1. Tracey Smith, PHCNS-BC, MS, CLC Harald Lausen, DO, MA Southern Illinois University School Of Medicine Department of Family & Community Medicine Springfield, Illinois

2. Curriculum and Nutrition 2002-2003 A nutritional subcommittee was developed to assess nutrition in the curriculum. Numerous gaps identified and recommendations made. 2007-2008 Nutritional subcommittee reconvened to reassess nutrition in the curriculum. Numerous gaps continued to be identified and recommendations made. 2009- FCM decided to address gaps

3. Medical School Curriculum Family & Community Medicine Clerkship (third year medical students) Electives (third and fourth year medical students)

4. Parents/ FamiliesSchools/ Community Medical Students/Primary Care Providers Parent/Family educationTeacher training Medical Student/ Health care provider training Kick-off Events Health fairs Community presentationsPre/post measuresParent/Family presentations Public Health press releases School and classroom resources & education Clinic resources University and community activities engaged three key audiences

5. Clerkship- Nutrition and Physical Activity Didactic session- incorporated topic into sessions on: Patient education/Shared Decision Making Health Literacy by practicing use of Personal Health Prescription Assignment- COPC/Health Literacy Assignment 1. Use IPLAN to identify the top five causes of mortality in county for clerkship. 2. Identify how and if the community is addressing one of five of the risk factors 3. Find two examples of educational material Assess literacy level (Use Fry Formula, SMOG, etc) Consider methods to decrease the reading level of the material 4. Complete a “Prescription for Health” for a patient that you saw with preceptor using one of the top five causes of mortality for that county

6. Clerkship

7. Descriptions of Electives Nutrition Basics and Teaching Skills  Introduction to basic nutrition principles and application of education theories and techniques for providing educational outreach to the community Physical Activity Basics and Training  Introduction to the theories and techniques of delivering physical activity in a clinic and in community education outreach programs

8. Example of Medical Student Electives- Nutrition Grocery Shopping Tour Fast Food evaluation experience Required outreach experience (translation of knowledge to practice) Self- study of Growth and Development and Communication Methods Across the Ages Search “Go, Slow, Whoa” at: http://kidshealth.org/http://kidshealth.org/ Choosemyplate: http://www.choosemyplate.gov/http://www.choosemyplate.gov/

9. Example of Medical Student Electives- Physical Activity Meeting with personal trainer & medical researcher on physical activity and health Required outreach experience Application of knowledge to case vignettes Self Study-Review exercise guidance for differing age groups and health profiles: WebMD:http://www.webmd.com/fitness- exercise/ss/slideshow-9-least-effective-exerciseshttp://www.webmd.com/fitness- exercise/ss/slideshow-9-least-effective-exercises Fitnessgram- The President’s Council on Fitness, Sports, and Nutrition: www.presidentialyouthfitnessprogram.org www.presidentialyouthfitnessprogram.org

10. How Achieve Grants to purchase outreach supplies New Partnerships FDA St. Louis District Dairy Council Schools Gold’s Gym

18. Evaluation

19. Evaluation of Clerkship Debriefing of Personal Health Prescription written at preceptor’s office 4.5/5 OSCE involving Personal Health Prescription 4.7/5

20. Evaluations of Electives Nutrition 4.78/5/00 “I think all students should take this elective to become better acquainted with nutrition and its role in medicine.” “Great refresher on some nutrition concepts an very educational regarding resources and ideas to improve the health and well being of one’s patients. Store and ethnic food assessments were valuable.” “One thing that may add to it is maybe a half day of clinic with a dietician or a nutritionalist.” Physical Activity 4.76/5.00 “This course is a great way to familiarize yourself with resources for understanding and improving physical activity needs and delivery. What I like about this kind of elective is that I leave with a tool kit of information and resources that I can dip into when I need it.”

21. Qualitative- Reflections “After this week, I feel I need to assume responsibility for making patients aware of nutrition and be a part of the movement towards encouraging healthy eating and lifestyles.” “This course opened my eyes to a small degree to the amount of legislature that goes on under my nose, so to speak, on nutrition and more specifically, feeding children in schools. From the perspective of a future physician, there are many avenues that one can pursue […] and “fight for” in the local, state, or even federal government.” “…I was interested in […]African Americans to learn more about and incorporate traditional African diets which may be healthier, in light of the many health concerns which are prevalent in the African American community, like hypertension and diabetes. […]approaching health/nutrition education from this point of view might provide people a greater sense of excitement and achievability about dietary changes, and making them feel like they are gaining something (connection with their heritage), rather than shaming bad eating habits…”

22. Quantitative Measurement Academic Year 2009 – 2010 2010 – 2011 2011- 2012 Outreach Events2136 49 Elective students Nutrition elective2658 44 Physical Activity elective 06 17 4 th year medical students who participated in either nutrition or physical activity elective and number of outreach events directly related to electives over a three-year period.

23. If you are interested in any further information please contact me at tsmith@siumed.edu