♪ ♪ SOMETIMES GOOD PEDIATRIC CARE INCLUDES PROVIDING CARE AND GUIDANCE FOR THE PARENT.

STAY WITH US AS WE TALK WITH PEDIATRICIAN Dr. CHARLOTTE GAY STITES ABOUT TWO GENERATION PEDIATRIC CARE NEXT ON "KENTUCKY HEALTH."

CONTRARY TO WHAT MANY OF US THINK, THE FAMILY DYNAMIC IS A TWO WAY STREET.

WE PARENTS AND ADULTS LIKE TO THINK THAT WE ARE IN CONTROL OF BOTH THE MESSAGE AND THE PATH THAT OUR CHILDREN WILL TAKE.

HOWEVER, THERE ARE TIMES, PROBABLY MORE THAN WE REALIZE, IN WAYS THAT OUR CHILDREN GUIDE OUR BEHAVIOR.

PESTER POWERING THE CLASSIC TOOL USED BY CHILDREN.

IT HAS EARNED A DECIDEDLY NEGATIVE CONNOTATION.

MANY OF US HAVE EITHER WITNESSED OR BEEN THE RECIPIENT OF A FULL ON ATTACK BY OUR CHARGES IN PURSUIT OF SOME IMMEDIATE GRATIFICATION AT A GROCERY STORE OR A MALL.

A CONCEPT UTILIZED BY SOME PEDIATRICIANS AND DISTINGTS FROM PESTER POWER IS TWO GENERATION PEDIATRICS.

THE PARENT IS THERE TO ACCOMPANY THE CHILD, BUT THEY THEMSELVES ARE ALSO TREATED.

DURING THE CHILD'S VISIT THE PEDIATRICIAN TAKES THE MEASURE OF HOW THE PARENTS IS COPING AND USING THIS OPPORTUNITY TO DISCUSS TOPICS SUCH AS HOW THEIR DIET AND SMOKING CAN IMPACT NOT ONLY THEIR HEALTH BUT ALSO THAT OF THEIR CHILD.

THIS APPROACH RECOGNIZES THE FIZZ AL AND MENTAL HEALTH AND WELL-BEING OF THE CHILD.

TO GIVE US A BETTER UNDERSTANDING OF WHAT TWO GENERATION PEDIATRICS IS AND PESTER POWER AND COMPREHENSIVE CARE PRACTICE, WE HAVE Dr. CHARLOTTE GAY STITES.

Dr. STITES RECEIVED HER UNDERGRADUATE DEGREE AT THE UNIVERSITY OF VIRGINIA.

SHE OBTAINED HER MEDICAL DEGREE AT THE UNIVERSITY OF KENTUCKY AND THEN COMPLETED HER RESIDENCY IN PEDIATRICS AT THE OREGON HEALTH SCIENCES UNIVERSITY CHILDREN'S HOSPITAL IN 2018, SHE FOUNDED THE WELLNESS CENTER TO RAISE CHILDREN TO BE HEALTHY IN MIND, BODY AND SPIRIT.

Dr. CHARLOTTE GAY STITES OR AS YOU LIKE TO BE KNOWN, Dr. CHARLOTTE.

THANKS FOR BEING WITH US.

>> THANK YOU.

>> HOW DID YOU GET INTO PEDIATRICS?

>> WELL, MY FATHER WAS A DOCTOR GROWING UP AND AS A CHILD WHEN PEOPLE WOULD ASK ME WHAT I WANTED TO BE, I WOULD SAY I DON'T KNOW, BUT NOT A DOCTOR.

AND AS I GROUP UP AND HAD HEALTH EXPERIENCE IS OF MY OWN, I HAD SOME PEOPLE WHO TREATED ME KINDLY AND WELL AND SOME PEOPLE WHO TREATED ME AS A DIAGNOSES AND I CAME MORE AND MORE INTERESTED IN HOW YOU TREAT THE WHOLE PERSON AND IN PEDIATRICS, WE DO A LOT OF ALL PIECES OF HEALTH, NOT JUST THE CLINICAL CARE.

THERE IS A LOT OF BEHAVIORAL HEALTH, NUTRITION, EXERCISE, COUNSELING ABOUT SCHOOL AND BEHAVIORS AND THAT IS THE PIECE THAT I LOVE ABOUT PEDIATRICS.

AND REALLY BEING ABLE TO SUPPORT PARENTS, VERY OVER MOMS, AS THEY GO FROM BEING YOUNG WOMEN TO MOTHERS AND HOW THEY MAKE THAT TRANSITION.

SO BEING A PEDIATRICIAN IS A WONDERFUL, VERY PRIVILEGED JOB.

SO I LOVE WHAT I DO.

