the Institute for Healthcare Advancement sought to provide Head Start parents with the skills and knowledge to


  • enable them to become better caregivers by improving health care knowledge and skills,
  • empower them in decision making,
  • enhance their self esteem and confidence, and
  • contribute to reducing escalating health care costs.

The program provides training and information for implementing health care literacy programs.

During the research phase, the institute conducted a survey of Head Start families. The survey revealed that only 20 percent of families had any health care reference material at home. Less than 5 percent said that they would first refer to a book for information if a child was sick. Almost 70 percent of families said that they would first go to their doctor if a child was sick; 4.5 percent said they would visit the emergency room. Once training was provided, there was a tenfold increase (from 4.7 percent to 47.55 percent) in the families who first referred to a book for information when a child was ill.

Since the program began, HCI has engaged in training with 55 Head Start programs in 38 states, resulting in 14,000 families of ten different ethnicities receiving training in seven languages. Training sessions took place in the evening after work for three hours. In the training sessions, parents learned when it is necessary to keep a child home due to illness and how to use their interactions with doctors effectively. An important observation made was that training cannot consist simply of giving a book to the parents. It takes personal interaction with a person who can notice if a parent cannot read, who can help the parent use a book effectively, and who can help personalize the book and make it the parent’s own. It takes someone whom the parents trust, who can sit down next to a parent and help him or her go through the materials. That, Person said, is what is special about Head Start and certain other community-based organizations.

Following the training there was a 42 percent drop in the number of doctor visits and a 58 percent drop in the number of emergency room visits. The institute was able to convince parents that doctors are resources, not only for medical care, but also for information and consultation. There was also a 29 percent drop in the average number of school days missed and a 42 percent drop in the average number of work days missed.

While the goal of training was not to save money, by decreasing doctor and emergency room visits, the savings per family trained was $554 per year. Given that there were approximately 9,000 Head Start families

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