Funded Projects

Healthy Habits for Patients with LEP

Project Year

2022

City & State

Portland, Maine

Program Name

CATCH Resident

Topic

Overweight & Obesity (LHI)

Program Description

Problem Increased childhood overweight and obesity has been seen across populations worldwide; however, data show a particularly rapid rise in children from immigrant and refugee families who have settled in a developed country. This increase likely contributes to the higher frequency of long-term adverse health outcomes (including hypertension and type 2 diabetes) that are seen in refugees who have relocated to the United States. Furthermore, children from families with low English proficiency (LEP) are more likely to experience poor health outcomes and have lower parental care satisfaction, both of which impact their ability to receive care for weight management. Primary Setting and Number of Children Affected In the Resident Pediatrics clinic at MMC we have a rate of elevated BMI (defined as BMI >85%ile) that is similar to the national average at about 43% of our patient panel. This represents 687 patients, 418 of whom have a language other than English listed as their preferred language. To address this need we have established a "Healthy Habits" clinic within our clinic one day per week, which includes a pediatrician with experience working with children carrying extra weight, a dietician, and a behavioral health clinician. While establishment of this clinic within our primary care clinic decreases some barriers to accessing weight-specific care (i.e. difficulties with transportation and difficulty managing appointments at multiple locations), one barrier that persists is that a large percentage (48%) of our patients come from recently immigrated or refugee families with LEP. Due to language barriers, cultural differences, and lack of translated resources, providing care for patients and families with LEP has proven to be difficult and requires a novel approach such that an extension of the current clinic is necessary. Project Goal The goal of my project is to address the health equity gap for children from families with LEP who are overweight or obese by improving access to in person and written recommendations and materials that promote healthy active living in a way that is culturally relevant and easy to understand in multiple languages. Proposed Intervention I plan to obtain and distribute written materials (including recipes, portion sizes, healthy food lists, and physical activity recommendations) in multiple languages to the patients and families with LEP who are seen at our Healthy Habits clinic. Translation and production costs of these materials will be funded by the MaineHealth Children's Service Line. The utility and cultural relevance of these materials will be evaluated using multiple PDSA cycles with patient and family opinions as the primary drivers. Due to COVID restrictions at our hospital we will be unable to conduct focus groups to elicit patient and family responses and so instead will conduct structured phone surveys within 1-2 weeks of the patient's appointment. To incentivize participation, and to help augment access to healthy foods, those who have answered the survey questions will receive a Hannaford Supermarkets gift card at their next Healthy Habits appointment. Patients and families who do not respond to initial phone surveys will have the opportunity to answer survey questions at their next follow up appointment. Anticipated Outcomes Within 12 months I aim to distribute translated resources to at least 50 different patients and families. With their feedback and input we will continue to improve the cultural applicability of the resources that we have available. Through survey responses and follow up appointments I hope to determine that having translated and culturally relevant written materials available contributes to positive lifestyle changes. Additionally, by partnering with Hannaford Supermarkets to distribute gift cards my goal is to forge a lasting relationship that will increase access to healthy foods to our families.

Project Goal

The goal of my project is to ensure that children from families with LEP who are overweight or obese are receiving the standard of care in addressing their weight by improving access to written recommendations and materials that promote healthy, active living in a way that is culturally relevant and easy to understand in their preferred language.

Project Objective 1

By the end of March 2023 project staff will distribute translated written nutrition- and physical activity-related materials to at least 50 different patients and families with LEP after their visits at the Healthy Habits clinic.

Project Objective 2

By the end of April 2023 at least 25 different patients and families will respond to structured survey questions administered via telephone or at follow up appointments and will receive a Hannaford gift card.

Project Objective 3

By the beginning of June 2023 the number of patients who have followed through on lifestyle changes as determined by survey responses will increase by 50% compared to pre-project values.

AAP District

District I

Institutional Name

Maine Medical Center

Contact 1

Sarah DiBrigida