
"We have spent a great deal of time creating our unique model that addresses childhood obesity. The program heightens awareness for the entire family and emphasizes that the parents have the responsibility to help the children change their eating habits and their lifestyle," she says.
With an eye to improving the health of their members over the long term, BlueCross and BlueShield of Tennessee has taken aim at childhood obesity.Subscribe Now for Access
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