Health Promotion

Pediatric Wellness Programs

The mission of the Children’s Foundation Research Center of Memphis is to provide the infrastructure, resources, and environment for the development of a major pediatric research center and to impact the health of children now and in future generations. The generous donation of $ 2 million by LHS, Inc. in 2001 created an infrastructure for pediatric wellness research, augmenting the CFRC’s clinical research capability in pediatric medicine.

LHS funding has allowed UT Pediatric faculty to develop community-based research initiatives in the following areas: 1) reducing obesity and diabetes risk in Latino children (Para los Niños); 2) increasing early childhood physical activity (SPARK Pre-K); 3) assessing target organ damage in children with hypertension; 4) lifestyle intervention in obese African American children; 5) promoting bicycle helmet use in preschoolers; and 6) developing a regional pediatric injury database.

Current health promotion efforts address reducing chronic disease risk (obesity, diabetes, asthma, cardiovascular disease), increasing access to care, and reducing health disparities (Latino health). Initiatives are local (Pediatric Wellness Roundtables, Pediatric Healthy Weight Seminar, NORFLEET Forum, Shelby County Breastfeeding Coalition, Latina Heart Conference, Memphis City Schools, Shelby County Schools); statewide (Tennessee Healthy Weight Network, Tennessee Department of Health); and national (NIH, CDC, HRSA) in scope.

Our goal is to establish a Pediatric Wellness Center that can serve as a regional resource for improving child health by using best practices and research-based programming to promote and support healthy lifestyles through preventive health.

The following details pediatric health promotion initiatives of the Children’s Foundation Research Center of Memphis.

CFRC Pediatric Wellness Projects LHS Funded Initiatives

1) Reducing obesity and diabetes risk in Latino children: Para los Niños:
•Gail Beeman, MD, MHPE, Principal Investigator; Marian Levy, DrPH, RD, Co-Principal Investigator; Espi Ralston, MA, MAT, MA, Project Coordinator. In this third year of funding, Para los Niños has enrolled over 260 Latino families in a community-based health promotion program at the Hickory Hill Community Center. Activities include nutrition classes, aerobics, soccer, Spanish dancing, basketball, karate and swimming. Pre-post data measure BMI, blood pressure, nutrient intake, and physical activity (steps taken). Data are also obtained on a group of Latinos in a comparison community in a neighboring state. Preliminary results indicate a reduction in BMI among those with the highest levels of participation, with women and girls receiving the greatest benefits. This project has received recognition from the Latino community, the American Heart Association, the Commercial Appeal, and was most recently recognized by the Memphis Business Journal as a “Health Care Hero 2003” finalist. Presentations have been made to the Society for Pediatric Research for two consecutive years. In 2002, the abstract was one of ten recognized for national press coverage.

2) Early childhood physical activity project: SPARK Pre-K:
• Marion Hare, MD, MS, Principal Investigator; Phyllis Richey, PhD, Co-Principal Investigator. In its third year, the project has nearly 1200 children in its first two cohorts of preschoolers. Longitudinal tracking includes 427 kindergarten children from cohort 1, with retention of cohort 2 in progress. Investigators have presented their data at three national conferences, have two manuscripts in preparation, and are submitting a grant application in 2005 as part of a multi-center collaboration with West Virginia University focusing on a physical activity and obesity intervention in preschool-age children in Head Start Early Childhood centers.

3) Assessing target organ damage in children with hypertension:
• Deborah Jones, MD, Principal Investigator. In the third year of study, Dr. Jones continues to study target organ damage in children with hypertension, assessed by ambulatory blood pressure monitoring. In Year 3 there were 116 children enrolled, of whom 100 are subjects and 16 are controls. Additional pediatric offices have been prepared to assist with additional recruitment. An application has been submitted to the NIH for funding of a 5-year training grant. Future substudies will include using new methodology to look at insulin resistance and vascular changes among these hypertensive children. Findings from this project were presented at the Society for Pediatric Research in Seattle in May, 2003, and a grant application to the National Institutes of Health is pending.

4) Lifestyle intervention in obese African American children:
• George Burghen, MD, Principal Investigator; Pedro Velasquez-Mieyer, Co-Principal Investigator. This project enrolled African American children in a clinical setting to participate in the SHAPEDOWN weight reduction program. Dr. Pedro Velasquez continues to follow the cohort recruited (n=50) under his currently funded study “Racial Differences in the Impact of Overweight in Adolescents,” supported by the Children’s Foundation Research Center. Furthermore, preliminary data from the original study have been included in an AREA (R-15) grant application to the NIH submitted May 2003. Dr. Velasquez submitted a K-23 grant application to NIH in February 2004, incorporating the follow-up data from this cohort.

