Elmo, Rosita, Sesame Street?Deborah Cohen, Environmental Health Center, National Safety CouncilWhat do Elmo, Rosita, and Sesame Street have to do with lead poisoning prevention education and outreach? You might think "not much," but a collaborative effort between the National Safety Council's Environmental Health Center(EHC) and the Children's Television Workshop(CTW) has brought together these lovable characters to help prevent lead poisoning. The Sesame Street Lead Away! Project is an outreach and education effort aimed at addressing the continuing threat of childhood lead poisoning. Despite substantial progress in the fight against childhood lead poisoning in recent years, this hazard remains a significant risk to children. Almost 1 million children in the Nation have elevated blood lead levels.The Sesame Street Lead Away! Project, which is funded by a grant from
the Prudential
The project produced multimedia lead educational materials including a video starring Elmo, Rosita, and other Sesame Street characters, a companion audiotape in English and Spanish, and an educational booklet and poster in English and Spanish. Input from both children and adults was vital to the development of materials. Also, a formal advisory committee of government, academic, and health care experts was formed to assist in the development. The video was designed with simple, easily understood, positive messages that directly involve children. Some of the main messages include "wash your hands before you eat," "take your shoes off at the door," "stay away from peeling paint," "visit your doctor for a blood test," and "stay away from yucky dust." Distribution of the materials was targeted primarily to settings where the materials could reach the largest audience. Particular efforts were made to target high-risk children, including low-income and minority families. Numerous state and local health departments across the country requested materials for their use and/or for distribution to others. More than 60,000 videos and 1 million booklets were distributed nationwide at a nominal fee to cover reproduction costs. The demand has been so great that additional copies have been produced. Because the materials were available through a toll-free number (the National Lead Information Center), callers could also receive answers to specific questions about lead and request other publications. A follow-up phone survey of 200 recipients of materials in 128 cities in 46 states confirmed that the materials were being used by broad and diverse audiences. Respondents noted that the messages were simple and well communicated, the value of lead awareness and action steps were clearly emphasized, and the video was successful in holding interest. Of all the materials, the videos were used most often. For more information, contact Deborah Cohen, Environmental Health Center, National Safety Council (e-mail cohend@nsc.org ) at (202) 974-2490. Children's Health-Risk Communication at the National Center for EnvironmentalClaudia Fishman Parvanta, National Center for Environmental Health, CDCThe National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC), addresses human-environmental interactions at all stages of the life cycle, but children are a primary focus because this population is the most vulnerable to environmental hazards. For this reason, a growing proportion of the work at NCEH is devoted to children's health risk communication. Three programs-lead poisoning prevention, asthma prevention, and promotion of folic acid use by reproductive-aged women-focus on outcomes for children and illustrate a range of approaches to child health risk communication. NCEH works with state and local health departments to implement their programs.Lead Poisoning PreventionAcross the Nation, average blood lead levels have fallen substantially since lead was eliminated from gasoline. However, 890,000 children still have blood lead levels high enough to adversely affect their ability to learn. This exposure occurs primarily through lead-based paint in their homes. Even though a disproportionate number of poor children have elevated blood lead levels, a 1994 survey showed that only a third of these at-risk children were being screened. To combat this problem, the lead poisoning prevention program recently published Screening Young Children for Lead Poisoning: Guidance for State and Local Health Officials. This publication contains detailed information to help state and local public health partners identify (1) children at greatest risk and (2) geographic areas in which universal blood lead screening would be most needed. Guidance on how to treat children who have elevated blood lead levels and on implementing educational outreach programs for parents of at-risk children is also provided.Asthma PreventionThe asthma prevention program offers a participatory approach to health-risk communication. The program is targeted to a cluster of inner-city, low-income neighborhoods with a high prevalence of childhood asthma in the Atlanta, Georgia, "Empowerment Zone." "ZAP Asthma" looks at the feasibility of educating community members about a health problem already identified as a priority in the community (in this case childhood asthma) and motivating them to be direct advocates for risk-reduction behaviors. ZAP Asthma empowers community members as partners to shape their own messages from the technical information provided, messages that may be more effective because they are coming from trusted friends and neighbors. The intervention also includes educational programs in churches, schools, and grocery stores; provider-based (hospitals, doctors) educational programs; community-wide partnerships; and surveillance strategies to determine success. In this kind of campaign, once the problems and solutions are on the table, community members express concepts in their own words.For example, to reduce indoor environmental asthma triggers such as
dust, animal hair, and insect droppings, community volunteers tactfully advise parents about
how to minimize their children's in-home exposure without placing blame on the parents. ZAP
Asthma offers many opportunities to learn from the community and to better
understand the processes of interpersonal communication and the lessons
that can be applied to larger-scale programs.
