Issuu

UNIT

Health Promotion

CONTENTS

CLASSROOM ACTIVITIES AND DISCUSSIONS..........................................................................3 Critical Thinking...................................................................................................................................... 8 First (refer to text page 11) ........................................................................................................................ 8 Second (refer to text page 26) ................................................................................................................... 9 Third (refer to text page 36) .................................................................................................................... 11 Fourth (refer to text page 39) .................................................................................................................. 11 Fifth (refer to text page 41) ..................................................................................................................... 11 Assess Your Learning ............................................................................................................................ 12 Resource Materials for Teaching........................................................................................................... 14

ANCILLARY MATERIALS ........................................................................................................15 Health Promotion: Getting Started Checklist ........................................................................................ 15 Medicare’s History: In Brief .................................................................................................................. 16 Some Practical Steps in Network Building for Educators ....................................................................... 16

ASSIGNMENT IDEAS .............................................................................................................18 TEST QUESTIONS ..................................................................................................................26 Terms from across Unit 1 ...................................................................................................................... 26 What Is Health? .................................................................................................................................... 28 Social Determinants of Health .............................................................................................................. 28 Canada’s Health Care System ............................................................................................................... 29 Changing Attitudes toward Health Care ................................................................................................ 31 Prevention and Health Promotion ........................................................................................................ 32 1-1

Health Promotion in Early Childhood Learning and Care Programs ....................................................... 34 Health Promotion Action Plan .............................................................................................................. 37 Networking with the Community ......................................................................................................... 39

HERE’S THE ANSWER—WHAT’S THE QUESTION? ...............................................................40

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Classroom Activities and Discussions Here’s the Answer—What’s the Question? (see handout, page 1-36) Divide students into four groups and have each group develop ideas for the three components of health promotion: In a high-density area of the city, hundreds of families are living in several apartment buildings side by side down the street. The park is five blocks away and it doesn’t have any playground equipment for children. •

individual problem solving and self-reliance (suggestions: parent and children walk to the park after supper and brings balls, etc., to use; enroll children in physically active programs before or after school; family moves)

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community action (suggestions: two or three families alternate taking all the children to the park or other facilities; tenants approach the landlord to renovate an empty apartment into an indoor play space and/or develop the rooftop; tenants from the various buildings approach the parks and recreation department, city hall, or a community service club to install playground equipment in the park)

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societal change (suggestions: architects recognize the importance of incorporating physical space outdoors, and perhaps indoors, for children and adults, into the design of apartment buildings; municipal zoning bylaws require a certain amount of park/playground space be allocated to apartment buildings by the number of units or neighbourhood density)

Other topics/issues students could integrate into the health promotion action plan: health promotion; smoking; drinking and driving; TV advertising to children; speeding; increasing adults’ physical activity; violence in society; products over packaging; or any number of environmental issues. For example: You are a family daycare provider with five children under your care. All the children live in your neighbourhood, which has smokestacks from two local factories. Three of the five children have been diagnosed with asthma over the past year. You are concerned about the impact of the environment on their health and want to do something about it. You are aware that four of the issues of greatest concern to children’s health are air pollution, lead, pesticides, and PVCs. Public health agency’s organizational structure: The agency should be able to provide you with a list of various health personnel (with or without names) working in the agency’s office, and the types of services available to programs, parents, children, and families in the community. This information will be useful not only for programs networking with public health on specific issues, but also for referring parents to health services.

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Invite a public health nurse, public health inspector, or nutritionist to come in and describe his or her role with programs in his or her area. Online posts to identify components of the health promotion action plan: Print posts (or view online) related to health issues that are currently appearing in the media. In their discussion of the issue (e.g., pesticides, food engineering, smoking, dangling curtain cords that have resulted in a child’s strangulation, etc.), most articles will include different components of action. The vast majority will at least discuss individual action and societal action (e.g., when a major food manufacturer recalls unsafe meat or the danger of small magnets that can be ingested). A number of media articles identify what consumers should be alerted to in regards to the meats they may have already purchased, and possible symptoms (individual problem solving). Most of these articles include the government’s reaction to this serious and widespread health occurrence, and what legislative changes need to happen to prevent recurrence (societal change). In addition to individual and societal action, there may be some discussion of the community action components of health promotion action; if not, it is interesting to brainstorm possibilities. Using current media information helps students to integrate their understanding of health promotion into “real” life and a way of thinking and acting. Identifying significant social determinants of health in early childhood learning and care (ECLC) programs: •

Download Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings by Best Start Resource Centre (2006) from https://www.beststart.org/resources/hlthy_chld_dev/pdf/hpaction.pdf

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Provide each small group with a program description. Each group will identify the most significant social determinants that their assigned program is promoting and provide rationale for their choices.

Poverty—resources: •

See Resource Materials for Teaching, page 1-14.

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Campaign 2000 produces a yearly report card on child poverty.

Health policies: Bring in (or ask students to bring in) examples of health policies from various ECLC programs (if you believe that the agency name should be anonymous, bring in the health policies with the names removed). In small groups, students work with two or three examples, evaluating the following:

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What seems to be the most obvious purpose(s) of these policies?

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Are the policies family-positive and do they promote family-centred partnerships, or are they written in a way that sounds inflexible?

It may be interesting to compare the same policies and procedures from different programs. You may be able to incorporate a timely local or national health issue into this discussion and its impact on policies (e.g., West Nile, unsafe water supply). Consider if program policy changes were a result based on fact rather than an overreaction to the issue and unrealistic perception of risk (e.g., overuse of gloves for diaper changes, the use of products claiming antibacterial properties). Health Promotion Action Plan Strategies: How Can We Do the Best for Our Children? 10 minutes: Write a specific example, including relevant information such as targeted age group, whether family members are involved, level of community or government if applicable, etc. Member 1: Individual Problem Solving and Self-Reliance _____________________________________________________________________ _____________________________________________________________________ Member 2: Community Action _____________________________________________________________________ _____________________________________________________________________ Member 3: Societal Change _____________________________________________________________________ _____________________________________________________________________ Cultural diversity: •

In small groups, students can share some health practices that they experienced growing up.

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Were these experiences based on particular health beliefs and practices, and where did they originate?

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Some questions that could stimulate this discussion include the following: o How were colds treated? o How were tummyaches treated?

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o Were there particular illnesses that people were embarrassed to talk about? o What were practices that you did at home that were intended to keep you healthy (e.g., not going outside with wet hair)? o What were some beliefs that your grandparents or parents held about keeping healthy, and do you follow these now that you are an adult? Health promotion is the process of enabling people to increase control over and to improve their health. Health promoters include those who work to promote health regardless of professional designation, including people, organizations, and groups from various sectors. After reading this unit, do you recognize the role educators have as health promoters? Health promotion has been discussed in general terms in this unit. The upcoming units focus on specific content areas: occupational health, preventing illness, managing illness, nutrition, safety, healthy active living, preventing child maltreatment, and supporting children’s development. Before you delve into these units, identify at least one specific way educators can be health promoters in each of these areas. After you complete these units, revisit your response to this question and compare it with what you have learned throughout the course. Suggestions: Educators play an important role in the promotion of the children’s healthy development and contribute to the health of the children and their families. Here are a few examples: Units Occupational Health Illness Prevention Illness Management Nutrition Healthy Active Living Safety Promotion Preventing Child Maltreatment Supporting Children’s Development

Examples of the Role of Health Promoter Modelling good lifting practices, which benefits self and coworkers Teaching children how and when to wash hands Communicating your program’s exclusion criteria with parents to ensure the recovery of their child and limit transmission to others Creating a positive eating environment Active involvement and supervision in children’s outdoor play Director and staff stay current on issues around environmental health and safety; regularly monitor the centre for possible environmental hazards Ensuring that behaviour guidance is child-positive and promotes children’s well-being Creating a curriculum that supports the development of children’s learning about self: feelings, rights, and responsibilities

The community centre that houses your ECLC program is offering a community kitchen on Saturday afternoons. All families are welcome. The children will be cared for by paid 1-6

staff while the adults will cook together and bring home enough food for two evening family meals. Use the handout Health Promotion: Getting Started Checklist (page 1-14) as a guide to identify the determinants of health being addressed, and provide an example for how each of the features and values of a health promotion philosophy can be met in this scenario (refer to High-Quality Early Childhood Learning and Care Programs, text page 41). Suggestions: Here are a few examples: In What Areas Are We Taking Action? Determinants of Health Income and Social Status Social Support Networks Personal Health Practices and Coping Skills

How? Having the opportunity to make two meals for each week reduces their weekly food budget. The community kitchen provides opportunities for families to connect and offers mutual support. The community kitchen offers opportunities to increase knowledge of nutrition, understand the Nutrition Facts table on packaging, and gain cooking skills.

Features of Health Promotion Taking Participatory Approaches The community kitchen’s program requires and recognizes each person’s contribution in menu planning, introducing others to favourite recipes and unique fruit and vegetables. Values of Health Promotion Inclusion The community kitchen’s policy ensures that everyone has equal access to the program and necessary resources.

