Statewide Health Improvement ProgramCommunity Health Indicators: SHIP Region Prepared by: Garth Kruger, Ph.D. Dmitri Poltavski, Ph.D. EvaluationGroup, LLC
Introduction • EvaluationGroup,LLC • Dmitri Poltavski, Ph.D. • Garth Kruger Ph.D. • Jacque Gray, Ph.D. • OUR SERVICES INCLUDE • PROGRAM EVALUATION DESIGN • WRITING LOGIC MODELS • NEEDS ASSESSMENTS • SURVEY CONSTRUCTION • DATA ANALYSIS • POLICY ANALYSIS • WEB PAGE DESIGN
Purpose of Presentation • To review Regional and state health risk indicators • Select interventions that provide maximum impact.
What are the results? • Adults in the NW MN Region are overweight/obese. • Increase physical activity and improve nutrition. • SHIP region youth need tobacco prevention • Use tobacco products significantly more often. • Cigarettes and Smokeless tobacco • Physical activity for those kids who get no weekly physical activity • Nutrition below state average
Overview • Behavioral Risk Statistics • Indexes of Obesity and Tobacco Use: Adults (18+) • Indexes of Obesity and Tobacco Use for High School Students (grade 12) • Overweight and Obesity • Exercise and Physical Activity • Fruit and Vegetable Consumption • Tobacco Use, Access, Smoking Policy • Interviews with County Residents • Review of Interventions and Recommendations
Behavioral Risk Statistics Indexes of Obesity and Tobacco Use: Adults (18+)
ESTIMATE ? Unknown ? Known Age Gender Risk Statistics (Adults) Data Used • Behavioral Risk Factor Surveillance Survey (BRFSS) databases 2004, 2007 and 2008. • There are only synthetic estimates of behavioral adult risk statistics for the 8-county SHIP region. • There are currently no recent BRFSS data available on smokeless tobacco use in Minnesota.
MN Risk Statistics (Adults) General Health and Obesity • Over 60% of all Minnesotans are overweight or obese (mean BMI of 27.5  ). • 37.5% of all Minnesotans were overweight. • 26.5% were classified obese.  BMI between 25.00 and 29.99 corresponds to the category “overweight”; BMI of 30.00 and above corresponds to the category “obese”.
MN Risk Statistics (Adults) 2007 Minnesota Physical Activity (PA) Categories (%). • 45.5% of Minnesotans met physical activity recommendations. • 40.4% reported insufficient levels of physical activity. • 12.9% had none at all.
NWMN Risk Statistics (Adults)  Aggregate data for Kittson, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake & Roseau Counties.
MN Risk Statistics (Adults) Fruit and Vegetable Consumption • 21.3% of Minnesotans reported consuming 5 or more servings of fruits and vegetables per day.
MN Risk Statistics (Adults) Tobacco Use and Smoking Policy • 15.7% of Minnesotans in 2008 reported currently smoking at least on some days. • 11.1% percent were regular smokers (smoke every day). • 53% of smokers reported trying to quit at least once in the past 12 months.
Summary • Data suggest • Over half the adult population is overweight or obese. • Only slightly more than 20% of adults eat the recommended guidelines of fruits and vegetables. • NWMN adults are much less physically active (no exercise) than other adults statewide.
Behavioral Risk Statistics Indexes of Obesity and Tobacco Use: High School Students (grade 12)
Risk Statistics (High School Students) Datasets Used • Minnesota Student Survey 2007 • Information used for only students in grade 12. • Good proxy for needs given SHIP parameters. • They show the greatest prevalence of health risk behaviors compared to grades 6 and 9. • 86.6% response rate • 72% response rate for SHIP region
Risk Statistics (High School Students) Datasets Used • MN Student survey administrators provided raw data sets in order for us to make statistical comparisons. • Confidence intervals used to assess statistical differences. 10.9% 4.9% 95% Confidence Interval 22.7%
Risk Statistics (High School Students) Overweight and Obesity –See Table 2, pg. 7 • 12.7% of 12th-graders in NWMN were classified ‘at risk’ for becoming overweight • 11.9% of 12th-graders in NWMN were considered overweight. • Adult population at 60% • 28.7% of NWMN students thoughtthey were overweight.
