ObjectivesDisparities in obesity care exist among African-American children and adults. We sought to test the feasibility of a pilot program, a 1-year family-based intervention for African-American families with obesity [shape up and eat right (SUPER)], adopting the shared medical appointment model (SMA) at an urban safety net hospital.OutcomesPrimary outcomes: (1) family attendance rate and (2) program satisfaction. Secondary outcomes: change in body mass index (BMI), eating behaviors, and sedentary activity.MethodsAdult parents (BMI ≥ 25 kg/m2) ≥18 years and their child(ren) (BMI ≥ 85th percentile) ages 6–12 years from adult or pediatric weight management clinics were recruited. One group visit per month (n = 12) consisting of a nutrition and exercise component was led by a nurse practitioner and registered dietitian. Height and weight were recorded during each visit. Participants were queried on program satisfaction, food logs and exercise journals, Food Stamp Program’s Food Behavior, and the Expanded Food and Nutrition Education Program food checklists.ResultsThirteen participants from lower socioeconomic zip codes consented [n = 5 mothers mean age 33 years, BMI of 47.4 kg/m2 (31.4–73.6 kg/m2); n = 8 children; mean age 9 years, BMI of 97.6th percentile (94–99th percentile); 60% enrolled in state Medicaid]. Average individual attendance was 23.4% (14–43%; n = 13); monthly session attendance rates declined from 100 to 40% by program completion; two families completed the program in entirety. Program was rated (n = 5 adults) very satisfactory (40%) and extremely satisfactory (60%). Pre-intervention, families rated their eating habits as fair and reported consuming sugar-sweetened beverages or sports drinks, more so than watching more than 1 h of television (p < 0.002) or video game/computer activity (p < 0.006) and consuming carbonated sodas (p < 0.004). Post-intervention, reducing salt intake was the only statistically significant variable (p < 0.029), while children watched fewer hours of television and spent less time playing video games (from average 2 to 3 h daily; p < 0.03).ConclusionAttendance was lower than expected though children seemed to decrease screen time and the program was rated satisfactory. Reported socioeconomic barriers precluded families from attending most sessions. Future reiterations of the intervention could be enhanced with community engagement strategies to increase participant retention.

Medical nutrition education in most US medical schools is lacking, despite an epidemic of lifestyle related chronic conditions and high rates of malnutrition in hospitals. In a unique response to this deficit, students at Boston University School of Medicine have created a novel student interest group entitled Student Nutrition Awareness and Action Council (SNAAC). This student group is unique in that it focuses on interprofessional collaboration and development of concrete practice skills and works to fill educational gaps. The goal of SNAAC is to increase medical student knowledge, attitude, and skills in medical nutrition through providing extracurricular activities and partnering with official medical school curriculum committees. To accomplish this, SNAAC has developed a multipartite group overseen by a mentoring team composed of a physician nutrition specialist, registered dietitian, and a mental health provider. SNAAC provides nutrition oriented opportunities for members and the student body at large. Participation is high because it fills an educational gap, offers a unique focus on expanding nutrition awareness and education, and provides opportunities for student leadership and professional development. We encourage other medical schools to use the SNAAC student involvement model to increase nutrition awareness and facilitate the incorporation of medical nutrition in their curriculum.

No abstract