The AIM-HI Family Medicine Residency Program Childhood Obesity Grant-I (FMRPCOG-I) funded by the MetLife Foundation distributed $202,560 in funds to family medicine residency programs (FMRPs) across the United States in 2011. Grant recipients developed family-centered, community projects designed to reduce childhood obesity and to promote fitness for the entire family. The AAFP defines fitness as physical activity, healthy eating, and emotional well-being.
Read about the family medicine residency projects that were awarded funding through the AIM-HI Childhood Obesity Grant.
Residents at Drexel University College of Medicine and Hahnemann University Hospital completed a project called “Move It with Mommy & Me,” which took place in a community shelter for women and children. The project aimed to decrease the number of children who are obese by educating children and their parents, and by promoting fitness and healthy eating.
According to Assistant Professor, Annete Gadegbeku, MD, "This grant was a wonderful learning opportunity for our residency program. It allowed the residents to become familiar with the application process of a grant, budget planning, and formulating reports. We, as a residency program, also learned how to design and implement a community project. Additionally, it provided a valuable service to the Eliza Shirley shelter(use.salvationarmy.org)."
The residents who participated in this project completed 12 successful sessions, in which they educated 291 participants that included children and their families on healthy eating and physical activity. Through pre- and post-session questionnaires, residents found that 53% of the project participants showed greater understanding of the concepts of fitness after sessions.
“The most poignant success was observing mothers and children getting excited about healthy activities and healthy eating, laughing, participating, and having fun with each other. For us, the epitome of success was when we observed a group of mothers and children jumping rope outside the shelter on the sidewalk as we were leaving after completing a session," says Gadegbeku.
Grant recipients at the Indiana University Health Ball Memorial Hospital completed a project called “Home for Supper: Creating Family Mealtimes that Sustain Mind, Body, and Spirit.” The goal of this project was to address childhood obesity in the community through a systems approach that recognizes the value of families eating together.
According to Linda Daniel, PhD, responsible for Community Intervention and Resident Curriculum, “The most enduring lesson learned from the community project was that if we, as care providers, remain engaged, our patients will remain engaged. Compliance is a two-way street. [The participants] repeatedly told us they came for the ‘lesson’ and the social support – not the door prize.”
The residency program enhanced its curriculum and training by increasing knowledge and raising awareness of childhood obesity in its clinic. Residents shared the results of their efforts through three poster presentations at regional and national conferences, and through a presentation at a hospital-sponsored continuing medical education symposium. During the project, residencies discovered that the prevalence of childhood obesity (95th percentile or higher) in their pediatric patient population was 25.5%.
The residents improved their processes for measuring and recording pediatric patients’ body mass index (BMI) and implemented counseling for unhealthy weight in at least 30% of applicable visits. The residency program also developed a local pediatric obesity multidisciplinary clinic with a dietitian and a pediatric physical rehabilitator.
“We were told by the president of the board of the center that our presence in the neighborhood helped them to start a revitalization of programming in general. They now have regular Friday programming for children that includes information on nutrition,” said Daniel.
The residents at Loma Linda University (LLU) completed a project called “Using Nutrition Prescriptions and Promotores to Combat Childhood Obesity,” with the goal of contributing to reversing the ongoing epidemic of childhood obesity in the Inland Empire area of Southern California. Their focus was on screening, diagnosing, and treating children ages one to four years who were at risk of developing obesity. With the help of the grant, they were able to train 41 residents and four medical assistants in state-of-the-art childhood obesity protocols.
“The AIM-HI grant led to strong collaboration with the School of Public Health at Loma Linda University, as well as with the Pediatrics department at Loma Linda University Medical Center. Both of these collaborations are substantial and strong, and would not have occurred at anywhere close to this level without the AIM-HI grant,” said Wayne Dysinger, MD, MPH, Residency Director at LLU.
The Lynchburg Family Medicine Residency project, “Training Residents in Modifying (TRIM) Lifestyle,” had the goal of training primary care physicians to provide intensive interventions to promote a healthy lifestyle for overweight and obese children and their families.
“Overall, we feel that the TRIM Lifestyle program has been a successful addition to our curriculum and office activity. The project has increased awareness of measuring and noting BMI results in both children and adults in our practice. Working together to develop the PowerPoint presentations has improved the teamwork of our residents and other staff,” according to Resident Coordinators, Jennifer Cunningham, MD, and Shital Patel, MD, and Faculty Supporter, Stacey Hinderliter, MD.
The residents identified overweight and obese children in their clinic, incorporated intensive education about the 5-4-3-2-1-0 Healthy Lifestyle into monthly office visits, and developed competency in identifying and managing overweight and obesity in children and their families.
“We have been able to incorporate the TRIM visits into our regular office schedule. Each TRIM visit is scheduled for 20 minutes as a routine acute visit. The nurses gather the written materials, teaching tools such as the food replicas, and the incentives for the visit. The resident finds the correct PowerPoint for the visit on the laptop computer and uses it to educate the family and organize the visit. There is no disruption to office flow,” said Cunningham, Patel, and Hinderliter.
