2018 Fall Kansas Child

ccaks2018

Community vitality, early childhood education

A publication of Child Care Aware ® of Kansas

Fall 2018 Volume 17, Issue 4

COMMUNITY

VITALITY

KANSAS HEALTH FOUNDATION

RELEASES STATE

4 DEMOGRAPHIC REPORT

16

IS MEET YOUR THE COMMUNITY NEEDS OF FAMILIES

ABLE TO

20

INVESTING

SEEKING CHILD CARE?

IN KIDS


LEADELL EDIGER

Kansas Child

is a publication of

Child Care Aware ®

of Kansas

Executive Director

Leadell Ediger

Editors

BWearing Consulting

Angie Saenger, Deputy Director

Publication Design

Julie Hess Design

On the Cover

Hayes Sanders, age 2, son

of Ben and Sarah Sanders,

Berryton, KS, imitates his

older brothers who love

to play football.

Child Care Aware ® of Kansas,

1508 East Iron, Salina, KS 67401,

publishes Kansas Child quarterly,

which is made possible through the

financial support of the members

of Child Care Aware ® of Kansas and

sponsorships from our corporate,

private, and foundation partners.

Kansas Child is intended to provide

a forum for the discussion of child

care and early education issues and

ideas. We hope to provoke thoughtful

discussions within the field and to

help those outside the field gain a

better understanding of priorities

and concerns. The views expressed

by the authors are not necessarily

those of Child Care Aware ® of Kansas

or its sponsors.

Copyright © 2018 by Child Care Aware ®

of Kansas, unless otherwise noted. No

permission is required to excerpt or

make copies of articles provided that

they are distributed at no cost. For

other uses, send written permission

requests to:

Child Care Aware ® of Kansas,

1508 East Iron, Salina, KS 67401

Executive Director

Child Care Aware ®

of Kansas

I grew up in the small town of Hillsboro, a true farming community in the middle of the state,

surrounded by wheat fields. In the ’50s and ’60s it had a modest population of slightly less than

3,000. It had two grocery stores, a drugstore complete with a soda fountain and also sold women’s

costume jewelry. On Main Street there was a clothing store, a “5 and dime store,” a bowling alley,

and one bar that sold beer but no hard liquor. There were two family restaurants with no drivethrough

windows and one ice cream shop with a walkup window.

Hillsboro was fortunate back then to have three family physicians, a small hospital, one dentist

and one optometrist. A cornerstone of this small town were the seven churches that served the

Mennonites, Methodists and Baptists.

My family lived in Hillsboro from the time I was 18 months old until I was 18 years old and

graduated from high school. My childhood home was a little unusual for the times, because both

my parents worked outside the home. They owned and operated one of the two restaurants in

town, the Wheel Inn Cafe. It was open from 7 a.m. to 11 p.m. Sunday through Friday. My dad

was the “chef,” having learned those skills in the Army. My mom did much of the baking and

made sure customers were well taken care of so they would come back for their next meal.

Our place was strategically located on the highway so it was easy for truckers to stop in for a

big piece of homemade pie. I grew up in the restaurant. I was either in the kitchen helping to peel

potatoes or delivering water to the tables before a waitress could stop to take an order.

As I got a little older, I had lots of free time to spend outside, at the swimming pool or the park

with friends. Life was simple then. I never felt unsafe in Hillsboro.

When I was in high school (and a little ornery) I always knew that if I did something

downtown that didn’t meet the approval of anyone who was watching, my mother would know

about it before I got home that night! I lived the old adage, “It takes a village to raise a child.”

Hillsboro collectively watched out for me and all of the kids growing up there.

Looking back, my childhood in Hillsboro directly influenced my choice of professions and is

reflected in the small-town values by which I have chosen to live my life.

I talk today about how the collective vision of early childhood professionals is that all children

have safe, loving, healthy, nurturing environments in which to grow, play, develop necessary skills,

and build relationships; and that all children deserve access to health and dental care. I recognize

that I was provided that environment, even though both my parents had jobs.

Today, I still go back to Hillsboro fairly frequently to visit my mother-in-law, and because

my parents are buried in one of the three cemeteries there. Hillsboro has changed, but the

values I learned there have stood the test of time. All Kansas children, whether their homes are

surrounded by wheat fields or skyscrapers, deserve the opportunity to have that same sense of

security and opportunity.

Kansas Child is distributed at no

cost to Child Care Aware ® of Kansas

donors. Single copies are available

to anyone at $5 each, prepaid.


IN THIS ISSUE

p. 4

Change: Kansas Health Foundation

Releases State Demographic Report.......4

Adolescent Health Literacy:

An Essential Life Skill for

Transitioning into Adulthood................... 8

Developing Early Regulation.................... 8

Kansans of Tomorrow............................. 10

Socio-Ecological Model of Health

Promotion and Childhood Obesity

in Kansas City......................................... 10

Exciting Opportunity for Wyandotte

County Children and Families.................12

On the Road in Northwest Kansas:

Community Strategic Doing....................13

Thrive Allen County:

The Best Days are Ahead!....................... 14

p. 16

Allen County, Kansas: 2017 Robert

Wood Johnson Foundation Culture

of Health Prize Winner............................15

Is Your Community Able to Meet the

Needs of Families Seeking Child Care?. 16

New Child Care Workforce Report..........17

Our Tomorrows: Using Kansans’ Voices

to Inform Services...................................18

Investing in Kids: How ending

extreme tax policy freed Kansas

lawmakers to lift the next generation....20

Child Care as Utility.................................21

p. 20

Book Nook: The Magical Richness

of Books.................................................. 22


Change

Kansas Health Foundation

Releases State

Demographic Report

STEVE COEN

Kansas Health Foundation,

President and CEO

Steve Coen has worked to improve the health of all

Kansans in his 30-plus years at the Kansas Health

Foundation. He has held his current position as president

and CEO since August 2008. Steve is a native of St. John,

KS, and graduated from Emporia State University and

Washburn University School of Law.

Imagine a small, rural Kansas town in the

1960s — children playing, families spending time together

and streets lined with storefronts. Neighbors are helping

each other in moments of need and everyone is working to

create a community that feels more like a family.

In all, it was just an easier, slower-paced life when things

didn’t seem as complicated. Parents had more time to

be intimately involved in their kids’ lives and children

could walk or ride their bikes almost anywhere without

supervision.

It was a time when almost every town had a drug store,

grocery store and movie theater, and the community was

vibrant with activity on any given night.

In the past 60 years, times seem to have changed.

Smaller towns are closing local storefronts and shuttering

windows as residents take their business elsewhere,

oftentimes driving to nearby larger towns or shopping

online.

As we think about this phenomenon, what do we really

know about how the state has changed? What will the next

20 to 50 years look like in Kansas? And, how will these

changes affect the health of our residents?

This is something we kept asking at the Kansas Health

Foundation, because we know that without a roadmap we’ll

never be able to reach our desired destination: a culture in

which every Kansan can make healthy choices where they

live, work and play.

We believe for our statewide organization, and many

others, the ability to make sound decisions is dependent

on having data detailing where we’ve been and where we’re

going. And only from there can we perform effective,

purposeful grantmaking and communication work.

With this in mind, we partnered with the Kansas

Health Institute — a nonprofit, nonpartisan educational

organization that delivers objective information, conducts

credible research, and supports civic dialogue enabling

policymakers to make informed health policy decisions

— to author and produce a report showing population

patterns in both Kansas and the United States.

