Project Charter: Pediatric Weight Management 862-04
Project Overview:
Project Dates | Year 1: 1/1/2019 – 7/31/2019 Year 2: 8/1/2019 – 7/31/2020 Year 3: 8/1/2020 – 7/31/2021 Year 4: 8/1/2021 – 7/31/2022 Year 5: 8/1/2022 – 7/31/2023 (Final Year) |
Funding Organization | CDC |
Technical Project Officer | Goodman, Alyson B. (CDC/DDNID/NCCDPHP/DNPAO) |
Executive Sponsor | Kathy McNamara, Associate VP, Clinical Affairs, NACHC |
Project Lead | Sarah Price, Deputy Director, Clinical Integration and Education, NACHC |
Description:
Obesity is a major public health issue in the United States with 20 % of children and 40 % of adults obese in 2020, resulting in 150 billion dollars in health care spending annually. Childhood overweight and obesity affects 1 in 4 children ages 2-5 years, the rate of monthly BMI change almost doubled for children 6-10 during the COVID 19 pandemic and the US is expected to have 17 million obese children by 2030.
In Year 5, the National Association of Community Health Centers (NACHC) will continue work in 7 areas to improve health centers’ ability to respond to pediatric wellness and weight management in health centers and in their communities. NACHC’s proposal, to Pediatric Weight Management in Community Health Centers includes a package of responses mechanisms:
· Multi State Strategy using evidence- based programs such as Mind, Exercise, Nutrition and Do it (MEND) with new models of virtual curriculum and family engagement.
· A virtual evidence-based curriculum for health centers getting started in pediatric weight management in primary care from ages 0-18 and aligned with the new AAP new guidelines.
· Validation of a progressive childhood obesity metric beyond the BMI from prevention to treatment.
· Partner with CDC to initiate a clinical and community data initiative (CODI 2.0) in North Carolina.
· Use of FHIR technology to scale and spread evidence based pediatric programs such as Bright Bodies.
· An analysis plan to improve further understand anemia and Iron Deficiency screening practices
· A communication strategy to highlight promising practices to disparities of childhood obesity
NACHC Buy in: NACHC will guide and work with HCCNs and their participating health centers through a process to support intervention prioritization, assessment of interventions using an implementation science framework, learning, and best practice sharing. HCCNs and their participating health centers will also have access to virtual peer learning events, experts from the field, and additional training and resources to translate evidence-based and emerging successful strategies into practice.
Goals and Performance Measure:
Case for Change:
Clinical Rationale: Child obesity doubled since quarantine/COVID
Project Approach:
Phase 1 & 2:
Measures of Success? Maybe as an addendum - vs critical success - do we need both?
No learning community - not every project has one - PWM - legacy teams and national series
Intervention Framework: AAP guidelines/CDC (project dependent)
Project Scope:
Project Staff Resources Requirements:
HCCN
PCA
Health Centers
Role/Responsibilities (table)
Appendix:
Nita's (Alliance Chicago) work - feed in dashboards/data
Project Scope
Target Population:
Community Health Centers
Year 5 Deliverables (draft):
Implement 2-4 cohorts of families (10-week intervention could easily be done 4x by sites that have a good system in place now. And that helps increase reach). And funding could be scaled based on how many they say they are able to do?
Participate in data collection and evaluation efforts:
Reach and effectiveness (via patient- and family-level surveys and EMR pulls)
Implementation science metrics (via RE-AIM/PRISM)
Qualitative data from participants and/or staff (details TBD)
Participate in/ provide technical assistance PRN regarding sustainability and reimbursement opportunities
Participate in opportunities to disseminate best practices and lessons learned from COMMIT years 1-5 (conferences, workshops, posters, virtual presentations, etc)
Contribute to a facilitation guide that highlights best practices for implementation of intensive PWMI/FWMIs in health centers
Partner Responsibilities:
· CODI 2.0: NACHC will continue to work with CDC, Mitre, Duke and multiple state and community partners to advance clinical and community data capture, analytics and reporting.
· Curlew Consulting: Work with CODI 2.0 Data Partners on PPRL.
· Multi State Legacy Teams: NACHC will continue to collaborate primary care associations, and large health centers to continue to implement statewide evidence-based models for pediatric weight management include alternative payment models, use of health care team extenders.
· National Virtual Curriculum for health centers will include collaborative partnerships with AAP, health centers pediatricians who are members of AAP to implement pediatric weight management in primary care. Multiple strategies may be employed including leveraging national, state, and health center infrastructures.
