# Presentation: 293980

## HealthierUSVeterans

**Notes:**
Speaker should introduce self and explain connection to HealthierUS Veterans, VA and/or HHS.

## What is HealthierUS Veterans?

- Initiative sponsored by Departments of Veterans Affairs and Health and Human Services
- Focus on improving health of veterans and family members by encouraging healthy eating and physical                           activity
- Aim to reduce risk of                          obesity and diabetes

**Notes:**
The U.S. Department of Veterans Affairs (VA) and the U.S. Department of Health and Human Services (HHS) have joined forces in an effort to improve the health of the nation. 
The focus of this joint initiative, HealthierUS Veterans, is to educate veterans, their families, and communities about the health risks of obesity and diabetes and ways to reduce risk - eating healthy and being active. 

VA Secretary James Nicholson said, “Obesity and diabetes are major threats to the health and lifestyles of our veterans, deserving a robust campaign to better educate them on healthy habits.”
HHS Secretary Michael Leavitt said, “We are working to encourage Americans to adopt a healthy lifestyle and to take responsibility for making wise choices to improve their fitness and health.”

## Why Focus on Obesity and Diabetes in Veterans?

**Why Focus on Obesity and Diabetes in Veterans?**

- National and VA-specific rates of obesity and diabetes are high and increasing
- Obesity and Diabetes are                            significant problems for                                    veterans who receive                                         health care from VA.
- Veterans and families make up 1⁄4 of US population (approximately 70 million)

**Notes:**
Both national and VA-specific rates are high and are continuing to increase. 
The national prevalence of overweight/obesity is 64% .  There has been a steady increase in overweight/obesity over the last 20 years.  That trend is continuing.  Maintaining a healthy weight is difficult for the general public and veterans.
Diabetes is a problem for many veterans receiving care in VA.
By focusing efforts to address these conditions on the population of veterans and their families, up to a quarter of the entire US population, about 70 million people, can be reached.  

## Health Risks of Obesity

- Diabetes
- High blood pressure
- High blood cholesterol
- Heart disease
- Sleep apnea
- Osteoarthritis
- Some types of cancer

**Notes:**
Obesity is a major risk factor for type 2 diabetes, heart disease, sleep apnea, osteoarthritis, as well as certain cancers.  It is associated with approximately 112,000 deaths each year in the United States. 
For those unfamiliar with sleep apnea, the Greek word "apnea" literally means "without breath." Individuals with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. 
Recognizing that health problems resulting from overweight and obesity could reverse many of the health gains achieved in the U.S. in recent decades, the Surgeon General issued a Call to Action to Prevent and Decrease Overweight and Obesity in 2001. 
Weight loss can reduce the risk of type 2 diabetes and in some cases decrease blood pressure and the risk for sleep apnea and osteoarthritis. 

## HealthierUS Veterans

- Message
- Eat Healthy. Be Active. Get Fit for Life.
- 3 main goals:
- Incorporate message into interactions with VA patients and staff
- Reach out to non-VA-using veterans
- Partner with community organizations

## HealthierUS Veterans

- Program Components
- VA’s *MOVE!* Weight Management Program
- Prescription for Health
- Fitness Challenges
- Partnerships between VA medical facilities and community-based programs funded by CDC
- Fit for Life Volunteer Corps

**Notes:**
This initiative will provide substantial momentum for obesity and diabetes prevention through its program components, which include national promotion of the VA’s MOVE! Weight Management Program, a “Prescription for Health” to encourage physical activity, Fitness Challenges, partnering of VA medical facilities with “Steps to a HealthierUS” and other Centers for Disease Control and Prevention programs, and a volunteer corps of active veterans and others.  

## National Promotion of VA                       Weight Management Program

- Patient-centered, comprehensive focus on behavior, nutrition, and physical activity
- Helps veterans lose weight, keep it off, and improve health
- Basic *MOVE!* Program components can be used by veterans, family members, and non-VA providers

**Notes:**
VA has developed a patient-centered weight management program called MOVE!, which is being implemented in VA medical facilities across the country. MOVE! has a comprehensive focus on behavior, nutrition and physical activity and is designed to help veterans interested in managing their weight to lose weight, keep it off and improve their health.  
Veterans first complete an online questionnaire, the MOVE!23, that asks questions about health status and eating and physical activity habits.  Their answers guide the generation of a tailored patient report with recommended handouts and instructions for follow-up with their VA healthcare team.  The VA healthcare team members help veterans to set goals and provide follow-up either in person or by telephone.  If a veteran needs more support for weight management, they can have one-on-one counseling with a dietitian, behavioral health expert or physical activity specialist.  They may also participate in group sessions on behavior, nutrition and physical activity.

