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EP47 Andrea Levy and the Buen Provecho- Eat Well Pilot
Alexandra Arriaga: Hi and welcome to I AM GPH. My name is Alexandra Arriaga and today we're going to talk to Andrea Levy. After more than 10 years as a speech pathologist in the New York City Metro area and abroad, Andrea was inspired to pursue public health. Working closely with families in their homes and encountering the many environmental, structural, and systemic factors impacting their health prompted her to examine broader ways to engage with and improve the health of populations. She graduated from the NYU Global MPH program in 2010 and today she will tell us more about her current projects, sustainability, and community engagement and her advice to other MPH graduates. Hi Andrea, how are you doing today?
Andrea Levy: Good, thanks.
Alexandra Arriaga: We are very happy to have you here. And first, could you please tell us a little bit about your background and your current work?
Andrea Levy: So my background really is as a speech therapist. So I started my career in healthcare and health, you could say, as a speech therapist. So I worked in hospitals, in nursing facilities, and most of my time as a speech therapist was spent in home care. So while I was a clinician addressing obviously communication disorders, I became interested in the chronic diseases that my patients had and the factors that were contributing to them. And I started to think about other ways of looking at health and what was impacting the lives of the people I was seeing. When you go into people's homes, I think you get a much more intimate picture of their lives than you would in just seeing someone in the hospital or in a clinic. I started to think about and question what are the other factors that have brought this person to this point in their life where they need a speech therapist? So I started thinking about public health and studying public health. I started the program here at NYU in 2008 and graduated in 2010 and then from there I was able to kind of transition, which I felt was a natural transition, from being a clinician to looking at broader areas in health.
Alexandra Arriaga: Great. And so we know that you're currently working with the Buen Provecho Nutrition Education program, so can you tell us a little bit more about that and how did you start working with them?
Andrea Levy: The program was the brainchild of a former nutrition policy advisor at the Health Department named Kathy Nowness. And it was a grant-funded initiative. The grant was provided by the Doris Duke Charitable Foundation. She came up with a novel concept of nutrition education for parents and children in schools. East Harlem was the community. So she advertised for a person to manage all facets of the program and started up basically from the beginning through now, it's still going on. Essentially the grant was awarded, but nothing else had been actually started from the program. I was hired to coordinate all of the facets of the program with her and manage it through the life of the grant, which will be through at the end of the summer. But of course we're hoping that the programming will continue now that we've been in the schools for a while. The program itself is novel because it has a parent nutrition education component. We offered free breakfast for parents when they come to drop off their kids at schools that we enrolled. The lower grades of those schools' teachers received a nutrition education curriculum as well. So the children in the lower grades received a curriculum that we developed with a nutrition education consultant who also used to work for the Health Department and the parents at the same time receive their component geared to them. At the same time, we worked with Grow NYC to promote access to farmer's markets. We provided vouchers for farmer's markets and for a fresh food box, which is a flexible CSA during the winter when a lot of farmer's markets are closed. There are various sites around East Harlem that you can purchase at a reduced price, fresh fruits and vegetables from local farms. So it was kind of a multi-component program. It was unique. We were offering parents to engage at breakfast instead of after school, which was traditionally when a lot of parent programs were designed. The classes for the parents were delivered by the Parent Coordinator, which is a paid position in elementary schools. It's a liaison between parents and the school. So rather than us coming in and doing everything, we really wanted the schools to take it on as their own and have someone in their school be managing it, be delivering that message to the parents. We trained them and provided all the materials for them to do that.
Alexandra Arriaga: So it definitely sounds like the project is very novel and community-oriented. But I do have a question. Have you found any challenges trying to manage programs from the community level?
