American Academy of Pediatrics
National Conference
Washington, DC, October 2015
Community Pediatrics
Background info about author (name/institution/address)
Sarah Kennedy
University of Chicago Pritzker School of Medicine
924 E 57th St, #104
Chicago, IL 60637
Abstract title
Academic-Community Collaboration to ImproveChild Health and Wellnessin Schools of Underserved Communities
Describe the program/project target population(s).
The South Side of Chicago is home to a historically underserved population of low-income minorities. Challenged by lacking resources, South Side residents face problems as diverse as violence, scarcity of nutritious and affordable food, few employment opportunities, and struggling school systems. Taken in whole, these factors lead to poor health outcomes which have their roots early in life. A striking example of this reality is demonstrated by a survey taken in 2008 which reports that the childhood obesity rate in the non-Hispanic black community in the South Side is 56.4% compared to the nation’s16.8%.
Endeavoring to enable youth from these neighborhoods to find success, the University of Chicago Charter Schooleducates children in pre-kindergarten through 12th grade. Of 1900 students across four campuses, 82% qualify for free and reduced lunch through the National School Lunch Program, and 97% are black or African American.The school’s mission is to prepare 100% of students for college acceptance and graduation. For the last four years (2012-2015), 100% of the graduates have been accepted to college.
Provide a description of the program/project.
In an effort to reduce health disparities while further optimizing educational success, physicians, residents, and students from University of Chicago Medicine formed a partnership with University of Chicago Charter School administrators, nurses, and staff. In the summer of 2014, the resulting health and wellness consortium began its work to improve overall health of students through a wellness-conscious school culture.
Provide the program/project methods.
Since August 2014, the health and wellness consortium has met monthly to develop, plan, implement, and assess programs focused on wellness at the school. Prior to the establishment of this structure for wellness planning, there was no formal body to address child health. Further, the four member campuses were unaware of the others’ best practices.
The first steps in the process were mainly focused on identification of assets and deficits in child health management, both within the schools and across the broader community. The consortium looked to a health needs assessment conducted in 2013for the neighborhoods served by the University of Chicago Charter School. The report indicated that fast food consumption, physical activity, computers and televisions in the bedroom, and obesity all represent target areas for improvement of child health.It was also determined that parents lack knowledge regarding health resourcesavailable to them.
Early in the fall semester, medical students from the Pritzker School of Medicine prepared a surveyto take stock of health and wellness policy at each school campus. The form is based on two validated school assessment tools - the Centers for Disease Control and Prevention “School Health Index” and United States Department of Agriculture “Wellness School Assessment Tool.” It focuses on areas of concern identified by consortium members: health education infrastructure and curricula, population characteristics, meal programs, and student nutrition and exercise behaviors. Finally, the assessment seeks teachers’ perspectives of student health and students’ perspectives of nutrition. Data for the assessment was collected at each of the four schools during a regular school day and involved both direct observation and discussion with administrators, teachers, cafeteria staff, and students.The format also allowed for comparison with another local school identified as a strong model for wellness programming.
Based on the gathered information, the committee has constructed a wellness policy to unify thecharter school network’s actions related to health and wellness. The policy sets forth the ideals for preventive health, nutrition, physical activity and education, social and emotional well-being, reproductive health, health education, and staff wellness, according to national and local standards and adapted to this school. Building upon the new health and wellness policy, the consortium has begun to develop specific programs aimed at reducing child health disparities in this underserved population.
Provide the program/project outcomes.
Through the application of the assessment tool in each school, areas of immediate concern were identified across campuses. Student nutrition included the consumption of calorie-dense foods while at school. The relatively healthful options provided through the lunch program were often rejected with a majority of food deposited directly into trash cans. Additionally, physical education and health instructors universally described a lack of the key resources of time, materials, and professional development which would allow them to provide a truly effective health education to their students.
Based on these and the other findings described above, the consortium wrote its comprehensive wellness policy, which was complete by the spring of 2015. An accompanying implementation plan sets forth yearly goalsfor establishment of programming and health-directed changes in the school. A budget was established with a plan for obtaining funds through donations and administrative support.
In this inaugural year of the consortium, a family wellness night served as an introduction to the new school culture of wellness. The event included interactive nutrition and physical activity information sessions for students and parents. It boldly demonstrated the value of the academic-community partnership as medical students and physicians shared their knowledge with attendees. For the start of the upcoming school year, the consortium is also organizing a 5k walk/run which will further highlight the schools’ improved commitment to child health.Fall 2015 will also mark the implementation of a strict food policy to reduce consumption of calorie-dense foods while at school.Teachers will integrate more movement-centered “brain breaks” into daily activities to increase physical activity. Finally, additional professional development and wellness programming will be available for staff at the schools.
On a broad level, this project has allowed individual campuses to identify best practices for child health and wellness in their own and the other campuseswithin the University of Chicago Charter School. The consortium has also already begun to increase awareness about health and wellness for involved members, as well as students and staff. It has allowed physicians and trainees at the University of Chicago to become more engaged in the community by understanding its current needs and has thus fostered future networking and collaboration.
Provide any key lessons learned.
Most importantly, shifts in school culture are slow and must be implemented in small, manageable pieces. Buy-in from faculty, staff, administration, students, and community is crucial to the implementation of the health and wellness program. Furthermore, some changes may be logistically challenging by nature. For example, the school lunch menu is limited by a contract for the meals with the providing company; while the menu cannot be completed changed, small changes in the ingredients can be made instead.
Additionally, the consortium has provided a great lesson in the value of bringing all stakeholders to the table in academic-community collaborations. Top-down planning by administrators and university physicians would be less effective because it does not allow investment in changes by the students, families, and school at the schools. More critically, it would likely not address the needs that were best identified by those who experience them daily. An ongoing culture of community has been fostered through the involvement of administrators, academic physicians and trainees, faculty and staff, parents, and students.
Can this program/project be duplicated in other communities? Yes/No. If yes, please describe.
This project can be adapted to fit the unique community of any school. The strength of the consortium has come from its responsiveness to needs self-identified by the population that it serves, and the same would need to be true of similar efforts. The ongoing value of this consortium will be in its constant evaluation of needs, program and policy effectiveness by the key stakeholders. Virtually any school community would benefit from the existence of such a body of individuals, the composition of which should reflect diverse perspectives and experiences.
Describe any innovative components of this project/program.
The project is innovative in the degree to which it relies on close collaboration between community schools and the university health system. Physicians do not simply act as consultants in school planning, but rather, along with residents and medical students, they are fully invested in every step of assessment and planning. Building these relationships allows for improved relations between the academic medical center and its surrounding underserved communities and fosters more effective addressing of health disparities outside of the clinical setting.