CaldWELL County group campaigns for smoking ban

A committee dedicated to the wellness of Caldwell County, which makes the most of the county's name, is pushing for a smoking ban. The CaldWELL Committee's internal acronym stands for Wellness Education through Local Leadership, and members did some of that Tuesday when the group asked the county Fiscal Court for an ordinance banning cigarette smoking indoors in public buildings. The group was joined by representatives from the local health department, housing authority, Extension office, law enforcement, education, emergency services, mental health, senior services and other public and private agencies, reports Jared Nelson of The Times Leader.

The committee has been collecting survey data from residents about their health perceptions and needs. Their request to the fiscal court is a direct result of that data, said Allison Beshear, health educator and public information officer with the Pennyrile District Health Department. In Caldwell County, about 27 percent of adults are identified as smokers. That number is down from 34 percent reported in the results of a 2008-10 survey. The Times-Leader is behind a paywall. To credit an account, go here.

Kentucky Parent Survey: We could do a lot better on school meals, we're very much in favor of more health education

Fewer than 10 percent of Kentucky
parents report that their child has ever
walked or biked to school.

When asked, only about one in four Kentucky parents describe the meals served at their child's schools or day care centers as being nutritious. Fewer than 10 percent report that their child have ever walked or biked to school. And an overwhelming majority want information about sexually transmitted infections, human anatomy, abstinence education, birth control methods and condom use taught in Kentucky's high schools.

These are just a few of the surprising results from the first Kentucky Parent Survey conducted by the Foundation for a Health Kentucky, a random telephone survey of 1,006 parents of children under 18. The survey assessed the views of parents, step-parents, grandparents, foster parents and other legal guardians of children in Kentucky. The term "school" was used broadly in the survey as included (2 percent of total surveyed), as well those in pre-school and day care. The study took on nutrition, physical activity and health education.

Eighty-eight percent of parents reported that it was "very important" that meals at schools meet a minimum standard for nutritional value. Only about 1 in 4 parents currently thought their schools were meeting that standard. Only 11 percent are concerned that their younger children are getting too many "celebration-related" treats at their school.

While parents in the state reported that a little more than half (52 percent) of school-age children took physical education classes, that class was not a daily occurrence but met between one and four times a week. Only about 1 in 3 students took a daily course in P.E. That leaves 14 percent without a planned daily class during the school year.

On the topic of health education, parents reported that half of school-age children in the state took health classes, but again not daily. According to the FHK, "The Kentucky Parent Survey included a series of questions about dating relationships and sexual health to determine support for covering those topics...
At the middle school level, more than 8 in 10 parents would favor teaching communication skills (99 percent), human anatomy (91 percent), abstinence education (85 percent), and information about HIV and sexually transmitted infections (84 percent). At the high school level, more than 8 in 10 would favor teaching communication skills (99 percent), information about HIV and sexually transmitted infections (97 percent), human anatomy (97 percent), abstinence education (94 percent), birth control methods (87 percent), and condom use (84 percent)."

Future reports in the FHV series will address access to safe and effective health care for children, children's health behaviors and family routines and the places where parents turn for information on raising healthy kids.

Eastern Kentucky native wants to alert Appalachian women about their high rate of cervical cancer and how to prevent it

University of Kentucky physician and Pike County native Baretta Casey, right, has spent most of her career providing health care and education throughout the state, with a focus on Appalachian Kentucky. The health disparities between Eastern Kentucky and the rest of the state, especially high rates of cancer, are of "special concern" to Casey, reports Ann Blackford of UKNow.

Cancer is prevalent in her Casey's own family, and this is why she "has taken on the challenge of helping reduce cancer rates in Kentucky, especially cervical cancer and other Human papillomavirus cancers," Blackford reports. Cervical cancer rates are highest in rural and Appalachian Kentucky. According to the Kentucky Cancer Registry from 2005 to 2009, the cervical cancer rate in the region was 9.85 per 100,000 people. The state rate was 8.6. The average of deaths per year in the region from cervical cancer was 258.

