Transcript for the Piece Audio version of Child Obesity - Part Three - Spreading the Lifestyle

This week, we’re looking at pediatric obesity in Holyoke – one of the poorest cities in Massachusetts. One community health center there runs an intensive weight-loss program for children. Today, we look at efforts to keep the momentum going after the program is over. Karen Brown reports.

ELEVEN-YEAR-OLD JAMES ORTIZ AND HIS 17-YEAR-OLD SISTER, VERONICA FERNANDEZ, ARE WALKING A DOG ALONG A BUSY STREET IN HOLYOKE. IT’S NOT ACTUALLY THEIR DOG – IT’S A NEIGHBOR’S – BUT THEY WERE LOOKING FOR A GOOD EXCUSE TO GET OUTSIDE AFTER SCHOOL.

V: instead of sitting down watching TV when there's nothing on TV, might as well go do exercise. you'll feel more refreshed and energized.

VERONICA AND JAMES ARE NEW GRADUATES OF THE HOLYOKE HEALTH CENTER’S HEALTHY WEIGHT CLINIC, A SIX-MONTH PROGRAM THAT COUNSELS ENTIRE FAMILIES ON NUTRITION AND EXERCISE. IT WAS LAUNCHED LAST YEAR TO ADDRESS CHILDHOOD OBESITY IN THIS LARGELY PUERTO-RICAN COMMUNITY – AS THE RATE OF OVERWEIGHT CHILDREN LOCALLY AND NATIONALLY CONTINUES TO CLIMB. JAMES SAYS HIS HOUSEHOLD WENT THROUGH SEVERAL CHANGES IN THOSE SIX MONTHS.

like you only get a portion of the size of your palm, like of meat, and you have to have more vegetables than anything. 0:05:26.0

THAT THOSE MESSAGES HAVE SUNK IN.... IS GREAT NEWS FOR DOCTOR VINNIE BIGGS, WHO RUNS THE WEIGHT CLINIC. WHAT HE’S WORRIED ABOUT... IS WHAT HAPPENS TO YOUNG PEOPLE LIKE JAMES AND VERONICA AS TIMES GOES ON.

lots of pp can show benefit over this intensive pd of time where you have the families enrolled. it's after that that i think is the difficulty.0:09:37….and it's pretty well documented that if these families have no more engagement 0:09:46.2, then they quickly return to the lifestyle prior to the intervention.

SO BIGGS AND HIS STAFF ARE TRYING TO JUMPSTART A SECOND PHASE OF THEIR PROGRAM. THEY'RE RECRUITING FAMILIES WHO'VE COMPLETED THE PROGRAM …. AS MENTORS FOR THOSE JUST STARTING OUT. THE GOAL IS TO DEVELOP A SUPPORT NETWORK THAT CAN THRIVE OUTSIDE THE HEALTH CENTER'S WALLS. CASE MANAGER NANCY RUBERT LAYS OUT THE MENTORS' TASKS AT WEEKLY MEETINGS....
and so you have a table in the waiting room...and you'll say, hi, i'm so and so, i'm a mentor, and they'll ask what that means, and you will tell them, if you have any questions, here's my number....

*like, i could tell them like snacks.

THAT’S NEW MENTOR ARELIS MARQUEZ, JAMES AND VERONICA’S MOTHER – WHO LOST 20 POUNDS HERSELF BY HELPING HER CHILDREN EAT BETTER AND EXERCISE MORE...SHE'S BECOME SOMETHING OF A NUTRITION EVANGELIST AMONG HER FRIENDS.

like when the kids get out of school, and pp cook -- let's fry this chicken and make some white rice. you know, that is high in calories. why don't you give them a little snack, a little bran flakes and a little bit of yogurt and a fruit. 0:14:05.3 ... so do it like that, help my mentor families change their habits little by little.

