Youth Obesity Learning Collaborative: Participating Site Summaries
This page displays summaries of participants' primary youth obesity prevention and reduction activities.
AtlantiCare (Egg Harbor, NJ)
California Pacific Medical Center (San Francisco, CA)
Children's Hospital of New York Presbyterian (New York, NY)
Children's Hospital and Research Center Oakland (Oakland, CA)
Children's Memorial Hospital (Chicago, IL)
Children's Mercy Hospitals and Clinics (Kansas City, MO)
INTEGRIS Health (Oklahoma City, OK)
Kaleida Health (Buffalo, NY)
Little Company of Mary (Los Angeles, CA)
AtlantiCare (Egg Harbor, NJ)
Healthy Schools, Healthy Children
Under the leadership of AtlantiCare Foundation, “Healthy Schools, Healthy Children” was organized early in 2005 to promote healthy eating, exercise, and positive body image among the school population in Atlantic County in efforts to combat the alarming increase in childhood obesity.
With the collaboration of community partners, resources have been made available to school districts that have asked to participate. School district participation in this initiative has doubled over the course of the year from an initial 6 districts to over a dozen, along with at least one parochial school.
Each school district has its own unique needs and culture and the Foundation’s School Health Coordinator helps, on an individual basis, to develop fitness plans and provide resources on nutrition education as requested by the districts, and as outlined by the 2006 School Wellness Policy mandated by the Child Nutrition and WIC Reauthorization Act. Examples of program efforts include providing schools with Mileage Club Kits and pedometers; supplying speakers for parent, student, and teacher assemblies; hosting a workshop for Food Service Staff encouraging healthier alternatives and promotional activities; as well as donating additional classroom resources to further support schools’ efforts.
Participating school districts have named themselves “Healthy Schools, Healthy Children” and meet as a Steering Committee on a quarterly basis. These forums enable the group to establish goals and measurements develop plans for activities, as well as to exchange information and learn about “best practices”.
Children's Hospital and Research Center Oakland (Oakland, CA)
In response to the growing obesity epidemic, in July 2004, Children’s Hospital and Research Center Oakland opened a clinic to:
- Reduce pediatric patients’ overweight-related diagnoses via interdisciplinary prevention and treatment
- Train health providers in pediatric obesity
- Perform research
- Partner with the community
Housed in the medical center’s Primary Care Center, the Healthy Eating Active Living (HEAL) Clinic benefits patients and their families by empowering them with culturally appropriate information, tools, and support to make life-saving behavior changes. CHRCO and local pediatricians refer overweight and at risk patients to HEAL, where a multi-disciplinary team conducts medical and psychosocial assessments and develops and implements health improvement plans in cooperation with patient, family, and school. Based on the chronic care model, the HEAL Clinic engages the hospital’s substantial resources in interactive relationships among clinicians, researchers, and the community. The clinic accepts all patients who are overweight or at-risk for overweight or who simply have concerns about healthy eating and active living. Divided into two sites and interventions according to age, HEAL consists of Teen HEAL (12-18 years of age) and Pediatric HEAL (2-11 years of age). At both sites, the HEAL staff are culturally and linguistically diverse and include a nutritionist, exercise physiologist, psychologist, nurse practitioner, and two physicians.
The experience of the clinic has shown that it is difficult to fulfill the complex needs of families with an overweight child in a brief problem-focused office visit. Low-income, minority families, in particular, face further environmental, economic, cultural, and psychosocial challenges that inhibit their capacity to alter dietary and physical activity behaviors to conform to standard weight management recommendations.
Recognizing pediatric obesity as a chronic medical condition, HEAL clinicians elaborated on the chronic care model, developed initially for use in diabetes and asthma. The chronic care model is a holistic approach that brings together health systems, community resources and policy in order to affect functional outcomes. The clinic team, in an effort to be a bridge between the medical professionals and community organizations, has worked with the Alameda County Public Health Department to be a resource and to learn from the Oakland Unified School parents groups called Healthy Living Councils. These “mini-PTAs” empower parents to become engaged in the nutritional health of their families, schools and communities. Another exciting county project supported by the California Endowment is bringing together providers of a specific neighborhood in Oakland to bring best case practices and resources to this particular community. Another exciting program that connects CHRCO to the schools is through FACES for the Future. This student internship allows CHRCO to provide trainings for Peer Educators who will work within the HEAL programs and will take health messages back to their schools. Another great ally in their community has been local YMCAs who help overcome the barriers around safe places to be physically active.
