The Fair Haven Community Health Center Visits the Peabody Museum’s FOOD EXHIBIT!!

Written by guest blogger Emilie Swenson

“Quien le gustaba el museo hoy?”  (Who liked the museum today?)  I asked in the van on the way back to Fair Haven.  Of my six passengers, everyone raised their hands!   Participants from the Diabetes Prevention and Bright Bodies programs took a field trip last Tuesday, April 17^th, to the Big Food exhibit at the Peabody Museum.  Tickets were generously donated by the Peabody Museum for the free entry of 38 patients and five program facilitators. The exhibit explores culture and eating, and focuses on many of the issues that participants learn about through the healthy lifestyle programs they attend through the Fair Haven Community Health Center.  The groups walked through the exhibit with Elizabeth Magenheimer, APRN CNM CDE, who used the exhibit to solidify many of the concepts about healthy eating she teaches in the weekly lifestyle program curriculum.  Participants balked at the amount of food one person consumes in a year—eight whole pizzas, many liters of soda, gallons and gallons of milk, and stacks of boxes full of vegetables.  They took examined nutrition facts and compared snacks, learning more about which snacks are good to eat (given a green light in the exhibit), and those to stay away from (red light)!

One of the main topics that is discussed during the education portion of these programs is how to look for healthy foods, how to make healthier choices, how to understand portion sizes, and how to be active.  This exhibit combined many of these things in interactive ways.  As we walked through, we talked about beverages—looking at the many teaspoons of sugar contained in different beverages—from Coke to Iced Tea to Capri Sun, realizing that water really is the best option!  We also saw how portion sizes have changed throughout the years; many foods like bagels have doubled in size over the past 20 years!  There was a display of a reclining youth, laying in bed, one hand in a bag of chips, and a can of soda beside his bed, remote in hand, TV on.  We talked about what was unhealthy about his behavior, and how we can all make changes.  No Chips, No Soda, and No TV, were all ideas mentioned by the children.

By far the biggest hit of the exhibit was the stationary bike that powered a light – the harder you peddled, the higher up on the wall the light went.  The kids and parents (and even nurse practitioner) tried their hand (or legs) at this activity while a crowd of onlookers cheered them on.  It was a great adventure to visit the Big Food exhibit in the museum and reinforce the concepts they are learning in their healthy lifestyle programs. Thank you to the Peabody Museum for hosting us!

Come Exercise with Us! FHCHC DPP’s Exercise Class Video!

Check out the FHCHC DPP’s latest video, and do the health-enhancing exercise video with us! No fancy equipment or space needed!

FHCHC DPP Partners with Wholesome Wave and City Seed to Provide Farmer’s Market Vouchers to Patients!

This summer, FHCHC’s Diabetes Prevention Program is partnering with City Seed and the Wholesome Wave Foundation to provide farmer’s market vouchers to our patients. The program is called the Fruit and Vegetable Prescription Program (FVRx), and aims to improve health through access to farmer’s markets.  Medical facilities across the country will be participating this year in the program, and measuring the effects on patient health through the 4-month market season.

Frederico Corazzini - Photographer

The FVRx program is perfectly aligned with our commitment to utilize innovative and practical strategies for improving the health of our patients. Obese children constitute the index patient – however, each of the index patients’ fellow household members receive $1/day each as well for use at the farmer’s markets. This feature of the program further supports the FHCHC DPP’s commitment to treating the entire household unit, and strays from traditional medical models that focus exclusively on the individual patient. Because diet-related chronic diseases often develop in the home, programs that include all household members tend to produce better results!

For more information on the FVRx Program, go to: http://wholesomewave.org/fvrx/

For more information on FHCHC’s farm-based activities, check out New Haven Farms: newhavenfarms.org

Fresh Direct, US/Mexican Style

One of the Diabetes Prevention Program participants, Anna for the purposes of this story, took it upon herself to prepare a distinctly Mexican salad for one of our nutrition class cooking demos this week. When collecting her receipt for the ingredients, I faintly balked. It was hand-written in pencil, and torn from a common academic three-ring binder. I sheepishly asked her whether she had a proper receipt, from the store in which she had purchased the vegetables. Then Anna tells me the most fascinating story.

Every week, she gets a call from a fruit and vegetable vendor asking whether he should come by on Saturday. Most weeks Anna says yes.

Around mid-day she hears someone knock at her front door. She descends the stairs of her own home, and proceeds to shop for good looking vegetables and fruits in the bed of this man’s pick-up truck! Indeed, the vendor brings his best vegetables and fruits to peoples’ doorsteps every Saturday for sale.

When I asked why she shops with him, as opposed to going to the store just over a mile from her home, she asks with patience how, exactly, she should shop without transportation? ‘ “Besides,” she explains, “he knows what we cook and always have exactly what we need for our favorite meals.”

Incredible the kinds of resources people with difficult circumstances create for themselves to meet their needs. If we continued to tap into this informal network, perhaps we could get even more vegetables and fruits on people’s tables on a daily basis, thereby lowering their risk for diet-related chronic disease!

The ingredients receipt!

