Meeting Minutes - Executive overview
The first work group meeting of the Mohawk Valley Population Health Improvement Program’s (MV PHIP) Obesity Work Group met on January 14, 2015 from 1-3pm at the Herkimer College campus. Ellie Wilson, a Sr. Nutritionist and Registered Dietician employed at Price Chopper, gave a presentation on the use and development of the NuVal® Scores. The work group also went over work group responsibilities which are to
1. Select a population-based intervention and
2. Have a measureable impact within the time frame of the grant.
The MV PHIP will facilitate meetings, provide technical assistance, and help with finding and writing of grants.
Work group members were given binders that contained:
1. MV PHIP factsheet
2. Work group charter
3. Work group composition based on sector, county, and organization
4. A copy of the previous stakeholder meeting presentation
5. Stakeholder meeting minutes
6. Obesity data
7. Prevention Agenda Action Plan Refresh, an updated version of the Prevention Agenda which includes process measures and resources
8. Resources
a. Complete Streets
b. Employer Toolkit for Breastfeeding
c. Creating Healthy Schools and Communities
Discussion was generated on the topics of
1. Promoting increased activity through Complete Streets and joint use agreements,
2. Promoting the NuVal® Scores, focusing on educational opportunities for clinicians and community members, as well as the use of technology to assist people with making healthy eating choices.
The next meeting will be on Thursday March 10, 2016 from 1-3pm in Johnstown at the Holiday Inn.
Mohawk Valley PHIP
January 14, 2016
Obesity Work Group Minutes
Stakeholders: Lynae Wyckoff (RHENSOM,) Heidi Bond (Otsego Dept. of Health,) Steph Tamsett (Montgomery Social Services,) Dave DeFazio (Carmel’s Free Diner,) Laurel Headwell (Montgomery Public Health,) Ellie Wilson (Price Chopper,) Virginia Whitford (House of the Good Shepherd,) Jen Balog (American Heart Association,) Steve Speelman (Price Chopper,) Lorrie Arcuri ( Excellus,) Karen Huxtable (Bassett Healthcare Network,) Kate Reese (Little Falls Hospital,) Tom Hohensee (Bassett Research Institute,) Deb Dolan (Cobleskill Regional Hospital,) Ken Riley, DO (Bassett Canajoharie,) Maureen Blanchard (Research Foundation,) Diana Haldenwang (Mohawk Valley Perinatal Network,) Tom Curnow (Herkimer County HealthNet,) David Jordan (Montgomery Office for the Aging,) Elyse Enea (Herkimer County HealthNet,) Robyn Dousharm (Bassett Healthcare Network,) Deborah LaVallee (River Ridge Living Center,) and Amy Gildemeister, PhD (Schoharie Public Health)
Staff: John May, MD, Aletha Sprague, Melissa Scribani, Anna Gleboff, Bonita Gibb, and Felicia Johnson
Welcome & Introductions:
Dr. May welcomes everyone. He describes the role of the work group as using the expertise and knowledge of its members in both the subject of obesity and the concerns of the region and then to review and select various evidence-based programs recommended in the NYS Prevention Agenda. The grant does not permit funds to be used for interventions, but the MV PHIP staff can write grants and to help fund the projects. He turns the meeting over to Ms. Sprague.
Ms. Sprague initiates introductions among the work group. Ms. Sprague explains the contents for work group binder which includes:
1. MV PHIP Factsheet and how the PHIP fits in with other NYSDOH initiatives including DSRIP
2. Work Group Charter and the MV PHIP mission statement, “All New Yorkers should have the opportunity to make the choices that allow them to live a long, healthy life, regardless of where they live, their income, education, or background.”
