Secretary of Health and Human Services, Mike Leavitt announced the winners of the third annual Innovation in Prevention Awards on October 24, 2005 at the 3rd National Prevention Summit, held in Washington, DC. Partnership for Prevention, acting at the Secretary’s request, convened a panel of 15 experts who reviewed, evaluated, and rated programs based on five criteria: creativity and innovation, leadership, sustainability, replicability and results/outcomes. To be considered, programs were required to address at least one of the following risk factors: obesity, physical inactivity, and/or poor nutrition. The panel reviewed 108 applications and provided recommendations to Secretary Leavitt, identifying those with the most merit.

The Awards are a component of STEPS to a HealthierUS, an HHS initiative to help Americans live longer, better, and healthier lives. Ten awards were given among the seven categories listed below. To view the press release, please go to www.hhs.gov, under “News.”

Awardees

Faith-based and community-based
Healthy Living Program (HLP), University of Rochester Medical Center, Center for Rochester’s Health, Rochester, NY

Provena St. Mary’s Wellness Center Special Needs Fitness Program, Provena St. Mary’s Hospital, Kankakee, IL

Health Care Delivery
Step Up, Excellus Blue Cross Blue Shield, Rochester, NY

Healthy Workplace — Large Employer (greater than 500 employees)
MFit Employee Wellness Program, University of Michigan Health System (UMHS), Ann Arbor, MI

Healthy Workplace — Small Employer (500 or less employees)
SHAPE, Schupan & Sons, Inc., Kalamazoo, MI

Non-Profit
EnhancedFitness (formerly Senior Wellness Project), Senior Services of Seattle/King County, Seattle, WA

Public Sector
The Arkansas School BMI Assessment Project, Arkansas Center for Health Improvement, Little Rock, AR

Eat and Play the Native Way: Building Strength through Healthy Choices, Coconino County Health Department, Flagstaff, AZ

Schools (K-12)
Fun 5, Honolulu, HI

Delta H.O.P.E. Tri-State Initiative, Wellness Incorporated, Duluth, GA

The Provena St. Mary’s Wellness Center entered into an agreement with the Kankakee County Training Center for the Disabled (KCTC) and the Chamness House, a group home, to provide fitness and general inclusion activities. Physical activity is important for these individuals, as their disabilities may increase their risk for heart disease, diabetes, falls, and dependence on others. Groups of 6 to 15 meet with an instructor two times per week for 45-minutes of fitness instruction. This includes cardiovascular and resistance/strength training exercises. The workouts are kept as structured as possible to document the development of each individual. The Wellness Center has a variety of cardiovascular options for the participants to choose from: treadmills, elliptical, Pro II (upper and lower body ergo meter), bikes (upright and recumbent), and Nu Steps. Instructors monitor the individual’s intensity on each of these machines. Following the cardiovascular workout, participants meet in the aerobics room to perform strength and balance training. Depending on the level of function, each participant will sit in a chair or stand and use either a body bar or dumbbells. Exercises performed include use of upper body and lower body extremities to ensure a full body workout.

The Excellus BCBS Step Up health initiative encourages adults to take small, simple, daily steps toward improving their health. To reach the goal of overall health improvement, the program focuses on increasing awareness and participation, as well as influencing and motivating adults to become more physically active and/or eat healthier. The program has both a web and non-web based component. The Step Up website offers program participants’ extensive health information, recipes, lifestyle tips, scientific calculators, activity conversion charts, and personal progress trackers. The program also offers “kits” to use at work to motivate increased activity. These kits include motivation “point of decision” posters (i.e. use the stairs posters placed at the elevator entrances), as well as information pamphlets, pedometers, and tracking booklets. The results of a post -deployment measurement survey showed that 26% of the Upstate New York population was aware of the program. Of those aware and participating, 18% stated that the program influenced them to be more physically active and/or eat healthier. An additional 28% stated the program had made them think about becoming more physically active and/or eat healthier.

