Small doses of education can make a big difference for parents with sick children - A program trains low-income parents to use basic tools such as reference books and digital thermometers to avoid unnecessary visits to ERs.
Molly Hennessy-Fiske, Los Angeles Times, October 20, 2010. Please click here for entire document (PDF).
Partners in Progress
Tricia Bisoux, BizEd, November/December 2009. Please click here for entire document (PDF).
If you are unsure what to do when your child gets sick, you're not alone
KEARNEYHUB.COM, January 2, 2010. Please click here for entire document (PDF).
Grant Bolsters Front Line of Health Reform: Knowing How to Treat Your Own Kids
GOOD NEWS NETWORK, March 3, 2009. Please click here for entire document (PDF).
Dose of Health Literacy Helps Parents to Avoid Trips to the ER
WALL STREET JOURNAL, May 2004
LOS ANGELES - New research proves that a dose of hands-on health care training can transform parents' abilities to care for common childhood ailments at home - and save Medicaid millions of dollars annually.
Tracking 9,240 Head Start families enrolled in a health literacy program - and impacting nearly 20,000 children in 35 states - researchers found that visits to a hospital ER or clinic dropped by 58 percent and 42 percent, respectively, as parents opted to treat their children’s fevers, colds and earaches at home. This added up to a potential annual savings to Medicaid of $554 per family in direct costs associated with such visits, or about $5.1 million annually, according to the UCLA/Johnson & Johnson Health Care Institute for Head Start, which conducted the study.
Moreover, parents' being better informed about handling their children's health needs translated to a 42 percent drop in the average number of days lost at work (from 6.7 to 3.8) and 29 percent drop in days children lost at school (from 13.3 to 9.5). Parents also reported feeling more confident in making health care decisions and in sharing knowledge with others in their families and communities.
Underwritten by Johnson & Johnson, the program carried a one-time cost of $60 per family on average, including pre-visits, hands-on training sessions and post-training follow up. Using $320 as the average cost for a visit to a hospital emergency room and $80 for a clinic visit, researchers at UCLA Anderson School of Management, which houses the Institute, estimated that savings could reach many millions per year if training were provided for the nearly one million families served by Head Start, many of whom depend on Medicaid. The Institute's 10-year goal is to serve 400,000 Head Start families, reaching approximately half the Head Start agencies in the United States.
"Head Start parents want to be the first line of defense in their children's health care, and our research leaves no doubt that they can be, once they have the tools to make the best choices," said Ariella Herman, Ph.D., Research Director of the Health Care Institute at UCLA Anderson School of Management and author of the study, which builds on the findings of the Institute's groundbreaking pilot study that was published in 2004.
What to Do at 99.5 Degrees?
Parents were surveyed about their family's health care habits three months prior to the training and six months afterward.
At the outset, 60 percent said that they did not have a health book at home to reference when a child fell ill. As part of the study, each Head Start family was given a low-literacy medical guide, What to Do When Your Child Gets Sick, by Gloria Mayer, R.N., and Ann Kuklierus, R.N., which offers clear information on more than 50 common childhood illnesses. The Health Care Institute training is adapted to various languages and cultural needs of the participating families.
Prior to the training, parents said they were "very confident" about caring for their sick children - yet, in reality 69 percent reported taking a child to a doctor or clinic at the first sign of illness. Almost 45 percent said they would take their child to a clinic or emergency room for a cough rather than provide care at home, with 43 percent doing so for a mild temperature of 99.5 degrees.
Post training, researchers found a marked improvement in parents' self confidence, with only 32 percent indicating that they would still go first to a doctor or clinic. More significantly, the number of parents using the medical guide as a first source of help jumped from five percent to 48 percent, indicating a better understanding and higher comfort level in dealing with common childhood illnesses.
"The Health Care Institute has provided a creative and practical solution for parents, giving them access to essential information and the confidence to address their children's basic health care needs," said Sharon D'Agostino, Vice President, Corporate Contributions and Community Relations for Johnson & Johnson. "The program has also helped these parents set a powerful example for others in the community, and is playing a role in raising the quality of health care in the communities where it has been implemented."
