- Childhood obesity rates in Idaho have more than tripled over the past 30 years, with over 30% of school-aged children classified as overweight or obese. - St. Luke's has established two models - a clinical model and community model called YEAH! - to address this issue through lifestyle change programs, nutrition education, and physical activity. - St. Luke's is working to standardize the YEAH! program, establish collaborations to take a system-wide approach, and explore funding opportunities to ensure long-term sustainability of childhood obesity prevention and intervention efforts.

1. A Multi-Disciplinary Approach to Childhood Obesity

2. Startling Statistics
•Childhood obesity has more than tripled over the past 30 years.
•A 2008-09 school year BMI assessment of Idaho students in all odd
grades 1 through 11 found that overall, 30.5% of the Idaho school
children in the sample were classified as overweight or obese.
•The study found that significantly more boys were obese than girls.
•Idaho has a projected obesity rate of 53% by 2030.
•Predicted annual economic obesity related costs in
Idaho are expected to reach $1.5 billion by 2018.
Source:
*Idaho Department of Health and Welfare
*Trust for America's Health and the Robert Wood Johnson Foundation

3. Two Models For Best Results
The best predictor for long-term success
is prevention and early intervention.
Our Community Health Needs Assessment identifies
weight management as a high priority need.
•With more than 30% of our school aged children classified
as overweight or obese, population health needs to be
addressed at pre-school age to help positively influence
habit forming behavior.
•By engaging children, we routinely see very positive health
changes in the parents.
Population Health and Community Need

4. Yeah! Making a Difference
Yeah! began four years ago as
part of the BrightPath
Network, and was funded
through a two year Pacific
Source grant. The initial
program has since expanded
to become part of
St. Luke’s Children’s.

5. Two Models For Best Results
Yeah! Clinical Model:
•Requires a health care provider referral
•Children ages 5-16 years of age
•BMI > 95% (AAP definition)
•Readiness to change and commitment are key
•16 week program
•Lifestyle change versus weight loss focus
Two Models for Best Outcomes

6. Clinic YEAH! Program Overview
Clinic Team:
Pediatrician, Nurse Coordinator, Physical Therapist,
Social Worker, Dietitian and Exercise Physiologist
Clinic Visits:
Initial/1 month/3 month/12 month
• Baseline data measurements include: weight,
height, waist circumference, blood pressure,
fitness testing, Peds QL
• Goal setting
• Physical Activity class weekly
• Nutrition class every other week
Clinical Model Components

7. Community Program Components
Yeah! Community Model:
•Requires a health care provider referral
•Children ages 5-16 years of age
•BMI > 85% (AAP definition)
•Readiness to change and commitment key indicators
•8 week program
•Lifestyle change versus weight loss focus

8. A System Wide Initiative
We have set three objectives to ensure we can
replicate the program across the health system:
producing outcomes, collaborating with others
and addressing sustainability for the future.

9. Objective 1: Program Standardization
EBP/Outcomes and
Standardization
EBP/Outcomes and
Standardization
Medical
Director/CHOICE
Medical
Director/CHOICE
Work Group LeadsWork Group Leads
Regional ManagersRegional Managers
Program TeamProgram Team
Plan to meet Objective:
1.Develop standardized processes, procedures and curriculum for Yeah!
medical and community programs.
2.Approved program material will be distributed to all Yeah! program
provider sites.
3.Workgroup leaders to provide shared decision making for process to
review, suggest changes and/or modifications to program.
4.Medical Director to review, approve, or make recommendation to ensure
evidence based practice is utilized.
5.Registry of participants to be developed so data can be tracked, analyzed
and reported for outcomes.
6.Program changes and modifications must be approved by the Medical
Director.
7.Standard review process will be lead by Medical Director with CHOICE
council members annually.

10. Objective 2: Childhood Obesity Collaborative
Collaborative Partners:
1.Healthcare Providers
2.Payors
3.Policy Makers
4.Community/State Agencies
5.Schools/Educators
6.Families/Caregivers
7.Community Partners
8.Funding/Philanthropy
Plan to Meet Objective:
1.Review CHOICE membership, identifying key
stakeholder/agencies who many need to be represented.
2.Identify collaborative objectives and approach to childhood
obesity initiative.
3.Draft a plan to create desired areas of strategic impact
(school programs, daycare facilities, WIC, other state and local
agencies), then identify representatives who may have the
best influence to move the metric.
4.Using shared decision making, identify timelines, metric
development, and anticipated results.

