Appendix A: Examples of Federal Programs and Initiatives
Programs on overweight and obesity span multiple departments, offices, and agencies in
the Federal Government and promote valuable research and action in various settings.
These programs are amplified by State, Tribal, local, and private-sector activities. Some
examples of Federal initiatives on overweight and obesity, and the programs that support
them, are listed below. For more information on a number of these programs, please see
appendix B.
Setting 1: Families and Communities
- The Centers for Disease Control and Prevention (CDC) has a community planning
tool called the Planned Approach to Community Health (PATCH). This tool can be
valuable in the process of developing and sustaining action.
- The Federal Highway Administration, the Environmental Protection Agency, and the
Georgia Department of Transportation have developed Strategies for Metropolitan
Atlanta’s Regional Transportation and Air Quality, a document that provides a
framework for assessing which factors of land use and transportation investment
policies have the greatest potential to reduce the level of automobile dependence,
which may consequently increase walking and bicycling activities while promoting
the economic and environmental health of the Atlanta metropolitan region.
- The Head Start Bureau of the Administration for Children and Families, in
conjunction with members of the community and various Federal agencies, will
convene a focus group in fall 2002 to identify issues, effective practices, and
recommendations addressing overweight in children of the Head Start Program.
- The Head Start Bureau has published a Training Guide for the Head Start Learning
Community: Enhancing Health in the Head Start Workplace. The guide addresses
the importance of health in the workplace and presents health promotion principles
and activities that can be applied to a variety of workplace health issues, including
achieving and maintaining a healthy weight.
- The Health Resources and Services Administration (HRSA) has sponsored Statewide
Partnerships in Women's Health that have begun a new prevention initiative entitled
WISEWOMAN. Three Statewide Partnerships in Women's Health grantees
(Alaska, North Carolina, and Vermont) have WISEWOMAN programs in their
States. These grantees are encouraged to collaborate with the WISEWOMAN
programs in their States and with other community-based partners to support
cardiovascular screenings for women aged 40 to 64 years who then receive nutrition
counseling and physical activity support.
- Under the Healthy People 2010 initiative, the Department of Health and Human
Services (HHS) has produced the document Healthy People in Healthy Communities:
A Community Planning Guide Using Healthy People 2010. This document is a guide
to developing an action plan through building community coalitions, creating a
vision, measuring results, and creating partnerships. It outlines strategies to help start
community activities.
- HHS sponsored the development of a Healthy People 2010 Toolkit to provide guidance, technical
tools, and resources to groups as they develop and sustain a successful plan of action.
The Toolkit is organized around common elements of health planning and
improvement and provides useful tips for getting started.
- HHS has recently released a Blueprint for Action on Breastfeeding. The Blueprint for
Action, which was developed by health and scientific experts from 14 Federal
agencies and 23 health care professional organizations, offers action steps for the
health care system, families, the community, researchers, and the workplace to better
focus attention on the importance of breastfeeding.
- HHS, the U.S. Department of Agriculture (USDA), and other organizations have
collaborated to form the United States Breastfeeding Committee. They have
developed Breastfeeding in the United States: A National Agenda, which is a strategic
plan to protect, promote, and support breastfeeding.
- The Indian Health Service and Head Start Bureau have partnered in the development
of an initiative, Healthy Children, Healthy Families, and Healthy Communities: A
Focus on Diabetes and Obesity Prevention, which has focused on obesity and
diabetes prevention activities for Head Start children, families, staff, and
communities.
- The National Institutes of Health (NIH) Pathways research fosters culturally
appropriate healthy eating practices and increased physical activity among American
Indian children, their families, food service staff, and physical education and
classroom teachers.
- NIH and the National Recreation and Park Association have developed the Hearts N’
Parks program, which will create national dissemination magnet sites for
implementing activities encouraging healthy eating and physical activity.
