Interprofessional Service Learning Project: Childhood Obesity

Building on the SCRIPT and Deans’ Rural Clerkship experience, the HPS program introduced a major new program in 2007-2008 that may well become a model for the nation on interprofessional education and service learning.  This project, known as The Interprofessional Service-Learning Project (ISLP), was designed by MUSC faculty from the disciplines of medicine, pharmacy, health administration, nursing, and physician assistant science as part of the Creating Collaborative Care Initiative. The program is being implemented in collaboration with the MUSC Junior Doctors of Health Program and Lowcountry AHEC.  Thus far, medicine, pharmacy, physician assistant, and health administration students have participated.   As the program evolves, the plan includes adding other disciplines.

The overall goal for the ISLP is to provide health professions students with collaborative, interprofessional learning experiences designed to increase their knowledge and skills in health promotion/disease prevention. The objectives of the ISLP are to teach students to recognize the value of the interprofessional healthcare team and the opportunity to work together with others to address prevention and wellness issues at the community level.  Students participate in an interprofessional, community health service-learning project where they learn about socio-cultural issues effecting the health of a population.  The first community health activity is to address the childhood obesity epidemic. 

The focus for the ISLP is to equip interprofessional teams of students with the knowledge and skills they can use to work with local schools to address childhood obesity and communicate with young people about health-related topics.  Health professions students serve as the mentors and instructors for these community-based projects.  Elementary school students participate in activities to encourage physical activity, balanced nutrition and improved health outcomes while schools, teachers and parents are encouraged to take an active role in reducing obesity rates in their schools and communities.  In addition, the young people are exposed to real-life examples of career opportunities in healthcare, and health professions students are challenged to find ways to communicate health information in an age-appropriate manner.

Childhood Obesity in the Nation

• Approximately 30 percent of youth (ages 6 to 19) are overweight and 15 percent are obese.
  
  • Roughly 25 million youth (6-11) are overweight or obese.
  • Over the past three decades, the childhood obesity rate has more than tripled
• Excess weight in childhood and adolescence has been found to predict overweight in adults.
• Overweight children, aged 10 to 14, with at least one overweight or obese parent were reported to have a 79 percent likelihood of overweight persisting into adulthood.
• In a population based sample, approximately 60 percent of obese children aged 5 to 10 years had at least one cardiovascular disease (CVD) risk factor, and 25 percent had two or more CVD risk factors : (elevated)
  • total cholesterol
  • triglycerides
  • insulin
  • blood pressure

• Youth are at risk for serious psychosocial burdens related to being obese in a society that stigmatizes this condition, often fostering:
  • shame
  • self-blame
  • low self-esteem
  • impaired academic and social functioning
• African American, Hispanic American and Native American children and adolescents have particularly high obesity prevalence.

CDC, National Center for Health Statistics, NHANES. Ogden et. al. JAMA 2002:288:1728-1732

Drawn from Preventing Childhood Obesity: Health in the Balance, 2005 • Institute of Medicine • www.iom.edu

School-Based Interventions

Multiple components of successful programs:

• Activity
• Nutrition education
• Health report cards raise parents awareness
• Healthy marketing strategies

Policy Changes needed:

• Increasing physical education/sports participation
• Increasing activity
  • Safe walking/cycling routes to school
  • Built environment encourages activity

Curriculum-based interventions can be offered in a variety of class settings:

• Physical education
• Health/nutrition
• Science/biology
  • After-school programs
  • Preschool programs

Foster, GD, et al. A policy-based school intervention to address overweight and obesity., Pediatrics 2008, 121(4):e794-802.

Robinson TN: Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA 1999, 282:1561-1567. Stone EJ, et al.

Effects of physical activity interventions in youth. Review and Synthesis. Am J Prev Med 1998, 15:298-315 Dehghan et al. Childhood obesity, prevalence and prevention. Nutritional Journal, 2005. Gortmaker et al.

Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health.222. Arch Pediatr Adolesc Med 1999, 153:409-418.

Potential Partners

• AHEC
• Health Professions Students
• Academic Health Centers- faculty/administration
• Schools and school systems
• School nurses Associations
• Department of Health and Environmental Control
• Communities in Schools
• State-specific obesity prevention organizations
• National organizations
  • American Academy of Family Physicians’
    • Ready, Set, FIT! is a school-based educational program that teaches 3rd and 4th graders about fitness.
  • Robert Wood Johnson Foundation
    • Publications, data, funding opportunities

Why AHEC?

• Health professions training
  • Community-based focus
  • Interprofessional models
• Health professions recruitment/retention
• Continuing Medical Education
• Future Collaboration with CTSA

Partnering AHEC for Success

• Arrange community-based experiences for students
• Orient the students to the community
• Identify schools interested in a childhood obesity focus
• Identify contacts within the school to coordinate student efforts
• Identify resources that can assist in project implementation
• Carry the project memory
• Relay pertinent information to the academic program
• Plan project “next steps” for future students

Childhood Obesity Project

• Teams of interprofessional students work with local schools to address childhood obesity
  • Nursing
  • Physician Assistant
  • Medical (Family Med)
  • Pharmacy
  • Health Administration
• AHEC health profession student (HPS) coordinators facilitate student training.
• Jan 2007 at an elementary school in a rural county
• Team: student, AHEC coordinator, principal, after school coordinator, family physician preceptor.
• Target Population:
  • Elementary school students
  • Teachers
  • Parents

Developing Learning Skills:

• MUSC Students Teach Health Education:
  • Session 1: Nutrition
  • Session 2: Exercise
  • Session 3: Lifestyle Choices
• Target Comprehensively:
  • Student Education
  • Parent Involvement
  • Teacher Participation
    • Teacher Exercise Class
    • Tae Bo
    • Supplemental Health Information
  • Community Support
• Productive Experience for MUSC Students:
  • Benefit from Interprofessional Interaction
  • Increased Awareness - "...we really need to get to know and interact with people. I didn't realize that was so important."
  • Positive and Ongoing Communication with Public

For Additional Information:

• Donna Kern, MD - Medical University of South Carolina
• Scotty Buff, PhD - Medical University of South Carolina
• Emily Warren, LMSW - Lowcountry AHEC
• David Garr, MD - South Carolina AHEC

Graduate Medical Education • Continuing Education • Health Careers Program