Module I

Points to Consider:

Wellness is a multi-faceted, dynamic state. No two people's
perceptions of wellness are the same, and anyone’s definition of
wellness may change over ime.

Th re are many ways to promote wellness.

Chronic illness or disability do not slop anyone from achieving a
Personal level of wellness.

Caring for our own health as caregivers sends an important Message to
coworkers, children, and parents.

Laying a Foundation in Health & Wellness



Module 2

Step 2:

Step 3:

Step 4:

Step §:

Step 6:

Head Start staff people are regularly faced with challenges in
everyday effectiveness. Ask your participants to take a few
moments and think about a time when a parent approached them
with a concern; a problem with everyday cifectivencss where
information from several team members could have been helpful.

Ask the participants to break into groups of five or six, with the
groups including staff people with different roles in the program.
Ask them to share the concerns that parents have brought to
them, Ask them io choose one story where many team members
could convibute to the family support action plan and use that
story to practice using the framework, Some examples:

+ “Jamal is always very ured when I pick him up and sleeps for
three hours where he never used to nap before...”

* “Monika won't run around with her brothers anymore and
seems to be having difficulty with her breathing since we
moved into our new apartment building near the interstate
freeway...”

+ “lve noticed that Sally has started hitting her friends again,
and | don’t have the patience to deal with her since my
husband moved out...”

The parent begins by explaining her concern about her child.
Staff members should discuss the situation from the perspective
of their own roles as consultants to the family. Emphasize that
staff members probably already have lots of knowledge and
information about this child and lots of understanding about this
situation-—-they should draw on that and share it with the rest of
the team.

Distribute Handout --Consulting Circle Framework. The parent
can begin by posing any questions she has for the team and shar-
ing her viewpoint and special understanding about the child.
Other members share their special viewpoint and understanding
that they have based on their roles in the child and family’s life
(ic, nutritionist, teacher, family service worker). In discu!
with the group, fill out the first table on Handout I—Co
Circle Framework, describing factors which impact eve
effectiveness, Remember to note strengths and supports to every-
day effectiveness as well as things that get in the way.

Once the team has considered the possible factors affecting
everyday eHectiveness, have them look at the lower half of the
handout

34

Laying a Foundation in Health & Wellness

41



Module 2

Handout C (Sample): Health Snapshot Worksheet

Instructions: In the column on the left, list everything you would like to know about the health
of children and families in your program. In the other column, write down where you could go for
that information. This is like a written “brainstorm,” so list everything you are curious about, even

if you don’t know how to find the answer.

|, Things 1 sould like: know ‘about the Sourcés of. information :
oo ealth of our’ children. » : See

What is the most common reason children in our
program miss school?

What are the most common health problems in the
program?

How many injuries did we have last month?
Where were they most likely to occur?

How many of our families don’t have health insurance?
What environmental hazards are in our community?
How many of our kids are fully immunized?

How many dentists in our community accept Medicaid?

Our health coordinator

Records on file with program

local public health department, public health nursing
Health Advisory Committee

Patents

OSPRI or PIR date for our program

Local environmental health or toxics unit in the public
health department

Daily classroom incident reports

Linking Heatth and Social Competence



Module 2: Linking Health & Social Competence

Handout D: Jelani’s Story

Jelani, 2%, has a hard time getting started most days. He often enters the group by grabbing a toy or disrupting an
activity that another child is engaged in during free play time. He seems to allernate between cranky/irritable and
Icthargic/low energy, with nothing in between. Jelani is pale and thin, The teachers have noticed that his behavior
improves after snack time and that he wolfs down food at snack and lunch time, particularly on Mondays.

A. What factors could be limiting Jelani’s social competence:

Physical:

Emotional:

Spiritual

Social-Cultural: __

Environmental: _

B. Given the possible causes you have listed, what can you do to help:

Right now:

Long term:

Laying a Foundation in Health & Wellness 39

UPANOY Yrs 28n 10,

c



Introduction

At a Glance
[Modules [ Activity [Time | Materials
Activity 1: The Wellness 20-45 Handout A
Pinwheel (W) minutes
Module 1: Activity 2: Wellness in My 30 Handout A
Health and Weliness— Lile & My Work (C) minutes

What do they mean?

Activity 3: Explore Difference! 30-60 Handout B
An Interview Activity (C) minutes
Activily 4: Mother Wit & 30-45 Handout B
Medical Wit: Listening minutes
______ for Common Ground (W) _ __|
Activity 1: Take a Program 45-120 Handout C
Health Snapshot (C) minutes
Module 2: p ©
Linking Heaith and Activity 2: Social 30-60. Handouts D - H
Social Competence Competence & Health (C) minutes
Activity 3: Consulting 45-120 Handout I
@ Circies (W) minutes
[ Activity 1: Connections (W) 45-120 Handouts J -M
Module 3: minutes
Planning for a : Role Modeling 30-60
Healthier Tomorrow minutes
3: Head Start Center 45-120 Handouts N - Q
Action Plan (W) minutes

(W, = Workshop Activity
(C) = Coaching Activity

Introduction

nm



Module 3: Planning for a Healthier Tomorrow

Handout M-1: Team D (copy onto yellow card stock and cut out)

Strong Heart/Aerobic Fitness

A Healthy Planet

Laying a Foundation in Health & Wellness

69

[dnansy ys asn 104


Module 3

Activity I:
Connections

Purpose: This activity is to raise participants’ awareness of how behavior
contributes to long-term health or to disease and about the overlapping
benefits of positive health behaviors.

Preliminary Preparation: This activity works best with 12 to 20
Participants. Divide them into four teams: A, B, C, D. There are
two handouts for each team; one handout of large cards and one
of small cards. Copy Handouts J-M onto card stock (red, green
and yellow) and cut out the cards. Each team should have 5 large
cards and 20 small cards. Place the cards in envelopes for each
team.

For this group activity you will need:
Mi Handouts J—-M copied onto red, green and yellow card stock
B® 4envelopes
@ Flip chart and markers

@ Writing materials for participants

Step 1: Define the following:

a. Outcome = something that happens to a person after time,
possibly many years

b. Behavior = a person’s actions or habits

c. Condition = the situation someone is in, can be unchangeable
such as ethnicity, family history

Step 2: Brainstorm with the group about outcomes and behaviors. Ask
them to suggest onc or two health outcomes such as obesity, a
healthy heart, »steoporosis, Write each outcome at the top of a
sheet of flip chart paper. Then ask them which behaviors contrib-
ute to each outceme and list the behaviors undemeath.

Planning for a Healthier Tomorrow 49

OG



Module 3

The Seven Healthy Habits (Alameda County Study')

1)
2)
3)
4)
5)
6)
7)

never smoke cigarettes

get regular physical activity

use no alcohol or use alcohol moderately*
sleep 7-8 hours each day regularly*
maintain proper weight

eat breakfast daily

do noi cat between meals

* Note: Some of these behaviors, ¢.g., moderate alcohol use, sleep

ing only 7-8 hours daily, and not snacking are not appropriate for
young child: zn.

How Important is Role Modeling to Health?

Children learn by imitating. From a baby’s first babbling to
preschoolers playing house, to teenagers exploring gender roles,
children are hard at work imitating what they see around them.
The video we show the children about choosing unprocessed
foods will have far less of an impact if we are sipping a diet soda
as we watch. Somctimes, children are too busy watching what we
do to hear what we say.

Children observe, imitate and leam from many adults, including
adults that are neither teachers nor caregivers. Adults are all-
powerful role models and we can use that power for health
regardless of our formal job within Head Start.

‘Rosenbaum and Luxembourg. “You Can’t Live Forever,” Better Health Foundation, University of California,

San Francisco/Mount Zion Hospital (1993).

?Kannel, W.B. and Larson, M. “Long-term Epidemiologic Prediction of Coronary Disease: The
Framingham Experience,” Cardiology (1993):82(2-3):137-52.

Planning for a Healthier Tomorrow

47



Module 3

Key to Handouts J - M (continued)
OUTCOME Cards

6. Strong Heart/Aerobic Fitness

7. Healthy Skin

(fewer wrinkles and less skin cancer)

8. Strong Bones and Teeth

9. A Healthy Planet

10. Happy, Alert Old Age

BEHAVIOR (or CONDITION) Cards
Eat low-fat foods
Have healthy ancestors
Don'tsmoke
Be very slow to anger
wo
Drive less to preserve Earth's ozone layer
Protect your skin from sunlight
Drink lots of water

Use soaps with lotion

Brush and floss teeth every day
Walk, jump, run—get exercise

Eat foods with lots of calcium (eg. milk,
greens, sardines)

Avoid soft drinks

Take up bicycling; save energy
Recycle as much as possible
Plant a garden

Reduce use of household toxic cleaners

Get plenty of rest
Try new things, think new thoughts
Have long-lived ancestors

Get preventive medical care (screening)

OU

54

Laying a Foundation in Health & Wellness



Module 3

Activity 3:

Head Start Purpose: This activity gives participants the opportunity to consider how
Center Action the three levels of services are provided in each component area of their
Plan Head Start Centers.

This exercise is a group activity. You will need:
One copy of the following handouts for each participant:
@ Handout N: Basic Health Needs ,
M@ Handout O: Disease Prevention/Injury Protection
@ Handout P: Health Promotion
@ Handout Q: Head Start Center Action Plan
@ Flip chart and markers

1 Writing materials for participants

Step 1: Review background information in Module 3 on the three levels
of health services (see p. 47):

. Basic Health Needs
. Disease Prevention and Protection from Injuries
. Health Promotion

Ona sheet of flip chart paper, list the three levels of health and
ask the participants to give examples of services and activities for
each level. Be sure to have examples from the physical, mental/
emotional, social, environmental, and spiritual dimensions of
health. Some examples:

. Basic Health Needs: some food to eat, someone to look
out for me, non-hazardous air, the ability to move about
(physical capabilities), removal of barriers

© Disease Prevention/Protection from Injuries: nutritious

food, someone to love me, clean and fresh air, good
shoes, and a safe climbing structure

64

Planning for a Healthier Tomorrow 59



Module 3

Planning for a Healthier Tommorrow

Outcomes Upon completing this module, participants—as individuals and in
teams—will develop strategies that incorporate health promotion into a
variety of interactions with Head Start staff, children, and families.

Key Concepts Habits and behaviors have powerful effects on long-term health. Be-
haviors learned in childhood, those that support health and those that
harm health, have lifelong effects.

Role modeling is a powerful way to teach children.

