Youth Obesity Learning Collaborative: Participating Site Summaries
This page displays summaries of participants' primary youth obesity prevention and reduction activities.
Allina Hospitals and Clinics (Minneapolis, MN)
The Children’s Hospital of Alabama (Birmingham, AL)
Children’s Hospital of The King’s Daughters (Norfolk, VA)
Clarian Health (Indianapolis, IN)
Owensboro Medical Health System (Owensboro, KY)
Saint John's Mercy Hospital (Washington, MO)
Saint Joseph Mercy Health System (Ann Arbor, MI)
WakeMed Health and Hospitals (Raleigh, NC)
Allina Hospitals and Clinics (Minneapolis, MN)
Allina Hospitals and Clinics seeks to reduce childhood obesity by improving nutrition and increasing physical activity among children in their communities. With Mercy and Unity Hospitals, the Northwest Metro Advisory Care Council (NMACC), and Anoka County, they have developed programs in three key areas to achieve this goal.
School Programs:
Allina has pursued two school-based initiatives as part of its youth obesity strategy. In collaboration with the Minnesota Medical Association, PreferredOne (a statewide health insurance organization) and the National Theatre for Children, they created an in-school theater performance called Power of the Pyramid. This performance emphasizes the importance of physical activity and healthy eating, and is followed with classroom and take-home materials to reinforce its message. To date, Allina and its partners have reached nearly 95,000 children in over 240 elementary schools throughout Allina’s service area.Mercy and Unity hospitals also partnered with local school staff and public health leaders to pilot an after-school program, Power Hour, to promote behavior changes. Based on the success of the pilot, the program is being expanded and will be introduced to three additional elementary schools with diverse student populations during the 2006-07 school year. It will be incorporated into the regular school day, with a greater emphasis on connecting with families and the larger community.
Clinical Intervention:
With the support of the University of Minnesota’s Obesity Prevention Center, Allina created a Body Mass Index assessment and behavioral counseling program for pediatric patients. Goals of the intervention include: encouragement of parental commitment to increase child’s physical activity level and fruit and vegetable intake; and increase proportion of children receiving annual BMI screening and behavioral counseling. The Pediatric and Adolescent Medical Department of the Allina Medical Clinic in Coon Rapids was selected as the pilot site, and a standard youth obesity intervention program will be implemented across additional Anoka County clinics during 2007 and 2008.Advocacy Agenda:
Allina aggressively pursues legislation to ensure regular physical education as part of every school’s curriculum. In 2006, more than 300 Allina advocates met with state legislators to better inform them of the magnitude of the youth obesity epidemic, the imperative role of physical activity and the need for government intervention. Recently, the Director of Allina’s Community Benefit program served as Co-Chair of the Minnesota Task Force on Childhood Obesity. Recommendations developed by the Task Force were presented to state legislature in January 2007. Additionally, Allina has partnered with the American Heart Association to conduct a public opinion poll of 800 adult Minnesota residents, designed to solicit perspectives regarding the role of health care providers in preventing and reducing youth obesity. The information will help orient future interventions as well as guide the legislative agenda.
The Children’s Hospital of Alabama – Children’s Center for Weight Management (Birmingham, AL)
The Children’s Center for Weight Management (CCWM) was established in July 2002 as a joint venture between the University of Alabama at Birmingham, Department of Pediatrics and Surgery and The Children’s Hospital of Alabama to provide an interdisciplinary approach in efforts of prevention, evaluation, treatment and research with children who are overweight.
The CCWM program includes three direct clinical service components:
- Weight Management Clinic: This outpatient interdisciplinary clinic serves approximately 400 families per year. The staff works collaboratively with these families to evaluate their medical status, prior attempts at weight loss, lifestyle factors contributing to an unhealthy weight, readiness to make behavioral and lifestyle changes, and possible barriers to success with the program. Follow-up visits are scheduled to monitor their progress.
- LESTER and Healthier Weigh: CCWM includes two group programs – “Let’s Eat Smart, Then Exercise Right® (LESTER®)” for ages 6-11 and Healthier Weigh for ages 12-18. Both groups are ten-week programs that focus on increasing activity levels and establishing more healthy nutrition patterns in families through education and counseling for lifestyle and behavior change. Both programs include individual assessment sessions prior to entry into the group and individual evaluation and planning at the end of the group. LESTER® is facilitated by registered dietitians and child-life specialists with consultation from physical therapy. Healthier Weigh is facilitated by a licensed clinical psychologist, registered dietitian and physical therapist.
