Tuesday, July 23, 2013

Integrating Nutrition Factors and Smoking Cessation

We already know that tobacco smoking can lead to lung cancer, coronary heart disease and other serious medical issues. We also know that exposure to second-hand smoke negatively affects other non-smokers.  Quitting smoking is a sensible and healthy option, so what's holding you back?  Is it the fear of gaining weight? You are not alone…

Weight gain is a common reason why people shy away from quitting smoking. Here is some information you should know about quitting smoking and weight gain.

Nicotine suppresses hunger by switching off the receptors associated with appetite and food intake.  Also, time spent puffing on a cigarette is time spent not snacking.   On average, people who quit smoking gain about 10 pounds.  

 Tobacco cessation program staff are trying to tackle the problem of weight gain associated with quitting smoking with a holistic model by addressing both nutritional factors and tobacco cessation. A local Montgomery County program  implemented by Mercy Health  and administered by Health Promotion Council, exemplifies this new integrated model. The  cessation counselors regularly give nutrition counseling to clients in their smoking cessation program. Cessation counselors across the United States are adopting this integrated approach dedicated to keeping patients healthy, nutrition-oriented, smoke-free, and active.  

Dr. Jeffrey Wigand (tobacco industry whistleblower depicted in the movie The Insider) who is currently working to assist Australia, New Zealand and Canadian cities to  go tobacco-free states:  

“Successful tobacco addiction treatment should be approached holistically where all body systems are addressed.  Like other addictions, it permanently transforms brain circuitry (neurochemistry), affects appetite and dietary choices as well as alters the user's ability to exercise.  Having accurate vital statistics assists the counselor to better understand and treat the individual more effectively in an integrated manner.  Nutrition is especially critical because many nicotine dependent individuals shy away from help for fear of gaining weight.  By simply measuring a client's height, weight, blood pressure and body fat on each visit, treatment is more tailored leading to greater awareness of nutritional needs and restrictions for clients.  The expected outcome is less weight gain, increased ability to exercise and better overall health....most important of which is a better outcome in the treatment of the underlying addiction. Behavior modification is critical for the management of nicotine addiction.”

Contact http://www.sepatobaccofree.org/site/index.phpfor assistance with quitting smoking!

Tuesday, June 25, 2013

Dads Matter

I recently found myself thinking about a conversation I had with a female participant in our REMix: Healthy Relationships in the Mix class. She was talking about her child’s father, with whom she has had a strained relationship for the past two years. She said, “He’s a waste of my time. I don’t need him anyway. I can give my son everything he could, and more.” This statement echoes a sentiment we hear often, especially with our female clients - a sentiment that is often repeated both overtly and subtly throughout our culture. When she made this statement, I paused and asked her if she thought that was true of every family in her situation - can a mother give her children everything and more than a father can? She replied with a definite “Yes, absolutely.” I then went on to ask her if the same applies to men in her situation - a father raising his child alone with no help from the mother. Can he give his child everything and more than the mother could? Her response was “Of course not. Every child needs their mother.”
I decided to pose these questions to the entire class, which included mothers and fathers. We asked them to name all the things mothers can do for their children. We then asked them to name everything fathers can do for their children. To the participants’ surprise (but not to the facilitators’), they listed the exact same things, maybe using a different word here and there. The only thing they could name that a father cannot do is breastfeed. Then we asked the question, “Do children need both their mother and father - or at least trusted males and females - to be a part of their lives?” This question was met with a resounding “Yes” from the group.
What do fathers and other male caregivers provide for children? How do they do this parenting thing differently than mothers? Do they have an important role to play in their children’s healthy development? These questions are raised a lot in the work we do with men. We’re always heartened when we hear our female clients say things like, “I want him to be more involved; my child needs him.” Or, “My father did so much for us; he would drop anything for us.” Unfortunately, for every client that says fathers are important, we have two that say women are always the better parent – and even sadder, many of our male clients are the ones saying so.
So what do fathers bring to the table? Looking at the research will show you that children who are raised by two involved, loving, and stable parents are less likely than children raised by only one parent to have behavioral problems, to drop out of school, to commit crimes as teenagers AND as adults, to be abused and neglected, to use drugs or alcohol, and to become sexually active at a very young age. They are more likely to do well in school, have stable friendships, understand gender roles, live in stable housing, attend college, and have positive self-confidence. Fathers and males, in general, approach some of the same parenting tasks in different ways that women. For instance, males are more likely to get down on the floor and play with their children. They roughhouse more (which is a very typical male-bonding approach). They are more likely to let their children take positive risks (“You can climb a little higher. You won’t fall.”). They can let their children fail and try to work out a task or problem on their own. And they often let their children decide how they feel before reacting and helping them. 
When we teach these concepts to fathers in our Focus on Fathers classes, we can sometimes see the internal struggle going on in the men who stated they believe mothers are better nurturers. They have been told all their lives that men can’t raise children as well as women. Some have been told by their own families and children’s mothers that their job is to make the money and mete out punishments – the rest the woman can do, better. They get excited to hear that getting on the floor and roughhousing with their children helps the child control his or her emotions and provides bonding experiences, especially for boys. They are happy that they can now put into words why they don’t automatically intervene when a child is working through a problem. They are relieved to be told that they can and should do things like sit down and read to their kids, comfort them when they are sad or hurt, and show them how much they love them. It’s a bittersweet thing to hear a man break down and say, “Why have I been hiding behind this tough-guy façade with my son? He needs me to talk to him, comfort him, help him with his problems. I needed all those things from my father, but didn’t get them. Why hasn’t anyone ever told me this before?” Our message is always the same: You are important. Don’t let anyone tell you differently.
At the end of the REMix class, the young lady came up to me and told me she had never had anyone dispute her beliefs that she could do it all on her own. She was amazed and surprised to hear that the rest of the class felt strongly that kids need positive male role models and admitted that maybe she really couldn’t do it all as well as she thought. Over the next few weeks she updated me on the progress she was making with her child’s father. She had called him soon after that first session and agreed to let him see their son. By the end of the twelve-week series, her son’s father was calling to talk to them every night of the week and spending time with his son every weekend. She said the changes in her son’s behavior were amazing – he was more compliant, didn’t act out as much, was doing better in school, and just seemed all-around happier… And so was she. 