Parents are the primary health role models for their children. In addi-
tion, all staff, regardless of job title, have opportunities to promote
wellness.

Efforts that support health can be organized into three levels, which
address:

@ + Basic Health Needs
+ Disease Prevention and Protection from Injuries

+ Health Promotion

Background Information A. How Does Health Build Over Time?

Over the past forty years, researchers have studied how our personal ac-
tions and habits present risks to our health. Some behaviors such as ciga-
rette smoking and seat belt usage are certainly linked to long-term health.
If you smoke cigarettes you are much more likely to suffer from lung can-
cer, heart disease or emphysema (among other sicknesses) and you are
much more likely to have a shorter life than someone who does not smcke,
If you wear seat belts when you drive, you are much more likely to sur-
vive a car crash than someone who is in a crash without seat belts.

Our role in health promotion in Head Start is very important because the
best time to start healthy habits is early in the life of child and a good time
to teach health habits to a family is when they are learning to care for
young children at home. Children are leaming attitudes and habits that are
more likely to become part of their lives if they begin early and are carried

@ out consistently.

Planning for a Healthier Tomorrow ea 45


Module I

Step 4:

Step 5:

Step 6:

Step 7:

from the worker's. The coach’s job is to observe and note
interactions that are respectful of differences and those that might
make the parent feel bad.

Call an end to the role play and ask the coach to share his or her
observations for discussion in the small group. The coach must
be prepared to note examples of positive communication as well
as areas that need improvement and be careful to offer feedback
in a respectful and gentle manner,

Give the group members an opportunity to switch roles and take
another turn.

Retum to the large group and ask each small group to share a
technique that the members used to help them listen respectfully
to the differences. List these techniques on flip chart paper. Also
list communication practices that “shut down” the speaker and
made him or her less willing to share openly.

Discuss how to handle health concems about a health practice
that may be harmful. Encourage the group to think about the
following questions:

a. What does it feel like to believe in an unconventional or
uncommon health practice?

b. Have you ever been in a situation in which you felt that an
unfamiliar health practic. was harmful? What made you
think that it was harmful? Some practices, for example
coining (rubbing the child’s skin with a coin in such a way
that it raises a bruise—believed to purify the blood), look
alarming but are not harmful. Are there ways to check out
these assumptions?

c. Ifthe practice is safe, are there ways to include it along with
the approach recommended by the program?

d, Who can you ask about the practice or about the individual
child’s health?

e. Ifyou believe the action is harmful, and discussion or
counseling do not lead to a resolution, what are the next
steps?

Laying a Foundation in Health & Wellness



Module 2

Step 7: Asa team, consider how each team member can contribute to

supporting the family. It may not make sense for every team
member to work directly with the family and child, but they all
may have a role in supporting and providing information to the
tcam member with whom the family feels most comfortable. For
example, the nutritionist who did an assessment of Jamal’s dict
may not need to work directly with his mom—this might feel
chaotic or overwhelming to Mom. The nutritionist might, instead,
help the family service worker to understand the nutrition
assessment so that the FSW can use that information in helping
Mom figure out why Jamal is so tired. The parent should note
exactly how she would like to be involved with each staff person.

Step 8: Bring the participants back to the larger group. Ask them to

Points to Consider: .

share the work of their team in planning their efforts. Consider
which parts of the exercise were casy to do and where there were
difficulties,

Coordination and teamwork take time and resources. How cari we
encourage communication among team members and with parents as a
regular practice in our program?

Are there barriers to team communication—climate, policies, time
constraints—which need to be addressed?

Were all five areas of wellness—physical, emotional, spiritual, socio-
cultural and cnvironmental—represented in the background for this
particular problem with everyday effectiveness? Only a few? Was an
arca present but not obvious?

How did overall community factors affect this situation?

Caring for young chiluren is hard work, especially when those children
and their families are experiencing many kinds of stress. Meeting
together in a Consulting Circle can make parents and staff feel less
alone and overwhelmed and provide an opportunity to learn from other
disciplines.

Pay attention to the process of the group so that it {eels and acts like a
team of equals, Check in to see how the group is handling differences
in level of education, training, etc. Each person has a unique
Perspective to contribute.



Module 3: Planning for a Healthier Tomorrow

Handout L-2: Team C (copy onto yellow card stock and cut out)

drive less to
be very slow preserve eat low-fat be of avoid
to anger Earth's foods non-European soft drinks
ozone layer ancestry
take up reduce use get plenty try new
bicycling of household. of rest things, think

toxic cleaners new thoughts

rey

For use with A

68 Laying a Foundation in Health & Wellness



Contents

Preface ix

Introduction 1

OVOTVIOW oo. eeeeececeeeeteeenstenesesenescnenenescanenseseneseaeseaeassenearnanensnenees 1
Purpose/Goals
Audience
Performance Standards

Orientation to Foundation Guide ................cccccseeeeeeseneeeeneeees 3
Definition Of ICOMS .............ccecscsesssesessesseseesesesestenesessesessanensseeesesnes 4
At A GLANCE on... eecccsecsesessessesnesesnseceneessenescsestscsessanessensneseneenenees 5

Module | 1

Heaith & Wellness - What Do They Mean?
Outcomes
Key Concepts

e@ Background Information
Activity I: The Wellness Pinwheel seeeeeeeaeeneceeneneneeeseees
Activity 2: Wellness in My Life & My Work.... 1
Activity 3: Explore Difference! An Interview Activity
Activity 4: Mother Wit & Medical Wit:
Listening for Common Ground...

Next Steps: Ideas to Extend Practice

Handout A: The Wellness Pinwheel ........ccsserssseresesaseseersecenree 19)

Handout B: Explore Difference! ........cscssssssessssssssssssereseesseensrsee 20
Module 2 2
Linking Health & Social Competence

Outcomes

Key Concepts

round Information

ty 1: Take a Program Health Snapshot ........c0cccceceseeeee 27
2: Social Competence and Health
ty 3: Consulting Circles

e Next Steps: Ideas to Extend Practice vicccsece scsseecssscssnescnsseeseneeeas 3O

Laying a Foundation in Health & Wellness Y



Module 3: Planning for a Healthier Tomorrow

Handout N: Basic Health Needs

Component Area

What WeDo Nove

How Ceuld We Do Better?

)

6

Laying a Foundation in Health & Wellness

71

€ SHANDY YIM asn 40g



Module 3: Planning for a Healthier Tomorrow

Handout M-2: Team D (copy onto yellow card stock and cut out)

drink lots use soaps have healthy don't smoke walk
of water with lotion ancestors every day
_|
get
eat foods recycle maintain preventative
with lots of plant a garden as much as your friendships medical care,
calcium possible including
screening
use sunscreen
|
1
|
i
i
|
_ _ _ ——-—|_ J
mS
60

Laying a Foundation in Health & Wellness



Module 3:

Planning for a Heaithier Tomorrow

Handout P: Health Promotion

Component Area

What We.Do Now

How Could WeDo Better?

‘2s

Laying a Foundation in Health & Wellness

73

g UIANOY YT asa 20]


Module 2

Activity 1:
Take a Program
Health Snapshot

a!

Purpose: This activity will help participants build a health status profile
of families in their program. Systematically collecting this information can
reveal pattems of illness that could suggest corrective actions. For
example, if many children in the program have asthma, it might help to
encourage the adults in the children’s lives (staff and parents) to stop
smoking. if many children have high blood lead levels, it suggests an effort
is needed to get paint, soil, and water tested in their neighborhoods. If
many children regularly miss school with-colds or diarrhea, maybe it is
time to do a refresher on handwashing and infection control. Doing a
health status profile from time to time can show changes (improvements
and new or more severe problems) over time.

This activity will be most useful for staff other than the health coordinator.

Participants can make it as simple or as elaborate as they like. You will
need:

Handout C: Health Snapshot Worksheet

@ Writing materials

Step 1: Fill out Handout C; Health Snapshot Worksheet. This will be the
basis of the work plan for your research project (see sample of
Handout C at the end of this activity for question ideas, but feel
free to list any others you are curious about). If you don’t know
what sources of information are available to you, check with
your center director for ideas for program information sources
and your local public health department for community
information sources.

Step 2: Looking at your questions and your possible sources of
information, pick three questions that you can find the answers to
given the amount of time and energy you want to devote to this.

Step 3: Seta timeline to gather the information you are looking for. You
might make phone calls, review records (with appropriate
confidentiality safeguards), or conduct in-person interviews.

Step 4: Share the information you have learned. You might put together a
brief presentation for a staff meeting, a parent group, or for the
Health Services Advisory Committee.

Step 5: Spend some time with your health coordinator discussing what
you have learned and brainstorming what actions to take.

Linking Health and Social Competence 36 21


Module 1

Activity 3:
Explore
Difference!—
An Interview
Activity

Q

|

ia

u

Purpose: This activity is designed to demonstrate that different cultures
define and treat health very differently, and to celebrate the richness of this
diversity. The activity encourages sharing beliefs and practices, and
strengthens interview skills.

For this activity you will need:
@ Handout B: Explore Difference! Question Cards

@ Writing materials

Step 1: Consider a health issue of your choice—four examples are
included in Handout B: Explore Difference! Question Cards.
Identify four people different from you—in age, ethnicity,
lifestyle, religion, or other factors—who you can interview.
Include a Head Start parent in your group.

Step 2: Ask these people how they would answer the questions on the
cards, or ask similar questions about another health issue that is
of interest to you. Is their approach the same as yours? Share
your approach with them.

Step 3: Discuss the benefits of the various approaches. All of the
approaches are likely to have something positive to offer.
Consider the following questions:

a. Didevery person interviewed approach common health
concems ina different way?

b. Did you learn ways to handle health concems that differ from
the Westem medicine approach? Were these alternative
approaches beneficial?

Step 4: Interview one of your four informants in depth about the health
beliefs of his community. Prepare for your coworkers a 10-15
minute presentation about that culture’s health beliefs.

Health and Wellness—What Do They Mean?

13



Module 1: Health and Wellness—What Do They Mean?
Handout A: The Wellness Pinwheel

Laying a Foundation in Health and Wellness 19

ZP I SanANIy YIM 2ST 40,7



Module 1

Activity 4:
Mother Wit &
Medical Wit:
Listening for
Common
Ground

Purpose: We all want the best possible health for the children in our
care—our own children and our students. Sometimes different ways to
achieve that goal are in conflict. This exercise offers an opportunity to
practice respectful listening to people with different health beliefs. It also
helps staff identify strategies to handle situations in which the health of
children may be endangered.

