Department of Population and Family Health

Research

Research, Service Evaluation, Technical Assistance, and Policy Programs

The Heilbrunn Department faculty are involved in a wide range of cutting edge research projects all over the world. From asthma treatment programs in Northern Manhattan to HIV/AIDS research in Uganda, Heilbrunn Department projects address important issues that have implications far beyond the neighborhood where the research is conducted. The next section describes several of the larger programs within the Department.

	Northern Manhattan Community Voices Asthma Basics for Children
	Head Start Bureau National Research Conference on Early Childhood Education and Development
	Law, Policy, and Rights Project
	Program on Forced Migration and Health
	Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative
	National Children's Study
	The Developing Families Project
	First Steps to Healthy Living
	Neurobehavioral Effects of Exposure to Organophosphorus Pesticides

Northern Manhattan Community
Voices Asthma Basics for Children

Asthma rates in Northern Manhattan, particularly Central and East Harlem, are among the highest in the city. For both children and adults, hospitalizations for asthma are two to three times higher than the New York City average, and four to five times the national average. The Northern Manhattan Community Voices Asthma Basics for Children Initiative (ABC), led by Sally Findley (Principal Investigator) and Gloria Thomas (Program Coordinator), is working to improve the coordination of integrated anagement of asthma for children in this community. With support from the CDC’s Controlling Asthma in American Cities project, ABC works with community health providers, community organizations, child care organizations and schools to develop more effective ways to empower parents to manage their children’s asthma.

The project has several objectives:

Strengthen linkages between parents of children with asthma, community organizations with asthma education programs, and medical providers;
Develop culturally appropriate educational materials promoting asthma management;
Build community-based asthma screening capacity;
Test the effectiveness of community and peerbased program to promote reduction of asthma triggers at home, school, and in the community;
Develop effective mechanisms to promote use of state-of-the-art asthma care practices among community medical providers;
Support advocacy for regulations promoting outdoor and indoor environments that reduce asthma triggers in the community.

Highlights of 2002 included the completion of a coordinated asthma educational program for early childhood providers and parents of young children; publication of the companion training handbooks: The Asthma Solutions Handbook for Early Childhood Educators; and for parents, Helping Your Child Live with Asthma; building community based screening programs;

Health Educators for the Asthma Basics for Children Program.

training for over 200 family day care providers, Head Start staff, and community organizations on asthma management and on asthma screening programs; and developing programs to help parents deal with asthma triggers in the home. ABC also initiated a program to develop innovative strategies to improve the use of state-of-the-art care by community providers.

The other project collaborators include the Mailman School of Public Health (the Department’s Center for Community Health Promotion; Center for Children’s Environmental Health, Department of Epidemiology), Northern Manhattan Community Voices, Northern Manhattan Improvement Corporation, West Harlem Environmental Action, Alianza Dominicana, Adair Community Life Center, Fort George Community Enrichment Center, Harlem Children’s Zone, Isabella Geriatric Center’s child care program, Northern Manhattan Perinatal Partnership, Northern Manhattan Pediatric Asthma Coalition, ACNC pediatric practices, Harlem Hospital/Harlem Renaissance Healthcare Network, the Department of Pediatrics and Pediatric Emergency Department, the New York City Asthma Partnership, New York City DOHMH, and Community Health Works Equip Program.

Head Start Bureau National Research Conference on Early Childhood Education
and Development

On June 26-29, 2002, almost 900 researchers, practitioners, students, and policy makers gathered to discuss the most current issues surrounding early childhood development and education. Head Start’s Sixth National Research Conference took place in Washington DC and featured educational workshops, research sessions, and speakers. The biennial conference, entitled “The First Eight Years: Pathways to the Future, Implications for Research, Policy, and Practice,” was sponsored by the Administration for Children and Families, Department of Health and Human Services, in collaboration with Columbia University, Mailman School of Public Health, and the Society for Research in Child Development. The Heilbrunn Department’s Faith Lamb-Parker was the project director.

Under the leadership of Professor Edward Zigler of Yale, the US Congress of the United States and the President authorized the National Head Start Program, which has been the most successful program for young children and their parents since its inception in 1964. The program, which was created to provide resource and assistance to low-income families with young children now boasts numerous comprehensive child development programs.

