Role of Community Health Organizers in public schools: Lessons learned

Background: The epidemic of childhood obesity is well-documented. Data collected by the Montefiore School Health Program in 5 low-income, minority public elementary schools in the Bronx indicate that 43% of students are overweight or at risk for overweight.

Purpose: To address this problem, the Montefiore School Health Program hired Community Health Organizers (CHOs) to introduce fitness and nutrition programs in these 5 schools.

Significance: To determine if CHOs can be a model for implementing and sustaining evidence-based nutrition and fitness programs in schools.

Methodology: To document how CHOs were implementing these programs, two self-reporting formats were used: (1) a daily on-line activity log; and (2) monthly written self-interviews. Data were collected from March 2008 to December 2008.

Results: CHOs spent less time than anticipated implementing the intended fitness and nutrition programs. For example, although one CHO spent approximately 15% of her time implementing active recess, other CHOs spent nearly zero time on this initiative. Similarly, CHOs spent very little time on initiatives such as classroom-based physical activity and healthy food policies. The self-interviews revealed that CHOs had difficulty implementing the programs because of changes in school personnel, competing school priorities and difficulties engaging school staff.

Conclusions/Recommendations: Our pilot data suggest that while CHOs can be beneficial in schools, a significant amount of time was needed to build relationships, and changes in school staff made progress less sustainable. By pairing their school-based activities with advocacy for state or district policy change, CHOs could create more widespread and sustainable healthy school environments.