For this activity you will need:

@ Handout B: Explore Difference! Question Cards (optional)

@ Flip chart and markers

@ Writing materials for participants

Step 1:

Step 2:

Step 3:

Ask the group to think of areas of health in which cultural beliefs
and practices differ. Use Handout B: Explore Difference!
Question Cards from Activity 3 for suggestions, or participants
may think of their own examples. Think about differences in
beliefs concerning:

* causes of illness

* — ways to maintain health and prevent illness

* — sources of health information and treatment methods

+ immunizations

e the use of traditional healers

° nutrition

Form groups of three and ask each member to play a role. One
person will be a parent; one will be a Head Start teacher, family
service worker, health aide—any role that has direct contact with
parents; the third will be a “coach.” Ask them to choose a health
situation to discuss.

Ask the group to spend 10 minutes or so role plaving a
discussion of the chosen health area. The worker is concemed
about the family’s health in that area, and the parent is

explaining how family members are handling the problem in the
context of their own health beliefs and practices, which differ

Health and Wellness—What Do They Mean?

ry 15



Module 2

Points to Consider: + Health information is personal and records should always be kept
confidential. Health information should be shared only with the

individual’s (or parents’) permission, and only when necessary for the
individual's care.

* Patterns of health needs emerge when we take a close look at
information about groups of children and families. We need to examine
the facts before we jump to conclusions.

Every community has many sources of information to explore. A
health snapshot could be a part of planning for expansion.

28 38 Laying a Foundation in Health & Wellness



Module 1

Points to Consider:

Step 4: Pe

§ Out Handout A: The Wellness Pinwheel and ask participants
to pair off. Take 5-10 minutes for each person to reflect on his or
her role in Head Start, then to write on the Pinwheel one or two
ways that he or she supports children’s health in cach area. After
they have finished, participants should show what they wrote to
their partners.

If someone leaves any petal of the Pinwheel blank, the partners
should brainstorm to identify what they could do in that area,
well as things that they currently do but don’t recognize as
health-supporting. Many things that staff do support health in
several areas. Not everyone will be able to list something in
every area and that is okay. Just encourage them to be as
comprehensive as possible.

Ss

Step 5: Ask participants to share some of their ideas with the larger

group,

Close the activily by remarking on the many ways that each
person contributes to wellness. Congratulate the participants on
their good work. Encourage them to continue to support wellness
ina variety of ways.

Wellness is a multi-faceted, dynamic state. No two people's
perceptions of wellness are the same. and anyone’s delinition of
wellness may change over time.

There are many ways to promote wellness.

Chronic illness or disability do not stop anyone from achieving a high
personal level of wellness.

Caring for our own health as caregiver
coworkers, children, and parents.

sends an important message to

10

Laying a Foundation in Health & Wellness



Module 3: Planning for a Healthier Tomorrow

Handout O: Disease Prevention/Injury Protection

Component Area

What We Do Now

How Could We Do Better?

72

Laying a Foundation in Health & Wellness


Module 3

Step 4:

Step 5:

Observing the children and considering the above questions, it’s
Clear that children leam by watching adults, even w’.en that is
not what we intend! Keeping that in mind, review ue list of be-
haviors we encourage in children. Do you ever have occasion to
model these behaviors? If there are other positive health behav-
iors you model, add them to the list. “Teachable moments” hap-
pen all the time, in and out of the classroom.

I can model...

Using words to resolve conflict Eating wholesome foods

Sharing Expressing feelings

Wearing seat belts Exercising regularly

Reading Not smoking cigarettes

Washing hands Using a tissue to wipe
nose

Cleaning up after myself Car-pooling or using
public transportation

With a partner, consider how your staff models health prac-
tices—during the course of their day with Head Start children
and famities—that lead to better health at all three levels:

. basic health needs
. disease prevention and protection from injuries
. health promotion

What more can be done? For example, using the above list:

° Wearing seat belts protects from injury—What could
staff in each component area do to encourage safe
travel?

. Expressing feelings is a basic human need, along with

the need for somcone to hear about those feelings—What
more could staff in each component area do to encourage
appropriate expressions of fectings?

62

56

Laying a Foundation in Health & Wellness



Introduction

Overview

Purpose/Goals

Audience

Performance Standards

Staff can use Laying a Foundation in Health & Wellness to begin to
explore the Head Start approach to health. This guide:

+ explains how important health is to Head Start’s central mission: to
encourage social competence;

e offers opportunities to arrive at personal definitions of health and en-
courages a comprehensive view of health and well-being;

* presents a visicn of health serviccs that begins with the basic health
needs, builds to include prevention of illness and injury, and expands
to the promotion of positive health behaviors;

+ clarifies for all staff how they contribute to the health of children,

families and fellow staff members through daily activitics and role
modeling.

This training guide is for all staff in a Head Start program. It explains
what they need to know about health and wellness in Head Start,
«New staff can learn Head Start’s approach to health.

Experienced health staff can use the guide as a review of health con-
cepts, and get ideas for training new staff.

+ For staff members who do not see thentselves as responsible for health
work, the guide can help them understand how important their work is
in promoting the health of children, families and staff.

Ideas and activities in this guide also can be adapted for parent and child
education,

The Head Start Performance Standards address practices and policies that
relate to the health of children, parents and staff, Overall, programs are
directed to:

provide comprehensive health services Wat help children develop to-
ward the overall goal of social competence;

* teach healthy behaviors that help prevent health problems, identify
illne: nd injuries, then ensure delivery of carly intervention strate-
gies and treatment;

Introduction



Module 2

on

Why do children in low-income families experience more
health problems?

We know that social, emotional, spiritual, and environmental
factors affect physical health. Low-income families may be
stressed in all of those dimensions; consequently, physical health
is affected. Lack of income limits access to health care services.
Some factors that influence low-income families’ health are in
their control (behaviors such as smoking, food choices), and
Others are not (systemic class- and race-based discrimination).
High risks for low-income families include exposure to
environmental hazards resulting from unsafe and unhealthy
neighborhoods, poor housing, poor nutrition, inadequate
preventive cire, and barricrs to care.

What is Head Start’s role?

Most children in Head Start are from families with incomes of
less than $12,000 a year. Even so, children in Head Start are
healthier than children from low-income families who do not
receive Head Start services. Head Start children are more likely
to get preventive care such as immunizations, have better
nutrition, fewer cavities, and practice better dental hygiene. Head
Start makes a difference! You make a difference!

Social Competence and Health

Building “social competence” has been the central goal of Head Start since
it began in the 1960s. Social competence means everyday effectiveness for
now and in the future. Everyday effectiveness means different things for
different people, but it can include:

For Children:

v

v

ability to play with friends cooperatively

ability to perform basic developmental self-care skills such as
dressing, cating, communicating needs

ability to cope with everyday stress such as waiting for their turn,
resolving conflict over sharing

ability to learn

ele.

Linking Health and Social Competence



For use with Activity 7

Module 3: Planning for a Heaithier Tomorrow

Handout J-2: Team A (copy onto yellow card stock and cut out)

drive a car
everywhere

cigarette
smoking

use alcohol to

forget, instead
of dealing

with problems

grow up ina
family where
violence occurs

forget to
wear
seatbelts

feel tense and
hurried to
pet things done

use hitting

as a way of

disciplining
children

use sweet
foods as a
reward

G2

64

Laying a Foundation in Health & Wellness



Module 3: Planning for a Healthier Tomorrow

Handout K-2: Team B (copy onto yellow card stock and cut out)

isolate believe that lift children
exposed to living with yourself from. you must quickly
asbestos lots of friends and excel at and without
air pollution family everything bending knees
live with
believe that someone who watch TV eat late
be overweight children must abuses more than at night
behave all of alcohol or three bvurs
the time other drugs each day
have unmet
needs left living with
over from asmoker
childhood
~
i
2
3
x
=
F
3 vt
5
x

66 Laying a Foundation in Health & Wellness



ry Module 3: Planning for a Healthier Tomorrow

Handout L-1: Team C (copy onto green card stock and cut out)

Healthy Skin

(Fewer Wrinkles & Less Skin Cancer)

Strong Bones and Teeth

Happy, Alert Old Age

[ Ananoy ystat asn 40.

Laying a Foundation in Health & Wellness

67



For use with Activities 3 & 4

Module 1: Health and Wellness—-What Do They Mean?

Handout B: Explore Difference! (continued)

Fill in these cards with your own questions or use for translation purposes.

Question Card #5

Question Card #6

a.

i)

2 Laying a Foundation in Health & Wellness



Resources
e

Books & Journals: Benson, Herbert, and E.M. Stuart, et al. THE WELLNESS BOOK: The
Comprehensive Guide to Maintaining Health and Treating Stress-
Related Illness. New York: Simon & Schuster, 1992.

This comprehensive guide provides basic information on how to com-
bine personal behaviors and scientific health care to enhance health
and wellness. Written in a self-help format that explains how to iden-
tify needed behavior changes and ways to make those changes. Topics
include the mind/body connection, exercise, nutrition, stress manage-
ment, and relapse prevention.

Boston Women's Health Care Collective. The NEW Our Bodies, Our-
selves—A Book By and For Women. New York: Touchstone/Simon &
Schuster, 1992.

This complete source book on women’s health care emphasizes what
women can do for themscives and for one another. For example. top-
ics include Body Image. Health & Healing, Environmental &
Occupational Health, and Developing an International Awareness.
The authors offer useful tools and ideas to enable women to take
greater charge of their own health care. They discuss nonmedical per-

@ spectives and remedies as well as snedical ones,

Editors of the Wellness Letter, U.C. Berkeley. The Wellness Encyclope-
dia. New York: Houghton Mifflin Company, 1991.

This thorough reference source of positive. practical health guidelines
is clear and up-to-date. The Wellness Encyclopedia is divided imo
five major parts that correspond to key areas of wellness: Longevity.
Nuwition, Exercise, Self-care, and Environment & Safety, Much in-
tormation is offered on how to work with family. friends and members
of the community to solve health-related problems, Tips and interest-
ing facts on how to change old habits for new healthier ones. Proce
for change presented in manageable steps.

