Sarasota Team Springs into Action

November 16, 2011
By Darry Madden

Sarasota County healthy weight collaborative message
The Sarasota team's healthy weight message. “We didn’t realize how important consistent messaging was until we participated in this collaborative,” says Kari Ellingstad. “We learned that we need it in order to push the other strategies forward.”
The first time parents in Sarasota County received letters telling them that their children were overweight, their anger lit up the phones.

Many of the people involved were caught off guard. The school nurses who already calculated BMI regularly as a state requirement, thought delivering the information was a service to parents, not an insult. Many parents saw only an indictment of their parenting. The public health professionals in the community saw that they needed to step up and help figure out how to manage the fallout, and quickly.

Before the Collaborative Began
FLSo community forums were called, and focus groups of parents convened. And slowly, over the course of the summer of 2010, a better way to communicate this information to parents was developed. The new letter was softer, friendlier, with more readable white space, and it backed into the news about the child’s weight. Nurses now follow up after the letter goes out with a draft script and parents are directed to an online toolkit of resources.

This is where things stood when the Sarasota team began its work in the Healthy Weight Learning Collaborative in September 2011. Essentially, the Florida team had undertaken its first Plan Do Study Act (PDSA) cycle without realizing it.

The Social Context
Sarasota County sits on the Gulf of Mexico, a popular destination for the wealthy. But, as is so often the case, where there is wealth there is poverty. Kari Ellingstad, the Florida team lead, describes a major divide between the very rich and very poor, a situation only exacerbated when the real estate crash of 2008 hit the county especially hard.

This is the social context for the Emma E. Book Elementary School in Sarasota, where the Florida team is focusing its efforts. Many will remember this as the school where former President George W. Bush was told about the events of September 11th while he was reading to children. It’s also distinguished for being mostly African American in a county that is 94 percent white. Ninety three percent of the children there are on free and reduced school lunch.

Settling on the Message
Like most of the teams participating in the Healthy Weight Learning Collaborative, messaging was their first official order of business. They’ve opted to co-brand ‘5-2-1-0’ with the Healthy Sarasota County brand and are currently determining what materials to produce that will bear both logos.

“We didn’t realize how important consistent messaging was until we participated in this collaborative,” says Ellingstad. “We learned that we need it in order to push the other strategies forward.”

Ellingstad was thrilled to learn that the local food bank has agreed to promote the 5-2-1-0/Healthy Sarasota County brand in the cooking and nutrition classes they offer. This is a coup for the team, as the food bank’s courses reach thousands of at-risk families every year.

Setting Goals with Parents
The team is now working on incorporating their messaging in a few new initiatives. In one, the Emma E. Booker School in Sarasota will be sending parents a new Healthy Lifestyle Goal Worksheet, which they are encouraged to complete and send back to the school. A school nurse will then follow-up and work with the family on its goals for the child.

“We are planning to have this goal worksheet sent home with a letter from the principal, and with results from the BMI assessment that is being carried out this month in grades 1 and 3,” explains Ellingstad.

To optimize this strategy, the team is also focused on the processes by which school nurses follow-up with families. Right now, they do not have a standard way to approach an overweight diagnosis. Different nurses are suggesting different courses of action to parents. While the team recognizes the value of individual approaches, it also sees opportunities in implementing a consistent strategy.

The team is also working to figure out the best way to make information from the child’s pediatrician available to the school nurses for more effective follow-up – to ensure that at-risk youth are not slipping through any cracks.

A New Energy
“The team has really sprung into action since the kick-off of the learning collaborative,” says Ellingstad. “There are so many good things happening on so many fronts.”

But happily, there is one thing that’s not happening: the phones are quiet at last.