Live Light
Live Right

Initial screening is conducted at primary care centers, public housing complexes, public schools, and community non-profit organizations. Overweight and obese children found to exhibit one or more metabolic abnormalities associated with obesity—that is hypertension, hyperinsulinemia and/or dyslipidemia-- are eligible for enrollment into Live Light Live Right. These children are at highest risk for chronic diseases, including coronary artery disease and type II diabetes. Families are interviewed by the care coordinator and selected for enrollment based on their readiness for change and willingness to adhere to consistent medical visits, counseling sessions, and physical activity programs.

Once enrolled, children and their family members are seen by specialist physicians at the Brookdale pediatric obesity clinic for comprehensive evaluation and treatment. The clinic sees patients regardless of ability to pay. The medical visit is covered by insurance, including Medicaid, and all other services including nutrition and exercise programs are free or subsidized. A thorough set of indicators are regularly monitored, including lipid profiles, glucose and insulin levels, liver function, blood pressure, Body mass index, Lean body mass, fat mass, waist circumference, and basal metabolic rate. The children are followed by physicians and a nutritionist at regular intervals depending on disease severity.

During medical visits, patients are also provided one-on-one counseling sessions with certified nutritionists. Children and their families undergo assessments with each appointment that involve food recalls. Behavior changes that are encouraged and tracked include: label reading, baking instead of frying, reduction in fast food and snack intake, reduction in juice and soda beverages, and regular breakfast intake. Patients also meet with the Senior Care Coordinator to discuss motivation and psychosocial issues.

Live Light Live Right partners with community recreation sites to operate structured physical activity programs supervised by certified trainers across multiple sites. Sessions are exclusive to Live Light participants only, providing a supportive environment for overweight children to exercise and play sports without being ostracized or teased. Instructor-to-participant ratios are kept at 1:12 . In addition to attendance, evaluation of the program includes administering “fit tests” at regular intervals. The Fit Test measures standard physical abilities (e.g., sit-ups, running short lengths, squats, reach length) and is based on the New York City Fitness Gram and the President’s Council on Exercise.

Based on the clinical evaluation, a care coordinator develops individual treatment plans, follows up with appointments, facilitates referrals to other community programs, and monitors attendance and participation. The coordinator and a physician reinforce education and skills training related to nutrition and behavior modifications during regular phone calls with parents. The care coordinator also conducts workshops and support groups for parents at the exercise sites. Nutrition experts, exercise consultants and/or behavior therapists are regularly invited to moderate the workshops or serve as guest speakers.

Current medical school and residency curricula do not adequately address childhood obesity. Many primary care physicians are not aware of the extent of the problem and are not well versed in clinical management of obesity and associated disorders. Live Light staff members deliver educational seminars for community doctors and regularly present at medical conferences such as the annual meeting of the Pediatric Academic Society and local meetings of the American Academy of Pediatrics. They also provide clinical training to pediatric residents and medical students from Brookdale Hospital and other programs. Numerous workshops are also conducted at local social service and faith-based agencies throughout the year.

In partnership with the New York City Department of Parks and Recreation, Live Light launched its first summer camp in 2009 for 40 participants in order to maintain consistent physical fitness habits and nutrition education outside of the academic school year. For six weeks Monday through Friday, 8am – 6pm, children participated in fitness activities such as swimming, aerobics, dance, martial arts, yoga, and basketball in combination with classroom education on nutrition and field trips twice per week. This inaugural session proved overwhelmingly successful not only in terms of keeping participants active during summer vacation but also in demonstrating positive health outcomes.

Community Education

Community Education is organized to disseminate information about the health risks associated with obesity, the importance of good nutrition and physical activity, and resources for treatment of obesity. Community education is accomplished through educational programs at community and faith-based agencies, the distribution of information and brochures, and a public awareness campaign using the media.