Mass in Motion Cheryl Bartlett, RN

Director, Bureau of Community Health and Prevention

Public Health CouncilJanuary 11, 2012

2

Mass in Motion: Eat Better, Move More

Multifaceted state initiative•

Call to Action report

•

Governor’s Executive Order 509

•

BMI regulation

•

School Nutrition Regulation

•

Public information campaigns

•

Municipal wellness grants

•

Worksite initiative

•

Website–

Info on physical activity and nutrition–

Calendars–

Blogs–

Links to state and local resources

MA Healthy Transportation Compact

Promote “Healthy, Livable and Sustainable Communities”

through land use, transportation and public health policies and initiatives

Promote and encourage walking, bicycling and transit through state policies and programs

Ensure “Complete Streets”

design approach that provides

appropriate accommodation of pedestrians and bicycles in all transportation and development projects that use federal or state funds, or that require state permits

Use Health Impact Assessments as a tool to promote healthy transportation goals

Health Impact Assessment Project

Goal

Further develop the relationship between land-use, transportation and health outcomes at the local level using Mass in Motion

and the Massachusetts Healthy

Transportation Compact

as key foundations for the

initiative

CDC Heath Impact Assessment Grant (3 years) - $175,446

RWJ/Pew HIA pilot for Grounding McGrath

Key Partners

State Agencies

MassDOT

Energy and Environmental Affairs

Housing and Community Development

Elder Affairs

Trade Associations

Boards of Health

Health Officers

Municipal Officials

Planning Directors

Regional Planning Agencies

Communities

Mass in Motion

others

Health Impact Assessment Project

Selecting HIAs

Prioritize housing, transportation and/or land-use projects taking place in Mass in Motion communities

Opportunities to build health in all policies and projects

Work with partners

Trainings

Regionally based trainings

Partnership with Regional Planning Agencies and trade associations

Select project for focus of HIA and training

New Inter-Agency Partnerships

Commissioners of DPH, Department of Agriculture Resources and Department of Conservation & Recreation signed a resolution to develop a joint action plan to promote healthy living.

A working group of senior managers will be meeting later in January.

New Inter-Agency Partnerships

The DPH-DCR-DAR partnership will focus on building state and local partnerships to encourage use of state parks for activity and promote access to healthy Massachusetts grown food.

New Inter-Agency Partnerships

An example of this partnership is mapping existing Walking Clubs (people 50+) and locations of DCR parks.

Cross promotional activities can be planned to encourage more walking.

ChopChop

Massachusetts

Partnership with ChopChop, the Fun Family Cooking Magazine, to produce a monthly e-

newsletter.

Launched Dec 20th

at

event with Governor.

Available in English and Spanish.

ChopChop Massachusetts

Mass in Motion Municipal Wellness & Leadership Grants

A public-private partnership supporting cities and towns

Using CDC recommended evidenced based strategies for community change

Initiating or expanding policy, systems, and environmental change approaches to:

•

Promote availability of affordable healthy food

•

Support healthy food and beverage choices

•

Create safe communities that support physical activity

Funding Partners

Blue Cross/Blue Shield of Massachusetts

Blue Cross/Blue Shield of Massachusetts Foundation

The Boston Foundation

Harvard Pilgrim Health Care Foundation

MetroWest Health Foundation

Tufts Health Plan Foundation

0 10 20 30Miles

LegendMass In Motion Communities

SpringfieldTri-town(Lee, Lenox, Stockbridge)

Fitchburg

Worcester

Northborough Gloucester

RevereEverett

DorchesterWeymouth

Brockton

Fall River

New Bedford

Franklin

FundedCommunities

New funding that expands Mass in Motion

Community Transformation Grant ( 5 years) -

$1,574,982 (Middlesex)

8 new Mass in Motion programs and 1 current Mass in Motion program

Community Transformation Grant ( 5 years) -

$1,505,006 (8 county)

8 new Mass in Motion programs and 3 current Mass in Motion programs

CORD (4 years) -

$1,743,442 (New Bedford and Fitchburg)

With this expansion, we now have Mass in Motion initiatives in 53 municipalities and every county in the Commonwealth.

Community Transformation Grants

Local policy and environmental change:Tobacco-free living/smokefree

housing

Healthy Eating/Active Living

Clinical Interventions

Three long-term outcomesReduce death and disability due to tobacco use by 5% in the implementation area.