California Pacific Medical Center (San Francisco, CA)
California Pacific Medical Center’s Health Champions Project is a 6-year-old health promotion program that is changing the way San Francisco’s school communities approach nutrition and physical activity. Unlike many traditional school-based health programs, the objectives of Health Champions extend beyond the bounds of disease education. Instead, the goal is to change schools themselves, integrating healthy practices into the school environment so that students experience health as well as learn about it.
Partnering with two schools at a time, Health Champions staff work intensively with students, parents, teachers, and school administrators over a three-year period. The program goal is to permeate each school day with opportunities for nutrition and physical activity and to establish the teacher buy-in and policy support needed to maintain these activities for years to come. By improving young people’s well-being through day-to-day health practices, the hope is to maximize their chances for a long and healthy life.
Since 2000, Health Champions interventions have provided over 1500 students and their families with ways to incorporate physical activity and nutritious foods into their daily routines. CPMC strives to help each student find enjoyable—and therefore sustainable—ways of being healthy. Program components include:
Students - Nutrition
From classroom cooking to hands-on nutrition education, the foundation of Health Champions’ nutrition program is, quite simply, eating. Elementary students, for example, try new foods through fruit and vegetable tastings, while middle school students participate in field trips to local farmer’s market and prepare a school-wide salad bar. These experiences are underscored by classroom lessons.Students - Physical Activity
Students are introduced to non-traditional P.E. options such as yoga and hip hop. Additionally, students are treated to active field trips such as mountain biking and indoor rock climbing. By increasing availability and choice, Health Champions strives to increase the amount of vigorous physical activity students get.Teachers
Health Champions provides teachers and staff with opportunities to invest in their own health. For example, teachers were provided with a small stipend to support personal health goals. Many teachers transfer their new health interests to the classroom where they encourage their students to stretch, eat well, and exercise. Other teacher-focused activities include salad bars during the lunch period and professional development in physical education.Families
Families are integral to Health Champions’ success, and the project aims to support them by creating opportunities to engage in fun health activities together. Examples include hip-hop dance, yoga, create a healthy pizza, and smoothie lab. Parents also attend discussions on nutrition and diabetes prevention and are offered health screenings.
Children's Hospital of New York Presbyterian (New York, NY)
Health Schools Healthy Families
The Healthy Schools, Healthy Families (HSHF) Coalition, begun in 2004, is a school-linked health promotion program for medically underserved children in seven elementary schools in Northern Manhattan and East Harlem. The HSHF Coalition is comprised of over fifteen community-based, local government, public, and private partners in conjunction with the New York Presbyterian Hospital’s Columbia and Weill-Cornell Medical Centers.
Program Goals
Within each school, a team composed of a Program Coordinator, a Healthy Lifestyles Coordinator, and a Family Care Worker (FCW), with leadership from an overall Program Manager and a Medical Director, engage participants in the program. The goal of HSHF is to develop a culture of healthy behaviors in the community, school, and home environment by introducing practical approaches to attaining adequate physical activity and increasing awareness of healthy eating.Community Needs:
Obesity Prevention, Insurance Enrollment, & Access to Services
Northern Manhattan is comprised of a predominantly minority population, affected by childhood obesity at a rate significantly higher than the average for NYC and the nation. Because the prevalence of obesity is so high, and because all children in the targeted schools face the challenge of finding healthy foods and getting enough exercise, all children are ultimately at risk for obesity, so the HSHF initiative targets all children for the healthy lifestyles interventions. Goals include a commitment to help develop school-based nutrition and physical activity policy; identification and development of resources to promote healthy lifestyles in the school and surrounding community; 20 minutes a day of physical activity (citywide standard); and creation of a school staff wellness program.HSHF also works to make sure every child is enrolled in insurance and that every child has a medical home. A system is being developed to assist families with the insurance recertification process so that a lapse in insurance coverage does not affect access to care.
Children who have difficulty accessing medical care are also assisted in obtaining needed services. In addition, HSHF actively reaches out to children with asthma. Working with our community partners, HSHF identifies children with high risk for asthma and offers care coordination and asthma education to these families.Accomplishments to Date:
- Immunizations: Over 99% of students at HSHF schools.
- BMI: measured for all students and results reported to families.
- Insurance Enrollment: Over 200 students and family members referred.
- Physical Activity Programs implemented: Tai Chi, Running Partners Mileage Club and Team, Capoeira, Transitional Exercise and double dutch/jump rope programs.
