An Ounce of Prevention
Seattle Children’s partners with community organizations to
tackle tough – and ticklish – issues that affect kids.
Sydney Schuchat, Naomi Price-Lazarus, Max Konsker and Ellie Scruggs are members of RADD (Raiders Against Destructive Decisions), a grassroots
organization focused on drug and alcohol prevention at Nathan Hale High School. RADD is supported by a community coalition that includes
adolescent medicine specialists from Seattle Children's.
Our first effort to protect the health
of kids outside Seattle Children’s walls
was in 1908, after Dr. George McCulloch
realized that infants were dying
because farmers were preserving
milk with formaldehyde rather than
pasteurizing it. At McCulloch’s
insistence, the city of Seattle
established a milk commission to
regulate pasteurization and protect
Over the decades, our regional
and national contributions to children’s
health and safety have included
establishing the state’s first poison
control information center, convincing
U.S. legislators to mandate flameresistant sleepwear for kids, and
conducting research that led to a state
law requiring water heater installation
at 120 degrees to decrease accidental
Today, we extend our commitment
to children, teens and families by
working to address a gamut of public health issues, including access to quality healthcare, obesity, substance
use, immunization hesitancy, autism,
and water, bike and child passenger
“Every prevention program we do,
we do in partnership with community
organizations whose expertise is
different than ours,” explains Elizabeth
Bennett, director of Guest Services,
Partnerships and Advocacy at
Children’s. “That way, we build on each
other’s strengths and work on issues
that are truly important to the
communities we serve.”
Children’s often lends the scientific
rigor that ups the odds for developing
interventions that truly work.
“Our goal is to respond to
community needs with programs and
services that reach children where
they live, so they never have to come
through our doors,” Bennett says.
Curtailing underage drinking
Kelly Kerby, chemical dependency counselor, Inga Manskopf, prevention specialist, and Dr. Ray
Hsiao, substance abuse expert, work with schools, parents, police, retailers and others in northeast
Seattle to curtail underage drinking and youth substance abuse.
In 2006, Seattle’s northeast community
got a wake-up call when a statewide
survey showed that the percentage
of high-schoolers reporting they
consumed alcohol was significantly
higher than the state average.
“It was a surprise. That area has
mostly high-achieving kids – 80%
go on to college,” says Inga Manskopf,
a prevention specialist tapped by the
Seattle School District to start a
community coalition against underage
One of the first people she reached
out to was Dr. Ray Hsiao, co-director
of Children’s Adolescent Substance Abuse Program.
“The earlier kids start using alcohol
and drugs, the more problems they
have in later life – from addiction and
mental illness to legal and relationship
issues,” explains Hsiao. “Every year that
we can convince a youth to wait is a
year in their favor for healthy brain
Hsiao and the Adolescent Medicine
team helped Manskopf and school administrators secure funding for a
chemical dependency counselor from
Children’s to teach prevention classes
and conduct outreach to parents at
Eckstein Middle School.
1 in 13 adolescents abuse or are dependent on alcohol or drugs.
“Research shows that starting with
prevention work when kids are sixth-graders will yield results in high school,”
says Kelly Kerby, the Children’s
counselor who works at Eckstein.
In fall 2011, sophomores at Nathan
Hale and Roosevelt High Schools – the same kids who attended Kerby’s
original classes at Eckstein – reported
drinking rates much lower than in 2006.
A grant awarded to Children’s
enables Manskopf to continue
helping the coalition build a positive
community environment for teens – one that is not conducive to alcohol
and drug use.
“Substance abuse prevention
matters for everyone in the community – and it’s particularly important for my
patients. They spend the majority of
their time among their peers. If I can
help create an environment where
the majority of teens aren’t using, my
patients have an easier time finding a
peer group that will support them in
their sobriety,” Hsiao says. “They’ll have
a much better chance of recovery once
they leave the hospital.”
Myson Weatherspoon, foreground, and Davon Lawley, both 12, prep veggies at Odessa Brown
Children’s Clinic as part of an ongoing partnership with Cooking Matters™, which teaches families at risk of hunger how to get more food
for their money and better nourishment from their meals.
According to the Centers for Disease
Control, obesity is now the leading cause
of death in America. Approximately
30% of children are now overweight or
obese – a statistic that suggests kids
born in the 2000s may be the first
generation who will not live to be as
old as their parents.
