Good medicine

How do you fight chronic absenteeism? Put a nurse in every school.

Almost a fifth of Memphis students are considered chronically absent from school, and too often it’s because of an asthma attack, a toothache or an undiagnosed psychological condition.

Community leaders grappling with the city’s high rate of absenteeism frequently have cited challenges rooted in poverty — from students who struggle to get a ride to school to embarrassment over dirty uniforms. Now they’re zeroing in on a deeper related problem: chronic health conditions.

Last year, a staggering 44,000 Memphis students reported suffering from a chronic health condition, contributing to 18 percent of students missing at least 18 days of class in Shelby County Schools or the state-run Achievement School District.

“It’s clear that having a nurse at every school could greatly reduce the number of students who miss school for preventable health reasons,” said Lora Jobe, executive director of PeopleFirst Partnership, a coalition of business, government, academic and civic leaders. “The health concerns we’re talking about disproportionately affect impoverished children and children of color. In Memphis, addressing this should be a top priority.”

Community leaders came together Wednesday at the University of Memphis for a summit on how health disparities are causing youngsters to miss school. The gathering follows last month’s launch of an attendance campaign by Shelby County Schools, providing supports for 10 schools with the most-absent students.

Students in Memphis are mostly people of color and from low-income families, both groups with higher-than-average rates of asthma and untreated dental cavities.

Last year, in fact, Memphis was named the nation’s worst city to live with asthma, a chronic lung condition that leads to episodes of wheezing, coughing and shortness of breath, among other symptoms.

Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.
PHOTO: Caroline Bauman
Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.

The summit was attended by doctors, dentists, nurses and mental health professionals, as well as education and nonprofit leaders. Discussions gravitated frequently to the importance of having a full-time nurse in each school, not only to treat students but also to educate their families about how to manage medical conditions that might keep their kids home from school.

Tennessee law requires only one nurse for every 3,000 students, and budget cuts have made it impossible for Shelby County Schools to keep a nurse in every school building. Instead, nurses rotate across the district, usually giving each school one day of medical staffing a week.

That’s not enough, said Angela Hargrave, the district’s director of attendance and discipline.

“Parents aren’t comfortable that their children will be properly cared for at school,” Hargrave said. “People at schools aren’t comfortable with that responsibility. We’re not medical professionals. Our front office staff isn’t trained for that.”

A full-time school nurse can provide the medical care or information that makes the difference in coming to school or staying home, said Cindy Hogg, director of health services at Le Bonheur Community Health.

“A nurse in the school building is often the only care provider many children in low-income areas in Memphis see for years,” Hogg said. “Of course, nurses should send students home when they are sick. But so often students are missing way more school than they should because no one in the health world is communicating with them or their parents.”

Jobe pledged that PeopleFirst Partnership, which organized the summit, will lobby local and state officials to enact and fund a policy that lower the school nurse-to-student ratio.

“I hope this time next year, when we see Tennessee require a nurse in every school, you will be able to say, ‘I was in the room when this started,’” Jobe told the group.

Not long for this world

Denver teen pregnancy prevention organization to close its doors at the end of the year

PHOTO: freestocks.org

A Denver-based nonprofit focused on teen pregnancy prevention and youth sexual health will close its doors at the end of 2017 after losing two major grants.

Andrea Miller, executive director of Colorado Youth Matter, announced the news in an email to supporters Monday afternoon.

The organization, begun in the 1980s as a volunteer-run group, provides teacher training and assistance in picking sex education curricula for 10 to 25 Colorado school district a year.

Miller said she’s hopeful other organizations will pick up where Colorado Youth Matter leaves off — possibly RMC Health, the Responsible Sex Education Institute of Planned Parenthood of the Rocky Mountains or the state-run Colorado Sexual Health Initiative.

Colorado Youth Matter’s biggest financial hit came in July when federal officials announced the end of a major teen pregnancy prevention grant mid-way through the five-year grant cycle. That funding made up three-quarters of Colorado Youth Matter’s $1 million annual budget.

“It feels like we’re getting cut off at the knees,” Miller said.

About the same time, the organization lost a family foundation grant that made up another 10 percent of its budget.

Miller, who took the helm of the organization just 10 months ago, said one of her primary goals was to diversify funding, but there wasn’t enough time.

Miller said with a variety of factors playing into the state’s teen pregnancy rates, which have been at record lows in recent years, it’s hard to say what the impact of the organization’s dissolution will be.

She said Colorado Youth Matter has worked successfully with school districts with different political leanings to find the right policies and resources to address the sexual health of their students.

“We have been masters at meeting the school districts where they are,” she said.