The report also features population projections by

race and ethnicity from recent research conducted

by the Wichita State University Center for Economic

Development and Business Research. “A Changing Kansas:

Implications for Health and Communities” highlights the

reality that the Kansas population is changing, and these

changes have important implications for the health of our

state and communities – no matter their size. Shifting

demographics also impact how communities will function

in the future and provide essential services for residents.

Continued on page 6

4 Kansas Child A Publication of Child Care Aware ® of Kansas


The Kansas Hispanic population is

expected to quadruple by 2066,

increasing nearly 287 percent.

www.ks.childcareaware.org Kansas Child 5


Continued from page 4

Throughout the report, pertinent facts become clear, and many

important conclusions can be drawn. At the highest level, one key

takeaway is that the Kansas population is growing slower than the

United States as a whole. In order to ensure a prosperous future,

a state must continue to grow its population and advance its

communities.

In the absence of massive overall population growth, it

becomes even more vital that we as Kansans focus on key

demographic shifts, especially those highlighted in this report.

By analyzing the numbers presented regarding population

and demographics in the coming decades, we are able to draw

three over-arching conclusions: Kansas is becoming increasingly

diverse, concentrating in urban areas, and is aging.

Growing Diversity

For years, Kansas communities of all sizes were predominately

non-Hispanic White. That reality is quickly changing.

Non-Hispanic Whites made up more than 84 percent of the

Kansas population in 2000, but 16 years later, represented only

77.5 percent.

Between 1960 and 2016, Kansas grew at a lower rate than the

national average. It is revealing that even this small growth was

completely due to minority populations. For the purposes of the

report, minority populations were defined as “any racial or ethnic

group other than non-Hispanic White.”

All 105 Kansas counties saw an increase in minority populations

during this time period. Projections indicate this trend will

continue, with the Kansas Hispanic population expected to

quadruple, increasing nearly 287 percent by the year 2066.

In contrast, the non-Hispanic White population is projected to

decrease by approximately 21 percent by 2066. This population

group already declined by 0.3 percent from 2000 to 2016. Current

growth patterns indicate this population will continue to decline

while minority populations substantially increase.

In addition to the anticipated growth of the Hispanic

population in the coming decades, other minorities are also

expected to see large increases:

Black population by more than 41%

Other/Multiple Races by 138%.

These population increases among minorities are predicted to

lead to a major “event” within the next 50 years: Between 2061

and 2066, researchers foretell Kansas will become a majority

people of color state.

Any time a shift this dramatic is predicted, the obvious

question becomes, “Is this good or bad for our state?” At the

Kansas Health Foundation, we believe that “change,” in and

of itself, is neither good or bad. Change is simply change, and

with changes, it’s important to look at the opportunities and the

potential challenges.

These changes bring great advantages, like a stable, growing

population base; a steady workforce needed for jobs; an

opportunity to keep unemployment levels from going lower,

which helps recruit new industries; and more vibrancy to cultural

life in Kansas.

But, challenges also come with growing diversity. When

looking at state health data based on race, income and education,

we see that minority populations tend to experience higher rates

of tobacco use, obesity and diabetes. They are also more likely

to have lower incomes, be uninsured and have lower levels of

educational attainment.

It will be important for community and state policymakers to

plan for and carefully consider how to mitigate these challenges

and especially to ensure educational systems remain strong.

Education will become even more important for the future of

By 2066 the non-Hispanic White population is projected

to decrease by 21 percent. Minorities are expected

to see large increases: Black population by more than

41%, Other/Multiple Races by 138%.

our state due to the connection between education, better jobs,

higher income, greater access to care, healthier behaviors and

ultimately better health outcomes for all Kansans.

With this knowledge of a shifting demographic landscape,

Kansas will have the opportunity during the next 50 years to

build on its pioneering past and solidify itself as a diverse and

progressive force.

Rural Flight

Another aspect the report touches on is a population shift away

from rural areas to more urban parts of the state.

Taking another step back in time, the Kansas population

between 1960 and 2016 increased by 33.4 percent, but the U.S.

population increased by more than 80 percent.

During these years, population growth has not occurred

uniformly in all geographic regions of the state. Most growth

occurred in highly populated areas or around livestock centers in

Southwest Kansas.

While urban counties increased in population during these 56

years (nearly 81 percent in urban and more than 24 percent in

semi-urban), rural and frontier counties saw significant decreases

in population (more than 22 percent and approximately 41

percent, respectively).

From 2000 to 2016, 82 of the 105 Kansas counties experienced

population loss, but the state as a whole saw a growth of more

than 8 percent.

Between now and 2066, rural counties are projected to see

6 Kansas Child A Publication of Child Care Aware ® of Kansas


a continual decrease in population of nearly 20 percent in the

western areas of the state, and approximately 32 percent in the east.

The report suggests more people will continue to make

metropolitan areas their home by 2066. The overall state

population is predicted to increase by 25 percent during this time

period, and growth will concentrate in urban areas of the state.

For instance, Topeka is projected to grow by more than 7 percent,

Lawrence by nearly 126 percent, the Kansas City area by 44.5

With this trend continuing, an interesting milestone will

be reached in the coming years: By 2034, the number of older

residents will exceed those under age 18 for the first time in our

state’s history. While the overall state population is expected to

grow by 25 percent between now and 2066, the projected growth

rate among people 65 and older will be nearly 70 percent.

When thinking about this imbalance between the older and

younger populations, we have to think about how this shift will

Topeka is projected to grow by more than 7 percent,

Lawrence by nearly 126 percent,

the Kansas City area by 44.5 percent

and Wichita by more than 28 percent

By 2034, the number of older residents will exceed

those under age 18 for the first time in our state’s

history. The projected growth rate among people 65 and

older will be nearly 70 percent.

percent and Wichita by more than 28 percent.

These trends and projections could greatly impact public

health, and pose problems for governments, education systems

and human service organizations. Urban areas will need to make

difficult decisions and important investments to ensure their

communities are capable of adding large increases in population

while maintaining critical aspects of quality of life.

Governments in rural areas will likely face mounting pressure

on local budgets to fund infrastructure and essential programs

with fewer residents to foot the bill. Rural areas will also have

to make difficult decisions. Instead of large investments like the

urban areas, rural decisions may focus instead on finding ways

simply to provide essential services.

It’s safe to say both urban and rural areas of the state must be

prepared for changes in the coming decades.

An Aging Population

It’s probably not surprising that while rising diversity and

urbanization are occurring, our population is also getting older.

What might not be as well known is that it’s happening at a much

faster rate than the rest of the nation. This trend is expected to

increase each year as Baby Boomers reach retirement age.

In 2000, Kansans were a median age of 35.2, but in 16 years this

number has increased to 36.5.

The number of Kansans age 65 and older is also increasing. In

2016, 15 percent of the population fell in this age bracket, which

was up from 13.3 percent just 16 years earlier.

affect our state’s economy — if we’ll have enough workers to

support our growing elderly population and how to best prepare

our health care systems, which will likely become more stressed

with additional chronic illness.

Generations of Kansans have used their ingenuity and wisdom

to set our state on the course to prosperity. As these generations

age, we must make sure we return the favor by providing them

with the necessary services in their golden years.

What now?

We know change will occur no matter what. We can look at

the opportunities to plan for the best health of our residents

and for the betterment of our communities. With this report,

we now have hard numbers and solid facts rather than merely

conjecture and hypotheses.

We have the privilege to create a better path for the health of

our people, and for stronger, more vibrant, communities.

But we can’t do it alone. It’s going to take all of us – with

different ideas, talents and working in ways that are much

different than we have before. State and local leaders must

engage with communities to learn how to address these trends,

and what it’ll mean for their unique makeup.

Can you, and your organization, commit to a future that is

inclusive and builds on the strengths of our people?

