Matt Masiello, M.D., MPH

Category: Public Health

  • Summary of Recent Publication- The Implementation of a Statewide Bullying Prevention Program: Preliminary Findings from the Field and the Importance of Coalitions

    Schroeder, B. A., Messina, A., Schroeder, D., Good, K., Barto, S., Saylor, J., & Masiello, M. (2012). The implementation of a statewide bullying prevention program: preliminary findings from the field and the importance of coalitions Health Promot Pract (Vol. 13, pp. 489-495). United States.

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    Recognizing bullying and low-level violence as a serious public health concern, The Center for Health Promotion and Disease Prevention at the Windber Research Institute has effectively shown to reduce bullying in schools through the Olweus Bullying Prevention Program (OBPP). Bullying is defined as a person being repeatedly exposed to negative actions by one or more person while lacking the ability to defend themselves (Olweus, 1993). Studies show in American schools, bullying affects nearly 30% of all students, daily, causing feelings of decreased safety, low personal satisfaction and self-esteem, and anxiety. Victims may experience low academic achievement, a greater chance of dropout, and absenteeism in schools. In taking a systematic, evidence-based approach, OBPP has been applied to populations worldwide, being labeled as the most effective bullying prevention programs in the world and is endorsed by the American Academy of Pediatrics (AAP). OBPP utilizes four components of concentration in the program: school, classroom, individual, and community initiatives.

    In 2000, the Highmark Foundation developed the Highmark Health High 5 initiative and started to provide more than six million dollars of funding to two bullying prevention programs.  Both HALT! A Bullying Prevention Program, led by the Windber Research Institute, and PA CARES (Creating an Atmosphere of Respect and Environment for Success), led by the Pennsylvania Department of Education, coordinated their programs along the guidelines of the OBPP.  HALT! and PA CARES determined an overall goal to provide and monitor bullying prevention strategies to schools across western and central Pennsylvania. This effort was informed by the PRECEDE-PROCEDE framework.

    With HALT! (WRI) managing district-wide implementation and PA CARES (Department of Education) monitoring building-only implementation, the Olweus Bullying Questionnaire (OBQ) was provided for students to evaluate student bullying behavior, perceptions, and teacher’s responsiveness.  Surveys were collected from HALT! cohorts after two years of program implementation providing positive results.  High school bullying reductions were reported in bullying between 15% and 39%.  Teachers spoke to students regularly about bullying, marking increases of anywhere between 14% and 131%.  Overall, the communication of bullying perceptions and school rules regarding bullying had increased in students, ranging from 17% to 69%.  Additionally, the program increased parental involvement in student bullying between 14% and 81%.  In elementary schools, more students testified to be willing to aid bully victims.  The data collected seemed to support the overall OBPP observation that bullying prevention efforts are more effective on a long-term basis.

    On a large scale, the Olweus Bullying Prevention Program and charitable foundations have taken a leadership role, making public health of children a priority.  Collaborating on bullying prevention efforts has resulted in school success on a long-term basis.  By providing partnerships compared with the public health model, students may experience benefits in school climate, the community, and their lives.

     

     

    References

    Olweus, Dan. (1993). Bullying at school : what we know and what we can do. Oxford, UK ; Cambridge, USA: Blackwell.

     

     

     

     

  • Summary of Recent Publication- The Role of a Health Care Foundation in a Statewide Bullying Prevention Initiative

    Schroeder, B. A., Messina, A., Holliday, C., Barto, S., Schroeder, D., & Masiello, M. (2012). The Role of a Health Care Foundation in a Statewide Bullying Prevention Initiative. Academy of Health Care Management Journal, 8(1), 33-40.

    In the field of health promotion, bullying in schools has been considered a priority and focal point of research throughout the past few years. Bullying is recognized as an individual with little defenses repeatedly experiencing negative actions from one or more persons.  Studies prove that bullying victims experience a greater change of serious health concerns such as depression, low self-esteem, and suicidal thoughts over their lifetime. However with the unrivaled support from a health care foundation, a bullying prevention program has been implemented on a wide scale in Pennsylvanian (U.S.) schools. Over a three year period, bullying has been addressed among 15 percent of school children in Pennsylvania to become the largest health promotion initiative focused on school bullying in the United States.

    In the past 70 years, Highmark Inc. has benefited many school-aged children in the Pennsylvania area.  In 2000, Highmark launched the Highmark Healthy High 5 to address nutrition, physical activity, grieving, self-esteem, and bullying prevention in children and teenagers ages six to eighteen.  The $100 million health promotion effort provides multi-year grants to community partners focused on the initiative as well.  By providing a significant amount of grant money, two advanced bullying prevention programs have been able to develop and flourish based on the internationally accepted, systematic and holistic Olweus Bullying Prevention Program (OBPP).  Leading in the largest OBPP implementation in the United States, approximately 260,000 out of 1,775,029 students have been reached in Pennsylvania.

