2018 Winter Kansas Child

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Public Health

A publication of Child Care Aware ® of Kansas

Winter 2018 Volume 17, Issue 1

















Kansas Child

is a publication of

Child Care Aware ®

of Kansas

Executive Director

Leadell Ediger


BWearing Consulting

Angie Saenger, Deputy


Publication Design

Julie Hess Design

On the Cover

Da’Sayvion Lee Hopkins, age

2, son of Misty Mathews and

Thaddeus Hopkins, of Salina,

likes to play with Tinkertoys ® and

balls, and run and jump around.


Executive Director

Child Care Aware ®

of Kansas

Child Care Aware ® of Kansas,

1508 East Iron, Salina, Kansas 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

Kansas Child is distributed at

no cost to Child Care Aware ®

of Kansas donors. Single

copies are available

to anyone at $5 each, prepaid.

I can remember when I was a child, sometime

in the early 1960s, I think, standing in a very

long line with my dad. At the end of the line I

received a sugar cube. That was how the polio

vaccination was given at that time. It was

painless and important, and I was fortunate my

parents saw the need to have me vaccinated.

Vaccinating children is still one of the most

important functions of public health, but it is not

the only public health issue to consider for child

care providers.

In my early years with KACCRRA, the

predecessor to Child Care Aware® of Kansas,

I met an incredible woman who worked

for the Kansas Department of Health and

Environment. Her name was Shirley Norris.

As early as 1957, Shirley played a significant

role in keeping children safe while they were

in child care through her efforts to establish

child care licensing regulations. She continued

work to expand and revise those regulations as

late as 1988. Shirley advocated for children and

changed the face of child care in Kansas.

While you may not think of regulations as a

public health issue, public health encompasses

many important issues that affect our work in

early childhood care and education.

Over the past 20 years, our work at Child

Care Aware has evolved to a focus on the whole

child and the family, as well as the provider.

Today, health -- in a broad sense -- consumes

much of our staff time.

Our work includes


and advocacy

on obesity


nutrition and

p. 4


physical activity. We also have worked on

prevention of abuse and neglect, and emergency

preparedness and planning. We have worked

with providers to become a welcoming place for

breastfeeding moms.

This issue of Kansas Child reflects the

importance of public health as it relates to child

care and highlights many of the providers of

these important services. Our partners at the

Kansas Department of Health and Environment,

Health Promotions Division, have been

instrumental in this issue of Kansas Child.

Moving forward, we know our children will

be safer because of the work of KDHE. Its efforts

and ours are built on the efforts of those who

came before us, such as Shirley Norris, and to a

lesser but equally important extent, parents like

my dad.

p. 12

p. 16

Improving the Health of Kansans:

We’re not in Samuel Crumbine’s

stream anymore!.......................................4

Immunize Kansas Coalition

Recommends Keeping Kansas

Children Healthy by Getting the

Influenza Vaccine...................................... 7

Every Kansan Deserves

to Be Healthy............................................ 8

Strengthening Healthy Food Access

Across Kansas......................................... 10

Growing Healthy Kansas Kids:

A Child Care Provider’s Story..................11

Risks of Vaping........................................12

Smoke-Free Public Housing....................13

Clean and Healthy Outdoor Spaces....... 14

Safe Routes to School:

You can do it, too!................................... 16

Fit-Tastic! Healthy Habits

for a Healthy Future.................................17

Protecting and Securing Healthier

Early Learning Environments..................18

Project NeuroNuture

to serve 850 families...............................20

Book Nook: Creating a Village

for Successful Living............................... 22

A statue of Dr. Samuel Crumbine was installed October 27 in the Kansas Health

Institute’s pocket park on the corner of Southwest 8th and Van Buren Streets,

Topeka. (Chris Neal/The Capital-Journal)


Image from the Kansas Historical Society

Director, Lawrence-Douglas County Health Department

Dan Partridge has worked in public health since 1991. He became

director of the Lawrence-Douglas County Health Department in


He has a dual bachelors of science degree in Fisheries Biology and

Chemical Science from Kansas State University and a master’s

degree in public health from the University of Kansas School of


Partridge currently serves on two NACCHO workgroups, public

health informatics and performance improvement. He is a Kansas

Health Foundation Fellow and a graduate of the Kansas Public

Health Leadership Institute and the Kansas Public Management

Center Public Health Certification program. He is a member of the

Kansas Association of Local Health Departments Board.

Improving the

Health of Kansans

We’re not in Samuel Crumbine’s

stream anymore!

Dr. Samuel Crumbine is an iconic public health figure. His

work as health officer with the Kansas State Board of Health in the

early 1900s was innovative and life-saving and is still recognized

as such today throughout the public health field.

So what did he do? In part, Crumbine recognized that “disease

drivers” were community based, and he actively intervened

upstream of diseases to prevent rather than treat illness.

