Valerie Minor, RN, MSN., Christa Ice, Ph.D., - PowerPoint Presentation

Slide1

Valerie Minor, RN, MSN., Christa Ice, Ph.D., & Shannon Holland, MA.

CARDIAC on the Move:

School-based Surveillance and InterventionSlide2

Valerie Minor, Associate Director CARDIAC, will introduce the CARDIAC projectChrista Ice will present findings from the past year of CARDIAC and give examples of CARDIAC research projects

Shannon Holland, Executive Director WVOM, will talk about the Schools on the Move grants

Outline for today’s talkSlide3

The West Virginia CARDIAC Project

C

oronary

A

rtery

RiskDetectionInAppalachianCommunities

“To reduce cardiovascular disease, diabetes, and other chronic illnesses in West Virginia through research and intervention in children.”Slide4

The CARDIAC story

1998: 3 counties

2012: 55 countiesSlide5

Once upon a time…Slide6

W.A.Neal, MD

…there was a famous pediatric cardiologist. He saved and improved the quality of the lives of hundreds of sick children. Slide7

He was very happy about this.Slide8

But he knew there was more.

In 1995, the WV age adjusted death rate from heart disease was 21% higher than the national average.Slide9

Something had to be done. But the grown-ups just didn’t seem to be getting it. Slide10

Now, this was not just your average “

run of the mill

” famous pediatric cardiologist. He was a deep thinker!

Hold that thought.Slide11

Meanwhile...Slide12

The postman delivered letters that invited lots of people (including the famous pediatric cardiologist and a cranky nurse) to a meeting.Slide13

And lots of people went to the meeting to do good work.Slide14

And everyone listened carefully to all the speeches.

Lfdoas lfoei ad ald da ll ldjpe fj j erd lfoe d 0p aod ap apo

A[a aeipf apoia’p d ka adl kSlide15

Then they all got their special assignment to a

special focus group

.Slide16

And the famous pediatric cardiologist with the bright idea was assigned to the same focus group as the cranky nurse.Slide17

Welcome to “our” focus group.

“Geez, you’re the worst focus group I’ve ever seen.”

Geez, you’re the worst focus group I’ve ever seen

.”Slide18

…blah

blah

…if the school nurses had money…blah blah…reports that never go anywhere…A-B nursing & RHEP…

The cranky nurse didn’t like focus groups with all talk and no action and said so as she introduced herself to the group.Slide19

The land of dead-end reports

The famous pediatric cardiologist agreed. He decided to introduce himself to the cranky nurse.Slide20

W.Neal, MD

And there are 2 others who can make this happen…

So over lunch at the meeting, the famous pediatric cardiologist talked to the cranky nurse. He told her about his bright idea and about 2 other people...Slide21

Paula Nicholson

WVU SOM Department of Pediatric CardiologySlide22

Super-duper RHEP Site Coordianator

Georgianna Tillis

And you will do community service projects…Slide23
Slide24

And the pieces came together…Slide25

CDC

Benedum Foundation

Department of

Pediatrics Foundation

Compton Nutrition Chair

American Heart Association…and the givers gave…

Private contributionsSlide26

WE CARDIAC

Roman Prezioso

…and the legislature gave…Slide27

And the famous pediatric cardiologist said, “This is good.”Slide28

A-B Senior Nursing Students:

The Dream Team since ’98 Slide29

Major Change: Demise of RHEPSlide30

Based at WVU SOMMany of the same people

Remains community based

Able to focus on CARDIAC aloneSo far, so good!Slide31

Active consent 5th grade (CARDIAC Kid)

Family history

BMIBlood pressure

Acanthosis Nigricans

Fasting lipid profile

Eight county active consent research programPassive consent 2nd grade (CARDIAC TOO)CARDIAC: Results from 2011-2012Slide32

County and state results for 5th grade are available on our website: www.cardiacwv.org

Since 1998, we’ve screened over 81,156 5

th graders!

I

n 2011-2012:

48 counties were screened259 schools4,780 students60 parentsResults – 5th gradeSlide33

Among those 4,780 screened:18.7% were overweight27.8% were obese

20.3% had high blood pressure

23.5% had abnormal lipids (high TC and/or low HDL)3.9% had Acanthosis NigricansOf those with AN, 62.1% had high insulin

Many of the students screened do not realize they need medical attention!

Parents can call our toll-free hotline with questions.

Parents are contacted if their child should seek immediate medical attention.5th grade results, cont.Slide34

Since 2005, over 50,082 2nd graders have been screenedDuring 2011-2012:

41 counties participated

8,591 students15.7% were overweight24.5% were obese

2% had Acanthosis Nigricans

Results for 2

nd gradeSlide35

Screened 868 kindergartners17.2% were overweight13.6% were obese0.7% had Acanthosis Nigricans

Screened 97 8

th graders19.8% were overweight26% were obese

6.2% had Acanthosis Nigricans

Other grades 2011-2012Slide36

Validate a Model for Reducing and Preventing Obesity in WV School Aged Children3 year project following students in 6th

, 7

th, and 8th grades

In collaboration with Marshall University regarding School Based Health Centers

Funded

by The Claude Worthington Benedum FoundationCompared school-based health centers to a physician office-based modelOther screening projectsSlide37

Evaluation and program develop of Greenbrier CHOICES, an integrated adolescent health promotion program on the physical activity, fitness, and dietary behaviors of middle school students.

