It Takes a Village

Studies predict that today’s youth will be the first generation not to live as long as their parents.

And America’s obesity problem has a lot to do with that disquieting trend. In the past 30 years, adult obesity rates have more than doubled, while youth rates have tripled. The availability and affordability of healthy food, restricted time and space for exercise, and limited public knowledge of the risks and costs associated with obesity have all contributed to this crisis.

A variety of initiatives at the state and national levels are addressing this issue, but more influential is what is happening locally. The Healthy Lifestyles School Project began in 2009 to promote healthy lifestyle choices at Garfield Primary, Trewyn Middle and Manual High School. Spearheaded by the Full Service Community Schools Advisory Council, the project is now poised to realize the synergies of a wide range of collaborative partners—while taking the first steps to fight back against the obesity epidemic.

A Central Hub
It’s no secret that crime, violence, poverty, substance abuse and mental health issues are crippling inner-city schools. When safety and hunger are top of mind, students are less able to focus on learning. Recognizing that a school’s success is directly tied to the stability of its neighborhood, the Full Service Community School (FSCS) model was introduced in Peoria’s District 150 in 2006.

“The basic premise is that schools ought to be more than a place where kids learn to read and write,” explains Kevin Curtin, principal of Garfield Primary School, an FSCS. “For the neighborhood in distress—with high mobility and high poverty—there needs to be stabilization and revitalization. And so, in addition to being an education center, the school becomes a community center.”

Full Service Community Schools provide comprehensive academic, social and health services, not only to students, but to their families and other residents as well. The idea is that when social, physical and emotional issues at home are addressed, parents can begin to concentrate on helping their children succeed in school. It relies on the collaboration of outside partners—businesses, agencies, foundations, service providers and individual citizens. By bringing essential services into the school, the school becomes an essential hub in the community.

A great example, says Curtin, is the Peoria Humane Society, which sends a representative to Garfield once a month to offer pet care advice and help with immunizations. Another would be Prairie State Legal Services, which also comes in monthly. “For many of the families in our neighborhood, downtown Peoria might as well be Siberia,” he says. “They can’t always get there, but they can get to the school and take care of their legal issues.”

With health clinics inside six District 150 schools, Methodist Medical Center is a critical partner. “Primary healthcare, for most of our families, is not in their pediatrician’s office, it’s in the ED,” notes Curtin. “Without [Methodist] in the building, they wouldn’t come to school because they’d have to get on the bus to go to an appointment. The appointment would get done, and it would be a half hour before the next bus comes. And when they get home, there is no bus to get them to school, so they miss an entire day. Instead, they come to the office and get their asthma treatment or whatever they need. They’re in there 20 or 30 minutes, and then they’re back in class.”

Encouraging data shows that the FSCS model may be bearing fruit. The mobility rate at Garfield—students who begin and end the year at different schools—has been cut in half in just six years, from 70 percent in 2004 to 35 percent last year. Many attribute that success to FSCS—no longer is the school just a place to send your kids during the day. “The intent,” says Curtin, “is that as goes the school, so goes the school’s community. So bring the school about, and the community is revitalized.”

Aligning Transformation
In just over three years of existence, Quality Quest for Health of Illinois has built remarkable momentum in its mission to transform healthcare in central Illinois. So in the spring of 2009, when the Full Service Community Schools Advisory Council asked the organization to lead a team charged with developing recommendations to promote healthier lifestyles at Garfield, Trewyn and Manual, it was a no-brainer. It aligned perfectly with the organization’s mission.

That fall, Quality Quest began building a diverse team of stakeholders to carry out the project, including school principals and staff, government officials, nonprofit groups, parents, nutritionists, medical experts and local businesses. Obesity was selected as the initial focus, not only because it is one of the nation’s most significant health issues, but the in-school clinics already had measurable BMI (Body Mass Index) data. “It’s not the be-all, end-all,” said Cheryl Toland, program manager and 6 Sigma Black Belt at Quality Quest, “but it was a place to start.”

The three Full Service Community Schools are natural links that feed into each other, from Garfield Primary to Trewyn Middle to Manual High. “So it’s continual until they graduate and go off to college or to the workplace,” said Curtin. “It really gives us a unique opportunity to demonstrate results. In other areas that are doing interventions, they don’t have the opportunity to go from kindergarten all the way through high school.”

Engaging the Community
While Methodist’s in-school clinics collected the data to develop BMI measurements, the team worked to assess the issue within the target community. “They started off by sending people door to door in the neighborhood, asking ‘What do you need?’” said Curtin. “Out of that came safety, health and education. Safety and health were the two biggies. If the families feel safe and healthy, then you can concentrate on doing well in school.”

