Training helps parents learn manage childhood diseases
Program slashes ED, clinic visits, cuts days missed
Hands-on health care training can empower parents to take care of common childhood ailments at home and save Medicaid millions of dollars annually, a study by UCLA/Johnson & Johnson Health Care Institute has concluded.
The study of 9,240 Head Start families enrolled in a health literacy program showed that visits to a hospital emergency department declined by 58% and visits to a clinic dropped by 42% as parents treated their children's fevers, colds, and earaches at home.
Researchers conclude that the potential savings for Medicaid was about $554 per family in direct costs, or about $5.1 million annually.
At the same time, the average school days missed by children in the program declined by 29%, and the average work days missed by family members dropped by 40%.
"The empowerment that this program brings to families is amazing. These parents want the best for their children and this program gives them the tools to make the best health care choices," Ariella Herman, PhD, director of the Health Care Institute at UCLA Anderson School of Management and author of the study.
The program centers around the book "What to Do When Your Child Gets Sick" produced by the Institute for Healthcare Advancement, a La Habra, CA-based non-profit organization focused on health literacy.
The book, written at a third-grade reading level, offers clear information on more than 50 childhood illnesses that can be treated at home. The book goes over the symptoms, tells parents how to treat them, and when they should call the doctor.
After receiving training at the Health Care Institute, local Head Start agencies develop programs tailored to the needs of their community during which they present the book, educate parents on how to use it, and set up in-home visits to reinforce its use.
"The book is wonderful but the book by itself wasn't enough. We determined that to have an impact on the low-income community, we had to think strategically about how to involve the health and business community in such a way that the family feels it's important to go to the training," she says.
When Herman's department asked more than 500 Head Start directors across the country the major barriers that their families face related to health care, the overwhelming answer was lack of health literacy and difficulty in getting families to attend educational classes if they are offered.
"Head Start offers comprehensive services and is very much in touch with the families they serve. Since these families don't come to the training programs, we knew we needed to take a different approach," she says.
The UCLA Health Care Institute brings a team from every Head Start agency in the program to a two-day train-the-trainer seminar.
"Besides showing them how to train, we give them strategic tools on how to motivate staff, how to motivate the families, and how to market the project," she says.
Once the team goes back to the agency, they have a few months to organize the training and tailor it to meet the needs of their community, Herman says. During this time, they market the project to the community, obtaining in-kind donations and enlisting the assistance of community physicians.
"When physicians attend, the community members know it is an important training session," she says.
The local Head Start agencies provide transportation and child care for participants and give them a meal.
In addition to giving them the book, they teach them how to use it and give them instructions on basic health care tasks, such as using and reading a thermometer.
"They learn the difference between 100.2 and 102 degrees and learn when to call their health care hotline and when to take the child to the emergency room," she said.
The local Head Start agencies adapt the program to meet the needs of their communities.
For instance, Head Start agencies in some cities taught the parents about rules for crossing the street. Others focused on children's safety in sports. In some areas, they added information on oral hygiene.
"We give them the training tools and they develop a program for the needs of their own families. If they serve people from four different ethnic groups, they translate the training documents into four languages and when they present the training class, they prepare a meal that will satisfy everyone," she says.
For instance, Head Start in Seattle conducted the training for families who spoke seven different languages, mainly Eastern African and Asian.
During the training, families sat at tables with a Head Start home visitor who speaks their language and a resident physician.
The training was conducted in English but after every few slides, the presenter stopped and the home visitor translated what had been said. The resident physician was there to answer any questions the families had.
Lunch was an array of foods from every country represented in the training.
"Once the training was over, we realized that it's not enough to teach these families and leave them on their own. We created a mandatory follow-up program," Herman says.
Over a three to four month time period following the training, the Head Start's home visitors visit the families to reinforce the training.
"They go over the contents of the book to show them what a wonderful tool it is to help them make a decision about which symptoms to treat at home and which symptoms mean you should call the doctor," she says.
Six months later, the families gather again for graduation.
The program started with a pilot project involving 400 families in four Head Start programs in four different states. The results were so good that the program was expanded to serve more than 20,000 families in 35 states.
Among the people who have received the training, about 30% are African-American, 30% Latino, 15% Caucasian, and the rest are immigrants from Asia and Africa.
The program is being expanded to other states in 2009.
"We're growing step by step. Clearly the health care training model can easily be replicated in many more states and by countless community-based groups, extending the ripple effect far beyond Head Start families and significantly increasing the benefits to our health care system exponentially," Herman says.
Hands-on health care training can empower parents to take care of common childhood ailments at home and save Medicaid millions of dollars annually, a study by UCLA/Johnson & Johnson Health Care Institute has concluded.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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