WHAT WAS THE AHA MOMENT OR EVENT THAT SAID I NEED TO FORM SMOKETOWN FAMILY WELLNESS CENTER?

>> WELL, I HAD THE GREAT PRIVILEGE OF BEING A VOLUNTEER AT THE LOUISVILLE DEPARTMENT OF PUBLIC HEALTH AND WELLNESS UNDER Dr. NISBET.

AND I WAS PART OF A TEAM THAT PUT TOGETHER A COMMUNITY HEALTH IMPROVEMENT PLAN FOR HER AS SHE WAS LOOKING FOR THE VISION OF HEALTH.

AND LOOKING AT ALL ASPECTS OF HEALTH, INCLUDING THE CLINICAL CARE, AS WELL AS LOOKING AT SOCIAL DETERMINANTS OF HEALTH OR ESSENTIAL NEEDS, LOOKING AT SOCIAL IMPACTS OF HEALTH AND THE BUILT-IN ENVIRONMENT AS WELL.

AND AS I WAS PART OF THIS GROUP OF EXPERTS LOOKING AT HOW DO WE ADDRESS HEALTH EQUITY GAPS IN OUR COMMUNITY, POST OF THE SOLUTIONS WERE GEARED AROUND HOW TO WE BETTER DIAGNOSE DISEASE AND HOW DO WE BETTER TREAT THEM AND AS A PEDIATRICIAN, A LOT OF WHAT WE DO IS PREVENTATIVE CARE.

VACCINES ARE A HUGE PART WHAT HAVE WE DO TO PREVENT FDIC AND INFECTIOUS DISEASE SO AS WE LOOK AT HOW DO WE ADDRESS GAPS IN CHRONIC HEALTH, MOST OF THE DISEASES FUNDAMENTALLY STARTED IN CHILDHOOD, WITH ACCESS TO GOOD FOOD, WITH ACCESS TO MOVEMENT, WITH YOUR SUCCESS IN SCHOOL AND WELL-BEING; AND WHETHER YOU ARE EXPOSED TO ADVERSE CHILDHOOD EXPERIENCES.

SO THE CONCEPT OF THIS SMOKETOWN FAMILY WELLNESS CENTER CAME ABOUT TO ADDRESS ALL OF THOSE COMPONENTS OF YOUR HEALTH IN COMMUNITY.

A LOT OF FAMILIES IN LOUISVILLE HAVE DIFFICULTY WITH TRANSPORTATION, AND IT WAS RIGHT AS THE SHEPHERD'S HOUSING PROJECT WAS BEING REBUILT AND Dr. NISBET HELPED US TO GET OUR LOCATION IN THE HISTORIC PRESBYTERIAN COMMUNITY CENTER IN SPOKETOWN SO THAT FAMILIES COULD WALK TO US FOR CARE AND THAT WE COULD REALLY BE PART OF THE COMMUNITY TO TRULY IMPACT HEALTH.

>> YOU SAID A LOT IN THERE.

WE ARE GOING TO COME BACK TO TALK ABOUT VACCINES IN A LITTLE BIT.

TELL ME ABOUT THIS MODEL.

YOU TALK ABOUT TREATING THE WHOLE PATIENT.

NOW, WHICH MEANS THE WHOLE PATIENT MEANS AND THEIR SUPPORTING STRUCTURES, THE PARENTS IN THIS CASE.

IS THERE A DISTINCTION BETWEEN THE PARENT AN THE CHILD IN YOUR PRACTICE?

>> IT'S VERY HARD AND A LOT OF THAT DEPENDS ON THE AGE.

PART OF GROWING UP, AS YOU MEET DEVELOPMENTAL STAGES AND YOU LEARN TO BE INDEPENDENT FROM YOUR PARENT, YOUR PARENT OR GAVE, THEIR JOB IS TO RAISE A CHILD TO BE ABLE TO BE SUCCESSFUL INDEPENDENTLY SO WHEN WE SEE A FAMILY WITH A NEW BABY, WE DO A LOT OF EDUCATION AND A LOT OF SUPPORT.

IT IS REALLY IMPORTANT FOR A PARENT TO KNOW THAT THEY ARE THEIR CHILD'S FIRST AND REALLY BEST TEACHER.

SO THAT PARENT IS STARTING TO TEACH RIGHT FROM THE BEGINNING.

BUT UNLIKE IF YOU BUY A NEW CAR OR BUY A NEW PHONE, YOU GET AN INSTRUCTION MANUAL AND YOU CAN GOOGLE IT AND FIND ALL THIS INFORMATION.

WHEN YOU HAVE A BABY, YOU ARE KIND OF OUT THERE, NOBODY REALLY GIVES YOU ANY INSTRUCTIONS.

