Be Our Voice Blog

Blog Entries in Healthy Kids

Monday, April 30th, 2012

Making the "Go Outside and Play" Prescription Possible

Posted by: Kristi Fossum Jones, MPH

As the weather gets warmer and spring arrives, pediatric care providers and healthcare professional advocates like to tell patients and families to “go outside and play!”

Play—especially free and unstructured play—is vital to kids’ healthy development physically, socially, and emotionally. And the fact that playtime offers physical health benefits is of particular relevance for healthcare professional advocates fighting childhood obesity. According to a clinical report published in the January 2012 issue of Pediatrics, “Play enhances physical health by building active, healthy bodies. Physical activity beginning in early childhood prevents obesity. In fact, play may be an exceptional way to increase physical activity levels in children and, therefore, may be included as an important strategy in addressing the obesity epidemic.1

Another reason why “go outside and play!” is good health advice has to do with the “go outside” part. According to the CDC, kids ages 8-18 spend an average of 7.5 hours a day using electronic media (e.g. TV, computers, video games, etc.) and 83% of kids six months to six years watch almost 2 hours of TV/videos per day. This sedentary time contributes to childhood obesity.2 In contrast, when kids are outside, they’re usually active doing things like riding bikes, swinging, playing sports, etc.

So clearly “go outside and play!” is good health advice, but sometimes it’s not that simple for families and kids to follow through. Too many kids and families live in areas where going outside isn’t safe, there aren’t any good outdoor play areas nearby, or they can’t afford outdoor recreation programs.

This is where advocacy comes into play! There are many ways in which pediatric care providers and other healthcare professionals can advocate for more and better outdoor play and exercise options for kids and families. Below are resources that may be useful.

Now get out there and start playing!

Connect Children and Families with Nature

Program: Children and Nature Initiative
Organization: National Environmental Education Foundation
Website: Click Here
Description: Training for healthcare providers on “prescribing nature” and on connecting families to natural areas.

Program: Grow Outside: Tools and Resources for Pediatricians
Organization: Children and Nature Networks
Website: Click Here
Description: Links to “nature prescriptions” and sample educational materials, plus information for pediatricians.

Create Affordable, Accessible Outdoor Play/Exercise Options

Organization: KaBoom!
Website: Click Here
Description: A national organization that helps communities build playgrounds.

Program: RecreationRx
Organization: San Diego County Parks and Recreation Department
Website: Click Here
Description: A California program that allows doctors to prescribe recreation and link patients to low-cost recreation options.

Program: Portland Play
Organization: Oregon Parks and Recreation Department
Website: Click Here
Description: A program in the greater Portland metropolitan area that enables pediatricians to connect families with parks and recreation programs.

Program: Make Way for Play
Organization: Healthy Places (an initiative of Healthy Chicago)
Website: Click Here
Description: A Chicago collaborative program striving to make parks more accessible to local residents.

Program: Park Prescriptions
Organization: Institute at the Golden Gate
Website: Click Here
Description: A movement to create a healthier population by strengthening the connection between the healthcare system and public lands across the country.

Advocate for Outdoor Safety

Program: Walking School Bus
Organization: Partnership for a Walkable America
Website: Click Here
Description: This program promotes kids walking and biking safely to school with parents or other adults supervising.

Program: Bicycle Helmet Program
Organization: Bicycle Helmet Safety Institute
Website: Click Here
Description: Information on how to create and implement bicycle helmet programs, providing affordable helmets to patients.

Program: Interactive Demonstrations of Safe Play Areas
Organization: National Children’s Center for Rural and Agricultural Health and Safety
Website: Click Here
Description: For those in rural areas, safe play area demonstrations for farm families can promote active, safe outdoor play areas for kids. This guide outlines how to hold demonstrations.

Program: Safe at Play
Organization: Injury Free Coalition for Kids of Chicago
Website: Click Here
Description: This group, based at Children’s Memorial Hospital in Chicago, helps community organizations build and renovate playgrounds. The coalition is also involved in evaluating playground safety, through playground safety checks and other activities.


  1. Ginsburg KR, Milteer RM, et al. “The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bond: Focus on Children in Poverty.” Pediatrics Vol. 129 No. 1, January 1, 2012, pp. e204 -e213.

