Healing with Food: Enhancing the Nutrition Component of the Camper Experience at Camp Holiday Trails A. Pierce, UVA Health System Dietetic Intern A. Hasemann, RD, CSP, UVA Health System Children’s Fitness Clinic T. LaRoche, Executive Director of Camp Holiday Trails Learning Outcome: To enhance the nutrition component of campers’ overall experience at Camp Holiday Trails through improved nutrition education to families and use of streamlined nutrition facts and carbohydrate counting tools by medical staff who provide care to campers. Abstract: Children with special health needs are at risk for diminished quality of life and may be limited in their opportunities to interact with other children. Therapeutic camps provide the camp experience to children with chronic illnesses in a setting that allows their individual health needs to be met. Camp Holiday Trails (CHT) is a camp for children with a number of various chronic illnesses. Members of the CHT medical staff aid each child with diabetes in carbohydrate-counting and administer insulin as needed at each meal time. This project is centered on the improvement of the carbohydrate-counting tool that had previously been developed for CHT to enable the staff to better understand and utilize the tool, thus promoting the delivery of the best possible care to campers. The nutrition needs of all of the campers will be addressed through the development of nutrition education materials for the campers and their families. Nutrition packets with illness-specific handouts will be developed for each of the ten most common chronic illnesses seen at CHT. Providing these materials will enable an amplified health impact beyond the child’s time at camp. Development of these resources will aid other therapeutic camps in having an effective nutrition component. Children with chronic illnesses may not get to experience the camp setting and the unique opportunity it provides. Therapeutic camps provide this experience to these children in a setting that allows their individual health needs to be met. These camps have been emerging over recent decades to provide the joy of the camp environment with a specialized staff and healthcare team to care for the needs of the children. CHT is unique in that it serves children with various chronic illnesses, rather than focusing on a single condition. Each year a large proportion of the campers are those with diabetes and one important responsibility of the healthcare team at CHT is assisting the children with diabetes with carbohydrate counting at meal times. Members of the medical staff aid each child with diabetes in carbohydrate counting and administer insulin as needed. This project centered on the improvement of the carbohydrate counting tool previously developed for CHT to enable the staff to better understand and utilize the tool, thus promoting the delivery of the best possible care to campers. The nutrition needs of all of the campers will be addressed through the development of nutrition education materials for the campers and their families. Nutrition packets with illness- specific handouts will be developed for each of the ten most common chronic illnesses seen at CHT. Packets will include general nutrition information to assist the entire family in addition to the more tailored information directed toward the child’s needs. Providing these materials will enable an amplified health impact beyond the child’s time at camp. ABSTRACT Introduction A literature review of related topics was done through PubMED and Ovid Medline. Topics researched included therapeutic camps and their impact on children with chronic illnesses, carbohydrate counting tools in the pediatric camp setting, and specific nutritional concerns for children with the special health needs most common to CHT. The articles found pertinent to the project were included in the literature review report and referenced here. A brief survey was sent out to solicit the input of the CHT medical staff on the current carb-counting tool. Questions included were: What aspects of the current carb-counting tool at Camp Holiday Trails (CHT) work well? What aspects of the current carb-counting tool at CHT DO NOT work well? What tools do you prefer to use for carb-counting? (specific apps, websites, etc.) What aspects of these tools make it your preferred option? What suggestions do you have for improving the current CHT carb-counting tool? Did you feel adequately trained in the use of the current CHT carb-counting tool? If not, how could this process be improved? The link to this survey was sent to 13 previous CHT medical staff including medical and physician assistant students. These are the personnel that directly assist the children with diabetes in their meal-time carbohydrate counting and insulin dosages. A review of the current carbohydrate- counting tool utilized at CHT, as well as common tools used in other settings, was completed. This included the survey to the medical staff, orientation to the current tool and procedure, and review of available diabetes-related smart phone apps. These tools were assessed based on user- friendliness, accessibility, content and overall usefulness. Individual apps were reviewed by accessing popular online app stores with user reviews and an app review conducted by The Academy of Nutrition and Dietetics. Knowledgeable colleagues were also contacted to ascertain information on validated carbohydrate-counting tools and resources. To address the nutrition education component of the project, research was conducted regarding current nutrition education programs being implemented at therapeutic camps. Nutrition handouts for children were reviewed and nutrition information specific to the ten most common conditions seen at CHT was gathered. Handouts were developed based on gathered information. METHODS Results Our project was able to enhance the nutrition component of CHT by gathering information to improve the carbohydrate-counting process at camp and developing a basic nutrition handout for children and their families, as well as handouts specific to the ten most common conditions seen at CHT. The results of our survey revealed that the current carbohydrate counting tool was useful to staff, but could be improved through updating and reorganization. The staff also provided suggestions regarding the menu and kitchen staff to make their process easier. Implementing these suggestions will allow the medical staff to effectively and efficiently administered the proper diabetes care. The nutrition handouts were created to be eye-catching and age- appropriate so that the children will be able to leave camp with practical information that they can use throughout their lives to improve their self- care. Nutrition is gaining recognition as a crucial aspect of the fight against childhood obesity. Camps like CHT are working to develop their nutrition programs in order to step up to their critical role in this fight. By improving diabetes care at camp, the medical staff will more easily be able to instill in those campers the skills they will need to manage their own care beyond their time at camp. Also, by increasing campers overall nutrition knowledge, as well as knowledge of how their nutrition impacts their specific condition, they will better be able to use their nutrition to have the best affect that it can on their health. These are just some of the steps that camps like CHT are taking to promote wellness and healthy living for the children that they are able to reach.