SurroundHealth recently attended a White House Roundtable on childhood obesity prevention. Olajide Williams, MD, MS of Hip Hop Public Health urged the roundtable attendees to actively involve youth in the design of interventions. After the Roundtable, SurroundHealth sat down with Dr. Williams to learn more about Hip Hop Public Health.
How did a Chief of Staff of Neurology at Columbia University Medical Center become Hip Hop Doc? It’s interesting the way worlds intersect. I was Chief of the Inpatient Neurology Service at Harlem Hospital Center. I wasn’t really planning on getting involved in community-based public health research until I was confronted with a real-world clinical problem that needed a public health solution.
More than half of our neurology patients had strokes and one of the tragedies was that these patients were really young – in their 20s, 30s and 40s. Even more tragic, almost all of these patients were arriving outside the window for emergency stroke treatment. Thrombolytic therapy can significantly decrease disability from stroke but only if the patient arrives in the hospital within 3 hours of the onset of symptoms. In Harlem, only 1.9% of stroke patients were arriving within this treatment window (compared with a national average of 5%). I realized this problem could only be fully solved by engaging the public in recognizing the symptoms and the need to get urgent care. That got me looking for ways to impact the problem positively. I partnered with the National Stroke Association to develop Hip Hop Stroke.
Hip Hop Stroke targets children but aren’t adults the ones who are having strokes? We are targeting high risk minorities in Harlem. Historically, it’s always hard to target adults in these high risk communities because many are working multiple jobs, trying to put food on the table and doing the best they can with meager resources. Health is not a priority. Through Hip Hop Stroke, we empower tweens (8 to 12 year olds) by teaching them stroke symptoms and prevention. We created a way for the kids to be a conduit of health information to their parents and grandparents.
Watch the Stroke Ain’t No Joke cartoon featuring Hip Hop Doc
How else do you involve the tweens in your programs? In public health, we think we know all the answers but we really have no idea. The world is forever changing. What is attractive and engaging to children is forever changing. The best way to create context-relevant, culturally tailored interventions is to get the target audience together with the design and research team and co-design the program. We have a student advisory board in which the students are appointed by their principal based on merit. The student advisors become directors of our organization. Their role is to help us develop, shape and re-tool our programming.
Tell me how the Hip Hop Stroke has evolved. The success of our stroke program led me to look at childhood obesity prevention. I realized the model we created could address other health problems. The HIP HOP team worked with nutritionists, behavioral scientists, pediatric endocrinologists to develop Hip Hop HEALS (Healthy Eating and Living in Schools). That program addresses menu board literacy, caloric literacy and physical activity.
As you transitioned from Hip Hop Stroke to Hip Hop HEALS, did you find a challenge you didn’t expect? I am constantly being challenged and surprised. When you work in economically disadvantaged communities, the enormity of the task can be humbling. You need to focus and aim to do 1 or 2 things well that can easily be measured. We decided we were going to be experts on menu board literacy and caloric literacy. We wanted to focus on small changes that would lead to big results on the population level.
Menu board and caloric literacy are the cornerstones of Hip Hop HEALS. Why did you focus there? New York City had recently passed a law mandating caloric listings on menu boards. I wanted to know whether laws can inspire change at the community level – especially among low income urban communities where health literacy levels may be low and poverty may be high. Research showed that the caloric listings on menus did not influence food choices among those living in low income neighborhoods. We explored why and found fundamental barriers to navigating menu boards. We also found that many people do not pay attention to the information on the menu boards because the numbers have no meaning to them.
Through Hip Hop HEALS, we have increased children’s menu board literacy and caloric literacy. And, we have shown that just by increasing those skills children are motivated to think about their decisions at the point of purchase. Hip Hop HEALS is not only showing a positive influence on children’s purchases but also on the family’s purchases at grocery stores and restaurants.
View Hip Hop HEALS in action
Where do you turn for inspiration as you work on these initiatives? For me, it’s being a physician and working in the hospitals and seeing the bad outcomes. When you are dealing with disease at a stage where it cannot be reversed, you become very inspired to go into the field to children and fight like hell to prevent them from getting these diseases. It is heart breaking and a tragedy to see young men and young women become disabled or die prematurely. Every day I see this, I feel more confident about the work I am doing and more inspired by the necessity of this work. That’s what keeps me going.
Hip Hop Health
Learn more about Hip Hop Health’s research findings
- Multimedia intervention: Uses entertainment as motivating tool to unlock the minds of youth
- Youth driven: Tweens are co-designers with the research team
- Based on theories of motivation and persuasion along with theories of behavior change (self-efficacy and reasoned action)