Kids’ Health #54

Dr. Lynne Tetreault:

If most of the population is immunized, it will protect the ones that are not. But as our rates go a little higher, there is that risk that if you're not immunized, you will catch the disease and then you spread it to other people. And those that are immunized will have a milder form of it and they'll be okay, but the ones who aren't will be more at risk.

Dr. Lisa Letourneau:

We need to address and prevent so many of these conditions that then turn into much bigger conditions and illnesses later on. So kids that stay more active, all those things that are being promoted, translate absolutely into better health and adult life and to lower cost.

Jen Rohde:

I mean, the best gift that we're giving these girls is that sense of like, this is not a selfish endeavor. You know, you are such a happier, healthier, more positive person when you take that time that it comes back to the people around you a thousandfold.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and podcast number 54, Kids Health, airing for the first time on WLOB and WPEI Radio Portland, Maine. On today's show, we will be speaking with Dr. Lynn Tetra of Maine Medical Partners Pediatrics in Saco and also the Medical Director of Vaxmeen kids, Dr. Amy Belisle, medical Director of the Child Health Quality Improvement Projects at the Maine quality counts program Dr. Lisa Letourneau, executive director of Maine Quality Counts and three representatives from the Girls on the Run main chapter, Jen Rhode, the Council Director Sandy Sinclair, Program Coordinator, and Stacy Olson, Outreach and Events coordinator. I first moved to Maine in 1977 as a fairly small child and have lived here for many of the years since. My family has 10 and I'm the oldest, so I've had a lot of experience with kids health from the very earliest years of my life. I myself have three children, and when it came time to be a doctor and raise them, I thought, you know, what better place to live than Maine? Kids Health has always been very important to me. Through my 10 years as a medical director at Maine Health, I worked for the Learning Resource Center Centers and the Maine Health Works on Wellness program and also the Raising Readers Program. I also wrote for 10 years for the Parent and Family newspaper in the Southern Maine area. So I know Kids Health and it's important to me. So I thought we'd bring together some of the thought leaders in Kids Health, thought leaders that not only are doing good work now, but have been doing good work for a long time. In fact, you'll find as you listen along that some of these individuals are ones that I've trained with, so some are ones that I've known all my life, and some are ones that have had an important impact on my life in public health over the last 15 years. And then we also bring in a new group of individuals who are also very enthusiastic about Kids Health. And these are the women from Girls on the Run, a new program which is encouraging girls to get out there and feel good about their bodies and themselves through running. There's a lot you're going to get from this program, and one of the topics that I know some of you may find controversial is vaccinations. But I hope you'll give it a listen, because what we strive to do in the Dr. Lisa Radio Hour is to represent different points of view. We think that everybody has a right to live their own life and have their own health their own way. But it's important to have as much information as possible when making good decisions. So thank you for being a part of the Dr. Lisa Radio Hour and Podcast and listening in and having an open mind and being inspired and going out and raising your own kids and helping other children to be as healthy as possible in this great state of Maine. The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of this sponsorship, we offer a segment we call UNE Wellness Innovations. This week's Wellness Innovation comes from the University of New England itself. According to the National Institute of Mental Health, anxiety disorders affect about 25% of adolescents age 13 to 18, with close to 6% seriously affected and close to 40 million suffering well into adulthood. With a $404,000 research grant it has just received from the National Institutes of Health, the University of New England plans to investigate some of the neurological basis of these debilitating anxiety disorders in adolescents. Michael Berman, Ph.D. assistant professor in the University of New England's Department of Psychology and principal investigator of the grant, says although the neural systems involved in adult fear and anxiety are well studied, how these systems develop and contribute to the occurrence of lifelong anxiety is not well understood. For more information on this Wellness Innovation, visit Dr. Lisa.org for more information on the University of New England, visit une.edu.

Dr. Lisa Belisle:

on today's Dr. Lisa Radio Hour podcast I have the great pleasure of having in the studio with me one of my former teachers and colleagues at the Maine Medical center. When I was a family practice resident, I was in training with this really wonderful pediatrician, now pediatrician Dr. Lynn Tetro, who is with the Maine Medical Partners Pediatrics Practice in Saco. I like to remember what it was that caused me to want to be a doctor and some of this was being in with people who also wanted to be doctors and teach. And I know this is part of what you do in your regular practice every day is teach.

Dr. Lynne Tetreault:

I do. I teach residents and I teach students. And in a way you also teach the parents of your patients. So I think being a teacher is a big part of my job, but I love doing it because I can share my enthusiasm for it with medical students and these young residents as they're learning, embarking on their profession in their career so I can show them that it isn't as stressful or as cumbersome as sometimes it can appear. A lot of docs who have been in this a while get so discouraged by the paperwork and everything else that you have to encounter in a day. But I really love what I do and it's been such a privilege to see patients grow. I've been in practice 14 years, so you know there are teen girls that are now mothers, married and have their own children that come to see me. So I feel like I've been around a little longer than some and also seeing these babies that I took care of 14 years ago now be teenagers.

Dr. Lisa Belisle:

Then why did you go into pediatrics in the first place? What was the decision making point? Because the show is about kids health. So you like kids?

