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Diabetes and Obesity Prevention by Promoting Healthy Behaviors

Team Leader: Henrietta Terry, MS Public Health Advisor

Type 2 diabetes is associated with older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes. Many people with type 2 diabetes can control their blood glucose by following a careful diet, exercise program, losing excess weight, and taking oral medication. Research studies in the United States and abroad have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high risk adults. Lifestyle interventions included diet and moderate intensity physical activity. For both sexes and all age and racial and ethnic groups, the development of diabetes was reduced 40% to 60% during these studies that lasted 3 to 6 years.

During the past 20 years, obesity among adults has risen significantly in the United States. The latest data from the National Center for Health Statistics shows that 30 percent of U.S. adults 20 years of age and older - over 60 million people - are obese. This increase is not limited to adults. The percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight. These increasing rates raise concern because of their implications for Americans' health. Being overweight or obese increases the risk of many diseases and health conditions, including the following: hypertension, dyslipidemia (for example, high total cholesterol or high levels of triglycerides), type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, some cancers, (endometrial, breast, and colon). Much of the chronic disease burden is preventable. Physical inactivity and unhealthy eating contribute to obesity and a number of chronic diseases, including cancer, cardiovascular disease, and diabetes.

2007 Program Objectives

To advance the President's HealthierUS goal of helping Americans live longer, better, and healthier lives and the Departments agenda of identifying and promoting programs that foster healthy behaviors and prevention, OWH will continue to develop and design innovative tools to assist the public in successfully addressing such chronic illnesses as diabetes, obesity, heart disease, and stroke due to poor nutrition and physical inactivity.

The 2006 Program Objectives

  1. Provide funds to a variety of organizations to aid in the development or sustainment of effective obesity-related programs in order to affect lifestyle changes that will control, prevent or delay the development of type II diabetes.
  2. The interventions implemented must be substantive in nature and incorporate nutrition, physical activity and health/wellness components.

Six grants awarded to Antietam Health Care Foundation/Washington County Hospital, Hagerstown, MD; Cambridge Health Alliance, Cambridge, MA; CHOICES, Kennesaw, GA; Community Health Center, Inc., Meriden, CT; National Kidney Foundation, Ann Arbor, MI; Spectrum Health Hospitals, Grand Rapids, MI.

Girl and Adolescent Health

Adolescence represents a dynamic, developmental period when young women make important choices about life-style behaviors, including diets, physical activity, sexual activity, and use of tobacco, alcohol, and other drugs that can influence their health and well-being throughout adulthood. The Office on Women's Health focuses on the overall health of all women throughout their lifespan. Below are some of the major programs and activities the Office on Women's Health is involved in.

Adolescent Girls Web Site

Team Leader: Ann Abercrombie, M.L.S.

In keeping with the mission statement of OWH of improving the health of women across their life span from childhood through adolescence and into adulthood, OWH has developed an adolescent girl health section that is part of the NWHIC site. This site (, which will continue to expand to new topics, focuses on friends and family relationships, trust, sexuality, violence and abuse, peer pressure, and self-esteem. The site is a resource that responds to adolescent girls' health concerns. The purpose of the site is to motivate girls to choose healthy behaviors without the tediousness "you should do this" message. A specialty section on Disabilities and Chronic Illness will be featured on the website. The Office on Women's Health partnered with FDA to develop a Girl Power! Component to the current "Take Time to Care" project, a project aimed at older women to raise awareness of using medications wisely and properly. The Disability and Chronic Illness Section of Girl Power targets girls ages 9–14 and focuses on how to handle hospital visits, how to talk to your doctor, and how to tell your friends about your illness or disability along with other vital information for this population.

BodyWise Eating Disorder Educational Campaign

Team Leader: Ann Abercrombie, M.L.S.

Eating Disorders are disabling illnesses that affect between 1-3 percent of young women in the United States. Congress, in the report language of Health and Human Services (HHS ) Appropriations for Fiscal Year (FY) 1998, directed the Office on Women's Health (OWH) to "develop a national media campaign targeting, but not limited to adolescent girls and women, to educate the public about healthy eating behavior". OWH is sponsoring the "BodyWise Eating Disorders Educational Campaign" targeting middle school educators and providers. The goal of the program is to increase awareness and knowledge of eating disorders, including their signs and symptoms, steps to take when concerned about students, and ways to promote healthy eating and reduce preoccupation with weight and size. An information packet is available that includes materials emphasizing the links among healthy eating, positive body image, and favorable learning outcomes, with some materials targeted to specific racial and ethnic groups. More information on BodyWise packets can be obtained by clicking here.