Andrea Levy: Yes. So it's always challenging to...communities have challenges for a variety of reasons. This program, being a school-based program is challenging because schools are very different from each other. They have different cultures, different leadership, different challenges of their own and different priorities. So while a program might come in and think it's the greatest thing and they should want this, they have their own priorities and they're also kind of pulled in a hundred directions, the staff. So this Parent Coordinator position, which is a great thing, they really are the key to the school. If you really want to get any information or be able to reach out to a leader, like a principal, the Parent Coordinator knows everything going on. But they're also being pulled in to a hundred different emergencies and everything throughout the day. So for them to actually do this program, it takes their time. That was a challenge. So according to the feedback that we got over the years, we made it so that it wasn't just the Parent Coordinator who could do the breakfast but it could be a parent or a PTA board member. And again with this effort to make it more sustainable and coming from the school, that they would take it on and keep it because it was not going to be such a strain on their time. So that's one challenge. Another is a lot of turnover with the leadership in the schools sometimes and even the Parent Coordinators, which was really key to getting into the school and doing anything. I've had several changes in that person among the schools that we've had. So change is a constant. I think that's with a lot of public health programs, but it's also one of the things that I think keeps it interesting and challenging. The schools being so diverse is I think a pro. You use it to your advantage really in programming.
Alexandra Arriaga: As public health professionals, we should always take into account the sustainability in community engagement, but how do you tackle sustainability as well as scaling projects?
Andrea Levy: So that's something that we really tried to keep in mind from the beginning of this initiative. Because I think too often programs, in general, which programs are great, they all have positive intentions, but too often we're coming in doing everything as an outsider and leaving. So from the beginning we really wanted it to be something that was embraced by the school, by the families, the community. There's no better cross section of a community really than a school. So we, like I said, engage the Parent Coordinators to be leaders of this program, to be delivering it. Then parents themselves, so we have some PTA parents, we train them in the parent curriculum. They are taking part in overseeing the parent breakfasts, delivering those little lessons. We don't even really call them lessons. They're like short discussions on different practical topics related to healthy eating. And the final thing that I'm hoping to do to make this sustainable is to turn what was my position, now that the startup and all of the management has been done for the last few years, to create a position for someone in the community who's already familiar with these schools, invested in the program, and give them the job of maybe just providing some support for the program, but that the schools have really taken it on as part of their wellness. They don't really need someone like me anymore. But someone in the community that's already in the schools, has all the relationships, and is really invested in that way. And then we've given a job to someone in the community, which is really sometimes more important than any kind of programming that might happen in a school. I think listening to the community throughout is really key to helping your sustainability efforts.
Alexandra Arriaga: Definitely. Now that I'm hearing you say that, of course it's really important, you're creating jobs for people in these communities. I think that just almost motivates them to keep the program going. So that's great. Another question. So the name of the project, Buen Provecho, it's a great name first of all, but then that's something that we don't really have in English.
Andrea Levy: It's actually Buen Provecho Eat Well, so both the Spanish and English expression. When we were trying to think of a name, which I wasn't familiar with how difficult a process that is, we actually worked with communications professionals at the health department who are very used to doing this kind of thing. They suggested something fun. Actually that's the name of the whole program. But then for the breakfast, we called the parent breakfast, The Breakfast Club, El Club del Desayuno. There's a lot of Spanish-speaking families and other languages. So it was The Breakfast Club and then the curriculum that we gave the parents was the Buen Provecho curriculum or The Breakfast Club curriculum. Then the child's curriculum had another name, Eating Healthy For Success. So, but the overall, which a lot of people know it as is Buen Provecho Eat Well. So I guess the feeling was we wanted to have something that sounded fun and positive and I think we wanted it to appeal to the Spanish-speaking community. But Eat Well, I thought it would be somewhat of a close translation to that in English. I know we don't say in English Buen Provecho or Bon Appetit or those, but Eat Well could mean enjoy or also to eat healthy, which of course was one of the messages.
Alexandra Arriaga: Right. Yeah, I guess that's what I was thinking. Here in the U.S., you sit down at a table and no one really tells you, Oh, Buen Provecho, like go and enjoy your meal. Whereas I feel like in most of Latin America, you sit down, you're at a table, and everyone is like Buen Provecho, like please enjoy your meal.
Andrea Levy: Yeah.
Alexandra Arriaga: So it's just that nuance, like cultural nuance.
