Health Impact Partnership

In Emily Frank’s prior role as a 7th grade science teacher, she was surprised to learn how much her students cared about their health, and that pressure from fellow peers had a tremendous influence on their health-related choices. She saw an opportunity to develop a structured program for students that would allow them to learn more about the health issues of concern to them, and would empower them to pass on this knowledge to their classmates.

After starting medical school in 2011, Emily still held onto her goal of developing a curriculum for a student health program. Through prior connections with Teach for America, she was able to establish an association with Boston English High School (EHS) in Jamaica Plain. When early programmatic attempts to help students turn science fair projects into peer interventions did not prove fruitful, TUSM’s Community Service Learning program presented a framework within which the Health Impact Partnership could develop and grow. In January of 2012 the program restructured itself, and funding from Tisch College’s Fund for Civic Engagement and TUSM’s Alumni Association helped provide a material foundation to help this happen.

EHS’s diverse student population and convenient access to TUSM has made it an ideal fit for this partnership. For many of the medical students involved in the program as mentors, this is their first time working in an urban community. They have gained invaluable experience communicating with non-native English speakers, learning the importance of mutual understanding and building confidence in their communication skills. The program also emphasizes a client-centered focus, reinforcing the skills a physician will need as patients become increasingly more educated and knowledgeable about health issues. Through the HIP program, TUSM students improve their workshop-design skills, gain confidence in their leadership abilities, and are inspired by the capacity to affect growth and transformation among the EHS students.

Emily has turned over the leadership of HIP to two first-year students, Clayton Barnes and Teresa Scontras so that the program can continue its momentum and growth each year. Eventually, the goal is to establish a multi-school initiative where administrators can share ideas and successes, but for now the medical students are enjoying another session at EHS.

News of the obesity epidemic in America arrives so regularly, it does not always register. But one new informal study is surprising not only for its results, but also for its investigators- high school students. Through the Health Impact Partnership (HIP), medical students at Tufts University School of Medicine (TUSM) are paired with students at Boston English High School (EHS) to teach leadership and advocacy skills through the lens of public health and medicine. “The high school students we select to participate show an interest in community health and the potential to be leaders,” said Emily Frank, M15, founder and coordinator of HIP. “They choose the health topics they want to explore, and we help them figure out how to gather and interpret data, and design an intervention.”

Engaging medical students as mentors, HIP is one of the many Community Service Learning (CSL) activities at TUSM. The CSL initiative stems from the firm belief that the role of physicians extends beyond clinic and hospital walls and that future physicians benefit enormously from firsthand experience working in the community. Supported in part by the Jonathan M. Tisch College of Citizenship and Public Service, the CSL program requires all medical students to complete 50 hours of community service prior to graduation.

This past fall, ten EHS student “Health Investigators” spent four months working with their TUSM mentors. Selecting obesity, diabetes, and barriers to healthy eating as areas for deeper analysis, they designed surveys and administered them to their peers. The students found among their small sample of fellow EHS students that: • Less than half are happy with their weight • 26% do not think they gain weight when they eat junk food • More than half believe that advertisements affect what they eat • 56% feel they eat healthier at home • 64% are worried about getting diabetes • 63% report exercising 3 or more days per week for 30 minutes or more • 24% eat 4 or more candy bars per week • 51% drink two or more cans of soda a day • 66% eat in front of a TV or computer screen

With this data in hand, the EHS students developed an information session for their peers that described their research and incorporated clips from “Super Size Me,” a documentary about the effects of eating fast food. They served healthy snacks, distributed a cookbook created by last year’s HIP participants, and ended the session with a survey that asked fellow students whether this information changed their opinion about fast food. Among the results: • 100% of the viewers knew “some” people or “lots” of people with diabetes, and 100% agreed that eating fast food could lead to diabetes • 25% said they “would not continue” and 75% said they “would maybe stop” eating unhealthy foods

At the end of January, the EHS students presented their findings at TUSM. Before their talk, the students had the opportunity to meet with a range of healthcare professionals, including a nurse, a pediatrician, a pharmacologist, a nutrition engineer and a nutrition scientist, to discuss the career pathways into these fields. After the presentation, there was a lively discussion with the audience that touched on the issues of access to healthy foods and family involvement, and the challenges of a tightly scheduled school day. “Where I live, there’s lots of convenience stores and fast food,” said Jonathan Almanzar, a junior who worked on the diabetes survey. “But it’s harder to find the kinds of foods that we really should be eating.”

Audience members responded both to the high school students’ commitment to peer health and education, and to their findings. “I was really impressed with their work,” said Andre Burey, M15. “I didn’t do any kind of research until I was well into college. To see students this age who already have this kind understanding of the issues, it’s really great.”

A new session of HIP is already underway at EHS. All of the students who participated in the program last fall will participate again, either continuing with their previous research or working on new projects, along with several other EHS students who have decided to join the program.