11. Outcomes Data
Objective 2: Childhood Obesity Collaborative Framework
Health Care Providers
Schools/Educators
Family/Care Givers
Policy Makers
Community Kids
Community
Agencies
Payors
Funding Community Partners

12. Case Studies
Program Sustainability
1.Health System Support
2.Payor Reimbursement Models
3.Endowment/Philanthropy
4.Sustaining Partnerships
5.Events
6.Grant Funding
7.Private Donations
Plan to meet Objective:
1.Business case development that identifies key drivers for
long-term sustainability and successful program outcomes.
2.Work with foundation to write case statement for Yeah!
campaign.
3.Identify potential sustaining partner opportunities,
appropriate communication channels, and full approval to
contact.
4.Create outcomes plan/case studies to present to payors for
consideration for preventative health assistance.
5.Identify key events that lend to generating program
awareness and sustainability of program.
6.Continue to identify appropriate grant funding opportunities
to supplement funding needs.
Objective 3: Program Sustainability

13. Case Studies
What do Our Outcomes Show?
Understanding participants are undergoing normal growth, and change in BMI through normal
childhood and adolescent growth, the following physical/physiological measures showed statistically
significant differences from baseline as a result of participation in our YEAH! Program:
· Waist size at 6 and 12 months
· Blood pressure at 6 months
· Resting heart rate at 6 months
· Distance run and 50 foot shuttle at 6 months
Several fitness measures, step, squat, crunches, pushups, back extension, all also statistically
significantly improved at 6 months.
A Pediatric Quality of Life tool was implemented containing questions relating to the participants’
and parents’ perceptions of physical, emotional, social and school-related issues which combine to
generate an overall score. For the participant (child), all parameters improved at six months and
only school narrowly missed statistical significance at 12 months (p = 0.58), attesting to the lasting
effect on a child’s self-image. Parents perceptions were also statistically significantly positive at six
and 12 months except for questions relating to physical attributes, a somewhat interesting
discrepancy.

14. •The Childhood Obesity Initiative Council for Excellence (CHOICE) has been
established to create a consistent, collaborative approach across our areas of
impact, and determine a road map for the program’s future. This
collaborative effort includes many community agencies and partners;
including, Central District Health, Department of Health and Welfare, State
Department of Education, Idaho Association for the Education of Young People
and many others.
•We continue to explore all funding opportunities through
philanthropy, sustaining events, and hope to soon
work with payors to identify new reimbursement models for
these types of programs.
In Progress, and On the Horizon

15. We held our First Annual Childhood Obesity Conference and Family
Wellness Festival on April 13, 2013
Items of note:
•Dr. David Katz, a renowned childhood obesity expert, keynoted the conference. He is
the Editor-in-Chief of the Childhood Obesity Journal, and is the founding director of
Yale University's Prevention Research Center.
•Dr. Katz also was the featured guest for a leadership dinner that convened mayors,
educators, policy makers, community advocates and health care leaders.
•Mayor Bieter led a walk as part of his Mayor’s Challenge to highlight activity and
walkable space in our community.
•The festival hosted more than 2000 people who actively engaged in
healthy, fun activity.
Childhood Obesity Conference and
Wellness Festival

16. Be Well Now! Family Festival

17. YEAH! Summer Camp
St. Luke’s hosted its first YEAH! summer camp at Bogus Basin. The
event was held from Aug. 12-16.
Items of note:
•During the camp, 18 area youth participated in a variety of healthy activities that
culminated in a three-mile hike. For many participants this was the first time
they had gone to a camp.
•Student volunteers in the group One Stone volunteered to serve as camp
counselors.
•The event wouldn’t have been possible without partners in the community
including Bogus Basis, City of Boise and Wal-Mart.
•At the conclusion of camp Wal-Mart presented a check for $25,000 to help
continue funding the YEAH! program.

18. YEAH! Summer Camp

19. St. Luke’s YEAH! Program
http://www.youtube.com/watch?v=SGflW-P0ilQ

20. Find Out More About the YEAH! Program
www.stlukesonline.org/childrens