This story originally appeared in UCLA Today, a discontinued publication.

Low-income parents learn to treat children's common ailments

Within the gleaming, white-walled interior of the Anderson School of Management, the focus is clearly on the intellectual grooming of future M.B.A.s, astute men and women who are destined one day to occupy the executive suite.

But nearby, something outside the realm of Wall Street, economics and finance is going on. In one small section of cubicles on the third floor, the main concern is how to teach an impoverished mother with limited English proficiency what to do when her child has diarrhea or the flu.

While this seems worlds apart from Anderson's primary mission, the UCLA/Johnson & Johnson Health Care Institute utilizes some of the same strategies that are fundamental to good management — recruitment, marketing, motivating, incentivizing and team-building — in a hands-on program to teach low-income parents how to treat common childhood ailments such as croup, fever, cuts and colic.
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A translator, right, watches as a local physician goes over a health care book with two Head Start mothers.

 The institute's impact may not reach into corporate boardrooms, but it has made a huge difference to the program's nearly 30,000 poor families all across the country who are now confident that they can recognize and treat common childhood ailments themselves — all because of a low health-literacy program developed and propagated by the small UCLA unit of staff and faculty working through federally funded Head Start centers.

It started in 2000 when Anderson Senior Lecturer Ariella Herman surveyed more than 1,000 Head Start directors and asked what they saw as the most significant barrier to health care for their families. "The answer I got was not at all what I expected; it was the parents' lack of health care knowledge," she recalled.

Soon after, the institute got under way with funding from Johnson & Johnson to launch a pilot program training 400 families in California, Michigan and Missouri. Ever since then, Herman, two other Anderson faculty members and a small staff have been building a movement, through a network of nearly 120 Head Start centers so far, to offer their program.

The value of training parents

Tracking 9,240 Head Start families enrolled in the health literacy program — impacting nearly 20,000 children in 35 states – researchers found that visits to a hospital ER or clinic dropped by 58 percent and 42 percent, respectively, as parents opted to treat their children’s fevers, colds and earaches at home. This added up to a potential annual savings to Medicaid of $554 per family in direct costs associated with such visits, or about $5.1 million annually, according to the health care institute, which conducted the study.

Moreover, parents’ becoming better informed about handling their children’s health needs translated to a 42 percent drop in the average number of days lost at work and 29 percent drop in days children lost at school.

That helped convince the state of Washington to fund training for thousands of Head Start families. The pharmaceutical giant Pfizer paid for the training of 5,000 families in New Mexico. And the U.S. Office of Head Start recently awarded a Head Start agency in Missouri, working hand-in-hand with the institute, a $1.1 million grant to train 8,000 families to treat ailments at home.

"It's been a life-changing experience for me and for these families," said Herman, who teaches operations management. In tandem with her teaching duties, she has served as the volunteer research director of the institute since it was created seven years ago. "How do I know I've helped change people's lives? You see it in their smiles, in the brightness of their eyes. And people simply tell me, 'You've changed my life.' And that's the best reward anyone can dream of in a career," she said.

Last month, Herman was in Brussels, Belgium, where she was invited to address the European Parliament to explain how the program works. Europe, she said, is burdened by the health care problems of new arrivals from North Africa, Eastern Europe and other regions who also suffer from poverty, limited education and low health literacy.

The institute is an outgrowth of the UCLA/Johnson & Johnson Head Start Management Fellows Program, which each summer trains Head Start directors selected from across the country in management skills. Both this program and the institute are under Anderson's Harold and Pauline Price Center for Entrepreneurial Studies, headed by Professor Al Osborne.

Passing on knowledge

The institute employs a trickle-down approach; for two days, Anderson staff train a core team of Head Start administrators, workers and sometimes parents from each participating program to "sell," organize and carry out the parent training, which lasts three to four hours on a single day.

"We show the trainers how to create excitement about the program in the community and how to maintain that excitement so the learning process just doesn't fade away," Herman said. "What we thought was simple was sometimes not simple at all."

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Children, wearing ethnic dress, accompanied their parents to one training in Seattle, where lessons were given in seven languages simultaneously.
Roughly 60 percent of the families come from immigrant communities — from Somalians to Hmong. One parent training in Seattle took place in seven different languages simultaneously, with translators and volunteer physicians sitting at tables for each language group.

Not only are local physicians asked to participate, but the business community is approached for its support. Transportation, door prizes such as digital thermometers and dosage spoons, gift cards as well as a free meal are offered so that families "really can't say no," Herman said.

There's lots of discussion and interaction during parent trainings. Each family takes home a book, "What to Do When Your Child Gets Sick," written at the third-grade level in large print. Then comes the follow-up. For the next three to six months, there are home-visits by the Head Start staff to assess whether parents are putting what they learned into practice.

"It's not our intent to train parents to be health care providers. It's really about empowering the family to feel like they are the first line of defense for their children's health," said Jeanette Lim, program director.

Pride in their new role

Finally, graduation day arrives six months after training.

It may not be an M.B.A., but the diploma parents receive makes them feel just as proud, Herman said. With their newfound knowledge, many become health resources for their entire neighborhood.

"They love it," Herman said. "It's the graduation that gives them the last boost of confidence that they can take care of their children's health. That's why this program is so touching and powerful."
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