V (L DEL ALLE - NADBserver.cocef.org/Final_Reports_B2012/20208/20208_Final...Environmental...

11/29/2012

Submittted by Luis Olmedo, Excecutive Director

COMITE

CIVICO

DEL VALLE

REDUCING CHILDREN’S ENVIRONMENTAL HEALTH

RISK (LEAD, ASTHMA AND PESTICIDES)

2

ABSTRACT

Reducing Children’s Environmental Health Risk (Lead, Asthma, and Pesticides)

Along the US Mexican Border

Project Period: April 2012-November 2012

Funded by the Border Environment Cooperation Commission (BECC) and the

Environmental Protection Agency, Clinicas de Salud del Pueblo, Inc, and Comite Civico del Valle,

Inc. independently yet collaboratively implemented a community health program aimed at reducing

the risk of environmental toxins derived from lead, pesticides, and cleaning products. The programs

used intervention strategies unique to each organization and tailored to specific sub-populations

along the US/Mexican border. While CSP and CCV both utilized individual and group platforms

from which to launch their educational campaign using a “promotora” or community healthcare

model, each owned a captive audience. For example, CSP was able to capitalize on the use of its

lobby and waiting rooms to recruit participants while CCV was forced to take stock in prior project

participant roster and agency partners. Whereas CCV employed a home visitation model, CSP was

limited to conducting intervention activities at community events. There are substantial benefits to

working in the “home” versus public events that may include logistical and practical complications.

However, community events provide a venue for disseminating information to large numbers where

a consideration for quantity over quality is appropriate. Both organizations employed similar

outreach strategies, however each executed them in a complementary fashion. In addition,

intervention activities varied. For example CCV conducted Green Cleaners demonstrations

exclusively as CSP implemented the Safe and Healthy Children’s Curriculum.

When raw data sets were compared, interesting findings were observed. Whereas both

organizations measured identical performance variables, frequencies were dissimilar. 17% of CSP

respondents reported pesticide drift, nearly double of the respondents from CCV reported that

pesticide application reached their home. Over 30% of CCV respondents stated they had at least

one child living with them who had asthma while 22% of CSP respondents stated the same. CCV

had a higher percentage (54%) of families living near agricultural fields while CSP had nearly 32%.

With respect to smoke reaching their homes, CCV reported 38% and CSP 1%. Overall knowledge

gains were comparable in that both cohorts experienced substantial cognitive gains post-intervention

indicating that both organizations experienced program effectiveness.

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Reducing Children’s Environmental Health Risk (Lead, Asthma, and Pesticides)

Along the US Mexican Border

Project Period: April 2012-November 2012

Introduction

Children are often more heavily exposed to toxics in the environment. Pound for pound, children

breathe more air, drink more water, and eat more food than adults. Their behavior patterns, such as

playing close to the ground and hand-to-mouth activity, increase their exposure to potential toxics.

In addition, they may be more vulnerable to environmental hazards because their systems are still

developing, often making them less able than adults to metabolize, detoxify, and excrete toxics.

Environmental risks to children include asthma-exacerbating air pollution, lead-based paint in older

homes, treatment-resistant microbes in drinking water, and persistent chemicals that may cause

cancer or induce reproductive or developmental changes (Environmental Protection Agency).

Comite Civico del Valle is a non-profit organization that is dedicated to improving the living conditions of Imperial County through advocacy, education, capacity building and civic participation. Comité Cívico Del Valle, Inc. (CCV) was founded in 1987 in Imperial County, California, as an organization striving to improve the lives of low-income families in Imperial County. Our mission is: “Improving access to healthcare and provide education and prevention programs for low income, underserved, Imperial County families.” Their work includes environmental justice, community organizing, policy development in areas of air quality, water contamination, and hazardous dumping. Implementing a “Promotora Model,” CCV has made numerous strides in advancing public health especially among migrant farmworkers along California’s US/Mexico Border Region.

Under this project, the objectives were as follows:

Visit at least 10 households per month with children 0-5 utilizing the “Tool Kit”

Visit 5 childcare providers per month utilizing the “Tool Kit”

Coordinate with Clinicas to participate in health fairs and Asthma Walk

Provide 2 workshops to Clinicas staff on 1) non-toxic green products, 2) IVAN web-based environmental reporting database

Meet bi-weekly with Clinicas staff to measure progress and coordinate project activities

Methods

4

A total of 184 individuals participated in the program which administered by promotoras/health

education specialists who were trained by Comite Civico del Valle. Participants were recruited from

a list of local child care providers that was acquired through the local resource and referral agency as

well as key informant interviews. Of those, 41 respondents reported providing child care from

nearly 20 different distinct sites. Nearly 100 children and 133 were single family households

(Appendix A) caring for over 120. After scheduling a mutually appealing time for an educational

visit, staff visited each childcare provider facility or household during both day and evening hours.

A variety of local activities were identified in a number of communities across the Imperial County

where the majority of participants were derived from the main county seat of El Centro with

Brawley and Calexico having a significant segment of the sample. The activities included health

fairs, buddy referrals, community venues, and early childhood partnership opportunities.

