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Extension’s Just in Time

ParentingDelivers!

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• Pat Tanner Nelson, Extension Family & Human Development Specialist, University of Delaware

• Carole Gnatuk, Extension Child Development Specialist, University of Kentucky

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Today, we will focus on

• Extension’s Just in Time Parenting • Evaluations• Emerging opportunities • Key messages for parents for

preventing childhood obesity

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–Is a research and evidence-based program

–With the potential to reach every family in America.

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–Capitalizes on the “teachable moment”

–Small amounts of info–Written at 4-6th grade level–Keyed to the birthdate of child–Delivered just in time

In a NUTSHELL

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• Great Beginnings(Delaware)

• Baby Bouncer1-2-3 Grow!(Georgia)

• Zero to One(Iowa)

• Parent Express(Kentucky)

• The Growing Years(Maine)

• Baby's First Wish(New Mexico)

• Healthy Children Ready to Learn(Tennessee)

• Parenting the First Year & Parenting the Second and Third Years(Wisconsin)

• Cradle CrierToddler Tales(New Hampshire)

http://www.parentinginfo.org/

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Pulls together core knowledge for children to thrive

Developmental milestones; promoting optimum growth  

Reinforcing positive parenting behaviors

Affirming healthy interpersonal and family relationships

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A Kentucky County’s Story

• Carole A. Gnatuk, Ed.D., Child Development Specialist

• Peggy H. Powell, M.S., Montgomery County Extension Agent for Family & Consumer Sciences

University of Kentucky Cooperative Extension Service

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Purpose: To describe…• An Appalachian county’s utilization of an

age-paced parenting newsletter

• Effectiveness of a committed community coalition for parenting newsletter delivery

• Importance of a simple newsletter evaluation tool for future planning

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Montgomery KENTUCKY

ALLEN

BALLARD

BUTLER

CALLOWAY

CARLISLE

CHRISTIAN

CRITTENDEN

DAVIESS

FULTON

GRAVES

GRAYSON

HANCOCK

HENDERSON

HICKMAN

HOPKINS

LIVING-

LOGAN

LYON

MCLEAN

MARSHALL

MEADE

OHIO

SIMPSON TRIGG

UNION

WARREN

WEBSTER

CRACKEN

MC-

EDMON-

SON MUHLEN- BERG

BRECKIN- RIDGE

TODD

CALDWELL STON

WWOOOODD--

FFOORRDD

ROB- ERT-

SON

ADAIR

BARREN

BATH

BELL

BOONE

BOURBON

BOYD

BOYLE

BRACKEN

BREATHITT

BULLITT

BELL

CARROLL

CARTER

CASEY

CLARK

CLAY

CLINTON

ELLIOTT

ESTILL

FAYETTE

FLEMING

FLOYD

GALLATIN GRANT

GREEN

GREENUP

HARDIN

HARLAN

HARRISON

HART

HENRY

JACKSON

JEFFERSON

JOHNSON

KEN-

KNOTT

KNOX

LARUE

LAUREL

LAWRENCE

LEE

LESLIE

LETCHER

LEWIS

LINCOLN

MCCREARY

MADISON

MARION

MARTIN

MASON

MENIFEE

MERCER

MONROE

MORGAN

NELSON

OLDHAM

OWEN

OWSLEY

PERRY

POWELL

PULASKI

ROWAN

RUSSELL

SCOTT

SHELBY

SPENCER

TAYLOR

TRIM-

WAYNE WHITLEY

WOLFE

CUMBER- LAND

CASTLE ROCK-

FFIN

MAGO-

MONT GOM- ERY

GARR- ARD

AMINE JESS-

WASH- ING-

TON

ANDER- SON

FRANK- LIN

CALFE

MET-

PEN-

DLE-

TON

OLAS

NICH-

PIKE

BLE

TON CAMP-

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ETHNIC COMPOSITION OF MONTGOMERY COUNTY

WHITES 94.4AF. AMER. 3.7HISPANIC 1.9OTHER 0

Source: U.S. Census Data

0102030405060708090

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WHITESAF. AMER.HISPANICOTHER