Risk Statistics (High School Students) • 67.4% of students met recommendations for regular weekly physical activity. • MN ave was 68.7% • 45% of MN Adults Exercise and Physical Activity • 19.3% of students reported insufficient physical activity. • 13.3% reported no weekly physical activity. (stat sig)
Risk Statistics (High School Students) Fruit and Vegetable Consumption • Only 12.0% of students reported adequate daily intake of fruits and vegetables. • Significantly less than MN (16.1%). • 21.3% of adults
Risk Statistics (High School Students) Tobacco Use and Access • 37.8% of the 12th-grade students reported using tobacco products in the 30 days preceding the survey. (15.7% of adult Minnesotans smoke) • Cigarette smoking was the most frequent form of tobacco use reported by approx 29.2% of students (significantly higher than the state average). • 16.0% used smokeless tobacco in the last 30 days! (compared to state average of 10%)
Risk Statistics (High School Students) • 69.1% of tobacco users purchased them at a gas station or a convenience store. • MN average was 63.1% ( not stat sig).
Summary of Findings Compared to the statewide averages of MN youth, NWMN youth… • Use tobacco products more often. • Cigarette use and smokeless tobacco. • Are meeting PA guidelines significantly less often than state average. • Need to work with youth who get no weekly physical activity. • Nutrition below state average.
County Resident Interviews Most Pressing Issues and Extent of Problems
Interviews • Comments from interviewers…
Interviews • Reasons for the lack of exercise and physical activities are that people are living “busy lives, people just don’t have time for exercise or to prepare healthy foods. It’s not like it was 25 years ago when we had more time for that. Now everyone is just busy, busy, busy”.
Interviews • One convenience store clerk respondent stated “I feel bad when people come into the store and say, I need my fruit for the day” when buying Starburst candy.
Recommendations Best Options for Addressing Overweight, Physical Activity and Tobacco Use in Adults and Youth
Intervention Settings Community Worksites Schools Tobacco Use and Obesity Healthcare
Recommendation: Collect Better Data • Conduct BRFSS locally within each of the eight counties to obtain a more accurate accounting of the adult population risk factors within northwest Minnesota.
Recommendation: Increase Adult Physical Activity COMMUNITY/WORKSITE SETTING INTERVENTIONS • Policies and practices that create active communities • Increase opportunities for non-motorized transportation (walking and biking) • Increase access to community recreation facilities. • Implement signage prompting use of stairs in community buildings. • A comprehensive employee wellness initiative • Provide health assessment with follow-up coaching, • Provide ongoing health education, • Provide policy and environmental supports that promotes healthy weight and behaviors. • HEALTHCARE SETTING INTERVENTIONS • Develop relationships among health care providers and community leaders to facilitate active referral of patients to resources that increase access to nutritious foods, physical activity, and tobacco use cessation.
Recommendation: Decrease Tobacco use by Youth • COMMUNITY SETTING INTERVENTIONS • Tobacco-free policies for parks, playgrounds, beaches, zoos, fairs, and other recreational settings. • Policies that restrict youth access to tobacco such as sales laws directed at tobacco retailers to reduce illegal sales to minors. • HEALTH CARE SETTING INTERVENTIONS • Better connect people with existing effective cessation services (such as the 5 A’s and fax referral).
Recommendation: Nutrition & Physical Activities for Youth • SCHOOL SETTING INTERVENTIONS • Comprehensive nutrition policies: • Breakfast promotion; • Healthy lunch and snacks; • School gardens; • Farm-to-school initiatives. • Creating more active schools through: • Supporting quality school-based physical activity • Increasing opportunities for non-motorized transportation • Increased access to school recreation facilities. • COMMUNITY SETTING INTERVENTIONS • Improving access to nutritious foods (e.g. fruits, vegetables) through: • Increased availability and affordability of nutritious foods in grocery stores, corner stores, concession facilities, and other food vendors. • License and facilitate the development of new farmer’s markets and promote their use.
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