Robin Miccio, MS, LMT; Dejenaba Gordon, MPH; Keanna Ralph, DSL, MPA

Every human deserves a fair shot at living a healthy life. However, many of our country’s societal systems have been established to exclude certain groups from this opportunity, leading to disparities in health and life expectancy. Children’s Hospital of Philadelphia has made health equity a strategic priority and is actively forging paths to make health and well-being accessible to all families. CHOP invests in various community programs to increase access to healthy food, housing, quality education, jobs, and healthcare. This is critical work and undoubtedly a heavy lift, and the Integrative Health (IH) Program humbly recognizes this call to action.

The IH Program at CHOP has brainstormed the ways we can help move this priority forward. Wellness practices such as mindfulness, nutrition, yoga, caregiver-child massage, and breathwork can mitigate stress, promote resiliency, and improve quality of life. The U.S. wellness industry has made these therapies exclusive to affluent populations; most therapies are not covered by health insurance.

There is a movement toward expanding diversity in wellness spaces, particularly in Philadelphia. Local yoga studios offer sliding scale options, schools invest in diverse yoga students, and practitioners are evaluating ways to promote inclusivity in this space. The IH Program strives for wellness equity by sharing these stress-relieving practices with families in low-income areas as many families are psychologically stressed by racism and other social influences of health.

We collaborated with partners in Department of Child and Adolescent Psychiatry and Behavioral Sciences to develop the BE-WEHL Project (BEhavioral Health – Wellness Equity for a Healthy Life). Each week families (children and caregivers) learn practical wellness strategies to help them manage their responses to stress. With funding from the Department of Pediatrics Diversity Endowment Award, we have enrolled 35 families in our program and have capacity for 50 additional families by June 30, 2022. CHOP’s primary care and behavioral health providers may refer patients via Epic order (search: BE-WEHL) or by emailing Our Behavioral Health partners review the patient’s chart to confirm eligibility. Modeled after CHOP’s Community Asthma Prevention Program, which utilizes a community health worker structure, our community wellness educators (CWEs) share 5 virtual wellness education and practice classes with families and send materials to offer continued practice. The curriculum was developed by experts internal and external to CHOP and is supported by evidence and a trauma-informed approach.

The CWE invites the entire family to participate because we believe the adoption of healthy lifestyle choices happens within the family unit. Furthermore, many of these practices promote bonding between family members. Similar wellness programs have been well received by minority populations in underserved areas. We are learning a lot and constantly calibrating based on family feedback, which has been very positive. Parents reported that, after the class, they were able to negotiate healthy bedtimes with their children (a fight they have lost in the past), and children have used the breathing techniques when faced with conflict at school or when feeling nervous before an exam. Families told us that learning about the stress cycle changed the way they responded during stressful events.

This year, Community Affairs provided us the opportunity to expand this project to the community at large. We now offer these classes to schools, youth programs, and providers who work with youth in Philadelphia, Montgomery, Delaware, and Chester counties in Pennsylvania, and Camden, New Jersey.

This expansion included a class on resiliency and coping to provide the important context to the original education series. The response has been overwhelmingly positive. Professionals have expressed how much the program has felt like a breath of fresh air and has helped them to develop better coping skills in their professional and personal lives. Young students have learned valuable insight on topics related to stress and how wellness practices can support them on their life-long journey toward overall well-being.

Be-Wehl chart

Wellness equity for a healthy life

Resiliency & Coping - Learn what it means to be resilient, how stress affects the body, and positive ways to manage stress

  • Affirmation cards
  • Gratitude journal

Activity & Rest - Learn the importance of physical activity and sleep, fun ways to move your body, sleep hygiene practices, and aromatherapy with breathwork to promote restorative sleep

  • Jump rope
  • Basketball
  • Aromatherapy
  • Sniffers

Pause & Reflect - Comprehend the meaning of mindfulness, how to practice it, and how to utilize mindfulness in times of stress

  • Feudtner Coping
  • Kit for Parents,
  • Mindfulness book

Caring Touch - Learn why positive touch is important, that positive touch always involves consent, self-massage practices, and how to use caring touch practices with your love ones

  • Coconut oil

Healthy Eating - Learn about different food groups, the importance of a plant-forward and anit-inflammatory diet, how to make good food choices, and practice making a healthy snack

  • Kid-friendly knife
  • Cutting board
  • Anti-inflammatory cookbook
  • Food ingredients delivered to home

Mindful Movement - Understand how mindful movement can help overall health, and practice yoga as a form of mindful movement

  • Yoga mat
  • Fitness tracker

References and suggested readings

Beltran M, et al. Yoga-based psychotherapy groups for boys exposed to trauma in urban settings. Altern Ther Health Med. 2016;22.1:39-46.

Khalsa SB, et al. Evaluation of the mental health benefits of yoga in a secondary school: a preliminary randomized controlled trial. J Behav Health Serv Res. 2012;39(1):80-90.

Pascoe, M et al. Mindfulness mediates the physiological markers of stress: systematic review and meta-analysis. J Psychiatr Res. 2017;95:156-178.

Underdown A, et al. Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Sys Rev. 2006;4:CD005038.

Michalsen A, et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a 3-month intensive yoga program. Med Sci Monit. 2005;11(12):561.

Special thanks to Tiffany Silliman Cohen, Sarah Knox, Preeti Soi, Lisa Squires, Jessi Erlichman, Tonia Kulp, Maureen Heil, Camya Van Cliff, Robin Ortiz, Olivia Lee, and Sara Blackburn for their contributions to this article.

Next Steps
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