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Population DistributionTotal population: 22,554

Population of Mt. Sterling: about 6000

Rural character: 62% of population classed as rural or non-farmNo county transportation system

Source: U.S. Census, 2000

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PERCENTAGE OF STUDENTS ON FREE OR REDUCED LUNCH

MONTGOMERY COUNTY 54%KENTUCKY 48%

Source: Annie Casey Foundation2002 KY Kids Court MONTGOMERY

COUNTYKENTUCKY

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Literacy and Education

Of population 25 and over --

– 14% – less than 9th grade education

– 14.8% more – dropped out between 9th and 12th grade

– High school drop-out rate – 4% (Kentucky – 3%)

Source: 2002 Kentucky Kids Count Data Book

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Montgomery County Children’s Coalition – 23 member agencies

• Addresses issues such as school retention, housing, family resources, reducing head lice, clothing drives, family literacy

• Each year a few Parent Express Newsletters mailed through county Cooperative Extension office by subscription – approximately 25 families/year.

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Parent Express Grant Project

• Early Childhood Initiative grant of $15,000

• Project Goal: Provide information on child development, literacy promotion, nutrition, wellness, and parenting skills

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Parent Express mailed free to --• All parents giving birth in county hospitals

• WIC recipients and other public health clients

• Every child care center and family day care

• Every public school preschool

• Every faith community

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Evaluation of Parent Express’s impact on parenting skills• Conducted during early 2003• Five-question survey sent to all recipients receiving

newsletters 5-14 months• Easy to read post card format• “Yes” or “no” answers required• Incentive: Chance to win $25 Wal-Mart gift

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Parents: Please take a moment to answer these questions. We value your answers. Drop this stamped card in the mail. Everyone returning a card will have a chance to win a $25.00 Wal-Mart gift certificate. Have the newsletters encouraged you to read more to your child? Yes ___ No ___ Have you used information from the newsletter in parenting your

child? Yes ___ No ___ Did the newsletter help you learn fun things to do with your child

by their age? Yes ___ No ___ Did the newsletter give you tips on what to feed your child for good nutrition? Yes ___ No ___ Do you think we should continue sending these newsletters to new

parents? Yes ___ No __ Name: ___________________ Age of your child (ren): __________ Address: _______________________________________________

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Rationale for simplicity of format --• Easy to understand for limited literacy parents

• Quick to complete

• Isolated the most important single concepts covered in the newsletters

• Non-intimidating

• More likely to be returned in post card form

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MONTGOMERY COUNTY EARLY CHILDHOOD COUNCIL PARENT EXPRESS NEWSLETTER SURVEY RESULTS

QUESTION

YES

NO NO

RESPONSE

1. Have the newsletters encouraged you to read more to your children?

94% 4% 2%

2. Have you used the information from the newsletter in parenting your child?

96% 2% 2%

3. Did the newsletter help you learn fun things to do with your child by their age?

96% 2% 2%

4. Did the newsletter give you tips on what to feed your child for good nutrition?

96% 2% 2%

5. Do you think we should continue sending these newsletters to new parents?

98% 0% 2%

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Post Card Survey Results94–96 percent of respondents felt that newsletters:• Encouraged them to read more to their children• Provided parenting information they can use• Helped them learn fun, age-appropriate activities• Gave useful feeding tips for good nutrition• Coalition should continue to send newsletters to

new parents (98 percent agree)

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Interpretation of Survey Results --

Recipients believe newsletters are effective for:

• Increasing child development knowledge

• Advancing parenting skills

• Increasing awareness of importance of literacy

• Utilizing nutrition and feeding tips

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Child Care Coalition’s assessment --

• More effective than group education in isolated rural areas without public transportation

• Congruent with Appalachian cultural tendency toward self-reliance, reluctance to leave the immediate neighborhood, and distrust of outsiders

• Non-discriminatory when sent to everyone

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Implications

This evaluation study, despite limitations, suggests:• An age-paced parenting newsletter in rural

Appalachian areas of Kentucky, utilized consistently, is effective in building parenting skills and increasing positive child development outcomes.