5) Promoting bicycle helmet use in preschoolers:
• Karen Lakin, MD, Principal Investigator. Dr. Lakin is studying the feasibility of “imprinting” positive health behavior (bicycle helmet use) with preschool children as a means of promoting helmet use with older children. She has recruited 4 preschools (2 church-affiliated; 2 privately owned) and has a subject pool of approximately 300. A pretest of parent attitudes was successfully conducted last April, with a near 100% rate of return. The safety curriculum has been implemented in intervention schools, and monthly observations of helmet use have been initiated.

6) Developing a regional pediatric injury database:
• Robert Tamburro, MD, Principal Investigator; Andy Spooner, MD, Co-Principal Investigator. The investigators have worked with a database provided by Methodist Healthcare (purchased from the Tennessee Hospital Association). They have conducted an initial review of variables to determine the suitability of this database for capturing cases of child injury as a means of observing for secular trends and relative impact of the SAFEKIDS Injury Prevention Program. A manuscript has been published examining the effect of the SAFEKIDS program in reducing unintentional injuries in the Mid-South.

Reducing Health Disparities

The following other projects initiated at the CFRC reflect our ongoing commitment and expertise with the Latino community:

• Comenzando Bien: ( link to more info  ) Prenatal nutrition program for Latinas (funding awarded from the March of Dimes)

• Proyecto SALUD: Survey of Latino health and social needs in rural West TN (funded by the Tennessee Department of Health)

• Cultural Competency Conference (November, 2003): Co-sponsored by Le Bonheur’s Education Department

• Su Corazon es un Tesoro: Evaluating the health impact of the Latina Heart Conference (sponsored by the American Heart Association)

• Health Care Interpreter Certificate Training: ( link to more info  ) In partnership with En Memphis Hablamos Juntos and funded by the Robert Wood Johnson Foundation, we have developed a training program for health care interpreters. This is only one of ten such programs nationally. A certificate is awarded through the College of Allied Health Sciences at UT. We have trained two classes of medical interpreters to date, graduating a total of 23 individuals. A new course begins October 11, 2005.

• Cultural Competency Training: Programs have been conducted training health care professionals in Latino values, health beliefs, and culture in order to facilitate access to health care. Workshops have conducted for the CFRC Pediatric Wellness Roundtable, UT Pediatric Residents Ethics Roundtable, Memphis District Dietetic Association, and UT Dental Hygiene students.

• Salud para Todos: We have received funding from the Aetna Foundation to conduct cultural competency workshops with health providers, hospital associates, and students in health professions throughout Shelby, Fayette, Hardeman, and Tipton counties in West Tennessee. Additionally, we have developed a 5-part series of “Cultural Capsules” for UTHSC students and delivered them during Chancellor’s Hours to students in UT’s colleges of medicine, nursing, pharmacy, dentistry, and allied health. Topics have included working with an interpreter, medical terminology, and diversity within Hispanic culture.

• Spanish classes for Health Care Professionals are held periodically during the year (link: spainsh classes)


Promoting Breastfeeding ( link to Breastfeeding info )

A community breastfeeding initiative has also been spearheaded by the CFRC. The Shelby County Breastfeeding Coalition is designed to promote and encourage breastfeeding community-wide. Partner agencies include the Memphis and Shelby County Health Dept; UT Pediatrics; Le Bonheur Children’s Medical Center; the MED Health Loop Clinic; Alpha MAXX Healthcare; and the Tennessee Chapter of the American Academy of Pediatrics. The breastfeeding initiative has received financial support from the United Way of the Mid-South and the Memphis Area Nutrition Council.

Obesity Prevention

Tennessee Healthy Weight Network is a collaboration of over 25 organizations across the state designed to reduce children’s obesity risk. Formed in 2003, the organization has developed a strategic plan which is research-based and incorporates best practices. Titled “Eat Smart… Move More… Tune In,” the Tennessee Healthy Weight Network (THWN) plan contains specific objectives and action steps for families, schools, child care, community, health care, media, and surveillance/research.

Faculty from the Children’s Foundation Research Center are members of the THWN Executive Committee and drafted sections of the plan. Dr. Gail Beeman drafted the Health Care section; Dr. Marian Levy drafted the Surveillance/Research section. Dr. Levy serves as Co-Chair of the Tennessee Healthy Weight Network.
The THWN plan has been distributed to all school districts in Tennessee to be used as a template for nutrition and physical activity programming.

(download the Plan - pdf format)

CFRC Pediatric Wellness Roundtable ( link to Calendar )

The Pediatric Wellness Roundtable is a monthly series designed to promote interdisciplinary collaboration in health promotion research. Participants discuss current research projects and topics of interest. Attendees include pediatric clinicians, university researchers, and community health professionals.