One hundred years ago, public health prevention was largely

centered on preventing communicable and infectious diseases

by reducing environmental sources of disease and improving

hygiene. In the 1885 Douglas County Health Officer’s annual

report, Dr. N. Simmons reported on the presence of diseases

such as typhoid, diphtheria and malaria. His description of living

conditions and the acceptance of death as commonplace seems

unreal and disconnected to the world we know today.

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

Paradoxically, while the burden of disease has shifted from

acute and infectious to chronic and non-communicable, there

remain some truths that have stood the test of time. Chief among

them, in my mind, is that place matters to our health. Current

evidence and theory tell us that our health, while rooted in our

genetics and moderated by the medical care we receive, is largely

determined by our behaviors and socio-economic status. The

diagram (right) illustrates the “Determinants of Health.”

In 2017, we know life span varies based upon where a

person lives. Census tracts show us that people associated with

lower socio-economic status (e.g. income and education) and

unhealthy behaviors (e.g. tobacco use, physical inactivity and

poor diet) consistently have shorter average life spans. In Douglas

County, the average life expectancy ranges from 75 to 83 years.

That’s an eight-year difference that can be attributed to placerelated





10 %

10 %


(e.g., access to and quality of

care, insurance status)



(e.g., place of residence,

exposure to toxic substances,

built environment such as

buildings and transporation

systems, natural environment

such as plants and weather)




(e.g., discrimination,

income, education

level, marital status and

economic factors)


(e.g., eating habits, alcohol or substance

use, hygiene, unprotected sex, smoking)

Source: Kansas Vital Statistics (2010-2015).

Here’s what else we know:

In 1985, life expectancy in Kansas was more than a year greater

than for the United States as a whole. Today, it is less.

Today, more Kansans live in poverty.

From 1995 to 2014, the rates for obesity and diabetes in Kansas

have more than doubled.

Today, public health continues to focus on the upstream causes

of disease, just as Crumbine did so effectively 100 years ago.

However, we are not in Crumbine’s stream anymore. Instead we

are in the “determinants of health” stream. This stream requires

public health practitioners to develop different skills and strategies

if we are to be effective in improving population health outcomes.

To accomplish this, we need leaders who will challenge health

departments and communities to change streams and to have the

willingness to start the journey without a clear roadmap of how to

get there.

At the Lawrence-Douglas County Health Department, our

journey began with a desire to expand our focus beyond the

20,000 individuals walking through our doors to receive clinical

services, and to instead address the health needs of all of the

county’s 116,000 residents. A population-focus for public health

means that we work across the health care, education, civic,

business and faith systems to establish policies and change our

environment so that place no longer determines how healthy we

will ultimately be.

Source: Booske B.C., Athens J.K. Kinding D.A. et al. County Health Rankings Working Paper: Different Perspectives

for Assigning Weights to Determinants of Health. February 2010. Available at: www.countyhealthrankings.org/sites/


To accomplish this required a shift in personnel and resources.

Over time we have replaced some of our traditional positions

with new ones, such as Community Health Planner, Analyst and

Health Promotion Specialist. We have done this without adding

staff or expanding our reliance on local tax support. These staff

are the nucleus of our Community Health program. As with each

of our program areas, the Community Health program is guided

by its unique purpose statement, which reads, “Improving the

health of all Douglas County residents by informing policy and

influencing systems and environmental change.”

Along the way Community Health staff have leveraged local

tax support with Kansas Department of Health and Environment

(KDHE) and Centers for Disease Control and Prevention (CDC)

funds to help communities in Douglas County accomplish the


Eudora: Passage of a tobacco-free public spaces ordinance and

creation of a walking path that connects their elementary school

to surrounding neighborhoods.

Continued on page 6

www.ks.childcareaware.org Kansas Child 5

Continued from page 5

With support from the Kansas Department

of Health and Environment, tobacco-free

signage was posted in Eudora, Lecompton

and other communities in Douglas County

Lecompton: Passage

of a tobacco-free parks


Lawrence: Passage

of a tobacco-free parks

policy; expansion of

the multi-use concrete

pathway called the

Lawrence Loop;

development of Safe

Routes to School

program, bicycle

safety and local food

procurement policies at

Lawrence Public Schools,

creation of a healthy

food vending policy with

Lawrence Parks and

Recreation along with

a “Fuel Good – Feel Good” public media campaign promoting

healthy food choices.

Douglas County: Support for the Douglas County Food Policy

Council and the development of plans and programs to support

local agriculture, including direct sales to schools in Lawrence,

Baldwin City and Eudora.

Not only do our Community Health staff work in the social

determinants of health stream, but so do our traditional health

department programs. The staff in these departments had to

rethink how they do business.

Clinic staff has:


Shifted from providing flu clinics at businesses as fee-forservice

to providing flu clinics at the Lawrence Homeless

Shelter, local food kitchens and other venues, with the goal

of providing no-cost flu shots to those who would otherwise

likely not be vaccinated.