Referring to The Federal and Provincial/Territorial Collaboration to Deliver Medicare (refer to text page 13), have class discussions, either in large or small groups. The discussions can help students clarify their understanding of which roles and responsibilities the levels of government hold: •

In small groups, give students a scrambled list of the roles and responsibilities identified in the text, and ask them to place them under either a provincial or federal role/responsibility.

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Can they identify specific examples of each of the National Principles of Medicare (five) “in action”?

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Can they give examples of the two levels of government working together to ensure that the National Principles of Medicare are met by Canadians?

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Discussion of the workings of transfer payments in your province or territory.

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Discussion of how the roles/responsibilities of the municipal government relate to the delivery of health care.

Discussion about Table 1.2: The Elements of Quality Early Childhood Learning and Care (refer to text page 43). Discussion about Figure 1.3: Groups and Individuals Who Interact with ECLC Programs (refer to text page 55). Can students identify specific examples in their community?

Critical Thinking First (refer to text page 11) Referring to the preceding discussion on the multipronged population health approach and the example of a community’s polluted water, let’s take a look at the ongoing discussion around another issue: harmonizing Canada’s immunization schedule. As you may or may not know, the provincial and territorial governments have responsibility for determining which routine immunizations will be recommended and funded. This results in a patchwork of routine schedules for infants and children, with possible serious health consequences. One example is the hepatitis B vaccine, where provinces and territorial programs vary widely in age of immunization. Some require it to begin at birth, whereas others have it available routinely as late as Grade 7. One major consideration that puts children in Canada at risk for inadequate immunization coverage is the reality that many families move from one province to another annually. Inconsistent immunization schedules result in infants and children missing doses, putting them unnecessarily at risk for certain contagious illnesses (Canadian Paediatric Society, 2018). Consider the following points to develop a population health strategy to harmonize the delivery of vaccines in Canada, which would address inequity and safety problems for children: •

Invest Upstream We have a national immunization schedule, yet the provinces and territories create their own and determine which vaccines are covered by their health plan (see The Federal and Provincial/Territorial Roles and Responsibilities, text page 13).

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Base Decisions on Evidence Science has demonstrated the effectiveness and safety of immunizing children and adults (see Immunization, text page 139). There are parents who choose not to immunize their children. There continue to be claims that immunizations are responsible for causing autism, yet science has proved that this is not true. Would these unfounded claims impact the lobbying effort to harmonize immunization and ensure that as many children’s immunizations as possible are upto-date?

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Apply Multiple Strategies to Act on the Determinants of Health If we were to snap our fingers and all the provinces and territories implemented the national immunization schedule tomorrow, the work still wouldn’t be done. What else would need to be done to support this program? (Examples include reducing the cost of

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vaccines, educating health care providers and the public on the national schedule, and catching up children’s immunizations.) •

Collaborate across Levels and Sectors The National Advisory Committee on Immunization (NACI) consists of a wide range of governmental, public health, and medical representatives. Aside from health care, who else in Canada may join the lobby nationally and locally to move to a harmonized program?

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Employ Mechanisms to Engage Citizens Ultimately, families are responsible for ensuring that their children are immunized. How does your strategy bring families into supporting the harmonization? Does the “one size fits all” approach work when developing educational material for families? If not, what factors do the writers need to keep in the forefront when developing material? (Some examples might be using social media or sending out reminders that a child is due for a vaccine using an automated phone and/or email system.)

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Increased Accountability for Health Outcomes What kind of research and feedback do you think needs to be shared with public health professionals and families as a harmonized program is rolled out and into the future? Suggestions: You may find these resources helpful for the discussion on immunization: •

Canadian Paediatric Society: https://www.cps.ca/en/documents/position/harmonized-immunizationschedule-Canada

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National Advisory Committee on Immunization, Government of Canada: https://www.canada.ca/en/public-health/services/immunization/nationaladvisory-committee-on-immunization-naci.html

Second (refer to text page 26) Serena, a young woman who spends most of her time on social media, sneaks away at work whenever possible and can’t wait for her next break time to check who has responded to her latest tweet or posted on Instagram. As coworkers stop talking to her, and friends only contact her on social media, Serena begins to realize that she has an addiction that has actually resulted in loneliness and isolation, rather than social wellbeing. Serena’s best friend, as well as her siblings, have told her that she doesn’t look or listen to anyone; she just stares at her phone. Her boss just gave Serena a final notice in writing that she will be fired if she doesn’t focus on her work. Give an example of a prevention strategy within a health promotion framework. Which of the social determinants of health could be affected by Serena’s addiction to social media? Suggestions: Serena must recognize the personal impact that her addiction to social media is having on a healthy life. Copyright © 2019 by Nelson Education Ltd.

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She needs to find ways to get support that will help reduce or fully stop this practice that is not only detrimental to her mental and social well-being but also may soon lead to a precarious (unstable) work-life situation. She is in serious danger of losing her job and her social support (family and friends). An example of a prevention goal is to completely stop sending tweets and posting on Instagram, using strategies that will help her focus on much more positive aspects of her life: •

Apologize to her closest friends and family members who are concerned about Serena’s well-being, and negotiate ways she can return to a more positive social life with them without the use of social media. For example, family may ask for Serena’s focus at the dinner table or other get-together opportunities where use of social media is off limits. Friends and coworkers may come up with suggestions to help Serena enjoy other activities, such as a walk with a work partner during the lunch hour or with a friend after dinner. There are many other ways that friends and family may be able to support Serena’s needs to stop her addiction, which will also help to improve her mental and social well-being.

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Ensure that her work ethic improves, including a focus on the responsibilities she has while in the workplace, so that she will not be fired.

When Serena’s goal to end her social media addiction is achieved, she will be on the way to improving her health. As is evident from Serena’s situation, the following social determinants of health could be detrimentally affected if her addiction to social media does not stop: •

Income and social status

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Social support networks

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Personal health practices and coping skills

See other suggestions to deal with social media addictions at

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“Addicted to Social Media?” in Psychology Today by M. D. Griffiths (May 7, 2018) from https://www.psychologytoday.com/ca/blog/inexcess/201805/addicted-social-media

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“6 Questions Help Reveal If You’re Addicted to Social Media” in The Washington Post by M. Griffiths & D. Kuss (April 25, 2018) from https://www.washingtonpost.com/news/theworldpost/wp/2018/04/25/socialmedia-addiction/?noredirect=on&utm_term=.808cbd5af28b

Third (refer to text page 36) For the education and literacy determinant of health, particularly health literacy, give an example of how an early childhood learning and care program can support newcomer families in promoting their health. Refer to the Canadian Paediatric Society’s Caring for Kids New to Canada website. Suggestions: In Section Four: Training & Resources (p. 41) of Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings by Best Start Resource Centre (2013), Early Learning Canada, which supports education and literacy, is summarized. Download from https://www.beststart.org/resources/hlthy_chld_dev/BSRC_HP_Action_June2013.pdf Fourth (refer to text page 39) Your program’s philosophy places a high value on helping children develop independence. However, one family in the program places a high value on interdependence (i.e., a long-term commitment to depending on one another, remaining close to family). How do the staff and parents compromise in the best interest of the child? Suggestions: Depending on the age of the child, different issues may arise. For example: Interdependence infants adult always holds toddlers adult always feeds preschoolers adult dresses child

Independence child encouraged to have more time on the floor child feeds self child tries to dress self

As long as the educators care for the well-being of the child and respect the child’s place in the family, most issues can be negotiated. For an infant—assure the parent that, although the infant won’t be held all the time due to their 1:3 ratio and because of the program’s philosophy, infants will be responded to and will never be left to cry. When an infant is not being held, an effort will be made to provide security and culturally relevant artifacts whenever possible. Younger infants are placed in a swing for short periods, familiar music from the child’s first language is played during floor time, and so on. If conflicts arise, try to negotiate—flexibility is an important role of the program. Fifth (refer to text page 41) Your main responsibility as an educator is to focus on each child’s healthy development and communicate updates with the child’s family on a regular basis. However, you may find that it is challenging for families, especially newcomer families, to focus on these discussions when they are facing immediate issues and problems. Refer to the most applicable social determinants of health to ECLC programs (see text page 27) to identify two relevant determinants that may be at the forefront of family concerns after arriving in Canada. Think of at least one positive, respectful way to support parents in becoming Copyright © 2019 by Nelson Education Ltd.

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more ready to discuss their child’s development with staff (see Growing Up in a New Land: A Guide for Newcomer Parents in the Resource Materials on the Nelson site). Suggestions: Although any of the social determinants of health may be of relevance to newcomer families to Canada, likely the following would be of most concern: •

Income and Social Status

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Education and Literacy

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Culture

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Social Support Networks

For positive, respectful ways to support parents in becoming more ready to discuss their child’s development with educators, we suggest referring to What’s Good for Children: A Multiethnic View (refer to text page 40). In addition, the Best Start Resource Centre has resources that are supportive to 1. Newcomer families with young children, such as Growing Up in a New Land: A Guide for Newcomer Parents: https://www.beststart.org/resources/hlthy_chld_dev/Growing_up_Parents_EN _online_Final.pdf 2. Staff in agencies working with newcomer families, such as Growing Up in a New Land: Strategies for Working with Newcomer Families: https://www.beststart.org/resources/hlthy_chld_dev/growin_up/growing_up_n ew_land_June2013.pdf Note: Although resources in these PDFs mostly include Ontario-based options, these can be substituted with those from your province/territory.

