PEDIATRIC ASTHMA CENTER
Asthma incidence rates in the Bronx are among the highest in the nation, with 1 in 4 children afflicted with this often life-threatening disease. Bronx-Lebanon’s Pediatric Asthma Center is widely recognized as a model treatment and educational program. In 2007, the Patient Choice Network rated it as being “the #1 provider” for asthma care (in comparison to hospitals within a 20-mile radius of the Bronx).

The Pediatric Asthma Center’s expert staff of pulmonary specialists, allergists, pediatricians, and respiratory therapists, provide necessary treatment, as well as one-on-one teaching, home visits, and a unique 24-hour on call service that has been effective in helping patients avoid potential hospitalizations. Additionally, the Pediatric Asthma Center is the lead organization for the South Bronx Asthma Partnership, a coalition of 54 community-based agencies. This partnership is actively involved in schools throughout the community, teaching children about the negative effects of smoking and other environmental factors on asthma, as well as promoting a better awareness of the “triggers” and physiological changes associated with the disease.

SUGAR BABES PLACE JUVENILE DIABETES PROGRAM
There are more than 20 million Americans living with diabetes. It is a disease that is on the rise, one which can have serious consequences for children as well as adults. Bronx-Lebanon’s unique pediatric diabetes program, “Sugar Babes Place” has been most successful in monitoring, stabilizing, and reducing diabetes complications in children. It is empowering patients with juvenile diabetes, through self management and peer education, to take control of their disease. Patients are also now able to use their home computers to upload their blood glucose measurements, via the Internet, to their physician/providers.

“Sugar Babes Place” patients are afforded a progressive educational environment that includes trips to museums, sporting events, and local theaters, as well as a comprehensive classroom curriculum, with guest lectures by entertainment and sport personalities that also have diabetes. Another key component of the program involves visits by nurse educators to local churches and schools.

CHILD STUDY CENTER
The Child Study Center is the only integrated and diagnostic treatment center of its kind in the Bronx. This unique facility, which provided more than 18,000 visits in 2006, is achieving positive outcomes for such conditions as Attention Deficit Hyperactivity Disorder (ADHD), school failure, depression, as well as anger management and eating disorders, among numerous other problems.

At the Child Study Center, a collaboration of the Departments of Pediatrics and Psychiatry, multidisciplinary teams of pediatricians, pediatric neurologists, psychiatrists, psychologists, social workers, and creative arts therapists work together to solve complex behavioral, emotional, and cognitive problems in children and their families. Its pediatric neurologists are also providing important neurological assessments, diagnoses, and treatments, as well as medication management, re-evaluation, and referral for psychotherapy, when necessary.

The Child Study Center is regionally recognized as the leading hospital-based provider of functional family therapy, an important new therapeutic approach to improving relations among all family members. Its psychiatric team, under the direction of Dr. Francis Hayden, has provided outreach mental health services and consultations to local schools throughout the community.

Bronx-Lebanon was recently chosen to lead a new mental health prevention and treatment initiative for more than 20,000 children in schools and foster care programs throughout the Bronx. As the program evolves, the Child Study Center is poised to become the largest provider of mental health outreach services to schools in New York State.

ADOLESCENT AND YOUNG ADULT HEALTH PROGRAM
It has been well-documented that the majority of health problems in teens and young adults are potentially preventable, including teenage pregnancy, sexually transmitted diseases (STDs), and HIV transmission.

In its commitment to address the health needs and provide preventive services to young adults, Bronx-Lebanon, through its Departments of Pediatrics and Obstetrics/Gynecology, established the Adolescent and Young Adult Health Program. It offers a friendly and confidential setting, with a bilingual staff that provides clinical and educational support, as well as treatment. Among the many services provided are primary health care, reproductive health services, STD screening and treatment, smoking cessation, routine gynecology care, support groups, teen parenting classes, and counseling services. The program also offers a 24-hour on call and emergency service capability, with access to physicians and nurse practitioners.

REACH OUT AND READ
Children between the ages of 6 months and 5 years are encouraged to participate in the “Reach Out and Read” program. During inpatient and outpatient visits, pediatricians speak with parents about the benefits of reading to their children. The program’s goal is to instill a sense of learning and enjoyment in books, thereby improving future school performance. Children are also given, at no cost, an age appropriate new book that the parent can read to them at home. As the child develops, other age-appropriate books are subsequently provided. In 2006, more than 3000 books were distributed, providing children and families with an important educational tool in child development.

