#  Collaboration With Other Agencies to Produce Exciting Environmental Health Programs for Children

# 2007 - 2008 

# 

#  Environmental Public Health Leadership Institute Fellow:

# John J. Zentgraf, M.S.T., R.S.

*Environmentalist III*

*City of West Allis Health Department*

*7120 W. National Avenue, West Allis, Wisconsin 53214*

*414/302-8656, jzentgraf@ci.west-allis.wi.us*

# 

# Mentor:

### **Timothy J. Murphy, Ph.D., R.E.H.S.**

Associate Professor; University of Findlay

# (Acknowledgements):

### **Jane Adams, B.S.,R.S.**

Environmentalist III; West Allis Health Department

### **Terry Brandenburg, M.B.A., M.P.A., R.S.**

Health Commissioner; West Allis Health Department

### **Eric Eggers, M.S., R.S.**

Environmentalist III; West Allis Health Department

### **Daniel Koralewski, B.S., R.S.**

Environmentalist III; West Allis Health Department

### **Geyla Savic, A.A.**

Clerk II; West Allis Health Department

I would like to express special thanks to my coworkers at the West Allis
Health Department. They challenge me each day, they are honest and
direct, and I only wish that each one of you have the opportunity to
work with dedicated individuals like them.

# EXECUTIVE SUMMARY:

As a child my Aunt Kate made me feel special. She always had positive
comments, took me places, and listened to me. I always looked forward to
seeing her because I knew that I would have a fun time.

Our local Fire Department lets children experience sitting in a fire
truck and putting out fake flames emitting from a fake house with a real
hose. Our Police Department hands out baseball cards and uses McGruff as
a crime fighting dog. Why is there so little effort made to provide
novel, creative lessons for school-aged children that effectively teach
Environmental Health?

We develop programs in lead, water, radon, and mold to protect children
in their homes and at school. However, what do we do to engage and
educate children about EH? And more importantly, how do we make this
process a fun experience?

The City of West Allis, Wisconsin, has developed a model program for
elementary and junior high school classes. Developed during the past 27
years, this program was the result of several tipping points and a
shifting of department structure. Our Environmental Health team has
ownership in what we do and operates as a people ready business. Our
customers are all the citizens of our community and programs have been
put in place to address each segment of the population. With just a few
Madagascar Roaches, beetle, larva, and crickets, our Environmental
Department has been continuously invited to the elementary schools for
their "High Interest Day" programs. Our department also presents a
program on "Food Safety," which according to the teachers, "Sets the
tone as to the importance of food preparation." Environmental Health is
now invited to the Fire Departments, "Open House," the Police
Department's," Night Out Celebration," and the School District's,
"Carnival."

My project focuses on the inability of Environmental Health to develop
extraordinary programs for children that will peek their interest and
curiosity. Too often, unwilling and unavailable inspectors reluctantly
develop something on the spur of the moment, that fills the time but
doesn't engage children. Needless to say, they are never called back and
a partnership is never developed.

With the collaboration of the thirteen Environmental Health Departments
in Milwaukee County, I propose that a coalition be formed to adopt a
school-age children EH program. Representatives from nine of the EH
Departments met in October 2007. Another meeting is scheduled for
February 2008, and at that time a pamphlet will be developed featuring
programs offered by each respective agency. After approval, these will
be sent to local schools and school districts. Training will be given to
those hesitant to participate as well as an invitation to shadow an
inspector during a presentation.

A pilot study for National Performance Standards for Environmental and
Public Health is now being done in 16 departments throughout the United
States. As these departments begin to re-evaluate their programs, gaps
will be noted. It will be up to us to fill those gaps with action steps
to better serve our community.

As we meet the future in EH, we will need to have developed a method for
getting school aged children excited about what we do. We need to show
youth that they are important to us and that their opinions and ideas do
matter. Traditional or nontraditional educational methods may be used.
Our legacy will not be in how many places we inspected or how many
violations noted. It will be by how we valued the members of our
communities and how we empowered them to lead healthier lives.

# 

# INTRODUCTION/BACKGROUND:

***Problem Statement:*** My problem statement reflects the difficulty
that Environmental Health Professionals have relating to children. It
asks, " Why is it so difficult for unwilling and unavailable
Environmental Health Staff to engage children to better appreciate and
gain knowledge about Environmental Health?"

