All right, we can go ahead and get started. Okay, welcome everyone here, everyone online, to a very special lecture. My name is Alexis Tingen. I am the session director, session moderator for this morning. This is the AMSSM exchange lecture for many of us here who are sports medicine doctors, those who are not, that's the American Medical Society for Sports Medicine. Each year, AMSSM and AP Menard share a lecture in exchange with the objective to bring to light some of the hot topics, some of the discussions that are going on in AMSSM. And today's topic is one that I think is very important for us as sports medicine physicians, as physiatrists. We spent the last couple of days talking about high-level athletes in the Olympics and the pro sports and all those things, which is great. It's a way that we can all have an impact at a high level. But the other side of it is that we see patients every day. And we see, lack of a better word, kind of normal patients, normal people that aren't freak athletes. And so this is really a discussion about how we can impact our communities. And what we'll discuss today is the epidemic of inactivity and obesity. And we all know the stats, and experts here will discuss it more in detail. But also how we can have an impact, how we can start initiatives ourselves, either big or small, to have impact on this problem in our community. All right. So I'll present our speakers, as I mentioned, to the far right here. We have Dr. Nyla Adams. She is from University of North Carolina. She is a primary care sports medicine physician and the program director for the Sports Medicine Fellowship there. I'm sorry. Dr. Adams earned her undergraduate degrees in biology and sports medicine at Howard University, and Master of Science in Nutrition from Columbia University, and received her medical education from Duke University School of Medicine. Dr. Adams completed family medicine residency at the University of Miami Jackson Memorial Hospital, including a year as chief resident. Then she completed her primary care sports medicine fellowship at UNC. As the daughter of two educators and a former teacher herself, Dr. Adams has an unwavering belief in patient empowerment through education and understanding their bodies. Dr. Adams is passionate about health promotion from an early age, and is committed to collaborating with individuals, schools, and communities, and other entities to bring this to fruition. Dr. Adams is the founder and medical director of Run for Life Trinidad and Tobago, which is a nonprofit organization, which we will hear about today, dedicated to the promotion of fun, healthy lifestyles for secondary school students through training for 5K, as well as Race to End Childhood Obesity Trinidad and Tobago, whose mission is to eliminate childhood obesity through action, advocacy, and awareness. Dr. Adams serves as a sports medicine team physician with Trinidad and Tobago Olympic Committee, and has provided coverage for USA Track and Field and USA Gymnastics. So welcome, Dr. Adams. And our other expert here is one of our own, a physiatrist. Dr. Hegar Elgendy is originally from Alexandria, Egypt. And upon immigrating to the United States, she found comfort and passion in the sport of swimming. Swimming took her to the University of Miami, where she completed at the Division I level and represented her home country of Egypt. She earned seven national championship titles, a national record, and an Olympic trial second place finish in 2012, in preparation for the Olympic Games. In her time at college, she served on the IAI ministry in transition to Tulane University, started and led a ministry that served to encourage 50 athletes in biblical training. She also at Tulane earned her master's degree in neuroscience, and served as a multidisciplinary team that founded what stands as the Trust Post-NFL Retirement Medical Care. Dr. Elgendy, along with her husband, Secretary Perman, who is a former running back and captain and veteran of the Cincinnati Bengals. So she has worked with them. And during their tenure together in the NFL, she represented the 2022 Super Bowl fashion show. She now serves as a vice president of the NFL Wives Association and chair of the development and community outreach. She completed medical school training at the University of Cincinnati, where she was an advocate for DEI. And she is now the chief administrative resident at UNC PM&R program, and then served to lead the house staff council of UNC, representing 1,100 trainee physicians of the UNC healthcare system. Together, Hager and her husband, Cedric, have five children together, Emmaus, Ava, Isabel, Elias, and Issa. And they value family time over anything, and their greatest achievement in work is progress and growing as young parents. So thank you. Welcome. I'll give the stage to you. And, of course, those of you in attendance here in person or online, feel free to send in your questions, and we'll address them at the end of our session. All right, good morning. Thank you so much, Dr. Tengun, for such an eloquent introduction. And as a program director, just listening to Dr. L. Gandy's past, present, and just seeing how bright her future is, I can't help but be extremely proud of you. I'm so, so, so proud of you. So I'm Dr. Adams. It's an honor and a privilege to have been invited as the AMSSM exchange lecturer at this conference. I'm a proud family physician and sports medicine physician, working so closely with my colleagues in PM&R and sports. It really is a pleasure to be here, and I'm so happy that Hagar decided to come along with me in this conversation today. And we're going to be talking about our community initiatives and the way in which you can put sports medicine in action. We have no financial disclosures. One day we might get to that level of wealth, but today is not that day. But we have no financial disclosures for you all. And so what we're going to do is take things on a global scale. We're going to bring it down to some national initiatives, and then we're going to see where you can do things right in your hometown. And so we're going to bring it down on those levels, and we're going to talk about the two things that we're very passionate about, which are child obesity and unfortunately swimming injuries, water injuries, and water safety. And then, like I said, we're going to highlight some initiatives that we have and then help you all work through how you can make an impact in your own communities. And so we know that obesity is an issue. In the U.S., one in three adults are overweight or obese, and that number has not changed in the last 20 years that I've been doing research on this topic, unfortunately, and maybe actually going in some unfortunate directions, particularly for children and adolescents. One in five children or adolescents are considered obese within the United States. And so from that level, on a global scale, there is actually an epidemic of obesity, of childhood obesity. In my home country of Trinidad and Tobago, one in four children are considered to be obese or overweight, and that number has continued to grow, again, over the past couple of decades that I've been doing this type of research. And so we know the significant burden that obesity can have on various sequelae, developing hypertension, diabetes, increasing risks of certain cancers, increasing risks of pain, osteoarthritis of that sort, but they do affect outcomes differently based on age. So older children, adolescents, tend to be more afflicted than younger children. Children who identify with the Hispanic ethnicity, non-Hispanic blacks, those outcomes and rates are higher disproportionately in those particular groups. And also children who come from families of lower socioeconomic status, so those who are more impoverished tend to have higher rates of obesity and overweight within their communities. And so we do note these disparities that exist, in addition to the disparities to accessing care, both from an access perspective of just having providers within their communities, getting to their doctor's appointments, knowing that these things can exist and have problems later on, and knowing that early interventions can change the outcomes in the future. So there are