PRACTICUM EXPERIENCE 3
Practicum Experience
Jessie McCarty
MPH 599: Public Health Practicum
Concordia University
Practicum Site: Childhood Obesity Prevention Collaborative
Supervisor: Julia Stanley
601 Whitney Way, Ste. B40
Madison, Wisconsin 53705
Abstract
This paper evaluates Jessie McCarty’s practicum experiences. Half of the practicum experience was completed in Belize on a global public health trip through Concordia University-Nebraska. The other part of the practicum experience was completed at the Childhood Obesity Prevention Collaborative in Madison, Wisconsin. This paper provides an in-depth analysis of the practicum experiences at both of these locations, including a discussion about barriers and future recommendations, as well as a personal assessment.
Introduction
My practicum experience was composed of hours of participation with two different organizations. I was able to go on a public health mission trip to Belize to gain half of my practicum hours and my other practicum hours I gained from working with the Childhood Obesity Prevention Collaborative in Madison, Wisconsin.
Obesity Prevention
Childhood obesity is serious problem in Wisconsin and throughout the entire United States. Statistics show that in 2011, 15.4% of children in Wisconsin were overweight and 10.7% were considered obese (National Conference of State Legislatures [NCSL], 2014). Childhood obesity is a serious health concern for a community because childhood obesity can cause serious health problems such as high blood pressure, high cholesterol, diabetes, breathing problems, reflux, fatty liver disease, and joint problems (Centers for Disease Control and Prevention [CDC], 2012). In addition, according to the CDC (2012), “Obese children are more likely to become obese adults. Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers. If children are overweight, obesity in adulthood is likely to be more severe”. Therefore, preventing childhood obesity should be a priority of every state to ensure healthier adults in the future.
The Childhood Obesity Prevention Collaborative (COPC) is an organization in Madison, Wisconsin which is working towards combating the childhood obesity epidemic in Wisconsin. The COPC “is a coalition of more than 90 partners working to develop and advance policies to improve the physical activity and nutrition environments for children in Dane County” (COPC, 2014). The COPC includes participation of members from a variety of backgrounds including healthcare, educators, government, and public health professionals.
There are five work groups within the COPC: Infant & Early Childhood, School Nutrition, School Physical Activity, Community, and Health Systems. The mission and purpose of all of these works group is to “identify opportunities for innovation and collaboration to promote healthy eating and physical activity in the places Dane County children live, learn and play. The collaborative works at the county, city and grassroots level to make the healthy choice accessible, affordable, and sensible for children and their families” (COPC, 2014). This organization was initially funded by grants from the CDC but now is funded by the American Family Children’s Hospital in Madison, Wisconsin.
Belize
In October 2014, I had the opportunity to go with other students from Concordia-Nebraska to Belize for a public health mission trip. The purpose of this trip was to help the local community with public health issues, both those issues which the community members identified and those which we, the students, observed. Some of the public health issues we focused on included clean water, proper hand washing, dental hygiene, breast cancer detection, and unintended pregnancies.
This trip was organized through Concordia University-Nebraska and Praying Pelican Missions. Praying Pelican Missions focus on mission trips which have the goals to ensure genuine partnerships, long-term relationships, and sustainable ministry (Praying Pelican Missions, n.d.). These goals correlate greatly with the goals of public health since global public health work should ideally be sustainable to the local community and generate positive partnerships and productive relationships.
Discussion
COPC
Throughout my practicum project with COPC, I worked with the director of the program, Julia Stanley. Julia is passionate about obesity prevention and started in this role when the program was funded with a grant from the CDC. Julia had a variety of work project ideas for me on my first day working with her.
Projects. The first project I worked on was defining family engagement so it was applicable to COPC and all the programs and roles related to COPC. Family engagement stems from the concept of understanding the important role families play in a child’s development, both educationally and physically. Family engagement concepts have most often been applied to a school setting and using family engagement tools to increase a student’s interest and success in a school. However, more health care settings are starting to realize the benefit in engaging the whole family in a child’s health.
I found multiple different definitions of family engagement and research showing how family engagement can be applied to successful childhood obesity reduction techniques. Julia and I went through every definition and picked out the definitions we found most beneficial and applicable to the overall goal of COPC. We found the research to be very supportive of family engagement techniques. Julia was very excited about all the information I found regarding supporting family engagement and she feels that family engagement will be the way she would like to measure all future COPC projects. Julia’s PHD student then compiled all the information I found into an official COPC document. This document can be found in the appendix of this paper.
Stemming from the family engagement project, I then worked with Julia to apply our family engagement concepts to the backpack program she is working on in Dane county. This past summer, Julia and her PHD student provided a select number of local day care centers with backpacks filled with healthy food ideas and ideas for family physical exercise programs. Children were allowed to take the backpack home for a week and parents could then provide feedback on the programs. Overall, the feedback was very positive and parents even reported the program was “life changing” and “made us look at food and exercise differently”. Due to the great reviews, Julia wanted to expand the program and get funding for this program. I worked with Julia to go to different meetings to try to get funding for this program. At these meetings, Julia explained the program while I provided information about family engagement and why communities should invest in family engagement programs. On December 8th we found out Healthy Dane, a group involving all three health organization in Dane county working towards a healthier county, will be providing a substantial amount of funding towards the back pack program. -
Besides defining family engagement and working on finding funding for the family engagement program, I also worked on finding out what different local health systems are using to assess pediatric patients for obesity detection. I then looked at what is used nationally and what programs can be used in the local electronic medical record system. Julia will then go on to use this information, after my practicum time is up, to try to push for all three health systems to use the same detection survey system.
