Early childhood health promotion programs implemented in healthcare settings can complement existing clinical
services. There are many ways clinics, hospitals, and other healthcare providers, can help children and families
achieve and maintain healthy lifestyles. Well-child visits, for example, provide routine touchpoints for
providers to encourage healthy development. Healthcare providers can screen for and diagnose overweight or
obesity, provide treatment plans, offer education about healthy lifestyles, and refer patients to community
resources. Additional health topics that can be discussed in the healthcare setting include physical
activity, nutrition, mental health, and emotional development.
Healthcare-based programs can also address the benefits of breastfeeding. Education and support from healthcare
providers and lay health workers increases
initiation, duration, and exclusivity of breastfeeding, especially among women with low incomes.
Examples of Healthcare-Based Models
The Institute for the Advancement of Breastfeeding & Lactation
Education is a nonprofit organization that promotes and supports breastfeeding in the
outpatient setting. It focuses on:
Education of outpatient care
Guidance in developing and sustaining breastfeeding support networks within medical systems
Breastfeeding support coordination among hospitals, healthcare systems, and communities
Distribution of educational resources
The organization provides a basic course that teaches optimal breastfeeding triage skills and problem-based
management. The Institute also provides podcasts, printable
breastfeeding fact sheets, videos,
photos, and a sharing library for families or anyone learning about breastfeeding.
Ready, Set, Baby is an
educational program designed for healthcare providers to counsel pregnant women about maternity care and
breastfeeding. Offered in English and Spanish, this free tool consists of a patient booklet, educator flip
chart, and an implementation guide. All materials are available to be printed and are designed to accommodate
lower literacy levels.
Reach Out and Read integrates
reading into pediatric visits, encouraging families to read to their children from a young age. Reading out loud
to a young child improves their health and well-being by cultivating their communication skills and promoting
brain development. Through this program, pediatricians “prescribe” reading during well-child checks
and provide a book to families. Reach Out and Read offers programs tailored to the unique needs of different
groups, including children with developmental disabilities, Spanish-speaking families, American Indian/Alaska
Native families, and military families.
Bright Futures is a
national health promotion program led by the American Academy of Pediatrics. The program is designed to support
pediatric primary care practices by offering evidence-based guidance for well-child visits and other clinical
care screenings. The program offers recommendations, tools, and resources to address a variety of health needs.
Materials are available in Spanish. Health topics include healthy development, mental health, healthy weight,
nutrition, physical activity, oral health, and injury prevention.
Therapy (CBT) reduces psychological harm to children who have experienced traumatic events,
especially violence. CBT may be offered to an individual or in group therapy sessions. It is usually
administered by a clinician with a doctoral degree, or by a professional with a graduate degree, such as a
social worker. Benefits of CBT include decreased shame, increased trust, and improved emotional strength.
Considerations for Implementation
Cultural adaption. Evidence indicates that culturally
adapted healthcare — adjusting services and communication to different audiences — improves
health outcomes and mental health. For example, the evidence is particularly
strong for children
with asthma as it improves both patient and caregiver understanding of the condition.
Staffing. There is a shortage of healthcare
providers in many rural areas. This may create understaffed healthcare clinics which leads to increased
workloads and long shifts with increased demands on time. It may not be feasible for providers to introduce a
new intervention into their services. Healthcare providers' competing demands should be considered before
considering which, if any, types of healthcare-based programs will be implemented. Additionally, interventions
like Cognitive Behavioral Therapy that require a provider with an advanced degree may not be feasible to
implement in some settings experiencing workforce shortages.
Resources to Learn More
TeleFIT: Telehealth to Assist with Pediatric
Obesity in Rural Populations
Examines the impact of TeleFIT, a telehealth initiative that established four rural satellite clinics to
increase access to pediatric obesity healthcare services in rural communities.
Author(s): Irby, M.B., Boles, K.A., Jordan, C., & Skelton, J.A.
Citation: Telemedicine Journal and E-Health, 18(3), 247-249