MCH Nutrition is vital to the healthy development and well-being of infants, children, youth, and adults, including those with special health care needs. This month, the Division of MCH Workforce Development (DMCHWD) is pleased to share grantee and trainee highlights focused on nutrition and childhood obesity prevention.
Did you know that the Special Supplemental Food Program for Women, Infants, and Children (WIC) was created as an amendment to the Children’s Nutrition Act of 1966? Have you heard about the White House Conference on Food, Nutrition, and Health that took place in 1969? Learn about these nutrition-related points in history and more on the MCH Timeline.
In recognition of National Nutrition Month, we would like to highlight work from our Maternal and Child Health (MCH) Training Program and the Michael & Susan Dell Center for Healthy Living (Center for Healthy Living) at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin. The MCH Training Program is housed within the Center for Healthy Living, whose vision of “healthy children in a healthy world” aligns strongly with our purpose.
With the goal of addressing disparities in access to MCH-related training, and in collaboration with Grand Valley State University in Michigan, our team provides accessible and relevant education for the growing MCH workforce in HRSA Region VI (TX, NM, OK, AR, and LA) and Michigan. Specifically, we develop online and in-person training courses for professionals who are serving diverse MCH populations, often in geographically-isolated and rural areas. These courses engage learners with dynamic content, active learning, and real-life scenarios to develop and enhance skills. Through our collaboration with the Texas Department of State Health Services, we have more than 1,000 course completions.
The MCH Training Program has 14 online courses available on the MCH Training Program website. All courses are provided at no cost and can also be offered in-person. During National Nutrition Month, we would like to spotlight our Nutrition and Exercise for Mental Wellness and Nutrition: 6 Months to 2 Years courses. These trainings are great for those who are interested in gaining newfound skills and knowledge in the realms of nutrition and mental wellness.
Additionally, the Center for Healthy Living has various nutrition resources online, such as the Food at School Parties infographic for parents describing healthier, nutritious alternatives to party snacks. In March 2019, we will release Texas Child Health Status Reports covering topics such as Child Nutrition, Child Beverage Consumption, Child Obesity, and more.
The reports will provide an overview on the status of child and adolescent health across Texas. Available to community members, policymakers, and advocacy groups, these one-page reports identify priority areas and assess health needs at a regional level in an attempt to guide informed decision-making. Check out the Center for Healthy Living website throughout National Nutrition Month to see more updates.
The Center for Healthy Living and MCH Training Program believe that with access to knowledge and practical training, people can create lasting, meaningful change in their local communities. We would like to thank HRSA for their continued support and funding. If you have any questions or would like to know more about the MCH Training Program, feel free to contact the Program Manager, Cristell Perez, MPH at email@example.com or (512) 482-6150. To learn more, contact us about the Michael & Susan Dell Center for Healthy Living.
Fresh Food for All Policy Brief Team: Marissa Black, Marleah Payne,
Marsha Spence, Chelsea Allison, Jennifer Russomanno, Marissa McElrone
As part of the University of Tennessee’s MCH Nutrition Leadership Education and Training Program, Marsha Spence, PhD, MPH, RDN, LDN, Program Director, taught a doctoral nutrition policy course in Spring 2018. One short-term trainee and four long-term trainees were enrolled in the course and funded trainee and doctoral candidate, Marissa McElrone, was a graduate teaching assistant. As the culminating experience, trainees wrote a policy brief and participated in the University of Tennessee’s Howard Baker Center’s Public Policy Challenge, which was open to all University of Tennessee (UT) graduate and undergraduate students. As part of the course and challenge, the trainees developed a blog post, prepared a video , a policy brief, entitled Fresh Food for All, and a presentation for review by an expert panel. The team received the first-place award and received $3,000 to advance their policy initiative, which aimed to increase WIC Farmer’s Market Nutrition Program (FMNP) voucher redemption during summer months in 2019.
In collaboration with community partners at the Knox County Health Department’s Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Nourish Knoxville, a non-profit organization that operates farmers’ markets in the Knox County area, the trainees developed an information flyer that was distributed by Knox County Health Department WIC staff, a website to assist WIC participants, and informative rack cards for display at participating farmers’ booths. Currently, the trainees and Dr. Spence are working to evaluate the policy initiative to see if it helped increase redemption rates via Knox County FMNP redemption rates, to determine the number of hits on the website, and to ascertain WIC participants’ overall experiences at area farmers’ markets using an online survey developed by the team. Jennifer Russomanno, a short-term trainee and doctoral candidate in Public Health, will present the findings at the University of Tennessee’s upcoming Promoting Healthy Weight 3.0 Colloquium: A Socio-Ecological Perspective - Policy at All Levels on March 29, 2019.