Dr. Lynne Tetreault:

Apparently I have always loved children. I come from a big French Canadian family, so I was always around children and got a great sense of enjoyment and satisfaction from just seeing children grow and encouraging them to be active and healthy. In my college years, in my summers, I used to work at the Parks Rec program, and I used to run programs for toddlers and their moms up to teenagers and do arts and crafts and things like that. So I've always enjoyed working with children. And I've told people that if I didn't end up being a pediatrician, I might work at Disney World doing some kind of rec management position, since I knew someone that ended up doing that and seemed to really like it.

Dr. Lisa Belisle:

So instead of Disney World, you're now on the other side of it, maybe tormenting kids just a little bit.

Dr. Lynne Tetreault:

Thankfully, my nurses do the shots, so I get to be the good lady in the office. But children do get apprehensive when they see me because it's the women in my office that do the shots. So they do get a little nervous seeing me. So most of the time I try not to torture them. But, yes, sometimes digging in the ears is not very fun for them, but you have to do what you have to do.

Dr. Lisa Belisle:

Well, talk to me a little bit about that. I know that your other job is working for the Maine Health Vax Main kids program, and that has to do with vaccinations. And you've already alluded to the fact that vaccinations are painful for children. I think they're also. Well, there's a lot of different ways we could go with this whole idea of vaccinations. But talk to me about what that program is.

Dr. Lynne Tetreault:

That program is raising awareness about the importance of vaccines and getting our kids vaccinated. In the state of Maine, a lot of people are apprehensive about vaccines. That's. There's been a lot of stuff in the media. Unfortunately, some of the stuff that was initially put out in the media got debunked, but that hasn't really got out there saying, you know, the guy that said that autism was linked with shots, his data actually was made up and he was found to have been a fraud. So unfortunately, that kind of message doesn't get out there. But it's so important to get our kids vaccinated. Recently, we've had outbreaks of pertussis in the area. Also, there was an outbreak of measles in the fall in the Boston area. So these diseases that are so important to be protected against are still out there. And a lot of parents don't realize that they should get their children up to date. Sometimes they might be missing a tetanus shot. You know, after their five year shots, they may think they're all set, but actually, as teenagers, they do need a booster for tetanus. And the new tetanus shot has pertussis as part of it. So they are able to get caught up and they should have that every 10 years. If a parent isn't sure if their child is up to date, they should contact their doc and have their child's record checked.

Dr. Lisa Belisle:

Well, talk to me about some of these things that we vaccinate against. I mean, I have three children. I chose to have them all fully vaccinated. Even though I was aware of the mercury, thimerosal, all of the controversies surrounding vaccinations. I did choose deliberately to have my children vaccinated. It was because the diseases we're preventing can be life threatening.

Dr. Lynne Tetreault:

Oh, absolutely. Pertussis in young babies can be fatal. There's meningitis. About one or two children a year in the Portland area still get meningitis. So it's very important to have your child immunized against these diseases. A lot of people don't know that chickenpox can be fatal. 100 kids a year were dying of chickenpox, and 60 of them were normal in this country. Now that the vaccine has been around for a few years, that number has gone down to almost zero, which is great. So it is important to get your children vaccinated, and the benefits do outweigh the risk. But it is important to do your research. Make sure you have all the information so that you feel comfortable with that decision. Ask your doctor questions. Go check the American Academy of Pediatrics website. They have a lot of good information about vaccine. So does the cdc, because there are things that are still out there. The meningitis, the measles, chickenpox. We also immunize against polio, and a lot of people think polio has been eradicated, but in actually some parts of the world, it isn't. Hepatitis A can be prevalent in some parts of the country, and that's a liver disease. One of my partners had a patient that had to have a liver transplant after being exposed to hepatitis A. So all these vaccines are important. They may seem numerous, but there is good logical reasoning behind recommending having them done.

Dr. Lisa Belisle:

Well, one of the things that I know a lot of parents have concerns about is the number of vaccines being given at one time. And if your child has a reaction, then how are you supposed to know what they're reacting to? What do you say to parents who ask that question?

Dr. Lynne Tetreault:

That is a tough question. If you have a lot at a time. I try to limit it to three at a time. And most of the most of the time, if there's a reaction, we know which one it is. The Whooping cough Tetanus 1 is the one that sometimes gives a low grade fever or sometimes a sore arm or a little bump on the leg called a little sterile abscess. And so we kind of do know which ones are the troublemakers for the vaccines, but they're mild, self limiting, meaning that they'll go away within a few days to a week. And Tylenol and ibuprofen can always help the discomfort of vaccines in terms of the immune system response. Some parents are apprehensive of giving so many shots at once. But many studies have shown that if you are given three or four shots at the same time, it doesn't inhibit the body's response to build immunity. So you still will get immune to those diseases.

Dr. Lisa Belisle:

And are there actually significant and serious side effects that have been associated with some shots?

Dr. Lynne Tetreault:

There has been, but a lot of times it's high fever or kids who are more predisposed to fever seizures. You know that there's an age range from 2 to 6 where they can get a seizure from having a high fever. So of course, if you get the vaccine and you have a high fever, you may get a seizure. That side effect is very rare, but it is there. It's usually in kids who are already predisposed to seizures. And in terms of the other reactions, there is a rare side effect called Guillain Barre Syndrome that can happen from a flu vaccine. But again, it's usually there's a family history or predisposition to developing these serious side effects. So usually the families are aware of those risks before the vaccines actually happen.