Assess Your Learning Evaluate your options in each situation. 1. Your doctor hands you a prescription. When you ask him what it’s for and whether there are any side effects, he replies, “Don’t worry about it. Just take these pills and you’ll feel better.” Suggestions: The doctor’s comment is a clue that he has a paternalistic view of the physician–patient relationship rather than a partnership; if you don’t feel intimidated and feel comfortable enough, you could respond by saying that you don’t take medication without understanding what it is for, what it can do, and potential side effects; if he doesn’t take the time to answer your questions, ask him who can (i.e., pharmacists); consider changing physicians to one with a patient-centred philosophy; in a community with only one doctor, continue to ask questions, ask the receptionist to book you enough time to talk with the doctor 1-12

during appointments, inform yourself with books, and speak with your community’s public health nurse. Over time, perhaps you and other like-minded patients will change the doctor’s attitude. 2. Classes have been cancelled for the day to allow students to attend a child care rally at the legislature. You are tempted to skip it because you have to study for a test. Suggestions: When you consider the short- and long-term consequences, it should become clear that attending the rally is a better choice. Examples: •

You have the opportunity to see the political process at work and find out where the MLAs stand on the ECLC issue, as their decisions will affect your professional future.

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You will experience first-hand the passion that ECLC advocates bring to the political process and the emotions among all the participants.

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By cancelling classes for the day, the ECLC instructors are making a powerful statement, viewing students’ attendance as a valuable experience, an experience equal to going to class.

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If you skip it and study, you may improve your mark, but in the grand scheme of things, is this the priority? You will have time to study before and after the rally.

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You will be able to participate in the class discussion about the rally.

3. A parent is angry at pickup time because his daughter’s sleeves are damp from water play, even though she was wearing a smock. He believes that this is how someone gets a cold. He asks that his daughter never play at the water table again. Suggestions: Although you know that this is a commonly held myth, the parent is obviously concerned about his child. Acknowledge the parent’s feelings: “I can see that you’re angry about your daughter’s wet sleeves, but she really loves water play.” Negotiate options, such as her changing into a short-sleeved top before water play, or having another top in the cubby to change into if what she is wearing gets wet. If a number of parents hold this myth and others around illness, it would be beneficial to have the public health nurse or an infectious disease expert come in to speak at a parents’ night; be sure to access material written in the parents’ first language. 4. One of the parents of a child in the infant room says she doesn’t know what to do because she gets different messages at every turn. The information in her magazines and what she finds on the Internet differs from what her husband’s family tells her, and that differs from what the educators say and do in the ECLC program. Suggestions: Educators listen to the mother’s concern about mixed messages; mutual respect makes ongoing communication more effective; when parents Copyright © 2019 by Nelson Education Ltd.

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believe they are being heard, they are more open to problem solving; this process can reduce confusion and mixed messages; it may be helpful to recommend resources and keep in mind cultural values and practices. 5. A safety issue arises at the centre. None of the staff can think of a viable response, and you suggest that consulting with another centre may provide options. The director insists, “We can work this out ourselves,” and does not want outside interference. Suggestions: You are placed in an awkward position since you look to the director for guidance yet she or he mistakenly believes that programs should operate completely independently; perhaps this comes from a lack of self-confidence, or concern that staff are usurping the director’s authority, or other directors will think the individual is not an effective director; when concerned about the safety of the children or staff, do your best to communicate the urgency of the situation to the director—for example, “I know you’ve really tried to come up with a solution, but if an injury occurs because of this hazard, the program could be held legally responsible. We must consult with someone else who has experience in this issue”; talk with someone from the program’s board; as a last resort, contact the consultant from the provincial/territorial child care licensing agency.

Resource Materials for Teaching National Collaborating Centre for Determinants of Health’s Resource Library: http://nccdh.ca/resources/library/ Let’s Start a Conversation about Health … and Not Talk about Health Care at All is a video on the social determinants of health that have been adapted to meet the needs of different public health regions in Ontario. The links to the various health regions’ videos are on the website along with a link to their user guide: To download the user guide, visit https://www.youtube.com/watch?v=QboVEEJPNX0 Ontario Health Promotion Resource System. Health Promotion Foundations Course. This series of interactive modules introduces the field of health promotion in Canada. Definitions, concepts, milestones, models, theories, strategies, and more are covered in this self-directed course. Completion certificates are available for each module. To learn more about this free course and how to complete it, visit https://www.publichealthontario.ca/en/LearningAndDevelopment/OnlineLearning/Health Promotion/Pages/default.aspx “Social Determinants of Children’s Health in Canada: Analysis and Implications,” International Journal of Child, Youth and Family Studies (2014) by Dennis Raphael. To view the article, visit http://scholar.google.ca/scholar_url?hl=en&q=http://journals.uvic.ca/index.php/ijcyfs/arti cle/download/12899/3988&sa=X&scisig=AAGBfm3t2hcShQhWaN57NcrF8icHJ7q8g&oi=scholaralrt

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Ancillary Materials Health Promotion: Getting Started Checklist This checklist may help you determine where your program currently practises health promotion and where it might be possible to include or address health promotion more. Use the checklist as a launching point to identify if your program is aware of the determinants of health and the features and values of health promotion. It may help you see what you are already doing and in what areas you may need to take more action. In the last column, you can briefly note what next steps you can take.

Health Promotion

Are We Aware of the Determinants of Health and the Features and Values of Health Promotion? DETERMINANTS OF HEALTH

In What Area Are We Taking Action?

In What Areas Do We Need Strengthening?

What Are the Next Steps to Consider?

Income & Social Status Social Support Networks Employment & Working Conditions Education & Literacy Social Environments Physical Environments Personal Health Practices & Coping Skills Healthy Child Development Biology & Genetic Endowment Health Services Gender Culture FEATURES OF HEALTH PROMOTION Taking a Holistic View of Health Taking Participatory Approaches Building on Strengths Addressing the Determinants of Health Using Multiple, Copyright © 2019 by Nelson Education Ltd.

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Complementary Approaches VALUES OF HEALTH PROMOTION Empowerment Respect Inclusion Social Justice & Equality Source: Best Start: Ontario’s Maternal, Newborn and Early Child Development Resource Centre. (n.d.). Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings, pp. 46–47. https://www.beststart.org/resources/hlthy_chld_dev/pdf/hpaction.pdf

Medicare’s History: In Brief The Evolution of Canada’s Medicare System 1867

The British North America Act (BNA) proclaimed Canada’s Confederation, which granted provinces jurisdiction over hospitals. Most hospitals were run by voluntary, charitable, or municipal organizations. Those who could afford to pay for services (fee-forservice) did so.

1935–1945

The federal government made two attempts at establishing a national health insurance program, but both attempts failed because the provinces viewed the program as an intrusion on their jurisdiction.

1947

Saskatchewan Premier Tommy Douglas introduced the first hospitalization plan in Canada, for all Saskatchewan residents. British Columbia, Alberta, and Newfoundland and Labrador soon followed with similar plans.

1957–1967

With the passage of the federal Hospital Insurance and Diagnostic Services Act (HIDS) and the Medical Care Act (medicare), respectively, the provinces recognized the advantage of a cost-sharing agreement with the federal government.

1972

All the provinces had now entered into this provincial–federal agreement. Health care for the territories and First Nations and Inuit communities is primarily the responsibility of the federal government. Transfer payments are made to each province, but each plan must comply with the national principles of medicare.

1984

The Canada Health Act abolished extra billing and user charges to ensure that all Canadians had equal access to necessary medical services.

Some Practical Steps in Network Building for Educators To Improve the Status of Early Childhood Learning and Care as a Profession 1-16

Actively participate in your local, provincial, or national early childhood education associations. Improve your own knowledge and skills through continuing education. Lobby for better working conditions and salaries. Demand better resource services. Support improved standards and insist that resources be made available to implement them.

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To Build a Local Network Exchange information with •

parents

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members of your board of directors or • parent advisory committee • coworkers • public health nurses • physicians •

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other health professionals social workers cultural centre representatives suppliers of goods and services politicians teachers

Seek help and advice from a wide variety of sources, such as universities, colleges, religious institutions, and bureaucrats. Make contact with local schools attended by older children and siblings of younger children. Open your centre to students in health care, social service, and education who express an interest in learning about ECLC. Offer your expertise to community groups. Present workshops at early childhood education and other meetings. Share information with other educators and interested professionals. Have open houses at centres. Write articles for local newspapers and professional journals. Invite a broad range of people to sit on your board of directors or parent advisory committee.

Assignment Ideas 1. Contact your public health department:

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Determine available publications and DVDs/videos, and in what language(s).

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Ask for the name of your medical officer of health.

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Inquire about the range of health services provided to programs in your area.