Wanna go outside?

Less plastic, more trees: New effort seeks to reinvent preschool playgrounds and capture kids’ imaginations

This play structure at Step By Step Child Development Center in Northglenn will go away under a plan to create a more natural and engaging outdoor play space.

Michelle Dalbotten, the energetic director of a Northglenn child care center called Step by Step, doesn’t like her playground.

Sure, it’s spacious, with a high privacy fence bordering an adjacent strip mall parking lot. It’s also got a brightly colored play structure surrounded by lots of spongy rubber mulch.

But Dalbotten and her staff have long noticed that the kids get bored there. They clump together in the small shady area or on a few popular pieces of equipment. Sometimes, they start throwing trucks off the play structure or shoving their friends down the slide.

Something about it just doesn’t work.

Recently, Dalbotten found a solution in the form of a new grant program called the ECHO initiative, which aims to reinvent more than 100 preschool and child care playgrounds across Colorado over the next few years. Think mud kitchens, looping tricycle trails, vegetable gardens, stages, shady reading nooks and dump truck construction zones.

The idea is to create outdoor spaces that capture kids’ imagination, connect them with nature and keep them active in every season. Such efforts grow out of a recognition in the education field that healthy habits start early and boost learning.

The current preschool playground at Step by Step is covered by rubber mulch.

Step by Step staff members had talked many times about their stagnant play space. But it was hard to envision anything different until they attended a design workshop with experts from ECHO, a partnership between the National Wildlife Federation, Qualistar Colorado and the Natural Learning Initiative at North Carolina State University.

“We knew we were missing the boat somewhere because (the children) weren’t super-engaged and we had a lot of behavioral issues,” Dalbotten said. “But we just couldn’t see past it, I guess.”

For child care providers, it’s a common challenge, said Sarah Konradi, ECHO program director with the regional office of the National Wildlife Federation

“This is a very new idea to a lot of folks,” she said. “It’s hard to sort out as a layperson.”

ECHO, borne out of a decade of research from the Natural Learning Initiative, will hand out $355,000 in grants over the next three years. The initiative prioritizes centers that serve children from low-income families or other vulnerable populations.

Fourteen centers — Step by Step and Wild Plum Learning Center in Longmont are the first two — will get $10,000 awards for serving as demonstration sites willing to host visits for other Colorado providers.

Leaders at Step by Step say kids and teachers often congregate in the limited shady spots.

Around 100 other centers will receive ECHO’s $5,000 seed grants and expert assistance to revamp their outdoor spaces.

Such transformations can have a big impact on children who may spend thousands of hours a year at such centers, said Nilda Cosco, director of programs at the Natural Learning Initiative.

“When we do a renovation of the outdoor learning environments as we call them — not playgrounds — we see increased physical activity … more social interactions among children … less altercations,” she said.

“The teachers have to do less because the children are so engaged. There is so much to do.”

ECHO, which stands for Early Childhood Health Outdoors, is the latest iteration of a program Cosco started a decade ago called “Preventing Obesity by Design.” That effort revamped outdoor space at about 260 child care centers in North Carolina, South Carolina and Texas.

Cosco said such makeovers can ”prevent obesity by counteracting sedentary lifestyles. Children walk more, exercise more, are conversant with healthy eating strategies.”

Dalbotten and her staff have big plans for their play areas, which sit behind a plaza that houses a bingo hall, Dollar Tree and Big D’s Liquor store. They’ll get rid of the colorful play structure and the rubber mulch in favor of a more natural look. There will be trees, shrubs, small grassy hills and a winding trail leading to a wide array of activity areas.

This porch will get new lighting, fencing and foliage to make it a more attractive outdoor space at Step by Step.

The center’s smaller toddler playground will get a similar reboot and its tiny yard for babies — mostly bare except for a couple low-hanging shade sails — will be expanded to include a shaded deck where teachers can sit or play with babies. A barren concrete porch on the side of the building will be remade into a cozy activity area decorated with bird houses, planter gardens and butterfly-attracting foliage.

At the recent design workshop Dalbotten attended, ECHO leaders displayed photos from other centers around the country that have gone through outdoor transformations. She saw one that stuck with her.

“There were kids everywhere,” she said. “It was super cool looking. I was like, ‘Oh look, we can be that. We can have kids everywhere.’”

PHOTO: Natural Learning Initiative
The play space at Johnson Pond Learning Center in Fuquay-Varina, NC, after a makeover.
PHOTO: Natural Learning Initiative
The outdoor play space at Spanish For Fun Academy in Chapel, Hill, NC, after a makeover.