3. A Copy of the obesity stakeholder presentation
4. Meeting minutes from the obesity stakeholder meeting
5. Obesity data
6. Prevention Agenda Action Plan Refresh, an updated version of the Prevention Agenda which includes process measures and resources
7. Resources
a. Complete Streets
b. Employer Toolkit for Breastfeeding
c. Creating Healthy Schools and Communities
Ms. Sprague also asks that the group establish a meeting schedule that would be most convenient for the work group members. She asks that the group meets at least 6 times per year. She states it is the responsibility of the MV PHIP team to collect that data for the work group and encourages the work group to ask for data. Ms. Sprague reviews the roles of the Board of Directors, MV PHIP Staff, Work Groups, Consultants like Healthy Communities Institute, who are developing the MV PHIP website and Technical Experts like Bassett Evaluation Study Team (BEST). Ms. Sprague solicits changes to the work group charter and none are given. Ms. Sprague asks for questions. Mr. Hohensee asks about the work group responsibilities and about the number of projects the group will undertake. Ms. Sprague responds that it is up to the group to decide on the number of projects. Mr. Hohensee asks about the measureable impact referred to in the charter and wants to know if it is the time frame of the PHIP grant or the grant that the group receives for the project(s). Ms. Sprague replies the measureable impact refers to time frame of the grant the group receives. She states that PHIP has a two-year contract with the possibility of three one-year renewals. The current PHIP contract ends on January 14, 2017.
Ms. Sprague requests nominations for the chair. The MV PHIP will facilitate the meetings, but the chair would help keep the meetings on track, as well as, have input on the agenda and topics discussed at the meetings. The MV PHIP team will be responsible for the meeting minutes. Ms Sprague passes around a sheet of paper for chair. She states that just because you are nominated doesn’t mean you are committed. She asks if anyone has any interest in being the chair. She states that the Access to Mental Health Services work group was offered a rotating chair position so that no one person had to be the chair at every meeting. Ms. Wilson suggests that the perceived work load of being chair could be a barrier to being nominated or volunteering. Ms. Sprague responds that the MV PHIP team will be the ones completing the task-oriented work and the chair would only be responsible for facilitating the meeting and approving the agenda beforehand. Ms. Whitford asks if there is a way for people to see a list of the types of initiatives going on in the region.
Ms. Sprague responds that this is the first work group meeting, but in the previous obesity stakeholder meeting there was a presentation that highlighted current programs. She reminds the work group that these initiatives may not be regional. Ms. Sprague reads the nominations and that there are 3 votes for Tom Hohensee and 2 votes for Lynae Wyckoff. Both nominees will have time to reflect on whether they will accept the chair responsibility.
Dr. May introduces Ellie Wilson, a Sr. Nutritionist and Registered Dietician, currently employed at Price Chopper. She presents on Price Chopper’s use of the NuVal® Scores. The NuVal System scores food on a scale of 1-100. The higher the NuVal® Scores, the higher the nutrition content of the food. She describes how the scores can be used to help shoppers make healthier choices in the grocery store. She states that as retailers offer more ways to select healthy options, the more producers are offering healthier foods. She explains that the NuVal® Scores are the only scores developed outside of the food industry. Dr. David Katz and a team of researchers, doctors, scientists and nutritionists at the Yale Griffin Prevention Research Center developed the scores. Ms. Dolan asks if retailers plan to adopt NuVal across the board and if there is a community initiative to encourage grocery stores to adopt them. Ms. Wilson replies that there is not.
Ms. Wilson explains that NuVal® Scores are a way to reduce perceived barriers to nutritious cooking. These barriers include lack of time, lack of flavor, lack of proper utensils to prepare the healthier foods and cost. She uses the example of green beans and notes that people tend to perceive healthy eating as more expensive. Frozen green beans and canned green beans in water have the same NuVal score as fresh but at a much cheaper price and longer shelf life.
Mr. Speelman of Price Chopper explains that the designing of new stores and the re-designing of existing stores will focus on making NuVal® Scores more prominent as well as making healthy choices more visible to consumers and less healthy choices less visible.
Ms. Whitford asks if food producers are changing how they produce their foods because of these scores. Ms. Wilson replies that food manufacturers want to score higher. She states that companies are now making products that meet or exceed the average NuVal® Scores for product. Ms. Arcuri asks if NuVal® Scores are beneficial regardless of the type of chronic condition. Ms. Wilson states that the NuVal® Scores work for everyone with every type of chronic condition except those who have kidney disease because potassium and phosphorus are two ingredients that push a NuVal score higher, but are not good for kidney disease. Ms. Arcuri gives kudos to Price Chopper for moving healthy choices to eye level.