2. What is the range of health care delivery services available (i.e., community-based health centres; physicians who practise complementary medicine) in your community? 3. Divide students into six groups and assign each with one grouping from Figure 1.3 (refer to text page 55) to develop specific examples of those interacting with organizations associated with your ECLC program. Return and share with the class. 4. Health policies: Using copies of policies from ECLC programs (anonymously), have students answer some or all of the following questions (refer to Early Childhood Learning and Care Program Policies, text page 43): •

Does it contribute to quality ECLC?

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Does it outline good practice for educators?

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Is the rationale clearly explained?

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Does it define lines of communication and confidentiality?

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Is it up-to-date with health and ECLC research?

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Could it be revised in any way? If so, make the specific changes and explain how you have improved (i.e., strengthened, clarified, added rationale, updated).

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How would the staff and parents be advised of the change in policy?

5. Debate: “CPS position on Natural Health Products” STUDENTS READ ARTICLE : https://www.cps.ca/en/documents/position/naturalhealth-products (Note: Link available in NELSONstudy, Resource Materials (Unit 1): Printed Matter and Online Resources ) “The use of complementary and alternative medicine (CAM) in Canada has grown exponentially in recent years” – opening sentence in POSITION STATEMENT (Canadian Paediatric Society): “Children and natural health products: What a clinician should know” Copyright © 2019 by Nelson Education Ltd.

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IN CLASS, EITHER FULL CLASS DISCUSSION, OR SMALL GROUPS OF 6 STUDENTS, WITH EITHER 2 DISCUSSING ON EACH SIDE (positive, negative, neutral) OR 3 DISCUSSING ON EITHER POSITIVE OR NEGATIVE SIDE (with some discussion from instructor re: neutral) AN INTRODUCTION TO STUDENTS SHOULD INCLUDE A REMINDER THAT THEY ARE NOT DOCTORS NOR NURSES; THE PURPOSE OF THIS ASSIGNMENT IS TO BRING AWARENESS THAT MANY FAMILIES MAY USE COMPLEMENTARY AND ALTERNATIVE MEDICINE INSTEAD OF OR IN ADDITION TO THEIR FAMILY DOCTOR’S PRESCRIPTIONS OR ADVICE. Educators need to have a nonjudgmental attitude- and avoid lack of sensitivity or concern for the family’s perspective. Additional resource: https://www.caringforkids.cps.ca/handouts/natural_health_products_and_children If instructor wants written work from each group: Blank table with 2 or 3 columns and at least 3 rows with examples of why positive, negative (or neutral), to be handed in with students’ names at the end of the discussion. Positive side

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Negative side

Unsure ( or ‘neutral’)

6. Example:

Positive side

Negative side

Unsure (or ‘neutral’)

Natural Health Products

There is considerable

Findings confirm what

have been used for

variation in the purity and

paediatricians have always

generations. These practices

potency of products, and

known: children are not

thrive within the

contamination is a major

small adults. Children are a

multicultural milieu of North

concern (e.g., heavy metal

special population by virtue

America. Each cultural

poisoning from traditional

of their small size, immature

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heritage is quite aware of

Chinese medicines has been

physiology and ongoing

which plants are poisonous

reported several times)

growth and development

and how to prepare them in a nontoxic manner. Moreover, these cultures have given us many drugs that are currently used (eg, reserpine, digoxin, vincristine) No doubt that these practices will lead to continued discoveries.

7. Health promotion action plan: You may want to combine this major assignment with the English department, which has a couple of advantages: •

Students complete this one assignment for both courses.

•

The ECE and English instructors are able to work collaboratively to give the students more comprehensive feedback.

This assignment provides students with the opportunity to think about a health issue in a way that makes it evident that most health concerns are multifaceted, and to explore the different parties’ perspectives and interests. We would suggest having students complete this assignment near the end of the course, which provides them with the opportunity to revisit the action plan found at the end of all units before they begin this assignment. There are many ways to adapt this assignment, including expanding the topic areas. We have chosen environmental and occupational health and safety topics because we haven’t been able to devote as much classroom time as we would like to these areas. However, there are endless possibilities. Students can make their selection from the list of topics you provide when the assignment is introduced. If students prefer to select a topic not listed, it is advisable to have them seek your approval before they begin to ensure its relevance. Environmental Health and Safety Topics 1-22

People in Canada are becoming increasingly aware of environmental health and safety from a personal perspective, at the community level, and globally. Identify one environmental health and safety issue that may impact upon the health of children, parents, and program staff, and explore how many perspectives this one issue may have. Here are a few examples: •

organic foods

•

hormones in meat and food additives

•

pesticides

•

climate change

•

product packaging

•

safe drinking water/bottled water

•

garbage disposal/waste management (e.g., diapers)

•

lead poisoning

•

air pollution

•

radon levels

Note: the discussion on Environmental Contaminants in Unit 7: Safety Promotion (refer to text page 444) and the Canadian Partnership for Children’s Health and Environment: http://www.healthyenvironmentforkids.ca/ Occupational Health Topics Our workplaces’ physical attributes contribute to our well-being either positively or negatively. The way in which work responsibilities are organized and the style of management, along with the skills and abilities of employees, can have a significant impact on our health. Identify one health issue that is common in ECLC programs and directly affects staff and may indirectly affect the children and families: • • • • • •

physical injuries use of cleaning and sanitizing products infections (e.g., respiratory, gastrointestinal, blood-borne) physical environment educators who are pregnant premenstrual syndrome

• • • • • •

issues for male educators stressors of working with different age groups turnover job advancement salaries access to post-diploma education

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One: Submit a preliminary plan to both instructors, which is due two or three weeks after the assignment is introduced to students. (This ensures that you know that the student is on the right track and you can provide each with your feedback before completing the assignment.) As well, you can allocate a portion of the final mark to this component. This plan includes: •

the key questions about the issue/topic the student has selected. At least one of these questions must deal directly with early childhood education. (Provide students with the following list of general questions, which will help them think about their specific issue.) For example: Questions to think about as you select your issue, conduct your research, and develop the assignment: o How is this issue a problem for you as well as for children, parents, and staff in the program? Put yourself in each of the players’ shoes. o What is currently being done, if anything? If something is being done, how effective is it? What possible alternatives exist, and how will that help? To gain insight and the various viewpoints of each of the players, ask yourself who benefits from each alternative. o How is this issue dealt with from the perspectives of prevention, management, and the promotion of appropriate attitudes and policies by the community, the program you are referring to, the various levels of government, institutions, and society at large? o What, if anything, could the other possible players do? o What approach(es) to health is/are being taken: a medical approach, a behavioural approach, or a socio-environmental approach? o Could this issue be incorporated into health curriculum for children? If so, choose either preschoolers or school-agers and describe.

Two: An annotated bibliography. Include at least 10 sources/references that you will use during the research of this assignment (e.g., academic journals, magazine and newspaper articles, online posts, books, TV programs, DVDs/videos, names of organizations, interviews with key informants, or surveys that you may want to conduct). (Provide students with an example of the style for citations, the bibliography, and direct quotes and explain how to avoid plagiarism. If you are collaborating with the English instructor, ideally both she or he and you can discuss this information with the students and provide them with a handout.) Three: The final assignment: 1-24

a) will be 1200 to 2000 words in length and typed or neatly written (doublespaced) b) will clearly and concretely identify the issue/topic c) will refer to the list of questions you submitted in the preliminary plan d) for each of the three components of the health promotion action plan, will indicate specific suggestions for action e) will include a complete bibliography (add any additional resources used after the preliminary plan was submitted) f) will be submitted to your ECE instructor, and another copy of the assignment to your English instructor 8. Report on a health story in the news. From a newspaper, magazine, or online post, each student selects a story covering a current health issue (at least 600 words in length). You could stipulate that the issue be related to children, but often students more fully understand the components of the Health Promotion Action Plan when using examples that are personally relevant. The following is a suggested grading scheme: Complete the following questions in a report format and bibliography: a) Summarize the article in 200 words or fewer, identifying the health promotion issue and the players. (graded on clarity and relevance to health promotion) Marks: 0, 1, 2, 3 b) Identify and briefly describe two components of the health promotion action plan (i.e., individual, community action, societal change) discussed in the article in 200 words or fewer for each level. (graded on correct identification and clarity of description) Marks: 0, 1, 2, 3, 4 c) For the health promotion action plan component that was not identified in the article, make a specific suggestion for action in 200 words or fewer. (graded on relevance of action to issue and creativity) Marks: 0, 1, 2, 3 9. Social determinants of health: •

Students are instructed to select one of the five social determinants most applicable to ECLC settings (refer to text page 27).

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•

Give a 100- to 200-word introduction describing the determinant.

•

Relate it to one of their practicum placements (approximately 500 words).

10. Cultural diversity: The goal of this group assignment is to have students become familiar with the culturally relevant resources that are available in their community on a variety of health issues. This can include public health information, communitybased health clinics, agencies that serve particular ethnocultures, government services, and immigration services. Have each group of students research and document the materials available, how they are accessed, languages they are available in, and resources that they find on their assigned topic (e.g., infection control, dental health, immunization, nutrition, physical activity, short-term illness, asthma, allergies, etc.).