AND SO WHAT REALLY, A LOT OF WHAT WE TRY TO DO IS THE BABY MAY BE OUR PATIENT BUT AGAIN FOR THAT BABY TO BE HEALTHY, THEIR PARENT OR CAREGIVER REALLY NEEDS TO KNOW HOW TO, HOW TO CARE FOR THE BABY.

AND THAT'S WHAT ESTABLISH HABITS AND ROUTINES TO SET A CHILD UP FOR A LIFETIME OF SUCCESS IN HEALTH AND WELL-BEING.

>> MY MOM IS A NURSE AND SHE STARTED OFF HER CAREER IN PUBLIC HEALTH BACK IN THE DISTRICT OF COLUMBIA.

AND I REMEMBER ONE OF THE THINGS SHE SAID FOR JOBS, WHEN A MOTHER WOULD COME HOME WITH THE BABY, THE VNA, VISITING NURSE ASSOCIATION WOULD GO OUT AND HELP THE MOTHER HOW DO BE A MOTHER.

IS THIS SOMETHING THAT YOU ARE TALKING ABOUT YOU ARE DOING NOW?

>> THERE ARE A COUPLE OF WONDERFUL PROGRAMS IN LOUISVILLE , THE HANDS PROGRAM AND THE HEALTHY BABIES PROGRAM, THAT THEY ACTUALLY HAVE HOME VISITS WITH NURSES.

A LOT OF OUR FAMILIES ARE VERY HESITANT ABOUT THAT.

THEY'RE HESITANT ABOUT HAVING FOR SOMEBODY COMING INTO THEIR HOME FOR ALL KINDS OF REASONS.

SO WE TRY TO ENCOURAGE THEM BECAUSE THESE ARE FABULOUS RESOURCES AND WONDERFUL PEOPLE THAT GO.

SO SOME PEOPLE WILL AGREE TO THAT, BUT A LOT OF THEM FEEL MORE COMFORTABLE IN COMING IN TO A SPACE AND GETTING THAT INFORMATION AND PART OF WHAT WE TRY TO DO IN A LOT OF OF OUR CLINICS AROUND TOWN, IF YOU HAVE AN ISSUE AFTER HOURS, YOU ARE GOING TO GET A CALL CENTER, AND WE TAKE ALL OF OUR OWN CALLS SO THAT IF IT'S NIGHT TIME AND YOUR CHILD HAS AN EMERGENCY, YOU GET YOUR DOCTOR.

SO YOU HAVE THAT COMFORT AND PEACE OF MIND THAT YOU KNOW WHO YOU ARE TALKING ABOUT AND WE KNOW WHO WE ARE TALKING TO.

AND WE CAN BETTER UNDERSTAND WHAT A PARENT'S COMFORT LEVEL IS.

>> TELL ME ABOUT THE HOLISTIC APPROACH.

WHAT DOES THAT REALLY MEAN?

>> THAT'S A GREAT QUESTION.

THANK YOU FOR ASKING IT.

A LOT OF TIMES PEOPLE THINK HOLISTIC IS ALTERNATIVE MEDICINE.

WE'RE NOT PROVIDING ALTERNATIVE MEDICINE.

WE ARE PROVIDING EVIDENCE-BASED CARE.

WE FOLLOW THE RECOMMENDATIONS OF THE AMERICAN ACADEMY OF PEDIATRICS.

S I THINK, FOR US, WHAT HOLISTIC CARE MEANS IS INSTEAD OF JUST LOOKING AT CLINICAL CARE, INSTEAD OF JUST LOOKING AT WHAT MEDICINES YOU TAKE, INSTEAD OF LOOKING AT HOW IS YOUR ASTHMA OR LOOKING AT CLINICAL ISSUES, IS THE UNDERSTANDING THAT DIET AND ACTIVITY AND SUCCESS IN SCHOOL AND BEHAVIORS AND DEVELOPING FRIENDSHIPS, TRANSPORTATION, THE ABILITY TO GET FOOD, ACCESS TO GET OUTSIDE AND PLAY.

DO YOU HAVE A BED TO SLEEP IN AT NIGHT?

THOSE OF ALL THINGS THAT GO INTO YOUR HEALTH AND WELL-BEING.

FOR US, HOLISTIC MEDICINE MEANS LOOKING INTO ALL OF THE PIECES THAT GO 234509 HEALTH.

>> WHEN YOU IDENTIFY A DEFICIENCY, IS THERE ANYTHING YOU CAN DO ABOUT IT?

>> ANOTHER GREAT POIGNANT QUESTION.

SOME OF THEM, YES, VERY MUCH SO, WE CAN HELP A LOT.

SOME OF THEM ARE HARDER.