We hope you can, and that you’ll join us in doing so.

Visit kansashealth.org to learn more about the Kansas Health

Foundation. n

www.ks.childcareaware.org Kansas Child 7


Adolescent Health Literacy

Imagine this scenario…

Teen, to his parent: Soccer tryouts are

coming up. I’ll need to turn in the sports

physical form on the first day of tryouts.

Parent: I can take you. Just call the office

and schedule an appointment.

Teen: Ok- I’ll do it later today.

Realistic? Probably not.

Would most teens know

what type of medical

practice to call for

a sports physical?

Would they have

the phone number

saved or know

the name of the

practice so they

could look up

the number?

Given that

only 12% of

American

adults have

proficient

health

literacy 1

and that

national

adolescent health literacy rates are difficult to

estimate, it is unlikely that most teens would

have the knowledge to complete a basic health

care task, such as scheduling their own sports

physical, without guidance from a parent or

guardian. Why does this matter?

Becoming self-sufficient is a key

developmental task of adolescence. To survive

and thrive as adults, teens must learn skills

such as managing money, cooking, doing

laundry, and working. Managing one’s own

health care is among these essential life skills.

In fact, health literacy is a stronger predictor of

health than age, income, employment status,

educational level, or race. 2 As health literacy

increases, people are more likely to seek

preventive services and enter the health system

healthier, have lower rates of preventable

hospital and emergency department visits and

are less likely to report their health as poor. 3

Increasingly, the medical community is

recognizing the importance of health literacy

among young adults. The American Academy

of Pediatrics, American College of Physicians,

and American Academy of Family Physicians

recognize that all adolescents require guidance,

education and planning to manage their

own health care as they become adults. 4 The

National Academy of Medicine suggests that

initiatives to improve health literacy through

primary and secondary education could lead

BOBBIE COOPRIDER

Licensed Masters Social

Worker

Bobbie Cooprider is a certified Attachment and Bio-

Behavioral Catch-Up (ABC) Coordinator/Parent Coach.

She is currently a trained forensic interviewer and is

pursuing Trauma-Focused Cognitive Behavioral Therapy

Certification. Bobbie is a Licensed Masters Social Worker.

She has 16 years of experience working with children,

conducting quality improvement in child care centers and

homes, and advocating for children and families.

Developing Early Regulation

Building strong relationships with children

can actually help to protect them from stress.

Parents strive to be highly committed to their

children, but the emotional challenge of caring

for a challenging child might cause parents to

hold back. No matter what situation parents

come up against, a high level of commitment

and responsiveness is recommended.

Infants depend on their caregivers to regulate

their body. The showing of outstretched arms

and crying are a way of maintaining proximity

to their caregiver. When parents show

sensitivity to a baby’s cues and bidding, the

infant feels secure. When a caregiver shows

a lack of commitment or response, the child

might be at risk of not being able to develop

strong relationships.

How commitment is communicated to

children is important. Most early education

professionals would say that commitment is

observable. It can be seen in the intensity of

a parent’s look and in expressions, such as

delight. This type of communication is the

same no matter what culture.

Although delight might not be a predictor

of relationship quality, it is a fundamental

element of attachment when reviewing

sensitivity, rejection, and support of a child’s

exploration. When children receive these

messages, they understand that they have

worth and importance in the world.

Caring actions such as being warm,

responsive, and affectionate, help children to

8 Kansas Child A Publication of Child Care Aware ® of Kansas


An Essential Life Skill for Transitioning into Adulthood

KATE BLACKBURN

to better health and decrease the cost of

health care in the United States. 5

Filling a Gap in Adolescent Health

Literacy Education: Navigating the

Health Care System

Recognizing the importance of

increasing health literacy among

adolescents and the scarcity of health

literacy interventions designed for

adolescents in the general population 6 ,

Nemours Children’s Health System created

Navigating the Health Care System, a fourunit

health literacy curriculum designed

for use with high-school-aged adolescents

in classroom and community settings.

Nemours is an internationally recognized

children’s health system that owns and

operates two, free-standing children’s

hospitals along with outpatient facilities

in five states to deliver pediatric primary,

specialty and urgent care.

Navigating the Health Care System

(NTHCS), which incorporates national

education standards, was piloted and

refined in collaboration with schools and

other community sites in Delaware. Topics

covered include primary and specialty

care, insurance, family history, logistics

of medical visits, and more. Information

is shared via four, 45-minute modules.

The content, which can be presented

by trained adults or peer educators,

includes presentation slides, student

workbooks, video clips and interactive

activities.

In three academic years of testing

involving nearly 2,900 students,

teenagers showed significant knowledge

gains—an average of almost 20

percentage points. In addition, adolescents

taking part in the sessions and adults

presenting the content reported high levels

of satisfaction with the curriculum.

Bringing Health Literacy

Education to All Youth: National

Expansion of NTHCS

Given these results, Nemours launched

a national expansion of the curriculum

in 2018. Recognizing that many of the

adolescents who are taught the NTHCS

curriculum will never receive clinical care

from Nemours, it remains committed to

creating a new generation of educated

health consumers. Therefore, Nemours

is providing free materials, training, and

assistance to partners that are interested in

implementing the curriculum anywhere in

the country. School districts, communities,

Nemours Children’s Health

System

Kate Burke Blackburn, MSW, has worked in the

health care sector for more than 20 years with a

focus on adolescent, community and population

health. Ms. Blackburn works for Nemours Children’s

Health System, where she is Manager of Practice

and Prevention within Nemours’ National Office of

Policy & Prevention.

health systems, health plans, and others

that are interested in implementing the

no-cost curriculum can contact NTHCS@

nemours.org or visit the program

website to learn more. n

ENDNOTES

1 Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low

health literacy and health outcomes: an updated systematic review.

Ann Intern Med. 2011;155(2):97–107.

2 American Medical Association Ad Hoc Committee on Health

Literacy for the Council on Scientific Affairs. Health Literacy: Report

of the Council on Scientific affairs. JAMA. 1999;281(6):552–557

3 https://health.gov/communication/literacy/quickguide/

factsliteracy.htm

4 American Academy of Pediatrics; American Academy of Family

Physicians; American College of Physicians; Transitions Clinical

Report Authoring Group, Cooley WC, Sagerman PJ. Supporting the

health care transition from adolescence to adulthood in the medical

home. Pediatrics. 2011;128(1):182-200.

5 Winkelman TNA, Caldwell MT, Bertram B, Davis MM. (2016)

Promoting Health Literacy for Children and Adolescents. Pediatrics.

Accessed at http://pediatrics.aappublications.org/content/

early/2016/11/08/peds.2016-1937

6 Hughes D, Maiden K. Navigating the health care system: an

adolescent health literacy unit for high schools. J Sch Health. 2018;

88: 341-349.

feel worthwhile and teach them how to show

affection. Reading and responding to cues

given by children is critical to their social and

emotional development. Look for indications

of children wanting to interact with signs of

smiles, reaching out or pulling away. Children

arching their back might mean they are

distressed, need a break or they are sad.

Participate in meaningful interactions with

children. Taking turns in interactions helps

young children feel competent. This is called a

serve-and-return interaction. When you mirror

what a child does, they recognize they have an

effect on their world.

Be physically and emotionally available when

young children explore their environment.

Mobile infants and toddlers will venture out and

return to their caregivers when they need security.

They find balance in being close to caregivers

along with accomplishing tasks on their own.

Success builds their confidence in the world.

Children need comfort when they become

distressed. Infants and toddlers learn to

manage their emotions when they have

consistent adult response to their

communication cues and comfort

from their distress. Their heart rate

comes down and they learn to

regulate their bodies more. This

will help them self-regulate as they

become closer to school age.