A substantial segment of the sample consisted of caregivers who provided care for children under

the age of 6. One particular childcare center had 60 children in their care. A total of 129 children

under the age of 6 were accounted for by caregiver report under the household segment (not under

facilty). A total of 55 household reported at least one child with 74 reporting two or more under age

6. In addition, over a dozen staff members from a Federal Head Start program were trained as a

component in their staff development protocol.

15%

15%

6%

37%

11%

2% 7%

0% 4% 3%

Geographic Location

Brawley

Calexico

Calipatria

El Centro

Heber

Holtville

Imperial

Niland

55 60

11 2 1

1 2 3 4 5

Number of Single Households with Children

under 6

5

Prior to each individual receiving a 1

hour, 34 slide presentation intervention, a

pre-test was administered (Appendix B).

A typical outreach and education session

consisted of a basic overview of asthma

and its triggers, pesticides and the

dangers of pesticides exposures along

with short and long term effects, what is

asthma and its triggers and an alternative

approach to harmful cleaning and

household chemicals used indoor, lead

poisoning education and alternatives to

harmful cleaning products. Each visit

will consisted of green cleaning products demonstration, toxics vs. green products education and

preparation of safe cleaning solutions as alternative to more toxic cleaning products.

Asthma Hospitalization Rates

Asthma Triggers

Pesticides Exposure

Lead Poisoning

Toxic vs. Green Cleaning Products

In addition, participants were asked to make

commitments to individual behaviors that put

them at less risk of exposure (Appendix C).

Caregivers were most likely to make commitments

to keeping children inside during poor air quality days than they were to run cool water as opposed

to hot water in order to reduce the risk of lead poisoning. They were more likely to engage in

simple behaviors such as handwashing versus more complex behaviors such as fixing leaks in the

plumbing system to prevent mold build-up.

Results

Elevated levels of lead were consistent with State levels at 2%. Twenty-two respondents

were unsure if anyone in their household or facility had elevated levels of lead.

Over 30% of the respondents stated they had at least one child living with them who had

asthma.

More than 70 respondents reported that smoke from burning fields had reached their home

or facility.

Over half the sample reported living in close proximity to an agricultural field and of those

almost 30% reported pesticide drift that reached their home

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Improved knowledge was demonstrated

across all measures as a result of the

intervention. The largest cognitive gains

were observed in relation to lead

poisoning and young children. Less

gains were observed with respect to

pesticide transmission with elevated

awareness about how pesticides enter

the body and how one can be exposed;

possibly lending itself to aggressive

educational campaigns launched over

the past few years. However, there

appeared to be some perception that

certain pesticides were safer than others. This might have been a result of the core content

highlighting household pest control measures such as roach or ant control that may have been

overlooked as hazardous.

Knowledge Item Pre (n) Post (n) % Change (+/-)

Imperial County has the highest asthma hospitalization rate in the state. (True)

162 180 +10

Asthma triggers like cockroaches, mold and dust can all make asthma worst. (True)

182 185 +2

Pesticides enter the body through the eyes, nose, skin and mouth. (True)

179 182 +1.7

All pesticides are poison. (True) 138 171 +24 My family can be affected by pesticides even if we don't work in the fields. (True)

177 183 +3.4

Children 6 years and older are at greater risk to lead poisoning. (True)

157 176 +12

A home built before 1978 may have lead based paint. (True) 169 184 +9 Lead is dangerous to small children because they put their hands and objects that may contain lead dust in their mouth. ( True)

101 135 +34

The more bleach or household products I use to clean my home the cleaner it is. (False)

77 63 +13

Nearly all participants found the information to be helpful and useful to their daily lives. Many

participants followed-up with qualitative comments and concerns that indicated the value conveyed

by project (Appendix D). We learned that caregivers are very concerned about living near

agricultural areas where pesticides are being applied and fields were being burned. Staff got the

sense that caregivers were better equipped to protect the children and themselves in both home and

work settings.

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Discussion and Implications

There are many benefits to reaching out to caregivers of young children regarding the dangers of

environmental hazards such as lead, poor air quality, mold, pesticide exposure, and cleaning agents.

There appears to be great interest in reducing the risk in the home as well as the child care facility.

This is evident is the excess numbers of presentations documented during this short 6 month

period. Along the US/Mexican Border, there are many barriers that create a heightened risk for

exposure to toxins. A program such as the one highlighted here reduces families’ risk of being

exposed to dangerous levels of lead, pesticides, and harmful chemicals. In addition, it trained

caregivers to provide additional safeguards when caring for young children as well as improving

occupational health.

