Category Archives: Children (6-10 years)
Hilary Levey Friedman, PhD, is an alumna of the Robert Wood Johnson Foundation (RWJF) Scholars in Health Policy Research program. She is a Harvard sociologist and author of the book Playing to Win: Raising Children in a Competitive Culture.
Youth sports have been taking a beating these days—for example we have serious concerns about concussions in football and other youth sports, along with worries about an educational system that often seems to emphasize athletics over academics. Not to mention overzealous parents and kids who attack referees, as I have previously written about. In this context it’s easy to forget that sports can help promote physical fitness, health, and even nutrition among our children.
There are additional benefits to participating in competitive youth sports, along with other competitive afterschool activities, as I detail in my recent book Playing to Win: Raising Children in a Competitive Culture (a manuscript I completed during my time as an RWJF Scholar in Health Policy Research). Children can also acquire important life lessons from activities like chess, dance, and soccer—what I call “Competitive Kid Capital,” based on my research with 95 families who have elementary school-age children involved in these competitive endeavors. These five skills and lessons are: (1) internalizing the importance of winning, (2) bouncing back from a loss to win in the future, (3) learning how to perform within time limits, (4) learning how to succeed in stressful situations, and (5) being able to perform under the gaze of others.
Ruchi S. Gupta, MD, MPH, is an alumna of the Robert Wood Johnson Foundation Physician Faculty Scholars program. She is an associate professor of pediatrics and director of the maternal and child healthcare program at the Northwestern University Feinberg School of Medicine, and an attending physician at the Ann & Robert H. Lurie Children's Hospital of Chicago. Learn more at www.ruchigupta.com.
This past spring, 12 students with asthma at James Hedges Elementary in Chicago’s Back of the Yards neighborhood took hundreds of pictures, filmed video Public Serve Announcements (PSAs), created a website, and rolled out a community intervention to improve asthma conditions. These activities were part of the Student Media-Based Asthma Research Team, or SMART program. We developed this program from a previous pilot program in Chicago’s Uptown neighborhood that empowered students to learn about their asthma and challenged them to create change in their own communities.
As the most common chronic condition in children and the most common cause of school absenteeism, asthma is responsible for 13 million days of school missed each year. Asthma disproportionately affects racial and ethnic minorities, as African Americans and Hispanics/Latino children have significantly higher asthma-related morbidity and mortality rates compared to White children. While evidence-based guidelines for asthma care have been available for 20 years, ethnic minorities have a lower likelihood of receiving or following proper asthma treatment. Across and within racial/ethnic groups, asthma care has been shown to be more effective when it is tailored to the individual community instead of one-size-fits-all intervention.
Nancy Ryan-Wenger, PhD, RN, CPNP, FAAN, is the director of nursing research and an investigator at the Center for Innovation in Pediatric Practice at Nationwide Children’s Hospital in Columbus, Ohio. As a grantee of the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI), she was a lead investigator of the first-ever study to systematically elicit the views of hospitalized children and adolescents on the quality of their nursing care, and also the first to evaluate children’s perceptions of nurses’ behavior for evidence of any disparities across demographic groups. This is part of a series of posts for National Nurses Week, highlighting how nurses are driving quality and innovation in patient care.
Have we asked the children?
That became a pressing question for me when I retired from academia after 30 years and joined the staff of Nationwide Children’s Hospital. I became aware of things that are highly important to hospitals, such as opinions of the quality of care. Yet when I saw the patient surveys at Nationwide, they were almost always completed by parents, and 80 percent of the questions were geared toward parents: Were they kept informed of their child’s condition? Did they have a comfortable place to sleep? Was their child treated kindly by staff member?
Those are important questions, certainly, but if you’re doing a patient survey, don’t you want to know what the patient thinks?
Have we asked the children?
Sammy Zahran, PhD, is a Robert Wood Johnson Foundation (RWJF) Health & Society Scholar (2012 - 2014). He is assistant professor of demography in the Department of Economics at Colorado State University, assistant professor in the Department of Epidemiology in the Colorado School of Public Health, and co-director of the Center for Disaster and Risk Analysis at Colorado State University. This blog is based on his study: "Linking Source and Effect: Resuspended Soil Lead, Air Lead, and Children's Blood Lead Levels in Detroit, Michigan."
RWJF Health & Society Scholars lead the field of environmental health. This is part of a series highlighting their 2013 research.
Human Capital Blog: Tell us about your recent study, published in Environmental Science and Technology. What questions did you set out to answer? And what did you find?