“We wanted to understand what the students and their families felt were their issues and what they wanted to do about them. If they’re not engaged, it’s just us sitting around a table spending a lot of time and energy,” said Stacey DeJaynes, who oversees the in-school clinics for Methodist. “Our intent all along has been to engage our community and for them to really take ownership.”

The team gathered observational data in the schools’ cafeterias and conducted a survey on nutrition, physical activity, sleep and screen time. In a series of focus groups with students and their parents, the two biggest reasons cited for poor eating habits were convenience and cost. Children eat too much junk food and are not monitored. Physical activity needs to be more fun. “Vacuuming” and “walking to the bus” were perceived as exercise.

They also offered feedback about sporting activities. “Soccer came up all the time,” recalled Denise Urycki of Gifts in the Moment, a local nonprofit and partner in the project. “They see the kids out north with soccer teams, and they don’t have that in this part of the city. So that was part of our recommendation as well—to get more of those types of activities.”

While parents were cooperative, they were also very protective of their children, and concerned that they would be labeled as “fat.” “They didn’t want them to be singled out or identified in negative ways,” DeJaynes acknowledged. “So it’s great if we offered physical activities, exercise or nutrition education to the entire group. But don’t pull my kid out of class or in any way identify him or her as ‘at-risk.’”

A Food Desert
An extensive community food assessment study was conducted by students from Bradley University, who examined all of the grocery markets in the targeted area—from the corner convenient store to the large supermarket—looking at pricing, availability and other indicators. Their findings confirmed what the team suspected: that the barriers to healthy eating were tremendous.

“It was pretty astonishing, actually,” said Toland. “Many residents don’t have transportation, so they’re shopping in the quick mart across the street. Skim milk wasn’t available at most of those quick marts; it was just whole milk, and at double the price of what you get at Aldi up the street on Western, or at Kroger. There were no vegetables, no fruits, no meats…it was mainly hot chips.” Indeed, hot chips were the No. 1 food in the study.

The food that’s widely available in these areas, as the study clearly showed, is not at all healthy, nor is it cheap. “The parents are not happy with the availability of healthy food in their neighborhood, and that in order to get it, they have to do some traveling,” said Curtin. “That’s tough. They want convenience as much as anybody.”

Recommendation Areas
After analyzing the data, the team reported its findings to the FSCS Advisory Council. It developed a wide-ranging series of recommendation areas, with the idea that the Full Service Community School would also serve as a “Wellness Home” for students and the surrounding community.

And with the creation of the FSCS Wellness Council, chaired by DeJaynes, the team’s first recommendation has already been achieved. The council will oversee the implementation of these recommendations and act as a point of contact for local health initiatives, service providers, FSCS and the school district. It currently meets every two weeks to assess progress and develop solutions to overcome barriers to change.

The team’s second recommendation was to develop a wellness model for Full Service Community Schools, a process ongoing through pilot projects at Garfield and Manual in the current school year. As initiatives are phased in over time, it is hoped that they will be extended to other D150 schools, and eventually, district-wide. These fall under the following recommendation areas:

• Physical activity. Expanded on-site afterschool and extracurricular programming, increased levels of daily physical activity (short- and mid-term).
• Nutrition. Nutrition education in all grades, working with food service providers for healthier meals, implementing gardens, promoting nutrition at childcare facilities and afterschool programs, establishing a farmers’ market, increasing access to healthy foods in retail locations (short- and mid-term).
• Health services. Increased communication with parents about wellness and BMI issues, increased support for young parents (short- and mid-term).
• Non-physical afterschool programs. Increasing alternative activities for youth not physically inclined (mid-term).
• Intervention. Developing programs to work with youth requiring focused intervention in addressing obesity (long-term).
• Measurement. Collecting BMI measurements, conducting wellness and observational surveys, coordination of data to increase analysis capabilities (short-term).

Underlying these recommendations are numerous practical concerns identified by the team. People are sensitive to the measurement of weight and BMI. Food served to students must be of good quality, flavor, temperature and appearance. New initiatives must be accessible—within walking distance or via public transportation—and affordable. Organized activities should be fun—especially exercise. And finally, parents are a huge influence on their children—they are the change agents, especially for younger ages, and must be included in any programs offered.

Also significant is the project’s “pipeline” approach. It’s hoped that those students who are exposed to healthy diet and exercise habits at Garfield will carry those habits over into Trewyn and then Manual. “Behaviors get more stuck as they get older,” explained Urycki. This was clear in the surveys and focus groups: the older children were more opinionated about what they liked to eat. “That’s why we want to start younger and follow these kids all the way through.”

“Little kids don’t necessarily have a choice about what they eat,” added Curtin. “So if you wake them up to eating carrots as their snack, then when they become middle school and high school kids, they will demand that their school provide carrots as a snack. That is our intent in terms of this transformational kind of work.”