Program Success Attracts More Support
Earlier this year, the State of New Mexico adopted the Health Care Institute's training program with support from Pfizer and will begin implementation this month with 5,000 Head Start families. Washington State Governor Chris Gregoire has also signed on and is currently planning a pilot implementation for an estimated 6,800 Head Start and Early Childhood Education and Assistance Program (ECEAP) families.
"Clearly, the health care training model can be easily replicated in many more states and by countless other community-based groups, extending the ripple effect far beyond Head Start families and significantly increasing the benefits to our health care system exponentially," Dr. Herman said.
Inspired by Head Start Directors
The Health Care Institute is an outgrowth of the UCLA-Johnson & Johnson Head Start Fellows Program, comprised of Head Start agency directors who have gone through management training at UCLA Anderson School of Management. Founded in 1991, 1050 Head Start directors have participated in the Fellows program to date, under the leadership of Senior Associate Dean Alfred E. Osborne, Jr., Faculty Director of the Harold and Pauline Price Center for Entrepreneurial Studies.
According to Dr. Osborne, the Head Start Fellows recognized that if parents could become better informed about fundamental health issues, it could lead directly to healthier outcomes for their children. "The leadership of Head Start directors has enabled the Health Care Institute to produce these benefits for families across the country and, ultimately, for Medicaid," noted Dr. Osborne. "Their discipline, integrity, operational abilities and single-minded focus have enriched the lives of countless children in the U.S. - and now, helped them be healthier."
Los Angeles; Giving Parents a Dose of Confidence; Among families getting a medical manual and training, trips to ERs and clinics plunge.
Ann M. Simmons. Los Angeles Times. Los Angeles, Calif.: May 20, 2004. pg. B.3
Copyright 2004 Los Angeles Times
Fior Abrego was the kind of mother who would rush her children to the hospital and spend hours waiting for a doctor to treat their minor ailments, even the sniffles, that she could have handled herself.
But that was before she received an easy-to-read medical reference manual, participated in a training session and became savvier in the art of caring for her children.
"It's like having your doctor at the house," Abrego, 32, said of the 187-page book, What to Do When Your Child Gets Sick.
The UCLA/Johnson & Johnson Health Care Institute launched the program in 2001, distributing the manual to 1,600 families nationwide. The results among those receiving the book were dramatic: Emergency room trips were cut by nearly half and clinic visits dropped more than a third.
That, in turn, led to a significant drop in the number of days parents missed work and students were kept out of school, the study's researchers said.
"The aim is to help these parents not panic, to make them have a sense of healthcare, and make them feel they are the first line of defense in taking care of their children's health," said Ariella Herman, a senior lecturer at the UCLA Anderson School of Management and the study's lead investigator. "I'm not saying these parents are totally health-literate after the program, but it's a start. They are more confident."
The institute hopes to train 12,000 more families nationwide by 2005 in simple healthcare techniques, focusing primarily on treating children up to age 5. Most of the parents a re covered by Medicaid -- known as Medi-Cal in California -- and participate in Head Start and Early Head Start, comprehensive government-funded programs to prepare children from low-income families for school.
Medicaid could save up to $2.4 million a year in direct costs associated with needless visits to hospitals and clinics after the nationwide training is completed, researchers estimate.
Abrego, a single mother and freshman studying early childhood development at Pasadena City College, said the book provided a "hint of what might be happening with the child."
Now, she said, she has a better idea of what to do when one of her girls -- ages 3 and 9 -- becomes sick: take the child's temperature, give a warm bath or administer some over-the-counter medication. If that didn't help, she said, only then would she consider seeing a doctor.
What to Do When Your Child Gets Sick, published in English and Spanish, uses simple terms and illustrations. It offers straightforward explanations for more than 50 common childhood ailments, such as coughs, fever, diaper rash, colic and diarrhea.
"It's doctors' talk oversimplified and user-friendly," said Wassy Tesfa, administrator for Head Start programs in Glendale and Pasadena. "And if [parents] call the doctor, they call more informed if they have read the book."
