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Disparities in Obesity & Disability (Part 2): Developing Research Partnerships & Collaborations. March 4, 2010 - 2:00 PM CST A Webcast/Teleconference Sponsored by the National Center for the Dissemination of Disability Research (NCDDR).

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Disparities in Obesity & Disability (Part 2):Developing Research Partnerships & Collaborations

March 4, 2010 - 2:00 PM CST

A Webcast/Teleconference Sponsored by the

National Center for the Dissemination of Disability Research (NCDDR)

Funded by NIDRR, US Department of Education, PR# H133A060028

© 2010 by SEDL


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Introductions

Overview/review of Part 1 – James Rimmer

STOP Obesity Alliance – Christine Ferguson

Office of Minority Health – Rochelle Rollins

Panelist discussion – Margaret Campbell

Q & A

Agenda

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James Rimmer, PhD

Professor, Department of Disability and Human Development, University of Illinois at Chicago

Professor, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Rehabilitation Institute of Chicago

Director, National Center on Physical Activity and Disability

Director, Rehabilitation Engineering Research Center on Exercise Physiology and Recreational Technologies for Persons with Disabilities

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Disparities in Obesity and Disability - Part 2:

Developing Research Partnerships

and Collaborations

James Rimmera, Ph.D, Kiyoshi Yamakia, Ph.D, Brienne Davisa, MPH, Edward Wangb, Ph.D., and Lawrence Vogelc, MD

aUniversity of Illinois at Chicago,

Department of Disability and Human Development

bUniversity of Illinois at Chicago, College of Nursing

cShriners Hospitals for Children, Chicago

March 4, 2010


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AA, African-American; Disability refers to having a mobility limitation.

Unpublished CDC Report

Source: National Health Interview Survey. (1997-2004).

Prevalence of Obesity and Physical Inactivity by Disability and Race (18-64 yrs)


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Reference group: white with no disability. AA, African-American; Disability refers to mobility limitation.

Unpublished CDC report

Data Source: National Health Interview Survey. (1997-2004).

Risk of Obesity and Physical Inactivity by Disability and Race (18-64 yrs)


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Extent of Disability Among Children: National Estimates African-American; Disability refers to mobility limitation.


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Prevalence of Disability Among Children by Race/Ethnicity African-American; Disability refers to mobility limitation.

Source: U.S. Department of Education, Office of Special Education and Rehabilitative Services, & Office of Special Education Programs. (2009). 28th Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2006. Washington, D.C


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Prevalence of Obesity (BMI African-American; Disability refers to mobility limitation. >=95th %) among Adolescents by Mobility Limitation and Sex

Source: NHANES (National Health and Nutrition Examination Survey) data reported by Bandini et al. 2005


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10 African-American; Disability refers to mobility limitation.


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Impact of Obesity on Persons with Disabilities African-American; Disability refers to mobility limitation.

  • Consequences of obesity may cause greater harm to people with disabilities due to:

    • lower threshold of health associated with various secondary and associated conditions accommodating certain disabling conditions.

    • difficulty in accessing health promotion programs in their home or community leading to continuing weight gain.

  • It is imperative that we increase awareness about the obesity-related health disparities that exist between adolescents with disabilities compared to their non-disabled peers.


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Potential Barriers to Participation in Health Promotion Activities for Youth with Disabilities

  • Youth with disabilities are often denied the opportunity to participate in the same physical and recreational opportunities as their non-disabled peers.

  • Certain accommodations are necessary to enable youth with disabilities to participate in physical activity and nutritional programs.

  • Many school-based obesity interventions do not address specific physical and nutritional concerns associated with particular disabilities.


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Evidence-Based Physical Activity Activities for Youth with DisabilitiesIntervention Programs for Children


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Currently funded projects on childhood obesity in youth with and without disability – NIH RePORTER

# of funded projects


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“Let’s Move” and without disability – NIH RePORTERwww.letsmove.gov

  • February 9, 2010 President Obama signed a memorandum on childhood obesity, an initiative launched by the First Lady called “Let’s Move.”

  • Within 90 days, the Task Force on Childhood Obesity

  • will develop and submit a comprehensive interagency

  • plan that details a coordinated strategy, identifies key

  • benchmarks, and outlines an action plan. 

  • Collaboration is crucial to accomplish our goals of:

    • increased awareness of the need and support for research on obesity in youth with disabilities,

    • the inclusion of youth with disabilities in all obesity prevention environmental and policy changes and interventions, including appropriate modifications where necessary, and

    • dissemination and promotion of recommendations and findings to the broader public.


