By Leslie King-Schultz, MD, MPH, chief resident, Mayo Clinic Pediatric Residency program
More than three-quarters of Minnesota children age 0-5 are enrolled in childcare centers. As with the rest of the population, this demographic is also experiencing a rise in the rate of obesity. In fact, among low-income preschoolers, 30 percent are considered overweight or obese. As concerned pediatricians-in-training, the University of Minnesota and the Mayo Pediatric Residency programs teamed up to improve physical activity in daycare centers in Minneapolis and Rochester through the Move2Grow project, funded by a Healthy Active Living grant from the American Academy of Pediatrics. Most pediatric residents have limited knowledge of childcare environments and the challenges that childcare providers face in offering high quality care, including adequate physical activity opportunities. This project afforded residents the chance to become familiar with childcare centers in the context of promoting child health. Using pediatric obesity as a platform for community engagement, the project aimed to develop residents’ skills in advocacy, inspire interest in life-long activism, and impact child health on a community level.
Through the Move2Grow project, leadership teams of residents and faculty from each program in partnership with the Minnesota Chapter of the AAP identified childcare centers in each community interested in improving physical activity within the center. The University of Minnesota chose four distinct centers in different regions of the city. The Mayo residency partnered with the largest Head Start center in Rochester. Teams of residents visited the centers periodically throughout the academic year, serving as coaches for the teachers in the classroom to achieve the goals they set at the start of the year. At Mayo, residents also visited the centers to observe and participate in a typical day. At each site, the residents helped lead a parent night to share the messages about healthy lifestyles including adequate physical activity with parents. Additionally, the residents helped craft new physical activity policy statements for the centers to incorporate into their existing policies.
In total, 51 residents from both programs participated in the project. In comparing pre and post-survey responses, residents reported increased confidence in counseling families regarding physical activity guidelines. They also demonstrated increased self-efficacy with regards to community engagement and policy activities with more residents feeling prepared to work at the community level to impact child health. In addition, more residents reported interest in public health, health policy, and community advocacy after participating in the project. Overall the centers really enjoyed having residents in the classrooms. The residents were most helpful in sharing resources with the teachers to help parents improve activity levels at home. The teachers felt the parent nights were very helpful, with fun shared by all.
Pediatricians have a responsibility to promote child health not only at an individual level, but also at a community level. The Move2Grow project gave pediatric residents in Minnesota a better understanding of the childcare setting and its important role in supporting child well-being. The project began relationships between residents and childcare centers which will continue to grow with new projects in coming years. At the same time, residents gained important skills to become stronger and more confident child advocates through community engagement in their future careers.
