Community nurses lead way with nutrition programs

When Courtney Jones, BSN, RN, was a school nurse at Dunbar High School in Washington, D.C., back in 2011, she and two colleagues started a group called The Ladies of Dunbar to mentor and support the school's female students. "We saw that the female students needed formal guidance in things like proper hygiene, how to dress for a job interview and how to prepare for college, among other things," Jones said. As a healthcare professional, however, Jones made sure the group also incorporated lessons in good health. "Being the nurse, I wanted to include a wellness and nutrition component as well." The Ladies of Dunbar would meet a couple of times a week after school to learn life skills and discuss diet and nutrition. "We talked about eating right and the types of foods they should and should not eat," she said. "Their diets consisted of lots of carry-out foods so we would discuss alternatives to the foods they were purchasing." Like Jones, who is now interim nurse manager, Ward 3, for children school services at the Children's National Health System in Washington, D.C., nurses throughout the U.S. realize the importance of healthy eating. Many have either created or manage programs that provide lessons in weight management and nutrition in lower socio-economic urban areas where access to fresh fruits and vegetables may be limited. In 2010, Susan C. Kay, MSN, RN, CPNP, a pediatric nurse practitioner at Nassau University Medical Center in East Meadow, N.Y., decided to take action after her health system's philanthropic foundation conducted a study of sixth- and eighth-grade students in the Roosevelt (N.Y.) Union Free School District that found 44% of the students in the Long Island school district were overweight or obese, higher than the CDC's national average of about 30%. Using a $50,000 grant from the Long Island Community Foundation, she led a program to enhance the diet, nutrition and fitness of the children and their families. In addition to educating families about the healthy plate, staff at Roosevelt Middle School taught families to read nutrition labels and educated them on the adequate daily consumption of fruits and vegetables through the use of school health fairs. "With the use of a computer, we did virtual food shopping to help them make healthy choices or healthy substitutions for their favorite foods," she said. Kay also runs an obesity clinic at NUMC for children in mostly indigent populations. "We provide nutritional counseling and try to encourage them to exercise," she said. "We don't have a formal exercise program here but we help them find resources within their communities for programs that would work best for them." Staff members also teach nutrition and food label reading. "We educate them on fast foods and teach 'think before you drink' and 'eat this not that'," she said. At Stephen and Sandra Sheller 11th Street Family Health Services of Drexel University -- a community-based center that services residents of four public housing developments in North Philadelphia -- patients have access to health and wellness programs that include fresh produce for purchase and group and individual cooking classes on preparing healthy meals. "Cooking classes are offered free of charge to patients and are given twice a week for adults," said Patricia Gerrity, PhD, RN, FAAN, director of the center and associate dean for community programs at Drexel's College of Nursing and Health Professions. "We also have a youth class, Teens in the Kitchen, and a cooking class specifically for pregnant women." Gerrity said the center participates in two programs that bring fresh produce to patients. "We participate in Farms to Families, which gives people access to healthy foods like fruits and vegetables at a low cost," she said. "They can even use their [Supplemental Nutrition Assistance Program] card to buy $30 worth of fruits and vegetables for about $10 to $15." The exchange takes place once a week and includes recipes. A small, urban farm also is part of the health center, Gerrity said, and sometimes that food is available for use in the cooking classes. "We also work with a group called Teens for Good who helps with our farm and who also have a farm about two blocks away from us," she said. Gerrity said the center will be expanding to double its size of 17,000 square feet with the hope of including a commercial kitchen, something the community has been asking for. "If the kitchen was commercially graded, we could prepare and sell food," she said. "The community wants access to high nutrient foods like smoothies, salads and wraps." The center's fitness trainer runs a Biggest Loser group and provides a Polar Fitness Assessment that gives patients their fitness age. "He actually takes patients to the grocery store and talks to them about how to eat. He's really a health coach," Gerrity said. "Access to clinical care is important but that alone is not going to make you healthier. You need all these supports to take charge of your health."