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MUSC students inspire lively 'junior doctors' of health
By Dawn Brazell | News Center | May 16, 2014
Pharmacy students Tom O'Donnell (right) and Ryan Linton field questions from Meeting Street Academy children during a Junior Doctors of Health session. View photo gallery here.
To download family handouts about being healthy, including a printable activity calendar, visit the News Center's News You Can Use website.
Teaching kindergarten children is much like herding cats. Energetic and curious, the children love information, but can be easily distracted.
“Let’s catch bubbles in our mouths,” pharmacy student Tom O’Donnell said, puffing out his cheeks to get the children to mimic him, something he didn’t think he’d be doing at this stage of his career. They puff out their cheeks, too, and stop talking, which is exactly the objective of O’Donnell, who is one of five Junior Doctors of Health (JDOH) instructors from the Medical University of South Carolina here to teach kindergarten students at Meeting Street Academy.
His other objective today, other than getting their attention, is to explain the good effects of exercise and why it’s so good to drink water versus sweetened beverages. O’Donnell points to a body model next to him and pulls out a lung.
“Does anybody want to hold a lung?”
“Ugh,” one student grimaces, but another reaches for the lobe, and the conversation turns to exercise and breathing.
After the 50-minute session, the students leave tired but happy. Dietetic intern Magie Young said she loved getting the children’s perspective and figuring out what resonated with them. “I think they’re hysterical. It’s fun to engage them on a topic you know that you’re going to get funny answers,” she said, referring to one child’s answer that chocolate milk comes from chocolate-colored cows. “It makes me aware of my audience and try to find out what they know and where they’re at.”
O’Donnell agreed, saying the experience was good practice for him in explaining health topics to a lay audience, a skill he will parlay into his work as a pharmacist. With the program celebrating its 10th anniversary this year, JDOH is proving to be effective in its mission of getting students, teachers and parents on healthier tracks.
JDOH Director Scotty Buff, Ph.D., said that was the original intent.
While a student and participant in MUSC’s Presidential Scholars Program, she helped found JDOH with the vision of putting undergraduate and graduate students in interdisciplinary teams to go into schools to encourage underserved youth to lead healthy lifestyles and to consider health care professions. In the past 10 years, JDOH has trained more than 850 students and reached more than 3,000 students. It has expanded across the state through a collaboration with the S.C. Area Health Education Consortium.
Buff said three students spearheaded it - a medical student who was concerned about exercise, a nursing student with an interest in diabetes and nutrition and herself. “I was interested in getting younger students interested in their careers, whether it be health care or a biomedical science career, but I wanted to start very, very young because one of the things I noticed when I was in school was that the higher I got through my education, the less and less diverse the group of people around me was.”
The program works with children preschool age all the way up to 8th grade, with plans to expand to high school students who could serve as mentors. Buff also sees the program adding more to its parent and community outreach segments. Jean McDowell, director of admissions and communications at Meeting Street Academy, is glad to hear that.
“I love the program. I think the kids really enjoy it. What I really love for Meeting Street Academy is that it includes a parent or family aspect to it so it’s not just with the child. It’s great we can tell the children to eat healthy until we’re blue in the face and to live healthy lifestyles, but they’re not the ones grocery shopping and cooking.”
She recalls a parent meeting on how to make healthy beverage choices where she sought feedback from a parent who attended. “One mother said, ‘oh my gosh. I had no idea. Do you know how much sugar is in a coke?’” I was like ‘yes, yes I do. It’s a lot of sugar.’ I just feel like it’s bringing things home for everyone involved. It’s working with the whole family and that’s a lot about what Meeting Street Academy is about. It’s being partners with the whole family, not just with the child because it takes everyone working together.”
The parent meetings have included free giveaways, such as a crockpot, and cooking lessons. “It’s not just lecturing about sugar’s bad and fruit sugar is good. It’s not stuff that everybody has heard. It’s really teaching real life cooking. You know - things that you can actually cook, and then getting them to taste it and take home the crockpot so that you can actually cook with it. MUSC has been really willing to morph to continue to provide the best means possible to reach as many of our families as they can.”
McDowell said she likes the partnership of the school, their families and MUSC. Young students get exposed to new ideas for careers and develop relationships with the student mentors during the four-week program. It’s exposure that seems to stick and be making an impact. Driving two girls home one day, she asked them the usual question she does about the best and worst parts of their days. The worst: They didn’t get seconds on the bell peppers in Junior Doctors of Health. “And I was like, ‘oh my gosh. In first grade, there is no way I would’ve eaten a bell pepper.’ It’s exposing them to more food choices, and they like it.”