  2. CDC Overweight and Obesity. “Childhood Overweight and Obesity: A Growing Problem.”

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Healthy Kids  General Childhood Obesity  General Childhood Obesity 

Monday, March 12th, 2012

Medical Home and Obesity: Connecting Patients to Community Resources

Posted by: Kristi Fossum Jones, MPH

In political and medical circles, the Medical Home is being called a critical part of the solution to our nation's healthcare system. While the term “medical home” may be newly in vogue, the idea of the medical home is nothing new, especially in pediatrics: the AAP started talking about medical homes in 19671. The current definition highlights the unique situation and needs of children: the medical home is a model of patient and family-centered, community-based care that provides continuity of care from childhood through adolescence and facilitates a smooth transition to adult services.2 Implementing the pediatric medical home model is an ongoing focus for NICHQ and other pediatric care organizations in order to achieve higher quality care for kids.

One component of the medical home that is particularly important for childhood obesity is the community-based system:  a patient and family-centered coordinated network of community-based services designed to promote the healthy development and well being of children and their families.3 “Community-based” means services are available in the communities where children and families live, work, learn, and play—not just within the walls of the doctor’s office or hospital. A community-based system with nutrition and exercise programs to support children and families can help to combat and prevent childhood obesity.

Communities everywhere offer a plethora of potentially helpful obesity-related services and programs, ranging from YMCA sports to community gardens, but families may not know these exist and may not know how to access them. The most at-risk families are often the most isolated due to poverty, language barriers, lack of transportation, etc. When children are too young for school, their families lack the community connections that would be facilitated via the school system. 

For some families, the pediatric provider may be their only reliable, regular source of information about child growth and development—and about community resources—until their child starts kindergarten. This is unfortunate because most parents need, and want, good information. Yet it makes a strong case for the unique position healthcare professionals hold as both medical caregivers and providers of  practical information. Indeed, “parents expect their doctor’s office and the health clinic to be a place where they can get reliable community resource information4.” Thus, healthcare professionals working within a medical home are crucial links in the chain between families and community resources.

How can healthcare professionals best connect families to resources? There are several ways.

First, connecting families and community programs can, and should, take place in a clinical setting. Waiting rooms and exam rooms are ideal places for brochure racks that house brochures about local nutrition and exercise programs, written in the languages of the patient population. Pediatric providers could use something like the AAP’s Healthy Active Living Prescription to give families information about community health resources—during a checkup, a pediatrician could write the phone number of the local YMCA on a prescription and give it to a parent. Some practices may already have staff or volunteers onsite whose express role is to help patients access community resources (e.g. Health Leads, Community Health Workers, etc.).

Second, when existing policies are hindering or even preventing efforts to address the causes of childhood obesity, healthcare professionals can use their unique and powerful position to advocate for sustainable changes in their communities. For example, a school nurse could go to the local school board to propose changes to the district’s nutrition policies and provide examples of patient stories that support such changes. NICHQ’s Be Our Voice project trains healthcare professionals in advocacy by providing a curriculum, toolkit, and technical assistance resources for those who wish to become advocates for policy changes that positively impact childhood obesity outside the clinic walls.

Third, if there are insufficient community resources to which families can be referred, healthcare providers can form partnerships or join coalitions to create community programs and services for their patients. This kind of work is happening in NICHQ’s Collaborate for Healthy Weight initiative, in which teams of primary care providers, public health professionals, and community organizations address obesity at the community level. Part of the project is coming up with long-term ways to promote nutrition and exercise plans in communities, which may involve developing new partnerships and new resources. Another example of creating resources is the program Walk With a Doc, in which healthcare providers lead community walks for patients and families to offer healthy exercise options. 