Jo Imlay and Jerry Howard, “Listening for a Change.” Nesy Age Journal,
(Nov.-Dee. 1993),

article describes the background and tenets of The Listening
Project. a grassroots organization based in the southern U.S. that is
devoted to community organizing and social change, Headed by a
southerner and Buddhist disciple, the organization stresses empathy
and listening in an effort to dispel long-held southern attitudes of rac-
ism and social injustice. The skills which are developed by The
Listening Project staff are valuable for anyone whose work requires
patient listening and understanding of a variety of beliet’s, Such skill is
certainly relevant when Head Start families present different—and
sometimes disturbing—beliefs and practices about health,

Laying a Foundation in Health & Wellness 1

SU



Contents

Continuing Professional
Development 75

Some Concrete Actions to Take

Resources 17
Books & Journals ..... Seeeseseseeuesssueseecseeesseeneneese
Health & Wellness Newsletters
Head Start Publications
Miscellaneous

Laying a Foundation in Health & Wellness



Contents

Handout C: Health Snapshot Worksheet ............ +. 38,

svssaseneensesees 3D

Handout D: Jelani's Story ......sssscssecsserseeneeees

Handout E: Dwayne's Story ......sssssseeesseseen sveasenee:
Handout F: Kyle's Story

Handout G: Huilin's Story ........csesssseessees sssseeseseneescensecasesnessensseeee 42

Handout H: Irma's Story .........000

wsvssssscsssecsssssreencssscsscsnssees 43,

Handout I: Consulting Circle Framework .....ssssssssesseesssessserseee 44

Module 3 45

Planning for a Healthier TOMOrrow .......sscssesseseesseees
Outcomes
Key Concepts
Background Information
Activity 1: Connections .....
Activity 2: Role Modeling
Activity 3: Head Start Center Action Plan
Next Steps: Ideas to Extend Practice...

5S
59
62

Handout J-L1: Tear A sssesssssssessssssssessssersenesssnsesneesscssscessecssseetsecsses 63

Handout J-2: Team A sssesssrsccrsessesseseresssessssceerscesssssscaneessscssesseveese OF
Handout K-1: Teatt B wsssssesssecsssersseessseessee oostr verses seceneee OS
Handout K-2: Team B +0 66
Handout L-1; Team C
Handout L-2; Team C.
Handout M-1: Team D
Handout M-2: Team D ..
Handout N: Basic Health Needs.....ssssesssseeseeesees

Handout O: Disease Prevention/Injury Protection .........s0s08 72
Handout P; Health Promotion .. ssaseessseavecssecssseonvovsseceseessee 13
Handout Q: Head Start Center Action Plan .........

vi

Laying a Foundation in Health & Wellness



Module 1

Activity 2:
Wellness in
My Life &
My Work

bo

|

HU

Purpose: This activity encourages Head Start staff to consider the many
dimensions of health, and the ways they support wholistic health in the

children.

For this activity you will need:

@ One copy of Handout A: The Wellness Pinwheel for each participant

@ Writing materials for each participant to keep a one-day journal

Step 1:

Step 2:

Step 3:

Step 4:

Step 5:

Ask each staff person to keep a simple journal for a day. Tell
each one: Take a few minutes each hour on the hour to jot down
how healthy you feel. If you are feeling very well, what has
happened during the past hour to make you feel that way? If you
are not feeling well, why not? What happened to make you feel
that way? Consider everything that has had an impact on your
day: people, your environment, what you are eating and drinking,
how you are getting from place to place.

Sit down together and take a look at what contributed to health
during the day. Check against the Wellness Pinwheel. Are there
items in your journal that relate to each of the five dimensions of
health? If any dimension is not represented, is it present but
simply not apparent on this day?

Discuss how the various dimensions of health interact. Do you
recall a time, for example, when you became distressed and then
experienced a physical symptom? What is your state of mind
when you are feeling physically healthy? Can you see the
interrelationship?

Select a time when you can work with a partner. For an hour or
SO, observe as your partner interacts with children in the Head
Start program. How does she support the health of children in all
five dimensions? At another time, your partner should observe
you. Ask her to make note of everything you do to support
children’s wellness.

Spend about 30 minutes with your partner discussing what you
observed. Are there ways that you could increase your support of
children’s health? Are you attending to the multi-dimens’ onal
health of children? Congratulate each other for all that you do to
support wellness.

Health and Wellness—What Do They Mean?

LJ



Preface

su BUE A

A to Lr.

San LE}

some changes, feel free to adapt. You may also want to change language or
examples to make the material more compatible with your community. The
order of activities and the ideas and strategies are suggestions; each user
will find some things more useful than others.

This i:aining guide was developed over a ten-month period. We solicited
ideas from the Head Start Bureau in Washington, from programs in the
field, and from Regional Offices, Technical Assistance Support Centers
(TASCs) and Regional Access Projects (RAPs) for Head Start. We made
many revisions to activities and concepts based on this feedback.

We are also grateful to those Head Start programs which allowed us to
visit them and field test activities and to the many staff people from Head
Start programs throughout the United States who gave feedback during
conferences and regional training sessions.

The ultimate test of any staff development tool is how well it transfers to
use in the everyday work setting. Best practice standards for adult learning
tell us that this takes place best when learning occurs over time and skills
and knowledge learned in a workshop or coaching session are supported by
follow-up activities, To help learners, trainers, and coaches design long-
term learning plans, all of the Training Guides for the Head Start
Learning Community include sections on continuing professional
development. We also know that adults, like children, learn when they are
playing—and so we hope that you have fun,

qs

Laying a Foundation in Health & Wellness



Resources

2. U.S. Dept. of Health and Human Services. Child Health USA '93.
Alexandria, VA: Matemal & Child Health Publications Center (DHHS
Pub. No. HRSA-MCH-91-1).

This booklet is the fifth annua! report on the health status and service
needs of America’s children. The publication brings together data
from various sources and presents in graphs, charts, and simple text
the sentinel measures by which to assess how well children are faring.
Information is presented on the health of children in various develop-
mental stages.

Miscellaneous 1, Bullard, Robert D. People of Color Environmental Groups 1994-95
Directory. Environmental Justice Resource Center—Clark Atlanta
University, Atlanta, GA, 1994.

A directory cataloging more than 300 people-of-color environmental

groups, Complete with a resource section and annotated bibliography,

this guide is a useful tool for planning, organizing, and networking

within environmental and economic social justice issues. The book

gives acomprehensive overview of the concept of environmental jus-
e@ tice—its origins, development and real-life applications.

2. The Elders of Cambridge. Recipes for Good Health: A collection of
home remedies, wisdom and cultural traditions. Cambridge Repro-
Graphics, Cambridge, MA, 1994,

Aneclectic, colorful collection of ideas and suggestions on how to
maintain good health. Compiled from the advice of more than 100
elders aged 51-100, this pamphlet is a unique testimony to past tradi-
tions from a variety of cultures.

aw

Laying a Foundation in Health & Wellness 19

EE



Module 1

Points to Consider: * Health practices that differ from those with which we are familiar and
comfortable can be beneficial, neutral, or harmful. We must be careful
about assuming into which category . 1e practice falls.

¢ Often significantly different practices can be used in a complementary
way, i.e., chicken soup and antibiotics or acupuncture to assist healing
after surgery.

we

Health and Wellness—What Do They Mean? 7



DOCUMENT RESUME

ED 394 737 PS 024 218

TITLE Laying a Foundation in Health and Wellness. Training
Guides for the Head Start Learning Community.

INSTITUTION Bowman (James) Associates, San Francisco, CA.

SPONS AGENCY Administration for Children, Youth, and Families
(DHHS), Washington, DC. Head Start Bureau.

PUB DATE [94]

CONTRACT 105-93-1578

NOTE 85p.

PUB TYPE Guides - Classroom Use - Teaching Guides (For
Teacher) (052)

EDRS PRICE MFO1/PCO4 Plus Postage.

DESCRIPTORS *Child Caregivers; “Child Hezith; Early Childhood

Education; “Family Healti; Health; Health Needs;
Health Programs; “Health Promotion; Health Services;
Learning Activities; *On the Job Training; Personnel;
Skill Development; *Staff Development; Staff Role;
Training; Training Objectives

IDENTIFIERS Caregiver Training; Professional Concerns; *Project
Head Start

ABSTRACT

This training guide is designed to aid Head Start
staff in exploring personal understandings of health and wellness and
to further their contribution to the health of coworkers, children,
and families. It explains the importance of health to Head Start's
mission--to encourage social competence; promote the development of
personal definitions of health; and present a vision of health
services that begins with basic health needs and expands to the
promotion of positive health behaviors. Each training module consists
of the following segments: expected outcomes, key concepts,
background information, questions for discussion/reflection, outlines
of 1 arning activities, handouts, points to consider, and ideas to
extend practice. The three modules are: (1) "Health and
Wellness--What Do They Mean?," aimed at developing individual
definitivus of health, increasing communication about health issues,
and increasing effectiveness as resource persons; (2) “Linking Health
and Social Competence," focusing on identifying health issues in
children and designing an action plan; and (3) "Planning for a
Healthier Tomorrow," helping individuals and teams develop strategies
that incorporate health promotion into interactions with Head Start
staff, children, and families. The conclusion suggests actions for
continuing professional development. Contains 14 references. (BGC)

a

Reproductions supplied by EDRS are the best that can be made *

from the original document. *
Fede de de dee ae de de de de dese de de te sede de He ak de ded de ae ak de de Tee de sede eke te de de te de see ede dee de de se de ae a ak ae ae ae de ae ae ae He



Module 2: Linking Health & Social Competence
Handout F: Kyle’s Story

Kyle was late to work because she had a fight with her boyfriend this morning. They have been fighting a lot
lately. On the way to work she began to have a headache and upset stomach. When she arrived she entered a
room where the children in the housekeeping area have started to play in a way that could be dangerous—they are
climbing onto the playhouse roof and jumping off. Kyle finds herself yelling at the children and being a bit rough
with the Icader of the group as she leads her away to talk about it. Kyle feels very angry. At recess, her teaching
team partner suggests some ways she might have handled the situation differently, and Kyle yells at her.

A. What factors could be limiting Kyle’s social competence?

Physical:

Emotional:

Spiritual:

Social-Cultural:

Environmental:

B. Given the possible causes you have listed, what can you do to help?

Right now:

Long term:

Laying a Foundation in Health & Wellness 41

OV YIM asm 10g



Introduction

Orientation to Foundarion Guide

The Foundation Guide has five working sections

a Module 1: Health and Wellness—What do they Mean?
i Module 2: Linking Heaith and Social Competence

a Module 3: Planning For a Healthier Tomorrow

a Continuing Professional Development

a Resources

Fach module is organized to provide learning opportunities tor a workshop
session or for coaching. Each has the following segments:

* Expected Outcomes are the skills which should be acquired by stalt
who participate in the module's act .