Studies show that the JDOH curriculum works. An evaluation funded by The Duke Endowment (2008-2012) found elementary age children who received JDOH significantly decreased consumption of sugar sweetened beverages and increased consumption of fruit and vegetables Preschoolers who received JDOH decreased their intake of sugar and consumption of fiber increased, knowledge of how to select healthy meal choices increased, and physical activity increased while sedentary behavior decreased. Buff said findings suggest that student participation in a preschool program that included JDOH health curriculum positively influences the children’s future risk of obesity.
One reason that makes JDOH so successful is that it’s based on relationships, Buff said.
“It’s not a one-time volunteer project. You go three or four times. You build relationships. We need students who want to have a deeper experience. The first time students go, it’s like deer in headlights with them afraid of doing something wrong. By the second session, everyone is more comfortable. By the third or fourth session, they are rocking and rolling – all the stereotypes either group has had have fallen away.”
She recounts a time a parent came to her to say her daughter insisted they change what they eat after doing JDOH, and she wanted to cook with her mother so they could try out healthier fare. “We’re only in the classroom four times. It’s interesting to see we can have that kind of impact on a household.”
An impact is made on MUSC’s students as well.
Buff said the program makes students step outside of their comfort zones and drop any stereotypes they may have. In trying to get out key health messages, the graduate students learn firsthand how well received they are. “It encourages students to look at the whole person – not just the person you see in clinic – whether it’s putting them at ease or better understanding adherence issues or learning how to communicate more effectively. All of those things we embody in what we teach students.”
Student mentors, after they go through JDOH training, report that they can better see the impact health care providers and the community can have on the health of children. “They learn it’s not just the parents’ jobs.”
Another good benefit is that it encourages more of these medical professionals to practice in underserved, resource-poor areas. “That’s huge,” Buff said. “That right there is more primary health care providers in South Carolina in rural areas.”
Elana Wells, a JDOH program coordinator who has developed much of the curriculum, said she likes the interprofessional learning that happens among team members.
“They have an opportunity to work with students from other professions and really learn their expertise. For example, a lot of students don’t really know what the dietetic interns do or that we even have dietetic interns on this campus. They also learn how important it is to work together and rely on each other’s knowledge because not one profession can know everything.”
Wells said the schools chosen for JDOH are rural and underserved schools or have Title 1 designations, which means they have student enrollments in which more than half of the students qualify as low income, so university students are exposed to how issues such as poverty may hinder healthy behavior choices. “I think in terms of cultural sensitivity, they are able to work with people and children who they may not have worked with before, but whom they’ll definitely work with in the future. That’s really important, “ Wells said.
“And then just hearing some of the children’s stories may bring a new reality. When children say something like, ‘oh my mom doesn’t let me play outside because the area I live in isn’t safe’ or ‘my mom says we can’t afford this type of fruit or vegetable,’ that opens their eyes to issues like that.”
Many of the students are interested in working with children, and it’s a great experience for them to practice that, Wells said. “They actually get to use information that they’ve learned in school and share it with the community. Also, there’s the value of prevention. This program is focused on obesity prevention so practicing that messaging in terms of preventative health care is important.”
The challenge facing JDOH now is how to keep up with the demand. Wells said the program needs more student and faculty involvement. They have worked to expand ways more colleges can be involved as well as more faculty and students at MUSC. At MUSC, students may volunteer or take JDOH as a course elective. They also can participate in a month-long experience, called the Inter-professional Service Learning Project, a statewide program that MUSC has partnered with AHEC to facilitate. More recently JDOH has partnered with the individual colleges at MUSC and locally to see how faculty members can integrate the curriculum into their course.
For example, in the physician’s assistant program, JDOH is being integrated into the community health course, she said.
“That’s been a really neat way for us to recruit more students and so we’re always looking for more faculty members who are interested in their students gaining information about prevention and community health and cultural sensitivity. This is a great program to fulfill those learning objectives.
Student mentors are trained to deliver the curriculum over four, one-hour sessions that are geared to be highly interactive and tailored to the respective grade level, Wells said. The sessions teach nutrition, exercise and health career exploration. When elementary students finish the program, they receive their Junior Doctor of Health certificates that have pictures and biographies of the students who taught the courses. The mission is empowerment.
“The point that the child becomes a Junior Doctor of Health is that they become an advocate for their own health.”
Buff agreed. The children learn they are in control over what they eat and the physical activity they get and how that affects their health. The student mentors role model how they can become anything they want to become and how education can provide that pathway. It’s a message children need to get at a very early age, she said.
“When you empower children that they can help influence those decisions, it leads to a train of thought where they start realizing they can have an impact on the trajectory of their lives. It’s empowering them to become health advocates, their own self advocates, to be on a course that’s healthy.”