"We have the tools to change these high rates and make a real difference in people's lives," Casey said. "I feel the best thing I can do for the people of Eastern Kentucky is to educate about prevention and screening of cervical cancer." Casey became the director of the Cervical Cancer-free Kentucky Initiative at UK's College of Public Health's Rural Cancer Prevention Center in 2010. Through this position, she makes connections with county health departments, community organizations and health advocacy groups that provide education and funding for cervical cancer prevention projects.

"Casey is passionate about educating people on the importance of vaccinating their children against HPV," Blackford writes. She said she wants people to look past the controversy of vaccinating their children and realize the importance of the vaccine. "The vaccine given for the appropriate reason can save a life," Casey said. (Read more)

Free webinars and annual forum to be hosted by Foundation for a Healthy Kentucky

The Foundation for a Healthy Kentucky will host several educational events in an effort to help communities improve their health.

On Wednesday, Aug. 8, the foundation will host a webinar about evidence-based policies and programs that improve health. The talk, called "Stop Reinventing the Wheel: A Useful Guide to Evidence-Based Health Programs," will be presented by Katherine Wilson, dissemination and implementation team leader with the Centers for Disease Control and Prevention. To register, click here. The deadline to register is Tuesday, Aug. 7.

An Aug. 29 webinar will look at ways communities can keep programs going when funding ends. Dr. Stephen Orton, deputy director of the Office of Executive Education with the North Carolina Institute for Public Health, will lead the talk. To register, click here. The deadline is Aug. 28.

On Sept. 17, the foundation will host its annual Howard L. Bost Memorial Health Policy Forum at the Embassy Suites in Lexington, with the theme "No Wrong Door: Integrating Care for Better Health." It will feature several speakers working at state and federal levels. Breakout sessions include:
• Respect: Working Across Disciplines for Patient-Centered Care
• Good Medicine is Good Business
• Health Home Opportunities, Focus on Outcomes
• Advocating for What You Need in the System You Have
The forum is free. Civic leaders, medical health and behavioral health providers, public officials, public-health professionals, business owners, policymakers, faith-based leaders, researchers and academics, coalitions and advocates are encouraged to attend. The forum runs from 9 a.m. to 3 p.m. Sept. 17. To register, click here.

Kentucky students will get extra education in nutrition, exercise

Kentucky children will get extra nutrition education at school starting Oct. 1, thanks to a $6 million federal grant intended to instill better eating and physical-activity habits in families eligible for food stamps.

The education will be provided by local health departments. It will encourage students to:
• Fill half their plates with fruits and vegetables; drink fat-free or low-fat milk; and make sure they eat whole grains.
• Increase physical activity and cut down on sedentary behaviors.
• Consume the appropriate amount of calories for their age.

Kentucky students will get more nutrition education
aimed at getting those eligible for the Supplemental
Nutrition Assistance Program to make healthy food
choices. (Photo from The Lane Report)

Details about how many children will benefit from the education and how many minutes of instruction they will receive per week have not yet been ironed out, said Beth Fisher, spokeswoman for the Cabinet for Health and Family Services.

"Sometimes children can be the best teachers, so our hope is that they will pass on to their parents some of what they have learned at school about the importance of nutrition and physical activity," said Teresa James, acting commissioner of the Department of Community Based Services. "If children ask their parents to serve more fruits and vegetables, or take a walk instead of watching TV and the parents comply, this effort can benefit the entire household — just look at the influence children have had on recycling." (Read more)

Journalists invited to apply for free, four-day obesity fellowship

Kentucky journalists wanting to expand their knowledge on obesity, one of the most critical and widespread health issues in the state and nation, should apply for the fellowship "Obesity Issues: The Complete Skinny on Why We're Getting Fatter, What it Means, and What We Can Do About It."

