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CHALK - Choosing Healthy & Active Lifestyles for Kids

Overview

CHALK (Choosing Healthy & Active Lifestyles for Kids), a collaboration between Community Pediatrics at NewYork-Presbyterian Hospital/Columbia University Medical Center and our community, is a five year Center for Best Practices grant funded by the New York State Department of Health starting in 2008.

The goals of CHALK are to reduce over time the prevalence of childhood obesity and its related morbidity in Northern Manhattan (with a focus on school-aged children), and to promote a culture and create an environment in which healthy lifestyles are integral to the lives of all children.

CHALK works with a community coalition of partners, initially focusing on Washington Heights/ Inwood to develop and disseminate a social marketing message that promotes healthy lifestyles, while identifying barriers and resources to healthy living.

CHALK also works internally within the hospital to engage and train health care providers to identify best practices and to foster an environment of healthy living.

Goals

• To reduce over time the prevalence of childhood obesity and its related morbidity in Northern Manhattan using prevention strategies and targeting the community
• To promote a culture and create an environment in which healthy lifestyles are integral to the lives of all children

Objectives

• Develop a culturally-appropriate community-wide obesity prevention/healthy lifestyle promotion strategy
• Coordinate broad dissemination of consistent information through community
• Identify resources to implement strategy
• Engage community agencies, leaders and elected officials in a broad initiative
• Engage and train health care providers
• Identify and evaluate best practices

In its second year, CHALK engages healthy lifestyles promotion on both the community and institutional level:

Community

• Community Task Force on Childhood Obesity Prevention and Healthy Lifestyles - Central to CHALK's work is engaging a community coalition of agencies, leaders and elected officials to develop a culturally appropriate community-wide healthy lifestyle promotion strategy. This coalition has developed a social marketing message that will be disseminated in Northern Manhattan around healthy living starting in the summer 2009, while identifying resources and barriers to implementation of its principles. As of its kick-off on October 8th 2008, there are thirty different organizations comprising this task force.
• The social marketing message - the community task force is currently testing the message:

The last three words of our message will be replaced with a specialized message that caters to the organization, business or individual that adopts it, highlighting how that group supports healthy lifestyles in their services. An example is below:

Our social marketing campaign will include organizations and businesses adopting this message in their marketing practices, a Chalk-it-up campaign throughout the neighborhood (where participating groups disseminate our message with chalk art), advertisements, etc.

• Family Fitness Night at the YM&YWHA of Washington Heights & Inwood - CHALK hosts popular, weekly hour-long fitness sessions for Northern Manhattan families at the YM&YWHA of WaHI. This follows the American Hospital Association's recommendation that hospitals partner with local Y's to improve community health, and builds on a two year Y-Healthy Schools, Healthy Families partnership. Now in its summer schedule from August 3rd-September 21st, "Family Fitness Night at the Y" takes place in Fort Tryon Park with organized fitness activities and free time. Equipment is provided for basketball, soccer, jump rope, team sports, tag games, and more. Every Monday, 6pm-7pm. Meet in front of the YM&YWHA at 54 Nagle Avenue at 6pm sharp.
• Farmers' Markets - In collaboration with organizations such as Greenmarket, Manhattan Borough President Scott Stringer's Go Green Initiative, and the Food & Fitness Partnership of New York, CHALK promotes access to healthy foods and farmers' markets in Northern Manhattan. CHALK conducts seasonal tours of farmers' markets in the area. Both Greenmarkets in Washington Heights/Inwood have "CHALK racks" with a collection of kid-friendly recipes, food-related games and tasty and delicious Latino recipes in Spanish and English. Look for us every Thursday 10am-2pm July-November at the 175th market with kids' activities, including: hula hooping, jump rope, chalk art and story telling! We also have a nutrition intern on site to help you shop. CHALK is also working to bring an additional farmers' market to the Washington Heights area that will be tied to patient and staff services at our medical center.
• Health Fairs - With help from interns and students from diverse disciplines, CHALK participates in health fairs throughout Northern Manhattan, providing educational material on healthy lifestyles, fitness games for kids (jump rope, hula hooping, chalk art, ball games) and information on how individuals can participate in our social marketing campaign by "Living their life".
• Community-based grants "CHALK is issuing a call for proposals (CFP) to community based organizations and initiatives that support healthy lifestyles for school-aged children in Washington Heights/Inwood. Specifically, we are interested in funding either new or ongoing initiatives that increase access to and knowledge about healthy foods and eating habits, and/or physical activity. We are looking for initiatives that are both innovative and creative, or are as simple as helping cover administrative costs relevant to healthy lifestyles promotion for your program. Programs will ideally demonstrate evidence of effectiveness, success in promoting healthy lifestyles and a high likelihood of producing sustained change. Applicants are strongly encouraged to incorporate into their proposals the community task forces social marketing message, "Live your life. Energy, balance, action.". Applications are due by Friday, August 14th, 2009 5pm."
• Collaborations - CHALK participates in a variety of initiatives centered around healthy living. This includes: Healthy Schools, Healthy Families; the Food and Fitness Partnership of New York; Manhattan Borough President Scott Stringer's Go Green Initiative; NYC DOHMH Green Cart Outreach; and New York Civic Participation Project's campaign "Parents Taking Action Against Obesity and Diabetes". Our work with NYCPP includes developing a home visit script in partnership with the Institute of Human Nutrition of Columbia University, train-the-trainer workshops and public community workshops on healthy lifestyles and diabetes prevention.