AFFORDABLE HOUSING IN OUR CITY IS INCRED BRING DIFFICULT.

WE WORK WITH PARTNERS TO HELP FAMILIES ACCESS HOUSING, BUT THAT IS A HUGE PROBLEM.

SOME OF THE OTHER ISSUES, WE REALLY CAN HELP QUITE CLEARLY.

DURING COVID A LOT OF 23578 LIST DIDN'T GET DENTAL CARE SO THERE IS A HUGE BACKLOG NOT ONLY THE NEED FOR RESTORATIVE CARE AND GENERAL CLEANINGS AND A LOT OF OUR FAMILIES COULDN'T GET AN APPOINTMENT OR IF THEY COULD GET AN APPOINTMENT, COULDN'T GET THERE.

AND SO WE'VE BEEN ABLE TO HIRE A COMMUNITY HEALTH WORKERS AND WITH THE SUPPORT OF THE KOSAIR FOR CHARITIES, WE HAVE A VAN.

AND NOW OUR COMMUNITY HEALTH WORKER IS ABLE TO PICK THE FAMILY UP, TAKE THEM TO THE DENTIST, GET THEIR CARE AND TAKE THEM BACK HOME.

SO WE HAVE HELPED WITH JOB PLACEMENT.

WE'VE HELPED WITH G.E.D.ES, WE HAVE A PRESCRIPTIVE FOOD PANTRY IN PARTNERSHIP WITH DARE TO CARE SO IF A FAMILY HAS TROUBLE KEEPING HEALTHY FOOD IN THE KITCHEN, THEN WE CAN HELP WITH THAT.

SO WE REALLY JUST TRY-- IF A CHILD IS STRUGGLING IN SCHOOL OR DAYCARE WITH A PARENT'S PERMISSION, WE SPEAK WITH THE TEACHER, WE SPEAK WITH THE CASE MANAGER, THE COUNSELOR AT SCHOOL, REALLY TRY TO LOOK AT A PLAN AND WHAT DOES THE CHILD NEED.

AND SOMETIMES IT'S TRULY AS SIMPLE AS SOMETHING LIKE DOING A VISION TEST CHILD CAN'T SEE.

CHILD IS ACTING UP IN SCHOOL.

THE CHILD IS SITTING IN A VACUUM AND CAN'T SEE WHAT IS GOING ON.

YOU GET THEM GLASSES AND WOW THEY'RE DOING GREAT.

SOMETIMES IT'S A LITTLE DIFFERENT.

SOMETIMES YOU HAVE A CHILD WHO IS ACTING OUT AND IF YOU REALLY DELVE IN AND TALK WITH THE FAMILY, THERE IS SOMETHING GOING ON AT HOME PLACE OF BUSINESS IN THEIR NEIGHBORHOOD THEY'RE HEARING GUNSHOTS AT NIGHT, MAYBE NOT SLEEPING BECAUSE THEY'RE HEARING GUNSHOTS OR THE PARENTS ARE ARGUING.

IF YOU CAN ADDRESS SOME OF THOSE ISSUES AND THE CHILD ACTUALLY GETS A FULL NIGHT SLEEP, YOU CAN SEE A LOT OF IMPROVEMENT WITH THEIR LEARNING AND THEIR BEHAVIORS IN SCHOOL AS WELL.

>> YOU MENTIONED QUITE A FEW THINGS THAT GO ON IN YOUR SHOP.

WHAT IS THE DIFFERENCE BETWEEN YOU AND YOUR BASIC PEDIATRICIAN?

>> I THINK FUNDAMENTALLY THE BIGGEST DIFFERENCE IS WE SPEND A LOT OF TIME WITH OUR FAMILIES.

AND THAT'S A LUXURY THAT MOST PHYSICIANS DON'T HAVE, WHETHER YOU ARE IN PEDIATRICS OR ANOTHER SYSTEM.

OUR HEALTHCARE SYSTEM HAS BECOME BUSINESS AND BUSINESS MEANS VOLUME.

AND SO WE ARE SET UP AS A NON-PROFIT ORGANIZATION IN ORDER TO BE ABLE TO PROVIDE REALLY TOP QUALITY CARE.

SO AT THIS TIME WE BLOCK AN HOUR FOR A WELL VISIT.

IF YOU GO TO-- >> ONE HOUR.

>> ONE HOUR.

AND ANOTHER PRACTICE, IF YOU, WHETHER YOU ARE AT A PRIVATE PEDIATRICIAN OR AT ONE OF OUR WONDERFUL FEDERALLY QUALIFIED HEALTH CENTERS OR AT THE NOVAC CENTER, YOU ARE LUCKY IF YOU GET 15 OR 20 MINUTES WITH YOUR DOCTOR SO WE ARE REALLY WORKING VERY HARD TO EARN TRUST.