    With the provision six million dollar grant, bullying prevention initiatives known as HALT! A Bullying Prevention Program, coordinated by the Windber Research Institute (WRI),and PA CARES (Creating an Atmosphere of Respect and Environment for Success), coordinated by the Pennsylvania Department of Education,have used OBPP to concentrate on school-wide, classroom, individual, and community bullying prevention measures.  HALT! managed district-wide implementation, while PA CARES focused on the implementation of OBPP in specific school buildings in a three year study.

    By using the Olweus Bullying Questionnaire (OBQ) on students in grades 3-12, data was collected assessing bullying issues, attitudes and beliefs about bullying, bystander perceptions, and student’s satisfaction with school.  107 total schools and 56,137 students participated in the OBQ by the end of the second year of the study.  Overall, the OBQ remained positive after program implementation, reporting a decrease in self-reports of bullying.  On the high school level, the prevention efforts decreased bullying by 15 to 39 percent.  In elementary schools, 27 percent more students testified that they would do their best to aid a bullied student after two years of implementation.

    With a goal to produce positive changes in school environments regarding bullying, the Highmark Health High 5, HALT! and PA CARES have reduced bullying incidents in schools while nurturing  a climate of positive peer relations and adult involvement.  By using evidence-based public health programs, bullying has comprehensively been addressed as a major health issue.  In the largest OBPP implementation in Pennsylvania and the United States, Highmark also had led the first pilot of OBPP in high schools within the United States.  Through the Highmark Foundations public health initiatives, programs such as the Olweus Bullying Prevention Program can remain on the radar of individuals to provide positive changes in school climate and students’ lives while reducing long-term health care expenses.

     

     

     

  • The Cost Benefit of Bullying Prevention: A First Time Analysis of Savings

    The Center for Health Promotion and Disease Prevention at the Windber Research Institute and the Highmark Foundation recently published, “The Cost Benefit of Bullying Prevention: A First Time Analysis of Savings“. This report demonstrates the cost benefit of  school-based bullying prevention from three perspectives, the perspectives of health care organizations, schools, and society as a whole. Bullying is a pervasive behavior that may have a negative impact on children, sometimes, even into adulthood. Nonetheless, through the implementation of an evidence-based, bullying prevention program, we have demonstrated the ability to allay academic, social, and health adversities related to bullying. While reading “The Cost Benefit of Bullying Prevention: A First Time Analysis of Savings“, please keep in mind that the purpose of this report is to shed light on the benefit of implementing bullying prevention.

  • Preventing Bullying in Schools Through Partnerships

    Partnership is often a component of successful public health programming. My team, The Center for Health Promotion and Disease at the Windber Research Institute, belongs to larger bullying prevention collaboration that extends throughout the state of Pennsylvania as well as nationally and internationally.

    The following research brief, “Preventing Bullying in Schools Through Partnerships” was developed by our collaboration and published by the National Institute on Health Care Management (NICHM)

  • Heart health: Smoking a prime heart disease culprit

    20120517-160303.jpgDr. Bernard Leech of Conemaugh Family Medicine Center has been known to ask patients if he can prescribe medicine that costs $7 a day and causes shortness of breath, raises blood pressure and heart rate, reduces oxygen levels, contains cancer-causing chemicals and will ultimately cause death.

    When patients balk, he points out that he just described their smoking habit.

    Although smoking is often associated with an increased risk of cancer, tobacco is also the No. 1 risk factor for heart disease.

    “Cigarettes increase your risk of atherosclerosis,” Dr. Jeanne Spencer, Memorial Medical Center family medicine residency program director said at the Family Medicine Center.

    Atherosclerosis refers to the buildup of fats as plaque on artery walls. Atherosclerosis in the arteries of the heart can lead to heart attacks.

    “Nicotine causes vasoconstriction, which is when the blood vessels spasm and close down a bit,” Spencer said. “If they tighten down when they are already narrowed (by atherosclerosis), you are in bigger trouble.”

    Smoking also increases the heart rate, but cuts down on the amount of oxygen pushing carbon monoxide and other waste materials into the bloodstream, said Michelle George, Memorial’s tobacco cessation/prevention program coordinator.

    And while the local medical experts stress the hazards of tobacco use, they understand the challenge quitting presents.

    ‘Dependency triangle’

    In 1988, a report by Surgeon General C. Everett Koop compared characteristics of tobacco addiction to heroin and cocaine addiction.

    “It is never going to be easy,” Leech said. “Ultimately, it boils down to empowering the individual to make that change. Our job is to assist them to that goal.”

