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Advisory Group on Prevention, Health Promotion, and Integrative and Public Health Teleconference Meeting Summary

July 11, 2016

Advisory Group Attendees: JudyAnn Bigby, Jonathan Fielding, Ned Helms, Patrik Johansson, Janet Kahn, Jeff Levi (Chair), Jacob Lozada, Elizabeth Mayer-Davis, Dean Ornish, Barbara Otto, Linda Rosenstock, John Seffrin, Ellen Semonoff, Susan Swider

HHS Attendees: Shavon Arline-Bradley, Brigette Ulin (Designated Federal Officer)

3:00 p.m. – Roll Call and Meeting Overview

Brigette Ulin, Designated Federal Officer (DFO), called the roll and confirmed a quorum was present.

Dr. Jeff Levi, Advisory Group Chair, reviewed the purpose of the meeting and the agenda items.

3:15 p.m. – Updates from the Office of the Surgeon General and the National Prevention Strategy Office

Ms. Shavon Arline-Bradley provided an update on the current activities taking place within the Office of the Surgeon General (OSG) on behalf of Surgeon General VADM, Dr. Vivek H. Murthy.

Update #1: The addiction crisis has been a key focus of the Surgeon General’s agenda. The “Turn the Tide” campaign tour launched in early June 2016, and will conclude in August 2016. During the tour, the Surgeon General visited Oklahoma City, Oklahoma; Baltimore, Maryland; Nashville, Tennessee; Knoxville, Tennessee; Phoenix, Arizona; Albuquerque, New Mexico; New York, New York; and Cleveland, Ohio. The campaign focuses on (1) the role of prescribers in the opioid epidemic and how they are part of the greater solution; (2) stigma associated with addiction; and (3) addiction as a chronic disease, not a moral failing.

Update #2: The Surgeon General is planning to release a report on substance abuse and health in 2016. The intent is to conduct outreach activities to promote the report.

Update #3: OSG will commemorate the one-year anniversary of the release of Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities, by challenging America to walk more and improve the walkability of their communities.

Discussion Highlights:

  • Congress should pass legislation requiring prescribers to use registries (Prescription Drug Monitoring Programs).
  • The root causes of addiction, such as depression, must be discussed.
  • There are a range of therapeutic options for the Surgeon General to consider that are proven effective in decreasing addiction. Dietary and lifestyle changes have been shown to reduce pain and suffering. The Surgeon General has received many questions from physicians about alternative options for pain management.
  • Little research has been done in the area of chronic pain and opioids.

Brigette Ulin, CDC: Ms. Ulin provided an update of the activities currently taking place in the Office of the National Prevention Strategy (ONPS).

Update #1: CDC has been working with the National Prevention Council (Council) to develop the Healthy Aging in Action (HAIA) report. The report will enter official federal clearance soon. CDC is working with OSG to establish dissemination procedures. CDC will engage the Healthy Aging Workgroup to garner further promotion opportunities post-launch. The input from the Advisory Group from the recent meetings was beneficial for improving the report overall.

Update #2: The Advisory Group recently received an email pertaining to ethics paperwork from Olga Nelson. The members must complete the paperwork for their 2016 service to the Advisory Group. If the Advisory Group has inquiries about the paperwork, the members should contact Olga Nelson.

Update #3: The next in-person Advisory Group meeting will take place on September 26, 2016, in Washington, DC.

3:30 p.m. – Discussion of Legacy Report Outline

The Advisory Group discussed revisions to its Legacy Report outline. Revisions were made in response to discussion from the May 9–10, 2016, meeting.

The key messages of the Legacy Report: 1) the goal of the National Prevention Strategy (Strategy) is to increase the number of Americans who are healthy at every stage of life; 2) the Strategy remains a relevant document, but requires revision; 3) the Strategy should be combined with a national dissemination campaign that catalyzes community partnerships at the state, county, and city levels. The Advisory Group believes the Council and Advisory Group can continue to play important roles—the Council as an entity that can catalyze cross-agency prevention efforts, and the Advisory Group can be a model for multisector community partnerships.

The Advisory Group agreed to highlight the following emerging issues: climate change, gun violence, and the prescription opioid crisis.

Discussion Highlights

  • Within the key messages or examples sections, lifestyle medicine, diet, nutrition, should be explicitly mentioned.
  • The transition of the Strategy to be truly national rather than federal was supported by the group.
  • The subjects of health prevention, health promotion, and integrative health are not featured as strongly as other elements in the report. An example of how these elements relate to the Strategy should be provided. 
  • The outline refers to examples of traditional prevention programs. However, a collective and cross-sector approach should be noted.
  • Emphasis of the early period of life trajectory’s impact on health is important.
  • In terms of structure, the report should mention the importance of incentives in improving health at the community level.
  • Internationally, there are many issues needing the Advisory Group’s attention, including the tobacco industry taxation, prevention of infectious diseases (e.g., Ebola, SARS).
  • The health care delivery system is a critical partner in bolstering primary and secondary prevention. It would be productive to identify the health care delivery system as one of the important partners in the multisector engagement process.
  • Based on overall comments throughout the call, the development of a broader legacy document was proposed.
  • Dr.  Levi requested input from the group as to whether the report will be a broad summary or highlight of several key issues the new administration should address. The Advisory Group suggested the additional issues wouldn’t require extensive or new sections, and could be weaved throughout the current outline.
  • Subjects highlighted in the final section may be organized by the Strategy’s four strategic directions to underscore that these strategic directions are powerful, and should be continuously addressed during the next administration.  
  • Dr. JudyAnn Bigby will collaborate with Dr. Levi to develop a logic model for inclusion in the report.

4:30 p.m. – Open Discussion – Advisory Group member updates

  • Dr. Jonathan Fielding chaired an Ebola external review report. Dr. Levi will share the report with the group.

Next Steps

  • Dr. Levi will revise the Legacy Report outline in early August.
  • Dr. Bigby will consult with Dr. Levi to develop a logic model to include in the Legacy Report.
  • The Legacy Working Group will further discuss the outline and draft.
  • By late August, a final detailed outline will be completed.
  • A draft will be discussed amongst the Advisory Group on September 26 at the in-person meeting. After the meeting, the draft will be finalized.