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Christine Ferguson, JD Research Project (DRRP) on Reducing Obesity and Obesity-Related Secondary Conditions in Adolescents with Disabilities, visit:

Director, STOP Obesity Alliance

Research Professor, George Washington University, School of Public Health and Health Services

Former Commissioner of the Massachusetts Department of Public Health

Former Director of Rhode Island Department of Human Services

Former counsel and deputy chief of staff to the late U.S. Senator John H. Chafee (R-RI)

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17th U.S. Surgeon General Research Project (DRRP) on Reducing Obesity and Obesity-Related Secondary Conditions in Adolescents with Disabilities, visit:

Richard H. Carmona,

Health & Wellness

Chairperson

Christine Ferguson, JD

Director

The STOP Obesity Alliance: A Unique Coalition Aligned for Change

LEADERSHIP

Steering Committee Members

MEMBERSHIP

Leading consumer, medical, government, labor, business, health insurer and quality-of-care orgs

Associate and Individual Members

Rebecca Puhl, Ph.D. Yale’s Rudd Center

Sponsored by


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Aligning Stakeholders That Matter: Research Project (DRRP) on Reducing Obesity and Obesity-Related Secondary Conditions in Adolescents with Disabilities, visit:Steering Committee Members

Insurers

Providers

Quality

Patients/Consumers

Business &Labor

Government


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Redefining Success Research Project (DRRP) on Reducing Obesity and Obesity-Related Secondary Conditions in Adolescents with Disabilities, visit:

The Alliance recommends promoting the use of a sustained loss of five to 10 percent of current weight as a key measure to judge the effectiveness of weight-reduction interventions.

Broadening the Research Agenda

Addressing and Reducing Stigma as Barrier to Treatment

The Alliance recommends a broadened research agenda that examines all of the important factors contributing to the obesity epidemic and how they interact with each other, as well as applied research to address the immediate needs of payers, providers, individuals and others on the front lines.

The Alliance recommends that healthcare professionals, government and private entities address the issue in a way that promotes open discussion rather than isolating those who are affected.

Alliance Core Principles: Overcoming Public and Private Sector, Medical Barriers

Encouraging Innovation and Best Practices

The Alliance recommends innovative approaches for obesity treatment, intervention and disease management for patients who have been unsuccessful with traditional nutrition and exercise only programs.


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Addressing Obesity Within Health Reform: Alliance Policy Recommendations

  • Standardized and effective clinical interventions, flowing from evidence-based guidelines, such as those approved by the National Heart, Lung and Blood Institute (NHLBI), that include acknowledging the health benefits of five to ten percent sustained weight loss to aid and support those individuals who are currently overweight or obese achieve improved health.

  • Enhanced use of clinical preventive services to monitor health status and help prevent weight gain, especially for individuals who are already overweight and are at risk of becoming obese.

  • Effective, evidence-based community programs and policies that encourage and support healthy lifestyles, focus on health literacy, address health disparities, and represent a significant investment in population-based prevention of obesity.

  • Coordinated research efforts to build the evidence for all three of the above elements, continuously improving quality of care, bolstering our understanding of what does and does not work in various settings, and helping to translate the scientific research into practice recommendations for real-world clinical settings and communities.


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Obesity GPS: Public and Private Sector Decision Making Tool Recommendations

Obesity GPS – A Guide for Policy and Program Solutions

  • First navigation tool to guide development of policies and programs geared to reducing the overweight and obesity epidemic

  • Includes questions for key areas including:

    • Legislative and private sector initiatives: Defining Success

    • Legislative and private sector initiatives: Encouraging innovation and multifactorial interventions

    • Initiatives aimed at clinicians: Creating positive attitudes and approaches

    • Research initiatives: Focusing and coordinate research efforts

  • Online version is available at www.stopobesityalliance.org


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29 Recommendations


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www.stopobesityalliance.org Recommendations

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Rochelle Rollins, PhD, MPH Recommendations

Director, Division of Policy and Data, Office of Minority Health (OMH), U.S. Department of Health and Human Services (DHHS)

Oversees OMH efforts to improve health disparities research coordination, evaluation and performance measurement, and data collection and reporting

Directs efforts to ensure minority communities benefit from and have access to health information technology and clinical trials

Participates on Healthy People 2010 and 2020

Alternate Chair, National Partnership for Action (NPA) to End Health Disparities Federal Team.