a lot of disparities that exist that we have noted and that drive our passions for what we do. And so one of the things I did when I finished sports medicine fellowship, and by the way, if anybody wants to talk to me about becoming a sports medicine fellow, please, I'll take you from a program director perspective. And Peter Said, who's in the front, I can tell you, I'll speak to anybody going anywhere about sports medicine, so please feel free to reach out to me afterwards. Anyway, when I finished sports medicine fellowship, I was home on a sabbatical before I started my first attending job. And all I wanted to do that summer was sleep. It was 2016, right before the Rio Olympics, but yeah, there were other plans for me. So I'd reached out to my Olympic committee since I was an undergrad, and with radio silence. And then when I actually became a sports medicine doctor, they finally answered and said, come in and see us. Long story short, because everyone else was going to Rio that year, they made me the medical director for the Junior Pan American Track Cycling Championships that our country was hosting that year. And I guess I did a good job, and I kept saying yes to things, and they kept asking me to do more things, because I kept saying yes to things, and here we are today. And so a little side note, just keep saying yes until you can afford to say no. Just be careful when you're watching your attendings, who can say no to things. When you're training and you're coming up in the ranks, you may not have that comfort and space just yet. Of course, don't overwhelm yourself. But just keep saying yes until you can afford to say no to things, just FYI. So the president at the time, I had brought an idea to him, because I found that every time I went home, things looked a little bit different among the kids that I would see. I was accustomed to playing in the streets, running up and down until our parents told us to come home to maybe take a nap and then go right back out and play again until it was time to go to sleep. And I didn't see that, and I wanted to find a way to give back to my own country that had given me so much. And so this is what we decided to do. BT Dubs, Hagar made that video, that's just FYI. So that was actually a plea for donations that we did, we did a donation drive in January of this year, and we were able within a morning to have all 60 student-athletes fully sponsored. These students can come into our programs from various ages and schools that we engage. And what we do is we pair them with alumni running mentors who also seek to give back to their schools, and they train for now a 5k, but they turn that into bigger international marathon that's held the day before the full marathon. They train for five months, more or less, three to five months. We do medical clearances for them, I take residents and fellows with me, whoever wants to come, they just come with me, and we do the PPEs with them, we do exit clearances, we do assessments of using the physical activity questionnaire for adolescents to track and see who's doing what in terms of physical activity in their lives, and ultimately we'll have a repository of data waiting for the 10-year mark for us to see what our program has done and impacted over a decade of being in existence. So we have a couple more years to go for that, but that was one of the initiatives that we did. Now out of that came Race to End Childhood Obesity, Trinidad and Tobago, which was, which ended up starting because one of the coaches from Run for Life wanted to do more in between the races and the seasons, and so we came up with having a vision of increasing action, advocacy, and awareness about childhood obesity, and just fun, unique ways in which we can get children and their families and schools and communities involved in being physically active, and that's what we did. And so we have a marketing person, so again, when we get to our what do we do and how do we do this, we're going to go through all of these steps with you all. So we did have a marketing person work out a target reach for us, we aimed for our first event, which is to host our very own 5K, which we decided to do in April. It was a very interesting few months, but we said our goal was going to be 400 runners, someone said 500, so we decided to go with 500 runners. And so within the area in which we were going, that area of Trinidad has a population of 640,000 people. Ultimately, we do want to reach all 1.5 to 1.7 million people, but we did want to focus on that target area of where our event is being held, and that community in which our event is being held, and we also counted 42 to 3,000 people who would be supporting these runners. So that's what we did. And we also, when you're thinking of especially global initiatives, the United Nations has Sustainable Development Goals, SDGs, it's all online. All of these icons are courtesy of their website, we made none of these things up, I promise, there's still copyrights to them, but you want to ensure if you're looking for a global impact, especially if you're looking for global funding, you want to align yourselves with the mission and the vision of the funders, and establish organizations like the United Nations. So these are the ways in which our program would meet the UN SDGs, and again, these are the different organizations that came together to form Race to End Childhood Obesity Trinidad and Tobago. The people that you work with, in terms of your sponsors and your partners, what we did for our Sugar Rush 5K, which is what we called it, we took our own culture. So with Trinidad and Tobago, our industry was historically built upon sugarcane and oil, and so with the sugarcane industry dying out eventually, we still kept all the sweetness of our culture, and so the name of our 5K was Sugar Rush, it was meant to be an enticing name to have people come together, like, End Childhood Obesity is not a cute name for a 5K, but Sugar Rush is, right? So people were like, why Sugar Rush if you're trying to fight obesity? Well, aren't we sweet? Sugar is a part of our culture, we cannot avoid it, it's just you have to teach them how to use it in moderation, and if you choose to eat this snow cone, how many cartwheels or how many jumping jacks or how many pushups or how many miles you have to run to burn that sugar off, that is the way that we're approaching it. Eat the, I mean, don't run away from your sugar, burn it, that was one of our things. And so this was actually really cute, we had a dentist in our health fair, we had a dentist, we had some energy, non-sugar-free energy drinks that were appropriate for kids, sugar-free options from the yogurt store, you know, Feminite is a menstrual hygiene initiative, and so we were teaching girls and women and people who have periods how to stay active during their pregnancies, you know, body glows, same thing, there's like healthy products that kids could use to help enhance, safely enhance their performance, so you want to bring together, like, think a little outside of the box and bring together people who share that mission and vision that you have, that might be a little bit unique from some of the 5K that may be going on at the same time, did that, yeah, we had another 5K at the same time, I think we won, we did great too, all right. And this is my favorite picture from the entire event, this was when the 5K had finished, and we'll show some numbers at the end and a little bit of the highlights from the 5K, but again, keeping that mantra of all children have the right, they deserve to be the happiest and healthiest selves, that is a big part of what we do, because a lot of children don't have choice in the matter, they don't work, they don't make an income, they don't buy the food, they don't cook the food, so it really is helpful to engage the families and the communities who do care for them and who do support them if we are trying to change things for the future. So this is one of the best highlights that we had, bib number 500 was the last bib that we had, and it was so fitting that this little baby just made it to the end, he just knocked out, he was just out, daddy had to make him cross the finish line, it was just, we were like crying, it was really, really