Program teaches women to make lifestyle changes

"I know you're all not eating that bread on your plate," Robin Pratts, MHA, jokes to a room of women. Laughter fills the room.

Some of the women take just a bite out of their roll and savor it, while others push the bread out of the way to focus on their salads. The actions may seem small, but for these women they represent much more in their journey to better health.

The women gathered in a conference room at Rush University Medical Center are participants in Rush's Health Legacy Program for Women. On this late October afternoon, they're celebrating their successes, big and small, from losing weight and starting exercise programs to being able to pass on the bread basket and learning how to cook healthier meals. All these little victories make this event a meaningful occasion for the 75 program graduates.

"The spirit of the program is to create a 'legacy of good health' by their own example and everyday modeling of health behaviors," Pratts says. "It's so exciting to see the women do this."

Pratts is the manager of health promotion programs in Rush's Health and Aging program, including the Health Legacy Program for Women, or HLP for short. The program's goal is to reduce health disparities by helping women become healthier in a meaningful way.

HLP Focuses on obesity and diabetes

As of November, this community-based program has touched the lives of more than 400 women and families across Chicago. Pratts and her team are committed to continuing the HLP's work to improve health equity, which the World Health Organization defines as the elimination of avoidable or solvable health differences among various groups of people.

"In underserved areas, so much is needed beyond 'health experts' passing out brochures and telling people to become healthier," Pratts says. "Particularly in the African-American community, type 2 diabetes and obesity is an epidemic, and African-Americans have the highest complications and amputations associated with this disease."

Due to the correlation between obesity and diabetes, and because 82 percent of African-American women are overweight or obese, something had to change. This problem became Pratts' focus.

"I started this program in 2013 to give women a real, hands-on way to change their lifestyle and behaviors so they can ultimately become healthier," she explains. "And for those with diabetes, our goal is help them learn how to better manage their diabetes and avoid complications, hospitalizations and amputations."

Program stresses support, exercise and healthy meals

The free program has four core components: health education, cardiovascular exercise, a weekly support circle, and hands-on meal planning and nutrition tips from a chef. It focuses on women, since they usually are the "health regulators" for the family.

If they cook healthy foods and model other health behaviors, the entire family unit benefits from their influence, according to Pratts. The HLP puts a strong emphasis on teaching these women to make healthier lifestyle changes, in the hope that they become sustained, permanent behavior changes.

For six weeks, participants meet twice per week for approximately 2 ½ hours, usually at churches on Chicago's West and South Sides. The first session of the week consists of health education, which is followed by 35 minutes of some type of cardio-pulmonary exercise, such as Zumba.

Education is as simple as the "5 Alive" rule—basically a commitment to eat a combination of five servings of fruit and vegetables a day. Other tips include eating a colorful diet, portion control, what a healthy plate looks like and more.

During the week's second session, often on a Saturday and referred to as the "Saturday support circle," the women meet with a therapist and discuss health barriers they experience with each other. "We also talk in group about reducing stress and the impact of stress on health," Pratts says. "It's exciting to see participants make action plans, problem-solve, and reduce stress in their lives in creative ways."

Following circle support, they break for 35 minutes of exercise then conclude with a chef who comes to show them how to prepare low-cost, healthy meals. They receive recipes and can ask questions.

A weekly action plan may be as simple as committing to exercise 20 minutes every day or to stop drinking sugary drinks. When the women return the following week, they'll talk about what did and didn't work. They talk through challenges and form genuine friendships.

'This program saved my life'

"We see women who had out-of-control diabetes get it under control by increased monitoring, exercise and dietary changes," Pratts says. "The results have far exceeded my expectations."

Once the six weeks are up, the women are recognized and celebrated with a "graduation." Twenty-five participants from JLM Abundant Life Community Center on Chicago's far West Side completed the program and lost 181 pounds collectively, an average weight loss of seven pounds per woman.

Pratts' own mother, Elmyra Powell, participated in the first pilot group at Liberty Baptist Church in the Bronzeville neighborhood on Chicago's South Side. She weighed 200 pounds, walked with a cane and was in pain all the time.

With the support of the program, she lost weight, walks without a cane and was able to recover from knee surgery much sooner. "This program saved my live," Powell says.

Measurable health improvements seen

The program has been a successful health intervention and community connection, Pratts says. The women who have participated in the HLP are moving more, with 91 percent reporting they're exercising, compared to 59 percent at the start. They're choosing healthier foods, shopping better, drinking water instead of sweetened drinks and increasing their overall health awareness.

On average, the women in the program have lost 6 pounds during it and seen their blood pressure decrease from 136/78 to 131/73. "Many of the women report feeling more in control of their health and feel really good about making themselves and their health a priority," Pratts says.

This HLP has been offered at 16 sites across Chicago and conducts ongoing recruitment as part of Rush's strategic efforts to serve vulnerable communities. Originally funded by Rush, the program's success has earned it current funding by the Retirement Research Foundation and the Cigna Foundation.

The next step for the program is the development of a manual and training guide for replication. "My hope is that this program is nationally used and recognized as a template and model for engaging vulnerable populations," Pratts says. "This is the way we can reduce health disparities—bringing health into the community and affecting one family at a time."