The UT MCH Nutrition Leadership Education and Training Program has a long history of partnership with community partners. MCH faculty work closely with community partners, including public health nutritionists from the Knox County Health Department, to develop community assessment projects that provide practice experience integrated with didactic learning components. A recently published manuscript highlights one of these projects , which demonstrates how partnering with community agencies can improve graduate education and children’s access to healthy foods.
Using longitudinal administrative data from children who participated in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County between 2003 and 2016, Dr. Chaparro is evaluating the impact of the 2009 WIC food package change on growth trajectories from 0-4 years and obesity risk at age 4 years. Along with her colleagues at UCLA and PHFE WIC, Dr. Chaparro found that exposure to the new food package (compared to the old) from 0 to 4 years was associated with healthier growth trajectories (i.e. weight-for-height z-scores [WHZ] closer to the mean of 0 and further from the overweight category of WHZ>2) and a 10-12% lower obesity risk at age 4 years (10% for girls, 12% for boys). A manuscript based on these findings was recently accepted for publication at the American Journal of Clinical Nutrition (forthcoming). Next steps include investigating if the type of infant food package received from 0-12 months could explain the observed improved obesity outcomes among children exposed to the new food package, and whether the effect of exposure to the new food package on child obesity varies by family and/or neighborhood socioeconomic characteristics. This study is funded by the American Heart Association (AHA)’s Scientist Development Grant (Grant No. 17SDG33660878; 7/1/2017-6/30/2020). Beginning Fall 2019, Tulane’s MCH Nutrition trainees will support this and other faculty-led MCH Nutrition research projects as part of their research rotations.
Dr. Pia Chaparro is an Assistant Professor at the Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine and Core Faculty of the Tulane’s Nutrition Leadership Training Program.
CHALK, New York-Presbyterian Hospital’s childhood obesity program, has expanded their programming to early childhood centers (CHALK Jr.) through Healthy Tomorrows. CHALK Jr. is currently partnering with three different early childhood centers in Washington Heights, located in Northern Manhattan. In addition to bringing direct programming at the centers to enhance healthier eating and active lifestyle practices amongst toddlers, parents, and staff, CHALK Jr. has been committed to strengthening and leveraging community resources in order to provide lower-income families with programs that promote overall well-being.
One such project is a partnership with New York City Parks and Recreation Center Department, specifically with Highbridge Recreation Center (HRC) located in Washington Heights. CHALK Jr. has engaged community fitness instructors, and purchased toddler fitness equipment, healthy snacks, and water in order to host free monthly “Family Wellness Saturdays” to the community at HRC. These monthly Saturdays consist of a combination of:
As part of the recruitment effort, CHALK Jr. has been hosting parent workshops at its early education partner sites on the importance of sleep, physical activity, nutrition, and overall family wellness. CHALK Jr. staff has facilitated workshops to increase family engagement in the overall topic of wellness and successfully sign families up for a tour at HRC. The purpose of the tour is to help motivate and bring families to the facility to see what is there, and to partake in the free family wellness session. CHALK Jr. aims to increase awareness and exposure to existing community resources and increase family participation in wellness activities.
The CHALK Jr. program takes into account that some families may not regularly have access nor the means to afford the cost of memberships to facilities, healthy eating options, and/or physical activity promoting toys. Although children under 18 have free membership to the recreation centers, adults need to buy a membership. Therefore, CHALK Jr. is sponsoring a raffle at these wellness Saturdays to help increase parents’ ability to access the full facility while also helping to increase membership numbers for HRC.
College students may not be a population that we traditionally thought of as dealing with hunger, but new research indicates that rates of food insecurity are high on college campuses throughout the US. Through a partnership with the Southeastern Universities Consortium on Hunger Poverty and Nutrition, MCH Nutrition Trainee, Ms. Ruth Wooten, and MCH Nutrition faculty Drs. Betsy Anderson Steeves and Marsha Spence completed a cross sectional survey assessment of more than 4,000 college students to measure the rates of food insecurity among college students within a large university system. They found that more than 1 out of 3 college students within the University system experienced food insecurity, meaning that the students’ struggled to get enough food overall, or enough variety of food to live a healthy lifestyle. This research has been published in the journal, Public Health Nutrition, and was featured on the local Knoxville NPR affiliate, WUOT, where Dr. Anderson Steeves was interviewed for a weekly health-focused program, Health Connections.
