The Healthy Weight Learning Collaborative:
Using Quality Improvement to
Prevent and Treat Obesity in Communities
CAPT Sarah Linde-Feucht, MD
Chief Public Health Officer
Health Resources and Services Administration
U.S. Department of Health and Human Services
USPHS Scientific and Training Symposium
College Park, MD
June 20, 2012
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Objectives
1. Describe the impact of overweight
and obesity on community health
2. Demonstrate the use of Quality
Improvement to prevent and treat
obesity communities
3. Identify sustainable ways to
achieve healthy weight in
communities
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HRSA Mission
To improve health and achieve health equity
through access to quality services, a skilled
health workforce and innovative programs.
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Access and Workforce
• Nearly 19 million patients are served through more than
8000 HRSA-funded health centers, including 1 in 3 people
with incomes below the poverty level.
• Over 500,000 people living with HIV/AIDS receive services
through more than 900 HRSA-funded Ryan White Clinics.
Two-thirds are members of minority groups.
• 34 million women, infants, children, and adolescents
benefit from HRSA’s maternal and child health programs.
• Currently more than 10,000 National Health Service Corps
clinicians are working in underserved areas in exchange for
loan repayment or scholarships.
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Access and Workforce
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Workforce training programs
Rural health care
Federal organ procurement system
Poison Control Centers
340B low-cost drug program
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Adult Obesity
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Childhood Obesity
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Impact
• Health
• Economics
• Policy
• Safety and security
• Human Cost
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Impact
• One in three children born in 2000 will develop diabetes in his or
her life, and among African-American and Latino children, that
number is one-in-two.
• The annual medical costs of an obese person are $1,400 more than
someone who’s not obese.
• Obesity costs $147 billion per year in medical costs and obesity in
the workforce costs more than $73 billion each year in lost
productivity.
• As a public policy problem, an overweight employee may face
higher health insurance premiums, and the taxpayer may face
higher Medicare and Medicaid costs.
• Our nation’s safety and security is threatened as fewer individuals
meet standards to serve as firefighters, police, and in the military.
• Weight discrimination has increased by 66% over the past decade.
Unlike Gender, ethnicity, religion, age, and disability, there are no
legal protections against discrimination based on weight.
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Collaborate for Healthy Weight
March 2010
October 2010-March 2013
Congress authorizes the
Affordable Care Act
NICHQ launches Collaborate
for Healthy Weight
July 2010
HRSA designs vision of Prevention
Center for Healthy Weight
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The Healthy Weight Collaborative
• National quality improvement
initiative
• Breakthrough Series Approach
• Multi-sector teams
• Evidence-based interventions
• Specifically related to prevention
and treatment of obesity in children
and families
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The Model for Improvement
What are we trying to
accomplish?
Aims
How will we know that a change is an
improvement?
Measures
Changes
What change can we make that will result in
improvement?