Test Questions Terms from across Unit 1 For each statement (1–14), fill in the blank with the most correct term from the following list (A–S): A. complementary (or traditional) health practitioner B. cultural safety C. culture D. developmental health E. health F. health policies G. health promotion

H. health promotion action plan I. interprofessional collaboration

N. prevention O. primary health care system P. public health system

J. national principles of medicare

Q. quality of life

K. natural health products

R. social capital

L. networking

S. social determinants

M. population health

1. _____ refers to the degree to which an individual enjoys the important dimensions of her or his life, including the fulfillment of physical and emotional needs, social belonging, and the realization of goals, hopes, and aspirations. (Q. quality of life) 2. _____ is the extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs, and, on the other hand, to change or cope with the environment. (E. health) 3. _____ is the process of enabling people to increase control over and to improve their health. (G. health promotion) 4. _____ A wealth of evidence supports the view that the social, economic, and physical environmental circumstances of individuals and groups are equally or more important to our health status than medical care and personal health 1-26

behaviour (S. social determinants) 5. _____ gives professionals the opportunity to learn with, from, and about each other, building mutual respect as well as shared knowledge and decision making in the best interests of patients. (I. interprofessional collaboration) 6. _____ publicly administered, comprehensiveness, universality, accessibility, and portability. (J. national principles of medicare) 7. _____ involves identifying the factors that cause a condition and then reducing or eliminating them. (N. prevention) 8. _____ approach aims to improve the health of the entire population and to reduce health inequities among population groups. (M. population health) 9. _____ refers to the outcome of interactions in which individuals experience their cultural identity and way of being as having been respected or, at least, not challenged or harmed. (B. cultural safety) 10. _____ are now the most popular form of complementary health care in North America. (K. natural health products) 11. _____ When they are well written, their rationale is clearly understood, and the stated procedures obviously promote the well-being of children, staff, and families. (F. health policies) 12. _____ essentially includes conventional medical services available to people who want to maintain their health and seek cures for illness. (O. primary health care system) 13. _____ establishes a set of strategies that can be divided into three components: individual problem solving and self-reliance, community action, and societal change. (H. health promotion action plan) 14. _____ is a term that means the power of socially cohesive communities that benefit all children and families, as communities support healthy practices by making a healthy choice the easy choice. (R. social capital)

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What Is Health? Objective: To identify the World Health Organization’s definition of health. (LO 1) •

(T or F) When a person isn’t sick, he or she is healthy.

•

Health is the interrelationship among our physical, __________, and __________ well-being. (answer: emotional; social)

•

Our __________ and ___________ well-being will have a positive or negative impact on our emotional well-being. (answer: physical; social)

•

In your own words, define health according to the World Health Organization (WHO). (answer: health is seen in the broader context for either an individual or group; health permits us to maximize our potential; our health status encompasses our physical, emotional, and social well-being and that these are interconnected)

•

World Health Organization’s definition of health includes a. health is the objective for living b. the extent to which we are able to realize our goals and satisfy our needs c. our ability to change or cope with change d. both b and c e. a, b, and c

Social Determinants of Health Objectives: To list the 12 social determinants of health, as defined by the Government of Canada. (LO 1) To define the term “population health.” (LO 1) To list the features of a population health approach. (LO 1) •

Identify 3 of the 12 social determinants of health and explain how each of these can impact an individual’s health. (answer: refer to text page 5)

•

Define population health.

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•

List three (3) features of a population health approach. (answer: refer to text page 8– 11)

•

(T or F) Canada has one of the highest standards of living in the world; therefore, we are fortunate that very few children live in poverty here.

•

Which of the following is not likely to be considered a social determinant of health? a. freedom from discrimination b. eating habits c. access to an adequate income d. life skills

•

Housing insecurity includes the following: a. living in unsafe housing b. having neighbours who make a lot of noise c. the need to spend half or more of an individual’s or family’s income d. a, b, and c e. a and c

•

Provide an example of how being a victim of discrimination can affect one’s health. (answer: examples—lack of suitable student housing; a senior citizen may not be given priority for an organ transplant; an individual with a low income has limited access to adequate health care and services, possibly due to others blaming the victim, causes low self-esteem; a child who is heavier than peers is always the last picked for a team, which will have a negative effect on his self-esteem and interest/motivation for physical activity)

Canada’s Health Care System Objectives: To list and define the national principles of medicare. (LO 3) To differentiate between the roles and responsibilities of the federal and provincial/territorial governments on the delivery of health care. (LO 5) To differentiate between the roles of the primary and public health care systems. (LO 5)

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•

(T or F) Our public health care system focuses primarily on the health of individuals.

•

(T or F) One of the roles of educators is to network with the local public health agency.

•

The national principles of medicare are a. universality, completeness, portability, publicly administered, accessibility b. universality, comprehensive, portability, publicly administered, accessibility c. universality, comprehensive, portability, privately administered, accessibility d. universality, comprehensive, portability, publicly administered, availability

•

List the national principles of medicare. (answer: universality, comprehensive, portability, publicly administered, accessibility)

•

A physician known as the __________ __________of health is responsible for public health in a geographic region. (answer: medical officer)

•

List the components of Canada’s health care system. (answer: primary health care and public health)

•

The following is true with reference to Canada’s health care system: a. One of the roles of staff is to network with the local public health agency. b. Each public health department serves a specific geographic area. c. The goal of the public health system is to improve the health status of Canadians. d. both a and b e. a, b, and c

•

For the following roles and responsibilities to deliver health care within Canada, identify whether it is applicable provincially (P) or federally (F): _____ Funds and/or delivers primary and supplementary services to certain groups of people, such as First Nations people living on reserves, Inuit, and active members of the Canadian Forces (F) _____ Provides an independent workers’ compensation agency (P) _____ Provides support for health promotion and health research (F)

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_____ Provides reasonable access to hospital and doctors’ services; expected to meet national principles set out under the Canada Health Care Act (P) _____ Sets and administers the national principles of the Canada Health Care Act, which establishes criteria and conditions for health insurance plans in order to send full cash transfers in support of health (F) _____ Regulates and protects health (e.g., regulation of pharmaceuticals, food, and medical devices), consumer safety, disease surveillance and prevention (F)

Changing Attitudes toward Health Care Objectives: To discuss a holistic view of health and its effect on Canada’s changing health care system. (LO 1) To describe how complementary health practitioners contribute to a collaborative approach to health care. (LO 1) To define the term “interprofessional collaboration.” (LO 1) To define the term “natural health products.” (LO 1) To describe the role that the federal government has in regulating natural health products. (LO 1) •

(T or F) As of the end of 2013, midwives are licensed to practise in every province/territory in Canada.

•

Use the example of midwifery or community health centres to illustrate the emerging collaborative approach in Canada’s health care system.

•

Conventional medical care primarily focuses on _______________________. (answer: refer to text page 17)

•

Which health care system costs more: a curative (conventional medicine) approach or a health promotion approach, and why? (answer: the curative approach costs more both financially and personally: o financial costs due to medical tests, treatments, medications, and surgical and non-surgical procedures; hospital admissions; days lost away from work due to hospital stays and recovery; doesn’t routinely utilize the expertise of other health professionals, which costs less than physicians; acute illnesses that can result in long-term medical conditions

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o personal costs due to loss of income, especially if ineligible for sick-leave benefits, hospital insurance that covers additional expenses beyond those covered by medicare, or disability insurance, or if self-employed; personal, social, and emotional consequences of being ill; disruption in family life) •

Circle all of the following that are considered to be natural health products (NHP), according to Health Canada’s NHP regulations: (answer: a, c, and d) a. homeopathic medicines b. antibiotics c. herb- and plant-based remedies d. vitamins and minerals e. over-the-counter pain medications

•

Ipsos Reid’s 2010 survey reported on Canadians’ attitudes toward natural health products (NHP). Which of the following are true? a. Three in four used NHPs, and a third used them every day. b. Canadians need more information on the safety, side effects, and regulations about NHPs. c. Many Canadians are confused about what NHPs are. d. a, b, and c e. a and b only

Prevention and Health Promotion Objectives: To define prevention. (LO 1, 3) To describe how prevention fits into the health promotion approach. (LO 1) To define health promotion according to the World Health Organization. (LO 1, 3) To define mental health promotion according to the Government of Canada. (LO 1, 3) •

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(T or F) Disease prevention is the primary goal of health promotion.

•

(T or F) Health promotion is the process of enabling people to increase control over their health.

•

(T or F) Individuals have complete control over their own health status.