Screening

6th, 7th, and 8

th

grade

studentsIn Greenbrier County middle schoolsAs part of the Clinical Component of the Carol M. White Physical Education Program (PEP) GrantOther screening projects, cont.Slide38

With the discontinuation of WVRHEP in the 2011-2012 school year, CARDIAC hired experienced Area CoordinatorsIf you are currently a school nurse participating in the CARDIAC Project, please see our booth, pick up screening results, and say hi to your Area Coordinator!

If you have any questions regarding CARDIAC screening of 2

nd or 5

th

grade students, please feel free to talk to them!

ChangesSlide39

One of the biggest questions we get is what can we do with these CARDIAC results to improve child health in WV?Area Coordinators will start implementing or facilitating intervention efforts in their areas in 2012-2013

We will generally only be screening passive consent 2

nd grade and active consent 5

th

grade schools

We value the expertise of the School Nurses and we request that they participate in the screeningChanges for 2012-2013 Slide40

These results are extremely important for families, who might not realize cardiovascular risk starts in young children They are also important for state and nationwide research implications.

CARDIAC in the state news:

Kate Long with the

Charleston Gazette:

http://theshapewerein.wordpress.com

/ResearchSlide41

Nationwide CARDIAC research in the news:2012 AHA EPI-NPAM Science News:

Sam

Gidding, MD, FAHA and Christa Ice, PhD. CV Risk Factors and Rurality

in Appalachian

Children

Ms. Ritchie’s 2010 article: Universal versus targeted blood cholesterol screening among Appalachian youth: The CARDIAC project. Pediatrics. 126, 260-265. Dr. Cottrell’s 2011 article: Metabolic abnormalities in children with asthma. American Journal of Respiratory and Critical Care Medicine. 183, 441-448. ResearchSlide42

20,266 Subjects Tested

(5

th

Graders)

14,468 met NCEP screening

Guidelines (71.4%)

5,798 did not meet NCEPScreening guidelines (28.6%)170 warrant pharmacologic tx (1.2% of those who met NCEP guidelines)

(1.7% of those who did not

Meet NCEP guidelines)

Universal versus Selective Screening:

Testing Current NCEP Guidelines

98 warrant pharmacologic tx

98 warrant pharmacologic

txSlide43

Results Summary:

Mid-sized metro areas consistently presented with the worst

outcomes (BP, BMI, cholesterol)All areas/counties have high rates of cardiovascular risk!

Cardiovascular Risk Factors

and

RuralityData from 2003 - 2011Slide44

Obesity by county since 1998

Obesity is defined as BMI ≥95

th

percentile

Data includes over 81,000 participants

National average is ~20%All counties have prevalence above the national averageSlide45

Take steps to improve West Virginia children’s health! Here are a few ways you can help:Ask parents and schools to participate in the CARDIAC P

roject

Encourage state legislators to continue supporting child health initiatives, such as healthy school meals and obesity screening

Volunteer

with local, community-based health initiatives, such as school gardens

Become a role model: Follow 5-2-1-0. Have your cholesterol and blood pressure checked.Partner with CARDIACSlide46

AAP 5-2-1-0 Campaign

5

2

1

0Slide47

Become involved in statewide initiatives, such as the physical activity plan: www.wvphysicalactivity.org

Go to West Virginia on the Move for other great physical activity ideas:

www.wvonthemove.netPartner with WVU Extension’s healthy lifestyle initiative:

www.ext.wvu.edu

CARDIAC PartnersSlide48

West Virginia on the Move Since 2004

Statewide non-profit

Mission : To promote a physically active lifestyle for all West Virginians, by providing leadership, technical expertise, and collaboration with the goal of reducing the prevalence of chronic disease.Slide49

ProgramsSlide50

Schools on the Move - Goal50

To help WV schools create and foster opportunities for comprehensive school physical activity that could not be developed without external funding. *

*WV Physical Activity Plan -

Priority Area 1: School-based Programs & Initiatives. Implement multi-year programs to provide resources and technical support for PK-12 schools seeking to establish comprehensive school physical activity programs. (ActiveWV Schools)

Warwood School 2010-2011Slide51

Schools on the Move51

Since 2005

Up to $5,000Pre-K to 12

Public or private

# of grants varies

5 to 11Increase physical activity opportunities before, during or after school for students, staff and familiesTunnelton-Denver Elementary (2011)Slide52

Project Examples52

Walking Tracks

Circuit Training & Hip Hope Dance ProgramMobile PE Boxes

Climbing Walls

Family Fun Nights

Cycling ClubsKids Run Wild ProgramSPARK TrainingSummer Shape Up ChallengeWilliamstown Elementary 2009Slide53

Congratulations! 2012-2013 Grants

Brandywine Elementary (Pendleton) - Walking Trail

Increase physical activity most students receive by twenty minutes on a new walking trail. Activities include after-school family walking program in addition to before and during school programs.