THE HEALTHCARE SYSTEM HAS, OVER THE DECADES AND GENERATIONS, HAS DONE A LOT TO LOSE TRUST IN COMMUNITIES AND SO WE WORK REALLY HARD TO LISTEN TO OUR FAMILIES AND TO WORK TO ESTABLISH THAT TRUST, TO UNDERSTAND WHAT THEIR PRIORITIES ARE AND TO MEET THOSE FIRST.

BECAUSE IF WE HAVE A PARENT WHO IS MOST WORRIED ABOUT WHETHER THEY'RE GOING TO LOSE THEIR APARTMENT, SHE IS NOT SO WORRIED ABOUT WHETHER THE CHILD IS GETTING THEIR ALLERGY MEDICINE OR THEIR ASTHMA MEDICINE.

AND SO REALLY WE NEED TO UNDERSTAND WHY FAT ALMOST I NEEDS IN ORDER TO ADDRESS THE HEALTHCARE NEEDS.

AND SO BY SPENDING TIME, BY HAVING COMIERNT HEALTH WORKER AND RECENTLY BEING ABLE TO ADD BEHAVIORAL HEALTH SERVICES ON SITE, THAT'S WHERE WE CAN REALLY BEGIN TO LOOK AT IT.

SO THAT TIME IS HUGE.

BECAUSE WE ARE SET UP THAT WAY, I LIKE TO SAY WE ARE PRACTICING CONS EERNL STYLE MEDICINE FOR FAMILIES WITH MEDICAID AND FAMILIES WITH MEDICAID, AS THEIR LIVES GO BY, ARE OFTEN HIGHER UTILIZERS OF THE HEALTHCARE SYSTEM.

SO INSTEAD OF BEING IN A CLINIC WHERE THEY HAVE LESS TIME AND LESS RESOURCES THEY NEED MORE TIME.

SOME PEOPLE MAY KNOW WHAT THEY SHOULD BE DOING.

THEY JUST DON'T HAVE THE CAPACITY TO GET IT DONE.

HOW DO WE HELP THEM TO BE ABLE TO START SOME OF THE POSITIVE HABITS AND POSITIVE ROUTINES.

IT'S HARD AND IT TAKES TIME.

>> SURE.

>> BUT THAT IS THE WORK THAT WE ARE REALLY TRYING TO DO.

I HAD A PARENT THIS WEEK, THIS CHILD, ONE EFFORT CHILDREN HAS HAD LOTS OF ISSUES IN SCHOOL WITH HEADACHESES STOMACH ACHES, ALL KINDS OF ISSUES.

WE HAVE BEEN ABLE TO GET THE CHILD AS WELL AS THE PARENT IN FOR BEHAVIORAL HEALTH SERVICES AND THIS PARENT PROUDLY WAS SHARING SOME SUCCESSES WITH SLEEP.

AND AGAIN, THE CHILD, YOU KNOW, THE SETTING BOUNDARIES FOR YOUR CHILD.

SO MANY FAMILIES, THEIR KIDS ARE ON THEIR PHONES ALL NIGHT.

THEY DON'T HAVE A BED TIME AND THIS WONDERFUL MOM SET THESE BOUNDARIES FOR HER CHILD.

SHE TAKES THE PHONE NOW, AND THE CHILD ACTUALLY SAID WOKE UP AND SAID I FEEL GOOD TODAY.

I GOT A GOOD NIGHT'S SLEEP.

SO THOSE ARE THE CHANGES THAT WE START TO SEE.

>> YOU LED ME INTO THIS SO TELL ME ABOUT THE TWO GENERATION PEDIATRIC MODEL BECAUSE THIS SOUNDS LIKE THE VERY THING.

>> SURE, THE CONCEPT OF TWO GENERATION PEDIATRICS IS ONE THAT HAS BEEN AROUND A LONG TIME AND MOST PEDIATRICIANS HAVE PRACTICED, THE NATURE WHAT HAVE WE DO.

BUT THE IDEA IS WHEN A PEDIATRICIAN SEES A FAMILY, THEY'RE THERE TO PROVIDE THE CARE FOR THE CHILD, BUT THEY ALSO, BY DEFINITION, IMPACT THE HEALTH OF THE PARENT AS WELL.

THE EASIEST DISCRIMINATION OF THAT IS SMOKING AND SMOKING CESSATION.