Drs. Anderson Steeves and Spence continue to work on addressing the issue of food insecurity on college campuses by serving as members of the Hunger and Homelessness Task Force at the University of Tennessee, and by forging innovative partnerships with the University of Tennessee, Knoxville, Student Health Center to routinely screen and provide referrals for campus-related resources to address food insecurity.
Left to Right: Ruth Wooten, MS, RDN; Betsy Anderson Steeves, PhD, RDN;
and Marsha Spence, PhD, MPH, RDN, LDN
The University of California, Berkeley School of Public Health’s Center of Excellence in MCH, Education, Science, and Practice has created a free, open-source, self-directed, training module series on Maternal, Child, and Adolescent Health (MCAH) Life Course Perspective, Practice, and Leadership.
This resource provides access to high-quality training for working healthcare clinicians, public health practitioners, students, and professionals from across disciplines, locations, and backgrounds to expand their knowledge of key MCAH concepts in research and practice. The training module series is also accessible to community members and community-based organizations.
Each module includes an interview with a subject matter expert, available readings, case studies of organizations in practice, and opportunities for reflection. The video series highlights 15 partner organizations and covers the following topics:
For additional information on the Maternal, Child, and Adolescent Health (MCAH) Life Course Perspective, Practice, & Leadership training series, contact Center Director Julianna Deardorff.
Yetunde and Melanie are both second year students in the coordinated Master of Public Health Nutrition program at the University of Minnesota. They serve as Nutrition Coordinators for the Phillips Neighborhood Clinic and organize the nutrition volunteers for the clinic. This is both Yetunde and Melanie’s second year volunteering at the Phillips Neighborhood Clinic (PNC) as student nutrition clinicians.
Located in the Phillips neighborhood of Minneapolis, the Phillips Neighborhood Clinic (PNC) is an entirely student-run clinic – supervised by licensed clinicians – that operates out of a local church two evenings a week year-round. The clinic is completely free for the uninsured and underinsured residents of Phillips, other areas of Minneapolis, and additional surrounding communities. The PNC’s mission is to increase accessibility to comprehensive, patient-centered, quality health services for those with unmet needs regardless of their insurance situation, citizenship status, or financial background. The clinic also works to support community partnerships and promote overall health and wellbeing in the communities it serves, and develop passionate, culturally sensitive health professionals through an interprofessional learning environment. The clinic participates in numerous outreach activities, provides specialty services and is able to perform full medical visits.
One of the specialty services that the clinic provides is nutrition. A student nutrition clinician is available every night the clinic is open to offer nutrition information and counseling directly to patients. Nutrition clinicians are equipped with a variety of education materials focused on topics such as diabetes, high blood pressure, heart disease, and weight management. Though the PNC sees more adult patients than children, the health of parents and grandparents ultimately affect the health of the children in their lives. Because of the large Spanish-speaking population in the Phillips neighborhood, Spanish interpreters are present every night to translate nutrition sessions. Food access resources designating food shelves and food banks in the area are also available for patients. Clinicians also have “fast passes” to give to patients—patients can bring them back to clinic and see a student nutrition clinician with no wait time. Lastly, the MOVE ‘N’ EAT Program is held twice a month and provides free cooking and exercising classes. Classes range from yoga to Zumba, and those who participate are served a healthy dinner.
Particpants at the Phillips Neighborhood Clinic of Mineapolis, MN
In today’s world, the ability to attain a healthy life is a privilege. With dietary and health recommendations changing and new fad diets coming out monthly, it can sometimes be difficult to discern the best way to create a healthy lifestyle for oneself and one’s family. At the Phillips Neighborhood Clinic (PNC), we have the privilege to serve a diverse range of people with varying health related needs. The PNC is located just south of downtown Minneapolis, nestled between a variety of large employers and small businesses, and is home to people of many different nationalities.