Dr. Lenna Liu, director of Children’s
Wellness Clinic, says children in poverty
suffer the most, because a healthy
lifestyle can be expensive to maintain.
“Low-income families often can’t
afford the things that make for an
active, healthy life,” she explains. “Afterschool sports programs, a safe place to
play outside or better quality foods
that contain less fat and salt can be
out of reach on a tight budget.”
Since 2004, Children’s and the
YMCA have partnered to change this
cycle of poverty and obesity with
Actively Changing Together (ACT) – a 12-week program that teaches child/
parent pairs to learn to read food
labels, prepare low-cost healthy snacks
and do activities they might not have
tried before, like swimming, Zumba,
weights and karate.
Patty Hencz, a Seattle Children's nurse (right), developed curriculum and helps oversee the ACT program.
Research by Dr. Mollie Grow identified what works best for families, like text messages with health
tips and flexibility with workouts.
“When kids see their parents
enjoying healthy foods and being
physically active, they are more likely
to do the same,” says Dr. Mollie Grow,
a Children’s physician who studies
ACT program results to identify the
most helpful aspects of the program.
“ACT works because families bond.
They eat together more and they play
ACT is so successful that it has
expanded from 5 to 14 sites
across three counties – and about
25% of families join the Y after the
program ends. Recently, the Agency for Healthcare Research Quality
included the program in a national
case study of effective clinical-community partnerships.
“We learned a lot about exercising
and eating healthier in the ACT
program,” says mom Genoveva Ordaz.
“Everyone in our class shared their
experiences and recipes. We still practice
the changes that our family made,
including going to the Y regularly.”
Honoring a rite of passage
Sushma and Trishala Jain, left, and Kayla and mom Tassa Boydston, right, connect with educator
Julie Metzger after attending her “For Girls Only” class at Children’s — a lively conversation about
adolescence and growing up.
A question on a survey sent Julie
Metzger, a former Children’s nurse,
on an unexpected career trajectory.
“I was analyzing a study on women’s
health while in graduate school and
the question ‘Who did you go to for
information about your period and did
it make a difference?’ got me thinking,”
“I started to visualize what all those
conversations looked like. Was it
comforting or embarrassing? Was
it at the kitchen table or in the car?
Was it a 45-minute conversation or
one sentence? I realized I could help
make it a more positive experience
for tweens and parents.”
In 1991, the hospital sponsored
Metzger to present a course she had
developed called “For Girls Only” – a
unique, no-holds-barred conversation
for 10-to-12-year-olds about their
puberty, boys’ puberty and sex. More
than 2,000 mother-daughter pairs
take the course each year.
Mom Sushma Jain was nervous
before the class, but came away feeling
like her daughter Trishala’s transition
from childhood to adolescence had
been celebrated, and not just explained
using clinical facts.
to be an event
that people flee
from, but we
step towards it.”
“Julie presents the material with
so much heart and humor,” she says.
“She’s given me a template for how
to talk with Trishala that I never had
growing up. It’s opened up all kinds
of dialogue in our house.”
Metzger intends that the class be
the start of many conversations about
how a tween’s body changes are
completely normal. “I tell families, ‘this
has been one 200-minute conversation,
now you go out and have 200 one-minute conversations.’”
In 1992, Metzger partnered with
pediatrician Dr. Rob Lehman, who
facilitates a similar class for boys and
their dads, to create Great Conversations. They currently provide
classes for Children’s, their primary
sponsor in the state of Washington,
and for Lucile Packard Children’s
Hospital in Palo Alto, Calif.
“Open communication with parents
is the number one reason why kids
delay having sex,” says Dr. Yolanda Evans, an adolescent medicine
specialist at Children’s. “We want
parents to be comfortable having an
open, truthful dialogue about the issues
that tweens are wondering and
worrying about. That’s why Children’s
sponsors this class.”
At the end of each class, Metzger
invites the girls to write any remaining
questions on index cards so she can
respond without singling anyone out.
Kayla Boydston, 10, wrote Metzger
a note saying, “I don’t have any
questions, because you were
Yet there are questions at the end
of every class – and one in particular
crops up frequently: “Does this mean
my parents have done this?”