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National Center for the Dissemination of Disability Research

Disparities in Obesity and Disability: Developing Research Partnerships and Collaborations

March 4, 2010

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HHS Office of Minority Health interest in obesity and disability research

The National Partnership for Action to End Health Disparities (NPA)

HHS Center of Excellence in Research on Disability Services and Care Coordination and Integration – (upcoming effort)

Discussion Points

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Improve the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities

Office of Minority HealthMission

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Advises the HHS Secretary and the Office of Public Health and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

HHS/Office of Minority Health

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Where are we Today? and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

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Imperatives and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

  • Significant racial/ethnic health disparities

  • Minorities are 34% of U.S. population today and 40% of population by 2030

  • Minorities will be 41.5% of workforce

  • Impact on American healthcare problem

  • Limited resources

  • Healthy People goal to eliminate disparities

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Approach Prior to and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.National Partnership for Action to End Health Disparities (NPA)

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NPA Mission and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

Increase the effectiveness of programs that target the elimination of health disparities through the coordination of partners, leaders, and stakeholders committed to action

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NPA Purpose & Components and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

  • Purpose: Establish a nationwide, comprehensive, community-driven, sustained approach to ending health disparities

  • Components: National Action Plan, Regional Blueprints, Initiatives and campaigns

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NPA Objectives and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.

  • Increase awareness of the significance of health disparities

  • Strengthen and broaden leadership

  • Improve health/health system experience

  • Improve cultural & linguistic competency

  • Improve coordination and use of research and evaluation outcomes

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46 and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.


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47 and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.


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48 and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.


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49 and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.


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50 and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.


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Federal Collaboration and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.Connecting the Pieces

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Foster communications and activities of the NPA within federal agencies and their partners

Increase the efficiencies and effectiveness of policies and programs at the national, state, tribal, and local levels that work toward ending health disparities

Federal Interagency Management Team(10 Federal Departments are Represented)

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UNITE around a national message federal agencies and their partners

COLLABORATE around common goals

LEVERAGE assets and experiences of partners

IDENTIFY opportunities for collaborations, partnerships, and communications

CREATE opportunities to transition evidence-based findings to practice / policy

Federal TeamSelect Goals

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Collects input from stakeholders to inform planning; federal agencies and their partners

Identifies emerging research areas;

Assesses research and knowledge gaps across the federal research agenda;

Seeks to identify unnecessary duplication of research effort;

Makes recommendations to strengthen federal policy coordination;

Provides recommendations for a cohesive, strategic program of federal disability research and related activities; and

Recommends research activities to be funded

Interagency Committee on Disability Research (ICDR)

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Health Disparities Listening Session: 3/5/10 federal agencies and their partners

Health Disparities Expert Panel: 4/13 - 4/14/10

Purpose:

To provide the opportunity for individuals with disabilities and other stakeholders to review and submit input regarding the National Plan for Action to eliminate health disparities.

Inform the NPA strategic goals and implementation of the plan.

Upcoming ICDR Activities

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56 federal agencies and their partners


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57 federal agencies and their partners


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Finalize National Plan for Action federal agencies and their partners

Regional review of Regional Blueprints

Formal launch of the National Plan for Action

National and regional implementation meetings

Next Steps

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Together we can. federal agencies and their partners

Together we will.

http://www.minorityhealth.hhs.gov/npa/templates/browse.aspx?lvl=1&lvlID=31

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Center of Excellence in Research on Disability Services and Care Coordination and Integration

Build the infrastructure necessary to carry out research on the effectiveness and comparative effectiveness of services provided to people with disabilities.

An important building block to improve data on the health and health care for people with disabilities, including a better Medicaid data system.

UPCOMING EFFORT - HHS Office on DisabilityComparative Effectiveness Research Initiative

  • Scientific Lead:

    • Rosaly Correa, MD, MSc, PhD

    • Deputy Director, HHS Office on Disability Rosaly.correa@hhs.gov

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Contact Information Care Coordination and Integration

Rochelle Rollins, PhD, MPH

Director, Division of Policy and Data

HHS/Office of Minority Health

(240) 453-6177

rochelle.rollins@hhs.gov

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Senior Scientist for Planning and Policy Support, National Institute on Disability and Rehabilitation Research (NIDRR), Office of Special Education and Rehabilitative Services (OSERS), U.S. Department of Education (ED).

Serves as a representative from ED to the Federal Interagency Workgroup (FIW) for National Health Objectives related to Healthy People 2020.

Former Research Director for the NIDRR-funded RRTC on Aging with Disability at Rancho Los Amigos National Rehabilitation Center, Downey, CA

Margaret Campbell, PhD

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Questions? Institute on Disability and Rehabilitation Research (NIDRR), Office of Special Education and Rehabilitative Services (OSERS), U.S. Department of Education (ED).

  • By email: webcast@ncddr.org

  • Voice/TTY: 800-266-1832

Thank you for Participating

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http://survey.sedl.org/efm/wsb.dll/s/1g7e

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