As nutrition clinicians at the clinic, we do our best to advise on many different nutrition related topics, oftentimes using interpreters because many of our patients do not speak English. The areas we cover are vast. During some visits we could be explaining what carbohydrates are to a person recently diagnosed with type 2 diabetes or encouraging consumption of fruits and vegetables. Other nights, we may be helping a person who works the night shift come up with an eating plan that will better provide the nutrients they need to feel their best. The topics may be different, but one thing is certain: we are privileged for the opportunity to do our best to find innovative, sustainable, and culturally relevant solutions to nutrition struggles for our patients. There is hope that we will take what we learn as clinicians at PNC into our future professional roles, continuously seeking to grasp the specific and unique needs of any population we may serve. To best serve a community, one must first seek to understand a community’s people and their needs, and the clients of PNC graciously allow us to do just that.
Whether it be listening to someone’s story, providing them with community resources, or helping with a specific goal they have in mind, the opportunities to learn, grown, and better connect with the community and their needs are endless. Knowledge can truly be powerful and life changing, and there is no doubt that the clients we work with use strategies discussed and learned to create healthier lifestyle habits and improve the nutrition of their children and family members.
Samantha and Jessica, pictured above with their preceptor, are currently pursuing a Master’s degree in Public Health Nutrition while also completing their dietetic internship. This blog highlights their experience at their community nutrition rotation for the dietetic internship at Perspectives, Inc.
Having nutrition focused backgrounds, Jessica and Samantha are aware of the concerns around food access and food insecurity and wanted to take part in making a difference in the community. Through their Coordinated Master’s Program at the University of Minnesota Jessica and Samantha were partnered with Perspectives, Inc. for the community nutrition rotation of their dietetic internship. Perspectives Kids Cafe is a commercial kitchen/dining classroom that is available to homeless and low-income families and children in St. Louis Park, MN with the purpose of improving access to nutritious foods. The program is designed to increase healthy food consumption for the children while providing a hands-on nutrition curriculum that addresses healthy food choices. With the objectives of having healthy, USDA approved snacks and dinners served after school and healthy breakfast and lunches served during the summer program, the kitchen is constantly working to provide the children with the adequate nutrition they need to live happy and healthy lives.
In addition to exposing children to a variety of nutritious foods, the Perspectives Kids Cafe provides them with a hands-on opportunity to learn skills in food preparation and kitchen safety. Each day a group of kids help out in the café preparing dinner for their peers under the direction of Chef Dan Tobias-Kotyk who is also a licensed teacher. Chef Dan and Perspective’s registered dietitian Kay Guidarelli educate students on making healthy food choices. Jessica and Samantha interacted with the kids and shared healthy nutrition information while preparing and eating meals. In addition, parent engagement is encouraged. Moms have the opportunity to come to the cafe for cooking groups, where they can learn how to cook new recipes or create their own recipes from the ingredients provided. Through these cooking groups, Jessica and Samantha were able to get to know the moms and become more familiar with their needs in the program. This allowed time for discussions around making healthy food choices. Developing relationships with the moms was also an integral part of creating monthly newsletters for them, which provide healthy recipes and education on various topics of nutrition. Recipes included in the newsletter focus on availability of foods, finances and ease of meal preparation, including reference to meals that the children had previous exposure to in the Kids Cafe. The goal of the newsletter articles is to bring the hands-on experience of the Kids Cafe home for mothers and their children to enjoy together.
Access to nutritious food is something that many people take for granted but the reality is that many struggle with this. Perspectives Kid Cafe provides an opportunity for homeless and at risk mothers and their children to have access to at least one nutritious meal and snack a day. This program is taking one step towards improving the lives of these families and Jessica and Samantha feel very fortunate to have taken part in such a great program.
My name is Lucy Berman. I am a first-year student in the coordinated MPH Nutrition program at the University of Minnesota, Twin Cities. My approach to improving child nutrition and contributing to obesity prevention begins at the source. With a substantial background in food production and agriculture, I have a mission to educate children about exactly where their food comes from. My aim is to talk about the trickier questions that go beyond the concept of planting seeds in the ground to produce fruits and vegetables. For example, how does food get to the grocery store? Where does meat come from? Do cows have to have given birth to produce milk? What exactly does it mean when we say, "processed food?"
My intention with this approach to nutrition education is to first and foremost create an understanding of what we are truly consuming and attempt to convey the beauty and awe of food production. Since food is a huge part of a human life, it’s only natural to be fascinated by its source. I strongly believe that this understanding can set a solid foundation for further nutrition education and in turn may help kids feel connected to what they eat and eager to learn about healthy nutrition habits.