Benchmark Measure Outcome Excess

60 Households 133 Presentations 73

30 Childcare Facilities 41 Presentations 11

2 Partner Workshops 2 Workshops met

Additional Activities: 1 staff development workshop 3 Community Health Fair

1 Summer In-Service 3 Green Product demonstrations

exceeded without measure

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APPENDIX A

Head Start Parent Meeting Presentations 1. Mckinley & Dr. Joseph Vogel Campesinos Unidos Head Start, El Centro 2. Claudio Carmona Campesinos Unidos Head Start, Calexico 3.Victor Jaime/K.M.M.M.C. Campesinos Unidos Head Start, El Centro 4. Claudio Carmona Campesinos Unidos Head Start, El Centro 5. Michael Aleksick Campesinos Unidos Head Start, Niland 6. Westmorland Campesinos Unidos Head Start, Westmorland 7. Imperial Campesinos Unidos Head Start, Imperial 8. Norah L. Sanchez Campesinos Unidos Head Start, Heber 9. United Families Salton City Preschool, Salton City 10. ICOE (IMPERIAL COUNTY OFFICE OF EDUCATION) Kids R Us Preschool, El Centro 11. ICOE Little Roadrunners Preschool, El Centro 12. United Families Calipatria Preschool, Calipatria Licensed Child Care Facilities 1. Lucero Altagracia Family Child Care, El Centro 2. Graciela Olivares Family Child Care, Brawley 3. Maria Olvera Family Child Care, Brawley 4.Valentina Soto Family Child Care, Brawley 5. Benitez Family Day Care, Calexico 6. Family Treehouse, Imperial 7. Alma Mercado Family Child Care, Calipatria 133 Households in El Centro and Imperial Health Fair 1. Family Treehouse Earth Day Celebration 2. 10th Annual Imperial Valley Housing & Supportive Service Fair (CalWorks and IVROP Project Work), El Centro 3. Imperial Valley Community Health Fair; Cool Kids Imperial Valley, Brawley Workshops 1. Non-Toxic Green Products to Clinicas de Salud del Pueblo 2.IVAN Website: Environmental Reporting Data Base to Clinicas de Salud del Pueblo Staff Development Campesinos Unidos Head Start Program (teacher's, supervisor's and other staff members)

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APPENDIX B

Pre-/Post- Test

City ? / ¿Ciudad?_____________________ Date/ Fecha___________

Are you a daycare provider? / ¿Es usted provedor de una guardería de

niños?_________________________________________

If answered yes, how many children do you provide care for? / Si contesto que sí a la pregunta anterior,

¿cuántos niños cuida?____________________________

How many children under the age of 6 live in your home? / ¿Cuántos niños menores de 6 años viven en

su hogar?______________________________________

How many children in your home or facility have asthma? / ¿Cuántos niños en su hogar o facilidad

tienen Asma? ___________________________________

Pre- Test TRUE/ Cierto

FALSE/ Falso

1. Imperial County has the highest asthma hospitalization rate in the state.

*El Condado de Imperial tiene el más alto porcentaje en hospitalizaciones por asma del estado.

2. Asthma triggers like cockroaches, mold and dust can all make asthma worst.

*Causantes del asma como cucarachas, moho y polvo pueden empeorar el asma.

3. A pesticide enters the body thru the eyes, nose, skin and mouth.

*Los pesticidas entran al cuerpo a través de los ojos, la nariz, piel y boca.

4. All pesticides are poison.

*Todos los pesticidas son venenosos.

5. My family can be affected by pesticides even if we don’t work in the fields.

*Mi familia puede ser afectada por los pesticidas, aún cuando no trabaje en los campos.

6. Children 6 years and under are at greater risk to lead poisoning.

*Niños de 6 años o menores están en mayor riesgo de envenenamiento por plomo.

7. A home built before 1978 may have lead based paint.

*Una casa construida antes de 1978, puede tener pintura a base de plomo.

8. Lead is dangerous to small children because their hands and objects in mouth that may contain lead dust.

*El plomo es solamente peligroso a niños pequeños, porque sus manos y los objetos que se colocan en la boca pueden contener polvo de plomo.

9. 9. The more bleach or household products I use when cleaning my home, the

the cleaner it is. *Mientras más productos de limpieza, como el blanqueador, utilice para

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Limpiar mi hogar, más limpio estará.

10. Do you live close to an agriculture field?

¿Usted vive cerca de un campo de agricultura?

Yes

No

11. If answered yes to question 10: Does the pesticide applied in nearby fields

reach you home? ¿Si contesto si a la pregunta 10: Los pesticidas que se aplican en los campos

cercanos, alcanzan a su hogar?

Yes

No

12. Has anyone in your household had elevated levels of lead?

¿Alguien en el hogar tiene niveles elevados de plomo?

Yes

No

13. Has the smoke from burning fields ever reached your home?

¿El humo de los incendios en los campos alcanza llegar a su hogar?

Yes

No

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APPENDIX C

How can I protect children from asthma attacks?

I commit to dishing the childcare center often. 96 72%

I commit to vacuuming carpets and fabric-covered furniture regularly. 109 81%

Exposure to mold can trigger an asthma attack.

I commit to preventing mold by fixing leaks and other water problems as soon as

possible to prevent mold from growing. 121 65%

Cockroaches can trigger an asthma attack.

I commit to keeping counters, sinks, tables, and floors clean and free of clutter. 129 70%

Pet dander can trigger an asthma attack.