During play, adults should not

be intrusive, but should provide

problem-solving support so that a

child’s confidence and motivation to

learn grows. Caregivers can do this

by asking open-ended questions as

a child plays, comfort them when they

are frustrated, and respond to the child’s

signals. Being responsive, nurturing, and

showing delight will strengthen your positive

relationship with your child, while helping your

child to develop in a healthy way. n

www.ks.childcareaware.org Kansas Child 9


Kansans of Tomorrow

We know how to create quality early learning experiences for children. We know

how to create nurturing spaces that allow for brain development and creative play.

Educators and researchers have cleared the way for all of us who work in this space.

Why then isn’t it quite working, at least not yet?

It takes adequate funding and political support to make these critical

experiences available for all children — especially children from communities of

color who face the highest barriers. Our knowledge can only go so far without

public will and commitment.

That’s why Kansas children need you — you reading this very article right now

— to help us change the political landscape. To find out who represents you in

Topeka, go to https://openstates.org/ and type in your address, then contact them.

Lawmakers and public officials across the spectrum need to understand that

early education and childhood brain development are:

1.) Relatively easy to understand.

2.) Crucially important for our state’s future.

You can make the first point by talking about the extraordinary journey that

children take from birth to age 5. Compare a tiny, crying infant to a confident,

talkative kindergartner. Imagine the enormous development in body and mind

that takes place over those years. Nearly everyone, and most certainly parents, have

seen those changes. Even politicians who might disagree with you ideologically

can understand the miracle of this growth.

Then note that anything that halts or reverses that development — adverse

childhood experiences, lack of nurturing environments, health or financial

challenges — can put that development at risk.

The second point should follow logically. These children are not only Kansans

today, they are the Kansans of tomorrow. Their success in growing and learning

now means they are on a path for health and success throughout their lives. And

that success has profound implications for our state’s communities and economy.

Kansans have made difficult decisions and choices before. It’s in the state motto:

Ad astra per aspera; “To the stars through difficulty.” Supporting early education

and investments in childhood brain development shouldn’t be difficult, though.

It’s just common sense. n

JOHN WILSON

Vice President of Advocacy,

Kansas Action for Children

John has spent his career working at the intersection

of design, public health, and policymaking. He spent

a decade working to improve the health of America’s

children at the Alliance for a Healthier Generation. As

a Kansas State Representative, John worked to redefine

the culture of the Legislature to be more open and

collaborative. He is a 2006 graduate of the University

of Kansas where he studied visual communication. The

best parts of his day are when he’s spending time with

his wife, Jami, and their two sons, Parker and Henry.

Socio-Ecological

Model of Health

Promotion

and Childhood

Obesity in

Kansas City

ROBIN SHOOK PhD

Children’s Mercy Hospitals

Robin Shook is a Research Assistant Professor in the

Department of Pediatrics at Children’s Mercy and

the Director of Weighing In. His research interests

include both public health and clinical approaches to

understanding obesity.

Public health officials are challenged

on a daily basis to promote healthy

behaviors among whatever population

they serve, from increasing seat belt use to

smoking cessation to violence prevention.

Unfortunately, a daily read of newspaper

headlines will reinforce what most of

us know from firsthand experience —

changing someone’s behavior is hard.

In an effort to better understand the

various factors that determine someone’s

behavior, public health officials and

academic researchers often turn to

the socio-ecological model of health

promotion. Socio-ecological models have

been developed over the past several

decades to facilitate an understanding of

multiple levels of influence on any number

of health behaviors, including nutrition

10 Kansas Child A Publication of Child Care Aware ® of Kansas


Policy Environment

Health care

policies/

incentives

Zoning codes

Development

regulations

Transport

investments/

regulations

Public recreation

investments

Park policies

Neighborhood

Ped/bike facilities

Aesthetics

Traffic safety

Recreation Environment

Home PA equipment

Parks, trails programs

Private rec. facilities

Community organizations

Sports: amateur, pro

Sedentary options

Home Environment

PA equipment

Gardens

Stairs

Subsidized equipment

Health care policies

Zoning codes

Home prices

Housing-jobs balance

Electronic entertainment

Labor-saving devices

Active

Recreation

Household

Activities

Safety

Attractiveness

Comfort

Healthcare: counseling, info

Mass media: news/ads

Sports

Informal discussions

Behavior Settings:

Access & Characteristics

Behavior:

Active Living Domains

Perceived Environment

Interpersonal

Demographics

Biological

Psychological

Family Situation

Perceived crime

Interpersonal modeling,

social support, partners

for social activities

Social climate, safety,

crime, clubs, teams,

programs, norms, culture,

social capital

Accessibility

Convenience

Weather

Topography

Open space

Air Quality

Neighborhood

Walkability

Ped/bike facilities

Parking

Transit

Traffic

Active

Transport

Zoning codes

Development

regulations

Transport

investments

Info during transport

Safety signage

Radio ads/news

Billboards

Workplace Environment

Neighboring walkability

Parking

Transit access

Trail access

Building design

Stair design

PA facilities/programs

Occupational

Activities School Environment

Neighborhood walkability

Ped/bike facilities

Facilities

PE program

Walk-to-School program

School sitting policies

PE policies/funding

Facility access policies

Facility budgets

Safe Routes to

School funding

Traffic demand

management

Parking regulations

Developer

incentives

Zoning codes

Fire codes

Building codes

Parking regulations

Transportation

investments

Health care policies

Media regulations

Health sector policies

Business practices

Advocacy by individuals

and organizations

Transport policies

Land use policies

Information

Environment

Social Cultural

Environment

Natural Environment

Figure 1. Ecological Model of Four Dimensions of Active Living

and physical activity (James F Sallis, Owen,

& Fisher, 2015). The primary utility of

these models is that they can be used to

inform comprehensive health behavior

change interventions. One of the key

aspects of socio-ecological models is that

they highlight the need for multiple levels

of interaction to create lasting populationbased

change (Huang, Brownson, Esposito,

Green, & Homer, 2013).

Weighing In, a coalition of community

organizations in Kansas City working

to address childhood obesity, recently

hosted a summit titled, Factors of Health:

Addressing the Systems Influencing

Childhood Obesity. One of the keynote

speakers was Dr. Jim Sallis, professor

emeritus at the University of California-

San Diego. Dr. Sallis has been a leader

in the field of obesity prevention and

behavior change for more than three

decades, and has developed the most

widely used socio-ecological model of

health promotion as it relates to physical

activity behaviors; see Figure 1 (J. F. Sallis

et al., 2006).

As you can see, the socio-ecological

model is a useful tool to describe how a

behavior — let’s use walking as an example

— is not determined by one, two, or even

three factors. Instead, there are a multitude

of factors across multiple different levels

that ultimately influence how many steps

a person achieves during the day. The

intrapersonal level, located in the center

of the figure, considers individual-level

factors. Is the person old or young?

Do they have any physical disabilities?

Are they a single mother of three, or a

rambunctious 10-year-old?

The next level describes the perception

of their environment. Is it safe to walk

down their street? Are there streetlights,

and do they work? Do they live on a busy

road or a quiet suburban cul-de-sac?

As we move outward in the model we

begin to consider other aspects of their

home, work, and play environments.