Because of the multidisciplinary, tiered structure of MOVE!, many private physicians will not be able to implement the entire program in their offices, but interested persons and providers can use some of the basic components available on the MOVE! website, such as the MOVE!23 questionnaire, the over 100 patient handouts and the resource materials for health professionals.  There are also links to additional nutrition, physical activity and community resources.

## www.move.va.gov

**Notes:**
Visit the MOVE! website at www.move.va.gov.

## Prescription for Health

- States BMI and notes health                          risks if high
- Prescribes daily physical activity                   to reduce risk
- Encourages use of a pedometer                     or an odometer
- Includes a recommended number                 of steps to walk or distance to roll                   if in a wheelchair

**Notes:**
VA primary care providers give each veteran enrolled in MOVE! a pedometer, a handout that explains how to use the pedometer, and an exercise prescription for recommended physical activity, such as a number of daily steps to walk.  For those in wheelchairs, odometers can also be obtained.
For HealthierUS Veterans, activity prescription pads have been developed to tell patients their Body Mass Index (BMI); explain that an elevated BMI puts them at risk for health problems such as diabetes, high blood pressure and heart disease; and give them a recommendation to increase physical activity. Providers have the option to use a prescription for pedometer use with a goal of number of steps to walk each day or a prescription for odometer use with a wheelchair and a goal for distance rolled. 

## Prescription for Health

**Notes:**
Veterans with a doctor’s order can pick up a pedometer or odometer in Prosthetics.  Providers outside VA can use a copy of the prescription from the HealthierUS Veterans website.  Pedometers and odometers can be easily purchased at a reasonable cost.
The brochure and handout on how to use a pedometer or odometer as well as activity logs are downloadable from the MOVE! website.

## Fitness Challenges

- Can be done in a group or individually
- Group challenges can be set up within           or between facilities or VISNs
- Register for the President’s Challenge                         and track fitness activities on-line
- Encourage co-workers, veterans,                 and families to take the challenge
- _[www.healthierusveterans.va.gov/FitnessChallenges.asp](http://www.healthierusveterans.va.gov/FitnessChallenges.asp)__ _

**Notes:**
Competition and sport are ways to inspire activity.  Fitness Challenges amongst VA medical centers, “Steps to a HealthierUS” communities, and others will encourage activity and involvement.  A Fitness Challenge can be a “Walk & Roll”, mini-marathon, or other creative event. 
Take the Challenge! Be a physically active role model for your co-workers, veterans, family, and friends. You can have activity challenges by setting up your own groups on the website for local competitions. 
HealthierUS Veterans promotes the President's Challenge, a program that encourages all Americans to make being active part of their everyday lives. No matter what your activity and fitness level, the President's Challenge can help motivate you to improve. To participate, you can register and log your fitness activities online. 

## Slide 12

**Notes:**
Please use the HealthierUS Veterans website portal to access the President’s Challenge.  This allows for tracking participation of veterans, family members, VA employees, and others and will help with the evaluation of the initiative.

## Slide 13

**Notes:**
This is the customized entry page for HealthierUS Veterans to the President’s Challenge website.  It also has links for physical activity resources on the HealthierUS Veterans and MOVE! websites.

## Community-Based Programs Funded by HHS

*Steps to a HealthierUS* programs in 40 communities address physical inactivity and  poor nutrition to reduce obesity and diabetes
- VAMCs will partner with                   *Steps to a HealthierUS          * communities and                                state-level programs

**Notes:**
The HHS Steps to a HealthierUS program has provided funding to states, cities, and tribal entities for innovative community-based programs that seek to adopt proven measures to reduce the burden of obesity, diabetes, and asthma-related complications. The CDC’s Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases is designed to help states prevent obesity and other chronic diseases by addressing two closely-related factors: poor nutrition and inadequate physical activity. The program supports states with developing and implementing science-based nutrition and physical activity interventions.  
Part of HealthierUS Veterans includes the connection of the 40 Steps to a HealthierUS communities and 28 CDC Nutrition and Physical Activity Program states with local VA medical facilities in order to reduce health disparities and promote quality health care and prevention services.  These resulting coalitions will be charged with implementing chronic disease prevention efforts focused on reducing the burden of diabetes as well as overweight and obesity and addressing related risk behaviors - physical inactivity and poor nutrition.  
As a partner in these programs, VA can contribute to the healthcare, media, and community components of their planned activities. VA will bring to the table resources that have been developed for use in VA medical facilities which can be exported to local healthcare providers. Through media and community activities, healthy eating and physical activity can be promoted by providing a range of recipes, menus, grocery shopping suggestions, and fitness tips using materials developed by CDC, the National Institutes of Health, and VA. 

## Slide 15

**Notes:**
Visit the Steps to a HealthierUS Web site, www.cdc.gov/steps. The HealthierUS Veterans website contains a link to this site.  The Steps site is a great place to access the latest information about the Steps Program, including community successes, partnership activities, and related resources. 

