Caregivers & Kids - License-Exempt & Child Inclusive Nutrition and Physical Activity Education

Our effort will address an acknowledged challenge for an already active and effective project in Los Angeles County which has set out to reduce obesity in child care settings by focusing on a specific demographic, the license-exempt caregiver, whose needs are distinct from the caregiver who perceives her/himself as a professional in child care community.

T&L Foundation for Child Care Information's goal is to boost participation in the health education of license-exempt child care providers by reaching 500 license-exempt caregivers (approximately 1,000 children) with a unique hands on and child inclusive educational and resource giving experience.

This authentic learning experience for license-exempt caregivers will address health and wellness topics such as Breastfeeding, Food and Drink, Physical Activity, Screen time and Valuable Community Resources.

The learning experience will:

• not use a powerpoint to teach the curriculum • utilize a format similar to a “mommy and me” class enabling the caregiver to bring the children to the class • perceived as a fun activity instead of a professional development course or training • have hands on elements making it easier for the caregiver to implement with the children at home • designed for the median education obtained by the caregiver • designed to address multi-cultural barriers to a healthy culture • be in a time-frame that is feasible for this demographic • address the varying ages of children that will attend the class with caregiver, and • be in a setting that is easy to access.

According to the First 5 LA report “Families, Friends and Neighbors” there are approximately “590,000 children under age 12 [that] receive care in license exempt settings throughout L.A. County.” After speaking with representatives from the Choose Health LA Child Care project, we learned this is a key demographic the project is trying to engage and has found that license-exempt participation is a challenge.

The challenge is not because these providers “can’t be found.” The challenge is messaging and offering an opportunity to learn about nutrition and physical activity in a format that appeals to the license-exempt child care provider.

Project Phases:

Phases: 1) establishing working partnerships with LA County Child Care Resource and Referral agencies and local businesses to assist with outreach, 2) Recruiting - RFP for curriculum, seek coaching volunteers and RFP for Train theTrainer, and secure meeting spaces 3) begin creation and distribution of materials via email/sms, snail mail and local businesses, 4) establish class schedule and open registration, 5) securing supplemental materials for classes, 6) creating pre/post evaluations, 7) give 2 "test" classes to invited community members and license-exempt caregivers and assess the feedback - change things if necessary, 8) start classes, 9) ongoing evaluation process.

Addressing the childhood obesity epidemic, a disease which fuels other chronic conditions such as diabetes, high blood pressure and heart disease, is an essential element to a healthy LA. By addressing the health culture of children, we effectively address the health culture of our future, in 2050, as the children positively impacted by the education of the caregivers in 2014, take with them the healthy habits established for their lifetime.

Our project addresses the LA2050 obesity metric by educating license-exempt caregivers who, if they take home, one element of the training and use it, will be creating a healthier present and future for themselves, their families and the children of LA’s future.

Another metric addressed is lack of access to parkland for Los Angles County children which then compounds the problem of access to physical activity. Our project will provide physical activity ideas and alternatives to parkland so as another LA2050 grantee works on furnishing LA County with more parks for outside recreation and physical activity, children can get moving now. Children understanding how to get physical in all types of spaces will be better off in their future as LA2050 residents as well.

Our project will effectively reduce childhood obesity through education of child caregivers who don’t typically get information and training materials or adhere to regulations, even the minimal ones that licensing requires.

This project will benefit:

License-exempt caregivers by providing them with an educational environment that works for them. They will not only learn about providing a healthy culture for the children in their care but will understand why and how to do it, motivating them to carry out at least one new thing learned in one category at home.

Children by educating their caregivers about breastfeeding, food and drinks, physical activity and screen time who are not typically exposed to informational material or in educational experiences tailored to their needs. Children who are cared for by the providers who attend this authentic training will have a better chance of establishing healthy habits to reduce childhood obesity than those who are in the care of license exempt caregivers who have not had the opportunity to participate in the educational experience.

Also, as caregivers bring their children to the “mommy and me” formatted class, the older children will have an opportunity to learn and ask questions which then gives them an opportunity to be an active participant in the health culture of their caregivers environment as well as take it home with them to share with parents.

Parents, as caregivers extend the education opportunity to them. Providers will be encouraged to engage parents in what they learned as they distribute ready-made information from the class as well as simple discussion with the parents about good nutrition, physical activity and the importance of limited screen time.

We do not have confirmation but these are the organizations with which we hope to engage as collaborators.

Child Care Resource and Referral Agencies

We hope to collaborate with the partners of Choose Health LA Child Care. Choose Health LA Child Care is a program funded by First 5 LA and administered through the Los Angeles County Department of Public Health. The Child Care Alliance is coordinating the Choose Health LA Child Care Project due to their long standing relationship with child care providers across the County and expertise in the child care field. We have had conversations about collaboration but could not determine a scope of work that could be committed to prior to submission of the proposal.

In addition to Child Care Alliance of Los Angeles, we would hope to collaborate all LA County Child Care Resource and Referral Agencies as they, too, have relationships with the child care field. The agencies are: Child Care Resource and Referral, Children’s Home Society of California, Connections for Children, Crystal Stairs, Mexican American Opportunity Foundation, Options, Pathways and Pomona Unified School District.

Potentially partnering with these R&R organizations would bring with them:

• The connections to the license-exempt providers receiving child care subsidies.

• Expertise regarding the license-exempt child care provider culture

• Network of potential volunteers to execute elements of the project

• Access to bilingual materials

• Knowledge of what does or does not work with the license-exempt child care providers after implementation of current curriculum

3 factors critical to success of potential collaboration

• Outreach to license-exempt child care providers

• Assistance in establishing a network of volunteers

• Consulting regarding the creation of new curriculum

We also intend to reach out to Child and Adult Care Food Program (CACFP) Sponsors for reaching out to license-exempt providers on their programs or seeking out volunteer coaches.