· NQF Measure Development and Validation: NACHC will partner with national subject matter experts, health center pediatricians, academics, and seasoned informatists to advance the design and recommendation of a new measure to enhance the BMI. New recommendation will build on results of year 4 and address social drivers of health and referrals.
· Iron Deficiency Analytics Plan: NACHC will partner with one HCCN and member health centers and academic partners to explore the landscape for data available for pregnant women and children 6-23 months with recommendations for next steps.
· FHIR App for Scale and Spread of Bright Bodies. NACHC will continue to support the spread and scale of Bright Bodies in health centers through use of the FHIR app.
· McKinstry Consulting to share best practices through social media.
· Legacy Team Learning Collaborative and Coaching with Denver Health and Hospitals with Jessica Wallace as the lead.
· Multi-State Legacy Teams (COMMIT) engaged in learning community include: Borinquen, El Rio, IL PCA, MS PCA to advance and reimagine evidence based pediatric weight management interventions based on MEND.
· CODI 2.0 eight community partners to include: WIC, Parks and Recreation, local health department, UNC, YMCA and NCCEH.
· AllianceChicago for validation testing of NQF measure and Iron Deficiency Data Analytic Plan.
· Yale University for scale and spread of Bright Bodies through FHIR app.
NACHC Offerings: NACHC will guide and work with HCCNs and their participating health centers through a process to support intervention prioritization, assessment of interventions using an implementation science framework, learning, and best practice sharing. HCCNs and their participating health centers will also have access to virtual peer learning events, experts from the field, and additional training and resources to translate evidence-based and emerging successful strategies into practice.
Goals and Performance Measures:
Performance Measure | Project Goal | Stretch Goal | Notes |
Activities* | Process Measures* | Outputs* |
In response to and in preparedness for prevention, care, and treatment of pediatric obesity in primary care, provide training and technical assistance to health centers using clinical evidence, implementation science, and data alignment/harmonization:
Multi State strategy working with AZ, MS, IL, Fl using evidence based pediatric weight interventions such as MEND and innovations captured through COVID 19 Pandemic. This will include: a. Virtual learning collaborative calls for participating primary care associations and legacy health centers. b. One to one coaching calls to include evidence based best practices, dissemination and implementation science, business models and recommendations for scale and spread. c. Highlight evidence based Best Practices from other sectors such as CORD, Bright Bodies, state initiatives and other health centers. d. Standard data elements to measure improvement and evaluation.
National Virtual Curricula for health center getting started . This will include: a. Working with AAP members and health center pediatricians. b. Informing of new AAP Clinical Guidelines. c. a virtual curriculum with expert faculty for health centers d. Evidence based tools and resources e. program evaluation
NQF Measure recommendation in HCCN, health centers and with multiple sector partners.
| PM 1. Number of Legacy Teams engaged in year 5. PM 2. Number of national virtual curriculums conducted for health centers and number of health centers engaged. PM 3. Number of NQF validation testing elements and the results.
| O 1. Summary report highlighting findings of Legacy Teams from Borinquen, El Rio, Il, and MS. 02. National virtual curriculum results and lessons learned. O3. Results of NQF validation and final recommendation. |
Project Approach:
Project phases include readiness activities (Phase 1), implementation (Phase 2), and Harvest and Evaluation (Phase 3)
TASK | PHASE | HCCN | HC | MEASURES OF SUCCESS |
Attend Launch Meeting | 1 | X | X |
|
Create a core project team | 1 | X X X |
X |
|
Complete Project Readiness Tasks | 1 | X X X | X X X |
|
Attend required project calls | 1,2,3 |
X X X |
X X X | 100% attendance and participation in virtual Learning Community:
|
Configure reporting systems to report monthly monitoring measures | 1 | X |
|
|
Report monthly monitoring measures | 1, 2, 3 | X X |
X |
|
Set health center performance goals. |
| X X X | X X X |
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Implement prioritized evidence-based intervention strategies to optimize care processes and improve outcomes. |
| X X X | X X |
|
Implement spread and scale plan |
| X X |
|
|
Use BPAA Roadmap to identify and prioritize interventions |
| X
X X X | X
X X X |
|
Support NACHC in disseminating content to promote Million Hearts® strategies |
| X X |
|
|
Attend Harvest Meeting in June 2023 (date TBD) in Bethesda, Maryland |
| X | X |
|
Complete final reporting |
| X X X
X X |
|
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