SO IF I'M SEEING A CHILD WITH ASTHMA, AND THE PARENT IS SMOKING, SMOKING AND SMOKE EXPOSURE IS CLEARLY A TRIGGER FOR ASTHMA, SO THE PARENT ISN'T MY PATIENT, BUT IF I CAN HELP THE PARENT UNDERSTAND AND RECOGNIZE THAT THE SMOKE EXPOSURE IS TRIGGERING THEIR CHILD'S ASTHMA, A PARENT IS OFTEN MUCH MORE LIKELY TO WORK TO, IF NOT QUIT, CHANGE THEIR HABITS TO DECREASE THEIR CHILD'S EXZ POSE YOUR-- EXPOSURE IF IT'S FOR THEIR CHILD.

WE ARE OFTEN MUCH MORE WILLING TO DO SOMETHING FOR OUR CHILD THAN WE ARE FOR OURSELVES.

WE ARE ABLE TO IMPACT THOSE CHANGES FOR OUR PARENTS EVEN THOUGH OUR PARENTS ARE NOT DIRECTLY OUR PATIENTS.

>> IS THIS SOMETHING THAT THE CAREGIVER WHO COMES IN WITH THE CHILD, THAT THEY HAVE TO WILLINGLY WANT THAT KIND OF INTERVENTION 1234 OR IS IT FORCED UPON THEM?

>> THAT'S SOMETHING HAVE I TO WORK ON MYSELF PERSONALLY OR PROFESSIONALLY BECAUSE IN MEDICAL SCHOOL WE ARE TAUGHT WE HAVE TO TEACH SMOKING CESSATION FOR EVERYBODY, RIGHT?

>> RIGHT.

>> BUT I CAN'T MAKE SOMEONE ELSE QUIT SMOKING, NO MATTER WHAT I SAY.

THEY HAVE TO DECIDE FOR THEMSELVES.

AND SO I MAY HAVE A PARENT WHO I UNDERSTAND, IF THEY SHARE WITH ME THAT THEY'RE SMOKE OR I CAN SMELL THEM WHEN THEY WALK IN THE ROOM, THEY'RE NOT READY TO QUIT, WE CAN SAY, UNTIL YOU ARE READY TO QUIT, WOULD YOU BE WILLING TO JUST SMOKE OUTSIDE.

UNTIL YOU ARE READY TO QUIT, WOULD YOU BE WILLING TO NOT SMOKE IN YOUR CAR?

SO THOSE KINDS OF THINGS AND GETTING A LITTLE BIT OF AGREEMENT.

THEY KNOW THAT WHEN THEY ARE READY AND READY TO TAKE THE NEXT STEP, WE'RE HERE TO SUPPORT THEM BUT THEY ALSO KNOW THAT WE ARE NOT GOING TO THINK POORLY OF THEM SMOKING IS AN ADDICTION.

IT'S VERY HARD TO QUIT.

AND AGAIN, IF YOU ARE A SINGLE PARENT AND YOU ARE WORRIED ABOUT THE ROOF OVER YOUR HEAD AND HAVING ENOUGH FOOD FOR YOUR CHILDREN, TRYING TO BREAK AN ADDICTIVE HABIT THAT IS GOING TO MAKE YOU STRESSED AND SHORT TEMPERED MIGHT NOT BE THE BEST THING FOR YOUR FAMILY.

SO YOU HAVE TO BE WILLING TO WRK WITH THE FAMILY AND SEE WHAT THEIR NEEDS AND PRIORITIES ARE AND HOW CAN WE BEST HELP THAT AND THAT'S WHERE WE START TO MOVE THE NEEDLE.

>> UNIVERSALLY,IF YOU ASK A TWO-PARENT HOME OR AT LEAST IF THERE IS A MALE AND FEMALE, AND I NOTICE IN MY OWN PERSONAL EXPERIENCE, IF THE MALE IS IN THE BATHROOM, THE DOOR STAYS CLOSED.

FEMALE IN THE BATHROOM, OPEN SEASON.

DO WOMEN GET A BREAK.

[LAUGHTER] AND HOW DOES THAT WORK FOR THE SINGLE PARENT BECAUSE YOU ARE ALWAYS ON.

>> THEY'RE ALWAYS ON.

AND IT IS REALLY, REALLY A DIFFICULT CHALLENGE.

HOW CAN YOU-- THE MOST IMPORTANT THING THAT WE CAN ALL DO AS PARENTS, BECAUSE WE ARE TEACHERS, RIGHT?

WE HAVE TO TEACH OUR CHILDREN HOW TO EAT, HOW TO BEHAVE, HOW TO MOVE THEIR BODY, WHEN TO GO TO SLEEP.

ALL OF THOSE THINGS ARE THINGS THAT ARE TAUGHT.

AND THEY'RE TAUGHT ABOUT BY A PARENT AND IF YOU ARE A SINGLE PARENT AND YOU ARE ALWAYS ON AND YOU DON'T HAVE A BREAK, YOUR PATIENCE GETS PUSHED REALLY HARD.

