Faces of Public Health: Susan Yee

May 21, 2013, 1:34 PM

A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.

>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.

Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:

  • Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
  • Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
  • Establish an afterschool culture that supports physical activity as well as academic achievement.

The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.

NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.

NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?

Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.

What I think sets us apart is that in the city many kids are very, very busy as are the parents or grandparents who take care of them. The kids have a lot of competing priorities during school hours, after school and on weekends. Asian parents also tend to emphasize academics over sports or recreation. Many students go to Chinese cultural schools during the weekends, so there really wasn't much time to fit in physical activity.

We looked at what the kids were already doing during their day to see how we could fit and integrate our programs into their existing schedule.

NewPublicHealth: What strategies did you use?

Susan Yee: Since this was a community grant, we had to focus on out of school time. We looked at afterschool programs and created a program called “iMove.” It’s a structured program of ten minutes of physical activity that we integrated into the afterschool curriculum many of the children were engaged in, which was focused on academics and tutoring. By integration we mean that once parents signed up for the afterschool program, it also included the iMove component. That let us capture the volume of children that we thought was important to make the changes that we wanted. We work with eight afterschool programs, reaching about 1,500 children and we've been running that for the last three years.

We also wanted to integrate into the existing infrastructure, so we looked at some of the partner agencies that we historically have strong relationships with. One was a mentorship organization that serves a couple of thousand kids in New York City, largely in the Asian-American community. It’s a mentorship/academic program where they match students with adult professionals in the work world. We felt that this was a good opportunity to introduce physical activity. So along with the academics and mentorship that they provided to the children, we have a basketball clinic that they run every Saturday. The kids have two hours of academics and two hours of a physical activity program, which has been in place for the last two years.

What we were able to do, serving as a liaison between these mentorship programs and the principals that we have relationships with through our iMove program, was to get space for the basketball clinics.

NPH: How were you able to convince the parents?

Susan Yee: Many of the parents allowed the kids to sign up for more practical reasons—some were working and not able to watch over the kids so they put them in these afterschool programs. They were also concerned about children doing well in school we were able to share with them studies from the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention about the positive connection between physical activity and academic performance. So we used that to our advantage when we tried to integrate our programs into the school as well as the mentorship program. We made sure that we let the parents know the reason why we're doing it, and so there was a lot of acceptance.

We haven’t done any long-term research on the impact of physical activity initiatives on the academic performance of our target population. However, in focus groups and the one-on-one interviews with some of the directors from the afterschool programs, the teachers who are running these programs, as well as the students who've participated in these programs have indicated the positive results of our initiatives. Some of the teachers have indicated that a lot of the children participating in the programs can concentrate a lot better. For example, they’ll have the afterschool program where they have some of the tutoring and the academic component and then they give a ten to fifteen minute break where they engage in physical activity, and they were able to come back and concentrate a little bit better. Previously, it was very hard to hold their attention for the three hours of the academic afterschool program.

NPH: What models did you have in setting up the programs?

Susan Yee: We actually had a lot of support from our funder and they had this model that was developed by the New York City Department of Health and Mental Hygiene in collaboration with the New York City Department of Education called Move-to-Improve, which incorporated structured fitness breaks into class time.

One key thing different about the Move to Improve program is that they used their physical activity lessons to align more with physical activity learning standards. Ours had more of an academic component aimed largely at getting buy-in from the parents. For example, in the first grade or kindergarten they're learning about communities, so we hired a consultant to create our physical activity components that align with what they were learning about communities. So, for example, what does a policeman do? And if they thought a policeman protects the community, the kids do a physical activity, such as ten jumping jacks. Their answers have to be aligned with a certain movement so that they were constantly moving and learning at the same time. So I think the parents responded very well to that, knowing that the kids were not just "playing" and wasting their time, which was I think a lot of the parents' concern initially.

NPH: Who were your partners and how did you make the case to them for the program?

Susan Yee: The partners were afterschool programs that had a good reputation in the community, one of which is the Chinese American Planning Council, a not-for-profit social service organization the Chinese community was very familiar with. It was important that the partners we were going to work with had a stake in the community already and a good reputation with the community.

The other one that we had a little bit more of a challenge working with, and over the last three years we were able to overcome that hurdle, was the NYC Department of Parks and Recreation. The Asian community did not have the closest ties there, specifically in Chinatown. Parks and Recreation had a facility that was situated on the outskirts of Chinatown and historically there was racial tension between the Asian community and the African-American and Hispanic communities. We had to convince the Asian community that they were welcome at that recreation center and that some of the tensions and fear are no longer a concern. We worked closely with the Parks Department to help welcome the Asian community.

And we did a lot of interviews with the community in focus groups to make sure that whatever we were creating was responsive to what their needs are rather than interjecting ourselves and plopping down a program or a model that did not resonate with them.

This commentary originally appeared on the RWJF New Public Health blog.