good, just to see, again, the impact that it has, and a lot of times dads get left out of the equation, and dads are really, really important, and this was just such a perfect moment that was unscripted, it was not a lifetime movie, I promise, it just happened that way. And so some of our outcomes, we had 500 people register, including sponsored, like all of the kids, almost all the kids were sponsored for the events, we ended up with 424 runners on the day of who crossed the finish line, the age ranges were from 0 to 89 years old, and then, let me see where that math is, 65 runners were under the age of 12 who were registered, we had a lot of baby babies as well, so again, just from April, thinking of something that was born from something else, I just want to tell you all, if we could pull this off, you all could more than do anything that you'll have to do, and we'll go through again these steps to help make your journey a lot easier. And so this is our Sugar Rush 5K. If we could pull that off, anyone can do anything, I promise you, it was really just such a great experience, and we are very proud of what we did. So that is an example of a global initiative, let's bring it home to a national campaign, and I'll have Dr. Elgandy take over. Hello, everyone, I am so excited to be with you, but even more excited that Dr. Adams has decided to share this platform with me, just to stand alongside her, just be under her wing, I mean, as you can see, there's no better example for me. So very humbled, very honored, thank you for having me. So I'm here to speak to you about the national platform, so same intention, similar vision, different platforms, but all with the mentality that we're here to build, encourage, empower the communities that we serve. So this idea came to be as a part of my role as Vice President for the NFL Wives Association, and we wanted to stand as an organization for something that could leave a lasting impact for this future year. And as we reflected on what that could be, it was coming at a time that we had recently lost some personal lives within our NFL community due to drownings and some near-drowning experiences. So we decided to sit on the other side of things, we were tired of seeing any more lives lost due to drownings, and we wanted to stand on the preventative side. I'm going to show you a promo video. This was just an idea that was in my head, and I thought that the best way that I could visually communicate what was in my head was just to pay a friend a couple dollars, just to ask him, a very talented videographer, to put together a video for me to just get the simple idea out of my head so that when I'm communicating to someone what I envision and how I can impact the 32 NFL City communities, it's much more clear. So let me share that with you here. And mind you, this video was edited as we gained more partners, so the partners that you see there were not there in the initial video. I didn't have money, I didn't have many sponsors, I really didn't have anything, I just had an idea. You understand how important it is to be safe on the field, but how about in the water? Did you know that if a parent doesn't know how to swim, there's only a 19% chance the child learns? Did you know that one month of formal swim lessons could reduce the risk of drowning in children by 88%? That's why the USA Swimming Foundation, Off the Field NFL Wives Association, YMCA, American Heart Association, and NFL alumni are partnering together to provide a free swimming workshop taught by USA Olympians, pro football champions, and NFL alumni. So kids and adults can stay safe in the water. Water safety is everyone's game. Join us in a city near you. All right, so that was the idea that I had in my head is how can I bring together NFL champions and USA swimming Olympians and use their platform to try to encourage and entice people to come on the pool deck and learn how to swim. And mind you, I didn't have any licensing agreements to use any of the footage really except from USA swimming and that football player was my husband. So just bare works just to get us to get us going. And as I'm going through this, we'll share this a bit more about this later, there's a couple questions that I want us to keep in mind and they're really quite simple. So why, who, how, and when. If you can answer those simple questions about whatever idea you have in your mind, then you're setting the foundation for yourself to launch your own campaign on whatever platform that you envision. So as I'm going through it, so the first question is why. And as a part of this question you have to think about what is it about this injury that forces you to move and to act? Why now? And as I reflect personally on some of these statistics, it's really quite shocking. So drowning is the leading cause of death in toddlers ages one through four, second, and children under 14 years old. Parents that don't know how to swim, there's a 19% chance that their children will learn. So there's a generational component that we're working to overcome. One month of formal swimming lessons can reduce the risk of drowning by almost 88% is such a significant amount that you've got to pay attention. Approximately 3,500 deaths annually in the USA due to drownings. And say we did our best and we fix some of those problems, well we get everybody on the pool deck and we don't have a lifeguard to support them to get in the pool. There's a lifeguard shortage currently affecting the USA which is limiting further access to swimming. So as a mom, some of these statistics definitely shake me up and they scare me. So that's a part of my reason for why. But as I'm answering and standing on some of these facts and some of these statistics, I have to think to myself too for and you as well for whatever vision you have in mind is why me? What is it about me that will have sponsors, donors, whoever I'm pitching this idea to trust me enough that they're willing to place millions of dollars in my hands to run a campaign like this? So they have to see me, they have to see that this mission is important to me personally and that I'm not wavering away from it. That this is something that I'm going to sustain. And so a part of that why question that you have to think about it's why me? What's motivating me? And what's going to sustain me as I'm going through this? Because it's not going to be easy. You're going to come across people that are just not in agreement or they think that things should be a different way which is okay. But how is this personal to you and how can you sustain through it? All right. The next question is who? So who are we or who are you as you know whether you're representing yourself or an organization that you stand for that makes you equipped to stand as a part of this mission? So for me personally as a part of the NFL Wives Association as I reflect on our stance as an organization we're a 501c3 nonprofit organization in a sense we're the philanthropic arm of the NFL Wives group and we have a reach of 4,500 members and we're also standing alongside one of the largest alumni networks in the country through the NFL which is a compromise of 17,000 players. And of course you know 32 active teams the best one is the Cincinnati Bengals. I'm just kidding. I'm not going to take away from my intelligence up here and hopefully you'll have me back after I said that. But in a sense there really isn't an entity and there's many entities that are partnered with the NFL that we don't have access to or working relationship with which is important because we have a legacy there to stand on and there's a saying within the NFL that if you want to get to the guys you've got to get through the wives which may stand outside of the NFL as well but I can't claim that we're the gatekeepers we just support in decision-making and we're respected with each one of these entities. So the trust is the post-retirement player care predominantly neurological care but it's expanding from that. The NFLPA is a players association or the union so to say the player care foundation supports and health screenings for retired and active players and then you know the NFL in itself. Pro Football Retired Players Association stemmed from some benefits being