- Bariatric Surgery Service: Select adolescents who are severely overweight are considered for surgical treatment. Since the initiation of the program there have been a total of 20 bariatric surgeries. Adolescents referred for bariatric surgery evaluation must meet specific medical criteria, including physical maturity and a diagnosis of a health related co-morbidity. Adolescents and their families are expected to actively participate in the Weight Management Clinic for six months prior to surgery and show success with making significant lifestyle changes before approval for surgery. A support group is also available for adolescents and their families who are interested in having or have previously had surgery.
Children's Hospital of the King's Daughters (Norfolk, VA)
Healthy You Pediatric Obesity Program:
In 2001, physicians at the Children’s Hospital of The King’s Daughters (CHKD) developed the Healthy You Pediatric Obesity Program to provide children and families with the tools, skills, support and knowledge they need to improve dietary, mental and physical activity for children and teens. This program is specifically designed for clinically obese children, and combines individualized clinical assessments with comprehensive education and family support together with weekly exercise sessions.Overweight children, ages 8-19 years of age, are accepted in Healthy You, with approximately 105 children and their families participating every year. Class topics, formats and teaching methods are age-appropriate and maximize participation, learning and interaction.
The Healthy You multidisciplinary team is comprised of the program coordinator/registered nurse, a dietician, licensed clinical social worker, physical therapist and parent educator. An initial assessment is conducted through a half-day session that includes personalized recommendations and goals. Each child’s doctor is notified of these recommendations and goals so that the child’s ongoing health care needs are coordinated and effective.
The ten-week educational class helps overweight children and their parents work together to achieve better health. Parental involvement is critical and therefore mandatory, and evening classes are held to ensure family attendance. The classes explore nutrition, physical activity and emotional aspects such as body image and self-esteem. Support groups are an important part of the ten-week series, and enable the child or young adult to take control of their health and address their challenges in a safe and supportive environment.
Following the ten-week session, aftercare support sessions are offered free of charge, and the program’s LCSW is also available to provide emotional support groups and one-on-one or family counseling.
Partnerships:
CHKD has formed a partnership with the YMCA, which has proven critical to the program's success. Local YMCA's offer meeting space for the program, provide a weekly fitness session to children, and extend a free temporary membership for Healthy You families while they are in the program. Additionally, Healthy You staff are helping the local YMCAs with their national initiative (the Gulic Initiative) to promote better nutrition among kids who participate in YMCA preschools and afterschool programs. They are also providing nutritional training to the YMCA afterschool and daycare providers.CHKD partners with two regional organizations dedicated to children’s health: the Consortium on Infant and Child Health (CINCH) and the Coalition for Obesity Prevention. Healthy You's program coordinator is the current chairperson of the obesity workgroup of CINCH. The hospital also meets with educators and school nurses, and conducts community outreach activities throughout the region.
Clarian Health (Indianapolis, IN)
Indiana’s children are among the most overweight in the nation. In 2001, Indiana ranked third in the nation for incidence of childhood obesity, and in 2005, 62.3% of the Hoosier population had a BMI considered to be overweight or obese. To address these alarming numbers, Clarian Health utilizes school-based programming as a method to engage children that are at the highest risk for obesity. Schools are one of the primary locations for reaching children and youth, and research suggests that children today are spending more of their time away from home in school, after-school programs, or daycare.
Clarian Health has implemented obesity prevention and reduction programming in 15 suburban Indianapolis schools within four suburban school districts, namely: Metropolitan School District of Perry Township, Metropolitan School District of Washington Township, Center Grove School District, and Hamilton Southeastern Schools.
Committed to Kids (CTK) has been implemented as an after-school program in five elementary and middle schools, two of which are suburban. CTK is a multidisciplinary outpatient response to the prevention and treatment of childhood obesity, developed in 1987 at Louisiana State University Medical Center. The program has been evaluated and is an evidence-based intervention and prevention tool. The 12-week program educates children ages 9-13 and their families in the lifelong behaviors and skills they need to live active and healthy lifestyles. Each 90-minute session covers a nutrition topic, a behavior topic and an exercise topic, along with 30 minutes of physical activity for parents and children.
In addition, Clarian has developed a classroom-based version of the CTK program, which is offered in health and PE classes. It has been implemented in 14 elementary and middle schools, six of which are suburban. The CTK Program Coordinator works closely with the school principal, teachers and nurses to plan the program, develop recruitment and referral strategies, and coordinate the pre- and post-assessments for participating students.
Clarian Health and the CTK program also strive to address the cultural and linguistic needs of its students. Bilingual anatomy charts, food guide pyramids, frequently asked questions, and worksheets are used, and an interpreter is provided when needed. Additionally, session topics are tailored for the cultures of the families represented in the session.