Institutional

• Clinical (the office visit) - CHALK facilitates a interdisciplinary work group on a monthly basis that aims to translate research into effective prevention and treatment. The group is working through various components of the screening and management that happens during an office visit and is working with information-technology staff to integrate these components into the medical record. By early summer we expect to finalize the components of an office visit, end of summer integrate them into the medical record, train providers during the fall and implement the protocol early 2010. This protocol will be used as standard in all Hospital-affiliated pediatric practices and ultimately will be introduced to all pediatricians in the community. CHALK also hosts and supports various workshops for continuing education for medical providers.
• Healthier Hospitals
• NYPgreen Wellness Task Force-CHALK has been instrumental in putting healthy, local foods on the hospital's eco-sustainability agenda. CHALK chairs the Wellness Task Force of NYPgreen, the hospital's eco-sustainability program, and links eco-sustainability initiatives with healthy lifestyles. Our work for 2009 includes a campus wide "Take the Stairs" campaign, expanding existing staff wellness initiatives, and working to procure and promote healthy, local foods for patients and staff (which includes securing a farmers market at our medical center). CHALK also collaborates with other task forces on related projects, and has assisted in efforts to bring bike racks to our ACN clinics.
• Pediatric Food Guidelines - Together with our ACN nutrition team, Food Services and students, CHALK is developing pediatric food guidelines for events that are hosted in the Wintergarden of MSCHONY (our children's hospital). This work includes exploring menu revisions with vendors to support healthy eating habits for our patients.
• Gift Shop Healthy Snack Promotion - Look for CHALK signs in our hospital's gifts shops which identify some best choices for healthy snacks and beverages.
• Healthy Tip of the Week - Based on the Healthy Schools, Healthy Families social marketing calendar and original tips, CHALK posts weekly healthy tips of the week on the Get Well Network of MSCHONY, an electronic bulletin board for patients. These tips are written in partnership with Healthy Schools, Healthy Families, our ACN nutrition team, and the Be Fit to Be'ne'fit program.
• Healthy Lifestyles Resource Library - CHALK runs a small resource library in the Vanderbilt Clinic (4th floor room 412) with books on nutrition, physical activity, program evaluation, social marketing, patient counseling, and sociology, as well as children's books. Books are available in Spanish and English. The library also includes musical CDs, sports equipment, guides for incorporating fitness activities into afterschool programs and a radio/CD player. The library is available during business hours for staff to use in their work with patients and community partners.
• Educate - Part of CHALK's work is educating to effect positive change in policies, laws, and environment regarding childhood obesity prevention and reduction. Past and current projects include improving greenways in Northern Manhattan, supporting community applications for the NYC Plaza program, and considering bike racks for the outside of our ACN clinics.