adopted in 2013 and then Hall of Fame health which is its own private health based entity that stems from supporting Hall of Fame athletes. So I think about who who am I representing who am I working for and what expertise am I standing on that makes me equipped to manage a campaign like this those things are important to consider. All right so not just me who can I come alongside who has a stronger history within this platform since this is my first time being introduced to it that I can benefit from being alongside. So what kind of strategic partners am I looking for so as I was coming up with this idea I wanted to think about where where would be my best access where would be my best foot in the door where are their established relationships already on this platform and how can I utilize those to our benefit for this campaign. So the first partner up for us is USA Swimming Foundation. This relationship actually came to be because I told Dr. Adams that I had a desire to cover USA swimming events and within a few days she had me on the sidelines for the USA Open for swimming. So that relationship the seed was planted by Dr. Adams so it was an easy email to send over to the foundation and just saying listen I have this idea I've got this promo video if you can just take a few seconds to watch this is what I envisioned to try to get to the 32 NFL team city sites. No better partner when you're considering swimming and that they're the experts within that platform. So as a foundation they were founded in 04. They've invested 17.7 million dollars up to date and saving lives and that that's a grant that's funding coaches team team support. They always want to work to eliminate any problem from a financial standpoint that's burying access to swimming. So those funds are directly appropriated to that. 14.2 million and building champions then 4.4 million is one of their most recent initiatives added on in 2023 for impacting the community. So bringing both competitive swimming to traditionally underserved communities for learn to swim programs scholarships improving technology and things like equipment. So longstanding funds longstanding relationship with this platform expertise there that we could definitely benefit from and with a simple email they responded back and said we would love to work with you which shocked me. All right. So that's one partner. Who else can we reach out to. So we covered swimming. Who do I need to get better access to the community. No better place than the YMCA. So one of the longest standing histories and one of the leading world organizations in a sense to supporting the community stands as the YMCA. They're actually the founders of swimming lessons. This happened in 1909 in Detroit where the idea this this one man came up with the idea of doing something that was considered radical at the time of having group swimming lessons and he ended up teaching 400 people how to swim within a matter of a few weeks. So from 1909 things continued you know going down going down that path and their reach is really quite tremendous and it's very much humbling. So they have 14 sorry 4.8 million children every year that they have access to and their reach. They have 2500 YMCA sites nationally and have over 14000 staff members. But as I reflect on their legacy within their history is this mission. And when I reached out to them for a chance to work with them they were there with open arms. They were fully in support of this mission which I was very thankful for. All right. I've covered swimming. I've covered the community. What health organization can I stand alongside that also has a long standing history for advocacy in this work. The American Heart Association. They actually have one of the longest standing partnerships with the NFL already in existence. So in a sense they've got a black book of team relationships that would only be to our benefit. There is an initiative called the NFL play 60 which is founded on the cardiovascular recommendations of 60 minute of exercises and the NFL play 60 goes around to different NFL team sites encouraging kids to stay active. But that stems from their 30 plus year history and relationship with the NFL as an organization. They have assets nearing one billion dollars. They've supported over 40 million. They're supported by over 40 million volunteers a staff of pioneer pioneering professionals and their mission as they would say is relentless force for a world of longer healthier lives. They've stood on the platforms of research education and stroke and cardiovascular health and their impact to the community again is limitless. Their most recent initiative and partnership with the NFL is the CPR campaign that stemmed from an unfortunate event on the field. So they actually have an established relationship now and they go to every third every team and they teach players and their family members and the coaches how to perform CPR training. So you can see how the campaign that we're aiming to achieve and that we're hoping to go to 32 NFL team city sites to teach swimming lessons both to NFL players their family members and the community at large. And someone's already doing something similar to that. So why not just go under their wing. You don't have to create the cycle all over again just learn from what they learn and just take it from there. And they were very gracious to us and that any point of contact that we needed they just almost handed us their black book which I'm very thankful for. All right. So you've now answered the who. The next question is how. So as you're writing up your campaign outline it really doesn't have to be something so significant that it takes you you know days and days to to work through. It's just for me it was just a simple slide. So can I communicate effectively and quickly sometimes because sometimes your pitches only five minutes or an hour just depends on to whatever opportunity is available to you that whoever I'm communicating this pitch to that their mission is my mission that we're like minded and if we come together we're going to achieve this together. So again simple slide. This is this is the exact same slide that I shared with all the partners that we earn. And it's just communicating that hey I've got an idea. Can we teach water safety in 32 city sites bring on board NFL players and their family members teach them how to swim because the demographic within the NFL already places us at a higher risk. And then can we join a long town halls for people like the Martin Luther King Foundation realizing the dream initiative. Can we I.D. the NFL champions and then the USA swimming champions and bring those together. That's our NFL impact. But then this is also what I'm hoping to achieve which is more of a national impact. And this is how I'm planning to do that. So really a campaign outline is just pitching your vision. You may not have any money at that point. I didn't. But this is what I hope to see and this is what I hope to achieve. All right. So this is our work for one of the first teams that we did which was with the Cincinnati Bengals. I will say that I was very humbled to be at this event and actually be in the pool teaching some of the swimming lessons to just to see three generations of the same family and one pool together all learning how to swim for the first time to seeing them overcome their fear out of a fear. That's so great of being in the water that I'm not even tipping the toes in the water. And by the end of the 45 minute session they're swimming a full lap was something truly humbling to see. So let me let you see this and we'll take it from there. Want to learn how to swim from Olympic USA swimmers for free. That's right. In an NFL city near you. We are bringing together pro football champions NFL alumni and Olympic USA swimmers for free swimming lessons for kids and adults so they can stay safe in the water. One month of formal swim lessons can reduce the risk of drowning in children by 88 percent. So let's do our part and be ready. It's fun for everyone. Yeah yesterday was fun. Well for me personally I learned how to float tread water certain ways learning how to do it and knowing how to do it something that is important. I'm one of the people who are learning