+ Key Concepts are the main ideas conveyed in the module.

* Background Information elaborates on the Key Concepts. This see-
tion is arranged so that it can be used as a coaching resource or as an
outline for a presentation ina group s on. Background information
sections can be used for handouts or as overheads to use in workshop:
sessions,

* Questions for Discussion/Reflection are at the end of cach back
ground section. They can help initiate discussion in workshops or
coaching s ons oF Serve as prompts for staff journals.

+ Learning Activities build the skills which are needed to achieve the
outcomes stated for each module. Managers can choose to use work-
shop activities, coaching activities, or a combination of beth,

+ Handouts are included at the end of cach module. Trainers should
reproduce the handouts as needed for participants.

* Points to Consider are issues listed at the end of each activity to Keep
in mind or to use as discussion prompts while working through the
activity

+ Next Steps: Ideas to Extend Practice are additional activities to rein
force the expected outcomes and enhance transfer of skills front train
ing to the work setting.

Introduction



Introduction

help families to develop skills and linkages that the family can use to
get necessary health care after leaving Head Start;

work toward safe- and health-promoting env.ronments at school, home,
and within the community; and

recognize that parents are a child’s primary health care decision-maker
and health promoter and offer support to them to fulfill that role.

w

Laying a Foundation in Health & Wellness



Modul? 3

Activity 2:
Role Modeling

a

is

&

Purpose: This activity is to help staff reflect on the way children Icarn and
the power staff hold as role models of health behavior.

For this activity you will need:
@ An opportunity for participants to observe children at play

M Writing materials including note pad for each participant

Step 1: Review the background information for Module 3. Arrange fora
time to watch a group of children in your program during free
play. If you are not regularly in the classroom, you will have to
arrange to do this with the classroom staff at a time that they feel
it would not be intrusive.

Step 2: Observe a group of children at free play for at least 20 minutes.
Bring paper and pencil and jot down your observations. What
language or behavior are they copying from the adults around
them? Make notes of the play the children are engaged in, the
language they use.

Step 3: Immediately after the observation period, or at another time,
review your notes and consider the following questions:

a. Did you see the children engage in behavior or hear them use
language that they copied from adults? That they copied
from TV or movies? Did any of the behavior or language
relate to health habits?

b. Do you think that someone taught them that behavior, or did
they just pick it up by listening and watching?

c. Did you notice any behavior or language that adults might
disapprove of? Assuming these things were not formally
taught to the children, how did they learn them?

d. Has achild ever copied something that you said or did? Was
it something you wanted the child to do? Were you surprised
that the child had leamed it?

Planning for a Healthier Tomorrow 55



Module 2

Invite a Local Health Expert to Be a Guest Speaker

If learning about the health status of children in the program generates
interest and curiosity, capitalize on it! Invite a local public health official
or a health/environmental community activist to speak at a staff/parent
gathering about health conditions for children.

Make Wellness and Everyday Effectiveness Part of Routine
Assessment

Review your family needs assessment format. Ask yourself: Does this
assessment capture information about all the dimensions of health? Does it
look for strengths as well as problems? Does it help us to know about the
child’s everyday effectiveness? If the answer to any of these questions is
no, consider how the assessment might be changed to become more
comprehensive.

Linking Health and Social Competence 37



Module 2

Relative Frequency of Health Problems ia ‘Children in Low-Income
Families Compared with Other, Children*

Health Problem Relative Frequency

Delayed immunization wiple

Asthma higher

Lead poisoning wiple

Death in the first nionth of life triple

Child death due to injuries double-triple

Child death due to disease tiple-quadruple

Percent with conditions limiting school activity | double-triple

Lost school days 40% more

Severe iron-deficiency anemia double

Delays in growth and development double

B, Health Status Questions & Answers

. Why is it important to know about all of these health
problems?

Pinpointing the problems lets us know where to take action.
Knowing the threats to health that low-income families face, we
can offer our respect and affirmation to families who are working
hard to achieve and maintain wellness. It is easy to become
frustrated with families who may not be taking care of health
concerns the way we want them to, Understanding that their
health problems are shared by other low-income familics is a sign
that some of the health risks they live with are not within their
control, rather they are built into the system. Unless we can.
identify the barriers we cannot help families to overcome them
through individual behavior change or organized action for
change in the community that will improve health (housing.
transportation, discrimination, health insurance. other factors).

“Barbara Starfield, "Child and Adolescent [lcalth Status Measures" (1992), article from The Future of Children
(volume 2, number 2), the annual report of The David and Lucile Packard Foundation,

Children’s Defense Fund, The State of America's Children, 199] (Washington, D.C. The CDM Group, Inc.). as
cited in A Descriptive Study of the Head Start Health Component: Literature Review (1994).

Adams and Hardy, Current [Estimates from the National Health Survey, United States, 1988, as cited in A De-
scriptive Study of the Head Scart Health Component: Literature Review (The CDM Group, £994),

Laying a Foundation in Health & Wellness

24 g

c



For use with Activuy 2

Module 2: Linking Health & Social Competence

Handout G: Huilin’s Story

Huilin’s teachers have noticed big changes in her behavior recently. Usually she is very quiet, so quiet it is casy to
forget she is in the room. She rarely raises her hand to participate at cirele time and needs encouragement to play
with other children. Lately, however, she has begun following along with stories and sometimes will even call out
an answer or talk about a picture that is shown at story time. Huilin’s vision screening at the start of the school
year had indicated she might need gl Her parents were initially reluctant to take her to see a specialist, but
Grandma intervened. Now, following a series of appointments, the eye doctor has prescribed glasses and eye exer-
cises for Huilin.

A. What factors could be limiting and supporting Huilin’s social competence?

Physical:

Emotional:

Spiritual:

Social-Cultural:

Environmental:

B. Given the possible causes you haye listed, w‘sat can you do to maintain or support social compe-
tence?

Right now:

Long term:

42 Laying a Foundation in Health & Wellness

4u


Module 2

Linking Health and Social! Competence

Outcomes

Key Concepts

Background Information

After completing this module, participants will be able to identify health
issues in children that limit their evervday effectiveness and devise an
action plan to improve effectivene

Social competence, as defined by Head Start, emphasizes skills and
behaviors that improve “everyday effectiveness.” Basic health needs
must be met to achieve social competence.

To support health, we must know the health status of Head Start
families.

Each person finds her or his own level of wellness and everyday
effectiveness—everyone is different and everyone changes throughout
life.

Joining families as partners in their health supports Head Start’s
central mission to develop social competence.

A. Health Status

Many things contribute to health, including family background. personal
behaviors, environment, and access to services. Some things that influence
health are in our control, others are not. One thing we know: In general.
some groups experience more health problems than others. Communities of
color (regardless of income level) and low-income families (regardless
race) carry a disproportionate share of preventable disease and injury.

Linking Health and Social Competence 23



e Module 3: Planning for a Healthier Tomorrow

Handout J-1: Team A (copy onto red card stock and cut out)

Emphysema/
Lung Cancer

Depression

Obesity

rr
1 Snanoy yin asn dog

Laying a Foundation in Health & Wellness 63



Preface

To Your Health!

We can learn about health and wellness by following the lead of children.
Think of Kenya, who has diabetes that she and her mom together have
Icarned to manage. Kenya has an illness, but Kenya is experiencing
wellness—she is a little girl who is learning, laughing, growing in spirit
and body. Kenya is thriving. Think then of Lucas. Lucas comes to school
hungry some mornings. When Lucas is hungry he can’t concentrate, or
play cooperatively, or feel good about a world where his basic needs are
going unanswered. Kenya and Lucas don’t separate themscl ves out into
components or disciplines; they simply engage in the world as integrated
and complex people. Although Kenya and Lucas may not be able to say so,
they each know that health and wellness depend on all the parts of
themselves functioning in harmony.

Each member of the Head Start family can play a role in promoting and
supporting the health and wellness of children, families. and communitics
so that \e can all thrive. Laying a Foundation in Health & Wellness is a
foundation training guide which can help participants explore their
personal understanding of health and wellness and further their
contribution to the health of coworkers, children, and familics. It
encourages a vision of health and wellness that is wholistic, preventi* + and
inclusive.

It’s easy to get caught up in the “medical model,” where we only think
about health if it’s not there. Yes, it is important to measure hematocrits,
check to be sure that immunizations are up to date. and practice good
infection control. However, our children and our spirits tell us that there is
more to health than the absence of illness! When we look at “wellne
consider Low a wellness attitude can improve our own health and the
health of the children and families we serve, it gives us a different
perspective. Wellness means every person is always striving in her own
way to be the best she can be. She may have a physical disability; she may
have an emotional difficulty—nevertheless she knows what makes her feel
well.

Training Guides for the Head Start Learning Community are designed
to help programs support and enhance quality. The Foundation series is for
all staff and sets forth the core principles and practices of the Head Start
approach, The guides which follow are more specific and may be used by
the management team to address needed technics rain job
categories, Together they make up a comprehensive staff development
library across all of the Head Start functional areas.

The concepts in this guide build one upon the other, so it is best to proceed.
trom the beginning to the end. However, we encourage users to adapt the
learning activities to their own situations. For example. if one of the
workshop activities Would work well for you in a coaching situation with

Laying a Foundation in Health & Wellness


Module I

Points To Consider: © Health beliefs vary between and within groups. Different people from
the same culture may have beliefs influenced by education, personal
experience, acculturation, and other factors. That’s why it is important
not to make assumptions, such as, “all Asians are uncomfortable with
eye contact,” or “all African-Americans encourage carly toilet
training.”

* The “correct” way to approach some healt’. issues changes over time.
Our parents were told to lay babies on their stomachs to slecp; now
experts tell parents to put their babies to bed lying on their backs or
sides,



Module 3

Key to Handouts J -M
OUTCOME Cards

1, Emphysema/Lung Cancer

2, Depression

3. A Bad Back

4, Injury Through Family Viol ce

5, Obesity

BEHAVIOR (or CONDITION) Cards

Cigarette smoking
Living with a smoker
Exposed to asbestos

Living with lots of air pollution

Isolate yourself from friends and family
Believe that you must excel at everything

Use alcohol to forget instead of dealing with
problems

Have unmet needs left over from childhood

Forget to wear seat belts
Lift children quickly and without bending knees
Be overweight

Feel tense and hurried to get things done

Grow up ina family where violence occurred
Believe that children must behave all the time
Use hitting as a way of disciplining children
Live with someone who overuses alcohol and
other drugs

Watch TV more than three hours each day
Use sweet foods as a reward

Drive a car everywhere.