Network of Partners
These recommendations are coming together in a patchwork of initiatives, driven by the collaborative efforts of a diverse network of community partners. Peoria’s YMCA is among those driving initiatives in the area of physical activity. For the last three years, it has offered physical fitness programs at eight D150 schools, led by members of the Peoria Fire Department. “We try to hit every school about twice a week,” said Beth Gilbert-Reusch, manager of programs at the Y. “We do pre- and post-testing, nutritional and health quizzes, and provide a healthy snack.” Through the initial research of the Healthy Lifestyles team, the exercise program and its work with the Wellness Council, the Y was able to win a grant from the Robert Wood Johnson Foundation to expand its efforts. It also successfully applied for Peoria’s inclusion—one of just 16 communities—in the national organization’s Pioneering Healthier Communities initiative, which also seeks to address the obesity epidemic.

For its part, Gifts in the Moment is spearheading The Schoolyard Habitat Project. Featuring native plants and housing for animal life, a schoolyard habitat will serve as an outdoor classroom. “Research tells us that when you bring a kid outside, their depression and anxiety goes down, their ability to concentrate increases, and the whole learning experience is better,” declared Urycki. The Peoria Park District recently approved the organization’s plans for the Garfield Schoolyard Habitat on adjacent land at Logan Park. Having partnered with the Park District, Bethany Baptist Church and neighborhood associations, GITM is leading the effort, with many volunteers having donated their time, labor and materials.

And with the assistance of Luthy Botanical Garden, the Dietetic Student Organization at Bradley University and Hy-Vee dietician Susan Waltrip, GITM plans to take the schoolyard habitat to a whole new level by developing a “soup garden.” “Each class will have a bed in the habitat in which to grow vegetables and herbs,” said Urycki. “Nutrition education will be based on what they grow. We’ll probably harvest through the summer, and when they come back in the fall, we will have a ‘soup day,’ a meal that will bring all the kids who were involved together.” Ultimately, the habitat will become a year-round community garden and possibly even a farmers' market.

Momentum is indeed building as new initiatives continue to develop. The Peoria County Health Department has identified obesity as one of its four strategic issues. Chartwells, District 150’s food service provider, is revising its menus to include more vegetables and whole grains and limits on sweet desserts. Skip-A-Long Company is working to provide an exercise curriculum and equipment to low-income home daycare centers. The Christian Center will be running a basketball clinic at Garfield. Each change, large or small, represents another step toward a healthier community.

The Challenge of Change
But the challenges are steep. You can’t just magically install a grocery store on the South Side. You can’t make food affordable. You can’t force a child to exercise, and you can’t force a parent to become a change agent.

“That’s why it’s a long, long project,” said DeJaynes, “because in order to institute that kind of change, first you have to change mindsets. It’s really a chicken-or-egg thing. Did produce become unavailable in that area because it wasn’t in demand?”

“That’s what the supermarkets said,” Curtin replied. “’They buy hot chips, they buy soda, they buy candy…and I need to make a living, so that’s what I’m going to stock, because that’s what my customers are buying.’”

“And a lot of that is marketing,” added Toland. “I know that groups at the state and national levels are trying to deal with some of that marketing to kids. These are big national policy issues.”

“But I also think that these challenges are probably the greatest opportunities for change,” noted Kim Keenan of GITM. “That’s why this project exists. Once you have multi-sensory education going on with these kids, that is where mindsets change. If you start to develop relationships with people who want to change, they will.”

“That’s why the community schools are so important,” suggested Toland. “A lot of these people need that sense of community.”

“It’s like the relationships that Beth’s firemen have with these kids,” added Urycki. “They come in with energy times 10, and these kids feed off it. They want to come back. They’re going to listen to you because they trust you. That’s how you get somebody to make change.”

The Snowball Effect
Stacey DeJaynes recalls a conference she attended recently in which a video was shown of 1950s-era children, all thin and fit, walking to school. Needless to say, the subsequent image on display—of our children today—was a marked contrast. “It’s been a long progression to get to where we are now,” said DeJaynes, “and it’s going to be a long progression to get back where we need to be.”

“Everyone knows that there are issues nationwide with regard to weight and health, particularly with kids,” said Curtin. “And everybody can talk about what we need to do, but it’s all just dancing around the edges. What came out of this was that we’re no longer dancing on the edges, we’re plowing into it and doing something.”

“The intent is that we’ll become a model—not just for our community, but for the state and then for the country,” noted DeJaynes. “[The council] is starting to look at how we can put policy into place. That’s really the next phase that we’re moving toward, so that these interventions will continue to benefit the community long after we’re finished.”

“The fix isn’t going to happen overnight,” added Curtin. “That slow, measured approach of taking one step at a time and creating a snowball effect is ultimately the goal. When the children at my school are sending their children to my school—that is when we’ll see it.” iBi