Dr. Lisa Belisle:

As you know, the Dr. Lisa Radio Hour and podcast is focused on the mind, body and soul. Sometimes our bodies are giving us a little indication that maybe things aren't quite right. Here to talk to us about some particular things that we can listen to when our bodies are acting up is Dr. John Herzog of Orthopedic specialists in Falmouth, Maine. Today's diagnosis is degenerative arthritis of the knee.

[Unidentified voice]:

Dr. John Degenerative arthritis of the knee is a very common thing I see in my practice. You know, it's usually people getting a bit older or who have had surgery or an athletic injury. We have treatment available utilizing PRP and in the future, stem cell injections to regrow the articular cartilage in your knee. For more information on that, you call 781-9077 or online@orthocareme.com

Dr. Lisa Belisle:

what about some of the newer vaccines that have come on the market, like Gardasil?

Dr. Lynne Tetreault:

MM Gardasil is definitely one of the ones that causes a lot of apprehension in the moms and dads of teenagers because it's relatively new. But it's been around since probably early 2000s in the research phase, and then it became broad marketed in 2006. So the data I've seen is in 2006 there was 21 million doses and only 8,000 side effects, which is like less than 1%. Of course, if you are one of those 8,000, that's significant. A lot of times, though, the Gardasil just gives a sore arm. Some kids get a little dizzy after a shot, but that's more just a reaction to the stress of the shot. In terms of our practices, we really, in the five practices I'm associated with, we haven't really seen much of a side effect to Gardasil. This is more just nationwide.

Dr. Lisa Belisle:

And what is Gardasil protecting against?

Dr. Lynne Tetreault:

Oh, it's protecting against cervical cancer. It tries to prevent you from getting infected from four different human papilloma viruses that are known to cause cervical cancer.

Dr. Lisa Belisle:

So when you vaccinate young, then you're protecting against something that girls can be exposed to over the course of their lifetimes, which could then lead to cancer.

Dr. Lynne Tetreault:

Exactly. And the important thing of getting them vaccinated young is that you want them to be vaccinated before they become sexually active.

Dr. Lisa Belisle:

And there are other. You alluded to the meningitis vaccine. There are other vaccines that do take place in the teens and actually later as kids are getting ready for college.

Dr. Lynne Tetreault:

Right, right. There is a meningitis vaccine called Menactra and it's very important to get them started. We do them at age of 11 and now there's a booster after the age of 16 so that they are doubly protected. The immunity of it should last at least 10 years to get them through the college years. The college kids are the most at risk for meningitis because they live in the dorm settings in close quarters, then high school kids are the next highest at risk, and then junior high. So that's why we try to get them vaccinated when they're 11.

Dr. Lisa Belisle:

What if a parent comes in and says, Dr. Lin, I just don't want my kid vaccinated? What's your response?

Dr. Lynne Tetreault:

You know, I respect the parent. You know, my role is being their medical advisor. Ultimately, you're the parent. You make the decision on your child. But I want you to be fully informed. And, you know, we'll talk about it. I'll make sure that they're aware of all the risks of not being vaccinated. But ultimately, if they've made that decision and they've done their research, I respect that. You know, you really can't force it. And in the state of Maine, I believe children can go to school and the parents can sign a waiver if they're philosophically opposed or if they have a health condition. You know, some kids don't get immunized from measles, the MMR vaccine, because they have an egg allergy. So, you know, I do respect what the parents have to say, but I try to make sure that they're as fully informed as they can be before they make that decision.

Dr. Lisa Belisle:

Well, let's talk about what happens if you don't vaccinate your child and you're exposing. Your child gets sick and you're exposed to things on an airplane or a foreign country or what's the public health risk of not vaccinating a child?

Dr. Lynne Tetreault:

There is a public health risk. That's why we have outbreaks of pertussis right now, because not everyone's fully immunized. If you get at least 95% of the population immunized, then I believe the risk for herd immunity or the risk for infection goes way down, because there's this thing called herd immunity that if most of the population is immunized, it will protect the ones that are not. But as our rates go a little higher, and again, I'm not exactly sure of the exact percentage, there is that risk that if you're not immunized, you will catch the disease and then you spread it to other people. And those that are immunized will have a milder form of it, and they'll be okay, but the ones who aren't will be more at risk. And the bummer thing, like for chickenpox, is, say your child is not immunized, and there's a case of Chickenpox in school, it takes sometimes 21 days for it to come out. Your child will miss 21 days of school and that can be very awful in terms of, you know, finding childcare. You're missing work. So there sometimes that you have to look at those risks as well to not immunizing your child. But in theory, if you have this thing called herd immunity and a lot of people get immunized, then it protects the small amount that are not. But again, it has to be a very small amount. And thankfully in my population, I actually don't have a lot of kids who don't get immunized.

Dr. Lisa Belisle:

Well, is there anything that you would leave as a parting message to parents who might be listening today, whether they're thinking about vaccinations or their children's health? What are some of the things that you routinely tell parents?

Dr. Lynne Tetreault:

I tell parents to definitely ask your doctor any questions that are on your mind. Sometimes with is worrying the parent the most actually can be easily reassured by giving them information and facts. So don't be afraid to talk to your doctor and get that information about shots and get your kids vaccinated.