Do they have an office job that requires

sitting at a desk all day? Or, does their job

involve lots of moving, such as a postal

carrier or waitress? Lastly, and perhaps

most importantly, are there policies in

place where they live, work, and play

that promote being active? Does their

community have a Complete Streets policy

Continued on page 19

www.ks.childcareaware.org Kansas Child 11


Exciting Opportunity for

Wyandotte County Children and Families

The Family Conservancy | www.thefamilyconservancy.org

When high-quality child care is accessible, parents can go to work with peace of mind — knowing their child is

safe, happy and receiving support that will prepare them for success in school and beyond. In Wyandotte County an

exciting, new project could provide that peace of mind for more than 1,200 families.

Strategic

Doing

is about

thinking,

behaving,

and doing

differently.

The Family Conservancy, a nonprofit serving at-risk children and families throughout the Kansas City metro area,

is launching a three-year pilot project called Start Young. Start Young will improve the child care landscape in

Wyandotte County by increasing quality, access and sustainability. Over the course of the pilot project, Start Young

will create new child care spaces and provide teachers and administrators with training and coaching.

A Collaborative Approach

The Family Conservancy will lead the project that will include 16 community child care

providers and four direct-service partners that have committed to the project: Mid-America

Regional Council, United Way of Wyandotte County, Juniper Gardens Children’s Project and

Child Care Aware of Kansas.

Funding for Start Young is provided by the Kansas Children’s Cabinet and Trust Fund through

Communities Aligned in Early Development and Education (CAEDE), and matched with

funds from the private sector.

Create

Change

and bring

ideas to

reality

Years in the Making: High-Quality Care is the Key to a Bright Future

Start Young reflects years of planning by several community stakeholders. Driven by

Wyandotte County’s poor health ranking (102 out of 105 Kansas counties), the Wyandotte

County Health Assessment was launched in 2016. The results, around per capita income

growth and improved wellbeing, pointed stakeholders to early education as a solution to

achieving the goals.

Currently, Wyandotte County has capacity to provide child care for only approximately 40

percent of working families with young children. Many of the programs that are available

are not full-day, full-year programs. Further complicating the issue, the average income in

Wyandotte County is roughly 60 percent of the state average. Even when parents can find

high-quality care that meets their needs, many have difficulty paying for it.

The Big Picture: Happy, Healthy Educated Children

While Start Young can drive short-term economic growth and improve health and happiness

for families in Wyandotte County, the most significant return on investment might materialize

as the next generation comes of age.

The first years of life are a crucial child development period, when 90 percent of brain growth

occurs. For children to reach their full potential, it’s important that the individuals caring for

them — whether parents, relatives or child care providers — know how to support healthy

physical and brain development.

Because a significant number of young children spend the majority of the week in child care,

we can’t overlook the role providers play in preparing children for success in school and

life. Research is clear — children who have access to high-quality early care and education

programs are more likely to enter kindergarten with the social, emotional, physical and

cognitive skills they need to be successful.

The Start Young project’s ability to address the immediate need for child care while focusing on improving quality

makes it truly a present and future solution to many of Wyandotte County’s most dire needs. n

12 Kansas Child A Publication of Child Care Aware ® of Kansas


BETTY JOHNSON

Betty Johnson & Associates

Betty is president of Betty Johnson & Associates, a

nonprofit consulting firm. Betty was raised in Smith

Center. She is an alum of Fort Hays State University,

is a member of KARL, Class V. She is a Certified

Fund-Raising Executive, a trained TOPS facilitator, and

certified in Strategic Doing. She lives in Lawrence and

is the mother of 3 sons.

On the Road in Northwest Kansas

Community

Strategic Doing

Making

things

happen

The Dane G. Hansen Foundation has been

very active in northwest Kansas — providing

opportunities and initiatives to the 26 northwest

Kansas counties in its service area. One initiative,

Strategic Doing, has provided a process that

allows residents in the counties and communities

to move local ideas and projects forward.

Strategic Doing is about thinking, behaving, and

doing differently. It’s about bringing our collective

networks, assets, skills, and passions to create

opportunities that will create change and bring

ideas to realities. It is about creating an environment

that is civil and inclusive as we determine where

we’re going and how we will get there. Four simple

questions are asked: what can we do together, what

should we do together, what will we do together,

and what’s our 30/30? Although simple

in form, it is not easy. But the process has

proven very successful around the world and

also in northwest Kansas.

Through a series of meetings, northwest

Kansas communities have been introduced

to and are implementing projects using the

Strategic Doing process. Common themes

have emerged across the region, including

economic development, jobs, health care, child

care, healthy living, arts and entertainment,

and housing. The Hansen Foundation is

addressing some of these common topics

on a regional level, while the counties and

communities are working through them locally.

The projects are varied, addressing the

specific needs and goals of each county. The process allows

for the projects to move forward when individuals want

to make them happen. Communities are building walking

trails and tracks, and creating countywide calendars

and marketing plans. They are enhancing child care and

healthcare options, revitalizing and beautifying downtowns,

cleaning up their communities, working on tourism,

designing festivals, bringing in entertainment and adding

leadership programs for youth and adults. They are working

on sports facilities, social services, transportation, schools

and education, and senior centers. They are creating

programs to encourage diversity and be more welcoming,

looking at ways to help their local businesses and encourage

entrepreneurs to locate in their area. Groups are working

on environmental issues, spiritual training, value-added,

community facilities, and enhancing technology in our

rural areas.

Many benefits are emerging through the Strategic

Doing process in northwest Kansas. Because the process

is presented to counties, not individual communities,

communities that have previously not worked together

are coming together and making projects a reality. New

leaders and community volunteers are stepping up to lead

and participate in projects to make change. Residents are

recognizing their role in changing their communities,

taking ownership and giving their time and energy to make

it happen.

Strategic Doing is a process that is helping to build a

future for northwest Kansas and encouraging collaboration

among all residents to accomplish clear, valuable and shared

outcomes. It is making northwest Kansas a welcoming,

vibrant area for its residents, visitors, and businesses. n

www.ks.childcareaware.org Kansas Child 13


Thrive Allen County The Best Days are Ahead!

Allen County is a community of 13,000

people spread over 505 square miles. Like

most rural communities it has experienced

nearly uninterrupted population loss for a

century. This loss brought about a decline

in the overall mood and well-being of the

population. The pervasive thought was

that tomorrow will be worse than today.

But a small group of community members

were not ready to throw in the towel.

In 2007 they formed a coalition to work

on the vision that Allen County would

be the healthiest rural county in Kansas,

with a belief that our county’s best days

were ahead of us. This coalition became

formalized as Thrive Allen County and in

2008 it recruited David Toland, a seventhgeneration

Allen countian who was

working and living in Washington, D.C., to

move back to his hometown and become

the first CEO of Thrive.

Thrive works to improve the quality

of life in Allen County by focusing on

health, wellness, economic development,

recreation and education conditions,

and by engaging people and institutions

around a common vision for the future.

This means working to increase access to

healthcare, connecting people to programs

and services, encouraging residents to live

healthier, more active lives, and providing

leadership on important public issues.

Thrive Allen County has worked as a

convener, local public policy leader, goalsetter,

prodder, cheerleader or critic—all

depending on the current need in the

community.

Improving quality of life is essential to

the survival of small towns.

People want to live in communities

with healthy, well-educated residents.

Businesses want to locate in communities

with a robust, adaptable workforce.

And young people are more receptive to

moving to communities with great schools,

parks and trails, and the feeling that the

community has a bright future.