Written by Nichole E. Kang, Director, Social Services for HPC’s Focus on Families program and facilitator of fatherhood classes for six years. 

Wednesday, May 15, 2013

Health Intervention Program (HIP)


One of Health Promotion Council’s newly-acquired programs is the Health Intervention Program (HIP), which has been, since 2006, working with families with at least one child with special health care needs. Some of the more noteworthy work HIP has conducted over the years is with immigrant families. Many times, new immigrants have only small social support networks and have difficulty understanding the workings of the US benefits and healthcare systems, which greatly limits their ability to provide for their children’s advanced needs. The expertise, patience, support, and concern the HIP staff provides the families helps to relieve their stress and anxiety and makes them better able to cope. One family, in particular, benefited greatly from the work of HIP and other service providers throughout Philadelphia.
 
The *Basri’s are immigrants from a Middle Eastern country. When they began HIP services, they had an 8-year-old daughter with intellectual disabilities and a set of infant twins who were born prematurely. They were having a difficult time understanding the medical issues their twins faced and found it difficult to give their daughter the time and attention she needed. The HIP team introduced the family to the medical specialists at Children’s Hospital of Pennsylvania. HIP helped the family set up all the appropriate appointments, accompanied them to their medical appointments in order to help them understand and be involved in treatment planning, educated them about the medical services, and trained them to respond to possible medical crises. One of the main goals of HIP is to make the family as self-sufficient and confident as possible before reducing or discontinuing services. Through this intervention, HIP was able to help them create and maintain a stable, on-going relationship with their medical providers. Establishing these relationships was an important step because the children will be in need of services for many years, but the family would be eligible for HIP services for only one year. HIP staff modeled appropriate parenting skills, including how to engage the children and use the designated activities to promote healthier development of the twins and their older daughter. HIP also helped the family understand and use the special education system in the public schools and to access and use local immigration services, which allowed for them to become documented citizens.
 
When Mr. Basri’s mother fell ill in their country of origin, HIP stepped in to help the family gain visas so they could travel to the Middle East to spend time with her. This process involved securing three months’ worth of a rare medication that all three children needed for the trip, and without which their health would have been greatly affected. During the time needed to plan the trip, HIP ensured the family was able to appropriately grieve the inevitable death of Mr. Basri’s mother. The family was incredibly grateful for the opportunity to visit their home and say their goodbyes.
 
The importance of social support during hard times permeates every service HIP provides. One of our newest case managers, Rachael McInnes, recalled a recent conversation she had with a mother of a child with autism. The mother asked, through a tearful gaze, if her son would ever “get better.” This is a difficult question to answer by even the most well-trained case manager, because the answer is almost always a “no.” Rachael had to take a deep breath and explain to this mother that, while her son would not reach the same milestones at the same time as his typically-developing peers, he would have the ability to reach his own milestones in time with support and care. She wanted the mother to understand that with all the work she and her son are doing, and through all the specialists he sees, his quality of life will be much improved, but not “perfect.” She also wanted the mother to know that she and her family would be supported emotionally by HIP and other social services as long as she sought that support. The conversation ended in tears, but showed Rachael this mother’s unconditional love for her son. Rachael is confident that, over time, this mother will come to accept that her son will always have special needs and that she will rise to the occasion every time her son needs her.
 
I leave you with a quote from Rachael, which sums up her feelings about the parents with whom she works. “As children age, their intellectual and physical disabilities become more evident to parents. At times, these disabilities illustrate the harsh reality of the difficulties their child may face. But these visible reminders can move parents to climb any obstacles with their child. 
 
*name changed in the interest of privacy.
 
The Health Intervention Program is funded through Philadelphia Department of Health’s Maternal, Child, and Family Health division.