Task Force on Obesity Progress Report

1. Task Force on ObesityProgress Report Nancy F. Krebs, MD Co-Chair Task Force on Obesity Presented at the AAP-NCE, Oct 2005

2. [2003] [2004]

3. Background • 2002 - # 1 prioritized resolution at Chapter Forum: “Comprehensive approach to obesity in children & adolescents” • 2003 - “Prevention of Pediatric Overweight & Obesity” Policy Statement • 2003 – AAP Strategic Plan: formation of Task Force on Obesity (TFOO) • 2005 - Numerous activities at Section / Committee & Chapter levels

4. Co-Chairs NF Krebs (CON) RL Washington (COSMF) Gastroenterology W Cochran General Pediatrics S Hassink J Calabrese Adolescent medicine M Jacobson Media expertise D Shifrin Liaisons: W Dietz (CDC) V Hubbard (NIH) AAP Task Force on Obesity (est 2003)

5. Consultants Endocrinology F Kaufman Primary Care R Holmberg Pediatric Surgery T Inge Behavior change K Resnicow Schools/community H Taras Reimbursement M Schulman Special Advisor R Schwartz AAP Task Force on Obesity (est 2003) AAP Staff: Pamela Kanda, MPH Jeanne Lindros, MPH Cindy Pellegrini

6. AAP Task Force on Obesity (est 2003) • Charge: direct the AAP’s policies on overweight and obesity • Strategic priorities: • Prevention • Treatment • Advocacy • Reimbursement

7. Selected TFOO Objectives… Obj # 1: Child health professionals will… • Make obesity prevention a part of every routine child health supervision visit; • Be able to identify&treat children and their families who are overweight, including the related co-morbidities

8. Obj #1: Routine prevention, identification & treatment in the office • Develop “Coding Fact Sheet” & “Strategy for Claim/Coverage Denials” • Website posting – June ‘05 • AAP News – August ’05 • Develop document to identify best assessment, prevention & treatment approaches • Collaborating with AMA, CDC, ADA, NIH, MCHB, et al, to develop consensus statement for revised guidelines – product mid-’06

9. Obj #1: Routine prevention,identification & treatment in the office • Develop plan to hold motivational interviewing & behavior change workshops at NCE & CME courses • Sessions at NCE – 2004, 2005, (2006) • Workshops at SuperCME • PediaLink obesity module • Under construction – Dec 05 available • Develop resource kit (aka “tool kit”) • Under construction – early 2006

10. Selected TFOO Objectives… • Obj # 2: Pediatricians will actively promote policies, programs, & interventions that support healthy active living by collaborating with… • Other health care professionals • Public health sector • Schools • Community-based organizations • Employers

11. Obj #2: To promote policies & interventions by collaborations • AAP representation/input • Agency for Health Research & Quality (Jan 2004) • Federal Trade Commission (July 2005) • AMA disparities workshop (Nov 2003) • American Heart Association (2003 + current) • Shaping America’s Youth • Obesity Summit (June 2004) • Post list of slide presentations on AAP obesity web site (www.aap.org/obesity)

12. Obj #2: To promote policies & interventions by collaborations • Facilitating local/chapter obesity initiatives • CATCH grantees • Health Tomorrow grantees • Healthy People 2010 grantees • CDC Grant: “Prevention of Obesity in School Health” • Hold educational seminars & provide technical support to AAP chapters re advocacy in schools • Develop a guide for community advocacy & collaboration (post online by Dec ’05)

13. Selected TFOO Objectives… • Obj #3: Pediatricians will be recognized by insurers, employers & legislators as critical providers of health services on overweight/obesity prevention & treatment to all children • Access to care/medical home • AAP reimbursement committee • Education on coding • Legislation/policy development

14. Obj # 3: Recognition of pediatricians as critical providers of services for obesity • [Develop “Coding Fact Sheet” & “Strategy for Claim/Coverage Denials”] • Develop resource materials for chapters to educate payers on evaluation & treatment of obesity by pediatricians; • “Backgrounder” for health insurance carriers • Participate in payer conferences and work groups: ongoing • Meet w/ national carriers to advocate for recognition of & reimbursement for obesity Dx code & reimbursement for preventive & treatment services: ongoing

15. Selected TFOO Objectives… • Obj #4: AAP will collaborate with medical schools, residency & fellowship programs to integrate childhood obesity prevention & treatment into respective curricula.

16. Obj #4: Advocate for training on pediatric obesity prevention & treatment • Identify key leaders & initiate discussions • American Board of Pediatrics • Pediatric Program Directors • Section on Residents • Identify & evaluate existing online curricula • Reviewed UNC/Nutrition in Medicine CD ROM (for medical students) • Position for federally supported training initiatives

17. Additional TFOO Activities • Media & public information • Facilitating local/chapter obesity initiatives • Partnerships w/ private sector • AAP Publications • Update of AAP Policy Statement • Review of relevant clinical reports, pamphlets • Consumer book for parents (draft in review)

18. Summary • Childhood overweight & obesity is a “mega issue” for children’s health & thus for AAP • Priority in current AAP Strategic Plan & for AAP leadership at all levels: • National: Committees/Sections • Local: Districts & Chapters • Individual practicing pediatricians • Pediatric healthcare arena is an essential sphere of influence that must be involved in reversing the current trends