March 2012 - A little over a year ago, the pediatric residents assembled at our annual retreat with the goal of developing an initiative that could affect health beyond our hospital’s doors. We considered a variety of interventions but it didn’t take long for us to identify an important area where we clearly need to improve. While it’s hard to make it through a day without hearing about the obesity epidemic in the news, we realized that an emphasis on healthy active living often gets left out of routine care at the hospital. That day marked the beginning of the Residents for Healthy Active Living in Youth (RHALY) advocacy project.

 

Those working extremely hard on this initiative include Dr. Elisa Ruano and Dr. Reem Al-Khalifah, as well as the other founding members of the RHALY committee (Drs. Catherine Nolin, Kim-Anh Nguyen, and Jade Seguin). New committee members include Drs. Sabrina Furtado, Conall Francoeur, Hugo Paquin and Janie Desrochers.

 

Our aim is to help children maintain healthy weights by increasing physical activity, eating better and developing healthy sleep habits. Sounds simple enough but how exactly do we intend to achieve this goal?

 

The Resident Continuity Clinic (RCC), where residents follow their own patients, was the ideal starting point for our efforts. Here we engage our patients and their families with questionnaires about physical activity, sedentary behaviour, sleep habits, diet, and socioeconomic status. These comprehensive questionnaires will help us target our counseling and will provide us with a baseline against which we can compare progress.

 

Probably our most important intervention however, is the patient tool-kit. Each child will receive a package that includes Canada’s most recent Food Guide, a pamphlet on age-specific activity recommendations, and region-specific information about community resources to encourage physical activity. Along with this package comes a prescription – but this isn’t your typical prescription. There are no pills, powders or suspensions but rather targets for activity, diet, and screen time.

 

As part of the RHALY initiative, we have been working closely with-- and extend our thanks to--the Public Relations and Communications team (notably Ms. Lisa Dutton) to create the RHALY logo as well as the Healthy Active Living information brochure and posters. We have already placed posters and brochures that help guide families in the hospital’s waiting rooms. Though RHALY’s roots are firmly planted in the RCC, the scope extends beyond the clinics. We hope to engage parents and patients with information sessions and motivational talks throughout the waiting rooms in the hospital. We also aim to work alongside the cafeteria staff to help role model healthy eating habits within the hospital. As RHALY’s activities grow, we foresee moving beyond the hospital and into schools, CLSCs and the YMCA to spread our message to the community as a whole.

 

The evaluation of any wellness strategies is critical. In this regard, Dr. Ruano and Dr. Al-Khalifah have been working closely with Dr. Evelyn Constantin to devise research projects to evaluate the impact of the RHALY initiative. Specifically, Dr. Al- Khalifah is working on a clinical research project proposal entitled: Impact of the Pediatric Residents’ Initiative for Healthy Active Living in Youth (RHALY): A Prospective Cohort Study (Principal Investigators: Drs. E Constantin, L. Legault, R. Al- Khalifah; Co-investigators: Drs. C. LeBlanc and E. Mok), and Dr. Ruano is currently conducting an education-based study related to RHALY and obesity counselling among pediatric residents (Principal Investigators: Dr. Mylene Dandavino, Dr. Elisa Ruano; Co-investigator: Dr. E Constantin).

 

The RHALY group would like to thank all of the above-mentioned research investigators, the RCC team (Dr. Catherine Henin, Ms. Kathy Clark), Drs. Preetha Krishnamoorthy, Meranda Nakhla, Helen Bui, Richard Gosselin and Paul Rossy, the Department of Pediatrics and the Division of General Pediatrics (notably Drs. Guyda, Brouillette, Shevell and Dougherty) for their support, input, financial contributions, and collaboration. The RHALY group looks forward to “RHALY”ing with and to continue collaborating with the hospital and the Department of Pediatrics on Healthy Active Living initiatives.