- NIH has developed a health awareness campaign called Sisters Together: Move More,
Eat Better to encourage African American women in Boston to maintain or achieve a
healthier weight by increasing their physical activity and eating healthy foods. NIH is
currently expanding this program to other sites.
- The Office for American Indian, Alaska Native, and Native Hawaiian Programs has
developed the Wisdom Steps Health Promotion Program for Elders, a partnership
between the Tribes and Minnesota’s State Unit on Aging. The program promotes
health awareness, with major emphasis on assisting elders in weight loss,
participation in exercise programs, improvement of diet, and smoking cessation.
- The Office on Women’s Health has developed the Girls and Obesity Initiative,
serving to identify existing government obesity programs and to adapt these programs
toward gender-specific guidance for girls.
- USDA’s Cooperative State Research, Education, and Extension Service (CSREES)
has developed a nationwide project, Reversing Childhood Obesity Trends: Helping
Children Achieve Healthy Weights. This project will achieve its goals through the
integration of research, education, and innovative approaches to help children achieve
healthy weights. The project will test a number of program interventions
designed to reduce the prevalence of childhood overweight and obesity in various
populations. Both
quantitative and qualitative methodologies will be employed in determining the most
appropriate and effective program intervention for a specific population.
- CSREES also funds WIN the Rockies (Wellness IN the Rockies), which seeks to
improve attitudes and behaviors about food, physical activity, and body image among
rural residents of Idaho, Montana, and Wyoming in order to reverse the rising tide of
obesity. Interventions will be community based and will target youth, limited-resource audiences, and overweight or obese adults.
- The Women, Infants, and Children (WIC) Farmer’s Market Nutrition Program was
established by Congress to provide fresh and nutritious foods from farmers’ markets
to low-income families participating in the WIC program.
Setting 2: Schools
- The Assistant Secretary for Health, the Assistant Secretary of Elementary and
Secondary Education, and USDA’s Under Secretary for Food, Nutrition, and
Consumer Services co-chair a Federal Interagency Committee on School Health that
serves to integrate efforts across three Cabinet departments to improve the health and
education of young people, including efforts to prevent and decrease obesity.
- CDC currently supports 20 State education agencies for coordinated school health
programs to reduce the following chronic disease risk factors: tobacco use, poor
eating habits, physical activity, and obesity. CDC also has developed guidelines for
school health programs based on a review of published research and input from
academic experts.
- School Health Index for Physical Activity and Healthy Eating: A Self-Assessment and
Planning Guide, is a guide developed by CDC that enables schools to identify
strengths and weaknesses of their physical activity and nutrition policies and
programs; develop an action plan for improving student health; and involve teachers,
parents, students, and the community in improving school services.
- CDC and USDA are developing a mentoring curriculum to promote nutrition and
physical activity in 11- to 18-year-old African American males in an effort to address
racial disparities in nutrition and physical activity.
- CDC, the President’s Council on Physical Fitness and Sports (PCPFS), and the
Department of Education have developed a report, Promoting Better Health for
Young People Through Physical Activity and Sports, in which they describe strategies
to increase the number of youth engaging in physical activity.
- PCPFS has developed the President’s Challenge Physical Activity and Fitness
Awards Program, incorporating the Presidential, National, Participant, and Health
Fitness Awards, and for the first time this year, the Presidential Active Lifestyle
Award; the State Champion Award; the National School Demonstration Program; and
the Presidential Sports Award Program as means of encouraging individual children
and schools to adopt and maintain an active, fit, and healthy lifestyle.
- USDA has launched efforts to foster healthy school environments that support proper
nutrition and the development of healthful eating habits, including re-emphasizing
regulations that prohibit serving foods of minimal nutritional value in the food service
area during meal periods.
- USDA’s Team Nutrition includes a multitude of nutrition education materials for
children ranging from prekindergarten through high school that support concepts to
maintain a healthy weight. Team Nutrition provides grants to States promoting the
Federal Dietary Guidelines for Americans, healthy food choices, and physical
activity.