how to swim today and I'm having a lot of fun. If you already know how to swim show up and be a part because it can be a benefit for others. It can be a draw if you come fathers who want to come on out also. The mission is to save lives and by signing up for this partnership you will be saving lives. It is never too late to learn how to swim. Water safety is everyone's game. Silent today and join us in a city near you. All right. So that was just an awesome event and I'm sure Dr. Adams got tired of me sending pictures and videos throughout that whole weekend with the Cincinnati Bengals but it was just so good to see a dream and a vision that you had come to fruition and you see it impacting lives. It's just very much satisfying as a physician especially being on the other side and seeing the impact of drowning to stand on the side of prevention was very much humbling. All right. So where are we going moving forward. So this comes to when. So again we're hoping to target the 32 NFL team city sites. We just signed for the Super Bowl. So we're going with the Saints for Super Bowl week. We'll be there to teach the Saints and their family members how to swim. And then we're extending that out to the community as well. And then we're also in 2025 targeting the Titans and the Raiders just because of close contacts as a starting point until we build up funding that's significant enough. And then we'll take it from there. But just like a quick you know idea of where what our outcomes are at least the demographics that we've served through this campaign so far. So the age range was 2 to 77. So a pretty large gap. The demographics. Fifty nine percent were African-American. Twenty four percent were non YMCA members. So in a sense new members being introduced to the YMCA which is a great thing and a significant proportion of our participants being African-American which is different than what we than what you say swimming had through their previous water safety campaigns. I don't know what the explanation is for that yet but I'm very thankful that we're opening the door and improving access to sport. What skills were developed. So we're we're tracking you know what the skill level is at the beginning of the sessions and we're hoping to track that over the course of the time that the participants get to stay. And we're very much intended intending to leave a lasting impact. So what funds we raise for that NFL team city site probably 75 percent of those funds stay behind with YMCA. So if any player family member or community participant wants to continue in swimming lessons since we've learned that over four weeks training improves risk of drowning they have access to do that for free. So most of our funds stay behind in each of the community sites to improve the skills that we see and we track that development over time and just think about the impact that you would get to see if this was more on a national platform and we complete our 32 NFL team city site we can really see what we've had in mind and how it's coming to fruition. As far as lifeguard certification that's just the constant communication between us and the American Heart Association and the Red Cross which are the primary people who certify for CPR training. How can we better equip them and support them so that they can continue to support us in response. And then again it comes back to access. So identifying any barriers that stand and just learning about what barriers are present at this point. And again just this is not my own saying this came directly from USA swimming is just going back and trying to negate generational wrongs that have stood in place that have prevented access to swimming. So that is where we're going but as you can see I went through why who how and when simple questions but if you have those foundations in place any idea that you have in mind I am confident that you can see it come to fruition. All right now it's your turn. So this is just an awesome opportunity again to stand alongside Dr. Adams. So we wanted to you know I don't know that our time here would be fruitful if we didn't leave you with something or equip you with something to feel empowered or empowered enough to take your idea moving forward and make your own change. So we want to spend some time talking about what it means to be a strategic partner. There's a mind map that we'd like to go through. So as you're thinking about who would be perfectly aligned with the idea that you have in mind some things that we'd like for you to consider. So what are their community strengths. So what's their impact their investment their reach. What is their community dynamic. So this is something that's important. Where are their hands currently standing. What's the character of the organization. What's the legacy that has stood for and does that align with what you envision and what you have in mind. That's something that's important that you kind of learn over time for what those organizations stand for. What are their priorities. What's their future direction. The American Heart Association has a clear 10 year plan that folks that's focused on public health and policy. And then of course they have that longstanding history with the NFL and they're targeting that by going through CPR training. So thinking about what's their current priorities what kind of impact have they made on the public health platform and what's their mission currently and how does that align with your mission is something that's important. Ideology intervention and policies. So just thinking about the roots of the reason for why they're pursuing the things that they're pursuing is important which kind of feeds back into their character and the legacy of their organization. So their history in that particular mission as I shared with you YMCA for example had founded swimming lessons so longstanding history there. Their current intervention to target whatever problem there is present there and what policy change have they stood to advocate for and aim to leave a lasting impact their research investment impact. So as I shared with the American Heart Association cardiovascular stroke health preventing risk of drowning CPR training all those things come to play action. This actually this this became more important as I went through this campaign. Are you meeting people that are like minded and saying yes there's nothing wrong with you know having that person that's within those you know those settings that kind of slows things down and just allows you to think for a moment before you go on to pursue different things but having people that stand alongside you that are more prone to say yes and to encourage and empower you on this walk is something that's very much important that they believe in you and what your vision is that's something that's important and a partner and if you don't have that consider where where where things are going with the future of that is dissemination. So in a sense kind of using their platforms what platforms do they already have in place what kind of media that works so they have access to and then maintaining do they look at you and sees a relationship that's going to be long-lasting or is this just something a quick fix or to get some media attention and just call it a day not a person that I've stood alongside so far in my own personal campaign has given me the impression that this is just a quick fix we're there to leave a lasting impact and that's been on everybody's mind. So that's our encouragement when you're considering partners and then now the big thing fundraising so how do you do any of this without money so I wanted to speak about sponsors as a starting point so I think sometimes when we think of sponsors we think about big-time organizations and Dr. Adams prove that wrong sometimes as the smaller businesses that want those platforms to be able to reflect their companies and what they stand for so for example the Super Bowl time I'm not going after you know the entities that have already signed with the NFL I'm going after you know sports-based companies or hair companies or whatever may be that still want access to those platforms and still want to support they just haven't had the opportunity so extending our minds from when