Reduce the rate of obesity through nutrition and physical activity interventions by 5% in the implementation area.

Reduce death and disability due to heart disease and stroke by 5% in the implementation area.

Mass in Motion Community Activities to Increase Healthy Eating

Support implementation of school nutrition regulations

Promote healthy dining in restaurants

Promote access to healthy food in retail stores

Implement EBT system and/or use of SNAP and WIC vouchers at farmers markets

Promote access to healthy food including farmers markets and increase access to farmers market via affordable transportation modes

Conduct community food assessment to determine food deserts; present data and recommendations to city officials

Review zoning/land use policies for usage of vacant

parcels of land as community

gardens

Mass in Motion Community Activities to Increase Active Living

Implement a safe routes to school initiative

Establish a “complete streets”

policy

Incorporate health outcomes into master plan

Pass policy to require all new development include sidewalks

Zoning ordinance that requires site plans for commercial/industrial buildings require bicycle racks

Conduct walkability assessment and sidewalk review

Citywide collaboration re: snow clearance

Mass in Motion: Get Fit Gloucester!

Stephen Winslow, Get Fit Gloucester!

MiM

Assessment Tool Helps Build  Community Partnerships

Gloucester / MiMCDC CHANGE Tool

•

5 Sector Assessment–

At‐Large–

Schools–

Workplaces–

Organizations–

Health Sector•

Community Action Plan

Lesson Learned:

Assessment Helps 

Build Partnership

MiM

Partnerships Promote Broader Change

Gloucester•

City–

Community Development & 

Health Depts.

•

School Department•

Addison Gilbert Hospital•

Farmer’s Market•

Food Pantry•

Pathways Headstart•

Senior Center•

The Trustees of Reservations•

Chill Zone – Youth Group•

Gorton’s

New•

Gloucester Fishermen’s 

Athletic Association

•

Open Space Committee•

The Food Project•

WalkBoston

Lesson Learned:

Partner Agendas 

Becomes a key part 

of the MiM  Agenda (and vice versa)

MIM Driven Dialogue  Draws Investment

•

Sidewalks:–

$150,000 directly invested–

Additional Improvements–

Safe Routes to School–

$ 4 million Streetscape Project

•

Bicycles–

Bicycle Racks–

Sharrows  

Mayor Carolyn Kirk

MiMMiM Funding for Project Staff Funding for Project Staff Leverages ResourcesLeverages Resources

1st

Open Space Plan in 13 years: Leveraged $250,000 to Improve Trail Access 

Restore Newell Athletic Stadium: $3.5 million project –

10x use of current field

$2.0 million private donations /grants, $1.5 million local bonds

Lesson Learned:

Small Amount of 

Strategic Funding 

Has Been Able to 

Leverage Many 

Resources

MiM

Helps Plant Seeds to Promote Positive  Change and Accomplish other MA DPH Goals

•

Burnham’s Garden–

Increased Safety of 

Downtown Park

–

Eliminated Drinking and 

Drugging spot

–

Grant Application for 

Additional Recreation and 

Safety Improvements

–

Featured Weekly on Local 

Blog (60,000 views/mo) 

Thank you! 

Stephen WinslowSr. Project ManagerCity of Gloucester978‐281‐9781swinslow@gloucester‐ma.gov

New Bedford Mass in Motion      

Dr. Pauline C. Hamel,  NB Mass in Motion and 

GNB Health Equity  Initiative

Project Coordinator 

New Bedford is on the Move!

January 11, 2012

A Success Story CDC, Capacity Building, & Community Action Plans

•

Board of Health Resolution/ Master Plan 2020

•

Adoption of School Wellness Policies–

Physical Activity:  Safe Routes to School; 

Walking

–

Nutrition: School Lunches; After School Programs 

•

Healthy Dining New Bedford (2011‐12)

•

South Coast Pathways–

New Bedford‐Fall River Bike Ride (11/2010)

–

South Coast Bike Summit  (2/2011)

–

Regional & Local Bicycle Committees (ongoing)

•

Groundwork South Coast:

Letter of Intent/Application

A Success Story

•

Integration of Health Equity/Social Determinants of Health 

into Mass in Motion initiatives–

Prevention for Health Caucus; Sen. Chandler, Rep. Lewis

–

SouthCoast Legislative Breakfasts: Mark Fenton 

Southcoast by Design (10/10); Food for Thought (10/11)

•

Policy Link:  Equity Summit 2011: Healthy Communities, 

Strong Regions, A Prosperous America; Detroit, MI (11/2011)

•

American Public Health Assn Annual Conference presenter;

Healthy Communities promote Healthy Minds and Bodies: 

“History, Public Health and Hip Hop:  Moving Toward a 

Healthier Community” in Washington, DC (11/2/2011)

•

Childhood Obesity Research Demonstration Project 

(CORD):  Launch with Dr. Lauren Smith, P.I. (11/21/11)

Communication, Policy, Systems, and  Environmental Strategies in Action

•

SAFE ROUTES TO SCHOOL, Mass RIDES–

Fed, State & City officials, Mayor Lang, Schools, New Bedford Police, Health Dept., St. Luke’s, parents and  children

–

International Walk to School Day–

SRTS Annual Forum, Newton, MA 

30

HHS R.Adm

Michael Milner 

at Roosevelt MS

Lincoln Elem School

Mayor Lang and School Committee members

Mass in Motion and Community Engagement

Healthy Dining New Bedford

New Bedford Mass in MotionMayor’s Office

New Bedford Health DepartmentNB Economic Development Council

Southcoast Health SystemLocal Restaurants

______

Promotional materials created incollaboration with 

Boston University AdLab

Healthy Dining New Bedford

Good for you.

Good for New Bedford.

GNB Health Equity Initiative: Our Time is Now !

•Build capacity to increase cancer screenings/outreach•Promote health equity and eliminate health disparities•Enhance/strengthen the identity of Community Health Workers

10/5/11

Health Communication, Awareness and Promotion

Questions?

Dr. Pauline C. Hamel, Project CoordinatorNew Bedford Mass in Motion

&

GNB Health Equity Initiative

Adjunct Faculty, Boston University  

508‐380‐7775       <phamel@bu.edu>

Thank You!

Mass in Motion

Community-Clinical Partnerships to Reduce Childhood Obesity

Dr. Lauren Smith

Medical Director, MDPH

A partnership between the City of New Bedford, the Massachusetts Department of Public Health, the

National Initiative for Children’s Health Care Quality, and Harvard University

Childhood Obesity Research Demonstration Project

$6,275,000 over 4 years

MA one of 3 sites selected by CDC

Only project lead by a state health department

Joint project with experienced partners

Harvard School of Public Health

Department of Population Medicine, Harvard Medical School

National Initiative for Children’s Healthcare Quality

Overall Approach

Build on successful Mass in Motion approach

Enhance connections between sectors

Maintain the focus on evidence-based strategies

Policies

Systems

Environmental changes

Aims of the Project

Decrease the number and percentage of children, aged 2-12 years who are obese or overweight, especially low income or minority children

Decrease the prevalence of chronic disease associated with unhealthy eating and lack of physical activity

Division of Nutrition, Physical Activity and Obesity

Obesity Prevention & Control Branch

Massachusetts San Diego Texas

Evaluation Center University of Houston

Fitchburg

New Bedford

CDC Funded Childhood Obesity Research Demonstration (CORD) Project

Changes we want to see: 5 Key Targets

1.

Decrease in childrens’

consumption of sugar- sweetened beverage

2.

Increase childrens’

moderate & vigorous physical activity

3.

Decrease in screen time & TV’s

in children’s bedrooms

4.

Increase childrens’

sleep duration & quality

5.

Replacement of calorically-dense or nutritionally poor foods with fruits and vegetables

Project Overview: 3 Levels of Intervention in 4 Domains

Individual/Family System CommunityHealth Care:Practice change initiative (High Five for Kids)

AssessmentCoachingCoordinated support

Obesity Learning Collaborative to improve quality of care

CHWs and physician champion link w/ local Mass in Motion initiative

Child Care: Nutritionist mentors support implementation of 2 linked interventions

I Am Moving, I Am Learning promotes daily physical activity and health food choices

NAP SACC supports policy, practice change in child care sites

Training of child care licensing staff to include elements in licensing visits

School: 3 evidenced based interventions

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

Community: Local Mass in Motion coalition initiatives

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

Programs Implementation

CHC InterventionOne large CHC per site reaching approx 20,000 patients/year34% of patients at 100% poverty

