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HealthPOWER! Prevention News - Spring 2010 (NCP News) HealthPOWER! Prevention News - Spring 2010 (NCP News)NCP News TeleMOVE! – Care Coordination Home TeleHealth MOVE! ProgramThe Office of Telehealth Services and the MOVE! Team at NCP has finalized the new Care Coordination Home Telehealth – Weight Management – Disease Management Protocol (CCHT-WM-DMP), also known as TeleMOVE!. TeleMOVE! was piloted first with patients at the James A. Haley VAMC in Tampa and then at additional facilities in VISNs 1, 8, and 16. TeleMOVE! provides individual weight self-management support as an alternative to telephone care. Patients enrolled in TeleMOVE! will interact daily through the home-messaging devices, responding to questions and receiving tips and guidance. NCP has stocked a booklet of all of the MOVE! Handouts in VA Forms that is a companion guide for TeleMOVE!. TeleMOVE! contains 82 separate daily communications that should be completed in about 90 days, and most patients will need to complete two cycles of the DMP, which will provide the recommended six months of weight management support required for most patients to meet their weight-loss goals. Patients will weigh in once per week through an attached electronic scale and report on their progress with personal weight loss, dietary change, physical activity, and behavioral goals. The care coordinators (staff who monitor patient progress in the CCHT system) will assist patients in problem solving and resetting goals, as needed, while also providing encouragement and support. OTS has secured funding through the New Models of Care portion of the Transformational Initiatives for the 21st Century to support VISNs in launching TeleMOVE!. Nineteen of the twenty one VISNs have requested this funding. 2009 MOVE! TrainingEight of the talks featured in the 2009 MOVE! training are now available to view in a video format on LMS. Log on to LMS and search with the keyword "MOVE!." Guidance on Clinical Preventive ServicesNCP is pleased to announce a new resource for staff on Clinical Preventive Services! VHA-specific ‘Guidance Statements’ are being developed for a wide range of Clinical Preventive Services (screenings, immunizations, brief counseling and preventive medications.) VHA Handbook 1120.05: Coordination and Development of Clinical Preventive Services describes the procedures used to develop the guidance statements. The first statement that has been posted is ‘Screening for Abdominal Aortic Aneurysm’. VA staff can access the home page for this new initiative by typing http://vaww.prevention.va.gov/Guidance_on_Clinical_Preventive_Services.asp into their Intranet browser. VHA Preventive Care ProgramThe VHA Preventive Care Program is designed to work closely with the Patient-Centered Medical Home (PCMH) Initiative to provide financial resources, training, and support for Health Promotion and Disease Prevention activities within the PCMH. NCP has posted more details, including role descriptions for the new HPDP Program Manager and Health Behavior Coordinators, on the Intranet. VA staff can access the home page for more information by typing http://vaww.prevention.va.gov/VHA_Preventive_Care_Program.asp into their Intranet browser. Transition in Employee Wellness ProgramThe need for additional NCP staff time and attention to initiate the new VHA Preventive Care Program—a major part of the VHA’s "New Models of Care" Transformation initiatives—has resulted in NCP no longer working in the area of employee wellness. NCP will, however, continue to support MOVEmployee! The lead for employee wellness has transitioned to the Occupational Health, Safety, and Prevention Strategic Health Care Group in the Office of Public Health and Environmental Hazards. The VISN 23 Employee Health Promotion and Disease Prevention Pilot project, directed by Dr. Ebi Awosika, is going well and will be the nexus for employee wellness activities in VHA. The VHA Preventive Employee Wellness email list is now managed by Sandra Schmunk in Minneapolis (sandra.schmunk@va.gov), Program Manager of the Employee Health Promotion/Disease Prevention Pilot project. We sincerely thank each of you for your interest and hard work over the years in promoting employee wellness throughout VHA, and hope your work in that area will continue unabated. Meet Becky Hartt MinorIn January 2010, Veterans Health Education and Information (VHEI) at the National Center for Health Promotion and Disease Prevention (NCP) welcomed Becky Hartt Minor as our new Health Educator. Prior to joining VHEI, Becky served as Program Director for the Cancer Information Service (CIS) Southeast Region, serving North Carolina, South Carolina, and Georgia. The Cancer Information Service (1-800-4-CANCER), a program of the National Cancer Institute, is a national information and education network. Becky