On a broader level, the CTK Program Coordinator has worked with four school districts at the administrative level to ensure that nutrition and fitness are incorporated into the development of Coordinated School Health Plans for more than 100 schools.
Owensboro Medical Health System / Foundation for Health (Owensboro, KY)
Owensboro Medical Health System and the Foundation For Health are part of the School Health Partnership, a collaborative effort involving Daviess County Public Schools, Owensboro Public Schools, Owensboro Catholic Schools, Audubon Area Head Start, Family Resource Centers, Green River District Health Department and The Hager Foundation. The Partnership has developed a series of programs and has enabled the community to provide a school nurse presence in every school to provide instruction on nutrition and wellness policies.
Fit For Life is a research-based fitness and wellness program that helps children incorporate health, wellness, and physical activity into their daily lifestyle. The goal of Fit For Life is to keep students active, with a focus on personal improvement, not competition, allowing them to succeed at their own pace and encouraging self-direction. In a typical Fit For Life class, students move through a series of cardiovascular fitness stations, and fitness measures are used to allow students to set goals and track their progress. The School Health Partnership has provided nearly $750,000 to equip every school in the Owensboro-Daviess County community with extensive fitness centers, heart rate monitors, and assessment systems.
Children’s Health Assessments is another aspect of the School Health Partnership. The program brings Owensboro Medical Health System’s Health Promotion Staff along with hospital and community volunteers into schools to perform physical and lifestyle assessments. These health assessments are used to identify and track the health status of students, so that staff can target interventions and help students learn to improve their health. These assessments are performed every other year at every school in the Owensboro-Daviess County community, from kindergarten through eighth grade. And, through the Fit For Life program, area high schools have been provided the equipment and assessment services necessary to evaluate themselves, enabling students to take charge of their own health.
Way to Go Kids is a fitness and nutrition education program designed specifically to teach kids, ages 9-12, who are under-active and/or overweight to develop healthy lifestyle habits. The program emphasizes eliminating weight gain while maintaining normal growth and development. The nine-week class meets twice a week, and is offered three to four times per year. Staff includes health promotion specialists, registered dieticians, registered nurses, exercise physiologists, and other professionals from Owensboro Medical Health System. Parental involvement is central to the program, and each week families are given specific goals to accomplish together. Children and their parents learn about all aspects of nutrition, including the food pyramid, healthy cooking, and label reading, and they learn easy ways to be physically active in their daily routines. Pre- and post-measurements of each participant are used to track their success with the program. Since its inception in 2002, every child that has completed the program has either lost or maintained their weight. Most importantly, though, they have each learned the skills necessary to be healthy for life.
Saint John's Mercy Hospital (Washington, MO)
In response to pediatricians’ pleas and the growing need for youth obesity prevention and treatment programs, St. John’s Mercy Hospital in the rural community of Washington, Missouri, has launched the Jump Into Health Program. The program is made up of four components.
In-School Prevention Program:
This program currently targets 4th and 5th graders in two schools, totaling about 150 students. Dieticians educate the children and lead them in goal setting and tracking. Students are given a pedometer and water bottle, and urged to take 10,000 steps each day. Prizes are awarded to children based on their achievements each week, and at the end of the year, a bicycle is awarded to one student from each class. The Washington School District Superintendent has requested that the program be brought into all 12 schools in the district.After-School Program:
Children are referred into this 10-week program by their pediatrician or primary care physician, and are placed into a group based on their age. Initially, a dietician holds a one-hour consultation with the parent and child, and individualized goals are agreed upon. Parental involvement is required for children age 6-10. Each class consists of 30 minutes of nutrition education and/or stress management followed by 45 minutes of exercise, taught by a physical therapist who also provides one-on-one counseling. Parents are able to consult with the dietician while children are exercising. The mental health counselor performs an initial emotional screening for every child, teaches sessions on self-esteem and positive body image and can provide up to three follow-up sessions with “at-risk” children. In addition to the mental health counselor, the 11-17yr old program introduces children to HeartMath’s Transforming Stress tools taught by a certified HeartMath® trainer.McAuley Pediatric Clinic Program:
Dieticians review the charts of every pediatric patient and provides nutrition education materials and referral forms for the Jump Into Health Program for those who are obese or “at-risk.” Additionally, a registered dietician is available in the clinic eight hours per week to work individually with families. Each Thursday, a dietician also holds interactive classes in the waiting room.Community Engagement:
A dietitian from St. John’s Mercy Hospital participates on a task force with principals from the Washington school district to create a plan to improve lunch menus, eliminate unhealthy snacks and drinks from vending machines and to integrate nutrition education into the school curriculum. The hospital also participates in the state’s Missouri Takes Action on Obesity task force. Recently, they presented the Jump Into Health Program at the annual Missouri/Arkansas Kiwanis convention in February 2006, and are now working with the local Kiwanis clubs to introduce healthy lifestyle programs in their communities. All materials and lesson plans developed in the program are free upon request. This year the program will sponsor its Second Annual Pediatric Expo using a community planning committee. Dieticians will also participate in the 1st Annual Wellness Expo for the employees of the Washington School District.
