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Healthcare-Based Programs

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 providers
  • 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.

Cognitive-Behavioral 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
Document
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
Date: 4/2012