Eat late at night

Planning for a Healthier Tomorrow

53



Resources

J. Melvin Witmer and Thomas J. Sweeney, "A Holistic Model for Wellness.
and Prevention Over the Life Span," Journal of Counseling and De-
velopment, vol. 71 (Nov.—Dee. 1992).

‘This well-documented essay presents an innovative approach to the
U.S. model for human development and health services. Pointing out
that 53% of deaths in the U.S. are caused by negligent and self-de-
structive life style behaviors, the authors propose a preventative model
of wellness to illustrate how the characteristics of a healthy person—
spirituality, self-regulation, work, friendship, and love—are
interconnected with overall well-being. The ultimate goal for any per-
son, the authors concur, is not merely adequate but optimum health.

Health & Weliness Several informative newsletters cover a wide variety of health and wellness

Newsletters topics. Following is a list of a few newsletters and their subscription infor-
mation. Also check with your local universities, health departments and
federal agencies for other publications.

University of California at Berkeley Wellness Letter, Published
monthly—subseription $24 per year, Health Letter Associates, P.O.
Box 420148, Palm Coast, Florida 32142 (phone 904/445-6414).

Harvard University Health Leuer. Published monthly—subscription ©
$24 per year. Harvard Health Letter, P.O. Box 420300, Palm Coast,
FL, 32142-0300 (phone 800/829-9045),

Tufts University Diet & Nutrition Leer. Published monthly— sub-
scription $20 per year. Tufts University Diet & Nutrition Letter, P.O.
Box 57857, Boulder, CO. 80322-7857 (phone 800/274-7581, in Colo-
rado, 303/447-9330),

Hope Health Leter, Published monthly—subscription $19.80 per
year. The Hope Heart Institute, $28 18th Avenue, Seattle. WA 98122
(phone 616/343-0770).

Pediatric Report's Child Health Newsletter. Eleven issues plus a
yearly index, $35 per year. Pediatric Report's Child Health Newslet-
ter, Box 155,71 Ho: * Street, Providence, RI 02906-2062.

Head Start Publications 1. U.S. Dept. of Health and Human Services. Getting and Staying
Healthy: A read Start Handbook for Parents. Alexandria, VA: Head
Sturt Publications Center.

This handbook is written in a very friendly, accessibic style ard
touches ©: nearly all of the areas needed when discussing aspects of a C
healthy life style,

| _ 84

| 78 Laying a Foundation in Health & Wellness



Module 3

Points to Consider: * Most programs offer services in the middle level: disease prevention
and protection from injury. Examples of such services are lessons in
using a toothbrush, washing hands, providing food that is nutritious
and adequate. Sometimes it is a challenge to think of what we can do

in the other two areas. Sometimes what is done in basic health needs is
“invisible.”

* Each component area can address health services. Those that are not
traditionally thought of as health areas, such as management or social
services, may have a hard time imagining how they help or how they

y can help. But, without each component team committing effort in its
own way, the entire effort will be limited.

Planning for a Heelthier Tomorrow 61


Module 2

Points to Consider: + Like wellness, everyday effectiveness is made up of a balance of skills
and capabilities in many dimensions. We strive to attain well-rounded
development and compet nee.

+ Basic health needs, if not attended to, can interfere with everyday
effectiveness. On the other hand, high-level wellness (health over and
above freedom from pain and illness) can raise the level of
effectiveness.

32 Laying a Foundation in Health & Wellness



174

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Module 2

Activity 3:
Consulting
Circles

Purpose:This activity offers a framework for a team of Head Start staff
people to look at everyday effectiveness from a wholistic perspective:

+ wholistic in terms of areas of health considered; and

e wholistic in terms of team communication practices.

For this activity you will need:

@ One copy of Handout I: Consulting Circles Framework for each
participant

@ Writing materials for participants

Notes to Trainer: Although this is a staff training activity, it can
be enhanced by the participation of a parent in the group discus-
sion. If there is an interested parent who feels comfortable being
involved in this exercise, please include her. If a parent is not
available, a staff person should take the role of a parent in the
discussion. Throughout these instructions, “parent” can be taken

to mean either an actual parent or a staff person playing that
role.

Step 1: Discuss with the participants the information outlined in the
background information related to everyday effectiveness, social
competence, health and health status. Explain that generally,
when everyday effectiveness is affected by a health concem, itis
not a simple issue. Parents often use Head Start staff as
resources when they have concems about their children. A parent
is likely to raise ¢ concern about a child’s everyday effectiveness
with the staff person with whom she is most comfortable.
However, the staff person can best support the parent in her
concem if the staff person calls on the expertise of the entire
Head Start team.

A ground rule of confidentiality needs to be set up in any
group discussing families, and parents need to be informed
and consent to the fact that information about their child’s
experience at Head Start will be shared with the team.

Linking Health and Social Competence

33



Module 3

Questions for Discussion!
Reflection

Cc. Where Can Head Start Work to Improve Health?

Head Start can intervene in health by providing services to families
regarding:

+ Basic Health Needs:

food, clothing, shelter, nurturance, treatment of acute illness/injury
conditions, safety

Disease Prevention and Protection from Injuries:

immunizations, safe environments, early intervention/
screening, smoking cessation programs

Health Promotion:hcalthy social relationships, personal satisfaction,
self-esteem, environmental appreciation, spiritual growth, physical
fitness,

How does thinking in terms of the three levels of health—as described
above—‘stretch” your vision of health services in Head Start?

Since parents are primary role models, how can we support health
teaching in the home?

What messages did your family give you about health habits related to
cating, sleeping, or exercise? Do you still have habits that you devel-
oped inchildhood?

Have you knowr. anyone who made a major change in lifestyle: quit
smoking, started a walking program, took up meditation...Has that
person found himself to be happier?

Laying a Foundation in Health & Wellness



For use with Activities 3 & 4

Module 1: Health and Weilness—What Do They Mean?

Handout B: Explore Difference!

Question Card #1
a. How do you treat a common cold?
b.

Is this what your parents or grandparents would have done? Do you think your children will treat
acold the same way?

What would you do if someone asked you to use a different treatment or said your approach was
harmful?

Question Card #2

a. What are the best foods for a baby under one year old?

b. At what age does the baby begin eating solid food?

c. At what age do you think a baby should no longer be drinking from breast or bottle?
d. How is this like or unlike what your parents or grandparents believed? Will your children do this
when they are parents?
Ow
mw
20

Laying a Foundation in Health & Wellness


Module 3

Points to Consider:

Step 7: Now go around the room and ask each group to read an outcome

card and list the behaviors that lead to that outcome.

Step 8: Ask each group to choose one outcome in their set that they think

can be most strongly affected by a Head Start program through
role modeling, not program activities. Ask them to describe ex-
actly what they do in this area to encourage healthy behaviors
and discourage unhealthy ones.

One behavior may have many effects, good and bad.
Many outcomes are very long-term, and won't be seen for many years.

Some behaviors and situations are in our power to change, some are.
not. However, we can usually affect the overall outcome. If a person's
family has an unfortunate tendency toward heart disease, he can still
minimize his own risk by not smoking, eating low-fat foods, managing
his stress, and enjoying aerobic exercise several times a week. If an-
other person's family of origin was abusive and overused alcohol, she
can still decide to avoid alcohol herself, and look to church, friends
and coworkers for emotional support,

Are there behavior connections that you don’t agree with? Are not sure
of? Was there teamwork in making these connections?

The connections with some behaviors and situations have been well
studied. We can be sure of these; other connections are not so certain.
Where connections are uncertain—does meditation really reduce my
tisk of heart disease? —the best approach is to try the behavior if it
has a likelihood of helping and there are no indications of harm.

Planning for a Healthier Tomorrow

51

1

Cr;



Module 3

Next Steps:
Ideas to Extend
Practice

Take a Field Trip

Is there another Head Start program you know of that has had success
promoting wellness in an innovative way? If so, organize a site visit with
interested staff to observe, ask questions, and get inspired. Contact your
Regional Office for nearby sites with excellent and innovative health pro-
grams.

Schedule a Program Planning Day

Take the program plan from Activity 3 and use it as a blueprint for a
planning day to be held in conjunction with a Health Services Advisory
Committee meeting. Use the experts on the HSAC and parents as strategic
planning consultants to help you achieve your goals,

Expand the Program Plan to Staff and Families

Redo Activity #3, the Head Start Center Action Plan. Instead of having e
each group consider what they do for the health of children, ask them to

consider what they offer or what they could offer to families in their pro-

grams.

Another time, redo the activity considering the health needs of staff.

6/

62

Laying a Foundation in Health & Wellness



This national training guide was developed by James Bowman Associates,
San Francisco, California, under contract #105-93-1578 of the Head Start
Bureau, Administration for Children and Families, Department of Health
and Human Services.



For use with Activity 2

Module 2: Linking Health & Social Competence

Handout E: Dwayne’s Story

Dwayne is feeling great this morning. He arrives at work in time to carefully plan his schedule of home visits for
the day. He takes a few moments to reflect on the challenges he might face at each visit and visualizes strategies or
techniques he might draw upon to help. Out in the field, *> is able to handle the no-shows and other frustrations of
the day without losing his cool. Dwayne is diabetic, and has been working hard with his doctor to get his insulin
level adjusted correctly. Today he remembered to carry snacks with him and allowed time in his schedule to do his
blood sugar level tests.

A. What factors could be supporting Dwayne’s social competence?

Physical:

Emotional: @

Spiritual:

Social-Cultural: _

Environmental: __

B. Given the possible causes you have listed, what can you do to help maintain and support social
competence?
Right now: _

Long term:

a °

40 Laying a Foundation in Health & Wellness



For use with Activity I

Module 2: Linking Health & Social Competence

Handout C: Health Snapshot Worksheet

Instructions: — In the column on the left, list everything you would like to know about the health of children and
families in your program. In the other column, write down where you could go for that information. This is like a
written “brainstorm,” so list everything you are curious about, even if you don’t know how to find the answer.