The first national research conference took place in 1991 with the goal to present cutting-edge early child development and education research, highlighting Head Start as the “national laboratory” for research and practice. Over the past decade, the conference has become a forum for individuals from around the world to discuss current policy issues, the research and practice, and federal initiatives.

Highlights of the conference:

Opening keynote address by James J. Heckman, Nobel Prize winner in economics, with Ann Crittenden, award winning journalist and author of The Price of Motherhood (2001), as moderator. Title: Human Capital: Investing in Parents to Facilitate Positive Outcomes in Young Children.”
Edward Zigler’s master lecture on the history of research in Head Start, and a student session with Julius Richmond and Judith Palfrey on the crucial role of mentoring the future generation of scholars.
The plenary sessions, all featuring leading academics, included: “Promoting Young Children’s Eagerness to Learn in Educational Settings,” with Ann Bardwell, Barbara T. Bowman, Ross A. Thompson, Susan H. Landry, and Ron Herndon; “Self-Regulation: The Interplay of Cognitive, Biologic, and Emotional Domains,” with John Hagen, Megan R. Gunnar, Claire B. Kopp, and Sybil Carrere; and “Policies and Programs that Support Families with Children from Birth to Three,” with Ruby Takanishi, Deborah A. Phillips, Marcia K. Meyers, and Steve A. Freedman.
Government leaders Beth Ann Bryan, Susan B. Neuman, Robert H. Pasternack, and Grover J. Whitehurst presented on the George W. Bush Administration’s new initiative, “No Child Left Behind,” focusing on the early childhood sections of the program.
Julius B. Richmond, MD, professor emeritus at Harvard and U.S. Surgeon General (1977-81) during the Carter administration, was honored for his mentoring of students at many levels as well as his outstanding contributions to child development and to the nation’s children and families. One of the Program Committee’s primary goals is student involvement.
Other speakers included Howard Markel, Steven Shelov, David Hall, Thomas Tonniges, Catherine Lord, Windy M. Hill, and the Heilbrunn Department’s newly appointed chair, Leslie L. Davidson.

For additional information about Head Start’s Sixth National Research Conference please visit www.headstartresearchconf.net. The Summary of Proceedings will be available in March 2003.

Law & Policy Project

For the last decade, the Law & Policy Project has played a leading role in the articulation of a human rights approach to reproductive health. Through publications, presentations, workshops, and teaching, the Project staff has helped shape a vision of reproductive health as a fundamental human right. The Director, Lynn Freedman, also a lawyer, and Dr. Joan Csete bring with them decades of experience in human rights, women’s health and advocacy. By working from within the Heilbrunn Department the Project is able to bridge the human rights, humanitarian issues, women’s human rights, and reproductive health movements, developing key linkages between the fields.

Giving immunizations in Rakai District, Uganda.

The Program works with NGO networks, human rights organizations, and women's health organizations in the US and internationally to address the legal, policy and human rights dimensions of health, with a particular emphasis on women's reproductive health and on the rights of people living with and vulnerable to HIV/AIDS. Program issues and perspectives are reflected in the Law, Policy and Rights course offered in the Department. There is an interest in expanding research capabilities in this area as well as placement opportunities for student practica.

The Developing Families Project

Leading world organizations advocate for investing in young children. The World Bank, in a 2007 policy statement, uses Nobel Prize winner James Heckman’s findings to substantiate its call to invest in Early Childhood Development (ECD). It mentions that the benefits of educating very early “encourage greater social equity, increase the efficacy of other investments” and that “integrated programs for young children can modify the effects of socioeconomic and gender-related inequities, some of the most entrenched causes of poverty” worldwide (http://web.worldbank.org, 2007). UNICEF has developed a strategic plan for 2006-2009 to invest in children as a way to reduce poverty worldwide. UNESCO’s Education for All Global Monitoring Report 2007, Strong Foundations (UNESCO, 2006); urged all countries to “develop national early childhood policy to promote the holistic development of young children.” Subsequently, the World Organization for Early Childhood Education (OMEP) has acknowledged that the lack of training for infant and toddler staff is a major barrier to quality care in developing countries, and made this their number one strategic goal for the coming year.