Childcare 6 childcare sites per community

School/after school

Minimum of 30 elementary/middle  schools and afterschool programs Reach at least 12,000 students in grades K‐7

Community

18,000 children ages 2‐12 across communitiesAll elementary schools 

Intervention communities: 

Fitchburg

and New Bedford

Evaluation 

CHC cohortIntervention sites only400 children per intervention CHC assessed at baseline, 1‐

and 2‐year follow‐up Measure 5 target behaviors, parent satisfaction with health care, utilization of servicesCHC surveillance

Intervention + control sitesExtract child BMI from EMR records at baseline, 1‐

and 2‐year follow‐up (N=8000)

Community 

surveillance

Intervention + control sites baseline and 2‐yr follow‐upWIC: BMI records and 5 target behaviors (N=2300) Schools: BMI (gr. 1,4,7) and behaviors (gr. 4, 7) N=4050

Intervention communities: 

Fitchburg

and New Bedford

Control community: ?

Outcomes

Main outcomesDecreases in BMI

5 key targets

Decrease in sugar 

sweetened beverages

Decrease in screen time

Increase in physical 

activity

Improvements in sleep

Replacement of empty 

calories w/ fruits & 

vegetables

Additional outcomesIncreased parent satisfaction with and utilization of health care services

Cost effectiveness of program

Community‐level policy change

CHC Intervention

Healthy weight clinicsEMR alerts RegistryClinician toolkits CHW inclusionClinic environmentLearning collaborativeAdvocacy training 

Childcare I am moving/I am learning 

NAP SACC assessment of environment and policy

School/after schoolPlanet HealthFood and FunEat well/Keep moving

CommunityLed by MiM coalitionsYouth driven social marketing campaignSafe Routes to School

Reducing Childhood Obesity In New Bedford

Community Health Centers: Primary Prevention

Goal: Prevention of child obesity

Activities

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

Community Health Centers: Secondary Prevention

Goal: Prevent disease progression and development of comorbidities

and complications

Activities

Efforts focus on overweight and obese children

EMR decision support tools for obesity management

Healthy Weight Clinics

Community Health Worker support of overweight/obese children and their families

Schools and Afterschools

Goal: Prevention of child obesity

Target population ActivitiesElementary Schools Eat Well, Keep Moving

Curriculum and materials

Staff training

Middle School Planet HealthCurriculum, lesson plans, materials

Integrated in to core subjects

Staff training

Afterschool Food and FunCurriculum

Support for environment changes

Child Care and Early Education Goal: Prevention of child obesity

ActivitiesNAP SACC Complete self-assessment for center

Set goals to improve nutrition and physical activity

Receive training, resources and materials from Mentors

I am Moving,

I am Learning

Receive training on ↑

physical activity

↓sugar-sweetened beverages and calorically dense foods

↑Fruit and vegetable consumption

Educate staff and parents on IM/IL practice

Community Interventions

Building on foundation of Mass in Motion

Evidenced-base strategies focused on policy, system and environment change

Creating environments to support healthy living

Media campaign

Youth empowerment approach

Developed in collaboration with schools to integrate school efforts into community approaches

Mass in Motion as Foundation

Enhance Community Action Plans to focus on evidence based strategies that have largest impact on the five obesity related behaviors

•IOM’s 2009 Local Government Actions to Prevent Childhood Obesity

Ensure coordination and integration of the multi-sectors at the local level

•Special role of the Community Health Workers

Engage champions from all sectors in community-wide efforts

Mass in Motion: Community Clinical

Partnerships to Reduce Childhood ObesitySteering

Committee

L. Smith, MDPHChair

Community Intervention

TeamL. Ojamaa,MDPH

Clinical Intervention

TeamE. Taveras, DPM

School and After School Intervention

TeamK. Davison, HSPH

Evaluation & DataAnalysis TeamK. Davison, HSPH

Communication Campaign Team

S. Moses, HSPH

MDPHHSPHDPM

NICHQ

Project Manager

J. Kwass, MDPH

Mass in Motion Coalition

CoordinatorsM. Giannetti, FitchburgP. Hamel, New Bedford

Mass in Motion Coalition Members

Questions?