Julianne is a first year Master’s student at University of Tennessee, Knoxville pursuing a degree in Public Health Nutrition. She hopes to work with medically underserved children and sustainable food systems. She holds a Bachelor’s degree from University of Dayton in Dietetics, Food and Nutrition.
On Friday, September 27th, the University of Tennessee’s MCH Nutrition Leadership team along with the Department of Nutrition hosted the Promoting Healthy Weight Colloquium 3.0 (PHW3.0): A Socio-Ecological Perspective – Healthful Food Access. This was my first time being involved in the planning of this event and participating in the colloquium. As I reflect on this series, I am optimistic about the future because I witnessed the impassioned leadership the presenters brought to the colloquium. Each speaker connected the programs or organizations they work for to the Socio-Ecological Model (SEM) and explained how their program or organization uniquely addressed barriers individuals and communities have to obtaining healthful access to foods.
One of the themes that sparked my own passions and interest was food equity and conversation regarding the nutritional value foods being served to the most vulnerable populations in society, especially single mothers and their children. Listening to the presenters speak about how their organizations or programs have made an impact reminded me how vital it is for collaboration across the SEM and between different professions for a common goal: equitable and healthful food access for the most vulnerable. My interests in working towards food equity and justice for the most vulnerable were strengthened by seeing all of the positive leverage of programs and organizations like EFNEP, SNAP-ED, Shop Smart Tennessee, Fresh Pantry through Second Harvest, and Partnership for Healthier America. PHW3.0 has challenged me to continue thinking about my time as a new graduate student to keep evaluating and improving positive initiatives addressing barriers to healthful food access for vulnerable populations.
Sa’Nealdra is a 4th year doctoral student at the University of Tennessee pursuing a degree in Nutritional Sciences in hopes of impacting women and girls of color as it pertains to dietary quality. She currently holds a degree in Health Education-Public Health from Middle Tennessee State University.
This summer I completed a 7-week internship with a Partnership for a Healthier America (PHA) as a part of our nutrition program requirements. PHA is a non-profit organization that was created by Michelle Obama to partner with the private sector while improving our nation’s food systems, in a larger effort to improve childhood obesity rates. As I reflect on this experience, I am reminded of how important it is as a future professional to embrace opportunities and to explore unfamiliar territory. I have always been comfortable embracing those familiar opportunities that are similar to what I aspire to do as a professional; however, I learned this summer that sometimes it is more beneficial to get your feet wet in other fields.
I interned with PHA’s Fruit and Vegetable campaign (initiative) which seeks to encourage the world to consume more fruits and vegetables: fresh, frozen, dried, or canned. Although I had no prior experience with non-profit organizations, I found this to be a fulfilling experience. It was different than the usual public health and community research I have been involved in. I was instead doing things such as assisting companies in improving the nutritional quality of their food products. I developed many new skills that I will continue to use throughout my career; however, my main takeaway was the reminder to always immerse myself in opportunities that are outside of my normal scope. This internship was definitely a highlight in my graduate career and I would encourage others to seek opportunities that are outside of their field!
This blog post highlights the work and experiences of two funded MCH trainees from Oregon Health and Sciences University (OHSU), Georgia Brown (left) and Nicole Thelan (right).
Georgia is a 1st year trainee at OHSU in Portland, Oregon. She is currently completing her Masters of Science degree in Human Nutrition in combination with her dietetic internship at OHSU School of Medicine, with a thesis focus in fatty acid oxidation disorders. She received her Bachelor of Science in Nutrition at Arizona State University in 2016. Georgia has a variety of interests including inborn errors of metabolism, disorder eating in adolescents and adult women, behavioral health and food insecurity.
From Georgia: “During the Winter 2019 term at OHSU I took a Maternal Infant Child nutrition course, which emphasizes the growth and development of a fetus during pregnancy up until young adulthood. In this time, I completed two presentations which included a focus on adolescent girls and body image with the use of social media, and another on pregnancy in bariatric surgery patients. Both presentations provided unique opportunities for learning about two distinct populations, all while still learning about maternal and child health. I felt these in-depth presentations afforded me the opportunity to continue building off my MCH competencies while exploring topics of interest to me, including disordered eating behaviors and pregnancy.”
Nicole is a 1st year trainee at OHSU and is finishing up her second year of her Master of Science in Human Nutrition. Nicole obtained her Bachelor of Science in Nutrition at Seattle Pacific University where she participated in the Community Kitchen program. This program aims to provide affordable meals to community members while teaching meal planning and cooking skills. As part of her graduate experience, Nicole spent 4 weeks interning at the Multnomah County WIC department and 2 weeks rotating in the Pediatric Metabolic Clinic at OHSU. Nicole’s nutrition related interests include gastrointestinal disorders, community nutrition, public policy and food insecurity.