Residents at Northridge Family Medicine Residency completed a project called “C.H.A.N.G.E.” or “Creating Healthy Attitudes About Nutrition/Fitness Through Guidance and Education.” The goals were to raise awareness and increase knowledge about healthy nutrition and fitness in 8th grade students and their parents in order to reduce childhood obesity. The residents worked with 20 8th-grade students four times during the year and conducted an educational presentation at a school assembly for 175 students. They also began an intervention and prevention program to help parents create a healthy food and fitness environment at home. For more about their program, read “Are You More Fit Than an Eighth Grader?”.
According to Program Director, Pamela Davis, MD, “Our residency program experienced the following significant grant-related successes:
Residents at Underwood-Memorial Hospital completed a project called “Healthy Habits,” with a goal of improving the knowledge, skills, and confidence in patients and parents regarding fitness to allow them to make good choices for themselves and their families.
Project leader, Maryette Sabater, MD, PGY-3, said “The residents have become active participants in promoting healthy habits and fitness at workshops and within our hospital. On “Wellness Wednesdays,” held at Underwood-Memorial Hospital, the residents staff an AIM-HI booth where they provide fitness assessments and assess body mass index for hospital employees.”
The residents at Underwood reached 192 participants at their monthly group workshops and their community health fair. They developed a program that incorporated Healthy Habits and AIM-HI in monthly group workshops that focused on motivational interviewing and addressed the importance of physical activity, healthy eating, and emotional well-being in relation to childhood obesity prevention. In addition, they held a Healthy Habits Community Health Fair to provide children, parents, and families with information about health and fitness.
According to Sabater, “Residents were trained on the core components of AIM-HI, motivational interviewing, and the use of AIM-HI tools. Three presentations were offered to residents, attending physicians, and office staff. AIM-HI handouts, fitness prescriptions, and food and activity journals are used for patients within our practice.”
Residents at the University of Maryland School of Medicine implemented a project called “B-M-I” or “Better My Identity,” with a goal of encouraging a wholesome lifestyle, happy outlook, and healthy self-image for school-aged pediatric patients.
According to Yvette L. Rooks, MD, CAQ, FAAFP, Vice Chair and Residency Director, “The entire University of Maryland Family and Community Medicine Department benefited from the BMI program. The exposure and success of the program brought awareness to our department and how we are effectively creating a program that addresses a true health crisis.”
They offered health education classes for students and their parents, incorporating a nutritionist, a cooking demonstration, group physical activities, and social and mental wellness activities. The BMI project reached more than 200 participants.
“All of our residents are trained to teach the Ready Set FIT! curriculum of AIM-HI and are currently teaching the curriculum in local elementary schools,” said Rooks.
Residents at Waco Family Medicine Residency conducted a project called “Fit and Healthy Families: leading the community to healthy behaviors through family group medical visits,” with the goal of using interactive teaching during group visits to enable families to become healthier and more physically active.
Program Director, John Gill, MD, said “The most effective recruitment strategy was having a family’s personal physician recommend the program of Fit and Healthy Family Camp to the parent in person. As for retention strategies, the children enjoying the sessions and wanting to come back next time seemed important.”
They taught motivational interviewing skills to residents and faculty, and conducted group medical visits in which they calculated BMI, assessed pediatric patients and their parents, demonstrated healthy cooking, participated in fun activities, and examined individual and family emotional health. Eight families participated in the Fit and Healthy Families sessions.
According to Gill, “The main benefits have been training in motivational interviewing skills for residents and faculty, as well as the development of collaborative teaching/research relationships with our consultants. These are also beneficial to the community as we find ways together to use these skills and relationships for the betterment of our patients and the community directly surrounding the residency main clinic site.”
Residents at York Hospital Family Medicine Residency completed a project called “Get Fit! Have Fun!” with the goal of decreasing the incidence of childhood obesity in a targeted neighborhood of York City, PA. They conducted monthly Get Fit! Have Fun! activities incorporating the AIM-HI Fitness Prescription, Ready, Set, FIT!, a walking program, and trips to a local farmers’ market.
“[Our project helped to] increase awareness about the negative impact of childhood overweight and obesity for 7 months [and] provided a safe and fun environment for kids to improve their fitness,” said Gordon Zubrod, MD, Associate Residency Program Director.
York residents estimated that they would educate 30 participants with their project, but ended up with more than 130! Initially 51.2% of participants reported participating in 60 minutes of physical activity five or more days per week. By the final survey in October 2012, this percentage had increased to 84.2% of participants.
According to Zubrod, “[The project] taught residents that they can have a significant impact through community-oriented primary care.”
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Medical School & Residency
Childhood Obesity Grant
2011-2012 Grant Recipients