Education is one of the 10 Essential Services of Environmental Health.
Essential in that we also need to get the word out that Environmental
Health even exists. How do we reach students at the college level if
they have never heard of Environmental Health, even at a younger age? We
need to develop programs for elementary, middle school, and high school
levels. These programs need to be based on school programs and curricula
that exist like High Interest Day, Foods courses, Environmental Science
courses, and Career Day, if still applicable. By helping them fulfill
their needs we will also be helping ourselves.

Too often we have overlooked this arena because of lack of interest,
lack of an effective program, or fear of talking to students. I propose
that 1% or even .5% time (20 to 40 hours) annually be spent in
classrooms actively engaging children in Environmental Health. These
children have wide-eyed wonder and teachers appreciate the interest our
programs generate. Students are also the eyes and ears of our community.
They will tell us if they see something that doesn't seem right
especially in restaurants, schools, and homes. We need to spend some of
our time seeding the future for Environmental Health.

By not planning for the future we will be limiting what could have been.
By not planning we will also continue to lose programs at the college
level. If we believe in what we are doing for our community, state, or
county, we need to promote what we do.

I would like to concentrate my efforts on Milwaukee County. Thirteen
local environmental health departments are concentrated in this county.
Milwaukee County contains 17 % of the population of the state and has
450 public and private schools. I would also like to see if WEHA could
offer some type of monetary scholarship for those students throughout
the state deciding to do a Science Fair project concerning some aspect
of Environmental Health. The availability of this scholarship could be
put out as a brochure at the State Teachers Convention.

Limited resources are not the issue. Limited thinking is. I would also
like to correlate the needs or wants of schools to the efforts that each
health department is willing and capable of doing. The West Allis Health
Department would like to initiate a coalition that includes the thirteen
agencies working together on this project.

Systems Thinking

The Systems Thinking Process uses archetypes to demonstrate, by loops
and verbiage, the complex system of problem solving. There are many
types of archetypes that can be used. Each simplifies the problem on a
chart whereby the problem is more easily addressed. They serve as
functional guides to problem solving.

The use of variables or a behavior-over-time graph gives you a picture
of what is happening over time to causes related to the problem.
Reducing your problem statement to this type of chart and graph helps to
readily address solutions to the problem.

####### ***Behavior Over Time Graph:***

![](media/image1.wmf)

####### 

####### ***10 Essential Environmental Health Services:***

Programs that are developed for Environmental Health should incorporate
several of the ten essential services. Part of any Educational Program
that we have should inform, educate, and especially empower local
constituents. If we are doing our jobs effectively, programs need to be
developed for each segment of the population. Elimination of any age
group shortchanges them. Also as we work with schools, teachers,
principals, PTA's, and Day Cares, we form Community Partnerships that
can be utilized in an emergency situation. As our identity in the
community is strengthened, we become more familiar to our constituents,
which I think also makes it easier do our jobs.

Another service we give to ourselves is promotion. Without
self-promotion some community leaders may think that our services are
not that important and budgets can be further reduced or even worse that
we can be eliminated. The partnerships, therefore, that we form give
them and us needed visibility for what we do.

![](media/image2.png){width="3.75in" height="3.8125in"}

Figure 1:

####### 

####### 

####### ***National Goals Supported*** 

Goal IV of the CDC Health Protection Goals is Communicating and
Marketing Environmental Health to the community, partners, stakeholders,
and the public. What better way to achieve this goal than to bring your
message to schools and have students actively participate in exciting
environmental health activities? Children relate these programs to their
parents, teachers tell other teachers, parent helpers relate their
experiences to other parents, and school principals relate these
activities to others. Our environmental bulletin board is covered with
thank you notes from students, teachers, principals, and school board
members. Good things that we do need to be marketed to other
Environmental Departments. Parents appreciate what we do for their
children and we now find ourselves on an equal level with the police and
fire departments. Communication, marketing, and exceptional service
supports and strengthens Environmental Public Health.

Use of major media outlets can make a powerful impact for environmental
health; however, we can make our own impact by use of our own local
cable network and local newspapers. The Internet can also spread our
message. A strong identity in the community can make your reception for
other programs much easier. As populations change so too do we need to
adapt. As we collaborate with other environmental agencies we will build
trust, which will allow us to mutually share ideas and resources.