If there is a pet inside, I commit to vacuuming carpets and furniture often. 94 51%

Chemical irritants found in cleaning products, pesticides, and air freshmen's

can trigger an asthma attack.

I commit to not using products with chemical irritants (such as cleaning products,

pesticides, and air fresheners) when chidden are around. 110 87%

I commit to opening windows or doors, or using and exhaust fan if I must

uses product with chemical irritants. 102 80%

Outdoor air pollution can trigger asthma.

I commit to letting children play outdoors when air quality is good. 115 91%

I commit to limiting children's play time outdoors when air quality is poor. 98 78%

How I can protect children from pesticide exposure:

I commit to store pesticides and toxic chemicals where children cannot reach them. 125 93%

If I have to use a pesticide or other chemical, I commit to not use pesticides

or other chemical products when children are present and will remove

children's toys from the area. 104 78%

How can I protect children from lead poisoning?

I commit to having children was their hands before eating. 128 94%

I commit to washing children's bottles and toys and washing floors

and windowsills often. 110 81%

I commit to reducing lead in drinking water by running the cold water for at

least 30 seconds to flush lead from pipes. 93 68%

I commit to only use cold water for drinking, cooking, and making buy

formula because hot water is likely to contain higher levels of lead. 88 65%

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APPENDIX D

Qualitative Commentary

Respondents were asked to share additional thoughts, concerns, or commentary with the Project.

1. Imperial Valley air quality can affect if we dont learn the right precautions. 2. Very helpful and great info. 3. Great presentation, practical ideas. Especially to think twice when using cleaners around the house. 4. I want to know if is there any place or help grant to help the community to know if in the house have

lead in the paint 5. Very helpful. Thank you. I wasn't aware of lead in candy. 6. Loved the presentation 7. Very good information. 8. Very good presentation, to bad that we didn't had any more time 9. Good information 10. Thanks 11. Very good information, very useful 12. Very good information 13. Good presentation 14. I learned about what kind of items contain lead and can cause lead poisoning to my son. It was very

helpful. 15. Thank you for all the information 16. I live near to the agriculture field and I am worried that the pesticide can reach to my house. The

presentation that I receive it was very important for me and my family. 17. Its very important this information for us, because we live so near of the agriculture fields pesticides 18. We have the field near to us. Thanks for give us the information 19. Thanks for the information and concern for our kids 20. Thanks for the information it was very important to know. 21. Thank you! It was very helpful 22. No buy more candies at Mexico 23. I learn a lot 24. the information is helpful 25. devemos de tomar muchas pecauciones, con los que limpiamos, en nuestro hogar. Y mivimos aun

lado de campo y fumigan muy amenudo. 26. its bad 27. My son and I have asthma so this is very important and helpful to me. 28. Very helpful information 29. Please provide CD regarding environmental issues 30. This was very helpful. 31. This was good information

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BORDER 2012 PROJECT

FINAL REPORT

I. SUB-GRANTEE/CONTRACTOR Information:

Name: Clinicas de Salud del Pueblo, Inc.

Institution: N/A

Address: 1166 K Street, Brawley, CA 92227

E-mail: [email protected]

II. Title of Project: Clinicas de Salud: Reducing Childhood Environmental Risks Along the US-Mexico Border

III. Starting date: April 17, 2012

IV. Total Project Duration: Six months

V. Date of Final Report: November 15, 2012

TABLE OF CONTENTS

VI. Introduction/ Background/Identified Problem Clinicas de Salud del Pueblo, Inc. (Clinicas) is based in the Imperial County, an international border community with an agricultural based economy. Residents in our area are exposed to the daily activities of the agriculture industry which includes ground and aerial application of pesticides and burning of fields. Although there are agencies and protocols in place to monitor and regulate these activities, residents are still vulnerable to exposure simply be virtue of proximity. The LA Times featured an article; Imperial County leads the state in treatment of children with asthma, by Ann Gorman, July 16, 2012, addressing the situation in our area and its impact children. “Doctors and public health officials said that a combination of whipping winds, pesticide-tinged farmland dust and large numbers of low-income families lacking health insurance contribute to high rates of asthma hospitalizations and ER visits… Asthma is so prevalent among the students at Barbara Worth Junior High School in Brawley that the principal sends air quality alerts to his teachers and regularly cancels outdoor activities.”

In fact, Clinicas Chief Medical Officer, Dr. Afshan Baig, and a pediatric patient of the Calexico clinic were cited in the article. Clinicas de Salud is a 501(C)3 non-profit community health center. The majority of 55,000 people served annually in our clinics are low-income, Medi-Cal patients. Many of the children suffering from asthma and other respiratory issues are patients of Clinicas. As a result, when Clinicas was offered consideration for the Border 2012 Project, we were pleased about the opportunity to: 1) increase awareness about childhood environmental risks; 2) educate patients, parents, and the public about minimizing risks for

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children; and, 3) create linkages between patients and service providers, programs, and resources.