AND ONE THING PROGRAM VETERANS KNOW…IS HOW HARD CHANGING HABITS CAN BE AND WHY IT’S IMPORTANT NOT TO GIVE UP AT THE FIRST BACKSLIDE.

arelis: even in school, when you see the people eating.what do you do? like oh my god, i wanted that candy bar so bad mommy, but -- J: like snickers! 0:32:04.3 (pp laugh)

* i used to look at myself and say, ok, i'm fat, i'm ugly. what am i supposed to do. i can't do nothing about it….

MARY- ANGELIE ROBLES IS A TEENAGER WITH DIABETES. SHE USED TO WEIGH 200 POUNDS. HER MOTHER HAD TO PUSH HER TO TAKE PART IN THE CLINIC, BUT SHE DID IT.... AND LOST 25 POUNDS. BOTH OF THEM ARE NOW MENTORS.

*hardest parts for me is, like, eat small portions. but it's for my health. so i gotta stop. i stopped eating candy. yeah, i eat candy once in a while, a little lollipop and this and that. and at school, i get tempted to eat candy, but i just turn my back on it.

IN ADDITION TO THE OCCASIONAL PEPTALK, MENTORS ARE SUPPOSED TO CHECK IN WITH THEIR FAMILIES BY PHONE, INVITE THEM OUT FOR STROLLS, DRIVE THEM TO THE GYM, REMIND THEM OF APPOINTMENTS. OF COURSE, THE SYSTEM DOESN’T ALWAYS WORK. THE HEALTH CENTER TRIED TO ORGANIZE A GROUP WALK THROUGH HOLYOKE IN THE SPRING, BUT OUT OF THE DOZEN FAMILIES WHO WERE INVITED, ONLY ONE SHOWED UP. THAT COULD HAVE BEEN DUE TO POOR WEATHER. REGARDLESS, DOCTOR VINNIE BIGGS SAYS IT’S IMPORTANT TO KEEP TRYING.

the numbers are so great, it'll be impossible to keep pp enrolled in these programs forever. Turning the trajectory of the epidemic really can only be done by impacting the community.

WHICH IS WHY THE MORE INFORMAL OUTREACH – FOLDED INTO THE SOCIAL LIVES OF YOUNG PEOPLE LIKE JAMES AND VERONICA -- MAY BE THE MOST USEFUL….

J: i help one of my friends, he lives in a building and sometimes i go over and tell him to play outside with us, football, baseball, or kickball. 0:06:36.6

V: i have a couple overweight friends. and i'll be like, you have to come with me, you have to do exercise! you have to eat healthy. oh no, i never eat healthy. what do you eat for bkfast? oh, i go to mcdonalds. come to my house, i'll make you fresh breakfast with eggs and veggies and good stuff, instead of mcdonalds.0:08:13.6…

VERONICA IS EVEN TRYING TO HELP A PLUMP 2-YEAR-OLD SHE BABYSITS; HIS MOTHER FEEDS HIM JUNK FOOD.

and i just had a talk with the mother and said, i think it's healthier if we walk around, bring the baby with us, have him eat healthy food, …. i already got him used to eating fruits and vegetables. and then, sometimes they'd rather eat the junk food but i take away the junk food! or i''ll grab the same chip bag, wash it out and put apples in it. and the baby will eat it!

ANOTHER REASON THAT PEDIATRICIANS ARE ROOTING FOR COMMUNITY SELF-HELP….IS ECONOMIC. MOST INSURERS, INCLUDING MEDICAID AND MEDICARE, DON’T PAY ENOUGH FOR INTENSIVE WEIGHT COUNSELING – SOMETHING DOCTOR BIGGS IS HOPING WILL CHANGE WITH HEALTH REFORM. IN THE MEANTIME, HE’S COUNTING ON HIS PATIENTS TO CARRY HEALTHY MESSAGES TO THEIR FRIENDS, EXTENDED FAMILIES….AND BEYOND.

I’M KAREN BROWN.

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