•

The ______________________ defines positive mental health as “the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with challenges we face.” (answer: Public Health Agency of Canada [PHAC])

•

Which of the following is/are a prevention strategy(ies)? a. wearing a bike helmet when riding b. parents using appropriate car seats/seatbelts for their children c. eating nutritious, well-balanced meals d. all of the above e. a and c only

•

Mental health: a. is a positive sense of physical and spiritual well-being b. is the capacity of each of us to feel, think, act in ways that enhance our ability to enjoy life and deal with challenges we face c. issues have decreased substantially for persons of all ages d. b only e. all of the above

•

Define “health promotion” according to the World Health Organization. (answer: refer to text page 23)

•

What is the difference between disease prevention and health promotion? (answer: refer to text page 22)

•

Explain how strict legislation around smoking in public can have a positive impact on individual health. (answer: benefits for the smokers: limits when and where they can smoke, which is an enforced deterrent with the potential to reduce the effects of nicotine on the individual’s lungs and any underlying long-term medical conditions such as heart disease, asthma, emphysema; benefits for the nonsmokers: improved air quality, better able to avoid second-hand and third-hand smoke, reinforces the public health message that supports scientific research linking smoking and cancer, good modelling for children)

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Health Promotion in Early Childhood Learning and Care Programs Objectives: To list and describe the five determinants of health most applicable to ECLC programs. (LO 2) To identify at least one strategy to promote health in the ECLC setting for each of the five determinants. (LO 2) To list the elements of quality in an ECLC program. (LO 2, 4) To list the purposes of program policies in an ECLC program. (LO 6) To discuss student and educator strategies to advocate for high-quality ECLC programs. (LO 2, 3, 4) •

(T or F) When educators and parents disagree on program policies, in the best interests of the children, educators will suggest to parents to find a new program for their child.

•

Shankoff (2010), a renowned researcher in early childhood development, acknowledges that a. solid evidence emphasizes that positive, early experiences strengthen brain formation in young children b. the later we wait to invest in children at greatest risk, the more challenging for them to have best developmental outcomes c. both a and b d. none of the above

•

List and describe the five (5) determinants of health most applicable to ECLC programs. (answer: refer to text page 27)

•

Identify at least one (1) strategy to promote health in the ECLC setting for each of the five determinants. (answer: refer to text page 27)

•

Circle each of the following social determinants of health that are included in the five (5) more applicable to ECLC programs: (answer: a, d, and e) a. social support networks b. biology and genetics

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c. health services and social services d. culture e. healthy child development •

Discuss three (3) ways that poverty can have a negative effect on children’s health. (answer: examples—refer to the discussion that picks up on text page 32)

•

Comparison of child poverty across industrialized countries shows that ____________ _____________ is a key driver to reduce child poverty. (answer: government action)

•

Developmental health combines which two (2) fields of study in recognizing the impact that early childhood experiences have on lifelong health? ______________ and ______________ (answer: population health; developmental psychology)

•

Match the following term that most closely relates to each statement below: (answer: b, a, d, e, and c) a. healthy child development b. education and literacy c. income and social status d. social support networks e. culture In an early childhood program, parents who are not sufficiently fluent in the same language as the educators may not understand when they are asked to bring in their child’s immunization record. Early learning, behaviour, and health are markers for brain development. Educators can encourage mutual support and connect families with services and support. How people view health and illness, and approaches to healing, may be influenced by their ethnicity. A standard of living that fosters well-being is achieved when adults work at meaningful jobs, have access to affordable housing, and have high-quality early childhood education for their children.

•

Identify each statement as true or false about the status of health for Indigenous people:

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a. (T or F) Indigenous people in Canada have contributed a rich heritage to the country but have not shared fully in its social and economic development. b. (T or F) To meet the challenge of administering and controlling their own health care, Indigenous communities do not need investment from the federal government to build infrastructure. c. (T or F) Indigenous people have the poorest health status of all Canadians. d. (T or F) Much support is needed from initiatives that draw on traditional knowledge and culture to develop culturally relevant approaches to problems such as substance abuse and family violence. e. (T or F) The provincial/territorial government holds the primary responsibility to support Indigenous communities in addressing the health gap. •

In Canada, health literacy is defined as “the ability to _________________, _________________, _________________, and _________________ information as a way to promote, maintain, and improve health in a variety of settings across the life course.” (answer: access, comprehend, evaluate, communicate)

•

Educators and all other professionals working with children and families new to Canada need to take steps to communicate by o providing information that is appropriate and _________________. (answer: easy to use) o using straightforward language and _________________ messages and body language. (answer: culturally appropriate) o recognizing that familiarizing themselves with _________________ system can be complicated for new immigrant families. (answer: Canada’s health care) o ensuring through various ways that _________________is being understood by both parties. (answer: communication)

•

To enable educators to implement policies and procedures outlined in their policy manuals, they must understand the _________________ behind specific policies. (answer: rationale or who, what, when, where, and why)

•

What is the relationship between quality ECLC and the well-being of children? (answer: has positive lifelong health effects; supports the physical, emotional, social, and intellectual well-being and the growth and development of children)

•

A policy manual is a. an informational tool used primarily to “sell” your program to the community

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b. a living document, evolving with the changing needs of the program c. a legal document that outlines the program philosophy, goals, and objectives d. all of the above e. b and c only •

Purposes of program policies include _________________. (answer: refer to text page 43)

•

Beyond the licensing requirements, what are four (4) other purposes of program policies? (answer: conducting staff orientation, in-service training, and job performance appraisals; extracting the most relevant policies to be developed into parent handbooks; defining lines of communication and confidentiality; containing administrative and health forms; containing information sheets, handouts, and routines that can be used for posters [e.g., diapering]; identifying names and associations with which the program networks; staying current with research)

•

How can your ECE training contribute to providing a high-quality ECLC program? (answer: provides knowledge and skills; allows you to provide care above the minimum provincial/territorial child care regulations; helps you recognize the importance of quality ECLC in promoting children’s health; provides increased awareness in professional advocacy role)

Health Promotion Action Plan Objectives: To identify the three components of a health promotion action plan and describe how they can be implemented. (LO 3) To list three reasons why a health promotion action approach contributes to ECLC programs. (LO 2, 3) To discuss student and educator strategies to advocate for high-quality ECLC programs. (LO 3, 5) •

Select the action-plan component (A, B, or C) that best matches each example. A) individual problem solving and self-reliance B) community action C) societal change Alcoholics Anonymous (answer: B) She enrolls in a “Cooking in a Rush” course (answer: A) A group protesting the location of a landfill site (answer: B)

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He recycles, reuses, reduces, and composts at home (answer A) You join a national group lobbying for stricter legislation against family violence (answer: C) Families living near a busy intersection have the town council install a fourway Stop sign (answer: B) Your provincial/territorial government has passed a law to ban smoking in vehicles where there are children/youth under 16 (answer: C) A few families decide to pool their resources and improve their nutrition by shopping and cooking together on Saturday, making enough meals for the week (answer: B) A municipal law is passed disallowing vehicles from idling for long periods of time (answer: C) You wear safety equipment to roller-blade (answer: A) •

Wearing a helmet while bike riding even though it is not a law is an example of a. individual problem solving and self-reliance b. community action c. societal change d. none of the above

•

In a high-density area of the city, hundreds of families are living in several apartment buildings side by side down the street. The park is five blocks away and it doesn’t have any playground equipment for children. Looking at the issue around the importance of physical activity for children and adults, use your imagination to develop scenarios for each of the following: o individual problem solving and self-reliance (answer: examples—parent and children walk to the park after supper and brings balls, etc., to use; enroll children in physically active programs before or after school; family moves) o community action (answer: examples—two families alternate taking all the children to the park or other facilities; tenants approach the landlord to renovate an empty apartment into a play space and/or develop the rooftop; tenants from the various buildings approach the parks and recreation department or city hall to install a playground in the park) o societal change (answer: examples—architects recognize the importance of incorporating into the design of apartment buildings physical space outdoors, and perhaps indoors, for children and adults; municipal zoning bylaws require a

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certain amount of park/playground space be allocated to apartments by the number of units or neighbourhood density) •

Identify three (3) reasons why a health promotion approach can have a positive impact on ECLC programs. (answer: refer to text page 53)

Networking with the Community Objectives: To list ways that educators and ECLC programs benefit from networking with the community. (LO 5) To describe strategies to handle “mixed messages” that families and educators are faced with around health issues. (LO 5, 6) •

(T or F) Your early childhood education equips you to effectively respond to and deal with every family issue that arises in your program.

•

(T or F) Health-related messages from public sources directed at families and educators are always clear and consistent.

•

(T or F) Interprofessional collaboration is learning with, from, and about each other.

•

Choose a current health-related issue with at least two (2) different messages directed at families.

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HERE’S THE ANSWER—WHAT’S THE QUESTION? Here’s the answer. primary health and public health medical officer of health and public health nurses and inspectors process that enables people to increase control over and improve their health the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with the challenges we face refers to the degree to which an individual enjoys the important dimensions of her or his life the first two interactions whereby individuals experience their identity and way of being as respected or, at least, not challenged or harmed identifies the factors that cause a medical condition/illness and tries to reduce or eliminate them individual problem solving and self-reliance; community action; societal change extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment they have been excluded from the conventional medical model in Canada but have been part of a tradition in other parts of Canada the study of why some groups of people are healthier than others publicly administered; comprehensiveness; universality; accessibility; portability provide a minimum standard of care to children program staff liaise with community and social agencies in order to contribute to the well-being of children and their families

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What’s the question? What are the components of Canada’s health care system? Who, from the community, is ultimately responsible for the health of children and educators in early childhood learning and care programs? What is health promotion? What is positive mental health?