    George says there are three aspects to the smoking addiction: Nicotine addiction, habit and emotion. Successful quitters have to break free from all three sides of the dependency triangle.

    Nicotine replacement therapy can help ease quitters through the withdrawal, she added.

    The second issue is breaking the smoking habit, which requires changes in routine, George said.

    “When do you smoke?” she asks. “When you get up in the morning? When you’re driving a car? You can modify your life-style. Take your coffee back to the bedroom and read the paper.”

    Spencer put it this way:

    “Try to change the routine.

    “Don’t sit in your smoking chair at smoking time and think you are not going to smoke.”

    20120517-160436.jpgThe third area, emotional dependency, also requires a change in routine. Smokers often light up when they feel stressed.

    “See what you can do in place of going out and having that cigarette,” George said.

    ‘Ready to quit’

    Memorial and Somerset Hospital each offer tobacco cessation classes that encourage participants to quit smoking by showing the health benefits and offering strategies for success.

    Tools include nicotine replacement products such as patches and chewing gum.

    But a study published last month in the scientific journal Tobacco Control casts some doubt on the value of replacement therapy.

    The study by Harvard Medical School’s Center for Global Tobacco Control and the University of Massachusetts found those using the replacement therapy were just as likely to relapse as those who quit “cold turkey.”

    Local cessation advocates believe more study is needed and continue to suggest nicotine replacement as a tool.

    “It helps get them through that relapse,” George said. “The patches help them not have as severe withdrawal symptoms. But they have to be ready to quit.”

    Dr. Matthew Masiello, director of the Center for Health Promotion and Disease Prevention at Windber Research Institute, said the study and the patches illustrate misconceptions.

    “We have to put it into context,” Masiello said. “There has to be a level of education accessible to use the products effectively. These patches will work if you use them effectively.

    “These studies tell us we have to stop thinking that the product is going to be it for us. You need to be working toward the optimal environment. You can’t think the product is going to change all of your environment.”

    The experts had several tips they like to share with smokers who want to quit.

    George and Spencer both urge smokers to set a quit date.

    As the date approaches, remove ashtrays and stashes of tobacco from the house.

    “Getting people around you to quit helps a lot,” Leech said.

    “That way you are not exposed to it.”

    Above all, be committed, Spencer said.

    “Most people try three times before they actually quit,” she said. “If they fail on the first try, we tell them to just do it again.”

    ‘Learn and live’

    Masiello’s tobacco-prevention advice took a different direction.

    “Get a high school education,” Masiello said. “I know that sounds absurd, but we have seen the research: The higher education level you obtain, the better you are going to take care of yourself.

    “We need to do a better job of keeping kids in high school.”

    It won’t be long before many Americans have additional incentives to quit, Masiello predicts.

    “Businesses are going to stop hiring smokers,” he said. “We now see 80 percent of the people don’t smoke.”

    Employees who smoke drive up a company’s health-care costs and increase absenteeism, he said.

    Masiello applauded Geisinger Health Care system’s new policy to stop hiring tobacco users, as of Feb. 1.

    All job applicants – including full-time and part-time positions, volunteers and students enrolled in the system’s schools – are now required to complete urine testing.

    Geisinger is not the first company to adopt a similar policy, which is legal in 20 states.

    More employers are bound to join the cause, Masiello said.

    “You are not affecting people’s rights,” he said. “You are helping them get healthy.”

    **This article was published in the Tribune Democrat on 2/18/12

    http://tribune-democrat.com/local/x1265287779/Heart-health-Smoking-a-prime-heart-disease-culprit

  • Local programs offer incentive for healthy living

    20120518-174043.jpgPrevention of heart disease begins young, experts say, encouraging parents to instill proven nutrition and exercise lifestyles from infancy.

    But with childhood obesity rates tripling in the past 30 years, many worry that Americans are losing the battle.

    “This is the first generation of Americans that will not live as long as the generation before,” said Dr. Lawrence Rosenberg, a pediatrician with Conemaugh Physicians Group of Johnstown.

    Rosenberg urges parents to be proactive by creating a healthy environment in their homes and getting the whole family involved.

    Fellow pediatrician Dr. Matthew Masiello, chief wellness officer at Windber Research Institute, takes the advice a step further. Healthy patients begin with healthy doctors, Masiello said.

    “You have to get yourself fit,” Masiello said. “Then you are able to help your patients. As physicians, we have to start taking care of ourselves.”

    The strategy has been proven by the decrease in tobacco use. As more doctors quit smoking, Masiello said, they were able to help more of their patients find strategies to quit. As government policies and businesses continued to limit opportunities to smoke, tobacco use has declined even more.

    “It comes down to education and policy,” Masiello said.