BodyWorks: A Toolkit for Healthy Girls and Strong Women

Team Leader: Ann Abercrombie, M.L.S.

BodyWorks is a program designed to help parents and caregivers of young adolescent girls (ages 9 to 13) improve family eating and activity habits. Using the BodyWorks Toolkit, the program focuses on parents as role models and provides them with hands-on tools to make small, specific behavior changes to prevent obesity and help maintain a healthy weight.

The BodyWorks program uses a train-the-trainer model to distribute the Toolkit through community-based organizations, state health agencies, non-profit organizations, health clinics, hospitals and health care systems. The program includes one six-hour training module for trainers and ten 90-minute weekly sessions for parents and caregivers. The Office on Women's Health, developed BodyWorks following two years of formative research.

Get Real! Video Kit

Today, behavioral and lifestyle factors constitute over 50% of the causation of all 10 of the leading causes of death in American women. As many as one million premature deaths in the U.S. could be prevented through changes in behavior. In an effort to address this issue, the Get Real project was designed with the following goals in mind:

  • To educate college aged women about important health issues;To provide a forum where young women can openly discuss their health concerns;To emphasize the importance of the behavioral components of health promotion and disease prevention; and
  • To empower young women to make decisions and take responsibility for their own health and well-being.

The Get Real project consists of a 27-minute video, facilitator's guide, fact sheets and promotional posters. The video portrays the typical activities, attitudes, and reactions of young people on college campuses today, and is meant to serve as an introduction to women's health issues and to stimulate further discussion. This video kit has been distributed across the country to college health centers. Health educators may wish to view and use this important tool to promote the health of college-age women.To request free copies of the Get Real: Straight Talk about Women's Health video, please call the National Women's Health Information Center, 1-800-994-9662.

National Bone Health Campaign

Team Leader: Calvin Teel, M.S.

The National Bone Health Campaign (NBHC) is a multiyear national campaign to promote optimal bone health, and thus reduce their risk of osteoporosis later in life. The goal is to educate and encourage girls to establish lifelong healthy habits, especially increased calcium consumption and physical activity to build and maintain strong bones. In addition to a focus on young women, the campaign will target adults who influence them, including parents, teachers, coaches, youth group leaders, and health care professionals.

To help extend the reach and impact of its messages, the NBHC is creating a national partnership network of Federal, state, and local government allies, and nonprofit organizations. The goal of this network is to facilitate resource and information sharing among a broad range of partner organizations across the country. Partners will be encouraged to incorporate bone health messages and activities into their existing programs and to share lessons learned.

This campaign is a unique public/nonprofit partnership among the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Service's Office on Women's Health (OWH) and the National Osteoporosis Foundation.

Lupus Education and Awareness

Team Leader: Susan Sanders, MSA, Public Health Advisor
Team Members: Frances E. Ashe-Goins RN, MPH Deputy Director
Aleisha Langhorne, MPH, MHSA, Health Scientist
Henrietta Terry, MS Public Health Advisor

This article addresses the problems women with lupus have in obtaining Social Security Disability

Lupus is a chronic autoimmune disease mainly affecting women. It is estimated that between 161,000 and 322,000 adults in the U.S. have lupus. Nine out of 10 people who have lupus are women. Most people with lupus develop symptoms during the childbearing years (ages 15-44). Lupus also is two to three times more common among African American, Latino, Asian, and Native American women. In addition, a CDC report revealed a 60 percent increase in deaths attributed to lupus over a 20-year period. Among older African-American women, the increase was nearly 70 percent. But it’s unclear whether the rise is due to an actual increase in lupus mortality or due to improved diagnosis and reporting or lupus deaths (CDC, 2002).

Although lupus is widespread, public knowledge of lupus is low, and its symptoms often are not recognized or misdiagnosed. Like many autoimmune diseases, lupus causes the immune system to attack parts of the body that "it is designed to protect" (NIH, SLE, 2003). The symptoms of lupus "can range from mild to severe and may come and go over time" (NIH, SLE, 2003). The symptoms of each patient are different but may include: pain in the joints and muscle pain, unexplained fever, red rashes commonly seen on the face, chest pain, unusual hair loss, pale or purple fingers, sensitivity to the sun, swelling in the legs or around the eyes, mouth ulcer, swollen glands, extreme fatigue, compromised kidney function, and cardiovascular complications (NIH, Systemic Lupus Erythematosus, 2003).