we think about sponsors to not just your fortune 500 companies but what small companies are present there that want to stand in line with you and and work with you in the future and then with respect to donations I asked my friends I did because I just very much happen to be in a group of people who are like-minded and also wants an opportunity to give back I want an opportunity to volunteer we say if you can't give money can you give time so so folks coming you know to volunteer with us to help set things up to help connect us with other people within their own Rolodex those are the kinds of people you want to engage and then grants grants I think grant the grants would be the main thing that's took us from one level to another so I found it one flight around to begin 2016 and we hadn't had a program coordinator until the AM SSM I was able to obtain the 2023 global humanitarian service project and would use that funding to pay for a stipend for a program coordinator and that is why we sustain ourselves now and I now see how essential it is to have that person in place to have that position in place and so seeking opportunities through the APM are through the AM SSM through other organizations endowment funds are big as well you know some small ones little $500 pilot grants could go a very long way to creating pilot data that you can then use to apply for a much larger award later on funders like to fund things at work so it is sometimes a little tricky to get pilot data of pilot studies of the ground or pilot projects because you haven't had the data yet but it's possible again as best as you can do some small information could be helpful to go a long way yes I would I would just add that pilot component so if you have the idea try to see it to fruition to just a pilot in place and you record that in some capacity so that when you go on advocate for future cities or future sites you can say this is what I did here and see what the impact is here people seem to be more prone to be able to support what they can see especially when it's something that's for the advancement of health and community And that goes straight into sustainability. Is this a one-off, is this a moment, or is this something, again, that can have a lasting impact? So you want to set your short, medium, and long-term goals. And so I did a faculty development fellowship at UNC within our Department of Family Medicine, and they always taught us about start with the end in mind. Start with what the very end would be, what you want to look like, and then see what steps you can do to work your way back to where you are right now. And so potentially start with your long-term goals, which would be your vision, and then work your way back to some medium and some shorter-term goals within whatever you have in this moment. The other thing that's really key is to learn what success would look like. Measurables are very important, especially for larger grants, because that's how you're able to justify the funding that you're able to receive. So you want to know what your outcomes are. For us, is our outcome a change in body mass index? Is there a change in waist circumference? Some of our successes are, does a child continue to be physically active after our program is done? And so we actually put things in place for that to be successful. So any child that completes Run for Life Trinidad and Tobago in January, any event that they want to do between January and our next season in September, we pay for them at no cost, none whatsoever. So you'll see some Run for Life kids who are doing the Sugar Rush 5K. So anything they want to do, triathlons, duathlons, if they want to go for national youth team trials, we will cover it. Cost could not be a barrier for them, because they did our program. That was part of the incentive. So you want to actually make your success outcome successful. If you can control those, you do that to the best of your ability. And then finally, how is change woven into the fabric of what you do? Change is the most inevitable thing ever. Change has to happen. Things happen. We never expected a global pandemic in our lifetime. Here we go. Right? And so you want to ensure that your framework isn't so rigid, that one piece could make it fall like Jenga. You want to ensure that things are more fluid. You have backup plans, plan K, plan Z, in case anything goes awry, because you want to be flexible. And sometimes those changes could be the most incredible things ever to happen, so that you're able to make your campaign even stronger than it would have been originally, had it gone perfectly. And so this is where we get y'all involved, all right? So this will take literally two minutes. Well, not even two minutes. If you could take 30 seconds per section, which is how I got the two minutes. Look how math is mathing today. Thank you. So 30 seconds for each. If you think of any idea right now, right, you could have had an idea back at elementary school. It could have been an idea from college, from fellowship, from last year, from last week. So take a few moments right now and think of an idea that you would want to engage your community in, or something you may see within your department or within your institution that you think would be a great idea. And just take 30 seconds, and you can even take a snapshot of this if you want, and work on it a little bit later. We'll give you just a few seconds just to think, even if not mentally, right? Just mentally think about it. And how could you start to formulate this idea of a program and a campaign within your own minds that you could potentially enact one day? And if you want to come and talk to us afterwards about it, we'll be happy to discuss with you. And no idea is too big or too small, I promise you, nothing, nothing at all. There's a saying I go by, I stand on the shoulders of giants. So I can only do what I'm able to do because I've stood on those ahead of me. A giant with a 5'9". Not aging you, I promise. But I say that just because it's big shoes to fill. So we're only here in front of you just because of those that have believed in us. So if we can stand as that for you in any capacity or open the doors for you with partners that we've come to know in any capacity, you just let us know, that's what we're here for. All right. And that brings us to the end of our presentation today. We just have some citations and a ton of acknowledgments. We are so grateful to the AAPMR for having us present, for the AMSSM for having us as the exchange lecturer to present to you all today. We are very, very grateful for this platform and to be able to bridge these two incredible organizations for a common goal of fulfilling and uplifting both of the organizations. And all of the members, we are really grateful for that. From UNC Chapel Hill, our Departments of Physical Medicine and Rehabilitation and our Department of Family Medicine. And as we continue to grow together for what we want to do in sports medicine as a whole. Thank you so much for the YMCA. Thank you from the Azure people. Yes. Yes. Very thankful for YMCA. That's just a couple of the different sites that we've been at. USA Swimming Foundation, American Heart Association, NFL Alumni Network. That's just a couple of the partners that we've had that have believed in us this far. And I should have put Dr. Adams on there. I don't know what else. Just in big writing. But of course, Dr. Adams is my mentor and somebody that I very much admire in my life. That's very kind. Thank you. And thank you to Alexis for making this happen. Thank you. All right. Well, thanks, guys. That was great. And I have to remind myself that Dr. Elginde is a resident. I'm trying to figure out what I'm doing with my life. And for the audience, certainly you can contribute via the app. Questions, comments, questions. We're going to have a Q&A. And as they come in, or wait for them to come in, I just want to engage you a little bit in a conversation. And you all did an amazing job talking about some really big projects, global as well as international projects. A lot of us maybe want to do that one day, but what can we do for our patients? Just someone comes into the office and they say, I want to start an exercise program. What