The MFit Employee Wellness Program is dedicated to educating, motivating, and empowering individuals to make healthy lifestyle choices. MFit offers many services to get employees on the path to good health, including health and fitness screenings, individual and group consultations, incentive programs, seminars and classes, special events, educational materials, and fitness center discounts. The staff is trained to help employees in areas, such as physical activity, nutrition, weight management, tobacco cessation, alcohol management, stress management, and general wellness. MFit also strives to support a healthy work environment through the MFit Healthy Dining Program in UMHS cafeterias and vending machines and the UMHS Smoke-Free Environment. MFit staff also have mapped indoor and outdoor walking trails and installed signage by elevators that encourages taking the stairs. In support of UMHS’ strategic objective to promote the physical activity and healthy eating of the workforce, MFit launched the Healthy Workforce Initiative. This series of health and fitness activities included: An intensive communications campaign called “Taking Care of Our Own;” engagement of “leadership champions” to increase participation; a “Physical Activity for Life Charity Challenge;” a wellness expo, featuring speakers and a variety of fun, interactive booths, and wellness screenings; “Super-Size Me” seminars that taught the importance of considering portion size and nutritional content in food choices; a “Colorful Choices” incentive program promoting daily intake of fruits and vegetables; Move, Lose, and Maintain—a 12-week weight management incentive program—and an Ask the Experts’ service that allows employees to communicate via email with MFit dietitians, exercise physiologists and behavior change specialists.

SHAPE (Schupan’s Health Awareness Program for Employees) is a multi-faceted program. The program provides both yearly health assessments and, as results dictate, more frequent assessments on-site at the facility. The assessment checks the employee’s fitness level, blood pressure, cholesterol, Body Mass Index (BMI), and assesses health risk factors (for example: smoking). Also offered are smoking cessation reimbursements of up to $200, health club membership and exercise equipment reimbursement of up to $50/year, and organized weight-loss program reimbursements up to $50/year. The employees are offered annual free flu shots for themselves, as well as their spouses and children. Employees receive a quarterly health newsletter mailed to their home, which is published in both English and Spanish. Each employee who participates in the health assessments receives their own assessment results and access to a monthly on-line health newsletter, as well as information on links to a variety of health-related websites.

EnhancedFitness is an evidence-based program, scientifically proven to improve health and physical performance in older adults. The program incorporates aerobic activity, strength conditioning, balance, and flexibility exercises. Project Enhance Program was launched as a pilot study in 1993 at a Senior Services of Seattle/King County-affiliated senior center. It received an overwhelming positive response and study results showed that the senior group improved significantly in almost every dimension tested—from physical and social functioning to levels of pain and depression. Once deemed a success, Project Enhance expanded and now offers the same proven program at 82 sites nation-wide. Using the “group-model,” the original goals of the Project Enhance Program were to provide a group exercise class that could be undertaken by sedentary older adults, utilizing the same type of fitness instructors commonly found working throughout the community in parks departments, senior centers, and commercial gyms. This approach provided the seniors with an understanding of and confidence in their ability to increase resistance and exercise vigor. Specifically designed to be “low-tech,” with the only required equipment being wrist and ankle weights, the program currently draws on the “social ecological model.” While seniors may do the exercises on their own and are encouraged to do so outside the class setting, there is a strong preference to continue the group model activity because of other health benefits associated with social interaction.

On April 11, 2003, Arkansas became the first state to provide comprehensive, multi-faceted approaches that bring families, schools, and communities together to combat the obesity epidemic. The Arkansas Departments of Education and Health asked the Arkansas Center for Health Improvement (ACHI) to oversee the BMI (Body Mass Index) assessments of the state’s public school children—as mandated by Act 1220. Because nothing of this magnitude had been attempted at state or national levels, ACHI devised a reliable method to uniformly measure ~ 440,000 students, while ensuring confidentiality. In year one, ACHI prepared and distributed nearly 346,000 individual Child Health Reports to parents detailing BMI classifications and health risks associated with being “at risk” for overweight children. Additionally, each school district and school was given reports showing the percentage of students by BMI classification. A state report, which provided comprehensive data by grade, gender, age, ethnicity, and geographic region, was publicly released to community leaders and elected officials, illustrating the pervasive problem of child obesity in Arkansas. In year two, ACHI reviewed and modified the assessment process to enhance communication and efficiency. Additionally, new technology was implemented to make the process more user-friendly and cost efficient. As of June 1, 2005, 442, 940 students have been assessed. This represents 97% of the students in the state and currently data entry is ongoing. A second state report was distributed in September 2005 that enabled the state to compare yearly progress and identify continuing problems. In an unprecedented way, Arkansas has accurately detailed the obesity epidemic and provided a method to track long-range changes. By identifying the depth and breadth of the obesity epidemic among the state’s children, ACHI has laid the groundwork for future efforts to combat this problem.