VII. Objectives Clinicas experience in health promotions and our network of community partners steered the outreach methodology to classroom presentations and community event outreach. These two forums provide an effective method to coordinate and deliver services to the public. Based on the program staffing and duration, and seasonal considerations, Clinicas de Salud projected serving 450 families and/or child care providers through the Border 2012 program as follows:

1. 200 (or more) parents and/or child care providers will participate in Educational Group Sessions; and,

2. 250 individuals will receive One-to-One Outreach at community events.

VIII. Project’s Strategy Clinicas approach to the Border 2012 project was to utilize the network of community resources at our disposal and take into account the limitations of accessibility to events and the public due to seasonal impacts during the summer months, which represented half the program duration. We hired two part time staff members to coordinate and implement the program. Upon reporting to work, staff was provided a program orientation and training on the Safe and Healthy Children curriculum, IVAN website, the local Environmental Task Force, CALPACT Asthma webinar, Green Cleaning Products, and Community Advocacy. (The Safe and Healthy Children training was opened to our program partner’s staff and to local community health workers who were interested in acquiring knowledge and/or expanding their subject matter expertise.) The community Health Workers promoted the program by coordinating visits to coalition, advisory committee, and work group meetings that Clinicas belongs to throughout the valley, and announcing the services available. They also made telephone solicitations to agencies serving the program’s targeted population. Staff then responded to requests for details about the outreach activities and provided samples of materials to be disseminated to demonstrate the content of the program. At the same time staff was gathering/ordering the necessary materials and scheduling activities with various agencies. The scheduling of outreach activities kicked off about the time summer was starting, school was ending, and child care centers were preparing to close for two months. Here, in the desert southwest, the pace slows down significantly between June and August, and community activities come to a standstill. It was challenging getting through to the child care centers before they went dark; still, staff managed to schedule One-to-One outreach activities at child care center parent meetings, a children’s fair and a library event for parents during the months of May and June. Benchmarks

The One-to-One objective was met two months into the six month program, with 267 parents being contacted April and June

The Educational Group Session objective was met between July and September with 239 parents being contacted

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Staff continued to promote One-to-One and Group Session activities after both objectives were met, and contacted an additional 564 parents during October

1,100 participants were served by the program in a six month period

IX. Methods or Work Description

Clinicas de Salud was to provide outreach to parents and/or child care providers of children ages 0-5 years of age through Educational Group Sessions and One-to-One Outreach. The Educational Group Sessions were presented in English and Spanish, as needed, throughout the Imperial Valley. The one-hour classes include a minimum of ten participants and were conducted from July through October. The classes were offered in cities though out the county; however, our largest responses came from organizations located in the county seat, El Centro. Clincas also performed One-to-One Outreach throughout the community at children’s fairs, health fairs, school events, a farm worker meeting, child care centers, a library, and clinic lobbies. The method of instruction for the educational group sessions included: facilitator instruction, group discussions, interactive activities, and demonstrations. The group sessions followed the Safe and Healthy Children’s curriculum and addressed the Unique Vulnerability of Children, Preventing and Reducing Exposure(s), Community Support and Collaboration, and Pre- and Post-Evaluation. The One-on-one Outreach covered the same content but in a condensed version. The same materials were distributed to all participants whether they were reached via a group session or one-on-one contact.

X. Results: One-to-One Outreach Objective: 250

753 parents received One-to-One contact overall One-to-One outreach objective was exceeded by 200% City of Calexico realized the 58% of participant contacts Community Fairs generated 62% of participant contacts

Geographic Location Number of Events

Participants Contacted

Percentage of People Served

Brawley 5 107 14%

Calexico 4 440 58%

Desert Shores 1 16 2%

El Centro 5 127 17%

Heber 1 17 2%

Holtville 1 13 2%

Westmorland 1 33 5%

Total 18 753 100%

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Outreach Forum Number of Events


Percentage

Library 1 13 2%

Grammar School 1 33 4%

Clinics 4 61 8%

Child Care Centers 6 179 24%

Community Fairs 6 467 62%

Total 18 753 100%

Educational Group Session Objective: 200

347 parents participated in Group Sessions overall Educational Group Session objective was exceeded by nearly 75% The Educational Group Sessions averaged 22 participants per session City of El Centro realized the 63% of participant contacts Child Care Centers generated 36% of participant contacts WIC followed closely with 32% on participant contacts

Geographic Location Number of Events


Percentage of People Served

Brawley 2 32 9%

Calexico 2 56 16%

El Centro 10 217 63%

Seeley 1 30 9%

Westmorland 1 12 3%

Total 16 347 100%

Outreach Forum Number of Events


Percentage

Community Fairs 1 21 6%

Clinics 2 25 7%

Training Centers 2 67 19%

WIC 5 109 32%

Child Care Centers 6 125 36%

Total 16 347 100%

Survey Responses Pre- and Post-Test Responses for Participants in the Educational Group Sessions

Nearly 3% of respondents (10 of 347) stated that a child in the home had tested positive for elevated level of lead

22% of respondents (79 of 347) indicated that a child in their home has asthma

Nearly 3% of respondents (10 of 347) reported that their child had had experienced pesticide exposure requiring medical attention