CULTURAL DIVERSITY INITIATIVE
The Interactive Workshop on Communication Skills and Cultural Sensitivity Program trains providers in developing a better understanding of culturally diverse populations. Lectures, videotaping, and live reenactments of patient-physician interactions are an integral part of the program. Additionally, “Africa Day” was created to remove the language barriers often experienced by providers in communicating with the large number of children and their families that have immigrated from Africa to the United States. In collaboration with the African Services Committee, a community based agency, multilingual and bicultural staff are available to assist in translation and patient education, as well as help the pediatric staff provide “user friendly” services to these children and their families.

COMMUNITY HEALTH EDUCATION CENTER (CHEC)
The Community Health Education Center (CHEC) is educating the community about prevention and control of major medical problems, such as heart disease, cancer, asthma, and diabetes. It was developed in response to the growing community need for detailed, easily understood, and culturally sensitive health related information. CHEC’s many initiatives are delivering educational messages, on-site, at numerous community based locations, including special programs funded by the Fledgling Fund at the Butler Houses and Crotona Inn Family Shelter. The Butler House initiative involves teaching teenage girls health education and leadership skills. The Crotona Inn program is bringing physicians, on-site, to provide education and medical screening to 85 families (with more than 125 children and adolescents enrolled).

CHEC was recently funded by the CJ Foundation for Sudden Infant Death Syndrome (SIDS) to deliver the message of prevention to pregnant, newly delivered, and parenting women. The issue of co-sleeping, often the cause of accidental infant smothering, is also being addressed by CHEC. It offers free cribs to those who cannot afford them, a unique approach to addressing this serious problem.

AUTISM TREATMENT AND ADVOCACY PROGRAM
Autism is the fastest-growing developmental disability, occurring in 1 in 150 births. Early identification of children with autism is critical for child development. The Autism Treatment and Advocacy Program is dedicated to diagnosing children with autism at its earliest stages, providing treatment to improve behavioral and educational outcomes, as well as quality of life. It is staffed by a multidisciplinary team of pediatric neurologists, pediatricians, educators, and specialty support staff. Children receive an extensive evaluation and a treatment strategy is then implemented, including medication, when necessary, family counseling, and appropriate educational and social support.

PEDIATRIC INFECTIOUS DISEASES
In the last decade, the incidence of mother-to-child transmission of HIV has been reduced from 25% to less than 1%. This astonishing decrease is the result of extensive research and new developments, including medications, many of which have been made available through clinical trials. Bronx-Lebanon’s Pediatric Infectious Disease Division remains a leader in the field. It has successfully utilized a family centered approach where children, their parents, and siblings receive medical treatment, case management, education, and other supportive services.

In 2007, the Division of Pediatric Infectious Diseases received more than $1.5 million to implement the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) and Pediatric HIV/AIDS Cohort Study (PHACS), funded by the National Institutes of Health (NIH). The division has also been awarded significant grant funding from the pharmaceutical industry to test new medications and vaccines.

Recently, a special Travel Clinic was implemented to prevent and control the increasing problem of children and their families contracting infectious diseases in their travels to other countries. The resulting success of this initiative led to participation in the Center for Disease Control (CDC) Geosentinel Surveillance Project that is investigating the frequency of travelers returning from overseas with illnesses.

SICKLE CELL PROGRAM
The Sickle Cell Program is addressing the multiple needs of children with this disease, and their families. In addition to managing its medical aspects, the program seeks to decrease the number of hospitalizations and Pediatric Emergency Room visits, as well as improve quality of life. Since sickle cell anemia is hereditary, pregnant women are encouraged to participate in genetic counseling to assess the risk of transmission. Newborns are also routinely screened to identify whether they may be carriers. In addition to sickle cell management, infants and children receive routine immunizations, as part of regular health maintenance.

One major symptom of sickle cell anemia is severe pain. Pediatricians at Bronx-Lebanon are trained to evaluate such pain and treat it, making the child as comfortable as possible. Children are placed on appropriate medications and are regularly monitored to evaluate treatment efficacy and potential adverse reactions. Self-management techniques to care for the disease at home are also taught. When physician intervention is necessary, a pediatric hematologist is available 24/7.