Fountain Primary School (Mineral) - On the Go

Increase physical activity levels of students and community members through programs using paved walking track. Promote use before during and after school and increase community access.

Marlowe Elementary (Berkeley) - Marlow is Walking around the World Increase student physical activity levels during the school day in addition to increasing levels for parents, staff and community weekly by creating walking clubs that will “walk around the world”. Point Harmony Elementary (Kanawha) - Point Harmony After-School Activity Program Increase physical activity levels and reduce screen time through after school clubs and integration of nature trail in school and community outdoor physical activity. Tucker County High School (Tucker) - Wheels for the Hills Create school based outdoor adventure club to foster a life-long enjoyment of outdoor recreation for students, staff and community through mountain biking. West Liberty Elementary (Ohio) - Heart of an Eagle Increase knowledge of moderate to vigorous physical activity using heart rate monitors through programming that includes best practices such as SPARK and Let’s Move! WV. Slide54

Reach

Total

39,281

Reported by Grant Contacts 2005 – 2011Slide55

Barbour

Berkeley

Boone

Braxton

Brooke

Cabell

Clay

Fayette

Gilmer

Grant

Greenbrier

Hampshire

Hancock

Hardy

Harrison

Jackson

Kanawha

Lewis

Lincoln

Logan

McDowell

Marion

Mason

Mercer

Mineral

Mingo

Monongalia

Monroe

Morgan

Nicholas

Ohio

Pendleton

Pocahontas

Preston

Putnam

Raleigh

Randolph

Ritchie

Roane

Taylor

Tucker

Tyler

Upshur

Wayne

Webster

Wetzel

Wirt

Wood

Wyoming

Marshall

Cal-

houn

Dodd-

ridge

Jefferson

Pleas-

ants

Sum-

mers

6 Grants

5 Grants

4 Grants

3 Grants

2 Grants

1 Grants

Grants

2005 to

2013

58 grants

in

30 counties

Funding for 2011-2013 Schools on the Move Program provided by WVU Children’s Hospital Foundation. Additional support from End Childhood Obesity Race (ECHO) and The CARDIAC Project.Slide56

56Reach Beyond Schools

2010-2011 Reported..

58% leveraged more funding

36% obtained up to $5,000

27% obtained >$10,000

100% received publicity91% reached desired target audience91% report SOM experience encouraged them to seek other funding or increased their grant writing capacityBridge Elementary 2011-2012Slide57

In their words…

“The sight of over 100 children staying after school and running happily on a trail that the school community built was the vision we hoped for…

…[Children] are learning the basics of health through the activity and parents see it in action.”

“…I have noticed that students that were not normally competitive in sports activities are very successful and enjoy using the climbing wall. “

“Through [this project] our school adopted an entire health and wellness initiative”

Story from ...parent : “They took a slow, trudging, injury prone, overweight work horse and turned her into a eager, peppy and healthy race horse who is forty pounds lighter. … that running club's last group was 180 kids out of an enrollment of 460 children, more than 1/3 of our school. Crazy amounts of kids are running here thanks …”Slide58

Funders and SupportersThanks!

WVU Children’s Hospital Foundation

Additional support provided by The CARDIAC Project and End Childhood Obesity (ECHO) Race, Wheeling

Initial program funding from The Benedum Foundation

WVOM Board Members provide their expertise

In-kind support from countless organizations who help spread the wordSlide59

New Funding for 2013-2014 Academic YearWVU Children’s Hospital Foundation Information on WVOM website by September 2012List of previously funded projects – available now

CARDIAC Area Coordinators role

www.wvonthemove.net 59

Announcing! Slide60

ApplicationFirst - Letter of Intent Form required

Then - Application:

Cover SheetCommittee ListNarrative

Need/Problem Statement

Expected Outcomes

Target AudienceIntervention DescriptionEvaluation.Outcomes TableBudget and Justification2 Letters of SupportSlide61

Thinking of Ideas? 61

Proposals should

support local initiatives that promote comprehensive approaches to youth physical activity:

(a) Quality physical education

(b) Alternative before, during or after school programs

(c) Parent/community outreach(d) Staff/faculty wellness(e) Active transportationTygarts Valley High SchoolSlide62

62Thanks for all you do to help …

West Virginia Schools Get on the Move!

www.wvonthemove.netSlide63

For Schools on the Move contact:

Shannon Holland:

sholland@wvonthemove.net

For CARDIAC contact:

Christa Ice:

cice@hsc.wvu.edu OR Valerie Minor vminor@hsc.wvu.edu