• A vibrant community coalition maximizes scarce resources, builds trust, and helps solve problems.

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Evaluations

• Annual mail-in surveys • Multi-state surveys with pre- and post-tests

– 16 state study– 5 state study with Head Start families

• Wisconsin study• Nevada evaluation

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Evaluations

• Parents say the newsletters make them feel more confident and competent.

• In CA, DE and WI, those who report changing behaviors and attitudes most are youngest, poorest and least educated.

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Parents rate• as highly useful more often than

any other source of information, including • Physicians• Nurses• Relatives• Other printed materials

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• A year -- compared to control group -- – had beliefs significantly less like those of

child- abusing parents. – also reported spanking or slapping their

babies significantly fewer times. • Two years -- high risk Nev. parents -- had

no substantiated reports of child maltreatment.

Parents receiving

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Parents receiving for a year

-- compared to control group, – provided a significantly more intellectually

stimulating home environment for their infants and toddlers.

– reported reading to their babies more often.

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In addition…

• Hispanic mothers in Oregon home visiting program – rated more useful than any other parenting

info – reported positive changes in six parenting

practices• Home visitors use as teaching tool

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Evaluation summary

• Helps parents have realistic expectations• Provides reassurance • Accentuates the positive • Can be read by all the adults in a family

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Evaluation summary

• Helps parents identify problems • Links parents to a broad range of

human services• Reaches “hard to reach” families• Cuts through social isolation of

abusive families

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Evaluation summary• Can reach vast audiences

– very time- efficiently and – cost-effectively.

• Can be combined with face-to-face interventions to reinforce key concepts and provide ongoing “contact.”

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Vision

– starting before birth and continuing through adolescence.

– available nationwide in every county.

– regularly updated by a multi-state, multi-disciplinary team.

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Emerging Developments

• eXtension Pioneer Community of Practice

• USDA Kobbe Innovation Grant

• NRI project with Children's Nutrition Research Center (CNRC) at Baylor College of Medicine

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An eXtension grant is helping us

• Develop core national JITP resources on an interactive web site– Ask the Expert sections– FAQs– State and county level contacts

• Recruit sustainable partners– Community of Practice and a Community of Interest

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• Develop and implement marketing strategies

• Visualize a flawless distribution system

And, the eXtension grant is helping us

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• Develop template evaluations• Focus on cost effectiveness of various

formats and delivery systems

The eXtension grant is helping to

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Who is making this happen?• eXtension Just in Time Leadership

– Aaron Ebata, PI, Univ.of Illinois– Diana DelCampo, NM State Univ.– Sally Martin, Univ of NV, Reno– Lesia Oesterreich, IA State Univ.– Susan Walker, Univ. of MD

• eXtension JITP Advisory Team– Sally Bowman, Oregon State

Univ.– Andrew Behnke, Univ. NC– Don Bower, Univ. GA– Dave Riley, Univ. WI– Lenna Ontai-Grzebik, UC Davis

• Esteemed advisors– Anna Mae Kobbe– Caroline Croccoll

• eXtension JITP Support Team– Kirk Bloir, Ohio State Univ– Denise Brandon, Univ of TN– Sharon Cowan, Univ of NH– Jodi Dworkin, Univ. of MN– Sara Gable, Univ. of MO– Kim Leon, Univ. of MO– Debbie McClelland, Univ of Il– Gerri Peeples, Univ of Il– Harriet Shaklee, Univ of ID

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Would you.. – Use eXtension Just in Time

Parenting?• How would you use?

– Like to be• A content reviewer?• A contributor for priority

topics?– Help with

• local and/or state contacts?

• marketing materials?• fund development?

– Help in other ways?