Dr. Lisa Belisle:

Well, it has truly been a pleasure to actually see you again after many years. I want the people who are listening today just to know. Dr. Tetro is an example of why people go into medicine in this great state state because she has always had this unbridled enthusiasm for teaching and children. And you can just tell being with her, she's caring and compassionate and she's so smart. So as the medical director for Vax Maine Kids, working with Maine Health and also pediatrician with Maine Medical Partners Pediatrics in Saco. We're so thrilled to have you here. Thanks for coming in.

Dr. Lynne Tetreault:

Oh, thank you again for having me. It was a pleasure. It was great to see you too.

Dr. Lisa Belisle:

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Dr. Lisa Belisle:

Today on the Dr. Lisa Radio Hour and Podcast we have the theme Kids Health. And we've had already some wonderful people talking about bringing health to the children of the great state of Maine. And today I'm very fortunate to have in the studio with me two people who I've known for many years, one for her entire life and one for significantly less time. But still, I feel like we're all kidding. Kindred spirits. The first one is Dr. Amy Belisle, who is the Medical Director for the Child Health Quality Improvement Projects at the Maine Quality Counts Program. And the Second one is Dr. Lisa Letourneau, who is the Executive Director of Maine Quality Counts. Thank you so much for coming in and joining us today.

Dr. Lisa Letourneau:

Thank you Lisa.

Dr. Amy Belisle:

Thank you very much. Lisa.

Dr. Lisa Belisle:

It's good to see you. Yes, good to see you. So we were joking earlier about there being now another Dr. Lisa in the studio. So we have got two Dr. Lisa's and we have a Dr. Amy and I think it's really interesting that all of us were raised in Maine. We have chosen to bring our to raise our children here. We've chosen to come back and practice here. Lisa, just tell me why would you choose to, why would you choose to come back to Maine? Winslow? That's where you're from.

Dr. Lisa Letourneau:

That's right, Lisa. I am a Winslow native and I was one of four girls growing up in a working class family that grew up saying we couldn't wait to get out of Maine. And no sooner had I been out for several years that I decided I wanted to come home because it very much felt like home and it felt like there were a lot of great opportunities for work here. So I actually came back after medical school, did my residency right here in Portland at Maine Medical center and have been working in the state ever since and feel very fortunate to have that opportunity because we often say it's a state that's just the right size to do this kind of improvement work. It's just big enough to have an impact and just small enough to know everybody and get everyone in the same room together.

Dr. Lisa Belisle:

And Amy, I know that you obviously anybody who hasn't figured this out yet, Amy's my next younger sister, 19 months younger. Her twin is Dr. Adele Belisle. And Amy went away and spent time overseas with the military. But you chose to come back. Why did you chose. Why did you decide to come back to Maine?

Dr. Amy Belisle:

Well, I think the reason I came back first and foremost was our family. We have a large family, 10 children, and our parents are close by. But like Lisa said, I did do residency in Portland. I trained at the Barber Bush Children's Hospital and had a very good experience there doing pediatrics, and then was in the Air Force and went overseas and we actually lived in Japan for three years in Washington D.C. for a year before deciding to come back to to Maine. And ultimately our decision was that we had small children and we wanted to be closer to our family. And I was very interested in health care issues, health policy, health education. And we felt like this would be a great state to come back and do that kind of work. So initially I came back and worked as a hospitalist and did work with kids who were in the hospital, both newborn babies and older children, and then got involved in some public health work and what we're doing now.

Dr. Lisa Belisle:

Well, let me take a step back. Both of you have been interested in public health related programs for a long time. I know, Amy, you did an educational program when you were a student at the University of Vermont where people went into students went in and were teaching health things in classrooms.

Dr. Amy Belisle:

That's right. We did what's called the Smile Doc program. So When I was a medical student, we had the first and second year medical students go out into the Burlington community. And I think we taught in about 10 schools in classes and really had them to go out to teach children about children's health. And that was a great way for medical students to learn. And it was a great way for the fifth and sixth grade children to learn. So they're continuing to do that work. Actually, the family medicine program in Portland has done a lot of work teaching in the Portland public schools around health education. So I think that that's important part of being a doctor is to teach. That's one of our missions in life. And it's important to teach not only the medical students, our fellow physicians, but also the families that we work with and other.

Dr. Lisa Belisle:

Dr. Lisa, across the microphone from me, you were an emergency room physician for many years. How did that translate into this interest in public health?

Dr. Lisa Letourneau:

Yeah, so it has been an interesting journey. I'm actually trained as an internist and then did emergency medicine for my clinical life. And it was a great experience, a great job. But I found myself getting a little bit frustrated with hearing a lot of the same stories over and over. People coming in with cough or infection and they continue to smoke. People who were having all kinds of health problems and clearly had not addressed root causes. And I remember one of the most dramatic was a middle aged gentleman who came in clearly having a heart attack. And I asked him before he could get his clothes off if he had a history of heart disease and he said no. And he didn't seem to know what was happening. And then we took his shirt off and he had a great big zipper scar running down his chest. He clearly had had bypass surgery. And I looked at the scar and said, I thought you said you didn't have heart problems. He said, well, they did surgery, but they fixed that. And I remember thinking, wow, there's a real need for education and for change here. So saw some opportunities to get involved in quality work and sort of changing systems and it really had a lot of appeal.