Andrea Levy: Yeah. I kind of thought it's sort of this double meaning to me. But then, and most people don't even say the Eat Well part, they just say Buen Provecho. That's how it's known around my offices, the health department, and in the schools. So it kind of stuck like that.
Alexandra Arriaga: No, I mean it's a great name. So Andrea, what type of research has been developed through the Buen Provecho program?
Andrea Levy: So we did a survey. We had three years of survey data. We surveyed parents, whether they participated in the breakfast program or not. All of the parents of the lower grades received a survey two times per school year. That survey had questions on health behaviors, fruit and vegetable intake for themselves and for the child, and then a few questions on food insecurity, which is a big challenge in this community. So over three years, we collected probably more than 800 surveys total. And right now, I work with a data consultant to analyze the data and to see the type of impact that we've had regarding those health behaviors.
Alexandra Arriaga: Great. And so what advice would you give MPH grads that are on the job market, who are either just starting out with their career or are seasoned professionals, who are looking for maybe changing careers or ... ?
Andrea Levy: That's a good question because I feel like I'm always still seeking that same advice and trying to use my own advice. But I would say the job that I'm in now is definitely the type of job I hoped to have when I was in graduate school for public health. It's what I envisioned working in public health would look like. Being on the side of health where you're working with the community and educating and also being part of an entity like the health department. But I had several positions before that so it didn't happen right away. I would say be patient because that helped me to get to this point and also be open. I was always and still am looking at what other organizations are out there doing the kind of work I might be interested in or what kind of job titles there are that I might not know about. And then you always circle back to what you're really interested in. So I think if you're open and patient, you end up where you're supposed to be. I like to think anyway. But yeah, those are some pieces of advice I think.
Alexandra Arriaga: No, that's great advice. Thank you for that. And how do you personally combine your passions with work and service?
Andrea Levy: I am fortunate that I have a job that I'm interested in. I'm always kind of seeking new things to learn about and to pursue. I do a lot of volunteer work aside from my job. So in those, because it's volunteer, those are things that I feel like I can pursue that there's no pressure to be highly skilled. But I'm passionate about service and I'm spending my time with causes that I'm interested in. So it's kind of like a job that's fun. It's unrelated to my profession. Well, sort of related. I think when you do service with that motivation, it comes through, the same motivation that you have in your job comes through. You want to do well. And in public health we want to help people. So volunteer work, I think, is not only a way to keep your passions alive, well obviously give back to the community, but you can engage with an area that you maybe wouldn't have the opportunity to before. Why more people don't spend their time doing that is beyond me. You could just try out something for a few months and say I never knew I wouldn't like this or I do like it. Or maybe it's something that I want to learn more about. People always need volunteer work. They need help with things in every field on every level. So I really encourage people to give back and volunteer their time.
Alexandra Arriaga: Yeah, I fully agree with that. And what motivates you to do this work, to put in the hours, to do this research? Where does that motivation come from for you?
Andrea Levy: Well, like I was saying, I'm interested in this area, so I'm interested in helping communities live more healthy lives. But also the motivation comes from being around other professionals who have similar passions. At the health department, I'm really fortunate to be in that type of environment. So I'm sitting around people who are doing various things in the community, things that I only used to hear about, like when I was in public health graduate school. The health department has so many initiatives in the community and so many things going on. So it's nice to be around people with similar passions. But also, the thing that really motivates me on a day when maybe I'm not having such a great day is the connection with the community. I've formed relationships not only with my own office and leadership in the health department, but the schools that we work with, the parents, of course. Even if I'm just walking to go run an errand in the neighborhood or get lunch, I'm always running into a parent or someone from one of my schools. And a lot of times that just really makes it all worthwhile because we've gotten to know each other, we have a relationship, they're used to seeing me, and they are really what keeps the program alive. So that really helps to motivate me. I think being connected with the community when you're doing this kind of work is really key.
Alexandra Arriaga: Absolutely. Well Andrea, thank you so much for joining us today. Thank you for sharing your advice and we hope all the best for you.
Andrea Levy: Thank you.