What is quality of life? What is cultural safety?

What is the principle behind disease prevention? What are the three components of the health promotion action plan? What is health? Who are complementary health practitioners? What is population health? What are the national principles of medicare? What do child care regulations require of programs? What is networking?

conduct staff orientation, training, and appraisals; inform parent handbooks; define the lines of communication; contain forms and information sheets healthy child development; education and literacy; social support networks; income and social status; culture the most popular form of complementary health care in North America professionals are learning with, from, and about each other, building mutual respect, shared knowledge, and decision making in the best interests of the child and family

What are the purposes of health policies?

What are the five most applicable social determinants to early childhood learning and care settings? What are natural health products? What are the benefits of interprofessional collaboration?

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UNIT

Occupational Health

2 CONTENTS CLASSROOM ACTIVITIES AND DISCUSSIONS..........................................................................2 Critical Thinking...................................................................................................................................... 7 First (refer to text page 100) ...................................................................................................................... 7 Second (refer to text page 113) ................................................................................................................. 7 Assess Your Learning .............................................................................................................................. 8 Resource Materials for Teaching............................................................................................................. 9

ANCILLARY MATERIAL ..........................................................................................................11 Are You Listening? ................................................................................................................................ 11

ASSIGNMENT IDEAS .............................................................................................................12 TEST QUESTIONS ..................................................................................................................13 Promoting Your Physical Well-Being ..................................................................................................... 14 Promoting Your Psychological Well-Being............................................................................................. 18

LIFESTYLE GOAL SETTING .....................................................................................................22 HEALTHY LIFESTYLE BINGO: PERSONAL ...............................................................................23 HEALTHY OCCUPATION BINGO: PROFESSIONAL .................................................................24 THE FINANCIAL DIMENSION ................................................................................................25 OCCUPATIONAL HEALTH PROBLEM SOLVING .....................................................................26

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Classroom Activities and Discussions Healthy Lifestyle Bingo: Personal (see handout, page 2-22) and Healthy Occupation Bingo: Professional (see handout, page 2-23); or, with a blank grid, each student can walk around and fill in the grid with each classmate’s suggestion for dealing with stress; “bingo” when the grid is complete. Before students read this unit, ask them to identify their top three concerns regarding occupational health. Keep this list. On completion of the unit, ask students to repeat this exercise and compare it with the original. Ask them if and why there may be differences. Appendix 2.3, Health Practice: You and Your Employer (refer to text page 122, the first half) Ask students to complete and in small groups or as a class discuss the list in general terms without anyone having to share personal items (e.g., identify practices that they can improve on and how). Physical activity: Using the blackboard or whiteboard, create a list of physical activities that students are involved with •

daily

•

weekly

•

once in a while

Ask students to share how they are able to make physical activity a priority, and for others, the reasons why they are not more physically active on a regular basis. Back injuries: Prevention is key. Demonstrate proper lifting techniques and postures. You may wish to invite a chiropractor or physiotherapist in as a guest speaker; 45 to 60 minutes should be sufficient (refer to Table 2.4, text page 86; Table 2.2, text page 72; Figure 2.1, text page 83, Figure 2.2, text page 84; Figure 2.3, text page 84). While doing a field placement with toddlers, you notice that you are starting to get lower back pain and are concerned that, as a young adult, this is already bothering you. You realize that you need to make some changes immediately in both your personal and professional practices to ensure that you prevent further back pain (refer to text page 88). Suggestions: Evaluate your current lifting technique with the proper techniques covered in Figure 2.1 (refer to text page 83), Figure 2.2 (refer to text page 84), and Figure 2.3 (refer to text page 84); use Table 2.4 (refer to text page 86) to identify possible workplace problems that may be contributing to your back issues and follow the recommendations consistently; consider the need for training in proper lifting that can be arranged by the director; consult with your health care provider or complementary practitioner on ways to strengthen your back muscles; ensure all 2-2

components of physical fitness are considered (i.e., aerobic fitness, flexibility, strength, and endurance) and incorporate regular exercise into your daily routine at work and at home. Refer students to Appendix 2.2 (refer to text page 120): •

In groups of 5 or 6, ask each student to remove one shoe. Refer to Appendix 2.2’s footwear policy criteria for the categories for working in an ECLC program: not appropriate, better but not best, and best. Have each student evaluate where her or his shoe falls in these categories, and why; then share the evaluation with the small group.

•

Perhaps each group can choose the best shoe for work with the class, and everyone can vote on the winning shoe (only for fun, not competitive!).

•

Another interesting activity in the large group could be for each student to place his or her shoe in the most suitable category pile at the front, to determine whether the majority of footwear in the class would be not appropriate, better but not best, or best for work.

WHMIS: Show students a WHMIS poster (usually easily available) and ask students if they can identify any of the products. Some, due to work experiences, may be aware of WHMIS and controlled products. Perhaps the health and safety officer at your college or the local public health inspector could speak about WHMIS in relation to programs and the type of products used in them. Workplace environmental issues: Discussions on issues such as the quality of programs’ ventilation/air quality, noise levels, temperature control, and lighting provide students with the opportunity to evaluate the classroom’s environment, which is where they will be spending the next year or two. This may be an eye-opener since so many college/university environments are not particularly conducive to the physical or emotional health of the employees or students. Using a typical classroom, have students evaluate features such as the following: •

Lighting: Is there more than one light switch to allow some lights to be on and others off, which is particularly useful for viewing videos and overheads?

•

Are there windows and, if so, can they be opened by you, or do you have to rely on a caretaker with a key or window crank? Are there curtains/blinds that allow you to control the amount of sunlight on particularly sunny days in the summer?

•

What is the quality of the air exchange in rooms when there are no operable windows?

•

Heating/cooling system: Is there a thermostat in each room and can you control it, or does a caretaker use a special key? Or is the whole school controlled with one,

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which can’t accommodate for rooms on the south and west walls with more summer light, or the north and west walls exposed to more of the winter winds? •

What are the noise levels in the classroom, including the overhead projector’s fan and those coming from the hall?

•

Comfort level of classroom furniture: Is it ergonomically correct for adults, which is of particular interest when used in two- to three-hour classes, and are you able to easily make rearrangements (e.g., small-group discussions)?

•

Do left-handed students have access to appropriate desks?

What are some strategies to improve the environment? •

Consult with the college’s health and safety officer.

•

Speak with the campus manager regarding structural issues (e.g., cold rooms in the winter).

•

The instructor can speak with the department responsible for servicing audiovisual equipment.

•

Document concerns that require action either in the short term or during renovations, and for replacing classroom furniture (perhaps the department responsible can consider your concerns and student teaching needs when purchasing new furniture in the future).

It may be difficult for us to acknowledge that the college’s environment is not conducive to health. However, it may be seen to be very inconsistent to support a health promotion model at work when we are not. Students may learn that working together for change brings results. They may be disappointed if they don’t get the results they had hoped for, but the instructor can help them to identify what the barriers are and possibly to reshape their plan. Often there has been some improvement and this needs acknowledgment. Creating a supportive environment: Ask students to role-play workplace situations, and then as a class discuss how they will resolve the situation and how the situation could have been prevented in the first place (see the Are You Listening? handout, page 2-11; refer to Table 2.6, text page 114). Scenario 1 Josée—“I’m leaving now, Maria. I have a doctor’s appointment so I asked Rita (director) if I could come in early tomorrow instead.” Maria—“You didn’t tell me you were leaving early, Josée. I’m the one who is really affected so why didn’t you let me know before now? Now I have to put everything away and close up the building by myself. It’s not fair.” 2-4

Josée—“Oh well, Rita should have told you. Gotta go. Bye.” Scenario 2 Lucy calls the director, Mrs. Fitts, at 6:00 a.m. and tells her that she isn’t feeling well, has a really awful head cold, and can’t come in today. Mrs. Fitts—“Oh, Lucy you can’t stay home. Mike is on vacation and the toddlers will be very upset if they see a stranger in their room this morning. At least come in for a few hours, and then go home if you’re still feeling sick.” Against her better judgment, Lucy arrives at the program and is feeling worse by the minute. The toddlers would be a lot happier with an educator who has energy and is able to cope, even if she is new to them, she thinks. I need to take care of me. Lucy asks Mrs. Fitts to come in and relieve her. Mrs. Fitts, who is obviously very angry, says, “You made your mind up that you wanted today off, no matter what, didn’t you?” Lucy, feeling so sick and upset, can’t answer her. She takes a taxi home, even though she can’t afford it. Scenario 3 Annie, an enthusiastic student in her program placement, insists that she doesn’t need breaks during the day. Although the staff in the room point out opportune times to leave the floor for 10 or 15 minutes, Annie says she’s fine and doesn’t want to miss a minute of learning opportunity. The educators appreciate her eagerness but are concerned that this is not a physically, emotionally, or socially healthy pattern to get into. What is your opinion?