Dr. Lisa Belisle:

And you and I both went and got our masters in public health at different schools, but around the same time. So I'm very familiar with this sort of seeing something clinically and then broadening it out and deciding to get more training. How has that translated into what you're doing now and what, what is Maine quality counts?

Dr. Lisa Letourneau:

Well, the opportunities that I've had to get public health training have really been wonderful for my work. I first did that when I was working for Maine Health, the health system here in Portland that includes Maine Medical center and several other hospitals, and really saw the public health training as a way to bring some discipline and additional tools to the kinds of work we were doing, which is really IC about trying to bridge clinical practice and public health in the US Environment. For whatever reason, public health and clinical medicine seem to have grown up and evolved into somewhat separate spheres. And oftentimes when I ask my physician colleagues about interest in public health, they'll refer to it as well, that's what other people do and that's what people do over there at the state. And I think since my early days working in this area, it's really been to try to bridge that gap between public health and clinical medicine and say they're not two separate things. It's about not just health care, but about health. So both at Maine Health and now in my role at Quality Counts, it's all about trying to bring together the different stakeholders that are really critical to have an impact in changing our health care system with the ultimate goal of improving our health. It's not just about improving health care. It's about having people grow up healthier as children, as young people to live healthier lives, and then when they do, need health care, to get better care as well. Maine Quality Counts is an organization that several of us actually helped to found, gosh, about eight or 10 years ago now, as people working in different arenas in health care that saw some opportunities to share what was going on at the national level and at the state level about who was doing a good job and in this area of trying to improve health and health care. And since then, it's grown from a very small sort of voluntary organization to a still small, but somewhat larger, more slightly more formal organization. We are a Separate non profit, 501c3 charitable organization with the mission of transforming health and healthcare in Maine by aligning, leading and collaborating in health improvement activities. So we specifically try to bring together the variety of stakeholders that are necessary to really change. It's taken a lot to get where we are. It's going to take a lot to change where we are. And by that I mean bringing together people, consumers, patients with providers, doctors, nurse practitioners, physician assistants, nurses with those who pay for care. So the employers, government, the health plans, public health, and bringing them all around the table. And ours, I think, is truly the 1 organization in the state that does that by bringing everyone together for the sole purpose of improving health and healthcare for everyone in the state. So there are a lot of organizations that do very good work in that area and tend to do it for a given geographic area or given group of providers or groups of patients. But ours is really about improving health of everyone in Maine.

Dr. Lisa Belisle:

And that starts with the children of Maine, which I know is. That's the issue that has been your primary importance. Amy, tell me about what is it that you actually are doing as the medical director of the Child Health Quality Improvement Project. Tell me what your role entails.

Dr. Amy Belisle:

Well, we have a few things going on at Quality Counts. I think what Lisa was highlighting earlier is that we really are trying to build a partnership in the state so that we have a lot of different people working on children's health and we're trying to bring them together. So ultimately, what we're trying to build at Quality Counts is what's called a Maine Child Health Improvement Partnership. Several states across the country have a child Health Improvement Partnership and that's bringing together both private and public organizations to work towards the goal of improving children's health care and children's health. And one of the first projects that we are actually working on right now is called First Steps. It's a public health initiative to strengthen early preventive services for children. We are currently funded as part of a federal grant that's come through MaineCare and we are working with the Muskie School, MaineCare, the main CDC and many state partners, as well as healthcare Systems on improving preventive services for children. We actually have a three year project going on. The first project we're doing is raising immunization rates. Our second project, which we're currently in the middle of, is around developmental screening and autism screening and improving that at the practice level. And our third project next spring will actually be working with the let's Go program and from the First Tooth to improve oral health and healthy weight.

Dr. Lisa Belisle:

Two of the other programs you referred to were the let's Go program and also the First Tooth program, which I know has to do with dental health. How does let's go, which Dr. Lynn Tetro has discussed previously. How does that relate to adult health. And why is it important to start early, getting kids to be healthy so that they can have healthy adulthoods?

Dr. Lisa Letourneau:

Well, that's a great question, Lisa, and it really relates to what you're saying, which is we need to start early. We know in this country that we spend more on health care than virtually any other country in the world and don't have as good outcomes, while we also know that we have a very excellent health care system. And that's part of the problem is we're just applying lots and lots of health care instead of getting at these underlying issues of health. And this, again, this sort of chasm I described before between public health and health care creates this unfortunate gap in the middle that a lot of young people fall into, and that is we need to address and prevent so many of these conditions that then turn into much bigger conditions and illnesses later on. So kids that stay healthy are less likely, or kids that are less likely to become overweight or obesity less likely to start smoking, kids that stay more active, all those things that are being promoted through the activities of the state. Let's go. The Healthy Maine Partnership. So many of the public health activities translate absolutely into better health in adult life and to lower cost. It costs a heck of a lot more to take care of an adult with smoking, obesity, diabetes, all of the chronic illnesses that are associated with these underlying health behaviors that later in life are just so much harder to change.

Dr. Lisa Belisle:

So how can people find out more about the vaccination programs you're describing or some of this child health, some of the child health initiatives that you've been talking about, Amy?

Dr. Amy Belisle:

Well, for healthcare providers, they could go to the Maine Quality Counts website and also the Maine Vaccine Board. But we're really excited to be supporting the new website that's come out, Vax Maine Kids. It's on Facebook. I think it's a Twitter feed. And there's also a website that has a lot of parent education and materials for families around vaccinations. And this has been supported by the Maine Health Childhood Immunization Task Force. So there's a lot of energy and passion right now around working with families on immunizations. And I think that those are some great websites to look at.

