AIM-HI Family Medicine Residency Childhood Grant Projects

Could you pass a Fitnessgram®? That’s what four second-year residents at Northridge Family Medicine Residency in Northridge, California asked themselves when they decided to partner with eighth-graders at Northridge Middle School for a community health project. A Fitnessgram is a six-part, California-mandated, physical-fitness test for students in grades 5, 7, and 9. Alarmingly, only 37% of all seventh-graders at Northridge Middle School passed all six components in 2010. Additionally, 31% of the students had poor body composition. “We knew,” said Kris Saab, MD, “that a middle-school partnership would require us to set an example. We’d have to walk the talk.”

The goal of CHANGE — Creating Healthy Attitudes about Nutrition/Fitness through Guidance and Education — is to reduce childhood obesity. “As family physicians, we need to be highly skilled in promoting health, as well as in treating disease,” said Camille Chandler, DO.

Through the CHANGE program and their collaboration with the middle-schoolers, the residents hope to gain a better understanding of the challenges that students and the community face in maintaining a healthful lifestyle. “We need to be in tune with our patients—their living arrangements, their work schedules, their financial situation—to be able to make nutrition and fitness recommendations that they can use,” said Chandler.

To kick off the program, the residents created a fitness contest for the clinic’s staff. “We all wear pedometers to track our activity,” said Saab. “We also keep food journals, and, like the middle-schoolers, we’re taking the Fitnessgram. The contest isn’t actually competitive; we just want to set an example for our patients.”

In addition, the clinic now displays AIM-HI posters in the reception area and in exam rooms, plays the AIM-HI DVD in the reception area, and provides fitness literature throughout the office.

The residents also visited an eighth-grade classroom at Northridge Middle School. The purpose of the first visit was two-fold. “We wanted to show the students that healthy foods can be tasty and easy to make,” explained Chandler. “We also wanted to remind them that physical activity can be fun.”

During the visit, the residents conducted two hands-on activities: “Kids in the Kitchen” and “Fitness Frolic.” The nutrition activity included making healthful snacks, such as nonfat yogurt and fruit parfaits. “The students loved those,” said Chandler. “Every time I turned around, they were asking for more.” In the physical fitness activity, the students measured their heart rates at rest and then again after jumping rope or playing team handball. “Although the kids knew that physical activity would increase their heart rate,” said Saab, “they were surprised by how much.”

On their second classroom visit, the residents arrived with digital cameras and asked the students to keep photo food journals for one week. “It’s one thing to read words in a journal, but something entirely different to see images of what you ate,” said Saab. “Some kids were embarrassed by the images.”

The students were also asked to write about the experience. “We were encouraged and surprised by the support of the students,” said Chandler. “They were all eager to provide information that would help us help our patients.”

Once the residents have compiled the data from the student photos and essays, they intend to make a presentation of their findings to the entire eighth-grade class.

Research indicates that parent education can increase the chances of success in the prevention and treatment of child obesity. The final phase of CHANGE involves a five-part nutrition/fitness course for the parents of the 22 eighth-graders who participated in the project, as well as for patients who have school-age children. “Ultimately, we’d like to provide a year-long lecture series to all eighth-graders at Northridge,” said Saab, “as well as provide free health-and-wellness courses to our community.”

As for the Fitnessgrams, how do the results of the clinic staff compare with those of the eighth-graders? According to Chandler, “We’re still working on that.”