joined the Southeast Region in August 2006, but had worked for the CIS since March 1998, serving as Partnership Program Manager for the CIS Mid-Atlantic Region. Becky provided education and awareness about early detection, screening, diagnosis, and treatment of cancer. Through the Southeast Partnership Program, Becky was responsible for reaching out to medically underserved audiences, including minority groups and people with limited to access to health information and services. Before working with the CIS, Becky was the director of the Virginia Breast and Cervical Cancer Early Detection Program (1994–1998), a CDC-funded program providing no- and/or low-cost mammograms and Pap tests to under- and uninsured women aged 50–64, within the Virginia Department of Health. Becky received a Masters in Education with an emphasis in Community Health Education from West Virginia University and has worked as a Health Educator throughout her career. Becky’s community and medical care health education experience, plus her work with underserved populations, will contribute to VHEI’s goal of promoting a comprehensive approach to Veteran-centered health education in Veterans Health Administration Central Office (VHACO) and the field. You can contact Becky at becky.minor@va.gov or (919) 383-7874 ext. 249. Please join us in welcoming Becky to VHEI and NCP. 2009 MOVE! Evaluation Report-Findings Now AvailableThe FY09 MOVE Evaluation Reports have been completed and have been mailed to all VISN coordinators and Facility coordinators who requested a hard copy. Electronic copies are available at the MOVE! Intranet website (http://vaww.move.med.va.gov/Reports09.asp). At this link you can select from among 3 documents:
Major additions from prior year evaluation reports include the addition of key weight and Body Mass Index (BMI) change measures, some measures reported out at the CBOC level, and new measures in a variety of evaluation domains. Findings from this report can be used to guide future program policy and planning at all levels of the VHA organization. For FY10, three areas for program improvement are suggested based on these findings: Increased use of motivational communication in primary care and other settings with patients who are ambivalent about seeking/receiving MOVE!-related care to promote increased engagement. Use of motivational communication to promote sustained engagement by patients who may stop participating in care after 1 or 2 visits. Ensuring the program is multidisciplinary in content and structure and is using behavioral strategies (as opposed to just educational strategies) for changing diet and physical activity behaviors that contribute to weight loss. Ensuring that height and weight for all visits (MOVE! and others) are documented within the Vital Signs Package of VISTA/CPRS, rather than as text entries in progress notes. A supplemental analysis of missing weight data by facility is available at the MOVE Sharepoint site: http://vaww.national.cmop.va.gov/ncp/move/Shared%20Documents/Forms/AllItems.aspx Recent Prevention-related research
This randomized clinical trial led by Dr. Will Yancy, a VA obesity researcher, compared a low-carbohydrate diet to orlistat combined with a low-fat diet in 146 primary care patients from the Durham VA Medical Center. After 48 weeks, weight loss and changes in lipids and glycemic measures were similar between the two groups; however, the group that received instruction on the low-carbohydrate diet had larger decreases in systolic and diastolic blood pressure.
This large retrospective cohort study used VHA administrative data from 6 VISNs over the years 2002 to 2006 for evaluating the extent to obesity diagnoses were made/coded and the various education, counseling, medical and/or surgical treatments for obesity that were delivered. Of 933,084 (88.6%) of 1,053,228 primary care patients who had recorded heights and weights allowing calculation of BMI, 330,802 (35.5%) met criteria for obesity. Among obese patients who survived and received active care (N = 264,667), 53.5% had a recorded obesity diagnosis, 34.1% received at least one outpatient visit for obesity-related education or counseling, 0.4% received weight-loss medications, and 0.2% had bariatric surgery between FY2002-FY2006. Receipt of obesity education varied by sociodemographic and clinical factors; providers may need to be cognizant of these when engaging patients in treatment.
This systematic review was conducted to assess the use and quality (including underuse, overuse, and misuse) of appropriate colorectal cancer (CRC) screening, including factors associated with screening, effective interventions to improve screening rates, current capacity, and monitoring and tracking the use and quality. Trends in the use and quality of CRC screening tests is also presented.
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