Dr. Lisa Belisle:

Well, I can't end the segment without talking about this award that I heard about from Dr. Lisa that, Amy, you were nominated for by the Maine Academy of Pediatrics, the Robert Wood Johnson Award, I think it's called the Young Leaders.

Dr. Lisa Letourneau:

Young Leaders Award.

Dr. Lisa Belisle:

Young Leaders Award. And truly, I know that you are a leader along with Dr. Lisa, the other Dr. Lisa in the room, in public health and children's health in the state of Maine. So it's important to that we have people who have gone away and come back to the state to be physicians in our community and to help us work on health from a systemic standpoint. So thank you for sharing the work that you're doing and for being here today.

Dr. Amy Belisle:

Thank you very much. And we just want to say that although I was nominated, this is really a team effort from everyone in the state and all the people that we work with. And we appreciate you having us today.

Dr. Lisa Letourneau:

Spoken like a true leader. Thank you, Lisa.

Dr. Lisa Belisle:

Today on the Dr. Lisa Radio Hour and Podcast, we have with us three wonderful women from the Girls on the Run main organization, which is a newly founded chapter or council of the Girls on the Run national organization. So we're very pleased to have with us Jen Rhode, the council director, Sandy Sinclair, program coordinator, and Stacy Olson, outreach and events coordinator. Thanks for coming in and talking to us about girls being on the run.

Staci Olson:

Thanks for having us.

Dr. Lisa Belisle:

Now tell me this is. Well, first, let me start with you, Jen. Why girls on the Run? Why running? Why girls? Why put them together? Why does it need to come to Maine?

Jen Rohde:

Girls on the Run is a nonprofit that helps preteen girls in third through fifth grade build their self esteem and wellness through a fun, experience based curriculum that creatively integrates running. And the idea was formulated by Molly Barker in 1996 and her idea was that to build up girls in this critical age of 8 to 13 prior to hitting middle school, because the studies show that by the time girls get to middle school, their self esteem, their body image, their desire to be in leadership roles all plummet. And so her idea was if we can build these girls up by making them physically strong and that's where the running comes in, then they'll be better prepared to handle all the challenges that we face in middle school.

Dr. Lisa Belisle:

And right now there are 200 councils across the United States, is that right?

Jen Rohde:

Right. And as of last year, Maine was only one of three states that did not have a council. So it's a really big deal for it finally to come to our state.

Dr. Lisa Belisle:

What was the impetus for bringing Girls on the Run to Maine?

Jen Rohde:

We there was a group of individuals all around the state who inquired with Girls on the Run International in North Carolina. And basically it was an email list that continued to grow and grow and grow over the years. And finally a few of us said, hey, let's meet, let's talk. And let's take this to the next step because the interest is there throughout the entire state. I think women are sensing that this is a really key way for young girls who are bombarded in our culture with so many media messages and so much pressure. And women who are getting active in their own lives see the benefit at all ages of how it has helped them and want that same thing for their girls.

Dr. Lisa Belisle:

Sandy, you used to coach in another council somewhere. I can't remember where, so forgive me, but where did you used to coach and what was your experience with girls on the run before?

Sandi Sinclair:

Sure, I coached in Northern Virginia. I lived in the Washington D.C. area and was a girls on the run coach there for one season and then a girls on track, which is the sort of next step after girls on the Run. It's for middle school girls to sort of continue their experience. So I coached for both programs and seeing the way that the girls came together as a team and were able to support each other through that sometimes challenging time in their lives was awesome. And that's sort of what drew me into helping to start the council here as well.

Dr. Lisa Belisle:

So describe the program itself. How does this begin? Is there an endpoint? Just talk to me about that.

Sandi Sinclair:

Yes, it's a 10 to 12 week program. We do the 10 week program here in Maine, mostly driven by the weather. And the program is broken into three sections. The first is based on sort of getting to know yourself, setting goals for yourself. The girls all set individual goals and then sort of learn to work together. And then from there they move into the second part of the curriculum which is based on, on teamwork, healthy relationships, being a good friend, not gossiping, all of those sorts of issues that can become so important at that age. And then they move into a community service project. So it sort of starts with the self, moves to the team and the relationships, and then moves beyond to the world, which is a nice flow for the program. And so the goal at the end of those 10 weeks is that each girl can finish a 5K. So whether it is, you know, that she can run it or that she can, we always sort of joke that she can hop, skip, jump, twirl, run, walk however she wants to cross the finish line. But that's the end goal that they, the curriculum integrates running and towards the end they can complete a 5k.

Dr. Lisa Belisle:

So I understand also that you have a 5k set up right now which is sponsored in part by May magazine. One of the reasons that I have you in today, because they're one of our sponsors for our show. And I know they're very involved in the community. Stacy, this is something that you've been working on. Tell me about this upcoming event.