    For parents, education should begin even before the baby is born, he said.

    “When I was training, breastfeeding was an issue we talked about in terms of the antibodies and the extra vitamins and minerals that came from the mother,” Masiello said.

    “We now know that breastfeeding is much more than that. Those kids are going to have better weight control when they get older. It is going to have a positive effect throughout their lives.”

    Part of the benefit, doctors believe, comes from getting mothers thinking about nutrition and wellness early.

    “Parents are more cognizant of weight issues,” Masiello said. “When parents absorb the educational aspects of breastfeeding, there is a connection with good nutrition later in life.”

    Health education for parents is vital to any program addressing childhood wellness and disease prevention, Rosenberg said, recalling earlier attempts to stem the obesity epidemic. When leaders first recognized the rise in the obesity rate, he said, hundreds of different programs were introduced addressing the issue at various levels, such as psychology, nutrition, medicine and education.

    “They were all uniformly unsuccessful,” Rosenberg said. “Then a study by the University of Washington showed you have to have the whole family buy into a program. It is pivotal for success.”

    Several local health-care organizations are offering evidence-based programs based on findings such as the Washington study.

    Memorial Medical Center is bringing the Edwards LifeSciences spring wellness events back to four locations in Cambria and Somerset counties, with outreach to more than 30 schools.

    Families will be invited to come together to the one-day events, coordinator Michelle George said.

    The programs will provide health screenings and information to parents while children participate in a fun, healthy activity.

    “We try to encourage healthy behavior through physical activity, even among those who don’t normally play basketball or football,” George said.

    A schedule for the spring wellness events will be announced soon, she said.

    Somerset Hospital has been conducting KidShape programs for several years in Somerset County, with funding from the Highmark Foundation. Windber Research Institute is reintroducing KidShape for Cambria County families.

    The Windber program is being held at Greater Johnstown YMCA, with support from the YMCA and Alternative Community Resource Program.

    KidShape targets children in the 85th percentile and above on body mass index screenings conducted at all schools, Masiello said.

    “That is the public health approach: To gather all these players together to bring these programs into focus.”

    Parents attend two-hour sessions each week for nine weeks with their children, meeting with nutrition, exercise, and mental-health professionals during every session. Participants move through seven different stations addressing all aspects of weight loss and healthy lifestyle, exercise physiologist and program coordinator Mike Seibert said from Somerset Hospital.

    “Parents learn as the kids learn,” Seibert said. “They tell us, ‘we want to do better; we just don’t know how.’ ”

    Working together with other families is an important part of the KidShape mission, fitness director Debbi Smith said at the YMCA

    “This just a starting point for these kids who are changing their lives,” Smith said. “We get the kids into the environment where they are surrounded by like-minded individuals, trying to make themselves healthy and to have fun.”

    Parents learn how to take better care of themselves and create healthier homes, Seibert said.

    “What I am asking the families to do is take the lead again,” Seibert said.

    “Take an active role in their kids’ health. The kids are counting on the parents to be the food cookers and shoppers.”

    Program director Vicki Clark said KidShape fits well into the YMCA’s new national focus: “For Youth Development; For Healthy Living; For Social Responsibility.”

    “KidShape hits all those components for us,” Clark said.

    Facilitators check in with families after three months, then six months and then a year after the final session.

    “If the families are held accountable, and they are working together, it works,” Seibert said.

    “We are hoping that we connect with these kids so when they are in the grocery store, they start looking at what is on the labels. Instead of sitting around watching TV, we encourage them to go outside.”

    Enrollment information

    • KidShape, Somerset County.

    Mike Seibert at 445-3330.

    • KidShape, Cambria County.

    Windber Research Institute KidShape line 361-6966.

    • Memorial Medical Center, Edwards LifeSciences screenings.

    (866) 839-3867.

    Consumer advice

    Here are some shopping and nutrition tips from Dr. Lawrence Rosenberg, a pediatrician with Conemaugh Physicians Group of Johnstown:

    • Shop on a full stomach, with a list and not with children.

    • Everybody older than 2 should drink skim milk.

    • Start meals with salads or light soup, lingering with 15 minutes of conversation at the dinner table.

    • Serve all meals on salad plates, with salad forks.

    • Get rid of frying.

    • Limit protein to a serving the size of your palm, and cook only one serving for each person. The rest is vegetables you will eat if you are hungry.

    • Snack on fresh-cut carrots or other vegetables in front of the television.

    • Mix children’s sugary cereal with more healthy cereal, gradually reducing the sugar content until it’s gone.

    **This article was published in the Tribune Democrat on 2/25/12

    http://tribune-democrat.com/local/x1875167287/Local-programs-offer-incentive-for-healthy-living