Nearly 33% of respondents (115 of 347) reported they live near and agriculture field

19% of respondents (55 of 288) said pesticide applications reach their home

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Nearly 23% of respondents (66 of 288) said smoke from burning fields reaches their home

Knowledge Increase: respondent’s knowledge of lead poisoning, asthma triggers and pesticide exposure prior to and following educational group sessions:

Response Pre-presentation Post-presentation Outcome

Poor 95 8 92% Increase

Fair 148 51 66% Increase

Good 74 141 48% Increase

Very Good 20 101 80% Increase

Excellent 5 40 87% Increase

Non-response 5 6 N/A

Total 347 347 N/A

Commitment Forms All participants of the Educational Group Sessions completed Commitment Forms. Staff assisted participants in completing the forms and verified that each participant had in fact read and completed a Commitment Form. However, due to time constraints and access to photocopiers at each of the sites, we were not able to keep a copy of the Commitment Forms.

XI. Discussion Clinicas de Salud was extremely pleased with the outcome of the EPA childhood environmental risk program. Local community partners were grateful for the opportunity to provide educational presentations to their clients. We found that a number of agencies had health care focused programs of their own going on at the same time, so our program complimented their programs. Also, despite the challenges of conducting outreach in our area during the summer months, staff managed to meet the objectives in a timely manner. Classroom discussions revealed that parents are not only interested in the topic of childhood environmental risks, but that they also needed information on local resources regarding available services. Our program facilitated linkages between the staff of agencies partaking of our services, as well as their participants. The majority of requests for information were directed to the local Asthma Society, and the Imperial County Public Health Department, Agricultural Commissioner’s Office, and Air Quality Control office.

XII. Recommendations: Clinicas de Salud’s Community Health Workers will continue to promote awareness about childhood environmental risks at outreach events. As a result of this program, we now have a section of updated resources in our health topics inventory designated to environmental health risks. Although the program ended October 31, 2012, Clinicas continues to receive requests for presentations on childhood environmental risks and will continue to accommodate these requests so long as staff is available, through other funding sources, to promote the program.

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Although, many concerns were voiced regarding children’s respiratory issues during the outreach contacts, lead poisoning is something that most people are not aware of. The program participants repeatedly voiced concerns regarding their lack of knowledge, local resources and legislation to address the matter. Program participants repeatedly mentioned frustration with the availability of food products and cookware containing lead. Also, when parents find out that a child has been exposed to lead, other than taking the child to the pediatrician for an exam they are clueless of what to do to avoid further exposure or reduce risks. It would be extremely beneficial for the EPA to make additional funding available to address these concerns and increase awareness about these risks. Because of our natural environment and the agricultural based economy, residents of Imperial County are vulnerable to exposure to harmful elements that can be avoided or minimized if people were aware of basic things they can do to protect themselves and their families from these risks.

XIII. Project related Photos Please see the attached two pages of photos from the outreach events staff participated in. Also, the digital camera that was used to photograph events during the summer months was damaged and the pictures were not retrievable. As a result, we only have photos from our participation in events the months of April, May, September and October. References None. Appendixes

A. One-to-One Outreach Summary B. Educational Group Presentation Summary C. Community Health Outreach Staff Training Summary

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Clinicas de Salud del Pueblo, Inc. Community Health Outreach Photographs

EPA Border 2012 Project

Reducing Childhood Environmental Health Risks along the U.S. - Mexico

Border

April 28, 2012, Mexican Consulado Di del

Niño. Cecilia Cota, CHW, providing

information to the public.

May 15, 2012, Calexico Neighborhood House.

Cecilia Cota, CHW, addressing parents about

lead poisoning and testing.

September 12, 2012, United Families

Preschool, Westmorland. Cecilia Cota, CHW,

talking to parents at a monthly meeting.

October 3, 2012, Westmorland Walk-to-

School Day. CHW’s providing information to

parents and conducting educational activities

with children.

October 3, 2012, Walk-to-School Day in

Westmorland. CHW Ana Solorio, students

and care givers walking to school.

October 9, 2012, CET in El Centro. Celina

Cisneros, CHW, informing parents about

childrens vulnerability and exposure risk

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Clinicas de Salud del Pueblo, Inc. Community Health Outreach Photographs



Border

October 9, 2012 CET Health in El Centro.

CHW’s Cecilia Cota, Celina Cisneros and Ana

Solorio teamed up for presntations.

October 10, 2012, Mental Health Fair in El

Centro. Mary Ramirez, Medical Assistant,

providing public with health information.

October 16, 2012, Desert Shores Health Fair.

Ana Solorio, CHW, providing asthma trigger

information to the parents.

October 19, 2012, Farm Worker Health Fair.

CHW’s Mireya & Ana providing educational

materials to all the attendees.

October 20, 2012 Down Syndrome Health

Fair. CHWs ready for the public, waiting for

event to kick-off and parents to arrive.

October 20, 2012, Down Syndrome event.

CHWs participating in a physical activity

demonstation with other presenters.