The four-day fellowship, a collaboration between the National Press Foundation and the Colorado Center for Health and Wellness, includes round-trip transportation to Denver, lodging and most food costs. The application deadline is Feb. 13. Sixteen fellows will be chosen.

Fellows will learn about the biology of obesity; environmental factors; the relationship between obesity and chronic diseases, including cardiovascular disease, disease and Alzheimer's; the economics of obesity; how the health-care system responds; why it's difficult to change behavior; and strategies for a healthier workforce.

Speakers include James O. Hill, executive director of the Colorado Center for Health and Wellness; D. John Peters, a leading nutrition and obesity researcher; and other scholars from the  University of Colorado. To apply, click here.

Appalachian Health Summit to be held in Lexington Thursday

Focusing on obesity, a topic that affects most adult Kentuckians, the Appalachian Health Summit will be held Thursday in Lexington. The meeting is designed for clinicians and researchers, but will also be a place for journalists interested in the issue to find story ideas and sources.

The first session of the gathering will focus on health disparities and health behaviors in Appalachia. Topics include "Socioeconomic status and its impact on health in Appalachia," "Culture of Choice and Culture of Care in Appalachia" and "Lessons Learned from the Appalachia Community Cancer Network."

The keynote address will discuss federal, state and local initiatives that address the obesity epidemic. It will be given by Dr. William Dietz, director of the Division of Nutrition, Physical Activity and Obesity with the Center for Chronic Disease Prevention and Health Promotion.

Concurrent sessions will discuss childhood obesity, food and nutrition; research networks and collaboratives; social networking for energy balance; and the link between obesity and cancer.

The summit is sponsored by the University of Kentucky, The Ohio State University, the University of Cincinnati, Marshall University, the Pikeville College of Osteopathic Medicine and the Appalachian Regional Commission.

The summit will be held from 8 a.m. to 5 p.m. on the third floor of the Lexington Convention Center. For more information, click here.

Two conferences this summer will focus on children's health

The 2011 Coordinated School Health Institute conference is set for June 29 in Lexington. The conference will focus on the roles community partners and families play in creating healthy places to learn and work.

The Growing Healthy Kids in Kentucky conference will follow June 30 and July 1. The conference will address how to create healthy, hunger-free communities.

Both conferences will be at the Marriott Griffin Gate hotel. Cost for both events is $205. To register, click here.

April 21 Appalachian Health Summit will focus on obesity

Focusing on obesity, a topic that affects the majority of adult Kentuckians, the Appalachian Health Summit will be from 8 a.m. to 5 p.m. April 21 in Lexington. The meeting is designed for clinicians and researchers, but it would alos be a place for  journalists interested in the issue to find story ideas and sources. The registration deadline is Friday, April 8.

The first session of the gathering will focus on health disparities and health behaviors in Appalachia. The keynote address will discuss federal, state and local initiatives that address the obesity epidemic. It will be given by Dr. William Dietz, director of the Division of Nutrition, Physical Activity and Obesity with the Center for Chronic Disease Prevention and Health Promotion.

Concurrent sessions will discuss childhood obesity, food and nutrition; research networks and collaboratives; social networking for energy balance; and the link between obesity and cancer.

The summit is sponsored by the University of Kentucky, The Ohio State University, the University of Cincinnati, Marshall University, the Pikeville College of Osteopathic Medicine and the Appalachian Regional Commission. To read details and register, click here.

People with low health literacy are more likely to get sick, die

Health literacy rates are increasingly gaining the attention of providers, organizations and lawmakers. A new report based on study of medical literature says people who are unable to understand and act on issues related to their own health care have poorer health and a higher risk of death.

Adults with low health literacy are less likely to get a flu shot, understand medical labels and instructions, and have a greater likelihood of taking medicine incorrectly, the report says. Also, women with low health literacy are less likely to get mammograms. Overall, the report indicates that minorities have lower health literacy rates than the rest of the population.

More than 75 million English-speaking adults across the nation have difficulty understanding and using basic health information. That was the focus of the second annual Kentucky Health Literacy Summit last week.