do you tell them? Or someone mentions to you that I don't know how to swim and my family doesn't know how to swim. So we'll get in a little bit in some of my questions of the big organizations that you're involved in, but I really want to know, and I'm sure the audience will want to know, what's it like on a kind of patient-to-patient basis whenever you're counseling them about these things? I can start with that one. So I was in clinic one day with a medical student preceptor with me, and I had a patient of mine who we were talking about physical activity and running and exercising and the impact of larger breast size as a barrier for physical activity and running. And the medical student and I, Samantha Thomas is her name, and this patient, we were just thinking, you know how much easier it would be if we could have sports bras that just fit properly? And that started us on a journey of research into sports bras. We came across work from Katie Rizzoni and a wonderful group of sports medicine leaders with the EMSSM and AAPMNR as well. And we tapped into an area that we didn't even know existed because of this simple patient conversation. And we actually ended up founding an entire organization based on sports bra research and education, and we go into middle and high schools and do workshops. And I ended up on the board of directors for Bras for Girls, which is an organization that donates sports bras out to Seattle, Washington from a patient conversation. So when you do have that conversation with your patients on a day-to-day basis, I mean this took a year and a half, by the way, but you definitely want to go with those things that interest you, that will be a passion for you, that you want to see it through to the end. And you must start with research, because there's no need to reinvent the wheel for everything. There may already be somebody within your institution doing some work or someone you could talk to or collaborate with, and if there's no one, then hey, be a pioneer. Oh well. But definitely simple patient conversations and just starting a little bit of background research could go a very long way. Yeah, I think that's great, because sometimes we can be very insular in our patient care, and that was just a wonderful example, because just that small conversation can make a big impact, and I think it's something that, as we encounter our patients, that we're thinking. We're thinking not just local. Think about how we can have a larger impact with our patients and our community. I'm just looking at our questions here. All right, so I'll get to this one in a second. So the other question I had for you guys is, you talked about all your partners and these great things that you're doing. I'm sure someone's told you no. So tell us about that. Tell us about when people say no, when you may have barriers to what you're trying to initiate. Yes, I've definitely come across that. We're not the only water safety campaign out there, and there's strength in that, in that we're different and we're approaching things from a different aspect, and that's how we can work together to target, or apart, to target a specific problem under the same mission. Just a different way to get there. So it can be discouraging when you're giving something your whole heart and you meet with someone and they think, no, this is just not the right way to do it. This is how I would do it instead. But if you believe enough in your mission and you believe enough in the vision that you have moving forward and you stand on that, and I've been very thankful in that there's people kind of sprinkled throughout your path that keep encouraging you just to keep going. Just put your head down. Just keep going. Keep believing in it. Even if something is not fitting up to exactly how you imagined, just like Dr. Adams has said, and being flexible enough that when change comes that you understand that it actually might grow you and strengthen you down the line. So don't be discouraged when that comes. It will come. But just standing firm in that this is what the vision I have in mind and this is my plan and my purpose and this is who I want to impact and I'm not going to sway from that. The only thing I would add to that is ask for feedback. Because if the no means it just wasn't meant to be and it's actually a great thing in a sense. But the no may also mean that you need to just go back to the drawing board with the feedback and come again at a different time. So I could promise you we had met with some sponsors, potential sponsors for the 5K. The timing was just not right. They had already done their corporate spending and benevolence for the year. I believe we will catch them January 1st, well, January 2nd, 2025. We'll give them New Year's Day off. But it may be just a not right now. But definitely if the situation is appropriate, ask for feedback on ways in which you could make things a little bit different or what would you have preferred to have seen in our portfolio. And it literally sometimes may be that it just wasn't the right fit and it's not to take things personally at all. That's really important. That's great. So we have a question from the audience and it's probably specific for you, Dr. Elgini. And this one is any recommendations for increasing pool access for patients in lower socioeconomic status groups who cannot afford a membership to the YMCA, et cetera? I think that's a great question. It is very much layered. When we talk about access, there are so many layers to what access actually means. So is it a matter of generational thoughts that have prevented things to be in place, fear that's prevented access to the water, actual financial costs that prevent people getting there, travel costs, travel access that prevent kids from being able to participate there, familial support that they can't get there. It's just so very much layered. And as you're going through this, you learn more and more layers. And part of not being discouraged is just taking one thing as you can at a time of, okay, how can I fix this problem or this barrier? How can I fix this one next? What can I do to solve this issue? I'll give you an example. As we're preparing for the Super Bowl time, part of planning the day with the Super Bowl events in place because the schedule is packed, let's find a time that works for the vendor and all those things. But how can we get the kids from the community to come in that time if it's the middle of the day and that's the time that works best for the Super Bowl schedules at the time that works best for the school system? Can we make this a field trip? Can we have the kids bust over from their schools, lower socioeconomic schools in New Orleans area, bust them over, provide them lunch, and give them the experience that they would have otherwise missed because we would have just put it on no travel, no things like that. And if anything, it actually made us stronger because, okay, we'll bring the kids, we'll bust them over, but their teachers can also come. So the teachers will also have a chance to learn as well. So how powerful is that for the children to be in the pool with people that they admire that teach them on a day-to-day basis? So when you identify a barrier that's preventing access, sometimes there is such a beautiful gift within that as you kind of unlayer that problem. Yeah. And you said it perfectly. The other thing to consider is when your stakeholder considerations would be school districts, the parents and guardians getting permission slips. You don't have to do all of that by yourself. You can find a point teacher who is embedded in the school system or a principal who will support your mission. They'll do all the work for you, you know, the leader of the parent-teacher-student association, the board of education. Those are the types of folks you want to start getting involved with and doing things, you know, genuinely in return. So, you know, we want kids to be involved in our initiatives. We also go back into the schools and do workshops on things they want to hear about, not necessarily what we want to talk about, right? So you want to also think of the environment and the community and their needs and what they are asking for. And I think what you said