Tesfa said about 40% of the parents in her program's coverage area were immigrants, many from South America, Asia and Armenia. Often unable to read English well enough to consult medical manuals - - or speak it enough to call a service provider and hear perhaps a simple solution to a child's illness -- many view a hospital or clinic as their only line of defense.
"Because I couldn't read English, I didn't know exactly how much medicine to give my baby," said Elsa Aragon, 30, a mother of two who emigrated from Mexico six years ago. "The book tau ght me what measurements are needed."
It also taught her how to use a thermometer and at what temperature she should become concerned. She learned that preventing water from getting into her son's ears while bathing him could help keep him from getting earaches.
And when her daughter's navel became slightly inflamed shortly after birth, Aragon consulted the book. It explained that such symptoms were typical and that, unless they got worse, she should keep the area dry, clean it with alcohol and take care not to let the baby's diaper rub against it.
"Now I don't go to the doctor for just any reason," Aragon said. "I try to solve the problem at home first."
Many parents agreed that having access to the guide and avoiding constant trips to the emergency room or clinic had saved time and money.
"Sometimes you could be there for four to five hours, just for them to give your child a Tylenol," said Sylvia Flores, 22, a single mother of a 4-year-old boy. "It's really frustrating, a waste of time."
"Having the book has given me more confidence," she said. "I've read it six times and I always go back to it."
Program Reduces Emergency Room Visits
Pasadena Star News
May 6, 2004
Pasadena– Mireya Sanchez took her 2-year-old to the emergency room four times last year for asthma attacks. But since a doctor showed Sanchez how to treat him at home with a nebulizer, "this year he didn't have to go at all,' she said with a smile.
Lessons that provide parents with such health-care information could cut the extra trips to emergency rooms and clinics that cost the federal government and private insurers billions of dollars every year, researchers say.
Sanchez and 75 other parents of Head Start preschoolers got more help with their children's health care at a training session organized by the Center for Community and Family Services Head Start program in Altadena on Thursday, part of a nationwide effort to reduce unnecessary clinic and emergency room visits.
The training is the result of a UCLA mathematician's discovery that parents of Head Start children often lacked the knowledge to care for their sick children at home.
"When I ask if they know what to do when their child gets sick, all the parents say yes,' said Ariella Herman, senior lecturer at UCLA's Anderson School of Management. "But then I ask what they do if their child has a 99.5 fever, and 60 to 70 percent say they go to an emergency clinic.'
In 2001, Herman launched a pilot parent-training program. After providing a reference book for parents to use, showing them how to use it and covering basic health information, visits to the doctor fell 38 percent and emergency room visits by 48 percent.
Herman calculated that training 12,000 families would save Medicaid $2.4 million, or $198 per family, each year.
The number of school days children missed also plummeted in the six months after the training, and parents' confidence in coping with their child's health increased.
Herman took those numbers to Johnson & Johnson, which funded a four-year grant to expand the training nationwide.
"It's wonderful from any perspective, whether you want to help children or save money or both,' Herman said.
At Thursday's training, the parents each received a 180-page book called "What to Do When Your Child Gets Sick,' by Gloria Mayer, R.N., and Ann Kuklierus, R.N., in English or Spanish.
Trainers walked them through the reference book, which explains home treatment for common ailments such as diaper rash, chicken pox and sore throat. The book advises parents when a doctor is needed for each kind of illness.
Social workers affiliated with the Head Start program will follow up with each family for six months. They will talk with parents about their children's health and encourage them to check the book for information about any questions parents have, Herman said.
"This really changes the habits of the parents,' she said. "I have a dream of reaching half of all Head Start parents in the next 10 years. It's such a wonderful cause.'
UCLA Study of Health Care Training for Head Start Parents
Points to Potential Multi-Million Dollar Cost Savings for Health Care System
Head Start and Johnson & Johnson Partner with Researchers at UCLA Anderson in Groundbreaking Study
LOS ANGELES — A pilot study conducted by researchers at UCLA Anderson School of Management has shown that providing Head Start parents with convenient, easy-to-understand health care information can improve the quality of care for sick children while reducing health care costs dramatically. Head Start families who participated in a health care training program reported a 37 percent drop in visits to health care providers and a 48 percent decrease in emergency room visits in the six months following the training.
