Healthy People eLearning Webinar: Reducing Childhood Obesity (Part 6 of 10)
KARI ELLINGSTAD: I did want to acknowledge
HRSA and NICHQ for advancing a tremendous framework for a collaborative, and a collaborative
approach, that really helped our community organize our obesity prevention efforts. I
wanted to take a minute to, you can go to the next slide please.
To touch upon some of the characteristics of the collaborative that I feel really helped
our team achieve focus and move forward. We know that with this work achieving focus can
be difficult and so this was really helpful. First, the Healthy Weight Collaborative approach
provided the strategic framework that we needed. We didn’t need to build it ourselves.
Goals and strategies and expectations were outlined from the beginning and we had to
sort of buy into that. It might seem prescriptive, but the framework really helped our team focus
and implement strategies in a way that aligned with the assets in our community. So there
was flexibility within that framework. We had to next define a small multi-sector team.
I think we had four sectors: public health, primary care, community, and consumer sectors.
And we were told that we couldn’t have more than 11 or 12 people on our core team.
As a team lead I had to be really thoughtful about who we would involve. Would they be
active participants, committed to the goals? Would their spheres of influence align with
what we needed? Did they have the authority and ability to impact change in their respective
sectors? All of those were considerations as I pulled together the team. As a team lead,
it was easier to define the roles for each team member and the smaller team was easier
to coordinate. And, I have learned that you can have a small, focused team, while still
maintaining broad community partnerships. Next, the focus on quality improvement was
so important. We didn’t have to come up with the perfect plan before testing small changes.
This meant that our team was doing things all along. Even if what we were doing needed
to be adjusted down the road, still we felt like we were making progress and learning
all the time. The learning collaborative approach meant
that our team had access to the Healthy Weight Collaborative faculty as well as other teams.
We just felt like we were connected to something bigger and that was really important for us.
We learned a lot, together, during the learning sessions and webinars that we participated
in. But we were also put in a position of teaching from time to time, and that, that
helped build capacity for our team. Next, we had to define a clear target population
at the outset, a population that we would be able to measure on a monthly basis. We
had a think smaller than we would have had we been left to our own devices. But having
the defined population allowed us to get the data we needed, because finally the measurements
that were expected of us were clarified from the outset and we needed to develop a habit
of getting and giving data on a regular basis. We were collecting or proving data on message
reach, process steps, policy change, and even the nature of our collaborative. Just as there
was a strategic framework, there was a corresponding measurement framework. And collecting the
data regularly helped our team see progress — which was encouraging — but we were also
able to share that data with key stakeholders later, so that they could better understand
our goals and the progress we’d made. So the measurement really helped us set ourselves
up to be sustainable. Next slide, please. And this is just an example of the strategy
map that we put together to help us organize our thinking and figure out which strategies
needed to be implemented or could be implemented in each of the sectors that we were working
in. Next slide. As Shaila mentioned, there were, we were required to select a core message to use throughout, to support our efforts. And like San Diego
we also selected the 5210 message. This common message linked the work in all of the sectors
and helped create more of a community movement. And I’ll describe how that transpired in a
bit but the message has really been vital for giving our efforts a “stickiness factor”
and has been a great tool for engaging partners. Next slide, please.
So I wanted to touch a little bit on the work that has been done in each sector. In the
primary care sector we’ve been working with a pediatric clinic managed by our local health
department. And here we’ve implemented some new processes and workflows to support improved
assessment and follow-up in addressing healthy weight. One of the biggest changes that we’ve
made was to develop and implement a healthy weight plan. This is a standardized tool which
helps our physicians navigate that somewhat difficult conversation about healthy weight
and also facilitates goal-setting among patients and families. This plan aligns with the 5210
message and was recently included in our new EHR.
We’ve done some early evaluation on the plan utilization and effectiveness and we found
that among patients who have completed the plan there have been some significant improvements
in BMI which is very encouraging. We have also had some great feedback from the physicians
and staff regarding the plan. They were engaged in the process of developing and testing this
tool and they are now very receptive to actually using it, which of course is important.
In our primary care site we’ve also implemented obesity-focused group visits and these provide
an opportunity for physicians to provide additional guidance, but also for patients and their
families to discuss challenges and successes. As a policy target we’re looking to embed
the use of the Healthy Weight plan into all of our clinical sites under our health department
and expand the group visits as well. And we’re hoping we can have some influence on other
primary care practices in our broader community as well.