Examples of Resident Advocacy

Pediatricians and Politics: Advocating for Pediatric Research

UHAT residents on RAP afternoon

Urban Health and Advocacy residents spent a Research, Advocacy and Policy (RAP) afternoon last Fall with Boston Children’s Office of Government Relations staff Amy DeLong and Kate Audette, learning how to lobby and speak to politicians. They put their skills to use that day, meeting with staffers in the offices of Senator Elizabeth Warren and Senator Ed Markey to advocate for legislation that would strengthen the NIH’s commitment to pediatric research.

REACH: Resident Education Advancing Communication in Hospitals

Zeena Audi and Neeru Narla (second and third from the right in the front row) and their colleagues

Confronted with the fact that patients with limited English proficiency are more likely to suffer adverse events and the realization that residents in the BCRP are caring for an increasing portion of non-English speaking patients, BCRP residents Neeru Narla and Zeena Audi created a cultural communication curriculum to improve the quality of care delivered to ethnically and linguistically diverse pediatric patients and their families. After completing a needs assessment of residents and interpreters and conducting focus groups with interpreters from different cultures, they realized that the obstacles to effective communication identified by interpreters were similar across cultures. They distilled these gaps in culture knowledge and interpreter interaction into the theme of a “10 and 10” curriculum – ten tips on working with interpreters and 10 tips on working with multicultural patients. Every BCRP intern rotating on the BMC Pediatric Ward team will now experience this curriculum, which combines interpreter feedback, an online virtual classroom, and simulation to disseminate the “10 and 10” and provide opportunities for residents to practice these skills.

Street Cred

Michael Hole and Lucy Marcil

One of every five children in the United States is growing up poor, which means America’s future faces increased risk of preventable disease, poor school performance, and loss of future economic productivity. In response, residents Michael Hole and Lucy Marcil teamed up and founded StreetCred, a social impact organization highlighted by the Boston Globe, Forbes Magazine and NPR. StreetCred is building one-stop shops of anti-poverty tools to help low-income families visiting pediatric clinics access basic resources and build assets while they wait on their doctor. So far this year, StreetCred has prepared tax returns and led voter registration for patients’ families, ultimately returning more than $1 million of Earned Income Tax Credit and Child Tax Credit to caregivers raising children. In the coming year, StreetCred will also help families apply for SNAP (formerly Food Stamps), Head Start (promotes school readiness), and FAFSA (determines financial aid eligibility for college), all before they leave the doctor’s office. StreetCred plans to expand its services portfolio to helping families set up savibngs accounts, file for housing subsidies, file for housing assistance and apply for other evidence-based government programs like WIC (nutrition for poor women and children), child support, and health insurance. They envision a free, one-stop shop of anti-poverty tools for America’s most vulnerable families raising children. To-date, StreetCred is financially supported by BMC’s Department of Pediatrics, BMC’s Philanthropic Trust, BMC’s Committee on Residents and Interns, a Boston Children’s Hospital’s Fred Lovejoy Award, the American Academy of Pediatrics, and several private donors. Six BCRP residents devoted their protected advocacy time to StreetCred during the 2016 tax season.

Advocating for Children’s Health Insurance

Elyse Portillo (right) and Amanda Stewart (second from right) at The Massachusetts State House

BCRP residents Elyse Portillo and Amanda Stewart at the Massachusetts State House after they and two other Boston Children’s Hospital providers shared testimony on a bill that would improve the way the Children’s Medical Security Plan—a safety net insurance plan for underserved children—is structured, allowing for a flexible program that would better serve the needs of children in the Commonwealth. Elyse and her fellow advocates from Boston Children’s shared patient stories as they urged policymakers to move forward on this important legislation.

Some Examples of Recent Resident Advocacy Accomplishments

  • Worked with a local charter middle school on a sleep hygiene project. Students with daytime sleepiness or behavioral issues were identified by the teaching staff. Each student received a wrist band accelerometer (FitBit) to track sleep and activity, and in monthly visits we reviewed the data together and did counseling on healthy sleep habits.
  • Partnered with the Boston Children’s Community Asthma Initiative to target health related social needs to improve asthma outcomes in this vulnerable population of low-income families with chronically sick children. We did this by implementing a standardized social screener to better target family’s needs as well as increasing access to federal poverty relief programs in partnership with StreetCred.
  • Testified at Boston City Council to advocate for safer streets for cycling. Vision and views were featured in Go Boston 2030 campaign to guide the city’s next steps in transportation planning. Developed a research/advocacy/policy session addressing food and transportation as medicine.
  • Founded the “CIR Center for Social Determinants of Health” at Boston Medical Center, a resident-led, interdisciplinary group of providers whose shared mission is to address disparities in healthcare by improving awareness of the social determinants of health.
  • Founded the Advocacy through Policy residency group to partner with the Boston Children’s Hospital Office of Government Affairs in advocating for policies to benefit child health.
  • Worked with a community health center to improve travel screening for immigrant patients.
  • Received a Picker Gold Challenge Grant to support the development of patient care initiatives and best practices for “Improving Family-Centered Care for Substance Exposed Newborns and their Mothers”
  • Started a resident interest group to support urban families around the impact of community gun violence, including a fundraiser to support the community organization L.I.P.S.T.I.C.K.
  • Designed and implemented a quality improvement project on the BMC pediatric service to facilitate family centered rounds for families whose primary language is not English.
  • Presented a workshop on social determinants of health screening in pediatric clinic at a national meeting, in collaboration with several other residency programs.
  • Received an International Elective Grant from the American Academy of Pediatrics to support work on newborn care in Kenya.
  • Started a project to bring home visits to children in the community as an alternative to the traditional primary care system.
  • Numerous residents have published articles in medical journals and public news sources on poverty and health, health disparities, and advocacy training.