Boston Steps, run by the Boston Public Health Commission (the City of Boston’s health department), is a community mobilization effort to address the burden of obesity, diabetes, and asthma in the highest-risk neighborhoods of Boston.
Boston Steps is funded through the Centers for Disease Control and Prevention’s (CDC) Steps to a Healthier US. Boston Steps was eager to add outreach activities to parents through the Boston Public Schools and community organizations; We Can!™ was well suited to meet these needs.
Boston Steps collaborated with four partners to implement We Can! Two of these partners, the YMCA of Greater Boston and community health centers, supported both youth and parent activities.
The Boston Organization of Nutritionists and Dietitians (BOND) of Color supported parent education, and the Boston Public Schools assisted in the recruitment of parent groups.
Key Site Successes
Boston Steps primarily reached out to the community by partnering with youth-service organizations to reach parents. Those outreach efforts included health fairs, school programs, and health center settings.
Whenever opportunities for outreach arose, such as instructional meetings for teachers, consortium meetings, weekend classes, or other Boston Steps activities, We Can! materials were distributed and participation in the Parent Curriculum was encouraged.
Boston Steps' events included -
Boston Steps used grassroots community mobilization rather than media outreach. The site did use media materials from the We Can! Energize Our Community: Toolkit for Action to help describe the program and to prepare reports for the CDC. The media materials were also distributed to all community health centers and community centers.
Boston Steps formed partnerships with groups and organizations to support the implementation of the Parent and Youth Curricula. These included working with groups that had a similar mission such as the Boston Central YMCA, BOND of Color, two Boston public schools, the John F. Kennedy School, and the Pathways to Health High School.
Partnerships with youth-serving programs were critical to recruitment of both youth and parents. The partnerships offered space for holding classes and child care support when needed. The YMCA offered three month discounted family memberships to all parents who completed the classes.
BOND of Color members provided instructors familiar with community resources to enhance parents’ knowledge and ability to access resources.
We Can! Energize Our Families: Curriculum for Parents and Caregivers
Boston Steps implemented the We Can! Parent Curriculum three times in July and November 2005 and in March 2006 with 36 parents—31 women and five men. All three implementations occurred at the Boston YMCA.
Two other classes were implemented. However, data were not collected for those additional classes due to language barriers or timing. The parents participating in all classes had varying literacy levels, so BOND of Color members convened smaller groups to discuss the content and allow participants to visualize its components in more detail. The site regularly brought in foods for taste tests, demonstrated portion sizes, and exchanged recipes.
The site condensed the program to five weekly lessons that included a final celebration class. The best celebration of all was had by the facilitators who reported, "The parents were asking for more; for a part two."
In general, Boston Steps found that messaging was critical to successfully recruiting participants to the Parent Curriculum, noting that they "had to really let the parents know that this was not just a basic nutrition class, but that they really were going to talk about skill building, recipes, shopping tips, shopping on a limited budget, and how to make healthy choices."
Boston also embarked on two unique implementations. For the first class, Boston Steps teamed up with Boston Public Schools (BPS) to implement a Parent Curriculum in Spanish and translated all course materials into Spanish. Average class attendance was eight to nine parents per session with the first and final class having twelve participants.
Based on this success, three additional schools requested to offer We Can! classes in Spanish in the Fall of 2006. The second class was held at the Mildred Avenue School Community center with five grandparents and three parents of children who attended the Mildred Avenue School or other BPS middle schools. Attendance was consistent across sessions.
All parents received memberships to the recreation facilities of the community center and immediately signed their children up for swimming classes.
An analysis of 22 respondent surveys found statistically significant increases related to physical activity attitudes. Parents’ reported improved attitudes toward overcoming barriers to engaging in physical activity. Although not statistically significant, scores on nine measures (healthy eating knowledge, attitudes and behaviors; healthy food behaviors; energy balance attitudes; portion size attitudes and behaviors; physical activity knowledge; and screen time behaviors) suggested positive movement toward We Can! objectives.
CATCH Kids Club
Boston Steps had challenges implementing the CATCH program. They partnered with the YMCA and invited the staff to attend the We Can! orientation. However, the staff members found it difficult to train other staff and implement the program when they returned to Boston.
There were several attempts to implement the program, but without a formalized CATCH training to offer staff, they were limited in achieving success. The staff did utilize the nutrition education component for CATCH and found that participating youths enjoyed the activities during the 2005 summer camp. No data were available for analysis.
Boston Steps experienced some initial challenges implementing the Media-Smart Youth Curriculum; it was difficult for the YMCA to implement the full program within the afterschool time structure. Ultimately, the site was able to partner with a Boston Public School to offer the program with a group of ninth graders. The program met weekly in an afterschool setting. Students received lessons teaching the connections between media and health.
In the initial classes, students lacked interest in the content. This created a challenge for the facilitators who decided to modify the curriculum to meet the needs of the participants by adopting a less didactic teaching style. The changes led to increased interest and participation from the students.
While the curriculum is designed to conclude with a “Big Production”—an opportunity for students to apply their new skills by creating a media project to motivate other young people to take action for better health—the afterschool program ended before the students could complete the actual taping of their Big Production. No data were available for analysis.
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