Act
Plan
Study
Do
Testing Cycle
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The Process of Improvement
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Healthy Weight Collaborative
Project Aims
• Establish sustainable community-based partnerships
consisting of primary care, public health and
community sector participants
• Implement and test selected evidence-based and
promising interventions to achieve healthy weight and
health equity
Phased Approach
• Phase One:
Ten teams, June 2011 - July 2012
• Phase Two:
40+ teams, Dec 2011 - January 2013
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Selected Focus Areas
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Tribal Communities
Faith-Based Communities
Women’s Health
Intergenerational Health
Community Health Workers
Federally Qualified Health Centers
Medically Underserved Areas
Rural
mHealth
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Collaborate for Healthy Weight
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Objectives, Strategies, and Activities
OBJECTIVE 1: The HWC Team will establish or
strengthen multi-sector community-based partnerships
so that the Team is both effective and sustainable
STRATEGY 1: Commit to the Healthy Weight
Collaborative Aim through the development of a
community action plan to improve healthy weight of the
target population, and establish the necessary
infrastructure to effectively implement the plan
ACTIVITY A: Create an action plan to improve healthy weight of
the target population
ACTIVITY B: Develop and strengthen the Team's capacity to
effectively implement the plan
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OBJECTIVE 2: Teams will provide appropriate,
planned and coordinated services tailored to the
individual and family across lifespan for the target
population
STRATEGY 2: Develop a consistent message to
promote healthy weight in the target
population and disseminate the message where the
target population lives, learns, works and plays
ACTIVITY A: Adopt a message that reflects the priorities of the
community around healthy weight promotion
ACTIVITY B: Develop and implement a communication plan to
reach the target population
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OBJECTIVE 2: Teams will provide appropriate,
planned and coordinated services tailored to the
individual and family across lifespan for the target
population
STRATEGY 3: Assess current weight status
throughout the target population using standardized,
evidence-based health assessment protocols
ACTIVITY A: Adopt a healthy weight assessment template;
adapt it to incorporate community priorities and messaging
ACTIVITY B: Develop and implement a plan to complete
healthy weight assessments in the target population
ACTIVITY C: Redesign clinical care delivery to reliably assess
patients for weight status including health behaviors
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OBJECTIVE 2: …coordinated services to individual and
family across lifespan…
STRATEGY 4: Use a standardized template for a healthy
weight plan that can be personalized to address the
needs of individuals within the target population
ACTIVITY A: Adopt a healthy weight plan that incorporates the
cultural, linguistic and literacy needs of the target population and
allows for pertinent individualized goals
ACTIVITY B: Create and implement a dissemination plan
ACTIVITY C: Redesign clinical care delivery to reliably offer plans
that support healthy weight, regardless of current weight status
ACTIVITY D: Provide education and activities to support
individuals and families to follow their healthy weight plans
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OBJECTIVE 2: …coordinated services to individual and
family across lifespan…
STRATEGY 5: Build capacity to meet the needs of the
target population utilizing an integrated approach that
provides ongoing assessment, prevention activities,
treatment and appropriate follow-up of healthy weight
ACTIVITY A: Assess gaps in capacity to promote healthy weight
assessment, healthy weight plans and prevention activities for the
target population
ACTIVITY B: Integrate efforts across sectors to meet the demand
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OBJECTIVE 3: Teams will create community
environments that enable healthy eating and active
living in the target population
STRATEGY 6: Implement strategies for improving the
environment to support promotion of healthy weight in
the target population
ACTIVITY A: Develop and implement one organizational policy to
improve physical activity
ACTIVITY B: Develop and implement one organizational policy to
increase healthy eating
ACTIVITY C: Develop an action plan for one public health policy
that would improve physical activity or healthy eating
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Virginia
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Michigan
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Collaborative Support Model
Content
• Healthy Weight
Interventions
• Implementation
Guide
• Change Package
• Collaborative Support
Model
• Tools/ Methods
• Measurement
Strategy
• Healthy Weight
Resources
Support
Learning Environment
• ILab
• Improvement Advisors
• www.CollaborateforHeal
thyWeight.org
• Technology Platform
• On Demand Learning
Library
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(IAs)
Expert Faculty
HRSA Regional Offices/
Staff
Partners
NICHQ staff enabled by
technology
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Collective Impact and Sustainable Change
1.Common Agenda
2.Shared Measurement Systems
3. Mutually Reinforcing Activities
4.Continuous Communication
5.Backbone Support
Organizations
Stanford Social Innovation Review, Winter 2011
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Objectives
1. Describe the impact of overweight
and obesity on community health
2. Demonstrate the use of Quality
Improvement to prevent and treat
obesity communities
3. Identify sustainable ways to
achieve healthy weight in
communities
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Thank you!
www.CollaborateForHealthyWeight.org
CAPT Sarah Linde-Feucht, MD
Chief Public Health Officer
301-443-2216
[email protected]
http://www.hrsa.gov
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