Highlights of MCH Nutrition Traineeship
As MCH trainees, we have had the pleasure of immersing ourselves in a variety of maternal and child nutrition related opportunities, including attending weekly Leadership Education in Neurodevelopmental and Related Disabilities (LEND) seminars which is a traineeship that provides graduate level interdisciplinary training and education. This traineeship focuses heavily on interdisciplinary work among a multitude of disciplines including Registered Dietitians, Speech Language Pathologists, Audiologists, Psychologists etc. with the goal of improving health outcomes in infants, children, and adolescents with disabilities. As attendees we were able to observe seminars with guest lecturers from both providers and patients/families, along with participating in a healthy discussion on how we can improve the health care experience for families. This opportunity has provided the unique experience of working specifically with families and children with disabilities, providing exposure and training on how to work with this commonly underserved population.
We also had the opportunity to attend the Western MCH Nutrition Leadership Network conference in February. The conference afforded us the chance to listen to the activities and accomplishments of the other trainees in our network and enhance our understanding of policy, system and environment concepts. We both walked away with a significantly deeper grasp of how to incorporate these ideas into our future practice as dietitians. Furthermore, the conference included a full day of education on building and further cultivating our leadership and communication skills — both of which will be key as they will allow us to go forward and make a meaningful difference in the lives of women and children, and really all people we work with.
We are currently working with the Multnomah County WIC office to develop a continuing education presentation for their providers. After hearing from the providers regarding a list of topics they would be interested in, we chose to focus on fad dieting for mothers and children. We plan to present on a range of diets including the ketogenic diet, veganism/vegetarianism, and the gluten free diet. Our goal is provide education the providers may apply in their practice and to help them answer questions they may receive from families about the practicality of these various diets for young children and pregnant or lactating mothers. Finally, we will be providing some online educational materials for the OHSU Hemophilia clinic and will specifically be focusing on topics families may find useful or interesting.
Laura is a 1st year trainee at the University of Minnesota – Twin Cities. She is pursuing a PhD in Nutrition and a doctoral minor in Epidemiology at UMN. Her research is focused on the intersection of obesity and disordered eating in children and adolescents. She is interested in understanding how external factors such as weight stigma and food insecurity impact health outcomes in these populations.
I was thrilled to learn that I would have the opportunity to work as a research assistant on the Positive Deviance Child Obesity Supplement for the MCH Nutrition Training Program here at UMN. What is Positive Deviance you ask? Positive Deviance is an innovative approach to public health research. Traditional research approaches investigate the sick, focusing on a particular disease. They focus on identifying risk factors associated with a particular disease, reducing modifiable risk factors, with the goal to mitigate the population’s risk for developing that disease. Positive Deviance uses a different approach. In Positive Deviance, instead of studying the “sick,” researchers study the “well.” Within an at-risk population, they ask who does not develop the disease? They aim to identify protective factors or protective behaviors within the “well” population. Finally, they aim to promote those protective behaviors within the at-risk population.
For the Positive Deviance Child Obesity Supplement, the condition we are studying is child obesity. We will be looking at 2- to 5-year-old children who are at risk for developing obesity. Our goal is to identify the characteristics that are associated with (and possibly responsible for) not developing obesity. For example, which children do not have accelerated weight gain and what characteristics do they share?
Why am I so excited about this approach, you ask? Well, before I returned to graduate school to purse a PhD, I worked as a MS, RDN for 10 years in child and adolescent obesity clinical programs at Seattle Children’s Hospital. We used a strengths-based approach to clinical care. We partnered with children, adolescents, and their families to help them to see what they were already doing well, then we built upon those strengths as we set SMART goals (Specific, Measurable, Agreed-Upon, Realistic, and Time-Oriented). I saw firsthand how helpful it was to patients and families when our clinical team was able to empower them to feel good about what they were already doing and then make changes based on those strengths. When I was first being trained in this approach to clinical care, one of my mentors used this analogy: “You don’t teach a child to read by listing off all the things they are doing wrong. You start with what they are doing well and then build from there.”
Even though the strengths-based approach to clinical care is not the same thing as Positive Deviance research, they both focus on investigating what is going well rather than investigating what is going wrong. Child obesity is such a complex, multifaceted, layered problem, and previous research approaches have not been able to adequately prevent the condition from developing. It is a puzzle that has yet to be solved. Our research team is currently recruiting participants, and we will be collecting qualitative data this summer. I am very excited for the opportunity to participate in this innovative approach to research and eager to see what we discover!
