The Statewide Health Improvement Program (SHIP) is a collaboration between 4 Minnesota counties aimed at preventing chronic diseases like obesity and tobacco use. SHIP uses policy, systems, and environmental changes across schools, communities, worksites and healthcare to promote healthy behaviors. The goal is to create sustainable changes that make healthy choices easier through initiatives like increasing physical activity opportunities, improving nutrition, and supporting healthcare provider guidelines. SHIP will be implemented in 4 communities over 2 years and success will be measured by increased healthy policies and lower rates of obesity, tobacco use, and other chronic disease risk factors over time.

1. Statewide Health Improvement Program A collaboration of Becker, Clay, Otter Tail and Wilkin Counties July 1, 2009-June 30, 2011

2. SHIP is…… A component of the overall health care reform initiative passed by the 2008 MN State Legislature. Designed to help Minnesotans live longer, healthier, better lives by preventing risk factors that lead to chronic disease. Intended to enhance patient experience and contain spiraling health care costs.

3. Why Do We Need SHIP? Tobacco use and exposure and obesity are the two leading causes of chronic disease 38% of MN adults are overweight, 25% obese 76% of adults consume less than 5 or more fruits & vegetables/day 49% of adults get fewer than 30 or more minutes of physical activity/day 18% of adults are current smokers Center for Disease Control and Prevention

4. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1998, 2006 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1998 1990 2006 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

5. What makes SHIP different? Instead of taking an individual and programmatic approach, SHIP engages in a comprehensive effort to improve the health of the environment. SHIP aims to create sustainable, systemic changes that make it easier for Minnesotans to choose healthy behaviors.

6. How will change be accomplished? By implementing evidenced-based strategies to make policy, system and environmental changes in four settings: Schools Community Worksites Healthcare

7. What are policy, system and environmental changes? Policy Interventions include changes in laws and regulations such as tobacco free public places or providing time off during work hours for physical activity. System Interventions create change in organizations and institutions such as school districts offering healthy snacks or more time for physical education. Environmental Interventions include decisions about land use, zoning and community design such as neighborhoods having access to healthy foods and sufficient opportunities for activities such as walking and biking.

8. School InterventionsBreckenridge, Detroit Lakes- Roosevelt ,DGF-Dilworth, Perham 1. Implement policies and practices that create active schools by increasing opportunities for non-motorized transportation (walking and biking to and from school) and access to recreation facilities.

9. School Interventions 2. Implement comprehensive nutrition policies including: breakfast promotion, healthy lunch and snacks, including classroom celebrations and incentives, fundraising, concessions, and vending; school gardens; Farm to School initiatives.

10. Community InterventionBreckenridge, Detroit Lakes, Dilworth, Perham Implement policies and practices that create active communities by increasing opportunities for non-motorized transportation (walking and biking) and access to community recreation facilities.

11. Worksite Intervention Becker County, City of PerhamMoorhead School District, Wilkin County Implement a comprehensive employee wellness initiative that provides health assessment with follow-up-coaching, ongoing health education, and has policies and an environment that promote healthy weight and healthy behaviors.

12. Health Care InterventionFamily Healthcare Center-Fargo, Lake Region Hospital/Fergus Falls Medical Group, Innovis ER/Urgent Care Fargo, MeritCare Clinic System Support implementation of ICSI guidelines for “Prevention and Management of Obesity” and “Primary Prevention of Chronic Disease Risk Factors” by healthcare providers

13. Maximizing Opportunities To maximize opportunities and impact, multiple interventions will be implemented in the following communities: Becker County - Detroit Lakes Clay County- Dilworth Otter Tail County- Perham Wilkin County- Breckenridge

14. How will we know SHIP is effective? Short‐Term Outcomes (1‐3 years) ↑policy, systems, and environmental changes in the 4 sectors: school, community, worksite, and healthcare Intermediate Outcomes (3‐10 years) ↓tobacco use & exposure ↑physical activity ↑nutritious eating Long‐Term Outcomes (10‐25 years) ↓tobacco use & exposure ↓obesity

15. For More Information Contact Jason Bergstrand SHIP Project Manager Phone: 701-306-5280 jason.bergstrand@co.clay.mn.us Minnesota Department of Health Website http://www.health.state.mn.us/healthreform/ship/index.html