- USDA’s Team Nutrition resources include a Food and Nutrition Service’s “action
kit,” Changing the Scene: Improving the School Nutrition Environment, which can be
used at the State and local levels to educate decision makers about the role school
environments play in helping students meet the goals of the Dietary Guidelines for
Americans.
Setting 3: Health Care
- The Agency for Healthcare Research and Quality is supporting the U.S. Preventive
Services Task Force’s update to the 1996 Guide to Clinical Preventive Services
chapter on screening for obesity. The report will be expanded to address screening
and counseling for overweight and obesity and will assess the effectiveness of
primary care-based interventions to prevent or treat obesity.
- CDC has been active in leading discussions about reimbursement, or inclusion as a
member benefit, for services relating to the prevention and treatment of overweight
and obesity.
- CDC is focusing on the prevention of pediatric overweight in the primary care setting.
- The Department of Defense has developed the LEAN Program, a healthy lifestyle
model for the treatment of obesity administered in the Tripler Army Medical Center.
- HRSA and other partners including PCPFS, NIH, and CDC have developed Bright
Futures in Practice: Physical Activity. These guidelines and tools emphasize health
promotion, disease prevention, and early recognition of physical activity issues and
concerns of infants, children, and adolescents.
- HRSA, in collaboration with other partners, has developed Bright Futures in
Practice: Nutrition. These nutrition guidelines provide a thorough overview of
nutrition supervision during infancy, childhood, and adolescence. The guidelines also
highlight how partnerships among health professionals, families, and communities
can improve the nutritional status of infants, children, and adolescents.
- HRSA sponsors a Diabetes and Hypertension Collaborative that includes nutrition
and weight management education for patients in community health centers.
- NIH has developed the Clinical Guidelines on the Identification, Evaluation, and
Treatment of Overweight and Obesity in Adults: Evidence Report, which has been
formatted into various products suitable for use by physicians and other health
professionals.
- NIH has collaborated with other Federal agencies to conduct and promote research on
obesity and associated diseases. These studies focus on biologic and environmental
determinants of human overweight and obesity, prevention strategies, and treatment
modalities.
- NIH has developed a Weight-control Information Network to provide health
professionals and consumers with science-based materials on obesity, weight control,
and nutrition.
- HHS has charged members of NIH’s National Task Force on Prevention and
Treatment of Obesity to publish evidence reviews of overweight and obesity in
leading medical journals to provide clinicians with the latest and most accurate
information.
Setting 4: Media and Communications
- CDC is using existing surveillance systems to develop biennial reports on national,
State, and local trends in the prevalence of cardiovascular disease, cancer, and
diabetes; the risk factors related to these diseases; and the school-based programs that
may reduce these risk factors.
- CDC, in conjunction with PCPFS and other private and public agencies, is Promoting
Better Health for Young People Through Physical Activity and Sports, a document
that reports on the strategies being used to involve families, school programs,
recreation programs, community structural environment, and media campaigns on
physical activity.
- The PCPFS Research Digest, a quarterly publication, synthesizes scientific
information on specific topics in physical fitness, exercise science, and sports
medicine for dissemination to fitness professionals and citizens.
Setting 5: Worksites
- CDC has developed the Personal Energy Plan (PEP), a self-help program that
promotes healthy eating and physical activity in the workplace. Worksites are
encouraged to supplement the PEP self-help kits with added activities and
modifications to the nutritional and physical environment.
- CDC has a Web site, Ready, Set, It’s Everywhere You Go: CDC’s Guide to
Promoting Moderate Physical Activity, which provides resources and information on
how adults can incorporate physical activity into their routines at the workplace.
- CDC has provided funding to State departments of health in Maine, Montana, New
York, and North Carolina for the establishment of health promotion programs at
multiple worksites. The programs are intended to formulate and implement policy
and environmental changes that support increased physical activity and healthy
eating.
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