- Parent and Staff wellness programs: Farmer’s market at PS 180, pedometer walking clubs at PS 128/102, Copeira workshops at multiple schools, and “Veggie of the Month” workshops conducted by Food Change in coordination with our FCW’s.
- Fitness and Nutrition Committees: established in all 7 schools.
Children's Memorial Hospital (Chicago, IL)
The Center on Obesity Management and Prevention (COMP) at Children’s Memorial Hospital (CMH) was established in 2004 to bring together those working on aspects of childhood overweight and to foster excellence and integration of effort across clinical, research, and advocacy/public education initiatives.
At Children’s Memorial Hospital, varied specialists see overweight children and those with co-morbidities. COMP has begun to gather data on overweight children seen in 7 clinics; since January 2006, they have seen 416 patients with BMI> 85th percentile (2/3 of these >95th). The overweight patients were 37% of all seen; they were evenly distributed across three age ranges: 6 or younger, 7 - 11, and 12 or older.
Research work is based at the Children’s Memorial Research Center, where there has been long collaboration with primary care practitioners in the Pediatric Practice Research Group (PPRG, led by Drs. Binns and Ariza). PPRG research includes implementation (in 10 practices) and evaluation of software to facilitate growth parameter analysis and related counseling. COMP’s community based research includes projects that examine the effects of the built environment and safety on child activity and BMI; trends in BMI and other parameters among students enrolled in an innovative charter school (Namaste); and levels of activity in children attending park district programs.
COMP includes the Consortium to Lower Obesity in Chicago Children (CLOCC, www.clocc.net, founded 2003), which emphasizes primary prevention in children 3-5 years. CLOCC includes >450 partner organizations and >1100 individuals, from every sector of society. The work of CLOCC’s partners occurs in 7 working groups (e.g., clinical, school systems) whose chairs form the Executive Committee. CLOCC also has an External Advisory Board and a Corporate Advisory Committee. Joint projects between the PPRG and CLOCC have resulted in the education of practitioners on billing codes and the compilation of a guide to parent educational materials.
CLOCC’s community work fosters multi-sector efforts at the community area (CA) level, with a focus in 6 CAs, which are largely minority and indigent. For example, a project called Community Organizing for Obesity Prevention: Humboldt Park (COOP: HP) is a collaborative effort including Sinai Urban Health Center (the funded group), the Puerto Rican Cultural Center, Centro Sin Fronteras, and CLOCC in lead roles. It is building community resources to promote healthy eating and activity. CLOCC’s public education initiatives use social marketing to ‘sell’ healthy lifestyles for young children, with a 5-4-3-2-1-Go! message (www.clocc.net/coo/prevention/resources.html). Our recently re-launched website was developed in consultation with 120+ partners.
CLOCC has facilitated the drafting and passage of 5 laws that address obesity surveillance (not screening), waivers from physical education requirements, a new state food systems policy council, safe routes to schools and parks, and the establishment of nutrition and physical activity standards for early childhood programs. Some of the legislation emerged from a novel consensus building process in 2005, involving scores of agencies.
COMP and CLOCC are funded by varied philanthropic, corporate, and government sources. CLOCC’s founding funder was the Otho S.A. Sprague Memorial Institute; its other major funders include the Chicago Community Trust and the Michael and Susan Dell Foundation.
Children's Mercy Hospitals and Clinics (Kansas City, MO)
Children’s Mercy Hospitals and Clinics is active in childhood obesity prevention and intervention efforts. CMHC staff joined with other community professionals in 2003 to develop a community-wide awareness campaign, kicked off by a town hall meeting and featuring billboards with slogans such as, “Supersize your play, not your meal”. Two final products of this campaign were a prevention program for tweens called KID POWER, and a “Best Practices Guide to Childhood Obesity Diagnosis and Management” distributed to over 3000 health care providers.
In addition to KID POWER, a 13-week healthy lifestyles educational intervention which has reached nearly 5000 underserved tweens to date, CMHC staff led efforts to develop a community-wide childhood obesity collaborative called “Weighing In” in 2004. This collaborative of members from over 60 organizations has active subcommittees such as “Public Awareness”, which aims to increase awareness of portion size among area tweens with their “eat small” campaign.
CMHC’s primary care clinic, the Pediatric Care Center, is the home to the PHIT KIDS (Promoting Health in Teens and Kids) program for obese youth and their families. This program combines a multidisciplinary clinical approach based on motivational interviewing principles with intensive long-term group education and followup for 2-17 year olds and parents. PHIT KIDS staff work with consultants to be as culturally informed as possible as the patients are often from different ethnic backgrounds than the staff.
