| SBHC baseline clinical assessment and follow-up visit | (i) BHA not consistently focused on screening for BMI ≥ 85th percentile
(ii) No protocol for routine treatment and follow-up of youths with elevated BMI | (i) Obtain written parental consent and child assent
(ii) 60-minute initial visit
(iii) Patient fills out 2-page weight history, 7 Target Behavior, and PSC-17 questionnaires,
(iv) LPN
(1) Height, weight, BP
(v) Medical provider:
(1) Questionnaire review
(2) Nutrition assessment
(3) Focused PE
(4) Orders labs
(vi) MHP referral per routine
(vii) 2nd 15-minute visit to review labs and treatment plan
(viii) 4 follow-up visits to review behavior and weight goals | (i) Difficulty obtaining written parental consent
(ii) Lengthy 60-minute visit difficult to implement during school schedule
(iii) Lack of onsite specialized nutritionists to support healthy lifestyle education
(iv) Busy clinic
(v) Length of time to complete the initial visits made 4 follow-up visits impractical to achieve | (i) Obtain verbal consents from parents rather than written consent
(ii) Split initial 60-minute visit into two 20-minute BHA visits:
(iii) Visit 1: complete questionnaires, PE, and labs
(iv) Visit 2: review lab work, and 1-page treatment plan, and target behavior education
(v) Limit follow-up visits to two additional visits
(vi) Completed repeat labs on those students with abnormal labs at initial visit |
| MMCC Afterschool Program | (i) From 3 to 6 pm daily (M-F) during year
(ii) Includes DYCD mandated three hours of leadership
(iii) Optional activities
(iv) Routinely collect daily attendance
(v) No routine curriculum for healthy lifestyle education | (i) DYCD mandated leadership includes the following:
(1) B’N Fit POWER leadership curriculum
(2) Cooking class
(3) Gardening
(ii) At least 5 hours of physical activity programming weekly
(iii) B’N Fit POWER participants may sign up for any other optional activity available to the other students in the afterschool program | (i) The need for youth leader training
(ii) B’N Fit POWER curriculum lessons were often lengthy and not well understood by youth leaders
(iii) Recipes in the B’N Fit POWER curriculum not well accepted because ingredients not readily available in the neighborhood
(iv) Busy afterschool setting | (i) Program Monitor serves as the education specialist and has reformatted and revised lesson plans to ensure clear, relatable, and relevant content
(ii) Program Monitor trains youth leaders in advance of sessions
(iii) Cooking specialist and WITS chefs altered recipes to better align with local community food availability |