Diabetes Prevention Program Nutrition Classes & Cooking Demonstrations

Since 2007, the Fair Haven Community Health Center’s Diabetes Prevention Program (FHCHC DPP) has offered 1-hour nutrition classes once per week for participants in the 12-week Intensive Lifestyle Intervention. The nutrition curriculum is based on the National Institutes of Health’s Diabetes Prevention Program curriculum, amended by the University of Pittsburgh to fit larger groups, and further translated to fit FHCHC’s particular low literate and predominantly Latino population. Classes are taught by FHCHC DPP clinicians, and are delivered in both English and Spanish. Bilingual PowerPoint presentations and handouts support participants in understanding the content of each session, while detailed facilitator scripts and facilitator guides support facilitators in addressing the widely diverse needs and experiences of participants. Cooking demonstrations and discussions are an experiential learning component of each class, and foods prepared each week reflect the ripe produce harvested that week from the program’s garden. Between 10-20 adults attend classes on a weekly basis, and often that same group stays the next hour for a professional trainer-led exercise class. Children attend their own exercise classes during the adult nutrition and exercise classes, while infants and toddlers attend onsite childcare. Aligned with the notion that diabetes is a family-oriented disease, when one patient is invited to attend nutrition classes, DPP staff invites members of the patient’s family to attend as well.

OGTT Sketch

Some drink the Glucola solemnly, obediently. It’s unclear whether they know the full extent to which we are testing their health status this morning. Others seem somewhat nervous, and still others chat away cheerfully until their name is called for the needle and flat orange sugar drink event.

The kids are restless, sucking on the backs of chairs as they watch the phlebotomy, or any sign of movement in the room.

The best is the tough guy with the mohawk. His name is called and he stays sitting, in a sheepish stand-off with the clinician’s assistant. And then, as he eventually pulls his tee shirt up over his tattooed forearm, he describes how much he hates needles.

Amazing how for style or nostalgia, an inked needle is welcome! And for an oral glucose tolerance test, it is so thoroughly resisted.

And yet resistant or not, bored or cheerful, nervous or curious, the 21 adults and their families present today will leave here with knowledge of diabetes, their risk, and some implementable-tools for improving the quality of their health. Cheers to them!

Tatoo!

OGTT!

Where have all the Registered Dietitians Gone?

Interestingly, the Fair Haven Community Health Center has struggled to find a registered dietitian (RD) for our Diabetes Prevention Program vacancy. At the outset, we had no concerns about our ability to obtain qualified candidates. And yet, as search stretched from weeks to months, we discovered that we were sorely mistaken. It turns out that a “Bilingual (Spanish/English) Registered Dietician” is a rare commodity.

Why, we wondered, is it that bilingual dieticians are scarce?

Theory: the return on investment is too low.

Many folks coming from underprivileged backgrounds are interested in working in the health field. When they explore their options, two professions seem to fit their criteria: becoming a nurse and becoming a registered dietician. There is a demand in the market for both, the living is decent in either case, and in each profession provides an opportunity to make a difference in people’s health. So how do they choose?

They look at the cost and duration of each degree.

At Gateway Community College, located not far from the Fair Haven Community Health Center, a state resident can earn an associates nursing degree in 2 years, or 4 semesters, for a grand total of $6,192. This is one of many community, state, and private institutions that offer nursing degrees.

Now take a registered dietitian degree. First off, there is just one such program in Connecticut, located in Storrs at UCONN. In order to earn this degree, read the following passage taken from the program website:

To become an RD, a student must earn a four year degree and complete a didactic program in dietetics that is accredited by the Commission on Accreditation of Dietetic Education(CADE).  Upon completion, a verification statement that verifies you completed a didactic program in dietetics.  You are then eligible to apply to a supervised practice program, also called a dietetic internship that is accredited by CADE.  An internship typically lasts 9 months and consists of at least 1200 supervised practice hours in the field.   Upon completion of an internship, he/she is able to sit for the national registration examination administered by the Commission on Dietetic Registration (CDR). http://www.canr.uconn.edu/nutsci/nutsci/dietetics.html

Four years of study at $8,256 equals $33,024.

Now look again at your choices: two years to become a practicing nurse in the field for $6,192, OR a minimum of 4 years plus a 9-month internship to become a registered dietitian, at a minimum cost of $33,024.

You may be thinking yes, but I can make a lot more money as a registered dietitian once I have the degree! Think again. A registered nurse makes between $21-$45/hour. An RD earns between $15-$36/hour.

There may be many reasons that people become registered dietitians; but cost and duration of the degree are certainly not two of them. The result of these aggravating factors is a scarcity of registered dietitians. Those who are bilingual often come from economically disadvantaged conditions, and although they are precisely the kinds of job candidates we are searching for, they are the people who can scarcely afford the 4 years 9 months and $33,024 cost of becoming registered dietitions.

 

 

What is the SINGLE BEST THING WE CAN DO FOR OUR HEALTH?

A Real Garden Tour Video Adventure!

Watch the Fair Haven Community Health Center Diabetes Prevention Program Program Coordinator and Garden Manager give you a virtual tour of the program garden! It’s almost as awesome as being there physically.

http://youtu.be/IqVGRVhzAa0