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Vital Signs

Small steps, big strides

By Susan Warner

Medical students Nicole Nakamaru (left) and Kelly Everhart work with young women with children at the Family Place in Norwich, Vt.

Teenagers are constantly bombarded with well-meaning public service messages: Don't smoke. Lose weight. Get some exercise. But, for a number of reasons, some find such advice almost impossible to heed.

That's especially true for teenage mothers in the Upper Valley. Many had difficult home lives and are likely to tune out the self-care platitudes they hear for one simple reason: everyone around them ignores these messages, too.

Although changing such attitudes is tough, the Family Place (TFP) in Norwich, Vt., has been working steadily the past seven years with young women with children through a program called Families Learning Together to reverse the tide of poverty and self-neglect. For the last three years, it has partnered with Geisel students from the New Hampshire-Vermont Schweitzer Fellows Program to bring the students' energy to the organization's mission.

The connection between TFP and Geisel came about through the work of Dr. William Boyle, professor emeritus of pediatrics and of community and family medicine at Geisel. "I wanted students to witness the many faces of chronic health conditions, including obesity, diabetes, and poverty," he says. "It seemed only natural to partner students with the Family Place to learn what they cannot in a sterile doctor's office or clinic."

It's a partnership second-year Geisel students and 2012 Schweitzer Fellows Kelly Everhart and Nicole Nakamaru welcomed. Everhart and Nakamaru are two of the 11 Schweitzer Fellows from Geisel for the 2012-2013 academic year. Schweitzer Fellows work with community organizations on projects related to public health. Both Everhart and Nakamaru are endurance athletes with passions for fitness and community action, and they saw a chance to bring those interests together to help the women at TFP. "We both believe in a strong connection between physical fitness engagement and mental health and well-being," says Everhart, a competitive cyclist. "Our idea was to extrapolate basic training goals toward making good life choices. And the Family Place is a community that could benefit from these skills."

The women, who range in age from 15 to 25, come to TFP with their children to take part in the Families Learning Together program. Often their goals include taking the courses they'll need to graduate from high school and mastering job skills to secure employment. Most come from backgrounds of multi-generation poverty and many have been victims of trauma. But TFP gives them an opportunity many missed at home: seeing good parenting in action.

"We want the women to use their time here to focus on bettering their education and to overcome barriers to their success," says Helene Meloche, a program coordinator at TFP. The education the women receive is comparable to a typical high school curriculum, adds Meloche. But she acknowledges that they could use help setting goals, particularly fitness goals. Many of the women are overweight and several smoke.

"Some of our curriculum includes road safety [and] nutrition for training," says Everhart. "We take them out on local routes and discuss what happens when you encounter an aggressive dog. Things that you should actually start to think about if you're going to do any kind of outdoor activity."

Before they could lace up their walking shoes, Everhart and Nakamaru first spent several weeks simply building rapport with the women; gradually they started coaching them on setting goals. "We knew we needed to create credibility with them," says Nakamaru, an accomplished triathlete. "But once established, we can help them begin to envision what they can do to change their habits and the effect this will have on their children's lives."

It was tough at first. The students often would hear comments such as "This physically active stuff is not for me," or "I never exercise." So Everhart and Nakamaru began slowly. The idea was not to run a marathon but to start walking a bit at a time, gradually increasing the women's comfort with exercise. "We want to meet them where they are and help them discover the option of having a dream, even a small one, and showing that some of it can happen," says Everhart. "Maybe they get up to one mile a day. Just achieving that can make you incredibly proud.

If you'd like to offer feedback about this article, we'd welcome getting your comments at DartMed@Dartmouth.edu.

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