AND SO IT BECOMES VERY DIFFICULT.

SO, AGAIN, WE TALK WITH OUR FAMILIES ABOUT WHO ARE THEIR SUPPORTS.

WHAT ARE THEIR STRENGTHS.

WE JUST STARTED, JUST THIS WEEK, IN PARTNERSHIP WITH THE BOUNCE COALITION, WE HOSTED A PARENT SUPPORT GROUP.

AND WE HAD A SMALL GROUP OF WOMEN, ALL WOMEN CAME TO THIS ONE.

MEN ARE INVITED.

WE HAVE SINGLE DADS, TOO, TO REALLY TALK ABOUT WHAT IT'S LIKE TO PARENT AND PARTICULARLY WHEN YOU ARE A SINGLE PARENT, WHAT ARE YOUR CHALLENGES.

WHO ARE YOUR SUPPORTS?

AND GIVING PEOPLE THAT OPPORTUNITY IS VERY POWERFUL.

ASKING PEOPLE, ASKING PARENTS WHAT THEIR STRENGTHS ARE IS ANOTHER VERY POWERFUL TOOL BECAUSE VERY OFTEN, THESE MOMS, THESE WOMEN, DON'T RECOGNIZE THAT THEY HAVE STRENGTHS, AND SO WE HAVE A SOCIAL SCREENER.

AT THE BOTTOM WE ASK OUR PARENTS, WHAT ARE YOUR STRENGTHS AND WHO ARE YOUR SUPPORTS?

AND SOMETIMES WE'LL COME TO THE BOTTOM AND IT'S EMPTY.

AND I'LL SAY, DID YOU GET A CHANCE TO FINISH THIS?

AND SOMETIMES THEY WILL LOOK AT ME AND SAY NO, Dr. CHARLOTTE, YOU KNOW, SUSIE WAS JUMPING ALL OVER THE PLACE.

I DIDN'T GET A CHANCE TO FINISH.

WHAT ARE YOUR STRENGTHS?

WELL, I'M REALLY RESOURCEFUL AND I'M A REALLY GOOD FRIEND TO MY NEIGHBORS AND THEY CAN TELL YOU.

AND SOMETIMES THEY GET REALLY QUIET AND THEY SAY I DON'T HAVE ANY STRENGTHS.

AND I ASK THEM IF THEY MIND IF I SHARE WHAT I SEE.

I SEE THAT THEY'RE A LOVING PARENT WHO CARES DEEPLY ABOUT THEIR CHILD.

THEY'RE HERE TO GET CARE FOR THEM.

THEY'RE ASKING ABOUT RESOURCES AND HOW TO GET THEM INTO A GOOD SCHOOL.

AND YOU CAN SEE THEM SIT UP A LITTLE BIT TALLER AND YOU CAN SEE THIS SENSE OF RECOGNITION AND LETTING THEM KNOW THAT SOMEBODY IS THERE TO BELIEVE IN THEM, AND THAT IF THEY HAVE QUESTIONS, IF THEY HAVE CONCERNS, THAT THEY CAN CALL US AND THAT IS WHERE WE CAN REALLY START, AGAIN, TO BUILD THAT TRUST, AND FOR PARENTS, PARTICULARLY SINGLE PARENTS, TO THINK ABOUT THEIR NETWORK, THEIR SUPPORT SYSTEM, AND WE HOPE TO BE A PART OF OUR FAMILY'S SUPPORT SYSTEM WHETHER YOU ARE A SINGLE PARENT WITH MEDICAID OR WHETHER YOU ARE A TWO PARENT FAMILY WITH TWO INCOME AND PRIVATE INSURANCE.

WE DO THOSE, TOO.

SO THAT WE CAN BE A PART OF OUR FAMILY'S SUPPORT SYSTEM.

>> ARE THERE SIMILAR ORGANIZATIONS OR PRACTICES LIKE YOURS THROUGHOUT THE COMMONWEALTH OF KENTUCKY?

>> WELL, I THINK FUNDAMENTALLY ALL FEDERALLY QUALIFIED HEALTH CENTERS STARTED THIS WAY.

THE SYSTEMS WERE SET UP IN A BEAUTIFUL, WONDERFUL WAY TO ADDRESS ALL OF THESE NEEDS.

AS TIME HAS GONE BY, YOU KNOW, I THINK OUR HEALTHCARE HAS BECOME MORE OF A COMMODITY, AND SO EVEN THE FEDERALLY QUALIFIED HEALTH SYSTEMS, THEIR REIMBURSEMENT IS BASED ON VOLUME.

AND SO IT'S BECOME HARDER TO CREATE THAT.

