CHMP Senior Fellows Research Projects
SENIOR FELLOW May May Leung, PhD, RD.
My research activities focus on the development and evaluation of innovative school and community-based nutrition and physical activity interventions to reduce the risk of childhood obesity, in primarily low-income and minority populations. One of my projects is the development and evaluation of a health communication media in the form of a Manga (Japanese-style) comic to promote fruit consumption in middle-school youth. I also use community-based participatory research methods, such as Photovoice, to engage and empower youth. In addition, I focus on the translation and dissemination of evidence-based interventions and policies to reduce the risk of chronic diseases.
Proposed Project: Understanding what a child-friendly nutrition and physical activity environment is in New York City: A Photovoice project
School-age children residing in urban communities are at risk for obesity due to multiple factors unique to their environment, such as higher crime rates, poor lighting and industrial sites located adjacent to homes.1 In New York City (NYC) alone, nearly 40% of public school children grades K-8 are overweight or obese,2 with those residing in low-income neighborhoods reporting higher rates than the rest of NYC.3 Environmental determinants such as neighborhood design, access to green spaces and recreation areas, and accessibility to fresh produce have been associated with physical activity engagement and nutrition behaviors, therefore, may play major roles in reducing the risk of obesity among urban youth.4 While policy and environmental approaches are particularly well suited as obesity prevention efforts,1 they are challenging to implement and reinforce. Creative ways must be found to engage both community members and political leaders around policy and environmental solutions to obesity-related public health issues concerning urban youth.1,5,6
Photovoice is a unique community-based participatory action research method that involves placing cameras in the hands of community members so that they may visually represent and communicate their experiences.7 This method has been shown to be one of the most promising strategies for engaging both residents and policy makers in efforts to improve the health of communities.1 Given its creative approach and two-tiered effect on self-empowerment and community activism, photovoice may be an ideal strategy to better understand children’s perceptions of environmental barriers and facilitators to physical activity and nutrition and to potentially inform policies that ultimately promote a more child-friendly nutrition and physical activity environment.
The purpose of this research is to identify perceived barriers and facilitators of physical activity and nutrition behaviors among urban youth living in a low-income, urban setting to reduce the risk of childhood obesity.
1. Kramer L, Schwartz P, Cheadle A, et al. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative. Health Promot Pract. 2010;11(3):332-339.
2. Egger JR, Bartley KF, Benson L, Bellino D, Kerker B. Childhood Obesity is a Serious Concern in New York City: Higher Levels of Fitness Associated with Better Academic Performance. NYC Vital Signs 2009, 8(1): 1-4.
3. Noyes P, Alberti P, Ghai N. Health Behaviors among Youth in East and
Central Harlem, Bedford-Stuyvesant and Bushwick, and the South Bronx. New York, NY: NewYork City Department of Health and Mental Hygiene, 2008.
4. Hennessy E, Kraak VI, Hyatt RR, et al. Active living for rural children: community perspectives using PhotoVOICE. Am J Prev Med. 2010;39(6):537-545.
5. Fitzgerald E, Bunde-Birouste A, Webster E. Through the eyes of children: engaging primary school-aged children in creating supportive school environments for physical activity and nutrition. Health Promot J Austr. 2009;20(2):127-132.
6. Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J. An ecological approach to creating active living communities. Annu Rev Public Health. 2006;27:297-322.
7. Wang C, Burris MA. Empowerment through photo novella: portraits of participation. Health Educ Q. 1994;21(2):171-186.
Nursing, Media and Public Policy: An Analysis of the Profession’s Response to the ProPublica Series on the Performance of the California Board of Registered Nurses
From October 2008 through 2010, Pulitzer-prize winning ProPublica journalists Charles Orsnstein and Tracey Webber produced a series of investigative reports on the disturbingly long length of time that the California Board of Registered Nursing (CBRN) took to act on complaints against nurses. The series entitled “When Caregivers Harm: America’s Unwatched Nurses” (www.propublica.org/series/nurses) reported that the board took an average of 3.5 years to act on complaints that included sexual assault of patients, substance abuse, and repeat medication errors. In June of 2009, then Governor Arnold Schwarzenegger terminated the entire board of nursing, and its appointed executive director resigned shortly thereafter. The response of many in the nursing community, including organized nursing, was to accuse the journalists of “picking on nursing” rather than supporting the call for expeditious handling of complaints against nurses in a way that would protect the public against unsafe practitioners.
This in-depth study examines key stakeholders’ responses to the intersections between media and policy as they occurred around the series “When Caregivers Harm”. Using a case study methodology, the researchers will interview public officials, organizational leaders, members of the CBRN, journalists, and others involved in the investigative series or who responded to it; written documents will also be analyzed. Specifically, the study aims to answer the following questions:
1. What are the responses of local, state and national nurse leaders and nursing organizations, public officials, and other key stakeholders to media disclosures of inadequate regulation of nurses? What are the policy implications of these responses?
2. What are the factors that influenced nurse leaders’ and organized nursing’s vs. public agencies’ responses to media disclosures of the shortcomings in regulating nurses?
3. What do nurse leaders and nursing organizations perceive to be the role of media in shaping legislation and regulations that promote health and protect the public from unsafe practitioners?
4. How can nurses and organized nursing be better prepared to use media in constructive ways to shape legislation, regulations, and system-wide changes that will promote the health of the public?
SENIOR FELLOW Liz Seegert, M.A.
Seniors, technology, and the digital divide –
As our society continues to “go digital,” one group of Americans is being left behind. Many seniors, especially those who are homebound, low-income, and ethnic minorities, have few opportunities or financial means to access and use the Internet. Several studies have shown that being “wired” helps alleviate social isolation and depression, improve cognitive function and overall health. On both federal and local levels, billions are being poured into health technology, yet questions remain about how the most vulnerable, and the most medically needy populations will be empowered to obtain and use this technology.
New York City, with its 1.1 million seniors, is a prime example of this gaping chasm between active, engaged, mobile elderly, and those who cannot afford or use computer technologies to improve health and lifestyle. I am investigating and reporting on this this literal disconnect of low-income, homebound elderly and the apparent disparities in access programs on federal and local levels. My intent is for this story to appear as a multi-part series in a major media outlet; depending upon the outcome, I may also develop a CHMP-sponsored white paper or article for a policy journal.