The report, which was released Monday, updates 2004 literature that reviewed the findings of more than 100 studies. It was compiled by the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services.

In May 2010, the department launched an action plan that asks stakeholders to simplify their health-related handouts, forms and websites by removing jargon and complicated explanations. It also calls for improving patient-provider communication. (Read more)

Health literacy is 'at a tipping point' as an issue to be confronted, federal official tells second Kentucky Health Literacy Summit

By Tara Kaprowy, Kentucky Health News

BOWLING GREEN, Ky. – The idea that people will be healthier if they can better navigate the boggy, confusing landscape of health care and insurance is gaining traction in Kentucky – which, relatively speaking, has poor health and low literacy.

On Thursday and Friday, scores of health professionals and their allies in the health-literacy cause gathered in Bowling Green for the annual Kentucky Health Literacy Summit. It was the second such gathering, but the first was by invitation, so this was the first opportunity for anyone interested in health literacy to attend a statewide conference about it. The first conference resulted in the formation of Health Literacy Kentucky, an alliance of more than 35 groups.

Health literacy is the "degree that an individual can obtain, communicate, process and understand" basic health information, said Dr. Linda Harris, a Bowling Green native who leads the health communication unit in the U.S. Department of Health and Human Services. Only 12 percent of U.S. adults are considered proficient in health literacy, while 21 percent have basic knowledge and 14 percent are below basic. About half of adults have intermediate knowledge, between basic and proficient.

Health literacy has become an increasing problem as health care has become more technical and complex, and as America has more people for whom English is a second language. If people can't understand what they're being told about their health, they are more likely to get sick -- and less likely to get better once they're ill, Harris said.

She illustrated her point with the story of "Mrs. Jones," a composite individual with issues requiring health literacy: a 62-year-old woman with diabetes, heart failure, low income and a history of depression. She gets sick, goes to the doctor, is prescribed several medications she doesn't know how to take, avoids taking them and eventually needs to be hospitalized. Then she is given a second set of prescriptions that she also doesn't understand. She is re-hospitalized "and the cycle continues," Harris said.

Harris said the issue is at a "tipping point" because it has gone from simply being discussed among advocates to being made policy in legislation like the Patient Protection and Affordable Care Act; the National Action Plan for Health Literacy, the Plain Writing Act of 2010; and Healthy People 2020. "We really think this is the moment," Harris said. "It's not just those people who have been laboring in the vineyards for so long."

Insurance companies making headway

Some of the most innovative health-literacy work is being done by insurance companies, most of which are taking steps to make sure their policyholders understand the forms and documents they're sending them, Humana Inc. marketing consultant Betsy Shirey said. In the past year, Humana has simplified more than 400 of its documents, most of which have been rewritten at a sixth-grade level, as determined by a computerized assessment tool, she said.

To test the rewritten materials, Humana had some of its Medicare members look at the new documents. One person said a form could be simplified if it only had a date at the bottom of it. "They told us about really simple things, and yet we hadn't done it," Shirey said.

The new forms are better designed, with headlines and age-appropriate photography, and "always have a P.S., because everyone always reads the P.S," Shirey said. The document that gives patients a rundown of their to-date expenses, medications and doctors' visits looks like a credit-card statement. "You have a complete picture both financial and medical," Shirey said.

(Humana was the major sponsor of the summit, along with the University of Kentucky and Western Kentucky University.)

Revelations among providers

Simplifying documents was also the goal at People's Community Clinic in Texas, when Special Projects Supervisor Dana Carpenter came across a form that detailed how to take birth control pills. "Someone with a Ph.D. would have trouble understanding it," she said. With help from patients, Carpenter simplified the form, adding photos and "plenty of white space."

About 80 percent of the clinic's patients are Hispanic, so Carpenter was shocked to learn that, when she called the clinic, there was no telephone prompt asking the caller if they wanted to converse in Spanish. "You had to listen to the entire English menu before it would roll into Spanish," she said, and the clinic's directional signs were all in English and hidden by clutter. New signage is bilingual and prominently displayed.