>> CAN WE SEE SOME OF THIS IN SOME OF THE CLINICS?

I KNOW YOU ALLUDED TO IT IN THE BEGINNING, SOME OF THE HOSPITAL CLINIC IS OR PRIVATE PRACTICES EVEN, CANNY WITH SEE SOME OF THE SAME ACTIVITY?

>> OF THE VOLUME-BASED?

>> NO, IN TERMS OF TAKING THE TIME TO TALK TO THE PATIENT?

>> OH SURE.

WE HAVE SO MANY WONDERFUL PEDIATRICIANS IN OUR COMMUNITY; SO MANY WONDERFUL PHYSICIANS IN OUR COMMUNITY AND EVERYBODY WANTS TO BE ABLE TO HAVE THAT TIME AND SOME ARE A LITTLE BETTER AT CARVING IT OUT AND RECOGNIZING THAT ONE FAMILY MAY NEED A LITTLE MORE HERE AND THE NEXT PATIENT MAYBE THEY CAN BE IN AND OUT A LITTLE MORE QUICKLY.

AND THAT'S WHAT PEDIATRICS IS.

A LOT OF OUR QUESTIONS ARE ABOUT MY CHILD IS ABOUT TO GET KICKED OUT OF DAYCARE BECAUSE THEY'RE BITING AND WE GET THOSE QUESTIONS A LOT.

>> GIVE ME THE ONE-MINUTE ANSWER ON THIS.

YOU ARE LUCKY BECAUSE YOU GET A SHORT TIME ON THIS ONE.

ARE YOU FINDING YOUR PARENTS MORE WILLING TO HAVE VACCINATIONS NOW OR LESS?

AND ARE YOU HAVING TO TALK MORE TO THEM?

>> THERE IS A LOT OF QUESTIONS ABOUT VACCINES, PARTICULARLY FLU AND COVID.

WE, AS A PRACTICE, DO NOT TURN FAMILIES AWAY IF THEY DON'T VACCINATE BECAUSE VERY OVER IF YOU, AGAIN, SPEND TIME AND UNDERSTAND WHY SOMEBODY DOES HAVE QUESTIONS ABOUT IT, AND WHAT THEIR CONCERNS ARE AND YOU CAN GRADUALLY BUILD THIS RELATIONSHIP, WE FIND THAT VERY OFTEN OUR FAMILIES ARE WILLING TO VACCINATE.

ITE JUST TAKES TIME.

BUT THERE ARE A LOT OF FAMILIES THAT CHOOSE NOT TO AND A LOT OF THAT HAS BEEN BECAUSE THE HEALTHCARES IS REALLY ALIENATED A LOT OF FAMILIES.

AND, YOU KNOW, MEDICAL RESEARCH WITH THE TUSK TUSKEGEE AIRMEN, A LOT OF PEOPLE HAVE BEEN STUDIED WITHOUT CONSENT AND THERE ARE REASONS FOR PEOPLE TO MISTRUST THE HEALTHCARES AND IT BREAKS MY HEART BECAUSE THESE STUDIES WERE DONE WITHOUT CONSENT AND THEN PEOPLE AREN'T TAKING ADVANTAGE OF THIS MAZING RESEARCH AND SCIENCE TO VACCINATE SO YES, WE DO.

BUT TIME, IT'S ABOUT SPENDING MORE TIME.

>> I CAN TELL YOU ARE A PERSON WHO LOVES SPENDING TIME TALKING TO YOUR PATIENCE AND I APPRECIATE YOU BEING WITH US TODAY.

ALSO LIKE TO THANK YOU FOR BEING WITH US.

I HOPE THAT YOU HAVE A BETTER UNDERSTANDING OF HOW WE, AS PARENTS, FAMILY AND THE HEALTHCARE MUST LISTEN, RESPECT AND REALLY TRUST EACH OTHER AND WORK TOGETHER TO RAISE HEALTHY AND HAPPY CHILDREN.

IF YOU WISH TO WATCH THIS SHOW AGAIN, OR WATCH AN ARCHIVED VERSION OF PAST SHOWS, PLEASE GO TO WWW.ket.org/HEALTH.

IF YOU HAVE A QUESTION OR A COMMENT ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KY HEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH."

BUT IN THE MEANTIME, TALK TO YOUR PEDIATRICIAN.

TALK TO YOUR FAMILY HEALTHCARE PROVIDER.

TRY TO GET AN UNDERSTANDING BETWEEN YOU BECAUSE TOGETHER WE ARE GOING TO MAKE OUR KIDS BETTER, HEALTHIER AND HAPPY AND WE'LL KEEP SAYING IT AT THE SAME TIME.

THANK YOU FOR BEING WITH US.

SEE YOU NEXT WEEK.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.