Staci Olson:

Yeah, we basically decided we wanted to do a fundraiser and also a kickoff celebration, which is basically our launch and our way to introduce Girls on the Run to the community. So this differs from the celebratory 5K that Sandy was talking about. Our girls will be doing the celebratory 5K in November, but this will take place on October 21st in Deering Oaks Park. And this is a chance for people to experience what it's like to be a girl on the run. So this is very different from your typical 5K. It's an untimed race, first of all, so there's no clock, no winners, no pressure. It's just a chance to come out and run and have fun. Most races give awards for the fastest runners. We are giving awards for things like best smile, snazziest socks, best air guitar, best finish line dance, things like that. There's also going to be fun surprises along the way to keep the runners entertained and motivated. And then at the end, each runner will get a mug of hot chocolate. Chocolate in a Girls on the Run travel mug. So we really wanted just to create a fun, spirited environment. And so we're encouraging all of our runners to come dress in their Girls on the Run spirit. Which basically, if you look at a lot of the pictures from the celebratory 5K, you'll see that girls, they love to put pink and green hairspray in their hair. They like to wear tutus, they wear superhero capes, they wear bright colored socks. So we'd love to see our runners dressed in those that attire. And to help them, we're gonna have a happy hair station where they can put pink and green hairspray in their hair as well. So like I said, not your typical 5k, but lots of fun and lots of energy. And I also would like to thank our sponsors for helping us getting this event organized and promoted. We have 21amazing sponsors who've helped us, including our platinum sponsor, Main Running Company and some of our gold level sponsors, Coast 931, Maine Magazine, Veral, Dana and Alan signs with Impact.

Dr. Lisa Belisle:

Why do you think that people are. It sounds like you haven't had too much trouble getting sponsors because this event is several weeks in the future and you have nice things planned. Why are people jumping on the bandwagon? Why is Girls on the Run such an appealing program to support?

Staci Olson:

Well, I think it's because it really differs from your typical running environment. You know, most after school running programs or cross country teams, you know, it's all about the winning and, you know, the competition. This has no competition. This is all about participation. And I think from our event, our fundraising event perspective, this is a chance for people who don't necessarily want to go do a timed race. This is a chance for them to come out and have fun and just experience the joy of exercise. And that's what Girls on the Run is. It's about participation, it's about enthusiasm, and it's about self esteem and empowerment.

Dr. Lisa Belisle:

Now, each of you have children. I think, Jen, you have four and each of you have two. Okay, so there's eight children amongst the three of you. And that's just a sampling of the people working on Girls on the Run. You're all very busy. Why was it important for you to take time out of raising your kids, doing your other activities to be involved in something like this? Do you have a thought on this, Jen?

Jen Rohde:

I have always believed in role modeling. Even before I had kids. I was involved with mentoring, even back in high school. And to me, you know, some of my greatest role models are people who've inspired me to do things that I never sort of believed in myself that I could do. And so, you know, I think that becomes even more amplified when you become a parent. And when Girls on the Run, like so many people who hear about it, it just strikes a chord with them, like, wow, I wish I had had this when I was a kid. I can't count how many times I've had adults say that to me. I think to answer your prior question about why it resonates so clearly is, I think it really fills a hole in so many people's lives, which, you know, activity and athletics can do. But the curriculum adds such an additional component that really speaks to women. So to answer your question, for me, role modeling for my kids and having them see me be very passionate about something and, and you know, last night, in fact, around the dinner table, I checked my computer really quickly and I said, oh my gosh, the girls are on the run. This was our first practice. And all four of my kids hooted and hollered and jumped up and started clapping. And so to see their mom really excited about something and to know that this is impacting and hopefully will impact girls and their families around the state, my kids are living it too.

Dr. Lisa Belisle:

And there's a parent component to the education as well. Is that true?

Sandi Sinclair:

There is, yes. The parents all of our parents so far have been super supportive, which is wonderful. They all really want their daughters to participate. They've all offered to volunteer. Some of our coaches, our parents, and we also have Girls on the Run International puts out something called a Grown Up Guide, which is this amazing resource for parents to sort of be able to follow along and know where their daughters are in the curriculum, what sort of things they're learning about this week, where they are in terms of their running, so that they can create those conversations around the dinner table or say, you know, how was your day today? I know you guys were talking about teamwork. How did that go? And have those nice conversations. We had some kickoff meetings with the parents and the daughters last week, and a couple of families ran to the meeting. I thought it was so cool that the parents, you know, wanted to be involved and they put on their running shoes and they ran to the meeting with their daughter. So it's really nice to see the parents involved as well.

Dr. Lisa Belisle:

And you have a background, I believe, as an educator yourself, and you do curriculum development even now. How does this match up with your experience in that world?

Sandi Sinclair:

It's so nice to see a curriculum that so many of us can get behind and believe in and then see that reflection reflected in activities that get the kids moving too. So it's been a really nice mix for me. When I was at, I taught eighth grade and that's such a tough time for a lot of kids. And so to be able to see them really take the curriculum and go out and run, it's a great mix.

Dr. Lisa Belisle:

And I think all of you are also runners. Is that true? So, Stacy, tell me, how has running impacted your life? Your life as a mother, your life as a woman, your life as a person?

