The Ribbon Newsletter

Reeve Chace, M.P.H.
Research Coordinator, The Community Outreach and Translation Core
Mount Sinai School of Medicine Breast Cancer and Environment Research Center

The Hip Hop Dance Party. The Central Park Scavenger Hunt. Cells, Genes, and Protein Machines. These may not sounds like the typical components of a research study, but they are integral to the success of the Growing Up Healthy study at the Mount Sinai School of Medicine's Center for Children's Environmental Health and Disease Prevention Research in New York City.

Children who enroll in Growing Up Healthy, a longitudinal study of environmental exposures during puberty, are invited to these activities on a regular basis in an effort to keep them involved with the study while educating them about the environmental health issues the study is intended to address.

The activities are planned and created by the Community Outreach and Translation Core (COTC), directed by Dr. Luz Claudio and managed by Reeve Chace, of the Mount Sinai School of Medicine. In addition to invitations to events, the COTC mails fact sheets, health bulletins, study updates, and special materials to participants' homes to keep study members involved in the research. The Growing Up Healthy study (GUH) is one of three epidemiological studies being conducted by the multi-site Breast Cancer and the Environment Research Centers, jointly funded by NCI and the NIEHS.

The goal of the COTC is two-fold. First, the aim is to engage children and their parents in the activities of the COTC for the duration of the five-year study. Participants only need to see study staff once per year, so the COTC aims to bridge the distance between study visits and maintain interest in the study by offering participants unique opportunities for fun and education. Second, the COTC aims to instill in study participants the sense that they are our partners in the scientific process.

Most participants in the Growing Up Healthy Study live in low-income, minority communities in East Harlem and the Bronx, NY. A key to engaging this population and building their trust has been our partnership with community-based organizations that already provide services to residents of these communities. For example, the COTC has partnered with the City Parks Foundation, an organization dedicated to increasing environmental awareness among New York City children, to bring its hands-on science programs to Growing Up Healthy enrollees. During the February school vacation of last year, the City Parks educators came to the Mount Sinai COTC laboratory bearing bugs and magnifying glasses for a series of workshops entitled Make Your Own Nature Journal. The educators encouraged the Growing Up Healthy kids to take a closer look at the creatures they can find in the park right outside their doors, and helped them increase their powers of observation by asking kids to record their observations in a home-made Nature Journal.

Another successful partnership was formed with Amy Jordan, who founded the organization Sweet Enuff to raise awareness of diabetes through dance. Jordan, who herself suffers from Type I diabetes, helped the COTC organize a highly successful Hip Hop Dance Party, held on Martin Luther King Day at the Julia de Burgos Cultural Center in East Harlem, a well-known community center. Jordan heads up a volunteer troupe of teenage dancers she calls Youth Ambassadors, who began the program by performing a dance routine. They then engaged the kids in an interactive discussion about healthy versus unhealthy foods. Finally, the Youth Ambassadors taught the kids a series of new dance routines, reminding everyone that exercise can be fun.

When not partnering with community organizations on health- or science-promoting activities for children, the COTC reaches out to parents and guardians of participants in ways that are intended to fill the needs of parents with young children, especially those who are low-income. For example, during the first week of September, the COTC purchased backpacks through the non-profit organization Kits for Kidz, filled them with basic school supplies such as notebooks, crayons, glue sticks, and pencils, and distributed them to over 100 study participants for our 2006 Back-to-School Backpack Giveaway. Parents were impressed with the quality of the backpacks, and appreciated the time and money saved by not having to do as much back-to-school shopping with their children. The backpack giveaway was a boon to parents, and it had the added bonus of aiding the COTC in its retention efforts, as research staff were able to follow up with participants when they came into the office to pick up their backpacks.

Similarly, just before the December holidays, the COTC held the Growing Up Healthy Photo Studio, a week-long event in which we transformed our lab into a "professional" photo studio. We purchased an inexpensive backdrop featuring a snow scene and snowman, took digital portraits of children posed alone or with siblings, parents, or grandparents (or whomever came along), and printed out the photos on the spot with a digital photo printer. Children decorated inexpensive cardboard frames with craft supplies, and then had portraits of themselves in a handmade frame to keep or give as gifts for the holidays. Many parents requested several copies of the photos, and one mother told us that she'd never before had a photograph of her two daughters together. Again, while generating goodwill and providing children and their relatives with a fun holiday activity, the event also gave research staff another opportunity to connect with participants between study visits.