Sammy Zahran: We sought to understand a mysterious statistical regularity in blood lead (Pb) data obtained from the Michigan Department of Community Health. The dataset contained information on the dates of blood sample collection for 367,800 children (<10 years of age) in Detroit. By graphing the average monthly blood Pb levels (μg/dL) of sampled children, we found a striking seasonal pattern (see Figure 1). Child blood Pb levels behaved cyclically. Compared to the reference month of January, blood Pb levels were 11-14 percent higher in the summer months of July, August, and September.
E. Alison Holman, PhD, FNP, is an assistant professor in nursing science at the University of California, Irvine and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar. She has received the Chaim Danieli Young Investigator’s Award from the International Society for Traumatic Stress Studies for her research on early cognitive predictors of long-term adjustment following trauma. She studies how people cope with highly stressful experiences with special interest in understanding how trauma affects long-term mental and physical health.
The tragedy in Newtown CT violated everything we hold dear, with 20 innocent children among the carnage. My heart aches for Newtown, the families who lost their children, the children who lost their siblings and friends. It is so sad.
According to FBI records, on average, 27 Americans were murdered with firearms every day in 2011. Yet, last Friday, White House spokesman Jay Carney said "today is not the day for a debate on gun control." But if not now, when? On April 28, 1996, 35 people were murdered in Port Arthur, Tasmania by a gunman from New Town, Australia. Within 12 days the Australian government adopted bipartisan gun control legislation. In the 15 years since these new gun control laws were passed, no mass shootings have occurred in Australia. Do we have the resolve to do the same here?
Manish K. Sethi, MD, is a health policy associate at the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College and a Pilot Project Mini-Grant recipient and renowned orthopaedic trauma surgeon at Vanderbilt University’s Orthopaedic Institute Center for Health Policy. Sethi spoke this morning during the 2012-2013 Grand Rounds Series, sponsored by Meharry Medical College School of Medicine, on “Gun Violence in Nashville: Working Towards Community Based Solutions.”
Human Capital Blog: What is the violence prevention program you’re directing with the RWJF Center for Health Policy at Meharry?
Sethi: We are doing a youth violence intervention program via partnership with Nashville schools funded by the RWJF Center for Health Policy at Meharry.
All of the data demonstrates that educational intervention with this age group demonstrates positive results. Currently, no such program exists in Nashville schools.
HCB: What drove your interest in this topic?
Sethi: I am a trauma surgeon and have been seeing an inordinate number of gun violence injuries in African American teenagers. I grew up in Tennessee and left for my medical training, but during childhood I never saw violence to this degree. Almost every week I see a teenager who either loses his life, or suffers major trauma secondary to a gun violence injury. I care very deeply about the future of these children and of Tennessee and I just feel that we have to do something.
Tamar Mendelson, PhD, is an assistant professor at the Johns Hopkins Bloomberg School of Public Health, and an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2004-2006). Her research interests include the development of prevention and intervention strategies for reducing mental health problems, with a focus on underserved urban populations. This post is part of a series on the RWJF Health & Society Scholars program, running in conjunction with the program’s tenth anniversary. The RWJF Health & Society Scholars program is designed to build the nation’s capacity for research, leadership and policy change to address the multiple determinants of population health. Mendelson is a member of the program’s 2nd cohort.
Anyone who's ever spread a yoga mat across a floor will tell you that it's about more than flexibility. One of many benefits of yoga is that it helps those who practice it deal with stress in their lives. An emerging body of research points to the conclusion that yoga can have a stress-relieving effect.
One problem with the research base is that it's mostly focused on adults. But grown-ups aren’t the only ones who deal with stress in their lives. Children face it as well, and they often do it without the same resources—emotional, financial and otherwise—that adults have.
Kynna Wright-Volel, PhD, RN, MPH, PNP-BC, FAAN, an assistant professor at the University of California, Los Angeles and Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar alumna, recently won a five-year, $1.2 million grant funded jointly by the National Institutes of Health’s National Institute of Nursing Research and Office of Behavioral Social Science Research. She will use the grant to work with the Los Angeles Unified School District to launch Project SHAPE LA™, a coordinated school-health program designed to increase physical activity among youth in Los Angeles County schools.
Human Capital Blog: Please share your vision for Project Shape LA™, what its goals are and how many children and teens it will reach.
Kynna Wright-Volel: Project SHAPE LA™ targets 24 middle schools in underserved areas of Los Angeles and will touch nearly 12,000 students. With this grant, we want physical education teachers to ignite a passion for physical activity – to teach kids that by being active, they can be healthy and achieve their dreams. Anticipated outcomes from this program include: increased moderate to vigorous physical activity; increased scores on the California State Board of Education’s FitnessGram Test in the areas of aerobic fitness, body composition and muscular strength/endurance; and increased academic achievement, as evidenced by higher scores on the California standardized test.
