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Thinking Outside the Clinical Box: "Dancetricians" Step Up Against Childhood Obesity

Claudia Hillam Lau
April 19, 2017

In the first months of my post-graduate job at one of Chicago's children's hospitals, a seventh grader died during a classroom party at a local school.  She did not choke on her food nor hit her head; she merely took a bite of noodles contaminated with peanuts.  What made this a true tragedy was that epinephrine autoinjectors – that could have easily saved her life – had been readily available for years.         

For the next four years, I worked with a team to develop school policy allowing children to carry their life-saving medications in school and, more importantly, stocks each school with autoinjectors.  In its first year of implementation, 37 of these epinephrine autoinjectors were administered in the classroom to prevent such tragedies. Seeing how thoughtful changes in school health policies can impact the everyday realities and lives of children sparked my desire to go to medical school, become a pediatrician, and start a career in school health.         

​As a medical student, I quickly learned that obesity is one of the most common health risks among school-age children. Rates have quadrupled in the last 30 years from 5 percent to 21 percent, with disproportionately higher rates among urban minority youth.  Driven in part by our increasingly sedentary lifestyle in the age of TV and video games, less than half of elementary school children now achieve the nationally recommended level of exercise of one hour daily.


How can we help these kids?  As we know, school plays a critical role in child development. It can also be a place where kids learn and practice healthy lifestyle habits at an age where they are most susceptible to change. But not all schools provide this type of environment.  In Ohio, where my medical school is located, fewer than half of the state's schools offer opportunities for extracurricular physical activity.            

Beyond public policy hurdles, devising ways to help school-age children get more exercise means thinking of activities that excite them.  As a dancer myself, I find it easier to build up motivation to exercise when the form of exercise is fun, like going to a dance class, or entering a dance battle with friends.  I decided to work this concept into a new public school program I created, Dancetricians, a series of afterschool hip-hop dance classes aimed at sparking children's interest in regular physical activity.             

As part of Dancetricians, which is run entirely by medical students at an urban elementary school in Cleveland, we teach economically-disadvantaged children everything from "popping" and "locking" to break-dancing. The medical student instructor also are urged to become role models for these children and help provide a positive and encouraging environment they may not always encounter at school, or even at home.  

The program has helped me realize that improving health of school children not only involves providing quality healthcare as a future pediatrician, but should also involve thinking outside the proverbial box. - See more at:
The program has helped me realize that improving health of school children not only invovle providing quality healthcare as a future pediatrician, but should also involve thinking outside the proverbial box."

To prove that Dancetricians was truly having an objectively measurable impact on these children's lives, I studied them before and after participation in the program.  Based on the health belief model, I hypothesized that to improve the external frequency of physical activity (or behavior change) in these kids, we have to first change internal, psychosocial constructs.      

To this end, I focused on two dimensions: the ability to exercise (physical activity "self efficacy"), and the motivation to exercise (the desire to do it).  Analysis of validated pre- and post-surveys revealed that children scored significantly higher on both the self-efficacy and motivation scales after participating in Dancetricians. More children reported that they are now able to exercise after school, ask their friends to exercise with them, and ask their parents to sign them up for a sport or dance event.  In addition, more children now believed that exercising would help them be healthy, keep in shape, and become better at sports.

The most exciting finding, however, was that more children now thought that exercising would not be boring!  

"I want my friends to come [to dance class] so when we get bored at home, we can do it at home, we can practice; and when we come back, y'all can say: Good, good!"  one little boy participating in Dancetricians told us. It was at this moment that I truly considered the program a success.

I am proud to report that Dancetricians is now in its 3rd year of implementation and going strong. The program has helped me realize that improving health of school children not only involves providing quality healthcare as a future pediatrician, but should also involve thinking outside the proverbial box. As respected individuals in our society, we as physicians have a responsibility to advocate for our patients both inside and out of the clinical setting.

I urge all pediatricians to become child health advocates for their patients, whether it is by simply strengthening relationships with local education or health policy makers, or by starting your own community or school program.  Healthcare providers, our patients, their families, educators, and policy-makers can all work together at this critical intersection between education and health to ensure that our children, particularly our disadvantaged urban minority children, have the tools and resources to succeed. 

The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics. ​​​

​​​Ab​out the ​​Author

Claudia Hillam Lau is a third-year medical student at the Case Western Reserve University School of Medicine, and a member of AAP's Section on Pediatric Trainees.