To supplement the activities and events on offer, the COTC also develops and disseminates environmental health materials. Some materials are specifically tailored to study participants, such as the Kids in Action newsletter, which is mailed out to the study cohort twice a year. The newsletter updates participants on important Growing Up Healthy study news, past COTC events, community resources, and other health information. Other materials, like the COTC Health Bulletins, provide environmental health information that is applicable to both study participants and the community in general. In the summer, we created fact sheets that listed the locations of all the farmers' markets in East Harlem and the Bronx, where most of our study participants live (see fact sheet below). With the help of medical students experienced in GIS mapping, we also created two different maps of East Harlem that showed the locations of public playgrounds and food stores with healthy options available (see map in Spanish, opposite page). Another map, entitled "East Harlem School Zones Are A Junk Food Target" graphically depicted just how close fast food stores are to local public schools.

One of our most popular items has been the credit card-sized, bilingual Pocket Guide to Plastics. Initially, we had created a fact sheet called the "Quick Guide to Safe Plastics" that we planned on mailing to our study participants. But at a Community Advisory Board meeting, a board member suggested that we develop something more long-lasting than a piece of paper, which would most likely be thrown away after one viewing. As a direct result of this suggestion, we came up with a laminated card that easily fits into a wallet, and graphically depicts the recycling symbols of the "safer" plastics on one side and those that should be avoided on the other (see card graphics, right). The card was mailed to participants with the fact sheet, and has also been distributed at health fairs and conferences, like the 3rd Annual Symposium of the Breast Cancer and the Environment Research Center in San Francisco. To date, copies of the cards have been requested by physicians, scientists, public health officials, breast cancer advocacy groups, community members and others nationwide.

As the Growing Up Healthy study progresses, the COTC plans to continue to tap into community resources and piggyback on already existing public health programs to give our participants the greatest access to all the health promoting resources available to them. Public health education is a collaborative endeavor, and in addition to the programs and activities originating with the COTC, we want to make Growing Up Healthy participants aware of and encourage them to take advantage of other programs already existing in the community.

A recent activity demonstrates how the COTC both benefits from and helps disseminate the message of other health agencies. The New York City Department of Health recently partnered with the State Department of Agriculture on the Healthy Bodegas Initiative, a city-wide effort to increase access to healthy foods in low-income neighborhoods by encouraging bodegas to carry new snack packages of sliced apples and baby carrots. In an effort to support this initiative, the COTC ordered 100 of these snack packages to give out at our Hip Hop Dance Party. The distributor was so impressed with the mission of Growing Up Healthy that he donated the snacks free of charge; in turn, COTC was able to promote the availability of these new products to the 200 community members who attended the dance party, while simultaneously introducing the children in the study to a wholesome, delicious snack available in their neighborhood food stores.

As the COTC moves forward through the next four years, we plan to continue to offer participants an ongoing menu of fun and educational activities adapted to the needs of the children in the study as they grow older. We recently began distributing "Young Scientists' Club" membership binders to study participants, where they can keep a library of the fact sheets and newsletters we send them, and can track their study progress using special Growing Up Healthy stickers, mailed to them upon completion of each study component. In addition, a comic book is in the works, featuring our specially-designed Growing Up Healthy mascot, Enviro-Gurl, renamed Starr of Health by a participant in one of our newsletter contests. Through these efforts, the COTC aims to keep study attrition to a minimum while increasing environmental health literacy in the East Harlem community served by the Mount Sinai Medical Center.

For further information, please contact Reeve Chace at:
Mount Sinai School of Medicine
Dept. of Community and Preventive Medicine, Box 1057
One Gustave L. Levy Place
New York, NY 10029
Tel: 212-241-1233
Fax: 212-996-0407
reeve.chace@mssm.edu

Growing Up Healthy in East Harlem and the Bronx, NY The Ribbon

Growing Up Healthy in East Harlem and the Bronx, NY
The Ribbon