It Takes a Village
Western Village Academy and Integris Health team up to reduce the
risk of childhood obesity in students

—Shauna Lawyer Struby

On the face of things, Western Village Academy in northwest Oklahoma City is like any other elementary school.
Halls are decorated with brightly colored student art. Outside the principal's office pictures and certificates noting the achievements of students line the walls. During recess the laughter of children reverberates across the campus.
And of course no school is complete without the smell of freshly sharpened pencils and cafeteria food wafting through the hallways.

But in at least one way, Western Village is different.

Western Village has David Dubé, a physician's assistant who came to the school five years ago and is actually an employee of Integris Health, Oklahoma's largest health care organization. Dubé's salary, paid by Integris, is a part of the corporation's sponsorship of the academy, the first elementary charter school in Oklahoma.

Since few schools have the luxury of a full-time nurse, much less a physician's assistant, Dubé is in many ways a pioneer in school health care.

During his first school year (2000-2001), he settled in and began interacting with the kids. As he took family medical histories, worked on getting immunizations up to date, and doctored skinned knees, intuitively he felt something was not quite right with the health of the students.

"When I got here, I just took a look around at the kids and intuitively I thought something was awry," says Dubé. "I had a feeling something wasn't right in regard to the health of the kids but I wasn't sure what it was."

So Dubé went on a fact-finding mission, searching for what his intuition was telling him. Dubé logged students' height and weight, calculated growth charts using the Center for Disease Control's body mass index (BMI) formula, and screened every single child's hearing and eyesight.

He also collected data on socio-economic indicators including a student's grades, family health history, and income level. The school is located in a low-income area of northwest Oklahoma City where many of the families have an average monthly income of less than $1,000.

Compiling such comprehensive data for 330 individual kids by hand was so time-consuming and data intensive that Dubé sought the help of a computer programmer, Kathleen Patton of Edmond. Patton created a program allowing Dubé to efficiently track every child at Western Village and analyze the factors influencing a child's health.

The result was Dubé got an expandable, adaptable tracking program and perhaps more importantly discovered what his instincts were trying to tell him.

"When we calculated the overall BMI of the children, 27.8 percent of the kids at Western Village were at risk for obesity," says Dubé. "I think at the time the national average was about 20 percent. We also found a direct correlation between the
economic status of the family and the risk for obesity, with lower income families at greater risk."

This was before the studies and headlines about America's obesity epidemic hit mainstream consciousness, but to Dubé, the statistics were disturbing considering the role childhood obesity plays in other health issues.

Obesity places children at an increased risk of high blood pressure, higher cholesterol and fat levels, and Type 2 (often referred to as adult-onset) diabetes. These conditions in adulthood are well-established risk factors for heart attacks, strokes and numerous other medical problems.

It's also known the longer a child remains obese, the more likely that child is to become an obese adult.
Alarmed by his discovery, Dubé shared his findings with Western Village Academy principal, Peggy Brinson. Fully aware they couldn't control all the factors contributing to the obesity risk for their students, Dubé and Brinson focused on factors they could change. Dubé assessed the school's programs in two vital areas: physical education and nutrition.

Dubé's examination of the school's lunch program revealed a menu high in fat, sweets, and fried and breaded foods. Working in partnership with the school district's meal planners, Dubé and Brinson made adjustments to meals and snacks that would continue to provide the amount of nourishment needed by the kids but that at the same time was lower in fat.

"Breakfast and snacks were easiest to address. We added a lot of fresh fruit, cheeses, crackers and that helped out quite a bit," says Dubé. "Lunch is more challenging due to state and federal guidelines on what children should be receiving every day, but we've made strides there as well." One student favorite: fresh fruit yogurt smoothies.

As a charter school, Western Village focuses on the arts. In keeping with this emphasis, the kids were doing primarily dance-based physical activities rather than traditional physical education.

The school decided to offer a more varied program. A walking program with prizes for the kids was instituted and new playground equipment was added.

The school also hired a full-time physical education teacher, Dana Chambers. Chambers started with a regular rotation of physical education each week for every child.

In addition to dance Chambers added seasonal games like soccer and basketball, gymnastics, jump rope and other games.
"The kids love it, they enjoy it," says Chambers. "Our physical education program is a very cooperative effort that involves the whole school. The teachers realize physical education stimulates the kids. They come back to their teachers after P.E. ready for class and ready to learn."

Through private donations, the school recently added a brand new walking track. "The track may seem like a small thing but to this school and the surrounding community it's huge," says Dubé. "People from the community are using it and families are walking together. They're proud of the track."

As a result of the school's efforts, student BMIs are coming down and this year hit the lowest level yet, with only 15.1 percent of Western Village's students found to be at risk for obesity. That's down more than 12 percentage points from 27.8 percent when Dubé first tallied BMIs.

Brinson is thrilled with the results and adds a decrease in discipline referrals could also be related to the release of energy the kids now get with the increased physical activity.

"The changes David instituted made a difference in the overall well-being of the kids," says Brinson. "They are more self-confident now and overall their physical health definitely is a piece of the larger success we're having with the kids here."
Brinson noted many of the school's success over the last few years are interrelated, building on and feeding each other, linked to the holistic approach they take in educating the children. For instance, when Brinson arrived only 25 percent of the children could read at or above their level.

With the addition of a rigorous reading program, that number is up to 66 percent, and as Brinson and Dubé proudly note, every child at Western Village has a mentor, which they feel makes a huge difference in the lives of the kids. Most of the volunteer mentors come from Integris Health, Oklahoma Christian University of Science and Arts in Edmond, and Heritage Hall High School in Oklahoma City.

"It's a slow process but we've made some big strides," says Dubé. "It's interesting. I've never been involved in a school quite like this where not only are we educating children, we we're also caring for them holistically."
"Our successes come from our partnerships with so many and a dedicated staff," says Brinson. "This is truly the epitome of the concept that it takes a village to raise a child. Everyone has their heart in doing the best for these children."

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