The Promoting Healthy Weight (PHW) Colloquia are a biannual series, held each spring and fall, that highlights the latest research in maternal and child health nutrition. The Colloquia are for practitioners, health agency employees, students, faculty, researchers, families, and the community. Viewers can attend the event onsite or view the live or archived webcast remotely.
On Friday, March 29, 2019, The University of Tennessee’s MCH Nutrition Leadership team along with the Department of Nutrition hosted the Promoting Healthy Weight Colloquium. The event, which launched our 3rd PHW Colloquia series focused on illustrating how policy is used to promote healthy weight in the MCH population at all levels of the Socio-Ecological Model (SEM) by Urie Bronfenbrenner.
The Spring 2019 colloquium featured five speakers, which included distinguished faculty from the Departments of Child & Family Studies and Public Health at UT, Dr. Hillary Fouts and Dr. Carole Myers, who introduced the Socio-Ecological model as a framework for promoting healthy weight and discussed how policy can influence healthy weight promotion at all levels. The next speaker, Dr. Karla Shelnutt, from The University of Florida provided an overview of the extension program and SNAP-Ed interventions from the individual level to a Policy, Systems, and Environmental (PSE) approach. Our fourth speaker, Jennifer Russomanno a DrPH student in the Public Health Department, presented on ways to connect participants in the Women, Infants, and Children (WIC) program with local farmers. To conclude, Leslie Lewis, from the Louisiana Department of Health spoke about the Collaborative Improvement & Innovative Network (CoIIN) and its role in implementation of state-level policies for the promotion of children’s healthy weight.
Yetunde is a 2nd year trainee at the University of Minnesota – Twin Cities. She is currently finishing up her MPH and dietetic internship at the UMN School of Public Health. She earned her Bachelor in Science in Nutrition – Dietetics at Auburn University in 2017. Her interests include maternal and child health, mental health, and nutritional counseling. She hopes to primarily work with women and children of color.
Community health workers (CHWs) are public health workers that typically come from the same culture, ethnicity and/or socioeconomic background, and speak the same language as the communities they serve. Because they often have similar life experiences as those they assist, they are able to build trusting relationships with their communities and are therefore an important link between health services and the people. CHWs are also involved in a number of other activities that seek to increase the health knowledge of both individuals and the community such as informal counseling, education, support, advocacy, outreach, and providing resources (1).
The Minnesota CHW Curriculum cancer course focuses on the role of the CHW when working with patients with cancer and their families. It places emphasis on understanding cancer, its risk factors, screening for detection and diagnosis, and the types of cancer treatments. It also seeks to understand the emotional factors involved when a cancer diagnosis is made, its treatment, and cultural considerations that must be addressed. Lastly, it helps CHWs in identifying resources and ensuring client access to those resources, as well as aid and support clients and families (2). However, the literature still reveals gaps in cancer training among CHWs in Minnesota.
The goal of my culminating experience (Master’s project) was to better understand the needs and barriers of CHWs and their health care employers as it relates to cancer detection, treatment, and survivorship of clients and their families across the state of Minnesota. Understanding these barriers could improve CHWs’ role in the spectrum of cancer care. I had the privilege of completing this project under the direction of the Program Coordinator of the Comprehensive Cancer Control at the Minnesota Department of Health, the Minnesota Cancer Alliance, and the Cancer Health Equity Network.
After completing a literature review, planning for data collection, and conducting 8 key informant interviews (2 more written responses to the interview questions were received totaling 10 participants), 9 top themes were discovered after thematic analysis: 1. Enrolling clients in screening programs; 2. Providing education; 3. Involvement in the community; 4. Providing culturally appropriate care; 5. Care coordination; 6. Transportation for clients; 7. Integration into the healthcare team; 8. Training for CHWs and 9. Defining the scope of the CHW. Based on the results of the interviews, there are a few recommendations that could be made to help elevate the work that CHWs do in the spectrum of cancer care in Minnesota: 1.Further formal training for CHWs, 2. Integration of CHWs into the primary care team, and 3. Clear scope of practice for CHWs.
CHWs have been shown to play a beneficial role on any interprofessional team, and this also applies to serving clients on the spectrum of cancer care. With further research and implemented recommendations, CHWs have the ability to enhance their work in the spectrum of cancer care in the state of Minnesota.
Through my research project, I acquired the Critical Thinking, Communication, Cultural Competency, and Working with Communities and Systems MCH Competencies.