March. 4, 2014
VANGUARD: It takes a village
The OSU Family Health and Nutrition Clinic combines research and community resources in the treatment of childhood obesity.
While it may take a village to raise a child, Dr. Colony Fugate and Dr. Teri Bourdeau know it takes an even greater commitment to raise a healthy child.
“It really takes an entire community to address the many underlying issues, such as poverty, lack of nutrition knowledge and even the number of sidewalks in a city that impact our state’s obesity level,” says Fugate, a pediatrician at OSU Center for Health Sciences and medical director of the OSU Family Health and Nutrition Clinic. “Addressing these issues can be challenging work because there are so many factors that contribute to the development of obesity.”
Fugate and Bourdeau, a clinical psychologist at OSU-CHS, are using an evidence-based approach to combat childhood obesity through the Tulsa-based clinic. Working with Sara Malone, a licensed dietitian, and Kerry Morgan, the clinic’s certified health education specialist and a clinical instructor in the School of Applied Health and Educational Psychology at OSU-Tulsa, the OSU team has developed a program to support children who are overweight or obese and their families. They have also built community partnerships with other local and state organizations to extend the clinic’s reach and developed new curricula to provide OSU students with the skills to address weight issues in Oklahoma’s communities.
“Our efforts are really aimed at assessing the motivational factors that lead to obesity in children,” says Bourdeau. “In childhood obesity treatment, we focus on optimizing health and teaching families to find the resources to make healthy decisions.”
The Family Health and Nutrition Clinic was launched in 2009 to provide individualized and comprehensive support for overweight and obese children and their families. It was the first clinic in the state to develop a multidisciplinary obesity treatment program for overweight and obese children, or those with a body mass index greater than 85 percent.
“The clinic is really the base of our services where we interact directly with children and families dealing with obesity,” says Fugate. “Through the clinic, we provide the education and support to patients and their health care providers to systematically address the issues causing obesity.”
The clinic takes an evidence-based approach to obesity treatment, following guidance outlined in the “Expert Committee Recommendations Regarding the Prevention, Assessment and Treatment of Child and Adolescent Overweight and Obesity Report.” Published in 2007, the recommendations include assessing families for unhealthy eating habits and encouraging families to incorporate physical activity into their daily routines.
“You are not just looking at the eating and exercising behaviors of a child, but also their parents and grandparents,” says Fugate. “Sometimes there are many generations of behaviors in a family you have to overcome.”
Since its inception, the clinic has had more than 600 patient referrals from OSU Physicians clinics, primary care providers, physician specialists and partner agencies in Tulsa and the surrounding areas.
“When working with families to increase physical activity, we want to help them identify activities that are enjoyable,” says Morgan. “If physical activity can be fun, they’re more likely to stick with it. We see patients with varied interests in physical activity as well as various ability levels, and we try to find something that fits well for the entire family.”
In addition to treating patients, one of the main goals for the clinic is to train primary care physicians and other health care providers on the latest obesity treatments via conference presentations, agency workshops and continuing education seminars.
Part of the new OSU College of Osteopathic Medicine curriculum includes courses for second-year students on nutrition, obesity medicine and health change behavior and a multidisciplinary course for fourth-year students combining health education and behavioral health. Research on helping patients make healthy behavior changes has also been integrated throughout the curriculum.
The clinic leaders also conduct a lot of advocacy work as active members of the Tulsa County Wellness Partnership and the Oklahoma Fit Kids Coalition, and work closely with the Tulsa City County Health Department, OSU Cooperative Extension, Indian Health Care Resource Center and many other agencies.
“We already have a lot of resources available in our community to help families struggling with obesity,” says Bourdeau. “We help bring together all of these community partners, referring the families to one program or another depending on their needs at a given time.”
The OSU Family Health and Nutrition Clinic has partnered with YMCA of Greater Tulsa and OSU Cooperative Extension for Cowboys Get Healthy, Get Fit. The group-based community program emphasizes incorporating healthy eating and physical activity into a family’s daily routine.
“The program encourages families to adopt healthy habits like eating more nutritious meals and adding exercise to their daily routine,” says Malone. “When children learn to make healthy choices about eating and exercise with their parents, they are more likely to maintain those habits as adults.”
The clinic has also partnered with Shapedown at Saint Francis Health Zone for the Pink to Orange Program. The partnership takes a team-based approach to helping families to utilize the resources of Saint Francis and OSU Physicians to address obesity in children 7 to 15 years old.
Families who visit the clinic are provided an individualized treatment plan that addresses areas such as nutrition, exercise and behavioral health. These plans are tailored to help all members of the family and are communicated to the primary care provider.
“We take these simple concepts and use them to address the complex issues that surround childhood obesity,” says Bourdeau. “In some cases, you find success not by helping someone lose a lot of weight, but when you help them stop gaining weight. You are continually working with families to develop the skills to be healthy.”
The OSU Family Health and Nutrition Clinic is using obesity research, treatment programs, education and advocacy to build community support for addressing obesity problems.
“It is easy to blame an individual for obesity, but we live in an environment that makes it challenging to live a healthy life,” says Fugate. “We spend a lot of time sitting down, many careers are not physically demanding, and we don’t place enough emphasis in society on getting exercise. In reality we are all culpable and it’s up to all of us to impact change. We see that in our work every day.”
This story originally ran in the 2014 issue of Vanguard.