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Suggestions: Benefits of Taking Breaks

Benefits of Not Taking Breaks

physical and emotional benefits (e.g., rest/relaxation, nutritional, time to think about self rather than others’ needs) and social benefits (e.g., with educators and fellow students)

if you’re in the staff room when your ECE instructor arrives, you may be concerned that it would give the impression that you’re not motivated enough

reduces the risk of burnout—not taking as a student, you may miss a learning breaks can lead to exhaustion at the moment while off the floor end of the day, which can affect your personal life and increase risk of burnout develops a healthy, balanced work style that affects your overall lifestyle demonstrates a sense of self-worth by making yourself a priority when tired or unfocused, may not be able to take full advantage of learning opportunities classmates will not see you as a keener: setting up expectations for others to match recognizes that child care is a physically and emotionally demanding job and that regular breaks are as important here as in any other job

In groups of three or four, students can discuss problem-solving scenarios. The instructor will decide how the information will be brought together as a group (numerous possibilities). (See the Occupational Health Problem Solving handout, which you can copy and distribute to students, page 2-25.)

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•

Discuss the pros and cons of working in unionized and non-unionized ECLC workplaces.

•

Discuss how you could approach the director about workplace environmental issues, such as indoor climate control, air quality and ventilation, noise levels, and poor lighting.

As one example of a strategy to manage stress, consider introducing mindfulness meditation to the class. You may want to invite a speaker or visit a site such as 15 Best Meditation and Mindfulness Apps for guided mindfulness sessions: https://www.developgoodhabits.com/best-mindfulness-apps/. Check YouTube for a range of videos on mindfulness by Jon Kabat-Zinn.

Critical Thinking First (refer to text page 100) Identify an issue that you are going to find stressful when you begin your career in ECLC. List three strategies that will help reduce your apprehension and build your confidence as you begin your career. Suggestions: The solution is going to depend on the specific issue; discuss your issue with fellow students, educators, and your instructors to gain insight and validate or allay your concern about this perceived stress factor; complete Appendix 2.3 (refer to text page 122) to identify if your stressor is in the list and to follow the recommended prevention strategies; when the issue has validity, a prevention plan would include when the issue is related to working conditions, you can ask relevant questions during the job interviews and ask to observe in the ECLC programs you are considering, using Table 2.6 (refer to text page 114) to decide if the environment is a good fit for you; have a method to self-evaluate the issue against your work experience during the first few months of employment to gauge the degree of stress you are experiencing; take an active role in problem solving and see the issues as learning opportunities; remember that you are promoting your own health by increasing your coping skills, in other words, think about what you can control in your work life and what you cannot (e.g., Do you have a tendency to look at a glass as half empty rather than a glass as half full? Do you overanalyze others’ comments directed at you and begin to see them as major sources of stress rather than as an innocent or unintentional comment?); stop negative self-talk; cue your relaxation response to calm yourself in times of stress (refer to the Canadian Mental Health Association’s website: https://cmha.ca/). Second (refer to text page 113) As a student, you are frustrated by a clique of three students who sit together and regularly disrupt the class. What do you do? Suggestions: An appropriate first step may be to approach the three students at a break or after class; perhaps they don’t realize how their behaviour affects others, so you can say something like, “I really find it hard to concentrate in class when you three are talking among yourselves”; they may be surprised and respond with an apology and stop, or they may become defensive and respond with denial of the behaviour and will continue with the talking, or they may become defiant and respond Copyright © 2019 by Nelson Education Ltd.

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with something like, “So, what are you going to do about it?” Regardless of the specific reaction, make it clear that you would appreciate that they stop this behaviour and will need to speak with the instructor if they don’t stop. To summarize, you have •

been direct, ensuring that they are aware of the situation rather than complaining to your classmates, which eventually will get back to the three students, who will probably resent the lack of direct communication that further complicates matters.

•

indicated your next step, thus being clear about a sequence and consequences.

Direct, tactful communication is most often the most appropriate strategy for preventing problems from becoming more complicated in the classroom and the workplace.

Assess Your Learning Evaluate your options in each situation. 1. A colleague buys her lunch from the nearby fast-food restaurant almost every day. You can’t resist having her pick up something for you, too, even though you often feel full after eating the nourishing hot lunches with the children before you have your lunch break. The fries or burger tastes great, but you feel sluggish all afternoon. Suggestions: Go to the fast-food restaurant with your coworker, make healthy food choices, eat together, and then go for a walk; reverse the order, motivate each other to incorporate walking before eating, and then see if you still want to eat out; stop asking her to pick up your food and bring in raw vegetables and fruit to munch on during your lunch break, but still go walking. 2. You and a coworker rarely agree on program-related issues. As a result, your relationship deteriorates to the point where you speak as little as possible, and the tension is felt by the other staff, children, and families. Suggestions: Recognize when you need help—most directors should have already identified the problem but are taking the wait-and-see approach to see if the two of you can resolve it; approach the director and ask for a process that would help rebuild the relationship and working conditions. 3. You and two coworkers have been injured over the past month from pinching fingers in a cupboard door while putting things away (out of children’s reach). Each of you completed a detailed injury report and submitted it to the director, yet none of you have heard anything from her about this situation. Suggestions: Talk with the director about an update on the resolution of the issue; refer to the program’s policy manual to review the process that is to be followed upon the submission of injury reports; when such a policy is excluded from the manual, this omission can be the topic for a staff meeting as the first step in 2-8

writing the policy; contact your program’s Workplace Health and Safety Committee (where available); contact the president or chair of the program’s board of directors about the incident; contact your provincial or territorial child care office; see the Canadian Centre for Occupational Health and Safety (CCOHS) website, which covers the occupational health and safety legislation surrounding due diligence by employers. 4. You enjoy communicating with family members of your program, but you are not confident trying to communicate with individuals whose first language is not English. You feel that you are being patronizing, speaking loudly and very slowly and making hand gestures. Suggestions: Parents are resources with specific knowledge and skills that they can share; enroll in courses or workshops; seek community resources that may provide language training and possible translation services for your parent handbook and information sheets; inquire if the parents are taking EAL classes; perhaps the program can provide an opportunity for professional development if cost or time away from work is required. 5. To the best of your parents’ and your knowledge, you never had rubella as a child. You are now pregnant, and three children in your preschool program have contracted rubella. Suggestions: Contact your physician immediately (refer to Table 2.3, text page 80).

Resource Materials for Teaching Canadian Centre for Occupational Health and Safety (CCOHS): https://www.ccohs.ca/ This site has an extensive amount of information and online modules that you may find helpful in your teaching. Canadian Heart & Stroke Foundation: http://www.heartandstroke.ca/ Canadian Mental Health Association: https://cmha.ca/ Child Care Human Resource Sector Council: http://www.ccsc-cssge.ca/ •

Occupational Standards for Early Childhood Educators (n.d.): To download the PDF, visit http://www.cccf-fcsge.ca/wp-content/uploads/occupational-standardsfor-ece_en.pdf

CSEP (n.d.) Canadian Physical Activity Guidelines for Adults—18–64 Years. To download the PDF, visit http://csepguidelines.ca/wpcontent/uploads/2018/03/CSEP_PAGuidelines_adults_en.pdf Day Nursery Centre’s Guide to Workplace Health, Safety and Wellness. A 15-minute DVD that introduces their child-hazard analysis process and helps students to understand Copyright © 2019 by Nelson Education Ltd.

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the breadth of workplace health and safety. A great springboard for discussion. The video can be purchased for $25 from Day Nursery Centre, Winnipeg, MB. Please contact the executive director at 204-775-6513, or email dnced@mymts.net for more information. Health Promotion 102 is a free three-part online session on workplace health promotion (developed by the Ontario Health Promotion Resource Centre). It contains nine learning modules. Refer to the list on the left-hand side of their Web page for a list of modules. It will take you 10–20 minutes to complete each module. There are no restrictions as to when, how, or in which order you choose to complete the modules. To access, visit http://www.ohpe.ca/node/11945 ParticipACTION: https://www.participaction.com/ WHO Collaborating Centre in Health Promotion, University of Toronto: http://www.dlsph.utoronto.ca/global-health/who-collaborating-centre-in-healthpromotion/

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Ancillary Material Are You Listening? When you and I are talking together … •

you make me feel as if this is the most important thing you could be doing right now and that your time is truly mine.

•

your attention is divided. You interrupt our conversation by answering the phone or addressing the needs of others who come by your door.

•

you begin shaking your head or saying “no” before I finish.

•

you make references to other conversations; there is a history to communication.

•

you fidget and squirm and look at the clock as though you cannot wait to get on to other, more important projects and conversations.

•

you begin asking questions before I finish my message.

•

you look me in the eye and really focus your attention.*

•

you ask questions that let me know you were not really listening.

•

you finish my sentences for me as though nothing I have to say could be new to you.

•

you express interest by asking thoughtful questions and by contributing your insights.

•

you change the agenda by taking over and changing the content of the conversation.

•

you follow up on what we discussed and keep me posted on what is happening.

•

you are sensitive to the tone of what I have to say and respond respectfully.

•

you give me credit for ideas and projects that grow out of our communications.

•

you try to speed things up and leap ahead with ideas or conclusions as though we are in a rush.

Often

Seldom

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