School Health Centers win BCBS TIEs award for obesity program

Gina Smith (left) and Christina Turbeville are shown with the certificate noting the Blue Cross Blue Shield of North Carolina Foundation’s recognition of the FirstHealth Montgomery School Health Centers. Smith is the family nurse practitioner for the School Health Centers program, and Turbeville is the program’s nutrition educator.

BISCOE – The Blue Cross and Blue Shield of North Carolina Foundation has recognized the FirstHealth Montgomery School Health Centers with a $10,000 Community TIEs Award for its innovative childhood obesity initiative.

The award was one of three Community TIEs awards given to nonprofit organizations that excel in their service to the community. The awards recognize excellence in the use of technology, innovation and evaluation and were presented this year in partnership with the North Carolina School Community Health Alliance.

The FirstHealth Montgomery School Health Centers (SHC) award was for their “exemplary” evaluation of childhood obesity and recognized an initiative that involved the collection of Body Mass Index (BMI) data for all students in Montgomery County Schools for the past three years – data revealing that 47 percent of the students are overweight or obese.

The FirstHealth Montgomery School Health Centers are located at East Middle School in Biscoe and West Middle School in Mt. Gilead and are operated by FirstHealth of the Carolinas and Montgomery County Schools. The two centers provide comprehensive on-site medical, mental health and nutritional care that is open to any child in the Montgomery County School System.

Collected in partnership with school staff, school nurses and the School Health Centers staff during the 2007-08, 2008-09 and 2009-10 school years, the disturbing BMI information on Montgomery County students prompted a concerted effort to combat the problem.

“We have been collaborating with the Montgomery County Schools for the past three years to compile BMI data that revealed a much higher percentage of overweight and obese students than state and national averages,” says Gina Smith, the family nurse practitioner for the FirstHealth Montgomery School Health Centers. “Since then, we have developed and implemented strategies that have proven to be successful in decreasing obesity, especially with students who have been seen for two or more nutritional counseling sessions at the School Health Centers.”

According to Smith, the SHC childhood obesity initiative included several components, each achieving specific successes. Early in the BMI collection process, third-graders at Page Street Elementary School were found to have the most overweight/obese students in the school system, a fact that produced a program specifically targeting those children. The HEAP (Healthy Eating Active Play) program developed by Smith, nutrition educator Christina Turbeville and registered dietitian Joanne Rinker began with a pre-test/post-test evaluation of each child’s knowledge of healthy eating and physical activity as well as child-friendly handouts for home use.

The program won the 2008 NC Stars Fruits and Veggies Award and has since been presented to other grades with the highest percentages of overweight and obesity.

For the past two years, the SHC staff has conducted nutritional assessments of all middle school students registered to receive SHC care by collecting height/weight/BMI and administering a quiz about nutrition and physical activity. Students found to have a BMI greater than 85 percent were referred for nutritional counseling. Students whose BMI was unchanged or had increased after two counseling sessions were referred for a third session during the 2008-09 school year and a fourth if the BMI was again unchanged or increased during the 2009-10 school year.

BMI was evaluated at each visit, with a significant number of students decreasing their BMIs – 60 percent during the 2008-09 school year and 88 percent during the 2009-10 school year. Whether reached by Smith, Turbeville or registered dietitian Melissa Herman (who sees students with BMIs greater than the 99th percentile), the message is always the same.

“It’s about being healthy and feeling good,” says Turbeville. “It really is.”

Smith says she, Herman and Turbeville focus on BMI, not weight and praise even the smallest losses. “The students are beginning to do a lot of the things we’re telling them,” she says.

The three also talk to students about the high incidence of weight-related diabetes in Montgomery County, noting the importance of healthy choices about diet and physical activity in preventing the disease. Since many of the children have relatives with diabetes, “They can relate to that,” Turbeville says.

The two other BCBS Community TIEs award went to the School Health Alliance for Forsyth County (innovation) for a mental health consultation clinic for ages 10 and older and to Wilmington Health Access for Teens (WHAT) (technology) for an electronic medical record system that covers all of its sites in New Hanover County.

The $10,000 financial award to each program is unrestricted.

“The work of these partnerships between schools and communities to provide affordable, quality physical and mental health care to adolescents is so critical to the health and education successes of our youth,” says Kathy Higgins, president of the BCBSNC Foundation. “Recognizing nonprofits for their work in technology, innovation and evaluation is important to the Blue Cross and Blue Shield of North Carolina Foundation as we continue our work to strengthen the nonprofit community in our state.”

Established in 2000, the Blue Cross and Blue Shield of North Carolina Foundation is dedicated to improving the health and well-being of North Carolinians through a focus on three key areas: improving health outcomes of populations served by safety net organizations, increasing physical activity and encouraging healthy eating habits, and increasing the effectiveness of nonprofit organizations. More information on the Blue Cross and Blue Shield Foundation of North Carolina is available at www.bcbsncfoundation. More information on the FirstHealth Montgomery School Health Centers is available at www.firsthealth.org.