Disease Management Update
Volume V, No. 42
March 5, 2009

Dear Healthcare Intelligence Network Client,

For the first time in recent history, children may have shorter lifespans than their parents. The reason: Childhood obesity.With more than 30 percent of U.S. children overweight or obese, many organizations are taking steps to battle the nation’s childhood obesity epidemic. A joint effort from the American Heart Association and the William J. Clinton Foundation — known collectively as the Alliance for a Healthier Generation — recently launched an initiative that will give children better access to the healthcare they need to fight childhood obesity. And in this week's Disease Management Update, find out how the state of New Jersey is doing their part in the fight against obesity, as well as the obstacles that obese adolescents face.

Your colleague in the business of healthcare,
Laura Greene
Editor, Disease Management Update

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Table of Contents

  1. NJ to Launch Statewide Effort to Prevent Childhood Obesity
  2. Disease Management Q&A: Launching a Childhood Obesity Program
  3. HealthSounds: PQRI Participation — Improvement Over Payments
  4. Teenage Obesity Just as Risky as Being a Smoker
  5. Survey of the Month: Medical Homes in 2009
  6. Treating Emergency Room Overcrowding

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1. NJ to Launch Statewide Effort to Prevent Childhood Obesity

A unique coalition of healthcare providers and other stakeholders plan to convene an important groundbreaking summit to provide professionals and other caregivers of children with practical hands-on guidance to help prevent childhood obesity in a child’s early years. The all-day “New Jersey Conference on the Prevention of Childhood Obesity” will be held on March 31, 2009. Professionals attending the conference will receive continuing education credit.

“Childhood obesity has reached epidemic levels not only in New Jersey but around the country. Experts reportthat the current generation of children may be the first in our nation’s history to live sicker and shorter livesthan their parents,” said New Jersey Department of Health and Senior Services Commissioner HeatherHoward. “We must address childhood obesity aggressively now to stem the growing number of overweightyoung people and improve quality of life for future generations.”

The conference is designed to be a unique educational symposium to equip those who care for children with practical “nuts and bolts” applications to prevent childhood obesity, particularly by engaging children and parents early in a child’s life. The conference is aimed at school administrators and nurses, physical education teachers, dietitians, physicians and patient safety administrators. It will review obesity rates among the youngest children in America; examine feeding patterns which have contributed to increased incidence; examine activity levels that promote health; teach participants how to use and interpret BMI for children 2 years of age and older; and introduce age appropriate anticipatory guidance and messages, in an effort to establish sound nutrition and activity advice.

To learn more about this research, please visit:

2. Disease Management Q&A: Launching a Childhood Obesity Program

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Peggy Crum, R.D., a nutritionist with the Health4U program at Michigan State University (MSU), which employs the eating competence model as part of its client-centered approach to nutrition education and guidance.

Question: Is it possible to be "eating incompetent" and not be overweight?

Response: (Peggy Crum) [Eating competence] is not an effort to lose weight; it's an effort to eat in a trusting way, in a way that knows you will always be fed. That allows you to quit eating chaotically. The agenda with the eating competence model is to nurture [clients] along in a way that they can begin to trust themselves again and rediscover what we know they have — the ability to eat competently. Now they know they need to take the time to be quiet and pay attention and realize that their body will tell them what it needs — eating and movement, for example.

It is a lot of work to pull that out, but if they do that work, they begin to discover hunger, appetite and the end point of eating — satiety. It becomes clear to them that they can trust themselves. It does wonders for their self esteem — how they view their body and their activity level. We no longer have to tell them to be more active. They just want to be, because they view themselves in a whole new way. We only talk about finding [a physical activity] that they will enjoy doing.

If you put the pressure of weight on people, then they can't become eating competent. It's two opposite ends of the spectrum because they become too focused on external regulation. You have to say, "Let's put weight aside, at least for a while, and take that pressure off so you can get out of that mode of diet thinking and restrictive thinking."

For more on MSU's approach to weight management as well as the latest metrics and approaches for obesity and weight management from 300 organizations, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

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3. HealthSounds Podcast: PQRI Participation — Improvement Over Payments

According to Dr. Bruce Bagley, the cornerstone of PQRI is quality improvement, and any bonus payments physicians receive for reporting efforts are just that — by-products of the process. Dr. Bagley, cal director of quality improvement for the American Academy of Family Physicians, also shares his views on the value of patient registries and other healthcare IT for PQRI, and advises physicians who may be frustrated by their PQRI experiences.

To listen to this complimentary HIN podcast, please visit: http://www.hin.com/podcasts/podcast.htm#80

4. Teenage Obesity Just as Risky as Being a Smoker

Obese adolescents have the same risk of premature death in adulthood as people who smoke more than 10 cigarettes a day, according to a new study from Karolinska Institutet in Stockholm, Sweden. What most interests the researchers is that the combination of overweight and smoking did not act synergistically as mortality risk factors.

"This means that being overweight or obese at the age of 18 increases the risk of premature death, regardless of smoking status," says Dr. Martin Neovius, at the Department of Medicine, Solna, who lead the study.

The study showed that obesity in teenagers carried the same risk as being a heavy smoker; a doubled risk for premature death was seen both in obese non-smokers and normal weight heavy smokers. Being an obese heavy smoker resulted in a five-fold risk increase.

To learn more about this research, please visit:

5. Survey of the Month: Medical Homes in 2009

In less than five years, the patient-centered medical home (PCMH) model has quickly grown from a pediatrics-based concept to a care approach embraced by thousands of healthcare organizations hoping to improve care and costs for the chronically ill. Complete HIN's third annual survey on the PCMH's role in your organization and get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Treating Emergency Room Overcrowding

An ED’s overcrowding can create a myriad of problems — from an increase in wait times to a decline in the quality of care being given to patients in need. In a recent e-survey from HIN, 73 healthcare professionals told us how they are responding to ED overcrowding and its effect on their organizations.

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Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

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