South Jersey Healthcare - S.T.E.P.S. for Kids

Overview

Success through Exercise, Physical Fitness and Sharing Information (S.T.E.P.S.) for Kids is a health intervention program to assist families with children at risk for obesity. Through interactive classes on nutrition, exercise, and behavior modification, families learn how to implement and sustain necessary lifestyle changes. The program is targeted to students, ages 8 through 12, with a body mass index (BMI) over the 85th percentile of their recommended BMI. Parent or guardian attendance is mandatory.

S.T.E.P.S. staff includes an exercise specialist, a registered dietitian, and a social worker (parent facilitator). Attendees are evaluated pre and post course. South Jersey Healthcare (SJH), in collaboration with its community partners, the Cumberland Cape Atlantic YMCA, and the Vineland Public Schools (VPS), launched the program in 2007 with the assistance of a three-year grant from the Robert Wood Johnson Foundation’s New Jersey Health Initiatives. Area pediatricians had reported to SJH that more than 35 percent of their patients were overweight or obese. They and VPS nurses identified the lack of local treatment programs as a hindrance. S.T.E.P.S. was developed to address this health issue.

Impact

Over the three-year grant period, we experienced a 59.47 percent completion rate, representing 113 children plus their parents and guardians who completed the program in Vineland. Since the grant ended, SJH now funds and operates the program. The structure is essentially the same except that it is now a 10-week program operating in two cities: Vineland and Bridgeton, in cooperation with the Bridgeton school system. Classes meet two hours in the early evening. Class size is generally 10 children plus parents, with the program offered three times a year at each location. The program now has its own web site for kids at sjhsteps.com.

Overall, completion rates have remained stable at about 50 percent at both sites. SJH continues to retool the program to meet the needs of the community and is active in giving community presentations on childhood obesity prevention and treatment options. The program received the 2010 Outstanding Contribution to a Childhood Obesity Program Award from the National Initiative for Children’s Healthcare Quality. The program also received a Community Fitness Innovation Award from the American Heart Association.

Challenges/success factors

Although recruitment was a challenge in the beginning of the program, we no longer have any problem enrolling children in the program. Referrals to the program regularly come from pediatrician offices, as well as school nurses and word-of-mouth testimonials from graduates. While a completion rate of 50 percent may seem low, we understand that a program like this can place a significant burden on a family. Many of our families do not have their own transportation to the program sites and must walk or rely on a taxi. Inclement weather can deter attendance as well as the cost of public transportation. Parents have childcare issues as well as competing time demands and responsibilities with other family members.

As the program has aged, we have become more aware of the literacy and language barriers of many parents. We have found that the literacy level is quite low for some parents and may have bearing on whether they complete the program. We know there are language barriers that are difficult to bridge even with an interpreter and translated materials. Therefore, we have made changes to materials as needed and are looking at ways to better prepare parents upfront for the program. Our parents are very engaged and create a bond with one another that goes beyond the 10-week program. Many parents ask to re-enroll because they say that they learned so much and had such a positive experience with the other parents. Having a social worker work with parents and kids at each session really provides an opportunity for parents to understand that kids can’t handle adult problems; they need to be kept at the adult level and for kids to have the opportunity to learn how to better deal with everyday stress. At close of the program, we have a graduation ceremony and party at which the children and their parents are recognized for completing the program.

Future direction/sustainability

Childhood obesity continues to be a pressing health problem in our service area. South Jersey Healthcare is committed to the S.T.E.P.S. for Kids program as one venue for addressing those children at greatest risk for adult health complications. Our program focuses on adoption of a healthier lifestyle – not weight loss – and provides both parents and children with tools for improving health. We hope to continue this important program in the coming years and are always looking for opportunities that will allow us to expand the program into other communities. The need is great both on the prevention and treatment side of the issue. We believe this is a valuable and welcome health service in our community.

Advice to others

Be careful about your age mix. Children younger than 8 are often too immature for this type of program and can be disruptive to the older kids. It is critical that you understand your adult audience. Literacy level can be a major roadblock in parents actively participating and completing the program. You must tailor your program to your audience and be prepared to adjust and tweak it as needed for parents to get the most from it. This program requires flexibility so as to best meet the needs of each group. Teaching basic nutrition skills are a must; we find that parents are very eager to learn them. Group learning with parents modeling behaviors are very important and set an example of how parents can interact with their children in a fun way. What parents learn from this program is as important as, if not more important than, the kids’ experience, because parents are the role models for their children. Healthy parents equal healthy kids.

Contact: Jackie Chanudet, MA MPH
Director, SJH Garden Area Health Education Center
Telephone: 856-575-4860
E-mail: chanudetj@sjhs.com