The Importance of Research in Preschool Health Education
Keeping children “healthy” is like a long marathon race that begins with birth and continues throughout childhood and adolescence. It is a race because we are racing against the threats to child health from accidents, injuries, and diseases that can be prevented. Children gradually need to learn how to “take care” of themselves- since parents and teachers cannot always be there to protect them.
This critical learning process must begin early in childhood -since even preschool children make important health decisions every day. These are decisions about safety (shall I touch that sharp knife?), hygiene (shall I wash my hands after I go to the bathroom?), smoking and drugs (shall I move away from that cigarette smoke?), sun-safety (shall I ask Mom or Dad for a hat and T-shirt since the sun is so hot?), nutrition (shall I ask Mom for an apple or a candy bar?); and physical activity (shall I ride my tricycle or watch TV?)
Preschool health education programs most likely to be effective are those designed to help children (a) learn to know what to do to keep themselves healthy (knowledge) , (b) believe that healthy living is really important to them (good attitudes), and ( c ) practice and reinforce good health behaviors, and not just talk about it (actions and behavior). The ultimate goal is to enable young children to make healthy lifestyle choices and develop good health habits in the first place - rather than try to undo bad habits later.
The most effective health education programs are those that have been put to the test and evaluated in the classroom. The evaluations may be designed to measure knowledge, attitudes, behavior, or environmental changes -like changes in the food service at school - or the physical education program. Evaluations may also be more general, such as asking teachers how easy or difficult the program was to implement; how age-appropriate the material was for the classroom; what they liked the best; what the children liked the best; and what they would change to improve the program. When choosing a health curriculum or other health program, be sure to ask how the program has been evaluated in the classroom - since this is the best measure of how effective the program will be for you. The best programs will have evaluations available for your review - many in the form of published papers.
The Healthy-Start comprehensive preschool program is very unique among early childhood health programs in that it has an excellent record of publications and evaluations. Healthy-Start was shown to be effective in improving nutrition and health knowledge and attitudes among preschool children, making meals and snacks in the preschool centers healthier, and in reducing heart disease risk (lowering cholesterol levels).
None of us need to be reminded that our children are our future, and for this reason we are especially alarmed with the rapid increase in obesity rates in childhood - now a staggering epidemic. To reverse this epidemic we need effective educational programs for children, teachers and parents- starting with preschool and continuing through young adulthood. Programs like “Healthy-Start” “Healthy Hops” and “Animal Trackers” can help - but only if they are “put to work” in the preschool classroom.
-Christine L. Williams, MD
Healthy-Start Published Articles and Abstracts as of March 1, 2004
To date 13 scientific papers have been published or are in press, and 14 abstracts have been presented at national meetings:
Abstracts presented at national meetings on the Healthy Start project are as follows:
- (2003) Bollella M, Williams CL, Strobino B, Brotanek J: Dietary predictors of cardiovascular risk factors among children in a 5-year health tracking study: Healthy Start. Presented at the American Dietetic Association (ADA) Food & Nutrition Conference & Expo (FNCE), San Antonio, Texas, October 25-28, 2003.
- (2003) Strobino B, Williams CL, Brotanek J, Campanaro L, Bollella M: Tracking of Serum Lipids from Pre-School to Elementary School. Presented at the Asia Pacific Scientific Forum 43nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, June 7-9, 2003.
- (2002) Williams CL, Strobino BA, Brotanek J, Campanaro L, and Bollella M: A five year prospective study of multiethnic preschoolers: Body size and blood pressure. Presented at the Asia Pacific Scientific Forum 42nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, April 25-28, 2002.
- (2002) Williams CL, Strobino BA, Brotanek J, Campanaro L, and Bollella M: Ethnicity and body size as predictors of blood lipids in early childhood: A prospective study. Presented at the Asia Pacific Scientific Forum 42nd Annual Conference on CVD Epidemiology and Prevention, Honolulu, HI, April 25-28, 2002.
- (2001) Strobino B, Williams CL, Brotanek J, Bollella, and Campanaro L: The Prevalence of Obesity in a Multiethnic Preschool Population. Presented at the American Heart Association annual meeting, Anaheim, Calif., November 11-14, 2001.
- (2000) Williams CL, Bollella M, Spark AS, Boccia L, Pittman BP. Promoting a heart healthy diet among preschool children: Outcome of the Healthy Start nutrition education and food service intervention. Presented at the American Heart Association, Lloyd J. Filer, Jr. 3rd International Conference on Atherosclerosis in the Young, San Diego, CA, March 3-5, 2000.
- (2000) Williams CL, Strobino BA, and Brotanek J, and Campanaro L: Overweight in 2 to 5 year old children is associated with CVD Co-Morbidity. Presented at the 40th American Heart Association, Council on Epidemiology and Prevention Annual Meeting, San Diego, California, March 1-4, 2000.
- (1998) Williams CL, D_Agostino C, Strobino BA, and Liebmann-Smith J: Preschool smoking knowledge and intention. Presented at the American Heart Association annual meeting, Dallas, Texas, November 8-11, 1998.
- (1998) Williams CL, Strobino BA, Squillace M, Brotanek J, Campanaro L and Pittman B: Reducing blood cholesterol in preschool children: The Healthy Start Project. Presented at the American Heart Association Annual Meeting, Council on Epidemiology and Prevention, Santa Fe, NM, Mar 20, 1998.
- (1997) D’Agostino C, D’Andrea T, Nix S, Williams CL: Increasing health knowledge in preschool children: The Healthy Start project Year 1. Presented at the annual meeting of the American School Health Association, Daytona Beach, Fla. October 22-26, 1997.
- (1997) Williams CL, Squillace M, Strobino BA, Brotanek J, Campanaro L: Cardiovascular risk factors in low income preschool children: Project Healthy Start. Presented at the 4th International Congress on Preventive Cardiology, Montreal Canada, June 29-July 3, 1997.
- (1997) Spark A, Pfau J, Bollella M, Williams CL: Does switching to 1% lowfat milk affect nutrient intake of preschoolers in day care? Presented at the annual meeting of the American College of Nutrition, New York, NY 1997.
- (1997) Bollella M, Boccia L, Nicklas C, Williams CL: Sources of nutrient intake in diets of Head Start children: Home vs School. Presented at the annual meeting of the American College of Nutrition, New York, NY 1997.
- (1997) Bollella M, Boccia L, Nicklas C, Williams CL: Assessing dietary intake in preschool children: Healthy Start, NY. Presented at FASEB, New Orleans, LA, April 1997.
- (1998). Reducing fat in preschool meals: Description of the food service intervention component of Healthy Start.
- (1998). Cardiovascular risk reduction in a preschool population: The Healthy Start Project.
- (1998). Healthy Start: A comprehensive health education program for preschool children.
- (1999). Healthy Start: A new comprehensive preschool health education program.
- (1999) Developing a computer-assisted health knowledge quiz for preschool children.
- (1999). Dietary assessment of children in preschool: Healthy Start.
- (1999). Increasing nutrition knowledge in preschool children: The Healthy Start project.
- (1999). Nutrient intake of Head Start children: home vs. school.
- (2000). What do preschool children think about cigarettes and smoking? Knowledge, attitudes, and future smoking intentions: The Healthy Start Project.
- (2002) ‘Healthy Start’: Outcome of an intervention to promote a heart healthy diet in preschool children.
- (2004) Body size and cardiovascular risk factors in a preschool population.
- Cardiovascular Risk Reduction in Preschool Children: the ‘Healthy Start’ project.
- Cardiovascular Health Promotion in the Schools. A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young