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 the public.
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 scalding.
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 safety.
“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 drinking.
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 development.”
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 together more.”
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,” recalls Metzger.
“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.
“Puberty tends 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 awesome.”
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?”