Folic Acid PromotionThe folic acid promotion program focuses on women of reproductive age. Together with a national coalition of partners, NCEH has developed promotional materials to educate women on the importance of taking at least 0.04 milligrams of folic acid each day to reduce the risk of having a child with a neural tube birth defect. Health-risk communication materials were tested on the target audience prior to distribution. The message of one proposed television spot liked by everyone was, "When you stop using birth control pills, start using these folic acid pills." Testing revealed that some women thought there might be drug interactions between folic acid and birth control pills. Some respondents also thought folic acid was an alternative form of birth control, and some thought that folic acid would help them become pregnant. This information was used to develop understandable concepts targeted to the intended audience.The folic acid promotion program will use different strategies for communicating directly with women thinking about becoming pregnant and with those who are not planning pregnancy. Listening to the intended audience and then structuring communications that best reach them are vitally important parts of children's health-risk communications. Although these offer three very different approaches to children's health-risk communication, each is structured to meet the circumstances and characteristics of each audience. For more information, contact Claudia Fishman Parvanta, National Center for Environmental Health, CDC (e-mail cip0@cdc.gov) at (770) 488-7029. FDA Monitors Food Pesticide ResidueYoung Lee, Food and Drug AdministrationPesticide residues in infant and adult foods eaten by infants and children have in recent years been gaining focus of public attention. The Food and Drug Administration (FDA) is aware of the importance of monitoring these foods for chemical contaminants, and over the years has collected and analyzed certain foods that are of prime interest to these population subgroups.The FDA approaches the problem of pesticide residues in foods from three directions; regulatory monitoring, incidence/level monitoring, and the Total Diet Study. Under regulatory monitoring, samples of foods which form a considerable part of the diets of infants and children are collected and analyzed for pesticide content on a regular basis. In recent years, the FDA has also initiated special incidence/level monitoring projects to focus on pesticide residues in infants' and children's foods. Through the Total Diet Study, dietary intakes of pesticide residues in foods are estimated for different age and sex groups including 6- to 11-month-old infants, 2-year-old and 6-year-old children, and 20-year-old young adults. The results of these three monitoring programs indicate that pesticide levels found in infant, children, and young adult diets are well below FDA reference levels. Testing by the FDA will continue to ensure that the foods children consume remain below these levels. For more information, contact Young Lee, Food and Drug Administration at (202) 260-0292. NIOSH's Health Communication Program Evaluation ChecklistAndrew Maxfield, National Institute of Occupational Safety and Health, CDCThe National Institute for Occupational Safety and Health (NIOSH) has developed a tool to help health communicators through evaluating communication programs, interventions, and campaigns. The Health Communication Program Checklist* shows program stages down the left side of the matrix and program components across the top. Each intersecting box in the matrix indicates some form of health communication research needed for understanding communication strategies and messages. The matrix can also be used as a tool for (a) educating program participants and grantees who may be unfamiliar with health communications processes, (b) evaluating past programs and initiatives to help determine their success, and (c) identifying the best practices that contributed to the program's operation.When the matrix was recently used to examine retrospectively a set of NIOSH-funded case studies conducted from 1990 through 1997, it became clear that the programs that had followed the greatest number of examples set in the matrix boxes were also the most successful at achieving their communication goals. For more information, contact Andrew Maxfield, National Institute of Occupational Safety and Health, CDC(e-mail aqm6@cdc.gov) at (202) 401-0834.
*Health Communication Program Checklist (a) HTML version (b) For a print-friendly version of the Health Communication Program Checklist, download the PDF version (16Kb). (You need to have Adobe Acrobat Reader to download a PDF version. Click here to go to the Adobe web site, and follow the instructions to install this free software on your computer.) |