Logic Model

**Assumptions:** Well-defined and excellent programs are designed to
incorporate the natural curiosity and excitement of children. Children
come away from these programs feeling excited and wanting to talk about
their great experience.

+---------+---------+----------+--------+--------+---------+--------+
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| NPUTS** | TPUTS** |          |        | OMES** |         |        |
+---------+---------+----------+--------+--------+---------+--------+
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| invest  | ITIES** | UTPUTS** | RTICIP | *SHORT | *MEDIUM | TERM** |
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+---------+---------+----------+--------+--------+---------+--------+
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|         |         | Careers  | School | Become | Re      | choose |
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|         |         |          |        |        | pr      | St     |
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|         | Summer  |          |        | Insp   | kn      |        |
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|         | Ed.     |          |        | to     |         | onship |
|         | P       |          |        | report |         | with   |
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|         |         |          |        | viol   |         | ctors. |
|         | Career  |          |        | ations |         |        |
|         | Days    |          |        |        |         | Impo   |
|         |         |          |        | Talk   |         | rtance |
|         |         |          |        | about  |         | of EH  |
|         |         |          |        | EH     |         | to     |
|         |         |          |        | with   |         | their  |
|         |         |          |        | their  |         | Com    |
|         |         |          |        | p      |         | munity |
|         |         |          |        | arents |         |        |
|         |         |          |        | and    |         |        |
|         |         |          |        | clas   |         |        |
|         |         |          |        | smates |         |        |
+---------+---------+----------+--------+--------+---------+--------+

# Impact: The Science of Environmental Health is lacking in Education today. Students need to be incorporated into the Environmental Health Equation. Students having practical experiences with EH will better understand its impact on the quality of life and may wish to pursue it as a career.

# 

# PROJECT OBJECTIVES/DESCRIPTION/DELIVERABLES:

####### ***Program Goal***

A dream or vision once written down becomes a goal. The goal of my
leadership project plan is that each environmental health department in
Milwaukee County would have an education program and part of this
program would be dedicated to school age children. This program would
also include: senior citizens, the general population, homebound,
special needs, scouts, and specialty groups. Topics to include: food
preparation and storage, general sanitation, mold, insects, vector
control, rabies, lead, asbestos, and other topics as needed.

####### ***Health Problem***

Children are not taught about environmental health at an early enough
age. Environmental health focuses on programs aimed at children's health
but not on children's ability to learn about environmental health.

####### ***Outcome Objective***

By January 1, 2013, 50% of the 450 schools in Milwaukee County will have
had at least one program in Environmental Health. Our shared vision is
to become a part of local, county, and state environmental programs over
a three to five year period, once the importance and training is in
place. Having a presence in our children's schools will add value to
their education and identify the practitioners of environmental health
to the schools. Partnerships will be formed and teachers and students
will know who to ask about Environmental health issues.

####### ***Determinant***

At this time environmental health personal are not adequately trained to
develop exceptional educational programs required to peek student
interest. Lectures and informative sessions do not get children
interested in environmental health. Only programs that engage each child
with all five senses will excite them.

***Impact Objective***

Each inspector needs proper training with children in order to relate
and have fun with the programs they are doing. Yes, you can talk with
children but you need to be excited about working with them. Not all
inspectors can do this and many are too busy to try.

***Contributing Factors***

By January 1, 2010, 75% of environmental health inspectors in Milwaukee
County will be confident to present a program in Environmental Health to
elementary, junior high, or high school students. Unless you have
teachers who know what they are looking for and who to call, they will
not know that your environmental department will have these types of
services available. Local schools need to be shown the benefits to them
and the students of having programs for their classes. Brochures and
pamphlets could be developed and sent to school districts, calls could
be made, or even presentations at State Teachers Conventions could be
given. Once on board with these types of programs other teachers will
spread the word.

***Process Objectives***

The process objectives are to get the thirteen Milwaukee environmental
agencies to meet and share information about what they are currently
doing for children's educational programs. From this meeting we would
work together to develop what each agency would like to do or share with
each other. Training and sharing of resources could be done as well.