OWH National Lupus Awareness Campaign

Project Officer: Frances E. Ashe-Goins RN, MPH Deputy Director

The U.S. DHHS Office on Women's Health (OWH) recognizes the impact of this disease in the lives of young women. OWH has sponsored many community based lupus awareness programs and has received an overwhelming response from the community that highlighted a significant need for comprehensive, widespread, information about Lupus.

OWH is currently working with the Advertising Council to develop a National Lupus Awareness Campaign. This campaign is designed to increase awareness and understanding of Lupus, recognizing that ignorance contributes to late diagnosis and increased complications. The campaign will alert the public to the symptoms of lupus, grabbing the attention of a woman's family, friends, and employers; helping them to better understand the physical, economic, and social effects of lupus. In addition, it will also help individuals who may have symptoms of Lupus, to seek medical evaluation for early diagnosis and treatment. This campaign will potentially save millions of lives and alleviate some of the more severe complications resulting from late diagnosis of lupus.

History of Past Collaborations

  • Unlocking the Mystery of Lupus. In 1999-2001, OWH partnered with the Lupus Foundation of America to hold this educational program, initially targeted for DHHS employees and their families. The program was so successful that it was offered to other federal employees, community leaders, and the general public, culminating in a Spring 2001 Lupus National Town Hall Meeting for congressional members and their staffs in Washington, D.C. The town hall was also shown as a satellite presentation around the nation and in real time on the internet.

  • National Community Outreach Awareness Program. Community groups in specified cities throughout the nation received funding on a competitive basis to conduct community seminars on the diagnosis, treatment, and care of lupus based on the format developed by OWH. The following organizations were awarded funding: Louisiana Office of Public Health, New Orleans, LA; Medical University of South Carolina, Charleston, SC; Mariposa Community Health Center, Nogales, AZ; Sanders & Associates, Richmond, VA; Jefferson County Clinic, Birmingham, AL; and the Alabama Department of Health, Montgomery, AL. For 2006, the most recent contracts were awarded to: Rivera, Sierra & Co., Brooklyn, NY; Rivera, Sierra & Co., Tulsa, OK; Scott Consulting, Inc., Richmond Center, WI; Alemap Consultants, Shreveport, LA; Sanders & Associates, Chester, VA; and Global Evaluation & Applied Research Solutions (GEARS), Decatur, GA.

    The contractors conducted more than 100 lupus education and awareness seminars with an average of 25 attendees per session. The target population was women between the ages of 18-68, representing all racial/ethnic groups. The most significant findings of these seminars was the desire for more information on the subject of lupus, a need for improved diagnosis and early detection of the disease, and the gap in knowledge about lupus among the medical professionals.

  • Local LFA Lupus Chapters. Several of local chapters of the Lupus Foundation of America were awarded competitive contracts to provide lupus education and awareness to patients and their families in community settings. The Memphis chapter was able to reach over 6,000 people.

  • Racial Disparities in Lupus Forum. OWH and the S.L.E. (Lupus) Foundation of NY participated in a forum at the 5th Annual International Lupus Congress in NYC. The forum included a presentation on new initiatives to establish a lupus registry to facilitate earlier disease intervention, case monitoring and the tracking of outcomes; government strategies to reduce health disparities in lupus; and discussion of the New York City Lupus Cooperative's success in addressing racial disparities in underserved communities, and its plans for a national program.

  • Lupus and Nurses. Several organizations competed and won contracts to provide education and awareness to nurses. These organizations were: Lupus Foundation of America National Office; Florida Department of Health; Medical University of South Carolina.

  • Women's Health Organizations. The Black Women's Health Imperative developed a lupus web-based outreach and education program. The site contained a physician locator service, a management and care section, and an educational module. The Full Circle Wellness Center in Inglewood, California, provided education, counseling and referral services to minority women.

  • African Americans and Lupus: Invisible No More. Continuing its collaborative efforts with the S.L.E. Lupus Foundation of New York, the OWH participated in this forum at the Congressional Black Caucus' 34th Annual Legislative Conference. The forum was sponsored by Rep. Edolphus Towns (D-NY). Topics included a lupus overview; research findings, clinical trials, and community awareness and education.

  • Medical Education: The National Hispanic Medical Association and the National Medical Association were awarded funding to provide lupus education to their members. The Lupus Foundation of America was funded to develop a national training program for medical professionals. OWH partnered with the NIH Office of Research and Women's Health and other partners to convene a scientific conference on the latest information on lupus diagnosis, care and treatment and future issues for medical/health care professionals, researchers, community leaders, and lupus patients.

Content last updated May 15, 2008.

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