Saint Joseph Mercy Health System (Ann Arbor, MI)
The percentage of overweight children in St. Joseph Mercy Health System’s (SJMHS) primary service area has increased dramatically from 1995 to 2000, jumping from 15.6% to 25.3%. SJMHS has begun to tackle this rising epidemic with its youth weight management programs, which has four key offerings. They remain one of the only organizations in its service area of Southeastern Michigan to offer comprehensive, family-centered programs that help to combat youth obesity. To date, SJMHS has served a total of 865 families.
Weight Management for Children and Teens:
This 10-week program for parents and children has nutrition, exercise and behavioral change components, which enhance the core curriculum of ShapeDown (a nationally based program developed in 1979 by the University of California, San Francisco School of Medicine).The treatment goals are to promote children’s acceptance of their own body type and improve self-esteem, increase physical activities, improve nutrition and eating habits, and improve family communication especially regarding limit setting, nutrition and expressing feelings.Advanced Weight Management for Children and Teens:
Families have the option to continue with advanced ongoing weekly classes upon completion of the initial 10-week session. This is strongly encouraged for children with a BMI above the 95th percentile. Interactive nutrition and behavior classes feature continued hands-on cooking classes, food-tasting exercises, fitness training and family communication skill building.School-Based Childhood Obesity Intervention:
In 2003, SJMHS began providing interventions within local schools with a high population of at-risk youth. A $25 fee is requested to demonstrate the family’s intention of following through with the program and to help them feel invested. Childcare for siblings is provided on-site, and transportation is provided when needed. School administration and staff are an integral part of social marketing, recruitment, staff education and some are instructors for the program.The above three programs follow a similar model and share core components, including:
- Free orientation and educational meeting for parents and children, followed by ten, two-hour weekly classes;
- Parent and child interaction with instructors during the first hour, followed by exercise activities for children during the second hour, while parents participate in educational group time;
- Goal logs to energize the participants by encouraging accountability and marking achievements;
- Teams of trained health professionals that co-lead each class, composed of a dietician, social worker and exercise specialist;
- Family meetings with a social worker for a one-hour assessment prior to and at the end of each 10-week session.
Individual / Family Nutrition Counseling:
Additionally, SJMHS uses the Nutricare nutrition program to provide customized services that help parents and children achieve weight loss goals, establish healthy eating habits and lower the risk of chronic diseases. The Nutricare staff consists of registered dieticians with an expertise in weight management, cardiovascular disease, cancer, diabetes, gastrointestinal disorders, emotional eating problems and childhood and adolescent nutrition. These services are available individually or in combination with the group classes outlined above.
WakeMed Health and Hospitals (Raleigh, NC)
The WHH Pediatric Diabetes Program was created in response to the need for improved diabetes care and prevention, and to educate children and their families in the management of this complex disease. The original target was children with type 1 diabetes, but the recent epidemic of childhood obesity has brought a dramatic rise in type 2 diabetes. Because these two health problems in children are inextricably linked, a community-wide response to this emerging public health problem is needed.
The Pediatric Diabetes Program now provides community-wide screening for type 2 diabetes and pre-diabetes through local public health clinics and physicians’ offices. Pediatricians are also educated and trained in order to effectively screen for diabetes risk factors.
Children then identified with diabetes or at high risk are offered extensive nutrition and exercise education and medical follow-up. This intensive lifestyle intervention is called ENERGIZE!, a 12-week, three night per week education and lifestyle change program. The nutrition, physical fitness, and behavior change classes take place in a local community center (YMCA, Parks and Rec, YWCA) and are taught collaboratively by WHH clinicians and fitness partners at each site. Families are integrated into the program through nutrition classes and fitness offerings.
The goals of the ENERGIZE! program are to improve the health of children with type 2 diabetes, and to detect and treat children with pre-diabetes to prevent the otherwise inevitable progression to type 2 diabetes and its complications. Accomplishment of these goals is determined through clinical measurements and behavioral process measures before, during and after participation in the program.
