Jan 23, 2015, 9:00 AM, Posted by
Erin D. Maughan, PhD, MS, RN, APHN-BC, is director of research at the National Association of School Nurses and a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2013 Cohort).
If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either. One of the places to begin coordinated cultural change is in schools.
Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.
There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.
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Nov 5, 2014, 11:00 AM, Posted by
Steven J. Palazzo, PhD, MN, RN, CNE, is an assistant professor in the College of Nursing at Seattle University, and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2013 – 2016. ) His research focuses on evaluating the effectiveness of the Teen Take Heart program in mitigating cardiovascular risk factors in at-risk high school students.
Difficult problems demand innovative solutions. Teen Take Heart (TTH) is a program I’ve worked to develop, in partnership with The Hope Heart Institute and with support from the RWJF Nurse Faulty Scholars Program, to address locally a problem we face nationally: an alarming increase in obesity and other modifiable cardiovascular risk factors among teenagers. The problem is substantial and costly in both economic and human terms. We developed TTH as a solution that could, if it proves effective in trials that begin this fall in my native Washington state, be translated to communities across the country.
The State of Obesity: Better Policies for a Healthier America, released recently by the Trust for America’s Health and RWJF, makes it clear that as a nation we are not winning the battle on obesity. The report reveals that a staggering 31.8 percent of children in the United States are overweight or obese and only 25 percent get the recommended 60 minutes of daily physical activity. The report also finds that only 5 percent of school districts nationwide have a wellness program that meets the physical education time requirement.
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Jul 28, 2014, 9:00 AM, Posted by
Lorraine McKelvey, PhD, is an associate professor of family and preventive medicine and pediatrics at the University of Arkansas for Medical Sciences. She is an alumna of the Robert Wood Johnson Foundation (RWJF) New Connections program (2008-2009) whose work focuses on vulnerable populations.
For children, stress can come from sources inside and outside the family. It was recently documented that nearly two out of every three children in the United States have witnessed or been victims of violence in their homes, schools, or communities. That’s a staggering statistic when we consider the well-established link between children’s exposure to stress and their long-term mental and physical health outcomes.
Indeed, we know that early exposure to adverse experiences can change the way that our brains develop and function. We also know that exposure to adversity increases the likelihood that children will develop psychosocial problems, like depression, aggression, and other antisocial behaviors. There is even evidence that exposure to stressors in childhood increases the likelihood of having heart disease and cancer in adulthood!
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May 7, 2014, 4:38 PM, Posted by
We’re seeing signs of promise in the effort to reverse the childhood obesity epidemic in the United States. Overall childhood obesity rates have leveled off—and they’ve even declined in some regions and among some age groups.
But it’s far too early to declare victory, writes RWJF President and CEO Risa Lavizzo-Mourey, MD, in a new post on the professional social networking site LinkedIn. The rate of obesity among U.S. teens, she notes, stands at a “shocking 21 percent, and Hispanic and African-American youth still have higher obesity rates than their white and Asian peers.”
To make more progress, Lavizzo-Mourey says, we need more people and organizations in the fight—particularly the business community.
So what more can be done? On Thursday, May 8, Lavizzo-Mourey and influential leaders from throughout the nation—including many from the business community—met to consider innovative approaches in a forum, “Closing the Gap in Childhood Obesity,” sponsored by RWJF and the Clinton Health Matters Initiative, in collaboration with Grantmakers in Health. The forum focused on developing solutions to the inequities that exist in childhood health and childhood obesity.
Apr 8, 2014, 9:42 AM, Posted by
Adam L. Sharp
Adam L. Sharp, MD, MS is an emergency physician and recent University of Michigan Robert Wood Johnson Foundation Clinical Scholar (2011-2013). He works for Kaiser Permanente Southern California in the Research and Evaluation Department performing acute care health services and implementation research.
Violence is a leading cause of death and injury in adolescents. Recent studies show effective interventions can prevent violent behavior in youth seen in the Emergency Department (ED). Adoption of this type of preventive care has not been broadly implemented in EDs, however, and cost concerns frequently create barriers to utilization of these types of best practices. Understanding the costs associated with preventive services will allow for wise stewardship over limited health care resources. In a recent publication in Pediatrics, "Cost Analysis of Youth Violence Prevention," colleagues and I predict that it costs just $17.06 to prevent an incident of youth violence.
The violence prevention intervention is a computer-assisted program using motivational interviewing techniques delivered by a trained social worker. The intervention takes about 30 minutes to perform and was evaluated within an urban ED for youth who screened positive for past year violence and alcohol abuse. The outcomes assessed were violence consequences (i.e., trouble at school because of fighting, family/friends suggested you stop fighting, arguments with family/friends because of fighting, felt cannot control fighting, trouble getting along with family/friends because of your fighting), peer victimization (i.e., hit or punched by someone, had a knife/gun used against them), and severe peer aggression (i.e., hit or punched someone, used a knife/gun against someone).
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Feb 28, 2014, 10:55 AM, Posted by
Nearly seven years ago, this Foundation made a major commitment to reversing the nation’s childhood obesity epidemic. We had many reasons, but chief among them was the decades of data showing more and more young people in America facing greater challenges to growing up healthy. We, and many others, knew it was an unsustainable path. So we pledged $500 million to reverse the trend, and joined forces with a wide range of partners to address the many different facets that an effort of this magnitude would require. Big challenges require big commitments.
This week has been one of the most exciting in the last seven years. Research published Tuesday shows a major decline in the obesity rate among children ages 2 to 5 over the last eight years. This is a very real sign of progress, because we know that preventing obesity at an early age is likely to help children maintain a healthy weight into adulthood. The significant decline measured by researchers with the Centers for Disease Control and Prevention follows progress we’ve started to see over the last 18 months.
