Helping Kids Make Healthy Choices in Grand Rapids

Through a series of conversations with Blue Cross Blue Shield of Michigan, Denise Holmes, Associate Dean for Government Relations and Outreach in MSU's College of Human Medicine and Director of the Institute for Health Care Studies, developed a project aimed at addressing the problem of childhood obesity in Michigan, specifically in Grand Rapids.

Project FIT aims to prevent childhood obesity by promoting healthy lifestyles in schools and the surrounding communities. The project is a partnership among many MSU departments, four Grand Rapids public schools, local health care systems, neighborhood associations, faith-based groups, businesses, and agencies, with funding by Blue Cross Blue Shield of Michigan. Holmes' role is to provide direction to this group—promoting teamwork, making sure the resources are appropriately assigned, and encouraging the research.

According to Holmes, "Blue Cross Blue Shield was very interested in what the University could bring to the table to help with what they see as a growing health concern in Michigan." Blue Cross Blue Shield was interested in whether MSU could develop a model within four Grand Rapids elementary schools that could subsequently be taken to various stakeholders and communities around the state, a model that would have the respect of the community because it comes out of a university medical school.

Holmes convened a group of researchers from many departments to help develop and implement the project, including Katherine Alaimo, Ph.D. (Human Nutrition), Karin Pfeiffer, Ph.D. (Kinesiology), Hye-Jin Paek, Ph.D. (Advertising & Retail), Joe Eisenmann, Ph.D. (Kinesiology), and Joseph Carlson, Ph.D. (Radiology). This project offered the opportunity to utilize the expertise within the University to help a community address a public health issue.

Because a number of programs aimed at childhood obesity were already in existence in Grand Rapids, Holmes' goal was to find a way to partner with them in order to increase the collective impact. The challenge was finding and bringing together all of these groups. Holmes' colleague, Tracy Thompson, Outreach Specialist in the College of Human Medicine, has the expertise needed for building community coalitions. "It's our philosophy that you do not change a social phenomenon by taking a one-dimensional approach," said Thompson. "It requires a broad approach that engages the entire community so that it can be sustainable afterward."

For Thompson, an exciting feature of the project is the acknowledgment that the reasons for obesity are "multi." To address these multiple targets—school, home, and community—the project has several components.

Healthy Eating Coaches

The school component has involved activities such as curriculum development, teacher training, and lunchroom programs. One exciting program started in the cafeteria and has expanded into the classrooms. A Project FIT partner, Paul Baumgartner, Director of Nutrition Services in the Grand Rapids Public Schools, created the Healthy Eating Coaches program to encourage kids to try new and healthy foods during their lunch time. The Grand Rapids schools he works with were already very progressive in their lunch menu, offering a variety of whole grains, vegetables, and legumes.

"There really wasn't a whole lot more you could do with our menu...The problem isn't the food; the problem is the environment in the lunch room. If we could have teachers eat lunch with the children and eat what the children are eating, and then incorporate teaching about it into the classrooms—that's a food coach," Baumgartner said. The kids have been enthusiastic about the program and Baumgartner has plans to continue to expand it even when Project FIT funding has ended.

Assessing Community Resources

The community component of the project started with a partnership with Grand Valley State University to assess what was already in the community so they could build on that. The plan included enhancing park spaces to increase access to safe and healthy physical activity as well as working with local convenience stores that could stock healthy foods on their shelves. Thompson is particularly excited about this component and said, "It's an opportunity for the message in stores to mirror the message in the schools and give more information to parents."

Sustainability is Built into the Plan

Now nearing the end of its two-year funding, the project has a goal that is two-fold: first, to take what "worked" from these components and create a toolkit for Blue Cross Blue Shield to use in various communities around the state; and second, to ensure that the intervention will be sustainable in the Grand Rapids area. Holmes sees some encouraging signs. "Schools have already begun to incorporate changes into what they're doing. As they see [the program] ending, they are approaching us saying they don't want to lose ground. So we've held a series of meetings on how to keep schools moving forward."

How will the program keep moving forward in the schools? "We do it by deliberately picking strategies that would be feasible to sustain. Schools are cutting back; it's not feasible to ask schools to make big changes that cost a lot of money, such as hiring new staff, or starting whole new programs," said Holmes. "But building in bits of curriculum to incorporate through the day is feasible. Also, they can use evidence-based curriculum that already exists. We can help access, facilitate, and package these existing curriculums to make it easier for teachers—and then provide training."

For Thompson, the highlight of the project has been seeing different groups coalesce. "It's been exciting watching how the different pieces begin to synergize and are working together—seeing relationships and projects grow and develop," she said.

Holmes is very aware of the reciprocal benefit to the university. "It will provide learning opportunities in an area in which the university is heavily involved. Many research papers will come out of this." And she is also thrilled about the level of engagement of many parts of the community and their enthusiasm and desire to sustain this into the future. "My goal was that we would leave the community with enough 'there' so... they could continue to 'run with it' after the project has ended," she said.