YOLO A COMPREHENSIVE INTERVENTION TO PROMOTE HEALTHY BEHAVIORS

YOLO: A COMPREHENSIVE INTERVENTION TO PROMOTE HEALTHY BEHAVIORS AMONG YOUTH & PHYSICIAN CAPACITY BUILDING HARBOR-UCLA DEPARTMENT OF FAMILY MEDICINE PRESENTERS: DR. MICHELLE GARRIDO, DR. FARAH IMAM, DR. ANNA LANDAU, DR. JOANNE SUH

SCOPE OF THE PROBLEM Ø Obesity is the leading cause of premature death in the United States Ø 1/3 of all youth <19 y/o are overweight or obese Ø >20% of health care spending is for obesity & related conditions Ø OBESITY IS NOW A DISEASE OF POVERTY, MAINLY EFFECTING ETHNIC MINORITIES

GARDENA HIGH SCHOOL STATISTICS Ø South L. A. center of poverty, food swamps, health disparities Ø Student body: § 77% Latino § 22% African-American Ø 74% of households live below Federal Poverty Level Ø More than 55% of students are overweight or obese

YOLO COMPONENTS Ø Healthcare workforce capacity building for medical students and family medicine residents Ø Youth Obesity Intervention through: § Group Medical Visits § After-school exercise program § Photovoice & Advocacy training

HEALTH WORKFORCE CAPACITY BUILDING Ø Resident & faculty “Train the Trainer” Ø Medical Student and Resident Poverty Medicine Seminars: § Social Determinants of Health § Health disparities § Health & Human Rights § Social Injustice & Health § Globalization & Health § Health Policy & Advocacy Ø Pipeline Programs & Mentoring

YOLO CURRICULUM HEALTH ASSESSMENT: Intake Survey; Nutrition Assessment MYTHBUSTERS: Weight loss and nutrition myths; Fad diets BREAK THE ICE: Defining Health & barriers to achieving optimal health THE PLATE IS SERVED: Food plate and food groups; Balanced Diet MIRROR, MIRROR ON THE WALL: Media and cultural messaging, self-image WHAT ARE WE RISKING? : Obesity, associated health risks, health disparities KEEP MOVING!: Physical activity, Fitness, Body Image FIELD TRIP #1: COMMUNITY HIKE HOT CHEETOS AND TAKIS: How to read food labels; Snacks FIELD TRIP #2: GROCERY STORE THE SWEET AND SALTY: Understanding carbohydrates and sodium FIGURING OUT FAT: Understanding cholesterol FIELD TRIP #3: COMMUNITY GARDEN MAKING IT LAST: Advocacy project poster presentations

RESULTS

PARTICIPANT DEMOGRAPHICS # Participants: 14 Age: 14 - 16 years Ethnicity: 28. 6% 21. 4% African American Latino Mixed Ethnicity Sex: § Female 10 (71%) § Male 4 (29%) 14. 3% Undisclosed 35. 7%

PARENT DEMOGRAPHICS Ø Single parent households: 7 (50%) Ø Parent Employed: 11 (78%) Ø Parental Income: only 3 participants answered – average income $34, 800 yearly

YOLO: PARTICIPANT BMI NOMOGRAM

YOLO INTAKE: HEALTH BEHAVIORS Ø 71% of participants ate fast food 2 or more times per week Ø 71% of participants reported being physically active 3 or more times per week Ø 28% of participants used electronics (video games, computers, social media) 4 or more hours per day Ø 57% of participants reported getting 8 or more hours of sleep per night

WEEKLY COMMITMENTS/ GOALS Ø Each participant is asked on a weekly basis to identify a goal for the week Ø There were 5 categories of goals that participants were encouraged to address: § # of Sweet/Sugary Drinks per week § # of Fast-food Meals per week § # of Family Meals per week § # of hours of screen time § # of hours and frequency of exercise

GOAL SETTING One student successfully went from 8 hours of electronic time/day to less than 2 hours/day & getting more sleep in < 5 weeks.

MODULE: SELF-IMAGE Ø Student describes her selfie as follows: § “imperfection, ugly, eyebrows on fleek, hair is ugly, ugly smile, hideous, not cute” Ø Her partner describes her image as: § “pretty smile, nice hair, beautiful face, cute little eyes, perfect eyebrows, cute pink cheeks”

MODULE: DIET MYTH BUSTERS One student who had said he would “never touch anything green” on his second salad serving.

MODULE: FITNESS Ø Students take ownership of the exercise component, and teach the Cha Slide to the Resident facilitator.

DISCUSSION

CHALLENGES Ø Changes at the school § Schedule changes § Changes in Principals Ø Selection Bias Ø Student reading/ comprehension level Ø Liability & approval for field trips pending Ø Shorter semester Ø Resident Schedules

SUMMARY Tackling chronic diseases of poverty will require: § Comprehensive programs involving families, communities & medical institutions § Training a competent health workforce that can address these illnesses in a culturally sensitive manner § Commitment to diminishing health disparities and improving overall health outcomes

ACKNOWLEDGEMENTS Ø Faculty Advisors: Dr. Diana Jochai, Dr. Jyoti Puvvula, Dr. Raquel Soto Ø Resident Facilitators: Dr. Revery Barnes, Dr. Becca Cohen, Dr. Asia de la Torre, Dr. Michelle Garrido, Dr. Farah Imam, Dr. Hela Issaq, Dr. Anna Landau, Dr. Joanne Suh Ø Gardena High School Healthy Start Coordinator Ø Song-Brown Grant Ø UCLA Changemakers Grant Ø Committee of Interns and Residents – SEIU QI Grant

THANK YOU! CONTACT INFORMATION: YOLO. FMEDUCLA@GMAIL. COM JOPUVVULA@HOTMAIL. COM