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Selected Contributions to Public Health

Individual, School, and Community Interventions

Examples of achievements are summarized here and regularly updated. Achievements associated with CDC’s Winnable Battles are noted. This term describes public health priorities having large-scale impact on health and for which effective strategies are known.

The University of Washington PRC created PEARLS (Program to Encourage Active, Rewarding Lives for Seniors). Listed in the National Registry of Evidence-based Programs and Practices (a product of the Substance Abuse and Mental Health Services Administration), PEARLS decreases depression and improves functional and emotional well-being. This home-based program has also been adapted and proven effective among people with epilepsy.

Read the case study and a feature story about PEARLS with seniors. And read the case study about PEARLS for people with epilepsy.

Texas A&M University PRC researchers evaluated the implementation and dissemination of a fall prevention program called A Matter of Balance/Volunteer Lay Leader (AMB/VLL) in Texas over the course of two years. The PRC partnered with the Texas Association of Area Agencies on Aging to train their local affiliates to implement the program. AMB/VLL program participants attend eight group sessions that teach them to view falls as preventable, change their environment to reduce fall hazards, and engage in physical activity to increase their strength and balance. From 2007—2009, PRC researchers found that the Texas Association of Area Agencies on Aging certified 98 master trainers and 402 lay leaders to deliver the program. Researchers also determined that the program reached more than 3,000 older Texans, including residents in 236 of 254 counties in Texas. Participants reported increased physically active days, increased confidence in preventing falls, fewer falls, and decreased number of days falls kept them from activities of daily living. This was the first comprehensive evaluation of the Texas AMB/VLL program. This evaluation will aide in disseminating the program in Texas and other states.

Read “Implementing and Disseminating an Evidence-Based Program to Prevent Falls in Older Adults, Texas, 2007-2009," about the work, published in the November 2010 issue of Preventing Chronic Disease.

Healthy BagHarvard University PRC researchers found that through the use of the Out of School Nutrition and Physical Activity Initiative (OSNAP), after-school programs can increase children’s access to drinking water during snack time. The PRC developed OSNAP to help programs that care for children outside of school improve nutrition and physical activity environments, policies, and practices. Ten programs participating in OSNAP took part in learning sessions focused on changing policies and environments to increase healthy eating, drinking, and physical activity opportunities. The researchers helped the programs set up standard operating procedures for water delivery, such as provision of cups to children at snack time, to increase the likelihood that changes would be maintained at the end of the study. Compared to ten control programs, at six-month follow-up the intervention sites served 3.6 more ounces of water on average per child per day, served water more frequently, and served 60.9 fewer beverage calories on average per snack per day. The researchers believe this study is the first group randomized control trial (RCT) of an intervention to increase the amount of water served in after-school programs. The changes made to the after-school snack menus of participating Boston Public Schools (BPS) are being adopted and implemented throughout the BPS system.

CDC Winnable Battle: Nutrition, Physical Activity, and Obesity

Read an abstract of an article describing the RCT, and visit the OSNAP website.

Healthy BagPartnering with the YMCA of the USA, the Harvard University PRC developed a curriculum, Food & Fun After School, to increase children's physical activity and healthy food options in after-school programs. The partners established standards for nutrition and physical activity in after-school settings. The standards were applied and their impact measured in seven YMCA child care programs in five states. Results included significant increases in weekly servings of fruits and vegetables and significant decreases in weekly servings of desserts, foods with added sugars, and foods with trans fats. In another study, the curriculum was implemented in 16 YMCA child care programs in four U.S. metropolitan areas (in the Pacific Northwest, Midwest, South, and East). Results included increased moderate and vigorous physical activity among children in programs where the standards were implemented. Related analyses of 32 YMCA after-school programs showed that unhealthy snacks could be replaced with low-priced fresh vegetables and whole grains without causing increases in price. The curriculum is available and free to anyone who is interested, including after-school program staff, parents, and children. In December 2011, the YMCA of the USA pledged that 85% of YMCAs would adopt by 2015 physical activity and healthy eating standards for early childhood and after-school programs similar to those of the YMCA-Harvard project.

CDC Winnable Battle: Nutrition, Physical Activity, and Obesity

View the Food & Fun After School materials. Read a journal article analyzing the price and nutrition of healthy versus less healthy snacks in after-school programs. Read article abstracts describing the program's impact on children's physical activity and healthy food access (through PubMed).

Tobacco Winnable BattleResearchers at the West Virginia University PRC added physical activity promotion to the Not on Tobacco (NOT) program, an effective teen smoking cessation program. The researchers found that the enhanced program, Quit and Fit, may increase the number of participants, particularly boys, who stop smoking.

CDC Winnable Battle: Tobacco

Access an abstract of an article about the research results published (through PubMed).

Teen Pregnancy Winnable BattleIn a randomized controlled study, the University of California at Los Angeles PRC demonstrated the effectiveness of its intervention, Talking Parents, Healthy Teens. Parents and adolescents who participated in the program—delivered to groups of parents at work sites during the lunch hour—reported improved ability to communicate with each other about sex. The effectiveness of the intervention persisted after program completion.