## Fit for Life Volunteer Corps

- Open to veterans, family members, and VSO groups
- Corps members may promote HealthierUS Veterans special events, Fitness Challenges and the President’s Challenge

**Notes:**
The Fit for Life Corps consists of volunteers made up of veterans, their families, friends, and anyone interested in supporting the effort. Volunteers will encourage veterans and their family members to establish and maintain behaviors that promote good nutrition, physical activity, and health and minimize risk of illness related to obesity and diabetes. 
Corps members can promote HealthierUS Veterans events, Fitness Challenges, activities of the President’s Council on Physical Fitness and Sports, and special events such as the VA Winter Sports Clinic, National Veterans Wheelchair Games, and Golden Age Games.  They can also serve as liaisons with VA medical facilities and community groups or as health and wellness event coordinators, health information coordinators, etc.

Speaker Reference:
The goals of the Fit for Life Veteran Volunteer Corps are to: 

•	Support the overall mission of the HealthierUS Veterans by encouraging veterans and their family members to 	prevent obesity and diabetes 
•	Provide volunteer resources to help realize the mission of the HealthierUS Veterans 
•	Develop partnerships with local non-profit agencies to promote health and wellness in the veteran community 
•	Generate a significant positive impact within the veteran population and the local community through health 	and wellness programs 
•	Develop positive outreach and networking opportunities with veterans service organizations and local 	community groups 
•	Celebrate, encourage and promote diversity throughout the program 

## My HealtheVet

- My Health_*e*_Vet offers tools for tracking food intake and physical activity
- Website: www.myhealth.va.gov

**Notes:**
My HealtheVet also offers tools for eating healthy, being active, and getting fit for life.  For example, veterans and family members can access online logs to keep track of what they eat and how active they are.  My HealtheVet has links to the MOVE! and HealthierUS Veterans websites.

## Fitness DVD

**Fitness DVD**

**Notes:**
The HealthierUS Veterans “Get Fit for Life” exercise DVD features a full exercise program and more.  The format allows participants to choose from chapters for a complete and personalized workout.  The exercise portion of the DVD starts with a warm-up and progresses to aerobic activity, strength and balance for beginners, intermediate strength training, stretching and cool-down.  Additional chapters include myths, tips and facts and inspirational stories from veterans who have added physical activity into their lives with positive results.  The DVD has easy to follow instructions and demonstrations, clinicians and veterans can use the DVD in a group or veterans can use it in the comfort and privacy of their home.  Accompanying the DVD is a 20-page companion booklet with supplementary information about the health benefits of physical activity and an activity log for use.

## Promotional Materials

- Brochure
- Poster
- Online toolkit with                                other downloadable                          resources
- Public service                      announcements

**Notes:**
A HealthierUS Veterans brochure, in English and Spanish, and a poster have been created to help with outreach.  Posters and brochures can be displayed in exam rooms, waiting areas, the canteen and other locations in VA medical facilities.  Brochures can also be handed out at promotional events. A virtual toolkit is available on the HealthierUS Veterans website.
A HealthierUS Veterans exhibit and display banner have been designed to use at special events.

## Ideas for Activities at VAMCs

- Establish walking trails on facility grounds
- Post reminders about taking the stairs near elevators; brighten/enhance stairwells
- Sponsor “lunch & learns” with healthy
- 	food and information about good nutrition and physical activity
- Organize farmers’ markets

**Notes:**
Here are some ideas for activities that can be done at VA medical facilities to promote healthy eating and physical activity by veterans and staff.

Speaker suggestion:
This slide should be customized or another slide added to explain what is being done locally to promote HealthierUS Veterans, MOVE!, healthy eating, and physical activity.

## How Can You Get Involved?

- Actively participate in HealthierUS Veterans activities at your local VAMC
- Request “Fit for Life” Volunteers
- Help promote this program to veterans, their families, community organizations and the public-at-large

**Notes:**
Here are some ways you (or your organization) can get involved.   Look in the online toolkit for ideas on how to promote HealthierUS Veterans.

Speaker Suggestion:
This slide could be customized to encourage participation in local activities – be specific about what those activities are.

## Evaluation

- Track events and participants to measure outreach for the HealthierUS Veterans initiative.
- Online field reporting form and success stories form (_[vaww.prevention.va.gov](http://www.prevention.va.gov/)_ - HUSV Toolkit page)
- VA NCP will evaluate various initiative components to understand best approaches for decreasing the risk for obesity and diabetes.

## www.healthierusveterans.va.gov

**Notes:**
A website has been developed that explains the HealthierUS Veterans initiative, suggests ways to get involved and provides links to nutrition and physical activity resources that have been specially chosen for this initiative.