22

Clinicas de Salud del Pueblo, Inc. One-to-One Outreach Summary



Border

Project Activity: One-to-One Outreach

Event Date Parents

Contacted

Staff Trained

Rockwood Park

5th

and Mary Streets

Calexico, CA 92231

Mexican Consulado Día de los

Niños

04/28/12 75 participants

3 sign-in sheets

N/A

Neighborhood House

506 East 4th

Street

Calexico, CA 92231

Parent Meeting


4 sign in sheets

7 Instructors

C.U.I. Head Start

1045 Heber Avenue

Heber, CA 92249

Parent Meeting


1 sign in sheet

2 Instructors

United Families Pre-school

300 North Palm Avenue

Brawley, CA 92227

Parent Meeting


3 sign in sheets

3 Instructors

United Families Preschool

1660 Smoketree Drive

El Centro, CA 92243

Parent Meeting


1 sign in sheet

2 Instructors

United Families Pre-school

937 Heber Avenue

Calexico, CA 92231

Parent Meeting


1 sign in sheet

2 Instructors

C.U.I Head Start

160 South Cesar Chavez

Brawley, CA 92227

Parent Meeting


2 sign in sheets

2 Instructors

I.C. Free Library

101 E. 6th

Street

Holtville, CA 92250

Health Fair


1 sign in sheet

2 Library Techs

1 Volunteer

Westmorland Elementary School

200 South C Street

Westmorland, CA 92281

Walk-to-School Day - Health Fair

10/3/12 33 Participants

4 sign in sheet

N/A

23

Women’s Center

651 Wake St. Suite A

El Centro, CA 92243

Patient Lobby


1 sign in sheet

N/A

Clínica de Salud

900 Main Street

Brawley, CA 92227

Patient Lobby


1 sign in sheet

N/A

Imperial County Behavioral Health

120 North 8th

Street

El Centro, CA 92243

Mental Health Fair


3 sign in sheet

N/A

Clínica de Salud

900 Main Street

Brawley, CA 92227

Patient Lobby


1 sign in sheet

N/A

Desert Shores Community

Services

Hwy 86 & Monterey Avenue

Desert Shores, CA 92274

Health Fair


1 sign in sheet

N/A

Imperial County One Stop

1500 Main Street

El Centro, CA 92243

Farm Worker Coalition Event


1 sign in sheet

N/A

Clínica de Salud

900 Main Street

Brawley, CA 92227

Patient Lobby


1 sign in sheet

N/A

Imperial County One Stop

Heber & 3rd

Avenue

Calexico, CA 92231 Bi-National Farmworker Health Fair


14 sign in sheet

N/A

Down Syndrome Association

Bucklin Park-Ross & 8th

Street

El Centro, CA 92227

9th

Annual Buddy Walk - Health

Fair


3 sign in sheet

N/A

Total Served through One-to-One Outreach: 753 Participants

24

Clinicas de Salud del Pueblo, Inc. Community Health Outreach



Border

Project Activity: Educational Group Presentations

Event Date Participants

Sign-in Sheets

Pre and Post

Questionnaires

Commitment

Forms ICOE Head Start

280 S. Fairfield Drive

El Centro, CA 92243

Parent Meeting


2 sign in sheets

17 Pre

17 Post

17

ICOE Head Start

937 Heber Avenue

Calexico, CA 92231

Parent Meeting


2 sign in sheets

17 Pre

17 Post

17

Imperial Valley Mall

3451 S. Dogwood Rd.

El Centro, CA 92243

Health Fair


2 sign in sheets

21 Pre

21 Post

21

WIC - El Centro

2600 Thomas Drive

El Centro, CA 92243

AGA-40 Presentation

08/15/12

08/16/12

43 participants

3 sign in sheets

43 Pre

43 Post

43

WIC - Brawley

561 E Street

Brawley, CA 92227

AGA-40 Presentation


2 sign in sheets

18 Pre

18 Post

18

United Families

179 Southwind Drive

El Centro, CA 92243

Parent Meeting


1 sign in sheet

10 Pre

10 Post

10

WIC El Centro

2600 Thomas Drive

El Centro, CA 92243

AGA-40 Presentation


1 sign in sheet

15 Pre

15 Post

15

WIC - El Centro

2600 Thomas Drive

El Centro, CA 92243

AGA-40 Presentation


2 sign in sheets

20 Pre

20 Post

20

IVROP

687 State Street

El Centro, CA 92243

Staff-Counselors Mtg.


