Expert presentations

Below are the expert presentations from the ‘Nurses leading the fight against chronic disease’ meeting in Washington DC, June 2010 (click here >> for the meeting homepage).

Karen Daley, President, American Nurses Association

The newly elected President of ANA emphasised the severity of the chronic disease challenge facing the world, including the dangers of environmental exposure.  In order to respond appropriately, nursing curricula need to focus on competencies to equip nurses to intervene early and support and encourage lifestyle change and behaviour modification. The changes to the health-care system in the United States provide a timely opportunity for a paradigm shift towards health promotion and prevention of disease.

Christine Hancock, Director, C3 Collaborating for Health

Christine set the scene on the changing patterns of disease globally and the challenge of chronic disease across the developed and developing world, emphasising that it is the poor who bear the brunt of the epidemic. She highlighted the importance of lifestyle and environmental factors in the prevention of chronic disease and focused attention particularly on the risk factors of tobacco, physical inactivity and poor diet. Her presentation concluded by adapting a quote from Haefden Mahler, WHO Director General (1985).  She proposed that: ‘If the millions of nurses in a thousand different places articulate the same ideas and convictions about preventing chronic disease and come together as one force, they could act as a powerhouse for change.’

Click here for Christine’s presentation

Tesfa Ghebrehiwet,  ICN Consultant in Nursing and Health Policy

Tesfa’s presentation focused on the importance of ‘upstream’ thinking by nurses to promote health and prevent chronic disease. He emphasised the fact that many non-communicable diseases have shared risk factors and are preventable. With the appropriate knowledge and skills nurses are well positioned to take a lead role in the fight against chronic disease at all levels from influencing their families and communities, to intervening with patients and influencing policy.

Click here for Tesfa’s presentation

Linda Sarna and Stella Bialous, Tobacco Free Nurses

Dr Sarna and Dr Bialous focused on the need to reframe and position the risk factors into the Millennium Development Goals (MDGs) – for example, linking smoking cessation to MDGs 4 and 5 on Maternal and Child Health.  They discussed some of the barriers and challenges facing nurses in promoting and supporting smoking cessation, including lack of knowledge and skills. They raised particular concerns about the fact that the messages are not reaching young girls and suggested that young people may respond better to ‘green’ messages about smoking than to health messages.

Click here for their presentation

Fleetwood Loustalot, Centers for Disease Control, Atlanta

Dr Loustalot, himself a nurse, provided up-to-date information and evidence about the importance of diet and physical activity in the prevention of chronic disease, and highlighted the link between physical activity and mental health. He emphasised the importance of providing clear, consistent messages and the importance of disaggregating data to local level. He proposed that CDC guidelines provide an evidence-based reference point, can be used to assign roles, responsibility and accountability and need to be used to inform local action and policy.  He also acknowledged that the risk factors of diet and physical activity are trailing behind tobacco in terms of policy at national and international level.

Click here for Fleetwood’s presentation

Martha Hill, Dean and Professor of Nursing, Medicine and Public Health, Johns Hopkins University

Dr Hill focused on the why, what, when and how of evaluation and stressed the importance of building evaluation into the design of the programme or initiative and the need for clarity about what you are trying to achieve or change. She highlighted the different phases and stages of evaluation and emphasised the value of intervening early to address problems. She suggested that the use of a logic model aids the process of thinking and clarification. She encouraged participants to use practical and feasible approaches to evaluation balancing the need for detail against the danger of being overwhelmed by too much information.

Click here for Martha’s presentation

Rachel Nugent, Deputy Director Global Health, Center for Global Development

Dr Nugent provided a global perspective on the cost-effectiveness of interventions; the impact of NCD on developing countries; and the contribution that donors are making to non-communicable diseases (NCDs) in developing countries. She suggested that many countries are moving from awareness-building to implementation, informed by WHO strategy.  She also highlighted the challenge of securing funding, as many funders are cutting back; there is increased diversification of funding streams with increased numbers of private-sector donors; and, despite rhetoric to the contrary, ‘disease silos’ remain strong and active. None of the cross-cutting approaches tend to include NCDs, although more evidence is required. There are many opportunities to link chronic disease with some of the MDGs, especially related to maternal and child health. In 2007, donor funding for health was $21.7bn, of which an estimated 2.7% share goes towards NCDs. It is important to focus attention on the forthcoming UN High Level Meeting on NCDs scheduled for September 2011and to clarify what is being asked by whom, and how nurses might best engage and contribute.

Myrl Weinberg, IAPO (Immediate Past Chair) and President of the Health Council

Myrl informed the group about the role, mission and ways of working of the International Association of Patient Organisations and its expanding interest and involvement in promotion of healthy lifestyles and prevention of ill-health, working especially with groups and organisations where the risk factors are shared. She stressed the importance of partnership working, with patients and carers being treated as equal partners and patient involvement being institutionalised into service development and delivery.

Click here for Myrl’s presentation

Paula DeCola, Senior Director, External Medical Affairs, Pfizer Inc.

Paula highlighted the importance to organisations of having a healthy workforce, and presented the Pfizer approach to supporting its workforce to adopt health-promoting behaviours in their day-to-day working environments. Initiatives include health-incentives programmes, healthy eating and exercise, health and wellness services and disease management, as well as social networking and communication.  She also noted that, while the programming Pfizer has engaged in is extensive, there is the opportunity for NNAs to consider if elements of the program in an adapted way could be an offering for NNA’s constituents.

Click here for Paula’s presentation