Over the past 10 years, Thrive has

developed from a fledgling, all-volunteer

coalition to the largest quality-oflife

coalition in Kansas. The work

accomplished by Thrive has included

obtaining voter approval for a new critical

access hospital; passage of the third

Tobacco 21 ordinance in Kansas and the

9th Complete Streets ordinance in the

state; lowering the uninsured rate in the

county from 21% in 2013 to 9% in 2017;

the development of 27 miles of new trails

including the Southwind Rail Trail and

the Lehigh Portland Trails; the opening

of a new, federally qualified health center

(FQHC); and the redevelopment of the

former Allen County Hospital site into a

new retail and apartment neighborhood,

including the first stand-alone grocery

store to open in Iola in 10 years. Most

prominently, in 2017, Thrive was the

driver of Allen County’s successful

application for the Robert Wood Johnson

Foundation Culture of Health prize.

Allen County became the first Kansas

community to win the prize, a point of

immense pride for the community and

recognition of the dedication and vision

Thrive has of Allen County becoming the

healthiest rural county in the state. “This

isn’t a rich place,” says Toland. “We don’t

14 Kansas Child A Publication of Child Care Aware ® of Kansas


Allen County, Kansas: 2017 Robert Wood Johnson

Foundation Culture of Health Prize Winner

DAVID TOLAND

CEO, Thrive Allen County

David Toland is the first CEO of Thrive Allen County, a

nonprofit working to improve quality of life and economic

conditions in Allen County, Kansas. A seventh-generation

Allen Countian, Toland oversees a coalition known

nationally for innovative approaches to improving rural

healthcare access, healthy lifestyles and economic

development.

have natural advantages, but we’re scrappy,

we’re resourceful, and our best asset is our

people.”

Allen County is a place with profound

challenges, as well as amazing opportunities.

Those two things—challenges and

opportunities—go hand in hand. Thrive

Allen County works to find and create

opportunities to overcome barriers and

challenges. Thrive reflects the best of their

community. They’re not afraid to take on the

hard issues. They love to innovate. They get

results. And above all, they believe that Allen

County’s best days are ahead of us. n

Allen County, Kansas, was named one of eight winners of the 2017 Robert Wood

Johnson Foundation Culture of Health Prize awarded by the Robert Wood Johnson

Foundation, and has the distinguished honor of being the first and only Kansas

community to be selected. The prize honors communities for their unwavering

efforts to ensure all residents have the opportunity to live healthier lives.

Allen County is being nationally recognized for pursuing innovative ideas and

bringing partners together to rally around a shared vision of health. Chosen

from more than 200 applicant communities across the country, Allen County’s

award-winning efforts include building and sustaining a robust healthcare safety

net, including constructing a new critical access hospital; establishing a local,

federally qualified health center; dramatically reducing the county’s uninsured

rate; recruiting new healthcare providers to the community; creating a built

environment that supports healthy physical activity, including developing 27

miles of trails; encouraging new development in walkable locations; constructing

a new supermarket in a USDA-designated “food desert”; making major policy

changes, including establishing a drug court and food policy council; restricting

youth access to tobacco through a “Tobacco 21” ordinance; supporting workplace

wellness policies at large and small employers; and encouraging consideration of all

modes of transportation through Complete Streets policies.

“Allen countians have been working for a decade toward becoming the healthiest

rural county in Kansas,” said David Toland, CEO of Thrive Allen County. “We’re not

there yet, and there’s a long way to go. But the progress our community has made

is nothing short of incredible, and we thank the Robert Wood Johnson Foundation

for recognizing the creativity, dedication and resourcefulness of Allen Countians in

creating and fostering a culture of health.”

www.ks.childcareaware.org Kansas Child 15


Is Your

Community

Able to Meet

the Needs

of Families

Seeking

Child Care?

By Child Care Aware ® of Kansas

In many Kansas communities, families

searching for child care find that the

number of openings for their children

can be few and far between. The lack of

available child care impacts more than

just families, it also creates challenges

for employers to attract and retain a

productive workforce.

If child care is clearly an important and

necessary part of a community’s economic

infrastructure, then why is there a lack of

child care in some Kansas communities?

There are a number of factors that

influence both the supply and the demand

of child care. Some of the factors include

the geographic landscape of Kansas,

industry and employment opportunities,

and the current capacity of child care

providers and early education facilities.

Kansas is a vast state, covering 105

counties and 82,277 square miles. It is

home to more than 332,000 families with

young children. The population density

within the counties can vary greatly. Urban

county settlements have greater than 150

residents per square mile, while frontier

county settlements have 6 or fewer people

per square mile. As you might imagine, the

industry and employment opportunities

within counties also differ and further

stress the demand for child care.

A deeper analysis shows that urban

county settlements, such as Wyandotte

County, claim manufacturing and retail

trade among the top employers. In

frontier county settlements, such as Jewell

County, agriculture employs a large

portion of the population. However, they

share a similar industry — healthcare.

When investigating the need for child

care, healthcare is a vitally important

industry to consider. Hospitals, health

departments and clinics often have several

shifts, creating a need for care during

nontraditional hours (evenings, weekends,

and overnight).

The 2018 Child Care Supply Demand

Report: The Landscape of Child Care in

Kansas, tells us that of the 105 Kansas

counties, licensed family and group day

care homes in just 57 counties and child

care centers in only 6 counties offer care

during nontraditional hours. Employers

interviewed in Anderson, Ford and Harvey

counties noted that their staffs struggle

to find care during nontraditional hours

or drop-in care for their children, which

affects the employees’ ability to maintain

employment.

Another factor that influences the

availability of care is simply the number of

child care providers and early education

facilities. While family and group day care

homes are the most common type of child

care facility in Kansas (2018), state licensing

regulations limit the number of children

they can care for. Each family must choose

the type of facility they are most interested

in for their child. Unfortunately, the

number of licensed family and group day

care homes has continued to decrease,

putting further strain on the already limited

capacity, and reducing choices for families.

16 Kansas Child A Publication of Child Care Aware ® of Kansas


NEW Child Care Workforce Report

While the child care landscape in

Kansas has experienced changes, one

thing remains the same. Kansas families

and employers need high-quality child

care that is accessible and affordable so

that parents can work and businesses can

grow — strengthening our economy and

ensuring strong leaders for our future.

To learn more about the availability of

child care in Kansas, and for information

about child care capacity in each county,

visit our website www.ks.childcareaware.

org to view the 2017 Child Care Supply

Demand Report: Child Care Availability

in Kansas and the 2018 Child Care Supply

Demand Report: The Landscape of Child

Care in Kansas; both reports take a closer

look at the factors that might impact

the supply and demand of child care in

Kansas. n

By Child Care Aware ® of Kansas

They greet us with warm smiles, kind words and nurturing hearts. They protect and care for

our greatest treasures, our children. Who are these amazing individuals? They are Kansas

child care providers and early education professionals. Far more than just caregivers, they are

an integral part of a strong team that includes families, communities and employers.

What do we really know about this part of the team?

To help answer this question, Child Care Aware ® of Kansas reached out to child care providers

and early education professionals, and they responded with a wealth of information. In all,

1,188 professionals from a variety of early education settings, including licensed family and

group day care homes, child care centers, Head Start and Early Head Start, preschool and

school age programs, participated in a detailed survey.

The resulting report, Who Cares for Kansas Children? 2018 Kansas Child Care Work Study and

State Child Care Profile, takes a closer look at trends and changes in the early education field,

and offers strategies to ensure a strong and sustainable child care workforce.

Who are the child care providers and early education professionals in Kansas?

Among those responding to the survey, licensed family and group day care providers reported

45% are over the age of 50; 87% work 50 or more hours weekly; and 56% have been in their

current role in the early childhood field for more than 15 years. The largest percentage of

licensed family and group day care home providers, 87%, reported their ethnicity as Caucasian,

and 8% have earned a Child Development Associate (CDA) credential.