‘Things E-would like'to: know’ about the ; Sources of inforination
vo)” health of our children. ian

38 Laying a Foundation in Health & Wellness


Module 3: Planning for a Healthier Tomorrow

Handout K-1: Team B (copy onto red card stock and cut out)

A Bad Back

Injury Through Family Violence

Laying a Foundation in Health & Wellness 65

1 (mapoy yas asn 40.4



Module 1

Health and Wéliness—What Do They Mean?

Outcomes

Key Concepts

Background Information

When participants complete this module, they will:
© develop their own individual definitions of health:

* conimunicate better with others who have different beliefs about
health; and

«he more effective health resource persons.

Health is made up of ail the parts of ourselves in relationship to the
world: physical, social, emotional, spiritual, and environmental. When
any of these parts are not well or out of balance, the other parts are
affected.

Wellness is a positive state of health, not just the absence of illness or
pain.

Health status, risk factors and health practices vary greatly. Head
Start’s vision of health and its health services programs acknowledge
and respect these differences,

Head Start supports children’s and families’ capacities to care for
themselves in every dimension of health,

ary, OF Course, as Many ways of looking at wellness as there are
Following are some of the common ways people think of the
various dimensions of health:

Physical: enjoying freedom trom physical pain and discomfort, keeping
fit, cating well, having healthy teeth, preventing illness and disease

Emotional/Mental: being happy and able to take care of basic needs for
self and family; having the ability to love, work, and play

Social/Cultural: having meaningful relationships and living in harmony
with family, neighbors, significant others, and feeling a part of a
communily

Health and Wellness—What Do They Mean?



Module 3

Step 3:

Step 4:

Step 5:

Step 6:

Tell participants they will be working in small groups to match
long-term health outcomes -vith the behaviors that cause or con-
tribute to them.

This is a friendly, competitive game to show participants the
great variety of health-promoting and health-damaging behaviors
in which we all engage. Then we link those behaviors to long-
term health outcomes.

Divide your group into four teams, 3 to 5 people per team. Give
each team the packet or envelope of cards you prepared before-
hand (see Preliminary Preparations). Tell participants to keep
their cards in their packet or envelope until you tell them to start.

When you say “go,” each team should begin to organize their
cards. They will need to sort, then fill in the blank cards; each
team has five outcome (large) cards and they need to organize
the behavior (small) cards underneath.

It is a puzzle, because some of their cards are blank. They
should fill in the appropriate blank cards with either behaviors or
outcomes. Their final product will be five outcome (large) cards
with at least four contributing behavior or condition (small)
cards under each one (see graphic below).

Behavior

Behavior.

Behavior}

First team done should call out. These team members gel a small
prize (an apple, a bookmark, a coupon for a healthy treat. . .)

Tell the teams with the red outcome cards (filled in and blank) to
get together. Tell the teams with the green outcome cards (filled
in and blank) to get together. Have them compare their results.
Where were there similarities? Where were there differences?

50

r
VG Laying a Foundation in Health & Wellness



Module 3

Points to Consider: + People learn very well through modeling because they can actually see
a behavior.

+ We model behaviors as groups and as individuals. People, especially
children, will avoid a behavior if the peer group disapproves, and will
try new things if others in the group are doing them.

Planning for a Healthier Tomorrow 57



Module 1

Activity I:
The Wellness
Pinwheel

Purpose: This activity gives participants the opportunity to think about
how the different dimensions of health interact, to consider how their job
roles support child and family health, and to affirm their good work.

For this activity you will need:

TM@ One copy of Handout A: The Wellness Pinwheel for each participant

@ Flip chart and markers

@ Writing materials for participants

Step 1:

Step 2:

Step 3:

Open the exercise by explaining that each “petal” of the Wellness
Pinwheel represents one of the dimensions of health—Physical,
Emotional, Spiritual, Social, and Environmental. If the wheel is
out of balance, if a petal is missing or damaged, the wheel cannot
spin.

Take five sheets of flip chart paper; at the top of each write one
of the dimensions of health. From the group, elicit ideas about
which behaviors and conditions contribute to health in each
dimension. Ask participants to list what is important to their own
wellness. (Or give each participant a marker and ask them to get
up and write at least one idea per dimension.)

Initiate a discussion of how the dimensions of health interact. Ask
the group if anyone can think of a time when one of their “petals”
of health was out of balance and affected their overall
functioning. People especially like to identify how the other
dimensions affect physical health. Some examples to help
stimulate discussion are:

a, an argument with your partner in the moming that leaves
you with a stomachache all day;

b. you have a sore back from lifting children all day, which
makes you grumpy;

c, children who do not receive physical affection may not grow
properly;

d. during times of emotional stress your immune system, which
fights off illness, is weakened and you catch a cold or other
infection.

Health and Wellness—What Do They Mean?



HEAD START? I j

Laying a Foundation in
Health & Wellness

Training Guides for the

Head Start Learning Community

- y

’ 5
i 1S ‘MENT OF HEALTH AND HUMAN SERVICES
Li Adm forChildrenand Families
4 Admi ildren, Youth and Families
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msec



Module 2

Activity 2:

Social 00 Purpose: This activity links sucial competence with the five dimensions of
Competence health by asking participants to analyze stories. It is intended to reinforce
and Health BX the point that basic health needs—including food, shelter, freedom from.

pain and illness, safety—must be taken care of before we can fully engage

in our developmental “work.” In each of the situations, health concerns are
having an impact on everyday effectiveness.

For this activity you will need:

Hl A copy of one story for each pair—Handouts D-H

@ Writing materials

Step 1:

Step 2:

Step 3:

Find a partner to work with. Together read the story at the top of
your handout.

Discuss the story and, irawing on your experiences as Head Start
staff, fill in the lines at the bottom of the page with ideas about
health problems or positive health behaviors and conditions that
might be affecting the situation described. These stories are
scenarios in which social competence (defined as everyday
effectiveness) is impacted, at least in part, by basic health
concems.

The five dimensions of health offer a framework for analysis.
Consider them; however, all of the situations might not have.
contributing factors in cach dimension. That is okay. If time
allows, discuss more than one story.

“After discussing the story, discuss the following questions with
your partner:

a. Have health concems ever gotten in the way of your own.
social competence?

b. Can you recall feeling particularly well and effective? What
factors contributed to that feeling?

If you want to, share your examples and think of actions that
occurred or could have occurred that would have supported your
everyday effectiveness.

Linking Health and Social Competence

3% a



Coniinuing Professional Development

re,

el

Head Start staff members are encouraged to think about health in a very
broad way. Laying a Foundation in Health & Wellness asks each staff
member to realize that her job is important in supporting the health of
Head Start children, families and fellow staff. Some staff are actively in-
volved in health education or health services; others’ roles are less obvious
but no less important.

Each staff member can use this guide as a “screen” through which to view
his job. Questions such as the following can be used to put the “screen” in
place:

+ How dol, in my day-to-day activities, support health in Head Start?
How do I support physical, emotional, social, spiritual, 2 :d environ-
mentalhealth?

+ Mycoworkers come from a wide variety of cultural backgrounds; they
represent many health beliefs and practices. How can I use my under-
standing of their beliefs to help people of similar beliefs to improve
their health?

« What do I do, day to day, to model healthy behaviors that will lead to
long-term health? What am I trying to improve about my own health?
How can I apply what I am leaming about changing my own behavior
to helping others who wish to change theirs?

Some Concrete Actions to Take

(1) Do the Head Start performance standards that are relevant to your
position in Head Start encourage you to support health in a wholistic
way? What specific directions for supporting health do they give? Do
they fall short in any way?

Are there changes that you need to make in your program to achieve
the Performance Standards for Health? How can you build on the stan-
dards to achieve excellence in your program's support for child, fam-
ily, and staff health and wellness? Which ideas from this training could
help you to meet and exceed the Performance Standards?

po

Laying a Foundation in Health & Wellness 15



Module 1

Next Steps:
Ideas to
Extend Practice

or}

Multicultural Health Fair

Stage a multicultural health fair one day at your program. Invite parents
join in and ask them and staff to make brief presentations about interesting
health practices from their cultures, Presentation: could include
storytelling, cooking demonstrations, sharing “mother wit.” Invite health
practitioners from the community (curanderas, acupuncturists,
homeopaths, herbalists, traditional healers, others) to come and explain
their approach. invite providers who do free health screenings for adults
such as a mammogram van, blood pressure checks, and/or cholesterol
ratings.

Go “Green”

Make your center ecology-smart. Build on the understanding that
environmental health is a petal o the pinwheel. Recycle paper products,
glass and cans. Buy bulk rather than prepackaged whenever possible.
Explore children’s activities that promote resource conservation and
respect for the environment. Determine whether environmentally friendly
practices save money. Document your efforts. Keer track of any savings
and income and use them to fund special projects.

Supporting the Wellness of Coworkers and Families

In the activities, “The Wellness Pinwheel” and “Wellness in My Life & in
My Work,” staff members considered how they support the health of Head
Start children. Re-do those activities with the following variations:

VariationA: — Substitute the word “coworker” for the word “child” in
eack of the instructions. How do we support the wellness
of our coworkers?

Variation B: Substitute “parent” or “caregiver” for the word “child”
in the instructions. What do we do to support the five
dimensions of health for parents/caregivers of children in
our program?

18

Laying a Foundatio.: in Health & Wel'ness


ED 394 737

PS Geec18 ©

Training Guides for the

HEAD START Af

_ Head Start Learning Community

Laying a Foundation
in Health & Wellness

BEST COPY AVAILABLE

|


Module 2: Linking Health & Social Competence

Handout H: Irma’s Story

At Irma’s Head Start, the children walk a few blocks through the city several times each day to reach a fenced-in
play area. Staff are having problems with 3-year-old Irma because, all of a sudden, she is unable to cooperate
with the group during the walk to the playground. She freezes at the first crosswalk and has a tantrum when urged
to continue. She cannot explain what’s the matter. The family service worker and mental health consultants are
called in, and they schedule a parent conference. Her parents shared that one day while walking with her big
brother Irma witnessed a shooting on the street near the playground. This occurred shortly before her unusual
behavior began. Her parents did not realize how the incident had upset her.

A. What factors could be limiting Irma’s social competence?

Physical:

Emotional:

Spiritual:

Social-Cultural:

Environmental

B Given the possible causes you have listed, what can you do to help?

Right now:

Long term:

Laying a Foundation in Health & Wellness OU 43

Z Annoy ya asm soy


Module 2

Questions for Discussion/
Reflection

For Adu'ts:
/ ability to relate to others: family, friends, coworkers

/ ability to handle most day-to-day activities: budget, buy
groceries, keep appointments, get car repaired

ability to meet responsibilities
ability to know when to seek help

Vv etc...

