A Worksite Health Promoting Program for Early Head Start and Head Start Workforce

INTRODUCTION

Early Head Start (EHS) and Head Start (HS) staff comprise a large segment of the public sector workforce and experience numerous risk and chronic factors for medical conditions or symptoms. Few health and wellness workplace interventions, however, specifically focus on EHS/HS staff.

METHODS

A train-the-trainer (TTT) approach was used to build capacity among directors and staff from 57 EHS/HS programs on how to strategically plan and implement a health promoting worksite program focusing on improving nutrition and physical activity practices among EHS/HS staff. Baseline and 3-month post-training questionnaires assessed EHS/HS staff changes on knowledge and practices related to nutrition and physical activity. Paired t-tests or chi2 statistics assessed changes in questionnaire responses over time.

RESULTS

1,363 staff from 57 programs completed baseline and follow-up surveys. Staff had high knowledge regarding healthful dietary patterns at baseline. Over one-third of staff reported drinking soda with meals and almost 50% identified soda as their most common drink. Roughly one-third of staff also reported no physical activity in the prior week at baseline. Staff demonstrated significant improvements in dietary, nutrition, and physical activity practices. Staff also improved grocery shopping behaviors.

IMPLICATIONS FOR PRACTICE

The TTT approach to disseminate an EHS/HS staff-focused health promotion program, "Eat Healthy, Stay Active!' provides a potentially promising strategy to build upon and disseminate more broadly to reach the over >300,000 EHS/HS staff workforce.

A LONGITUDINAL, PERSON-CENTERED ANALYSIS OF EARLY HEAD START MOTHERS' PARENTING

This study used a person-centered approach to examine stability and change in parenting typologies across early childhood. Profiles were associated within and across time with contextual covariates, including demographic characteristics, risk factors, and Early Head Start participation. Participants were drawn from the Early Head Start Research and Evaluation Project (N = 2, 876). Parenting profiles were identified based on observed parenting dimensions at 14, 24, and 36 months, and pre-Kindergarten (pre-K). Results suggested a four-profile solution at each time point: Supportive, Lukewarm (14 & 24 months)/Sufficient (36 months and pre-K), Harsh, and Detached. Supportive was the largest, most stable, and most likely transitioned into profile while Harsh and Detached represented rare profiles with moderate to low membership stability across time. Depression and family conflict emerged as important correlates of unsupportive parenting profiles both within and across time. Findings are discussed in terms of their relevance for both policy and implementation practices for low-income mothers with young children.

Buffering boys and boosting girls: The protective and promotive effects of Early Head Start for children's expressive language in the context of parenting stress

Children's characteristics, including gender, influence their development by eliciting differential responses from their environments, and by influencing differential responses to their environments. Parenting-related stress, associated with poverty environments, negatively influences children's language, likely through its impact on parent-child interactions, but may impact boys' and girls' development differently. Early intervention represents one tool for supporting development in at-risk toddlers, but gender-differences in effects of intervention are rarely described. The current studies assessed the effects of Early Head Start (EHS) on children's productive vocabulary in the context of parenting stress and examined gender differences in program effects on vocbulary. Data were from the national EHS Research and Evaluation (EHSRE) study (Study 1, N = 3,001), and from a dataset associated with one EHSRE site (Study 2, N = 146) where additional data on productive vocabulary were collected. Study 1 found that at 24 months of age, the EHS program protected girls' productive vocabulary from the negative effects of parenting stress, but had little impact on boys' vocabulary. In Study 2, the local EHS site promoted girls' vocabulary development over time from 14 to 36 months despite the negative effects of parenting stress, and protected boys' vocabulary from the negative parenting stress effects. These results suggest differential ways in which at-risk toddlers are affected by early intervention.

Oral health activities of early head start teachers directed toward children and parents

OBJECTIVES

This cross-sectional study examined Early Head Start (EHS) teachers' oral health program activities and their association with teacher and program characteristics.

METHODS

Self-completed questionnaires were distributed to the staff in all EHS programs in North Carolina. Variables for dental health activities for parents (four items) and children (four items) were constructed as the sum of responses to a 0-4 Likert-type scale (never to very frequently). Ordinary least squares regression models examined the association between teachers' oral health program activities and modifiable teacher (oral health knowledge, values, self-efficacy, dental health training, perceived barriers to dental activities) and program (director and health coordinator knowledge and perceived barriers to dental activities) characteristics.

RESULTS

Teachers in the parent (n=260) and child (n=231) analyses were a subset of the 485 staff respondents (98 percent response rate). Teachers engaged in child oral health activities (range = 0-16; mean = 9.0) more frequently than parent activities (range = 0-16; mean = 6.9). Teachers' oral health values, perceived oral health self-efficacy, dental training, and director and health coordinator knowledge were positively associated with oral health activities (P < 0.05). Perceived barriers were negatively associated with child activities (P < 0.05).

CONCLUSION

The level of oral health activity in EHS programs is less than optimal. Several characteristics of EHS staff were identified that can be targeted with education interventions. Evidence for effectiveness of EHS interventions needs to be strengthened, but results of this survey provide encouraging findings about the potential effects of teacher training on their oral health practices.