The Eat and Play the Native Way Program was initially developed from a mini-grant funded by the Arizona Department of Health Services. Originally to be a year-long program, it was so well received by the reservation schools that the funding was continued. The Eat and Play the Native Way Program was developed to provide physical activity and nutrition education to K-3 grades in the Navajo reservation schools within the Coconino County district. The focus of the program is to develop a physical activity and nutrition curriculum related to the Native American culture for teachers to teach as lessons and use as a resource in their health education classes. A component of the curriculum uses traditional Native American games or games that help depict the culture of Native Americans to build the skills that were needed long ago to live in harmony with the environment and remain applicable today. The curriculum was scheduled to have four to five physical activities and nutrition lessons. The lessons were to establish the ground work in the understanding of the importance of physical activity and nutrition within the Native American culture. After the curriculum was developed, it was tested in five schools where 866 students participated in the program. In its second year, the program decided to focus on finishing the development of the curriculum and, therefore, downsized the participation from five schools to three. This has worked well in focusing on the lessons and working with the students on a one-on-one basis. The curriculum is scheduled to be completed within the next school year.

Fun 5 was created to address the rising obesity epidemic. The program promotes physical activity and nutrition in the After School Plus (A+) program and encourages children to develop life-long commitment to physical activity and healthy dietary habits. Guided by the Sports, Play, and Active Recreation for Kids (SPARK) Active Recreation (AR) program, Fun 5 offers a variety of organized, non-competitive, non-gender specific, and fun physical activities in which children of all skill levels can participate and experience success. Fun 5 encourages 5 days of physical activity per week and consumption of 5 fruits and vegetables per day. Participating A+ sites are expected to implement SPARK a minimum of 3 times per week (minimum 30 minutes/session), encourage children to involve the family in leisure-time physical activity, and promote fruit and vegetable consumption. Through a partnership with the State Department of Education, the Hawaii Medical Service Association (Blue Cross Blue Shield of Hawaii), and the University of Hawaii, the program began with a pilot project in 2003. Implemented in two phases, January through June 2003 (Phase I) and August through December 2003 (Phase II), the pilot was offered at thirteen Department of Education (DOE) A+ program sites to children in grades 4-6 (n=533). Participating A+ site coordinators and group leaders attended training and received sports equipment to ensure effective implementation of organized physical activities. This project increased active time during the A+ program by 140% (from 13 to 31 minutes during an average A+ day) and significantly increased the frequency of moderate physical activity during leisure time (outside of school or A+ 3.1 days/week to 3.6 days/week). Due to the pilot’s success, Fun 5 now is offered for statewide dissemination. Seventy-two sites were trained (over 9000 students) in the first dissemination semester (Fall 2004), with planned RE-AIM evaluation. Currently 12 of the thirteen pilot sites continue implementation.

Wellness Incorporated, The Mississippi Alliance for Self-Sufficiency (MASS), and the ILSI Center for Health Promotion are collaborating with cooperative extension agents and elementary schools in the Delta Regions of Mississippi, Louisiana, and Arkansas to improve children’s health. The Delta H.O.P.E. Tri-State Initiative (H.O.P.E. - Health Options for People through Extension) supports the implementation and evaluation of a classroom-based intervention that: 1.) presents the OrganWise Guys (OWG) characters to help teach young children physiology and lifelong healthy behaviors—including nutrition education—through read-along books, games, dolls, and informational videos, and 2.) encourages short bouts of physical activity, integrated with academic lessons (TAKE 10!). H.O.P.E. is the expansion of a pilot program that is added to multiple schools each year in Mississippi, Louisiana, and Arkansas, with the objective of coalescing organizations to combat the epidemic of children who are overweight and “at risk” for overweight and obesity. Sample results are as follows:

• During the 2003–2004 school year, 185 classrooms (approximately 3,559 students) from schools in the Delta region utilized the OWG/Take 10! materials
• Student knowledge assessments indicated that, in all grade levels, at least 50% of the students achieved full mastery of objectives on Nutrition, Physical Activity, and General Health and Safety
• H.O.P.E has been selected for presentation at nearly a dozen national conferences
• In May 2005, H.O.P.E. received a GOLD rating from the Cooper Institute (Dallas, TX) for a program “with the greatest potential to help reduce childhood obesity.”