The training program, along with initial and follow-up surveys, were underwritten by Johnson & Johnson, which is preparing to expand the program nationwide, in order to train 10,000 Head Start households over the next three years. If results from the pilot study hold, researchers predict that the program could save $2 million annually in Medicaid costs associated with unnecessary clinical and emergency room visits.
Prompted by a group of Head Start directors, Dr. Ariella Herman, a senior lecturer at The Anderson School, led the research team that conducted the study. The directors noted that many Head Start parents did not know how to treat common childhood illnesses, and wondered how their agencies could help.
Working in partnership with Johnson & Johnson and The Anderson School at UCLA, the team developed a training program that was delivered over a 30-day period in the fall of 2001. An important part of the training was incorporating the use of an easy-to-read book, What to Do When Your Child Gets Sick, written by Gloria Mayer. The book teaches parents how to care for their sick children and can subsequently be used as a reference following the training.
"Our previous research has shown that many parents lack a basic understanding of children's health care issues," said Dr. Herman, who is a senior lecturer at The Anderson School. "Our findings clearly demonstrate that with proper training, parents can provide a better quality of care for their sick children. We look forward to implementing this successful health care training pilot study to Head Start parents nationwide."
Dr. Herman is very familiar with the issues of Head Start parents and families, having taught in The Anderson School's Head Start-Johnson & Johnson Management Fellows Program for more than a decade. She was recognized with the program's first "Outstanding Head Start Faculty Award" in 2000 for her consistently high ratings from program participants.
The six month follow-up study, completed in June 2002, used surveys, focus groups, and informal interviews with parents, as well as with Head Start health care and parent coordinators, to evaluate the effectiveness of the training. The study found that the training had a remarkable impact on the families, as shown by the results in the accompanying table (Table 1).
Impact of Health Care Training (Table 1)
Calls to Health Care
The qualitative impacts of the program were significant as well. Parents reported that they were better able to determine if they could treat their child at home, or if the advice of a health care professional was needed. Benefits from the training included increased parental awareness of symptoms related to common illnesses, earlier and improved treatment, fewer days of missed school for children, and a reduction in work absences for parents.
"We are delighted that Dr. Herman led this groundbreaking study, and we are honored to partner with Head Start and The Anderson School at UCLA in this effort," said Alfred T. Mays, Johnson & Johnson vice president, corporate contributions and community relations. "As we prepare to roll out this program nationwide, the potential implications for children, families and our health care system are enormous."
Mernell King, director of the DCS Head Start site that was involved in the pilot, affirmed the impact of the training program. "This training program has had a profound impact on our children and families. The knowledge imparted by the training has enabled these parents to better care for their children, and their improved self-esteem at being able to do so is evident," noted King. "Moreover, our staff has seen the changes that have occurred and have found a renewed commitment in working with the families we serve."
Click here (PDF 609K) to download Dr. Herman's executive summary of the study's research results (Executive Summary: Ensuring Positive Health Outcomes in Head Start Children and Families)
About UCLA Anderson School of Management
The Anderson School at UCLA is perennially ranked among the top-tier business schools in the world. Award winning faculty renowned for their research and teaching, highly selective students, successful alumni and world-class facilities combine to provide an extraordinary learning opportunity. Established in 1935, The Anderson School provides management education to more than 1,300 students enrolled in full-time, part-time and executive MBA programs and academic master's and Ph.D. programs.
The Anderson School's faculty includes outstanding educators and researchers who share their scholarship and expertise in such fundamental areas as finance, marketing, accounting, business economics, decisions, operations and technology management, human resources and organizational behavior, information systems, strategy and policy.
Offering unparalleled expertise in management education, the world's business community turns to The Anderson School at UCLA as a center of influence for the ideas, innovations, strategies, and talent that will shape the future.