was so incredible because as you were saying it, I was like, okay, did they do this, this, this? And you did exactly that, which is absolutely wonderful. But the school board, like, and don't get discouraged with the school board. They are not your enemies, they are your friends. Anytime you're doing stuff for kids, that's definitely who you want to go for. But all that to say, just think of the stakeholders who may be involved as well. Yes, and I'll say that there's definitely an opportunity to learn in every circumstance. Just yesterday as I was sitting with Dr. Adams and we were talking about some of the barriers, she asked me, well, do you have large enough caps, you know, caps available to the kids that come? Because sometimes that's a barrier. Kids don't want to get in the water because they don't want to mess up their hair and I understandably so. So we have a partner in Speedo and they've been sending us caps and goggles. But I went right back to Speedo and I said, do you have access to larger caps? So it's just, you know, doing what you can. The partners are in support. Just as you learn over time, doing your best to honor those things that come across you. Thanks. So how do you engage, or I'm sure you do, but can you explain to us how you engage your colleagues in the work that you do? So basically saying, hey, can you help me? Can you, volunteering them as we say sometimes. Yeah. So Dr. Josh Berkowitz was my co-fellow in Sports Medicine Fellowship at Carolina. And he is the head team physician among many things. The head team physician for swimming and diving in Chapel Hill. And he was the main one who actually did the Greensboro connection, not me, for USA Swimming. So I just want to make sure and clarify that. But he and I are a unit, so yes. It's really to, again, surrounding yourself with the people. I don't know if it's just our energy. It's just magnetic and attracts people who are as like-minded as we are to give to the communities. And it really is easy. I don't know what else to say. We really are fortunate to be surrounded by people who are so like-minded for giving. Of what they have to others. And, yeah, just saying, hey, I'm going to be in this place and I need X, Y, and Z people. Students are amazing resources if you're in the attending position, of course. Not in an exploitative way, but students also need for their applications, want for their own personal fulfillment. And in some cases are mandated to do volunteer work. And so, again, using the resources that you have, the personnel that you have to support them in their mission. And their dreams and goals as well. And learning from them. I've learned so much from Dr. El-Gandhi. And just having them come along in the initiatives that you do. I agree. Sorry, Dr. Adams. I agree fully. I'm only here because she chose to share the platform that she had. And I see two medical students here that I've worked with directly in my time. And it's just, you know, if something comes up. I firmly believe that I'm not here just for myself. I'm not going to graduate from UNC just for myself. So what opportunities I have open door. So Pete, Bryson, join me. So it's always a matter of just, do you want to join me for these meetings? Do you just want to sit there with me and just learn as I go through this as I'm learning? So it's just whatever platform you have, just being gracious in that. And extending that and opening that. Because you don't know what kind of impact it can have on someone's life. Just like she's impacted mine. Thanks. So we'll get to our final question here. And as I think about the theme that we've developed. It was really eloquent and elegant how at the end you charge all of us into thinking about how we can be engaged. So the theme is charging us to be engaged in our communities with both exercise and safety. So this is somewhat personal. But Dr. Elgin, you said that we don't necessarily do it for ourselves. We do it for other people, which is true. But there's also probably some good feelings that come with it. So as we leave this morning, now getting into the afternoon. As we leave this morning, give us kind of your final thoughts. Tell us about the feeling that you get when you're engaged. When you're feeling like you're making an impact. And how it continues to inspire you to continue to be engaged. I will say that it keeps being going. It is really just the fire under me. So there's been some moments that I've loved it so much. I've loved being in those environments so much. I'm like, okay, I'm just going to stop residency and I'm just going to do this for a long time. But I didn't. I actually just applied to UNC Sports Med Fellowship. So if you could put in a good word for me. So I will say it's something that's so fulfilling to step out of the hospital system. Not that the place being in there isn't gift giving in itself. But just to step out of there to be one-on-one with the people that you're hoping to reach, hoping to impact. This is why I personally went into medicine. So it's just pushing yourself outside of the walls of the hospital as time allows for what you can do in that season of life. That's been for me personally the fire that's kept me going. All right, thank you. Well, that was we just had one last minute one come in from the audience. And I think it may be fairly quick. Dr. Elgin, you're very popular here. So I think this question is for you. Is there any initiative in place currently to encourage lifeguard training to improve public school availability? That is a great one. There is not. Not to my knowledge, yes. There's some smaller community-based organizations that I think have that component embedded in their own pursuits for water safety. But not as its own entity. Actually, as I reflect on the American Heart Association, their campaign focus on water safety is also a bit outdated. It's been 15 years. So we have the opportunity that if we wanted to draft water safety, what does it mean to be safe in the water? How can we develop these new recommendations under the American Heart Association? I think that door is open and they're listening. They just need some support and some help to do that. So, no, there's no direct initiative that I'm aware of to improve lifeguard training and access to lifeguard training. And the pioneers in that are the American Heart Association and the Red Cross Association. But I think there's an open door that if that's something that you had in mind, you can. And I'm sure Alexis would be more familiar with the specific funding opportunities through the AAPMR. But from the AMSSM, for those who are members, there are $2,000 community service grants for something that sounds exactly like this. I think that would be something that would be a favorable application. Of course, I can't speak on their behalf. But that would be something that would be wonderful to apply for to set up that type of initiative and, you know, figure out how you're going to justify the funding. Whether it's to pay for transportation for the school bus drivers, if it's something like an after-school program or event, if it's something that's going to be ongoing over four weeks so you can split that money over the four-week time. Since there's the evidence that exists for, you know, a month of sessions for food and snacks for the kids, you know, to bring in, you know, celebrities or people who are mentors or, you know, superstars in the kids' eyes. I think that would be a phenomenal opportunity to apply for that type of grant. So, again, those are the types of things where these ideas, that question, that question right there, should become a clinical project, should become a community project. That is exactly how those things happen. And we have frameworks to build from a question to a project. And we have those frameworks available if anybody would be interested in that. I think that would be just an amazing, amazing initiative to begin. All right. Thanks, ladies. Very nicely done. Thank you for the audience, for your attention. And that concludes our time. Let's all go out and make a difference. Thank you.

AMSSM

sports medicine

inactivity

obesity

water safety

community engagement

partnerships

swimming lessons

health initiatives

overcoming barriers