Ariella Herman is the research director of the Health Care Institute at the UCLA Anderson School of Management. She has focused on using systemic approaches to improve health promotion for underserved communities. This op-ed appeared on Zócalo Public Square.
Head Start is already great at helping kids succeed in life. Now it’s working at helping families become healthier too.
The National Center for Early Childhood Health and Wellness has recognized how important it is to engage and educate entire families in their own health. Improving health literacy means helping parents become better health decision-makers for their children. I’ve seen this firsthand working with Head Start agencies across the nation as the research director of the UCLA Health Care Institute.
The UCLA Health Care Institute, founded in 2001, has developed a way to use business management principles to improve the health of families. What that means in practice is that we’ve changed the way Head Start staff are trained to do health promotion. Over many years, we’ve learned that it’s not enough to just provide accessible written materials to families. Instead, families change their behavior when they get live interactive training sessions with the familiar staff at their child’s Head Start school. Through such sessions, staffers can show them how much they care and want to support the children and their families.
This work on health is part of a journey that began over 25 years ago, when the UCLA Anderson School of Management, where my teaching and research focuses on data analysis and statistics, started a program to provide leadership and management training to Head Start executives. I find teaching the Head Start directors and managers, who come from all over the country, extremely gratifying. Head Start executives typically have backgrounds in early childhood education, but tend to be less familiar with the particulars of managing an organization efficiently.
In the year 2000, I conducted a survey asking 600 Head Start directors what major barriers the families they served faced relative to health. And I got the same answer from an overwhelming percentage of those surveyed and those barriers were huge. The survey found very low attendance at Head Start health education programs, and Head Start directors told me they didn’t have the right kind of materials and training for families on health. The health materials they gave families often ended up in the trash.
That led us to create the Health Care Institute and expand our mission to include helping Head Start agencies plan effective health education sessions. Head Start started by holding special fun and engaging health events to attract families. We also created new health materials focused on prevention at home. These materials were easier to understand (they were pitched at a third-grade reading level) and could be adapted to the wide variety of communities and cultures they serve.
We’ve refined and expanded that program in recent years. At first, our health education focused on how to prevent and respond to common childhood illnesses and injuries that can be big burdens on families. But we soon saw that many families and children were suffering from poor oral health and added oral health trainings—sometimes the parents didn’t know what to do, sometimes there were very few dentists who could provide them with service. We expanded our offerings to include obesity prevention and mental health, and developed webinars for staff and toolkits to use with parents.
So far, we’ve trained more than 120,000 families across all 50 states, and we want to reach many more. The staff have also personally benefited from the health information. Since 2011, we’ve been supported by a federal grant from the Office of Head Start, which is part of the U.S. Department of Health and Human Services.
One of the challenges of working with a program like Head Start is that so many different people and communities are involved. Head Start serves a million children annually which means hundreds of thousands of families, in thousands of communities. Expanding the reach for health education meant a new way of thinking about organizing and communicating through the organization and assessing the impact.
We learned we had to train teams of Head Start staff first, bringing the personnel from different states into one place, while integrating health training with management training. This was not merely training, we wanted to create a culture of health and an agency shaped by caring. To do that, we had staffers participate as parents in mock parent-training sessions. Stepping into the parents’ shoes helped staff understand how to make the program more engaging for parents. Once engaged, they were able to learn and interact with other parents, further enhancing the learning and reinforcement. We’ve found that when parents get the right information in the right way, they really use it.
What’s the right way? Well, business school professors and data analysts don’t often talk about “love,” but I do. It means offering information in a way that shows real respect for people. When people feel respected and cared for, they are open to learning. L.O.V.E. is a trademarked acronym for the core belief of the training: listening, observing, valuing, and encouraging.
The success of the local training requires marketing. That may not be a word people like, but marketing, particularly internal marketing, is vital inside institutions, to get buy-in from all staff in the management training and health education, to assure good attendance by families, and thus to maximize impact.
We collect data. We’ve found that when families can better manage acute illnesses in their children they feel empowered. Among the data we’ve seen is that parents use the health system more appropriately after training—decreasing emergency room visits by 58 percent, for example. We’ve also seen an increase in the use of health resource materials at home, and a 29-percent decrease in the amount of school missed by children whose families receive the health education. Parents also showed a 42-percent decrease in work days missed after attending the trainings and learning how to manage illnesses in their children at home. This is an important benefit for families on limited income.
As it takes this research and these implementation strategies for prevention and applies them to the child care environment, Head Start has even more potential to improve the health of more children and adults in this country. It won’t be easy, but Head Start is moving in the right direction by engaging entire families in their own health and prevention. Improving health literacy opens the door for improving health in our communities.