Pilot Project to Integrate Community and Clinical Level Systems to Address Health Disparities in the Prevention and Treatment of Obesity among Ethnic Minority Inner-City Middle School Students: Lessons Learned

Table 1

Contributing stakeholders and their role in the B’N Fit POWER implementation.

Stakeholders	Description	Staffing	Implementation role in B’N Fit POWER
Bronx Nutrition And Fitness Initiative For Teens	Program activities: Adolescent Weight Management Program operated out of the Children’s Hospital at Montefiore	(i) 0.15 FTE Project Director; (ii) 0.5 FTE POWER Program Coordinator; (iii) Student volunteers	(i) Provision of guidelines for screening, clinical evaluation, treatment plans, and afterschool requirements; (ii) Development of program metrics; (iii) Integration of stakeholder efforts; (iv) Conducts MMCC afterschool staff trainings to support screening process; (v) Conducts height and weight screenings
Mosholu Montefiore Community Center (MMCC)	Program activities: operates afterschool (3–6 pm) programs in 15 sites: (i) Recreation and physical activity opportunities; (ii) Educational support; (iii) Enrichment and socialization; (iv) Youth leadership	(i) In-kind program director; (ii) In-kind youth leaders ×4; (iii) In-kind administrative staff; (iv) Per diem cooking specialist; (v) Per diem exercise specialist	(i) Supports community-led recruitment; (ii) Provides afterschool group-based healthy lifestyle behavior education, cooking and gardening classes, and daily physical activity opportunities; (iii) Integrates B’N Fit POWER into existing afterschool program structure
The Montefiore School Health Program (MSHP)	Program activities: operates during the school day (8 am–3 pm); provides onsite coordinated primary and preventive health care in 25 locations; (i) Delivers medical, mental health, dental, and community health services	(i) In-kind primary care MD/NP; (ii) In-kind social worker; (iii) In-kind licensed practical nurse; (iv) In-kind, community health organizer (CHO); (v) In-kind receptionist; (vi) In-kind medical director	(i) Develops efficient clinic protocols; (ii) Conducts comprehensive wellness medical assessments, ordering standard lab set, generates 1-page treatment plan, and supports healthy lifestyle education as part of the routine onsite clinical practice; (iii) Conducts follow-up visits as per routine clinical practice to monitor progress
PS/MS-95 School And Wellness Council	Governance activities: USDA-funded school food program, mandated to have an onsite Wellness Council	(i) School principal; (ii) MSHP CHO; (iii) Education consultant; (iv) PTA president; (v) WITS staff; (vi) Students and parents	(i) Facilitates understanding of existing healthy lifestyle programming; (ii) Incorporates target behavior concepts into school wellness activities; (iii) Establishes outcomes of interest
Prevention Intervention Research Center (PIRC)	Research evaluation activities: develop and test interventions to prevent mental health problems in children and youths with chronic health conditions	(i) In-kind Director; (ii) In-kind developmental psychologist; (iii) Program staff	(i) Supports program evaluation; (ii) Incorporates YD concepts into the program curriculum
Wellness in the Schools (WITS)	Program activities: national nonprofit that teaches kids healthy habits to learn and live better	(i) In-kind onsite chefs	(i) Supports healthy menus during cooking and family events
Students and families	Students attend school, B’N Fit afterschool, and on wellness council, parents serve on PTA	(i) Student volunteers; (ii) Parent volunteers	(i) Informs need for and interest in program; (ii) Identifies barriers to enrollment, program engagement, and outcomes of interest

Staff funded specifically for B’N Fit POWER, and all others staffing in-kind or volunteers.