Staci Olson:

Yeah, that's actually interesting. I came to running just in the past few years. Growing up, I was an athlete, I was a soccer player, I was a swimmer, I played some basketball. I never really had any interest in running. And then I had my two kids and wanted to find a way to, to kind of get back into the athletic world. And my friend said, let's try and do a triathlon. And we did it. And I kind of then gravitated towards running longer distances as well. So it really just kind of gave me an opportunity to do something for myself. You know, I'm a full time mom. And so this was a chance for me to take a half hour every day or, you know, even longer and just have some time. And I realized the power that that gave me. The rejuvenation that it gave me. And it just, it's something that became important to me right away. And the fact that these girls get to learn this at such an early age. I mean, when I completed my first 5k, it was awesome. I loved it. You know, it was such a great feeling of accomplishment. And that's what you see when these girls get to finish their 5Ks is their sense of accomplishment. That the I did it feeling is a really exciting one.

Dr. Lisa Belisle:

Do you think that this is one of the challenges that parents face is sort of maintaining their own sense of self, their own need to run or, I don't know, experience the joy of being outside as they go into parenting, whether it's full time or working outside the home? Is this something that you think is a universal theme, perhaps?

Dr. Amy Belisle:

I think you're all nodding, so I'm

Dr. Lisa Belisle:

just waiting to see which one of you jumps in here.

Jen Rohde:

I think women tend to feel so guilty about their the time they take, whether they're working full time part time, or working in the home full time. I mean, we all have so many obligations and want to give. I mean, I'm speaking in generalities, but, you know, I was a coach prior to doing Girls on the Run. I was a coach for women doing a couch to 5K program. And, you know, it pained me to see women in the later parts of their life still feeling the guilt associated with taking that time for themselves. And I think Stacey really hit the nail on the head. I mean, the best gift that we're giving these girls is that sense of, like, this is not a selfish endeavor. You know, you are such a happier, healthier, more positive person when you take that time that it comes back to the people around you a thousandfold.

Dr. Lisa Belisle:

Do you have thoughts on this, Sandy?

Sandi Sinclair:

Yeah, I agree completely with what they both said. I think that, you know, being able to, as an adult, enjoy some of those things that we watch the girls learn throughout this process is wonderful to be able to just have that, you know, if it's half an hour or an hour every day to be able to clear your head. It just for me personally, it makes sense. Me hopefully a better parent. And I think that a lot of people feel that way, that if you can take that little bit of time for yourself, that it helps you in the other parts of your world and also is a great example for your children as well.

Dr. Lisa Belisle:

What about the question of boys? I have a son. I know Jen has a son.

Dr. Lisa Letourneau:

I have two.

Dr. Lisa Belisle:

You have two sons? I have one. And so, so there's a lot of boys also floating around here. And we interviewed Boyz II Men and Drew Wing and Roger Martin back in June around our Father's Day show. Do people ask you questions as to why we're doing something that's girl specific and how do you answer?

Sandi Sinclair:

Absolutely. People ask those questions a lot. And the sort of short answer is that Molly Barker, who Jen mentioned, who started Girls on the Run, has been great resource for several men's boys groups that are trying to get started and have a similar curriculum. We get asked those questions a lot. My son asks all the time, when is there going to be boys on the run? And I tell him as soon as it happens, I'll start to work on it because I think it is important for boys as well. I think the thought between having girls on the run be limited just to girls is that sort of safe space to talk about any issue that comes up and anything that you know, is sort of contained just to girls. But boys can be running buddies for the girls in their 5k. They can help support them through the process. So if a girl has an older brother, maybe in high school, he can be her running buddy. Men can be assistant coaches. We've had dads who've been really involved and want to be volunteers. So there is room for a boy or a man to participate as sort of a cheerleader for the girls as well, which is awesome.

Dr. Lisa Belisle:

Well, as any longtime listener of Dr. Lisa Radio Hour knows and any longtime reader of my blog or my website knows, I'm a runner and I have daughters and I'm really a huge fan of what you're doing. So I hope people will take care of the time to go to your website, go to your Facebook page, maybe think about signing up for a chapter. Go to the Hot Choco Trot. That's what it's called. It's sold on October 21st.

Sandi Sinclair:

Yep.

Staci Olson:

At Deering Oaks in Portland.

Dr. Lisa Belisle:

Deering Oaks in Portland.

Sandi Sinclair:

Thank you.

Jen Rohde:

Thanks for having us.

Dr. Lisa Belisle:

You have been listening to the Dr. Lisa Radio Hour and podcast show number 54, Kids Health. Today's guests have included Dr. Lynn Tetro of the Maine Medical Partners Pediatrics Group in Saco and also Medical Director of the maine health vax maine kids program Dr. Amy Belisle, medical Director of the Child Health Quality Improvement Projects at the Maine quality counts program Dr. Lisa Letourneau, executive director of Maine Quality Counts and representatives from the Girls on the Run program Jen Rhode, Sandy Sinclair and Stacy Olson. Our discussions today have ranged from vaccinations to obesity prevention to self esteem in girls to public health. We hope you'll take the time to go to drlisabelisle.com and learn more about our guests and link through to some of the programs that they describe. We also hope you'll take a moment and like our Facebook page. For those of you who don't receive our email yet, go to our drlisabelisle.com and sign up for our weekly E News so we can tell you what's happening on upcoming shows. Also, take a look at the people who sponsor our program and please do let them know that you appreciate the sponsorship. We certainly could not have made it for the last year without the financial support of the those who have been with us from the very beginning. So let them know that you've heard their names and support their businesses as well. This is Dr. Lisa Belisle. Thank you for being a part of our world. May you have a bountiful life.