Shape Your Environment

1
Shape Your Environment Making the Right
Choice The Easy Choice!
Fname Lname Title Department Name Company Name
2
Environment Major Weight Gain Factor
Policies/rules
Culture
Availability
Personal Choice
Advertising/ Marketing
Cost
Aesthetics
3
Intervention Pyramid
4
Environmental Roadmap

• Research-based assessment tool to build an
  environment which encourages fitness/healthy
  eating
• Leverages existing command/ communication
  channels to facilitate dialog/collaboration among
  installation leaders
• Planning guide to create a healthy environment

5
Built Environment

• Man-made, physical components of
• human settlements and how they
• support physical activity

• KEY AREAS ASSESSED
• Sidewalks, exercise trails, parks, bike racks
• Designated exercise trail/path
• Maintained, safe/visually appealing
• Involves engineering, safety, services, fitness
  center representatives

6
Work Environment

• Factors at or associated with the
• workplace that impact an
• individuals physical activity and
• healthy eating options

• KEY AREAS ASSESSED
• Leadership/peer modeling
• Satisfactory/accessible exercise areas
• Healthy/appetizing foods accessible
• Adequate food storage/reheating equipment
• Encouraging stairway use

7
Fitness NutritionOptimization Plans Programs

• Companys efforts to plan,
• implement, and evaluate programs
• that promote sound fitness
• and nutrition principles

• KEY AREAS ASSESSED
• Multidisciplinary team of experts/stakeholders
• Broaden the concept of assessment
• Diverse, multi-agency programming
• Resource sharing
• Outcome measurement

8
Primary Health Care Services

• Interactions between health care
• personnel and their patients

• KEY AREAS ASSESSED
• Partners with health care integrators,
• Population Health Working Group, clinic
• leaders, education coordinators
• Documenting actual weight/weight trends
• Counseling/referral
• Resources for weight gain prevention
• Annual training for primary care teams

9
Proposed Leadership Action

• Direct Environmental Roadmap Assessment
• Charter and Appoint Multidisciplinary Team
• Review/Approve Installation Action Plan
• Review Status Quarterly
• Reassess Action Plan Every 2 Years

10
Prevalence
33.5 Overweight 31 Obese
Our Company
47 Overweight 13 Obese
11
Performance Impact

• Increased BMI risk factors for low back pain
  sprains/strains in US workders 1
• Obese truck drivers have twice as many accidents
  as non-obese2
• 70 Canadian military members evaluated for sleep
  disorder had a mean BMI of 303
• Workders with BMIgt27 are 3.5 times as likely to
  suffer heat injury4
• Increased fitness test failure5,6
• Increased wound infection especially with burns7,
  8
• Increased surgical risk9

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References

• Chung and Pin 1994
• Cottam et al 2003
• Dodd et al 2004
• Finkelstein, E. A., Fiebelkorn, I. C. Wang, G.
  (2004). State-level estimates of annual medical
  expenditures attributable to Obesity. Obesity
  Research. 12(1) 18-24.
• Fonseca, V. P. (2004). Behavioral risk factor
  (BRF) overview. Presented at the Health
  Promotion Course 19 Apr 2004. Population Health
  Support Division. Air Force Medical Service
  Agency, Brooks City-Base.
• Galuska et al. and Wadden et al. as cited by
  Wadden, T.A., Tsai, A.G. (2005) Weight
  management in primary care Can we talk? Obesity
  Management 1(1) 9-14.)
• Healthy weight, overweight, and obesity among
  persons 20 years of age and over, according to
  sex, age, race, and hispanic origin United
  States, 1960-62,1971-74, 1976-80, 1988-94, and
  1999-2000 (2002). Retrieved from the worldwide
  web on April 13, 2004 from http//www.cdc.gov/n
  chs/data/hus/tables/2002/02hus070.pdf.
• Kryger et al
• Kushner as cited by Wadden, T.A., Tsai, A.G.
  (2005) Weight management in primary care Can we
  talk? Obesity Management 1(1) 9-14.
• Lamas et al 2002
• Mokdad, A. H., Marks, J. S., Stroup, D. F.,
  Gerberding, J. L. (2004). Actual causes of death
  in the United States, 2000. Journal of the
  American Medical Association. 291(10)1238-1245.
  Review. (Also CDC press release to update
  figures, Jan 2005)
• NHLBI obesity education initiative expert panel
  on the identification, evaluation, and treatment
  of overweight and obesity in adults Clinical
  guidelines on the identification, evaluation, and
  treatment of overweight and obesity in adults
  The evidence report (NIH Publication No.
  98-4083.) Bethesda, MD National Institutes of
  Health, 1998. Retrieved August 20, 2002 from the
  world wide web http//www.nhlbi.nih.gov/guidelin
  es/obesity/ob_home.htm.

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References (continued)

• Prevalence of overweight and obesity among
  adults United States, 1999-2000. (2002).
  National Center for Health Statistics. 1-2.
  Retrieved October 11, 2002 from the world wide
  web http//www.cdc.gov/nchs/products/pubs/pubd/
  hestats/obese/obse99.htm.
• The Surgeon Generals call to action to prevent
  and decrease overweight and obesity
  Epidemiology. (December 13, 2001). Retrieved
  from the world wide web January 15, 2002
  http//www.surgeongeneral.gov/topics/obesity/.
• Reynolds et al. 2002
• Robbins, A. S, Chao, S. Y., Fonseca, V. P.,
  Snedecor, M. R., Knapik, J. J. (2001).
  Predictors of low physical fitness in a cohort of
  active-duty U.S. Air Force members. American
  Journal of Preventive Medicine, 20, 90-96.
• Solomon, C. G., Willett, W. C., Manson, J. E.
  Body weight and mortality. In VanItallie, T.
  B., Simonpoulos, A. P., editors. (1995).
  Obesity New directions in assessment and
  management. Philadelphia PA The Charles Press,
  Publishers, 1-11.
• Stoohs 1994
• U.S. Preventive Services Task Force (USPSTF).
  (December, 2003). Screening and Interventions
  for Obesity in Adults Summary of the Evidence
  for the U.S. Preventive Services Task Force.
  Retrieved 19 February 2004 from the world wide
  web http//www.ahrq.gov/clinic/3rduspstf/obesity
  /obessum.pdf http//www.ahrq.gov/clinic/uspstf/usp
  sobes.htm
• Wadden, T.A., Tsai, A.G. (2005) Weight
  management in primary care Can we talk? Obesity
  Management 1(1) 9-14.
• Willett, W. C. Manson, J. E. (1995).
  Epidemiological studies of health risks due to
  excess weight. Eating Disorders and Obesity.
  Gulford Press, New York, 396-400.
• Zajdowicz MJ, McKenzie RT. Predictors of
  successful physical readiness testing under the
  new standard OPNAV Instruction 6110.1F. Mil Med.
  2003 May168(5)394-8.

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Questions?