# METHODOLOGY:

Methodology includes events that have occurred already as well as the
events and activities that will be planned for the future. As this
project is ongoing, some of these maybe changed in the future.

**Objective:** By November 1, 2007, a representative from each
environmental health department will be asked to join this shared
vision.

**Event:** Meeting was scheduled October 18, 2007 at the West Allis
Health Department

**Activities:** Two power point presentations and discussion of what
each agency does was given. We also discussed what is being done
presently and how we can share resources and ideas. Actually at this
point I needed not only to share the vision but also to align their
vision to mine. Evidently it worked because all were in favor of
scheduling another meeting in early February 2008.

**Objective:** By March 1. 2008, group would have solidified ideas and
list of contact personal and agencies abilities to produce programs
could be accomplished.

**Event:** Meeting

**Activities:** Discussion -- Begin development of pamphlet on
children's environmental health programs from agencies in Milwaukee
County

**Objective:** By July 1, 2008, pamphlet completion and approval by each
agency

**Event:** E-mail to each

**Activities:** Have each agency approve and then e-mail back to me.

**Objective:** By October 1, 2008 have sent pamphlets to school
districts, private schools, and teachers.

**Event:** Mailing -- Need to see where funds might be available for
this.

**Activities:** Address labeling

**Objectives:** By January 1, 2010, 75% of environmental health
inspectors will be confident giving environmental health programs to
children

**Event:** Training Sessions

**Activities:** Use of DVD to show and explain what can be done and how
to react with children.

**Objectives:** By January 1, 2013, 50% of the 450 schools in Milwaukee
County will have had at least one program in environmental health.

**Event:** Survey

**Activities:** E-mail questionnaire to inspectors

# NEXT STEPS:

Following the methodology above I expect the following to happen:

-   Develop a countywide description of contact persons and types of
    programs available for each Environmental Health Department in
    Milwaukee County.

-   Offer training to inspectors. Record a DVD of several different
    types of programs so that inspectors become confident in their
    abilities to work with children.

-   Send pamphlet to school districts, hand out at teacher meetings, and
    give some to representative from each community.

-   Keep reinforcing the importance of this type of program by sending
    out e-mails and calling each representative every six-month period.
    Remind inspectors of the availability of help if they need any.

-   By January 1, 2113, I hope that 50% of the 450 schools in Milwaukee
    County will have had at least one program on environmental health.

# EXPECTED OUTCOMES:

Our job descriptions give us the opportunity to make a difference in
peoples lives. We see what exists and work to remove the hazard or take
the present and help to make a better future. Reduction in risky
behaviors and actions leads to a healthier community, and a longer and
more productive lifespan.

Environmental Health Practitioners are lacking the self-esteem,
willingness, and self-confidence to go out into the community and shine.
Talk about our profession being invisible, we are doing this to
ourselves because of the actions that we are taking. Our link to the
future is with children. They need to learn about our profession and
that we are working to protect their health. They also have the
responsibility to call us if they see something that is not right.

Children are an important component of any environmental program. Group
presentations give us a chance to promote EH and attach a face to the
program. Too many EH inspectors say NO when asked. We need to change our
thinking and ideas of what constitutes a full service environmental
department.

Presentations multiply our efforts. Each day you may speak with 12 -- 15
customers. On a day with 4 presentations to groups of twenty or more
students, and adding parent helpers and teachers, your message would be
given to 100+ people and then children also take this message home and
tell their parents. This message goes beyond city borders and we find
schools in other communities calling and asking us for these
presentations. We advise them to call their local EH agencies who tell
them that they do not offer anything.

I expect that as inspectors begin to dialog with children, other needs
will be noted. More partnerships will be formed with teachers,
principals, and PTAs. Inspectors will become more identifiable in their
community and inspectors will actually look forward to going into the
classrooms. Yes, these presentations are a lot of work but they are also
very rewarding. I can never say no to any request for presentations,
especially those given to children. That is why another inspector in our
department does the scheduling. After scheduling six schools with four
to five presentations at each school, we found ourselves drained. Now we
rotate schools and I give the food presentations.