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Feb 27, 2014, 4:30 PM, Posted by
When he was 17, Dexter Harris was good at two things: football and hustling. Although he went to school, he spent most of his time trying to earn money. He wasn’t thinking about his future. He was thinking about surviving the here and now.
Instead of finishing his senior year, Dexter found himself in a California juvenile facility. There, he met a mentor named Mike who told Dexter about a new program, EMS Corps, that offered far more than emergency medical training (EMT) classes. EMS Corps also provided tutoring, mentoring and leadership classes, and was looking for people from the community who were willing and ready to serve in the emergency services field.
After hearing about EMS Corps, something changed for Dexter. He weighed his options and saw that with EMS Corps he could actually have the chance for a different life. Dexter threw himself into studying, and eventually graduated first in his EMS Corps class. As a certified EMT, Dexter now has a career with Paramedics Plus and returns to the juvenile facility to teach other young people about being a First Responder.
In every community there are young men like Dexter who have the potential to succeed. But like most young people, they need help and support to bring out their best.
Today, I was honored to be present at the White House as President Obama helped to add more momentum to a growing movement to expand opportunity for young men of color. I was joined by leaders from both the public and private sector committing their intellect, creativity, passion and resources to continue to identify solutions for men and boys of color.
I was inspired by the continuing and new energy to ensure that every young man has the opportunity make healthy choices and has the tools to live a healthy life. That includes skills to succeed in school and work. EMS Corps is just one bright light among the many innovative and inspiring approaches that the Robert Wood Johnson Foundation has been proud to support as part of its effort to create a culture of health and opportunity for all young people. This new national initiative announced at the White House brings a new chance to build upon this exciting and important work.
It’s not just EMS Corps. Look at our Forward Promise partners to see the richness of programs already lifting up young men. It’s not just the White House and our Foundation colleagues in this movement either. There are thousands of teachers, police chiefs, state and local legislators, judges, church leaders, and community based organizations from across the country that are taking steps to ensure that all young people in America, including our young men of color, have the opportunity to succeed. If our job is to build a culture of health for all young men, then those collective efforts are its vital building blocks.
As I arrived at the White House this afternoon, I couldn’t help but think of Dexter. And of all of the “Dexters” who will benefit from this unprecedented moment of commitment to hope, change, and opportunity for our sons, brothers, students and neighbors. I’m proud to be a part of the Robert Wood Johnson Foundation and of this larger movement. Together we can bring out the best in our young men. And they—in achieving their promise—can bring out the best in all of us.
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The EMS Corps program helps local health care providers expand and diversify their workforce by training young men and women from the community to be emergency medical professionals. The program also gives young people mentoring and life coaching to help them become healthy, responsible adults.
Jan 6, 2014, 9:00 AM, Posted by
Katherine A. Auger
Katherine A. Auger, MD, MSc, a pediatrician in the Division of Hospital Medicine, Department of General Pediatrics at Cincinnati Children’s Hospital Medical Center, is an alumna of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program.
A 2006 recommendation from the Centers for Disease Control and Prevention (CDC) that all adolescents receive vaccines for pertussis, also known as whooping cough, is having a positive impact. A new study that I led shows it is associated with lower rates of infant hospitalizations for the respiratory infection than would have been expected had teens not been inoculated.
The study, published in Pediatrics, found that the CDC recommendation led not only to a significant increase in vaccination rates among teens, but also to a reduction in severe pertussis-related hospitalizations among infants, who often catch the disease from family members, including older siblings.
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Oct 10, 2013, 10:13 AM, Posted by
When I see top athletes hawking junk foods and sugary beverages, it makes me want to blow a whistle and call a foul. When men and women who are at the peak of their athletic prowess push products that do nothing to contribute to peak performance, our nation’s kids are getting the wrong messages.
A new study by the Rudd Center on Food Policy & Obesity at Yale University shows that the vast majority of foods and beverages touted by top athletes are unhealthy products, like sports drinks, soft drinks, and fast food. It also reveals that adolescents ages 12 to 17 see the most TV ads for foods endorsed by athletes. The Robert Wood Johnson Foundation and Rudd Foundation funded the study, which appears in the November edition of Pediatrics.
So what effect might this have on kids?
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Jun 19, 2013, 4:18 PM, Posted by
Fifteen years ago the Centers for Disease Control and Prevention’s Adverse Childhood Experiences (ACEs) study found that children exposed to traumatic events were more likely to develop mental and behavioral health problems like depression and addiction. They were also more likely to have physical illnesses like heart disease and diabetes.
Today, based on that evidence, we are witnessing a health revolution.
An op-ed published today in The Philadelphia Inquirer highlights a recent summit and ongoing efforts in Philadelphia to raise awareness about the negative impact of ACEs on health, education, and other outcomes. The piece states:
Neuroscientists have found that traumatic childhood events like abuse and neglect can create dangerous levels of stress and derail healthy brain development, putting young brains in permanent "fight or flight" mode. What scientists often refer to as "toxic stress" has damaging long-term effects on learning, behavior, and health. Very young children are especially vulnerable.
The same message was echoed in testimony today at the RWJF Commission to Build a Healthier America convening in Washington, D.C., where panelists like Jack Shonkoff of the Harvard Center for the Developing Child emphasized the need for early childhood interventions that focus on building the capabilities of parents to protect their children from high levels of violence and stress, and model resilience.
Continuing to develop our understanding of the connection between ACEs and poor health and other social outcomes, and supporting interventions like Child First, Nurse-Family Partnership, and other efforts that work to stabilize fragile families and put children on the path to healthy development will help shape RWJF’s ongoing efforts to foster a vibrant culture of health in communities nationwide.
Learn more about ACEs