1 sign in sheet

10 Pre

10 Post

10

United Families

198 E. 3rd Street Westmorland, CA 92281

Parent Meeting


3 sign in sheets

30 Pre

30 Post

30

Women’s Center

651 Wake St. Suite A

El Centro, Ca. 92243

Patient Lobby

09/27/12 11Participants

1 sign in sheets

11 Pre

11 Pro

11

25

WIC - El Centro

2600 Thomas Drive

El Centro, CA. 92243

AGA-40 Presentation


1 sign in sheets

13 Pre

13 Pro

13

Women’s Center

900 Main St.

Brawley, CA 92227

Patient Lobby


1 sign in sheets

14 Pre

14 Pro

14

United Families

Head Start

1813 Rio Vista

Seeley, CA 92273


1 sign in sheet

12

12

12

Center for Employment Training 204 South Third Street

El Centro, CA 92243


4 sign in sheets

57

57

57

Neighborhood House

Preschool

506 4th Street

Calexico, CA 92231


3 sign in sheets

39

39

39

Total served through Education Group Presentations: 347 Participants

26

Clinicas de Salud del Pueblo, Inc. Staff Training Summary


Reducing Childhood Environmental Health Risks along the U.S.-Mexico

Border Green Cleaning Products Training

July 20, 2012, 1:00 – 2:00 pm: CDSDP Corporate Conference Room, Lorraine Alexandra, presenter

The focus of the training was to provide information on how to prepare green cleaning products using

toxic free biodegradable products such as; Borax, vinegar, baking soda, and water. With the knowledge

gained from this training staff will be able to educate the community on ways to reduce asthma triggers in

their homes by eliminating the use of chemical irritants found in Pine-Sol, Clorox, Windex and other

cleaning products used in the home that may cause a child’s asthma to worsen. By using green cleaning

products the community is not only reducing children’s environmental health risks but they are also

helping our environment.

Presenter: Lorraine Alexandra, Comité Civico, Community Health Worker

Attendees: Cynthia Dagnino, CDSDP Director of Programs

Cecilia Cota, CDSDP Community Health Worker III

Ana Solorio, CDSDP Community Health Worker I

Celina Cisneros, CDSDP Community Health Worker I

Francisca Izaguirre, CDSDP CHW Volunteer

Elva King, CDSDP CHW Volunteer

Mireya Preciado, CDSDP CHW Volunteer

Sylvia Zendejas, CDSDP CHW Volunteer

IVAN and Environmental Task Force Training

July 20, 2012, 2:00 – 4:00 pm: CDSDP Computer Lab; Luis Olmedo, presenter.

Imperial Vision Action Network (IVAN) is the first community-based environmental reporting site in all

of California. The task force brought attention to environmental issues in Imperial County and ways to

work together to resolve them. These issues included water pollution, dumping and/or burying of toxic

materials, air quality, contaminated land, unsecured sites where chemicals are stored, illegal transport of

hazardous materials, etc. Other topics covered in training are as follow:

Environmental laws and regulations

How to navigate the IVAN website www.ivanonline.org

How to submit an environmental complaint and incident report

Bilingual task force meetings held the third Thursday of the month in El Centro to review

reports and discuss govt.’s progress in addressing verified environmental hazards/damage

Presenter: Luis Olmedo, Comité Civico, Executive Director





Francisca Izaguirre, CDSDP CHW Volunteer

Elva King, CDSDP CHW Volunteer

Mireya Preciado, CDSDP CHW Volunteer

Sylvia Zendejas, CDSDP CHW Volunteer

http://www.ivanonline.org/

27

Asthma Webinar

July 31, 2012, 1:30 - 2:30 pm: CDSDP Corporate Office, online asthma webinar

Presented by the California Pacific Public Health Training Center (CALPACT), the focus of the Asthma

webinar was to address asthma in California as well as local strategies to help residents breathe easier.

The topics covered are as follows:

Pathophysiology of Asthma

Asthma by Race/Ethnicity statistics

Asthma triggers

Clinical care and public health interventions

Strategies for asthma prevention

Green cleaning products

Tots Breathe Freely Project

Strategic Plan Implementation Grants (SPIG)

Presenters: Deanna Rossi, MPH, Ass. Dir., CA Breathing Asthma Program, CA Dept. of Public

Health

Jacquelyn Komplin RN, PHN, MSN, Public Health Nurse Consultant, Child Start, Inc.

Attendees: Cecilia Cota, CDSDP Community Health Worker III



Safe and Healthy Children Curriculum Training:

August 28, 2012, 9:00 am - 5:00 pm: CDSDP El Centro Women’s Center Conference Room

Presented by Health Outreach Partners, Oakland California, the focus of the training was to Train-the-

Trainer and review the Safe and Healthy Children Curriculum. The topics covered included:

Adult learning

Facilitation strategies

Demonstration of unique vulnerability of children

Preventing and reducing exposure

Program planning

Community support

Evaluation recommendations

Presenters: Alexis Wielunski, MPH, Project Manager, Health Outreach Partners Sonia Lee, MPH, Project Evaluation Analyst, Health Outreach Partners





Francisca Izaguirre, CDSDP CSW Volunteer

Elva King, CDSDP CSW Volunteer

Luz Moreno, CDSDP Community Health Worker Coordinator Mireya Preciado, CDSDP CSW Volunteer

Sylvia Zendejas, CDSDP CSW Volunteer

Lorraine Alexandra, Comite Civico Community Health Worker

V (L DEL ALLE - NADBserver.cocef.org/Final_Reports_B2012/20208/20208_Final...Environmental...

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