Lastly, Julia is hoping to someday get funding for a website solely used to promote a healthy community. I examined websites from other cities and made a list of ideas that could be applied to a future site for Dane county. Our hope is get funding for a website that maps out local farmers markets, healthy food options, and a variety of physical exercise ideas.
Assessment. Overall, my proposed objectives were appropriate at addressing the obesity problem in Dane county. My objectives were to define family engagement, find research which supports family engagement in terms of obesity prevention, find funding for the backpack program, and review current obesity prevention tools. In my short time frame of the practicum, I was able to do work on all of these goals and objectives. My work helped to convince a local group to fund the backpack program. The literature review I completed on family engagement, per Julia, is “a turning point for this whole organization” and she also stated “the information you found for family engagement may be what our whole program eventually will be based on”.
Although my projects will not fully fix the problem of childhood obesity, I do feel my projects provided important steps at tackling this issue in my own community. Childhood obesity is a complex issue and meeting one single goal or objective will not fix this problem. In order to deal with childhood obesity, we must start in our local communities and make programs that are beneficial and applicable locally. Although this may seem like one small step, if more communities take these small steps, eventually an entire state can be changed for the better.
Barriers. Overall, I felt most of my work was perceived in a positive light and most people were very receptive to hearing about the work the COPC was doing. However, as with any health change, there were barriers. Some of the medical professionals I encountered in various meetings, mostly medical doctors, were not entirely convinced certain programs would be beneficial. For example, most public health professionals were very interested in the backpack program Julia had started at childcare centers, especially after the initial positive reviews and parent feedback. However, some of the doctors questioned how influential this would really be on the entire community. This questioning really opened my eyes to the barriers public health professionals deal with in terms of the medical community. To deal with this barrier, we simply did further education with the doctors to show how family engagement has been proven to work and informed them that research has shown the best way to deal with childhood obesity is to make changes starting in the home.
Another barrier I encountered was simply the cost barrier. As aforementioned, COPC was initially funded and supported by a CDC grant. This grant is no longer available to communities, but luckily the local hospital funds COPC now. However, being funded by the hospital does not supply enough funding for all the outreach programs Julia wants to do. Therefore, Julia must get additional funding from different organizations. Having to search for funding with every new program can be a frustrating barrier. However, Julia showed me how to look at this process in a positive light and how to trust enough in your work that it makes others want to fund your work.
Belize
Our MPH mission trip to Belize was a very rewarding and positive experience. All of us Concordia students went on this trip as part of the Praying Pelican Missions organization. With this organization, there were also healthcare teams who worked both with us and at the clinics doing direct health care at the clinics.
Projects. Before going to Belize, we had different projects and health topics picked out to focus on. However, as with any global health trip, we quickly learned we had to be flexible with our teaching plans and adjust to the local community. For example, we had planned to do a lot of health education on the health of women, but quickly learned the women from the local community were on a retreat and there were would be few women attending our health education sessions. Instead, more of our health sessions were focused on children and we had to adjust our topics and teachings to this age group.
The first project I took part in was teaching dental hygiene to different villages and communities in Belize. Our teachings focused on how to correctly brush teeth with an emphasis on correct technique and frequency. Many children had obvious poor dental hygiene. Most children reported they had never been to a dentist and the adults reported only going to a dentist for a severe dental issue and not for preventative health. Overall, there seemed to be no access for anyone to go to a dentist for cleanings. Even those people who were educated and had money did not report going to a dentist for preventative reasons. Therefore, we quickly realized this was not a practice we could really promote since dentists were not even providing this type of care. Instead, we had to focus on steps they could take at home and make sure the locals understood how often to brush their teeth and how to do this correctly. We had initially also wanted to teach about flossing but this was not something the locals had access to. We still quickly covered flossing but did not go into detail since we did not even see floss available in the store to buy.
Besides dental care, I also did projects and work on hand hygiene. Overall, most of the children and women were familiar with why hand washing was important and when to hand wash. However, we observed few people washing their hands frequently or with proper technique. Therefore, we felt this was something basic but important to emphasize. We used soap and hand gel to work with the children to provide education about how to properly wash hands and had the children demonstrate proper hand washing back to us. We made sure to make this teaching fun for the kids so they wanted to participate but still educational. We even had children come back to wash their hands multiple times simply to get positive reinforcement from us. In addition, we would have the kids name reasons why they washed their hands and would provide them then with additional reasons as well. Therefore, not only were the kids washing their hands properly, but we also knew they understand why they were doing this.