CMHC staff created a clinical practice guideline on childhood obesity management to guide clinicians’ practice and to inform outreach to area pediatric offices with brief and longer-term educational “lunch and learn” interventions for management of childhood obesity. Recognizing the potential influence that pediatricians can have in their communities, CMHC staff partnered with the Kansas Chapter of the American Academy of Pediatrics (AAP) to develop the “Healthy Choices Make Healthy Kids” project, which brought pediatricians together with local high school students to develop and disseminate a healthy lifestyles skit for elementary schoolchildren. Most recently, CMHC staff are directing and participating in the AAP Prevention of Obesity in School Health project to further educate pediatricians state-wide in advocacy skills with their local schools. CMHC staff partner with area organizations such as the American Heart Association-Heartland Affiliate and the Midwest Dairy Association to host yearly “Creating Healthy Schools” conferences for parents, school personnel and others wishing to promote healthier school nutrition and physical activity environments. The hospital’s Healthy Kids University offers classes at local YMCA’s for parents on obesity prevention topics such as “Food Fight: Battling Childhood Obesity”.
Children's Mercy's Project Storyboard 1
Children's Mercy's Project Storyboard 2
INTEGRIS Health (Oklahoma City, OK)
INTEGRIS has taken a multi-faceted approach to the problem of obesity. Two major projects are the Fit Kids Coalition and Move for Life.
Fit Kids Coalition
Advocating health and fitness for the legacy of Oklahoma, the Fit Kids Coalition is a positive solution to childhood overweight and obesity. With the mission to make a major contribution to the health and well being of all Oklahomans, this non-profit Coalition of more than 90 organizations is united to combat childhood obesity. The Coalition accomplishes this mission through a comprehensive program of activities including education, collaboration and advocacy.In January 2004, the Fit Kids Coalition launched a statewide effort to pass three pieces of legislation that proposed restrictions on vending machines in schools, more physical education for children and expanded advisory committees in schools (with an added health component). All passed.
In March, 2006, the Coalition introduced another legislative package. The package includes three bills that: create a Farm to School program within the Department of Agriculture to coordinate the efforts of schools and farmers across the state; direct the Department of Education to develop a fitness assessment software program with the ability to track various measurements of student fitness including Body Mass Index, aerobic endurance, strength and flexibility; and provide additional resources to the Healthy & Fit School Advisory Committees. All four measures have passed through committee and the full Senate floor.
In addition to advocacy, INTEGRIS underwrote a statewide advertising campaign and a web site (http://integrislifespan.com) on Child Obesity offering an overview of facts, programs and resources and a Speakers Bureau.
Results have been significant. The University of Baltimore publishes a report card comparing all 50 states’ efforts to fight childhood obesity. In one year, Oklahoma rose from an "F" to a "B", and is now ranked as one of the top 12 states.
Move For Life
Western Village Academy, an at-risk elementary school in Oklahoma City run by INTEGRIS Health, includes a full time clinic offering free care to students, their families and the surrounding neighborhoods. In 2002, in an attempt to reduce the high incidence of obesity at the school, INTEGRIS began Move For Life. Western Village became one of the first schools in the state to provide an obesity risk assessment for all students. Parents are asked to complete a one-page survey in the student’s enrollment packet that tracks obesity patterns based on height, weight and a number of social factors including family income and alcohol/tobacco use in the home.The program includes exercise programs – such as an early morning walking program. Pedometers were distributed and prizes are awarded as students accumulate miles. Children also compete on jump rope teams and hip-hop dance troupes. Free Jazzercise classes are offered for both students and adults. Nutritional guidelines for the students and parents are handed out weekly. Additional school programs have been tailored to meet individual needs. And nearly one-third of the school’s 330 students participate in after-school activities.
When the program began 27.8% of the school’s students were at risk for obesity. Today, the obesity risk percentage has dropped to 18.6%. Due to the success of this program, Fillmore Elementary (another Oklahoma City public school) began the "Move For Life" program in 2005.