CDC Winnable Battle: Teen pregnancy

Read the case study about Talking Parents, Healthy Teens.

EnhanceFitness, developed by the University of Washington PRC, enhances physical and psychosocial functioning among older adults. It is one of five proven physical activity programs that the CDC Arthritis Program recommends to improve the quality of life for people with arthritis. In 1998, Group Health Cooperative (GHC), a large Seattle-based HMO, began offering participation in the program as a free benefit to all its Medicare enrollees. In 2009, EnhanceFitness had 5,900 seniors enrolled at 315 sites in 26 states.

Read the case study about EnhanceFitness.

Tobacco Winnable BattleNot on Tobacco, a successful smoking cessation program for teenagers developed by the West Virginia University PRC, is disseminated by the American Lung Association through a jointly created website. By offering tools and training to facilitators, the site is making the program available worldwide.

CDC Winnable Battle: Tobacco

Read the case study about Not on Tobacco.

The Emory University PRC developed WebEase, an Internet-based program designed to promote self-management among people with epilepsy. In a pilot study, participants reported improved self-management, sleep quality, self-efficacy, and social support. These results encouraged support for continued development and testing of the program, which is ongoing. The research is one activity of the Managing Epilepsy Well Network, which is addressing the needs of an estimated 2 million people in the United States who have epilepsy.

Read article about WebEase published in the January 2009 issue of Preventing Chronic Disease.

Access network’s website.

Winnable BattlesThe lack of a positive father-son relationship may contribute to behaviors among the adolescents that compromise short- and long-term health and well-being. The Fathers and Sons Program, a University of Michigan PRC study for fathers and sons in Flint, Michigan, who do not live together, suggested improved parent-child communication and increased healthy behaviors among the adolescents. An effectiveness trial is now under way at four sites in different geographical areas.

CDC Winnable Battles: Tobacco; Nutrition, Physical Activity, and Obesity; Motor vehicle injuries; Teen pregnancy; HIV prevention

Read the case study about Fathers and Sons.

Obesity Winnable BattlePlanet Health, physical activity and nutrition lessons woven into middle school curricula, reduces TV viewing time in boys and girls and decreases obesity in girls. The program, developed by the Harvard University PRC, is available for purchase, and more than 120 schools in Massachusetts use it.

CDC Winnable Battle: Nutrition, Physical Activity, and Obesity

Read the case study about Planet Health.

The University of California at Los Angeles PRC developedCBITS (Cognitive-Behavioral Therapy Intervention for Trauma in Schools). The program, delivered by school-based mental health professionals, decreases symptoms of posttraumatic stress disorder, depression, and psychosocial dysfunction. The National Child Traumatic Stress Network disseminates CBITS as a best practice model.

Read the case study about CBITS.

Obesity Winnable BattleTobacco Winnable BattleStories from the Body Love hair salon—the fictitious site of a radio soap opera—reach listeners with messages that promote physical and mental health. The show, which originated in the University of Alabama at Birmingham PRC’s Health Communications Unit, is aired by 16 locally owned radio stations in 4 states (Alabama, Georgia, Florida, and Mississippi), and episodes can be streamed online ( A new series of episodes, funded in part through the local health department’s participation in CDC’s Communities Putting Prevention to Work, focuses on preventing obesity and tobacco use, and some episodes air in Spanish.

CDC Winnable Battles: Tobacco; Nutrition, Physical Activity, and Obesity

The Columbia University PRC and partners collaborated with the Harlem Children’s Zone Project to design and test an intervention to manage asthma among children living in Central Harlem. In early results, children’s symptoms, school absenteeism, emergency department visits, and hospitalizations were reduced. Expansion and further testing of the promising intervention now continue under a grant from the National Institute of Environmental Health Sciences.

Read the case study about the initiative.

The University of Washington PRC created PEARLS (Program to Encourage Active, Rewarding Lives for Seniors). Listed in the National Registry of Evidence-based Programs and Practices (a product of the Substance Abuse and Mental Health Services Administration), PEARLS decreases depression and improves functional and emotional well-being. Now the PRC is adapting the program for people with epilepsy.

Read the case study and a feature story about PEARLS.

Teen Pregnancy Winnable BattleIt’s Your Game: Keep It Real is a product of the University of Texas Health Science Center at Houston PRC. This middle school sex education program uses a curriculum, a computer component, and parental involvement to reduce initiation of sexual activity by the ninth grade. The National Campaign to Prevent Teen and Unplanned Pregnancy includes It’s Your Game in a list of effective programs, and it is one of 28 teen pregnancy prevention programs eligible for federal funds. The PRC is now developing an Internet-based decision tool to help adults (including parents, school boards, teachers, and clergy) understand the burden of teen pregnancy in Texas and how evidence-based programs can help reduce it.

CDC Winnable Battle: Teen pregnancy

Read the case study about It's Your Game: Keep It Real.

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