HCB: Why is a project like this needed in your community?
Wright-Volel: According to the L.A. County Department of Public Health, one in five children in the Los Angeles Unified School District is considered obese. Health inequities exist as well; children who are racial and ethnic minorities and/or come from families with low incomes have higher rates of obesity.
February is National Children’s Dental Health Month, so the Human Capital Blog reached out to John Gusha, DMD, PC, a 2003 Robert Wood Johnson Foundation (RWJF) Community Health Leader, to learn more about children’s oral health. As project director of the Central Massachusetts Oral Health Initiative, Gusha mobilized dozens of dental societies and non-profit groups to provide dental care for low-income residents of Worcester County. Although funding for the Oral Health Initiative has ended, many of the programs Gusha helped create are still in place.
Human Capital Blog: What spurred the Central Massachusetts Oral Health Initiative? What made you aware of this need for oral health care in your community?
John Gusha: There was a special legislative report in 2000 that described disparities in access to oral health care for low-income populations. It raised a lot of questions about what we could be doing in the community and in the dental society to address these gaps. We got funding from the Health Foundation of Central Massachusetts, which also saw this as a critical need for our area, to launch the initiative.
HCB: Tell us about the school-based programs you put in place.
Gusha: The decay rate in Worcester County schools was very high—more than one-third of the students had active decay in their mouths. It was especially prominent in schools with high numbers of free and reduced price lunches, where students came from low-income families that are more likely to be using Medicaid. These students didn’t have access to care and weren’t getting the preventive services they needed.
We started a school-based program that is now in place in more than 30 Worcester County schools. Dental hygiene students from a local community college provide fluoride varnishes, cleanings and other preventive services to students, and the University of Massachusetts’ Ronald McDonald “Care Mobile” visits schools to offer the same services. Community health centers also participate in these programs by adding dental to their school-based health centers. In the past you could go to schools and provide services, but Medicaid rules didn’t allow you to get reimbursed. We were able to help get those rules changed so the program could become sustainable.
HCB: You also had a role in creating a dental residency program and training primary care providers to screen for oral health needs.
Gusha: We wanted to better integrate dentistry into medicine. The University of Massachusetts was the administrator of our program, and the team there developed a dental residency program at the medical school. The University had no classes in oral health before this. The local hospitals were in desperate need of professionals with this kind of training, particularly in emergency rooms. The Medicaid population was presenting there frequently for treatment because they had nowhere else to go, and people with other issues like cardiac problems or cancer needed clearance on their oral health in order to proceed with treatment.
The residency program is still in place at our two local community health centers, and it’s grown now to include education for other disciplines.
In May, the U.S. Department of Housing and Urban Development (HUD) awarded a multi-year grant to an asthma prevention and treatment program run by 2008 Robert Wood Johnson Foundation Community Health Leader Ray Lopez of New York City. Lopez is the director of environmental health services at the Little Sisters of the Assumption Family Health Service in New York’s East Harlem. The grant award is shared with the New York Academy of Medicine.
Ray Lopez: Our mission is to serve children in East Harlem by helping their families treat and prevent asthma incidents. Asthma rates are unusually high in New York City in general, and the problem’s even more acute in Harlem, the South Bronx and Central Brooklyn where there are all kinds of environmental factors in children’s homes. We’re focused on children in public housing, where there are a number of problems. A lot of the apartments have mold that has grown as a result of leaks, and they’ve also got a lot of cockroaches, and mice, which all contribute as well. What we do, and what this grant will help us do a lot more broadly, is to get treatment for the kids, but also to go into their apartments and get to work on reducing the environmental factors. Sometimes that means identifying moisture sources and safely cleaning the mold. Sometimes it means pressing the city’s housing authority to do major work. Sometimes it involves teaching the adults in the family about the safe use of pesticides and cleaning products. For each family we visit, we work with them to create an individualized service plan, and then we focus on remediating the asthma triggers.
Teaching is a major part of this, too, and the plan is to teach by showing and doing. Families are enrolled with us for a year, and by end of year, we hope they will have accumulated skills to manage these problems on their own in the long-term. It’s a three-year project, in all: two-plus years working with the families, and then a final phase that consists of data analysis and policy initiatives led by the New York Academy of Medicine.
HCB: And then what’s the plan with the data and the analysis?
Lopez: The plan is to build the business case for this kind of intervention, and then to persuade insurance companies and providers that it’s worth the investment to them to spend a little money up front to prevent asthma incidents, rather than paying for them in the emergency room.