Child care centers, Head Starts, Early Head Starts, preschools and school-age programs

responding to the survey reported that 36% of the lead teachers are 21-30 years of age; 44%

work 40-49 hours weekly; and 39% have been in their current role in the early childhood

field for 3-10 years. The largest percentage of lead teachers, 79%, reported their ethnicity as

Caucasian, and 6% have earned a Child Development Associate (CDA) credential.

Why can working in child care be so hard?

A typical day for a child care provider includes long hours, often early mornings or late

evenings. They have to be flexible and creative to navigate all of the unique qualities of the

children in their program. They are problem-solvers: tackling differences in family schedules

and expectations at home as well as more complex

challenges — such as how children might be coping with

a separation/divorce, and variations in bedtime or nap

routines. For programs that offer to transport to/from

school, budget implications need to be factored in. Each

day is different. All of this for an average annual salary

of $19,981 and little to no benefits, such as access to

health insurance.

What changes have occurred in the early

education field?

During the past eight years the number of family and

group child care homes has decreased from 6,119 to

4,010. While child care centers have decreased only

1%, the overall capacity has increased 8%, showing a

trend that child care centers are growing in size but not

in the number of facilities. The demand for child care,

however, remains significant with 154,991 children

under the age of 6 with all available parents in the

workforce.

To support families, new child care provider recruitment strategies need to be implemented

that will attract and keep educated, early education professionals in the early childhood field.

To help stabilize the workforce, Child Care Aware believes that child care providers and early

education professionals need access to low-cost training and support for continuing education,

so that they have current information and confidence about how to provide the best care possible

to children and families. And they need salary supplements to help them earn a living wage.

What can you do to support this passionate, hardworking team? To view the full report, check

out www.ks.childcareaware.org. n

www.ks.childcareaware.org Kansas Child 17


Using Kansans’ Voices

to Inform Services

What do families need to thrive? What can we do to support

them? We know what the research says, but what do families

across Kansas have to say? A new initiative, Our Tomorrows, aims

to ask these questions and use the answers to create small changes

that can become big ripples.

Whether we interact with children in child care settings,

schools, home visits, doctors offices, churches, grocery stores,

or other settings, we all have a role to play in creating an

environment that supports families. Research tells us that one

caring adult can make all the difference for a struggling child or

youth (https://developingchild.harvard.edu/science/key-concepts/

resilience/). How can we build on this research and learn from

individual family stories to identify defining moments that can

alter the trajectory of a young child or offer a family the support

they need to get through a difficult time?

Individual stories provide a rich and powerful view into what

families need and want in order to thrive. Every family’s story is

different.

Stories shape the way we view the world. They might reveal our

role in making the world a better place, or reveal views that are

negative and counterproductive.

The experiences we share with those closest to us become our

own story and can also resonate for generations to come.

Our Tomorrows

The Center for Public Partnerships and Research at the

University of Kansas set a goal of gathering 1,000 family stories.

Some are stories of families who are truly thriving, and others are

from families who are just surviving. These stories may be used to

shape policy and programming decisions in your community and

across the country.

Stories are gathered using an innovative technology called

SenseMaker. SenseMaker asks the user to submit an experience

through a simple online tool. Next, the user answers several

questions about what the experience meant to him or her. It takes

between 10 and 15 minutes to complete the process, depending

on the length of the story.

After collecting stories over the next several months, the data

will be analyzed. Community SenseMaking sessions will be

offered to present the data and the anonymous stories. All those

attending will be given the opportunity to provide input on the

data patterns and the stories. From these sessions, we will identify

what types of stories we want to hear more of and what types

of stories we want to hear less of. Next, we will start generating

a menu of small nudges that can be implemented without

significant resources. In other words, what small changes are

within our control that might lead to more of the types of stories

we want for families?

We invite you to join is in our quest to build better tomorrows

for families in Kansas. You can share a story, get others to share

a story, or participate in community SenseMaking. Or you can

do all three. We want to hear from families of all kinds, so go

to http://bit.ly/OurTomorrows and submit your story today. If

you’d like to learn more about the project or would like for us to

come to your community or organization to talk about it, please

reach out to us at jcounts@ku.edu. n

JACQUELINE COUNTS,

M.S.W., Ph.D.

Director, Center for Public

Partnerships & Research

AMANDA DAVIS

KEIL EGGERS

Jacqueline Counts, M.S.W., Ph.D., is the director of the

Center for Public Partnerships & Research. She received

her training at the University of California-Berkeley and

the University of Kansas. Previously, she was the Region

VII Project Officer for the Early Childhood Health and

Development Branch of the Maternal Child Health

Bureau of Health Resources and Services Administration.

Jacqueline has been the principal investigator on numerous

early childhood, systems-building, accountability and

evaluation projects. She was a co-founder of Lemonade for

Life, a program designed to support professionals in using

ACEs research to build hope and resilience with families.

You can follow her work on Twitter @Jackstercounts.

Amanda earned her Master’s degree in Digital Content

Strategy at the William Allen White School of Journalism

at the University of Kansas. She works primarily on

the Institute for the Advancement of Family Support

Professionals project along with communications

across the Center. You can find her writing on travel,

food, photography, and other interests on her website at

AmandaNWoodward.com and follow her on Twitter

@Amanda66044.

Keil earned his Master’s degree in Peace Studies from

the UN-Mandated University for Peace in San Jose, Costa

Rica. He is an Assistant Researcher at the Center for Public

Partnerships and Research at the University of Kansas. You

can find Keil’s writings on conflict resolution, peace, and

politics on his blog, Octaguante or on Twitter @kleggers.

18 Kansas Child A Publication of Child Care Aware ® of Kansas


Continued from page 11

in place, resulting in protected bike lanes

connecting major parts of the community?

Do city planners create ordinances to

promote development and housing close

together, or does it take a car to move

around a community? Does the family

have a limit on the amount of television

and screen time for their children?

The key point that the socio-ecological

model of health promotion nicely

portrays is that behavior is determined

by multiple factors across multiple levels.

By understanding this important point,

effective prevention and interventions

efforts can be developed. As a public

health researcher, my biggest challenge

is to develop programs that address all

levels of the socio-ecological model.

Training a third-grade teacher on how to

develop movement-based curriculums is

a great start; however, it should be part of

a larger plan that includes a schoolwide

policy including daily recess and physical

education. Bike lanes are wonderful!

However, if they do not account for

perceptions of the environment and are

placed right next to three lanes of highspeed

traffic and not protected, they might

not be used.

Figure 2. The number of childhood obesity programs

in the Kansas City area as distributed across the

socio-ecological model of health promotion.

Here’s the good news — Kansas City

is well-positioned to take meaningful

action. Weighing In completed an

extensive audit of all the programs

being offered in the area of childhood

obesity, specifically asking where the

programs were offered and who the

intended recipients were. It documented

260 individual programs, offered by

100 different organizations operating

in the Kanas City area. All relevant

populations and locations were included,

led by programs directed towards both

school-aged children (26%) and their

parents and families (18%). When

considering the socio-ecological model

of health promotion, we observed a

great distribution of programs across

the different levels (Figure 2), with

248 programs targeting individual

behaviors (e.g. healthy cooking classes),

333 programs (a program focused on

both bike lanes and parks would be

counted twice) targeting the social and

physical environment, and 143 programs

targeting policy (e.g. citywide Complete

Streets initiatives).

Our goal at Weighing In is to make

sure these organizations and programs

are connected and working together as a

system. There are no simple solutions to

childhood obesity, so partnerships across

multiple sectors of society are critical.

The socio-ecological model of health

promotion is one framework we use to

help us understand the system. n

REFERENCES

Huang, T. T., Brownson, R., Esposito, L., Green, L., & Homer, C.