Access to healthy food

Obesity rates

Health Culture in Child Care and Early Education

Access to Healthy Food, Obesity Rates, Other: improving the culture of health overall for children in license-exempt child care.

Access to healthy food: providing education and materials to license-exempt caregivers can improve the access to healthy food by the children in their care. The project will also impact access to healthy food by providing information to the license-exempt community about the Child and Adult Care Food Program (“Food Program”) which partially reimburses child care providers for feeding the children healthy foods. All children are eligible for this program which also addresses the food insecure child population.

Obesity rates: by educating license-exempt child care providers we have the potential to impact a portion of the 23% of children that are obese in LA County which would also positively impact the LA of 2050 as these children become the adults with healthy habits, effectively decreasing the 19% of adults that are obese as well as addressing the health concerns that correlate with obesity – heart disease and diabetes.

Health culture and early education: while the goal of the curriculum is to decrease obesity in child care settings, the training and the topics addressed also create a healthy learning environment overall, establishing a better setting for the children to be ready to learn as the opportunities present themselves.

Track where the caregivers have been referred from via number on invitation that will be brought with caregiver in order to attend the training.

Engage 400 license-exempt child care providers through various R&R networks. 75% sign up and 50% of registered attendees actually come to the training.

Engage an additional 100 license exempt child care providers through word of mouth referrals and social media outreach. 75% sign up and 50% of registered attendees actually come to the training.

Engage 50 parents via the license-exempt providers that participate in the educational opportunity.

Pre and post evaluations will be distributed and collected in order to collect the below information.

80% of the attendees give a 90% or higher on curriculum/format evaluations

80% of the attendees give an 85% or higher on coach evaluations

25% of the attendees would recommend to a fellow license-exempt provider

25% of the participants follow up with post evaluation

60% of the attendee respondents implement three items they learn about at their home and with the children in their care

40% of the attendee respondents implement 5 items they learned about at their home and with the children in their care

25% of attendee respondents share the information and materials with parents

1) The Growing, Learning Care Project of California, in 2007, shared several lessons learned for supporting license-exempt child care providers. Along with challenges they also share successful outreach and training strategies which include:

a. For outreach: Personal connections, word of mouth, and community partners to name a few

b. For Training strategies: Play days in the park, playgroups, in-home training and workshops in community settings

c. Characteristics of trainings: simple, informal, interactive, hands on, child focused and linguistically diverse

From: (Effective Ways to Reach and Support Family, Friend and Neighbor Care Providers: Lessons Learned from California’s Statewide Initiative, Patty Siegel & Ana M. Fernandez Leon, Webinar, November 29, 2007) http://action.nwlc.org/site/DocServer/FFN_Webinar_112907.pdf?docID=341

2) Learning from the experience, feedback and evaluations from the Choose Health LA Child Care project. There is not a lack of knowhow regarding reach as far as “finding” license-exempt providers, however, there is a noticeable gap in participation in the trainings between professional child care providers and license-exempt providers. Many times the license-exempt child care providers who see themselves as professionals will take trainings such as this one and it is plausible that the 162 license-exempt providers that have taken the training are those that see themselves as professionals, also informing the need for a more informal experience in order to engage additional license-exempt participants.

3) The report “Families, Friends & Neighbors: Understanding the Needs of FFN Child Care Providers in L.A. County” provides insight into this group. Our project addresses 5 of 6 recommended ways to support the license-exempt caregiver:

a. Offer Resources in Spanish

b. Provide resources and education for providers bout licensure process

c. Offer classes and activities in evenings

d. Link providers to community resources

e. Provide classes in the topics where there is greatest interest in which health and nutrition is included in the list. Link to the report http://www.first5la.org/files/FFNReport_r4_0.pdf

1) We have a network of organizations and people throughout the child care industry to help us reach the individuals we need to reach, whether it be experts in the industry to do trainings or accessing the license-exempt providers

2) Already know the information and topics for the customized training, therefore able to focus on a different structure to complement the audience and information being provided

3) Access to many different materials for use as supplemental materials for learning experiences

4) We are a small and nimble organization

1) Finding the right person to create the curriculum and effectively creating it to “speak to” the audience it is intended for. We plan to address this challenge by proactively using existing networks of industry professionals to create the curriculum as well as reaching out to ‘mommy and me’ teachers to get a good perspective of how to facilitate a class in that format. Also, engage a handful of license-exempt providers that will be willing to work with us as we create the curriculum.

2) Finding coach volunteers and creating buy-in that this is the best format for the license-exempt demographic and encouraging them to learn and get comfortable with the new format. Hire a consultant for “train the trainer” to establish confidence and excitement with the coaches. We will also provide additional compensation to the top 3 coaches who train the most license-exempt providers as well as additional compensation for those who get the most follow up evaluations returned (encouraging follow up between coach and provider).

3) Getting follow up evaluations and information from the attendees to gauge whether or not they implemented anything they learned. Provide a material incentive – gift card or something else of monetary value to those that fill out and return their evaluations.

4) Getting the license-exempt providers to the trainings. Working with Child Care Resource and Referral Agencies to assist in outreach, choosing settings in which caregivers can easily attend and consistent, specified messaging leading up to the classes.

Network/relationship support

Money (financial capital)

Volunteers/staff (human capital)

Publicity/awareness (social capital)

Education/training

Community outreach

Quality improvement research