Fourth, healthcare professionals can practice both clinical and community advocacy by joining with external organizations to offer resources onsite. In some places, to meet the needs of those at highest risk, such “one-stop shops” offer medical care and more. For example, the Hennepin County Medical Center Pediatric Clinic in Minnesota has instituted a hospital-based food pantry where food is given to needy patients and families when they come for office visits. This strategy both helps to prevent hunger and, since the food meets clinical nutrition standards, helps address some of the possible causes of obesity.5 On a national level, Kaiser Permanente’s prevention efforts include teaming with local organizations near their medical centers to offer Farmers’ Markets onsite, which increases access to fresh produce for patients, families, and staff.6

Medical homes offer the opportunity for children and families to receive comprehensive, coordinated medical care—and, as part of this, to be connected to community resources that can help them lead healthier, more productive lives. Making these connections is a vital part of addressing and preventing childhood obesity, and it benefits patients, families, and healthcare professionals alike.      


1. National Center for Medical Home Implementation. “History of Medical Home at the AAP.”                       
2. National Initiative for Children’s Healthcare Quality. “Area of Focus: Medical Home.”
3. National Center for Medical Home Implementation. “Family-Centered Medical Home Overview.”
4. Palfrey, Judith. Child Health in America: Making a Difference Through Advocacy. Baltimore: The Johns Hopkins University Press, 2006. Page 107.
5. Barr, Sarah. “Where 'Hospital Food' Takes On A New Meaning.” Kaiser Health News. November 22, 2011.
6. Kaiser Permanente. “Medical Center and…Grocery Store?”   

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Healthy Kids  General Childhood Obesity  General Childhood Obesity 

Friday, February 19th, 2010

$1 Billion to Support Child Nutrition

Posted by: Rachelle Mirkin

US Department of Agriculture Secretary Tom Vilsack held a conference call to outline the Administration’s priorities for the upcoming Child Nutrition Reauthorization. The President has proposed an additional $1 billion per year in new funding in his 2011 Budget to focus on efforts such as: expanding use of direct certification to help more children participate; increasing participation in school breakfast programs; improving the nutritional quality of meals and snacks; and supporting local farmers and ranchers by promoting farm to school programs.

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Tuesday, December 15th, 2009

Joining the Childhood Obesity Movement

Posted by: Rachelle Mirkin, Executive Program Director, NICHQ

Last month I attended a meeting of Robert Wood Johnson Foundation grantees working to reduce childhood obesity across the country.  Over 400 dedicated, motivated and passionate people gathered in Atlanta, GA to catalyze the “movement.”  This got me thinking of the word movement?  Is there a movement?  Am I part of the movement?  What is the movement?

My mind first goes to my internal organs – I guess too many years of being around the practice of healthcare.  Then, quickly realizing we are not talking about my innards,  I switch gears.   My first reaction is a very excited “yes!” (not to look a gift horse in the mouth, this is a RWJF grantee meeting, and I am a grantee).  But then, I remember the reality that obesity among children has reached epidemic proportions and everywhere I look I see a fast food outlet or soft drink advertisement.

I am stumped.  How can I make a difference in this environment? 

What’s to be done?  As I often do, I go straight from denial to anger to action.  I quickly realize I can no longer  sit back and watch the ads with a soda in my hand.  It is time to take a stand. 

Just as I was sitting back, noshing on pre-Thanksgiving dinner appetizers, I was struck by the voice of our President.  President Obama was suddenly on the screen talking about  choosing healthy foods and getting active.
I was immediately inspired to share President Obama's commercial with my colleagues at NICHQ. I wanted to help push the momentum of this movement within my team at the office. Movement is all about energy and as the team and I worked in the final weeks to launch this advocacy Web site, I hope to encourage all of those I work with that they can be advocates, too.

So, this is it.  Advocates of all kinds, from the White House to the NFL to my family sitting at the Thanksgiving table, and to my colleagues educating others on the benefits of helping kids, and ourselves, get active. I see our White House growing vegetables and fruits, a First Lady talking about the issues and the White House Chef eating with kids at their school meals.  YMCA’s, Boys and Girls Clubs, schools, and workplaces such as SAS and Google are making strides to offer healthy choices for their employees.  Research and articles are published on a daily basis.

How do all these great pieces translate into a movement?  Federal action, state action, local action and of course, those 400 + individuals. 

As President Obama says, I would like to give a “Shout out” to those colleagues and to say, yes, I am proud to be part of the movement. 

What inspires you to be part of the movement?

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Healthy Kids  General Childhood Obesity  General Childhood Obesity