Christine Nagy and Diane Sprowl said they went through a similar process in a joint venture between Western Kentucky University and the Barren River District Health Department. The goal was to get participants in the Women, Infants and Children food program to eat more fruits and vegetables. Patients were asked to fill out surveys, which needed to be designed for people who did not speak English well. Nagy, Sprowl and WKU students designed materials with bullet points, white space and culturally appropriate graphics. They kept the reading level low by using words with few syllables. They also met with patients face to face to help avoid communication breakdown.

Oral communication

More than just rewriting forms, health literacy involves making sure people understand what they're being told. To that end, insurance firms like Humana and providers like the People's Community Clinic are teaching employees how to communicate in a simple, uniform way. Often this involves the "teach-back technique," where you "have them explain back what you've gone over," said Dr. David Susman, psychology services coordinator at Eastern State Hospital.

Susman said it's important to look for clues that a person is having difficulty understanding, such as incomplete forms, lack of adherence to directions, or even looking in a pill bottle to determine what pill they're taking rather than reading the label.

Ultimately, the goal is to keep patients from the fate of Mrs. Jones. "No one is going to say, 'Oh by the way, I have limited health literacy,'" Susman said. "And no one complains about information being too simple."

For a list of advance registrants for the summit, click here.

New fitness program in Clay County designed to get kids moving

Every fourth- and fifth-grader in the Clay County schools will receive a pedometer as part of a new fitness program designed to combat childhood obesity.

"The goal is to motivate students to be more physically active in a county where one research project found that 47 percent of children were overweight or obese," the Lexington Herald-Leader's Bill Estep reports.

The program integrates physical activity in lesson planning in subjects like math and geography. "It does that through challenges to walk enough steps to get to Houston, for instance, with lessons about the geography or history of places along the route," Estep reports. "We want to see some changes," said Deann Allen, instructional supervisor for the school system.

The program is a venture between the system, Kosair Children's Hospital in Louisville and Manchester Memorial Hospital. Kosair is paying for the pedometers, expected to cost about $15,000. A similar program was started in Louisville last year. (Read more)

Foundation matches Social Innovation Fund money to create grants for improving health services in seven Kentucky counties

The Foundation for a Healthy Kentucky today announced four equal Social Innovation Fund grants totaling $1 million to improve access to health services, reduce health risks and disparities, and promote health equity in Jefferson, McCreary, Wolfe, Powell, Montgomery, Bath and Menifee counties. The projects are expected to serve nearly 9,000 people in the next year.

Home of the Innocents in Louisville will establish a dental clinic at the newly opened interdisciplinary Hockensmith Pediatric Assessment Center. The program will provide dental services to children in state care, children with special health care needs, and other children and families served by the Home and its partner agencies.

St. Joseph Health System, based in Lexington, will establish primary care clinics in Powell and Wolfe counties, both rural and low-income. These satellite clinics will be staffed by nurse practitioners and will utilize telemedicine to collaborate with physicians and specialists at a central location.

Cumberland Family Medical Center, based in Burkesville, will establish a nurse-managed health center and rural training program for nurse practitioners and physician assistants. Funds will be used to expand the scope of services provided in McCreary County to include x-ray and utilize health IT to connect with other CFMC sites. This will be the county's first x-ray, reducing travel for local residents who previously had to travel ouside the county for x-ray services.

The Montgomery County Health Department in Mount Sterling will establish a health education and navigation program to serve a low-income population in Montgomery, Bath and Menifee counties. Four full-time health navigators will be employed to serve the community by assessing individual needs and linking patients with services.

Each $250,000 grtant includes $125,000 from the Foundation for a Healthy Kentucky. As an endowed public charity, the foundation was able to provide the matching funds that were required to secure the Social Innovation Fund award for Kentucky. Learn more about the grants here.