Due to widespread poverty and the HIV pandemic in South Africa, an increasing number of primary caregivers are working outside the home, resulting in a growing number of infants and toddlers being placed in daily group care. In these care situations, most of the practitioners have little formal schooling and minimal, if any, training in infant and toddler development. The majority of Black township facilities for babies and toddlers are small, tight spaces where children have limited access to toys or opportunities for interaction and relationship building, both of which are key ingredients for healthy development. At about 3 years of age, the children in ECD programs-sometimes located in the very same preschool-have activities, materials, and adult-child ratios that encourage learning and social interaction. In response to the noted dearth of quality programs for infants and toddlers, one practitioner commented that ‘they were waiting to be 3.’

The Developing Families Project (DFP) is a 3-year intervention/evaluation that uses the preschool as the ‘port of entry’ for training ECD non-governmental organizations (NGOs) in infant and toddler development, health, education and care; as well as local community collaboration and advocacy for this age group. Trainees are selected from local NGOs, preschool practitioners, parents of babies and toddlers, and other community stakeholders. Project objectives are to

improve the quality of group care for infants and toddlers;
integrate HIV prevention and stigma reduction education into the preschool community and beyond;
strengthen NGO capacity to train and support preschool practitioners and parents; and
motivate NGOs, preschools and communities to advocate for the unique strengths and needs of infants and toddlers and their families.

The DFP team is led by Dr. Faith Lamb-Parker and Dr. Virgina Casper. Drs. Lamb-Parker and Casper are faculty of the Mailman School of Public Health at Columbia University and Bank Street College, respectively. Dr. Lamb-Parker has been working with Ntataise, a well-established South African NGO, since 2000. Ntataise has conducted ECD training to over 100,000 preschool practitioners, who in turn have taught and cared for approximately 350,000 children nationwide. Her work with them includes community development and empowerment, staff and parent education, and organizational capacity-building. Dr. Casper has worked in the Western Cape collaborating on an Infant/Toddler Caregiver Curriculum with Grassroots NGOs, taking it national through a Train the Trainer program. She also worked in an Infant Mental Health service in Khayelitsha Township, Cape Town.

First Steps to Healthy Living: An evaluation of the impact of the New York State WIC programs on early childhood obesity

Childhood obesity is well-documented as increasing the subsequent risk of adult obesity, Type 2 diabetes, metabolic syndrome, cancer, and cardiovascular disease. While the majority of obesity prevention projects are targeted to school-age children, obesity begins much earlier in life.

The Columbia University Mailman School of Public Health's mission is to integrate teaching, service, and research. The proposed evaluation will measure changes in food consumption patterns, physical activity, and Body Mass Index in children participating in the State’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) - within the context of other local and regional initiatives - using WIC administrative data, staff, and parent interviews, and direct measures of child height, weight, and physical activity. WIC is a federally funded grant program ideally positioned to play an important role in childhood obesity prevention.

The innovative programs initiated by the New York State WIC Program in 2009 are designed to improve health outcomes in young children through changes to the WIC food package and implementation of Fit WIC NY, which has both physical activity and nutritional counseling components. The evaluation is a partnership of academia and government. The Mailman School of Public Health developed the evaluation objectives and plan in concert with the New York State Department of Health’s Division of Nutrition with input from the New York City Department of Health and Mental Hygiene’s Division of Physical Activity and Nutrition.

Neurobehavioral Effects of Exposure to Organophosphorus Pesticides

The purpose of this study is to assess the effects of pre- and postnatal exposure to the organophosphorus pesticide chlorpyrifos on neurobehavioral functioning in a cohort of inner-city children who have reached 9 years of age. This work builds on, and shares a cohort with, a prospective cohort study of ambient air pollutant effects on child development and respiratory health, being conducted by the Columbia Center for Children's Environmental Health. Previous findings from the Children's Center study reveal adverse effects of prenatal exposure to CPF (validated with biomarkers in cord blood) on birth weight (Whyatt et al., 2004), cognitive and motor development, and neuro-behavioral problems at 3 years (Rauh et al., 2006). Affected neurobehavioral areas
include attention and ADHD-type problems--conditions with serious long-term clinical implications. We will use Magnetic Resonance Imaging (MRI) to define the intermediary neurobiological effects of CPF exposure on the structure, metabolism, and anatomical connectivity of the brain in 200 children in this cohort. Chlorpyrifos was selected as a model for translational research because it is representative of the class of OP pesticides, well characterized, and well-studied in animals. Furthermore, agricultural and commercial uses continue, despite the 2001 residential ban by EPA, with possible hazardous consequences for exposed children.