By Sarah Sonies
Among New York State counties, the Bronx has some of the poorest health outcomes. National data show that the Bronx lags behind in areas such as childhood obesity, pediatric asthma, and overall pediatric health.
The commonality of these conditions and high rates of hospital readmissions led resident physicians of the Service Employees International Union (SEIU) Committee of Interns and Residents (CIR) to create the Healthy Bronx Initiative in order to address the underlying causes of pediatric obesity and pediatric asthma, two of the major public health concerns in the Bronx.
Part of the HBI featured a partnership between the CIR partnered and community members from the Mary Mitchell Centerfor the Family Health Challenge, which celebrated its third consecutive year this January.
Structured as an eight-week program for children ages 7-11, the challenge provides a curriculum focused on health behavior changes. Physician residents teach weekly interactive sessions on nutrition, exercise, and environmental health topics in after-school programs at the Mary Mitchell Center. The lessons include takeaways that the students and their families could incorporate into their daily routine each week.
“We were presented with an opportunity to work directly with community members to develop lifelong habits,” said Camille Rodriguez, a first-year pediatric resident at Jacobi Medical Center in the Bronx and a Family Health Challenge teacher. “In order to keep kids motivated and engaged, the lessons were simple. Like encouraging kids to select low-fat milk instead of whole milk, or do 30 minutes of daily exercise.”
According to Alyssa Ruiz, coordinator of the Healthy Bronx Initiative, the program’s curriculum was developed by the Mary Mitchell Center, with CIR providing educational and research support.
The program aims to expand residents’ knowledge of the social and environmental determinants of health while encouraging them to engage in community-based solutions to health disparities and provide a supplemental resource system.
“Some of the interns and residents might not have previously had the chance to see how effective these programs can truly be,” said Rodriguez. “We wanted to address the root causes of diseases through community service, as well as move doctors out of the hospital and into the community.”
In January 2013, the program completed a year-long pilot study partnership between the CIR, Mary Mitchell Center, and the Prevention and Control Core (PCC) of the Albert Einstein Diabetes Research Center to measure the program’s effectiveness in reducing unhealthy behaviors in participants.
Einstein calculated the data for the study, which indicated that children who participated in the Family Health Challenge showed improvements in many of the major behaviors targeted in the program’s fitness and nutritional curriculum.
“While the results of this pilot study are considered to be preliminary, we saw positive results in terms of self-reported behavior change in the majority of behaviors, which is encouraging,” said Elizabeth Walker, a behavioral scientist and professor of medicine at the Albert Einstein College of Medicine and director of the Prevention and Control Core for the Diabetes Research and Training Center.
Ruiz adds that having a diverse population of physicians providing information in a way that is easily synthesized for community members also helps the effectiveness of the program’s curriculum.
“The program is an opportunity to see doctors in a different setting and for the children to have access to a doctor in a very informal way,” said Ruiz. “The kids are more susceptible to retaining the information because they can interact with the doctor in a very different way than they are used to.”
Rodriguez and her peers recently presented their results in a poster session at the 2014 ACGME Educational Conference. In addition to improved pediatric health, a majority of the resident participants reported an interest in pursuing a career in addressing health disparities through advocacy or education.
“The key lesson we learned is that health issues do not dissipate once the patient leaves the hospital or clinic,” said Rodriguez. “There need to be healthy habits incorporated into their daily living. Small lifestyle changes can make a big difference.”
Video Extra: The SEIU CIR provided a series of video clips from this year’s family health challenge with classroom interviews, lesson samples, and physician interviews which can be seen here:
—Sarah Sonies is associate editor of Wing of Zock. She can be reached firstname.lastname@example.org or on Twitter @ssonies.