General Pediatrics

Patient Care/Community Health Programs

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NewYork-Presbyterian Morgan Stanley Children's Hospital.

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While high quality clinical care is vital to the children of our community, so is proactively addressing major threats to our children's health today -- problems such as infant mortality, chronic illness including diabetes and asthma, obesity, domestic violence, and intentional and unintentional injuries of children.

Over the past 15 years, the Department of Pediatrics has created a Community Pediatrics Program in partnership with the Washington Heights community. Pediatricians advocate for improving disparities in children's health outcomes in the local community. In turn, the community and its leaders are now active partners in healthcare service delivery to children and families. Our pediatricians work side by side with community agencies to develop important initiatives that affect clinical practice and bring about institutional change.

Future pediatricians are taught the skills to understand community health and to work collaboratively with their communities. All Pediatric residents receive extensive training in principles of community health, cultural competence and advocacy skills through our Community Pediatrics Program, which includes:

Best Beginnings
Best Beginnings is a Healthy Families of America home visitation program for high-risk families. Best Beginnings is unique in its focus on urban, Latino, immigrant families. The goal of the program is primary prevention of child abuse and neglect and building healthy families. Paraprofessionals provide home visitations services, link families to community resources, and teach parents about positive parent-child interaction. Alianza Dominican, a large social service agency focused on the needs of the Dominican community, is the lead agency responsible for Best Beginnings. This program is operated in partnership with General Pediatrics at Columbia University. The research team of Best Beginnings recently completed a randomized trail. Child Advocacy Center

Established in 1995, the Child Advocacy Center is the first hospital based center for the evaluation and treatment of child maltreatment in New York City. The Center is recognized for expertise in the medical diagnosis of child sexual abuse. The Center uses an inter-agency approach, working with the New York City Administration for Children’s Services, law enforcement agencies, the District Attorney, educators and other professionals. The bilingual staff of social workers, nurse practitioners, psychologist and pediatricians conduct forensic evaluations for cases of physical and sexual abuse and meets monthly with the larger multi-disciplinary team for case conferences. The Center has developed an expertise in the evaluation for child abuse that is recognized by the new York City Family and Criminal Courts.

Choosing Healthy & Active Lifestyles for Kids
CHALK (Choosing Healthy & Active Lifestyles for Kids), a collaboration between Community Pediatrics, is a five year Center for Best Practices grant funded by the New York State Department of Health starting in 2008 at New York-Presbyterian Hospital. The goals of CHALK are to reduce over time the prevalence of childhood obesity and its related morbidity in Northern Manhattan (with a focus on school-aged children), and to promote a culture and create an environment in which healthy lifestyles are integral to the lives of all children. CHALK works with a community coalition of partners, initially focusing on Washington Heights/ Inwood to develop and disseminate a social marketing message that promotes healthy lifestyles, while identifying barriers and resources to healthy living. CHALK also works internally within the hospital to engage and train health care providers to identify best practices and to foster an environment of healthy living.

Families Together and Project DOCC (Delivery of Chronic Care) form a network of experienced volunteers parents who provide mentoring and support to parents of children with special health care needs.

Head Start and Early Head Start Program
Columbia University Head Start was founded as a partnership with General Pediatrics and the Mailman School of Public Health in 1992. Head Start provides home-based services to high-risk Latino children in northern Manhattan. The families receive weekly home visits and center based services. Early Head Start is a relatively new initiative that operates in conjunction with two community based pediatric practices of the GPGP. The services emphasize parent-child attachment, child health and development and adult vocational development. Head Start and Early Head Start assist families with achieving economic self-sufficiency. Parents identify their goals and learn job readiness skills.

Healthy Schools Healthy Families
This school-based collaboration was designed to partner health professionals with school staff and community organizations to assess the needs of children and families and to mobilize resources to address those needs. Begun at P.S. 128M in 1999, the program today serves some 5,000 children in seven elementary schools (kindergarten through fifth grade) in Washington Heights, West Harlem and East Harlem.

Using a school based decision making model HSHF schools have implemented the program with the following goals:

• to identify uninsured children and families and to facilitate insurance enrollment
• to make sure 100% of children have completed their required immunizations
• to cultivate a culture of physical fitness, good nutrition, and healthy lifestyle behaviors
• to screen for and facilitate access to services for children with identified health needs, particularly for asthma
• to integrate mental health promotion with healthy lifestyles interventions to realize a holistic view of optimal health and wellness

Lang Youth Medical Program
Lang Youth Medical Program is a science education program at New York Presbyterian Hospital for middle school students from the local community entering the 7th grade. Participation extends through 12th grade. The program will encourage and prepare students for further education and careers in health care. On Saturdays during the school year and for four weeks during the summer, students will participate in hands-on science activities and experiments at the Hospital. Faculty and staff from the Health Science campus will work with the students and serve as mentors. There is a competitive application process for the selection of families.

Reach Out and Read
Children living in impoverished urban communities are at increased risk of language delay. Early literacy activities have been shown to lead to improved language development and school readiness. Reach Out and Read, an early literacy project that began at Boston City Hospital, has evolved into a national movement. It has three simple ingredients: 1) pediatric providers promote early literacy as part of the everyday pediatric practice, 2) children between the ages of six months and six years receive a developmentally-appropriate book at each well-child visit, and 3) volunteers read books in the waiting room to engage young children and model reading aloud to parents. In 1997, the Division of General Pediatrics established Reach Out and Read in the pediatric primary care practices of New York Presbyterian Hospital. Our program is one of the largest in New York City and in the country. Since 1997, our program has given out over 120,000 books.

WIN for Asthma
Funded in December 2005, the WIN for Asthma coalition is a partnership between Community Pediatrics, the Mailman School of Public Health’s Asthma Basics for Children program and multiple community agencies in Northern Manhattan with the goal of improving resources available to children with asthma, especially children with poorly controlled asthma. Children enrolled in the program have decreased their asthma hospitalizations by 85%, decreased Emergency room visits by 66% and decreased School absences by over 50%.