Kaleida Health (Buffalo, NY)
Kaleida Health encompasses five hospitals, including Women and Children's Hospital of Buffalo(WCHOB). Among many services for children and adolescents, WCHOB operates 13 school-based health centers in Buffalo, New York. These centers are located in 13 elementary and high schools and offer an array of services including direct primary care, monitoring of chronic diseases and illnesses, nutrition counseling, preventative and outreach services, mental health, and youth development programs. The programs serve approximately 6,300 elementary and 2,600 high school students daily. All services at the school-based health centers are offered free of charge to the families served. The health center patients are students who reside in low-income areas of the East Side and Lower West Side neighborhoods of the City of Buffalo.
For the past three years, services have included healthy interventions to improve eating habits and physical activity. It is well documented that education can play a major role in prevention of certain diseases related to obesity. To address these issues, the WCHOB school-based health center staff have developed educational programs to reduce the incidence of childhood obesity and assist in management of chronic diseases including diabetes.
The goals of the service are to:
- Empower students by emphasizing skills required of them to change their behaviors and to maintain the changes
- Educate and counsel overweight and obese students in order to decrease the incidence of childhood obesity in the community
Objectives include:
- Increase students' understanding of the concepts of calories ingested vs expended
- Improve students' awareness of health food choices
- Increase students' understanding of the role of water consumption
- Counsel and treat uncomplicated overweight and obesity to achieve healthy eating and improve overall health
The Dietitian and Nurse Practitioners work closely together to target the children in need of services. One way this is accomplished is during the students' physical exams, the Nurse Practitioner records the BMI and refers students with a BMI greater than 26. The family is contacted to see if there is an interest; if so, an initial meeting with the student, parent or guardian, and dietitian is made. Many follow up visits are suggested.
Some of the programs are: one-on-one counseling with students and parents, small-group classes at the lunch hour, classroom education, health fairs, career days, and science fairs. Kaleida also works closely with food service in the Buffalo Public Schools to make policy changes and improve food selection.
Kaleida has also collaborated with other agencies such as the Buffalo Bills and Blue Cross and Blue Shield of WNY, and has implemented the First and Fit program for students in third and fourth grade in 9 of the 13 schools. This program partners with teachers, parents and students to incorporate healthy eating and physical activity into schools, neighborhoods, and homes. A partnership was formed among Kaleida Health, Cornell Cooperative Extension, and Buffalo Public Schools to provide a six-week nutrition education program. Topics include the New Food Pyramid, Fruits and Vegetables, Healthy Grains, and the Importance of Breakfast. At the end of the class, a healthy snack and information for parents is provided.
Little Company of Mary – San Pedro Hospital (Los Angeles, CA)
Creating Opportunities for Physical Activity
Creating Opportunities for Physical Activity (COPA) is a Hospital-sponsored initiative to motivate primarily Latino children and families to increase the frequency of physical activity in their daily lives and expand community access to public and private recreation and activity sites. COPA was selected in 2005 by the Health Resources and Service Administration for its Healthy Tomorrows Partnership for Children, with expansion funding from Providence Health System. Partners include four elementary schools in the Los Angeles Unified School District, the Department of Family Medicine at Harbor UCLA Medical Center and Little Company of Mary – San Pedro Hospital, which functions as the lead agency. COPA has three goals
- Increase the frequency of developmentally appropriate physical activity in elementary-aged school children through an eight-week, after-school intervention.
- Encourage parents/guardians and school staff to become health champions for themselves and their children through special events and family activity workshops.
- Involve community stakeholders to raise the community priority for physical activity in children through advocacy and improvements in community infrastructure.
The COPA after-school curriculum is sequenced over 16 lessons to teach age-appropriate locomotor (ie. running, skipping, jumping, galloping), non-locomotor (ie. bending, turning stretching, twisting) and object control skills (ie. throwing, catching, bouncing, rolling, scooping), using simple equipment like foam, waffle and playground balls. Instructors emphasize maximum activity time, a positive learning environment, and appropriate personal and general space during physical activity. Central to each lesson is the emphasis on personal improvement, which students monitor in their COPA workbook. Children learn games and activities that are easy and inexpensive to implement, for use at home or with friends. Since July 2005, 174 children have participated in COPA.
Family Practice residents lead the family workshops, in collaboration with COPA staff, and model the importance of family involvement in physical activity and good nutritional habits. Since September 2005, 141 families have completed the sequence of 3 family workshops.
The first coalition meeting, which encompasses leaders from local business, local and County government, community-based organizations, parents, and educators, is scheduled to convene at the end of May. The purpose of this coalition is to develop a consensus about how best to improve recreation access and infrastructure in the Los Angeles neighborhoods known as San Pedro and Wilmington.