(2013). Next steps in obesity prevention: applying the systems

approach. Child Obes, 9(1), 11-14. doi:10.1089/chi.2013.9102

Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M.

K., & Kerr, J. (2006). An ecological approach to creating active

living communities. Annual Review of Public Health, 27, 297-322.

doi:10.1146/annurev.publhealth.27.021405.102100

Sallis, J. F., Owen, N., & Fisher, E. (2015). Ecological models of health

behavior. Health behavior: Theory, research, and practice, 5, 43-64.

www.ks.childcareaware.org Kansas Child 19


Investing in Kids

How ending extreme tax

policy freed Kansas lawmakers

to lift the next generation

Investments in early childhood

education are good for Kansas

children and families, businesses,

and our economy. Yet for many

years, investments in early childhood

were undermined by Gov. Sam

Brownback’s 2012 tax “experiment.”

Money was stolen from the

Children’s Initiative Fund as the state

failed to make revenue projections,

resulting in fewer kids receiving

vital services. Threats to securitize

the fund to pay off Kansas’ bills

failed, thanks to advocacy from

Kansans like you. Lawmakers ended

our state’s five-year experiment in

supply-side economics last year,

putting Kansas on a path to

recovery.

With the budget crisis behind us,

lawmakers have been able to once again

invest in early childhood education. The

2017 education bill increased funding

for the 4-year-old at-risk program and

fully funded all-day kindergarten across

the state. This year, lawmakers returned

to Topeka and built on that progress,

avoiding risky tax plans that would

have jeopardized our state’s recovery

and making smart investments in early

childhood education.

These investments included restoring

previous cuts to programs such as Early

Childhood Block Grants, the Child Care

Quality Initiative, Autism Diagnosis,

Family Preservation, and the Healthy

Start/Home Visitor program. Lawmakers

also enhanced the budget for the Kansas

Preschool Program, Parents as Teachers,

and tiny-k (also known as Infant-Toddler

Services), as well as invested in a pilot

program to support early learning

opportunities in Wyandotte County (See

story on page 12).

According to Kansas Action for

Children, “Investments in high quality

early learning and development

opportunities are among the best ways

to ensure positive health, economic, and

education outcomes for every child.” There

is also a business case for these efforts.

Early childhood investments make good

economic sense. Evidence-based early

childhood programs support the healthy

development of children and can help

close the educational achievement gap.

Nobel laureate James Heckman recently

documented that “every dollar spent on

high-quality, birth-to-five programs for

disadvantaged children delivers a 13% per

annum return on investment.” It’s difficult

to imagine an ROI that good in the stock

market.

When children start kindergarten

unprepared, it can lead to long-term

negative consequences, including later

dropping out of school. We can close that

educational achievement gap through

high-quality early childhood care and

education. This translates into better

outcomes — both in education, and in

20 Kansas Child A Publication of Child Care Aware ® of Kansas


Child Care as a Utility

HEIDI HOLIDAY

Executive Director,

Kansas Center for

Economic Growth

Heidi Holiday is Executive Director of the Kansas

Center for Economic Growth. She previously served

as the Executive Director of the Rosedale Development

Association in Kansas City, KS. She holds a Bachelor’s

Degree from Bethel College and a Master’s Degree in

public administration from the Henry W. Bloch School of

Management at the University of Missouri Kansas City.

life. Businesses support these investments

and know that early education is a key

tool for ensuring the availability of quality

employees to meet growing demand.

Every family should have access to highquality,

affordable early childhood care and

education. We commend lawmakers for

taking steps the past two years to increase

Kansas’ investment in early childhood

programs and encourage them to continue

these investments. Our state’s recent tax

experiment is a vivid example of the both

the effects of budget and tax policy on

all facets of Kansas life, and the power of

Kansans to make a difference. n

One ever-present concern for Kansas

communities is access to quality,

affordable child care. While a multitude

of elements affect this seemingly simple

issue, the bottom line is that for many

communities, child care’s importance

and function rise to the level of any

public utility.

Think about the following:

When businesses want to build

or expand, they look for access to

high-quality utilities central to their

development, such as electricity and

high-speed Internet access.

When families are looking to work

for these businesses, they, too, search

for the utility most important to their

development, child care.

BRADFORD B.

WILES, Ph.D.

Assistant Professor and

Extension Specialist, Early

Childhood Development,

Kansas State University

Thus, recruiting and retaining

businesses and their workers all boils

down to utilities. Child care is as

important a utility as electricity for many

communities. What good does lightningfast

Internet and a fully equipped

workspace do if the employees cannot

go to work because of a lack of quality

child care? Families need to provide safe,

nurturing, and quality care to their most

important investment — their children.

By shifting our perspective on child

care from thinking of it as private school

to likening it to a public utility, we can

reflect its central and essential nature to

child, family, and economic development.

www.ks.childcareaware.org Kansas Child 21


The Magical Richness of Books

For young children and their caregivers,

the world is increasingly rich, including

some delightful new

books. I went to our

library to visit with

the always helpful

librarians in search

of new books. I was

in heaven – could

have stayed there all

day and ignored closing time altogether!

Book or Bell

Book or Bell, written by Chris Barton

and illustrated by Ashley Spires, exactly

described my plight. Stop reading and exit

the library. It is time to move on, Alice.

I don’t want to. I want to be like Henry,

who finds a chapter book that so entrances

him, he simply stays put, no matter

what is happening at school, even lunch.

This book should be read with lots of

imaginative loud noises and time to look

at and describe the happenings on every

page. Adults will want to clone Henry,

who loves to read a good book more than

anything. The loudest bell in the world has

no effect. Only when Saturday comes does

Henry stop reading and go outdoors where

he can have fun and avoid chores.

The Other Ducks

Next, I was drawn to a book called

The Other Ducks, by Ellen Yeomans and

illustrated by Chris Sheban. Perhaps it

was because it made me think of my

5-year-old great-granddaughter Nadia.

She and her family just moved to a farm

where their first farm animals were 3

ducks. Or perhaps because it reminded

me of taking groups of preschool children

to duck ponds to feed ducks and to sing

Three Little Ducks That I Once Knew. In

the story, This Duck and That Duck are a

pair that discover the magic of swimming,

reflections and flying like birdy-birds.

They waddle into new adventures, migrate

out of their cold climate, then return to

raise a family.

The writing makes me smile: “And what

exactly is swimming?’ That Duck asked.

“This,” said This Duck. “It’s like waddling,

but in the water, I don’t think my feet are

touching bottom.” If I were a teacher,

I would want to have duck puppets for

every child.

Stick

Stick, by Irene Dickson, is the ultimate

book about sticks. I have taken pictures of

children playing with sticks everywhere I

have gone, even in Paris. The story begins

with “Find a stick, a very useful stick.” It

then shows all the things that a little boy

and his dog can do for hours with one of

nature’s favorite free toys. Throw it, write

with it, float it, balance it, etc. It makes

me want to grab my camera and go to

the Kansas Children’s Discovery Center,

where the playground is full of an endless

variety of sticks.

This month’s books encourage reading,

dialogue and creative play. Visit your local

library to find these and other wonderful

reads. One of the greatest riches of our

society is our local library. I celebrate all

of you who share a love of books with

children in your lives. It warms my heart

to think of you with children in your

laps, clustered in circles, lying in beds or

napping cots enjoying the amazing world

of stories; building literacy skills, nurturing

creativity, molding the next generation,

and celebrating relationships. n

22 Kansas Child A Publication of Child Care Aware ® of Kansas


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www.ks.childcareaware.org Kansas Child 23


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Picture this...

Happy, healthy Kansas children

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