I was given an opportunity to discuss where food comes from with a fourth-grade class at Chanhassen Elementary School during my time in my school food service rotation with Eastern Carver County for my dietetic internship. For an hour and a half, I went through 70+ pictures describing everything from different cuts of meat to the production of Oreos. The presentation was completely discussion-based, with multiple students asking questions with each new picture. At the end of the presentation, we continued our discussion as students tasted different fruits and herbs, compared dark chocolate vs. milk chocolate, and ate raisins as they watched a video about how raisins are dried and harvested. The level of engagement from the students was incredible. It showed me that children have a natural curiosity about what they are eating and when shown the source, may be more inclined to try new foods. I am grateful for the experience I had with these students and look forward to my next opportunity to show children the wonders of food production.
Kalia is a second year MPH Nutrition student, a MCH Nutrition Trainee, and a MNLEND Trainee. She completed her undergraduate degree in Nutritional Science from Northeastern State University in Tahlequah, OK and her dietetic internship through Iowa State University. She is currently working as a Nutrition Educator for WIC. She has found a passion in helping underserved populations as well as learning more about individuals with neurodevelopmental disorders and helping them with their needs.
As the semester began in September, I was fortunate enough to have been selected as a trainee in MN LEND. What exactly is MN LEND? MN LEND stands for Minnesota Leadership Education in Neurodevelopmental and Related Disabilities. When I first heard about it, I didn’t know exactly what I was signing myself up for. With my experiences so far as a LEND trainee, it really has allowed me to view things differently from other disciplines outside of nutrition for individuals who may have neurodevelopmental disabilities. During undergrad, I always wondered why nutrition choices were so limited for certain individuals with disabilities and why these individuals tended to be so “picky” when it came to meal times. With what I’ve learned so far, I can see a small glimpse of what these individuals see – how their daily activity is affected by their surroundings, what their lens is on their surroundings and their thought process on their surroundings, early signs of developmental delays and more. Being a fellow and with the year continuing, I only hope to continue to learn more about individuals with neurodevelopmental or related disorders.
As a LEND fellow and working with WIC, I am fortunate enough to be able to work on a project for both organizations. With the project, we hope to identify issues that WIC staff may have in addressing delays with families. We also hope to find partnerships with other programs and find interventions that help families with identification of possible developmental delays in their young children, oftentimes these delays can be overlooked. Offering support could be as simple as making a referral for other programs in Minnesota known as Help Me Grow or "Learn the Signs. Act Early." With the knowledge I have gained from being a LEND fellow, I have realized the importance of my experiences in MN LEND in working with young children and how important this could be in helping families.
For more information on MN LEND, visit the MN LEND website.
Veronica is a first-year graduate student in the Nutrition program at the University of Tennessee, Knoxville (UTK). Veronica also received her Bachelor of Science in Nutrition at UTK in 2014. She then went on to complete her dietetic internship at Vanderbilt University Medical Center. Veronica worked as a registered dietitian in the Women, Infants and Children (WIC) program in South Carolina, and served as a clinical dietitian on the island of American Samoa. Veronica has been a MCH Nutrition trainee since August 2018.
My earliest experience working with the MCH population dates back to my volunteer work as an undergraduate. I worked as a research assistant with Dr. Marsha Spence (UTK) for the Cardiac Club Program, which is an afterschool nutrition and physical activity intervention program for elementary school-age children in fourth and fifth grades. Additionally, I worked as a nutrition educator for the Healthy Kid’s Club program run by East Tennessee Children’s Hospital. For this program, I helped plan and teach weekly nutrition lessons and games that focused on movement and physical activity. My interest in working with this population grew throughout my dietetic internship, both in my community and clinical rotations, where I chose a concentration in pediatrics/pediatric oncology. My experience in public health nutrition further developed with my work as an RD for the WIC program.
So far, as a trainee, one of the projects I am leading is the diversity recruitment and retention committee. The committee is comprised of faculty members from both the Departments of Nutrition and Public Health at UTK. Currently, the committee is planning strategies to increase recruitment efforts of racially/ethnically diverse students into the dietetics profession. One of these strategies includes visiting historically black colleges and universities (HBCUs) in the surrounding states. Another strategy is to create an infographic to disseminate to Hispanic-serving institutions and tribal colleges/universities that are further away. I am excited about the many opportunities the traineeship offers, and am looking forward to increasing my knowledge, refining my leadership skills, and better serving the MCH population.