Ms. Sprague thanks Ms. Wilson for presenting the information. She asks if there is anything anyone would like to add or ask. Dr. Riley notes that exercise is also an important part of the equation. He states that Complete Streets is great in the good weather, but not in the winter. He wonders if there are any initiatives being looked at to promote access to exercise. Ms. Sprague states that Dr. Strogatz of the Bassett Research Institute was researching the feasibility of local schools making the facilities open after hours to community members. Ms. Bond responds that her local school opens up in the evening for community members. She suggests that the work group get together a list of schools that do this for providers so they can give this information to their patients. Ms. Wyckoff states that if a lot of providers started asking the schools directly, there would be more cooperation. She suggests the group get together a letter asking schools to open after hours for community use, which she believes would show a lot of community support and help convince the schools. Mr. Hohensee adds that Dr. Strogatz is working on a study, Walk with Ease, which gives providers the opportunity to refer patients to walk more. The hope is that community institutions, schools included, will open up to provide what support they can. He states that there are pilot programs in Gloversvillle and Fort Plain. Ms. Bond states that there is also a state initiative from the Office of the Aging to provide Tai Chi classes for arthritis sufferers. Ms. Wilson states that DASH-NY website offers a tool kit for developing joint use agreements.
Ms. Headwell adds that Montgomery County does offer Tai Chi at the senior centers, and some of the schools open up their pools a few times per week to the community. She states that some of the schools will offer birthday swim parties. She also mentions that some of the school pools are shutting down due to lack of utilization. Mr. DeFazio comments that work place education has a real impact on exercise and healthy choices. Dr. Gildemeister wonders if there was a way to encourage outside activity regardless of the weather. Ms. Blanchard responds that Schoharie County has snowshoes people can borrow to try out and see if they enjoy them. She also states that they have community ice-skating rinks with community use skates. She states that some communities offer sidewalk shoveling to encourage people to walk. Dr. Gildemeister states that society either encourages or discourages winter activities. She states that in Minnesota schools have recess outside in all kinds of weather, but in her daughter’s school they stay inside for recess for much of the winter. She also states that towns have the responsibility of shoveling sidewalks. Mr. DeFazio states that shoveling is great exercise. Ms. Blanchard suggests using the word “exercise” might be a barrier. She suggests using “increased activity” rather than exercise.
Ms. Sprague asks if the group is leaving with more information about NuVal® Scores than when they came in. Ms. Dolan states that she did not know anything about NuVal® Scores until today. Ms. Wilson comments that there are many competing messages in grocery stores. Ms. Dolan requests more information on having an educational opportunity in Cobleskill Regional Hospital. Ms. Wilson states she would love to do it and in the meantime, refers Ms Dolan to the printed material provided by Price Chopper. Mr. Hohensee states that he likes the idea of integrating the NuVal® Scores in community education. Ms. Wilson responds that daycare providers are required to have nutrition education. She states she would love the opportunity to reinforce the message. Ms. Dousharm comments that it is important for providers to have this information, but she is concerned that Bassett in particular might not like that the message is tied to Price Chopper. She thinks that providing the data and information without using the Price Chopper logo would be a better idea. Ms. Wilson states that she would love to see NuVal as a promising practice.
Ms. Haldenwang wonders about alternatives for providers who have patients who don’t shop at Price Chopper. She wants to know if there are tips or tricks, or some kind of app, something that will help those patients or clients shop in stores outside of Price Chopper and still have access to the NuVal® Scores. Ms. Wilson replies that at this time there is not. She states that this is a very visual program. Dr. Riley offers that it sounds like the resources are available, but he wants the group to focus on identifying the best resources that are already available and educate the regional population. He posits that any grants the group seeks should be for education. Ms. Wilson replies that NuVal® Scores are very passable for all levels of educations. Ms. Sprague adds that the PHIP staff will help look up all the resources available in the region. Ms. Wyckoff states that these interventions are more at the individual level and not a population-based approach. She asks if there is a copy of the Health Impact Pyramid to remind people about the “gold-standard” of population-based approaches. Ms. Sprague responds that the NYS Prevention Agenda did not include NuVal system on their website, but the MV PHIP can include it. She also states that the PHIP staff can show where any proposed interventions rate on the Health Impact Pyramid. Dr. Gildemeister wonders what is wrong with having an app, or something similar, as a tool for someone shopping at a store that doesn’t have NuVal® Scores.