Many things we do every day in Head Start help children to be effective in
their world. We also know that learning to be effective in the preschool
years helps to build a foundation for effectiveness in school and as an
adult. Experiences that make leaming fun and teach children they are
worthy of love and respect build their self-confidence.

Persons with disabilities and/or chronic illnesses achieve social competence
and everyday effectiveness. Each person can be supported to achieve his
own level of everyday effectiveness and wellness.

Head Start has always understood that all the dimensions of health are
related and each dimension needs to be supported to achieve lifelong social
competence, The legislation that authorized Head Start reads, in part:

“The overall goal of the Head Start Program is to bring about a greater
degree of social competence in children of low-income families. By social
competence is meant the child’s everyday effectiveness in dealing with
both present environment and later responsibilities in school and life.
Social competence takes into account the interrelatedness of cognitive
and intellectual development, physical and mental health, nutritional
needs, and other factors that enable a developmental approach to helping
children achieve social competence.”

+ What barriers to health are common among the families you work
with?

+ Can you identify characteristics that are shared by low-income
familics who do not experience many health problems—characteristics
that scem to improve resiliency and contribute to wellness?

+ Consider that the goal of Head Start was written in the early 1960s.
What do you think about it today’? Is it out of date, or was it ahead of
its time? How does the work you do with children and familics cach
day correspond to the Head Start mission?

26

Oe Laying a Foundation in Health & Wellness



Module 2

Next Steps: Work for Environmental Health in Your Community

Ideas to Extend ae . . | | ;

Practice f Low-income communities suffer disproportionately from environmental
aay threats to wellness because:

* polluting industries and freeways are often located in low-income
communities

+ the families may have poorer health to begin with and therefore are
more likely to become ill from poor air quality, substandard housing,
polluted water, unwholesome food, and other environmental problems

People in many communities have organized successfully to clean up their
environment, or to prevent polluters from coming in. What can you do?

If there is vacant land in your community, try to put it to good use for all.
See if there is a gardening organization that can help you set up a
community garden, Helpers can be the Mayor's Office in some cities, or
such groups as the San Francisco League of Urban Gardeners (SLUG),
Boston Urban Gardeners (BUG), New York's Green Guerrillas, or Tree
People in Los Angeles.

What is the major type of employment in your area? If it is agriculture, @
look into the kind of chemicals to which workers may be exposed. If it is a

type of manufacturing, investigate whether workers might be exposed to

unsafe conditions or substances. If you are concemed, contact the health

department or the local office of the US or state Occupational Safety and

Health Administration (OSHA).

A neighborhood cleanup can be a great way to build a community spirit
and to empower neighbors to become more active in environmental issues.
It is something that everyone can support, and it can show results very
quickly. If graffiti is a problem, help to organize a day where neighbors of
all ages can gather to paint it out. See if your local planning department or
garbage company will help you sponsor a “neighborhood pick-up day”
during which people can put out old furniture, appliances and other large
items which are unsightly if left on the sidewalk. Helpers in these causes
can be the mayor’s office, local foundations and businesses and
corporations.

d3 r)

36 Laying a Foundation in Health & Wellness



Module 1: Health and Wellness—What Do They Mean?

Handout B: Explore Difference! (continued)

Question Card #3

a. What treatment do you believe in for arthritis?

b. Is this belief the same as your parents’ and grandparents’?
c

How would you handle it if someone was using a different treatment approach or said your
approach was harmful?

Question Card #4
a. What would you do, who would you talk with if you were depressed?
b.

How do people in your community view depression? Is it an illness? Is it something that is
talked about or “hushed” up?

Would your parents and grandparents have acted the same way? Will your children handle it the
same way?

Ww

Laying a Foundation in Health and Wellness 1

bP € SamIanry yIIM asm 404


Introduction

Definition of Icons

Coaching

A training strategy that fosters the development of skills
through tailored ‘struction, demonstrations, practice, and
feedback. The activities are written for a coach to werk
closely with one to three participants.

Workshops

A facilitated group training strategy that fosters the devel-
opment of skills through activities which build on learning
through group interaction. These activities are written for
up to 25 participants working in small or large groups with
one or two trainers.

Next Steps:
Ideas to Extend Practice

Activities assigned by the trainer immediately following the
completion of the module to help participants review key
information, practice skills, and examine their progress
toward expected outcomes of the module.

Continuing
Professional Development

he

,

Followup activities for the program to support continued
staff development in the regular use of the skills addressed
in a particular training guide. It includes:

1) opportunities tailored to the participant to continue build-
ing on the skills leamed in the training; and

2) ways to identify new skills and knowledge needed to
expand and/or complement these skills through opportuni-
ties in such areas as in higher education, credentialing, or
community educational programs.



Module 3

Step 2:

Step 3:

Step 4:

Step 5:

. Health Promotion: tasty and diverse food, loving sup-
port for my adventures and growth, a chance to visit
mountains or beaches, special training for my favorite
sport or activity

Divide your participants into groups by component or functional
area. Give each person in the group the following handouts:

. N: Basic Health Needs;
. O: Disease Prevention/Injury Protection; and
. P: Health Promotion.

Ask them to fill these out as they consider ways in which they—
as a component team—support the health of children on the dif-
ferent levels. What activities or services are being provided?
Where are the gaps? Where are improvements needed?

After approximately 10 minutes, ask the group members to con-
sider their lists. Ask them to think of the one area where they
believe they can make a change, an improvement, during the next
few months. This could be a change in meeting basic needs, dis-
ease prevention/injury protection, or health promotion, Ask them
to star that item, and to think about what resources are necessary
for them to make that change.

On flip chart paper, draw a large grid to look like the Head Start
Center Action Plan provided. Distribute Handout Q: Head Start
Center Action Plan.

Bring the group back together and, on the grid, build a pian for
the program, listing the most important areas for action. Ask
each component team to indicate which level of service or activ-
ity they plan to address, Check off that one and write in their
plan. Be sure to indicate, as you write what must be done, the
resources necessary to achieve this goal.

Discuss any barriers that may be in the way of achieving the
goals they set for their program(s). How can the barriers be ad-
dressed? How can the team in one component area support the
efforts of another? See Next Steps: Ideas to Extend Practice (p.
62) for ways to continue and expand this activity.

635

60

Laying a Foundation in Health & Wellness



Continuing Professional Development

(2) Select a period of time within this program year to gather with other
staff members in your program and decide what you can do to improve
health for yourselves. Choose a common challenge to health (e.g.,
Does everyone want to eat lower-fat food? Would everyone like to take
a quict-lime break once during the day? Would it help if you could
plant a tree somewhere near the center?).

Plan to support cach other, Assign tasks to make these goals become a
reality.

(3:

After staff have chosen some health behaviors to change, work to-
gether to make those changes a reality. Then, let parents know about
your successes. If several staff members were able to lose weight,
what worked? If you were able to incorporate a few minutes of quict
time into each day for the children and the teaching staff, how could
the parents carry out that at home? Teaching others is an excellent
way to reinforce our own behavior.

Ask parents to tell of ways that they have tried to work toward well-
ness—successes they can share with the staff.

4

Develop at your center a resource place for multicultural healing. Ask
staff and parents to bring in strategies for health and healing that have @
worked for their families and their communities. Even include ideas

that may have seemed strange to them but that they know other peopic

swear by, Then look for resources. including national organizations, to

help you evaluate health and healing beliefs that differ from the main-

stream,

(5

Review the Head Start definition of social competence. Now and then
at team meetings ask a staff member to bring up for di ion an
example of a child or a family member whose social competence has
been affected (positively or negatively) by cither getting or lacking
some basic health need,

16 Laying a Foundation in Health & Wellness



For use with Activity 3

Module 2: Linking Health & Social Competence

Handout I: Consulting Circle Framework

Date:

Possible:Factors Impacting Everyday Effectiveness

Physical:

Emotional:

Spiritual:

Socio-cultural:

Environmental:

the long term?

Given the possible factors you listed, what can you do to help improve/maintain effectiveness for now and for

. Staff Person Action:

Parent Action: By what
date:

Resources needed:

Date for follow-up:

44

Laying a Foundation in Heaith & Weliness

ol



Module 3

For example, the child who leams to be active and enjoy sports is more
likely to exercise throughout her life. The child who eats lots of fruits, veg-
etables and whole grains is more likely to enjoy those foods throughout his
life. We can think about each of the healthy or unhealthy habits in this way.
The earlier they are started, the more likely it is that they will be continued.
When something negative cannot be changed—say a family history of heart
disease—healthy habits can reduce risk.

Many studies of people’s behavior and their long-term health have been.
carried out. Two of the most famous studies are those carried out on the
whole population of the town of Framingham, Massachusetts and the one
which looked at 7,000 people who lived in Alameda County, California.
Both studies followed the people for over twenty years. These two studies
are considered “classics.”

The Framingham and Alameda County studies have been very important to
the fields of health education and medicine because they looked at many
people over long periods of time. The problems whicn lead to heart failure,
cancer, early death, etc., are problems which build for a long time. These.
studies showed us that people’s behaviors early in life definitely had an
effect on their longevity. Perhaps more importantly for many people, the
studies have shown that people's quality of life is affected. People who
practice positive health behaviors feel better regardless of the length of their
lives. The researchers of the Framingham study have challenged medical
professionals to look at heart disease (and other health problems) very dif-
ferently from how they have looked at them in the past. The researchers
belicve that heart failure should not be considered an “accident” or “tragic
act of God,” but a failure of the medical care system to teach people to
practice preventive, health promoting behaviors.

The two studies found certain specific behaviors with varying impacts,
which affected the length of peoples’ lives:

*Eight Unhealthy Habits or Circumstances (Framingham 'leart Study”)

1) high blood pressure

2) diabetes

3) obesity

4) lack of exercise

5) high cholesterol levels

6) cigarette smoking

7) family history of heart disease

8) “Type A” (hostile, aggressive) behavior

5 J Laying a Foundation in Health & Wellness



Module 1

Spiritual: nourishing—through worship, meditation. reflection—that part
of each of us that connects with something greater than ourselves

Environmental: having clean water, clean air, open space. pleasant
surroundings, peace and quict

Questions for Discussion/ * Are any of the dimensions of wellness unexpected? Can you think of
Reflection things in each dimension that are important to your personal wellness?

How would you complete this sentence: “To me, wellness means

tb

8 Laying a Foundation in Health & Wellness