Send your contact information and a brief summary of how you would like to get involved to ptnelson@udel.edu

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USDA Kobbe Innovation Grant

Lit. Review: parents’ role in childhood obesity prevention  

Highlights of the Lit. Review

Key Messages for parentsIntegrate into JITP

Available http://ag.udel.edu/extension/fam/

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Childhood Obesity Prevention Team

• Drew Betz, Whatcom County Extension Educator, Washington State University

• Diana DelCampo, Extension Family Life Specialist, Child Development & Family Life Specialist, New Mexico State University

• Shirley Gerrior, CSREES National Program Leader in Human Nutrition

• Carole Gnatuk, Extension Child Development Specialist, University of Kentucky

• Sheryl Hughes, Developmental Psychologist, Children’s Nutrition Research Center, Baylor College of Medicine

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Childhood Obesity Prevention Team

• Sally Martin, Human Development Specialist, University of Nevada, Reno

• Susan Nitzke, Nutrition Specialist, University of Wisconsin

• Madeleine Sigman-Grant, Extension Health and Nutrition Specialist, University of Nevada, Reno

• Sue Snider, Nutrition Specialist, University of Delaware• Beth Van Horn, Centre County Extension Educator,

Penn State University• Susan Walker, Extension Child Development & Family

Support Specialist, University of Maryland

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Factors associated with lowering obesity risks• Regular physical exercise• High dietary fiber intake (veggies, fruits)• Healthful food choice environments• Breast-feeding• Shared family meals• Mother’s knowledge of nutrition• Positive parental role modeling

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Parents

• play key role in – Food consumed in and outside the home– Children’s food preferences– Exercise habits– Amount and timing of television

• often find their efforts overridden by the broader environment.

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Broad themes to promote…

Breastfeeding

Physical activity Reduced screen time

Nutrition education Food education

Family mealtimes Environmental awareness

Developmentally keyed Positive parenting

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Key messages for parents

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Help children learn to like the foods that are good for them.• Offer healthful food regularly.

– Breastfeed• Children have to learn to like fruits, veggies and whole

grains.– It may take up to 15 times.– Be a great role model.

• Accent foods that are nutrient rich.– Limit foods that are low in nutrients and high in fats and calories– Avoid sweetened drinks and limit fruit juice– Offer milk at meals and water between meals.

• Limit children’s exposure to advertising.

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Help children learn to eat the amount that is “just right.” • Eat when you are

hungry, stop when you are full.– Recognize hunger

cues.– Avoid using food as a

reward or comfort.

• Mind portion sizes.– Most will overeat when

given large portion sizes.

– Let children serve themselves.

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Avoid restriction.

• Restriction nearly always backfires – and makes the problem worse.

• Make food choices in your home as healthful as possible.

• Never put a child on a diet to lose weight unless under a doctor’s close supervision.

• Help children grow into healthy weights by accenting healthy habits – not diets.– Some children are born to

be large, some small.

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Move more. Sit less.• Help everyone find

physical activity they can enjoy every day.– Physical activity tends

to drop in teen years.• Think up ways to

have active family fun.

• Limit screen time for everyone in the family to less than 2 hours a day.– No screen time under

2!– No TVs or computers

in bedrooms.• Limit children’s

exposure to advertising.

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Be the best “healthy habits” role model you can be.

• Your child learns by watching and imitating you.

• Love your body. Your child will pick up on your cues and learn to like or dislike his/her body.

• Start as healthy as possible.– Being overweight presents

special challenges for pregnant moms and their babies.

• Evolve toward a healthy weight by focusing on healthy habits, not diets.

• Small changes over time can make a BIG difference!

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Use routines and limits to help children feel safe, loved.

• Set regular times for family meals, snacks, naps and bedtimes.

• Eat better. Eat together. Focus on each other.

• Involve children in choosing and preparing healthful foods.

• Build activity into your routines with family chores and family walks.

• Plan fun times together – “family glue.”

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Discussion and Feedback

• How would you change the key messages? – What would you add? Subtract? Modify?

• For parents, should this be framed as – Make healthy habits a family affair (gently)– Help your child have a healthy weight (straight on)

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Please share your ideas!

ptnelson@udel.edu Pat Nelson