For the past 27 years I have given presentations to Foods classes in
West Allis, WI. Even though I gave this program, my initial methods were
less than adequate. I did what I had to, a 20 minute film with a 25
minute presentation. Presently, I give a full 50-minute presentation
incorporating all five senses. Since approximately 43% of the students
will work at some point in their life in restaurants or in retail food
establishments and so far I have presented food courses to approximately
5,800 students, then 2,500 people working in food type establishments
will have some knowledge of EH.

Somehow we also found a need to develop a program for elementary
schools. We wanted to bring some excitement and generate interest in EH.
We found High Interest Days to be our niche. Purchasing Madagascar
Hissing Roaches was the best thing we ever did to advance this program.
Once we added the Cricket Lickit suckers and dried larva, we were on our
way to success. Once you give children an exciting taste of
environmental health, you will not have to worry about finding schools
to give presentations.

***Environmental Leaders also working with children:***

Kara Stevens, from Idaho has been working with developing Environmental
Health curricula for school-aged children. Tammy Dillard-Steels has also
been working with high school students in an after-school program that
exposes students to health careers. Teachers have been changing careers
at a faster pace, now is our time to enter the classroom and shine.

***Other Ideas:***

1.  Environmental Health Camp -- Partnership with University and
    establish a 3-5 day camp for students to get the feel for
    environmental health. For students ages 16-18 a college credit could
    be included.

2.  Develop some Environmental Health books for those students 3-8 years
    old that could be used during story time at libraries, or even read
    by Environmental Staff at the library.

3.  Produce Environmental Health programming for local cable television.

4.  Develop a DVD with programs that have been done at the Health
    Department.

5.  Create a method of sharing PowerPoint presentations with other
    Environmental Health Agencies. NEHA could be involved as they could
    be paid a royalty that could be used to further scholarships in
    Environmental Health.

# LEADERSHIP DEVELOPMENT OPPORTUNITIES:

####### ***John J. Zentgraf***

At this point in my career I thought that I would have established a low
profile until I retired. Now I feel that there is much to do. I am
encouraged and energized networking on a national level with
Environmental Health leaders. I appreciate the education and training
that I have received and will apply these to other facets of my life.
Some leaders prefer to be out on the cutting edge of Environmental
Health, others like myself prefer to stay in the background, motivating
and challenging other inspectors to develop themselves. I am ever so
grateful to EPHLi for the chance to develop my leadership ability. I
have realized that at times I take on too much because I easily become
bored with the every day routine activities and am always looking for
something different to do. EPHLi gave me a chance to examine my
personality while also having other staff members rate my abilities. It
was hard for me to accept the negatives, however, through the past year
I realize what my abilities are, and what I can achieve.

####### 

# ABOUT THE EPHLI FELLOW

John Zentgraf has been an Environmental Specialist with the city of West
Allis, Wisconsin for 28 years. He has an undergraduate and Masters
Degree in Biology. He has taught fifth grade through Junior College and
for the past 17 years has taught Environmental Science, part-time, at
the Milwaukee Area Technical College. He has had a varied career working
as an Asst. Fish Biologist for the Wisconsin DNR and worked part-time in
the jewelry industry for 20 years. He has been President of WEHA, the
Wisconsin Weights and Measures Association, and the Wisconsin
Association of Food and Sanitation Officials. In 1997 the Wisconsin
Environmental Health Association named him Environmental Health
Professional of the year. He initiated a silent auction at WEHA
Conferences to raise money for the Scholarship Fund. Within 10 years
under his direction WEHA raised \$20,000. He has also spoken at WEHA
Conferences. Even though it took him until he was 32 to find
Environmental Health, he knew that he had found a perfect match for his
talent and abilities. He especially likes what he refers to as the
perfect complaint. A complainant calls, John empowers them with
knowledge and while talking to them gives them the courage and ability
to handle the situation, and they thank him and hang up.

John and his wife of thirty-seven years, Frances, reside in West Allis
and have three grown children.

# REFERENCES

1.  Senge PM, Kleiner A, Roberts C, Ros RB, Smith BJ, eds. 1994. *The
    Fifth Discipline Fieldbook*. New York, NY: Doubleday.

2.  Osaki, C., eds. 2004. *Essential Services of Environmental Health*.
    Northwest Center for Public Health Practice, University of
    Washington School of Public Health and Community Medicine, Seattle.

3.  CDC NOW: Health Protection Goals Fact Sheet-Goals for the 21^st^
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