Partnered with a local federally qualified health care center to

establish a primary care team within the Health Department

clinic. This was done after recognizing that pre-hypertensive

and hypertensive family planning clients were not receiving

sufficient primary care service.


Received training to provide smoking cessation referrals and

track the success as part of their performance metrics.

Family and Senior Support staff have:


Partnered with local pediatricians to screen new families

for exposure to adverse childhood experiences (ACES).

At-risk families are referred to the Health Department for

potential enrollment in the Healthy Families or Healthy Dads



Partnered with the Lawrence-Douglas County Fire Medical

to provide in-home screening and care-connection services

for elderly individuals who frequently require EMS services.

Working upstream means working to address root causes. It

no longer makes sense to wait for people to get sick and then care

for them. Instead, let’s recognize and address the determinants of

health in our communities.

Kansans have their share of health challenges but also believe

in the value and importance of community. If we leverage this

strength, I believe we can create communities all across Kansas

where the opportunity for good health exists for all. n

Stephen Mason, of Lawrence Parks and Recreation, shows students how to

change a bicycle tire at a Lesson and Safety Training class at Broken Arrow

Elementary School in Lawrence.

Dr. Jeff Mincher of Heartland Community Health Center, visits with Public

Health Nurse Nicole Herrera, of the Lawrence-Douglas County Health

Department. Dr. Mincher leads the primary care team that is located in the

Health Department’s clinic.

Robert Kortlucke, left, Fatherhood Initiative case manager at the Lawrence

Community Shelter, visits with Healthy Dads Coordinator Jery Màrquez, of the

Health Department. Kortlucke and Màrquez facilitate classes for the Healthy

Dads program, which aims to help fathers build positive, lasting relationships

with their children.

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

Immunize Kansas Coalition

Recommends Keeping Kansas Children

Healthy by Getting Influenza the Vaccine

The flu vaccine is necessary and safe for


The flu virus is common and

unpredictable, and it can cause serious

complications and death, even in healthy

children. Immunization for influenza is the

best way to protect children.

Five to 20 percent of the U.S. population

gets the flu, and every year, more than

200,000 people are hospitalized from

complications. At least 101 children died

from the flu in the 2016-2017 influenza

season. In Kansas, 99 deaths were directly

attributed to influenza. This was a fivefold

increase from the previous season,

with only 19 deaths (Kansas Department

of Health and Environment Kansas

Surveillance Report Sept 2016-2017).

The American Academy of Pediatrics

(AAP) and the Center for Disease Control

and Prevention (CDC) recommends

annual influenza immunization for all

people ages 6 months and older, including

children and adolescents.

Sometimes people think because they

have never received a flu shot they do not

need one. Other people believe because

they have already been sick with a cold,

they do not need a flu shot. The fact is

that it is still important to get the vaccine

now. This is especially true for children,

people with asthma, heart disease,

diabetes, weakened immune systems, and

Has child received 2 or more total doses a

of any trivalent or quadrivalent vaccine b

before to July 1, 2017?


1 Dose

NO/Don’t Know

2 Doses

(Interval is 4 weeks)

pregnant women, who are at particularly

high risk for complications of influenza,

such as pneumonia.

The flu vaccine cannot cause the flu

and has been safely given to hundreds of

millions of Americans over the past 50

years (Centers for Disease Control).

Infants and children up to 8 years of

age receiving the flu shot for the first

time may need two doses of the vaccine,

administered at least four weeks apart. It is

important that these children get their first

dose as soon as possible to be sure they can

complete both doses before the flu season

begins. (American Academy of Pediatrics

Gateway September 2017 Publication)

For the 2017-2018 season,

manufacturers of the vaccine have

projected that they will produce up to 166

million doses of flu vaccine. This year’s

vaccine is available only as a shot. The

nasal spray is not available this year.

Children with an egg allergy can safely

get the flu shot from their pediatrician



Dr. Gretchen Homan earned her medical

degree from The University of Kansas

School of Medicine and completed

residency training in pediatrics. She is

an Assistant Professor with KU Wichita

Pediatrics and her area of focus is

preventive medicine with special interest

in immunizations. She is a board member

of the Kansas Chapter of the American

Academy of Pediatrics and Chair-elect

for the Immunize Kansas Coalition.

,without going to an allergy specialist.

Even those with a history of severe egg

allergy are not likely to have a reaction to

the flu vaccine. n

Additional Information & Resources:


Immunize Kansas Coalition


Kansas Department of Health and

Environment Immunization Program


Preventing the Flu: Resources for Parents &

Child Care Providers


Flu: A Guide for Parents of Children and

Adolescents with Chronic Health Conditions


Influenza Immunization for All Health Care

Personnel: Keep It Mandatory (AAP Policy



Flu.gov (Centers for Disease Control and



PreventChildhoodInfluenza.org (National

Foundation for Infectious Diseases/

Childhood Influenza Immunization



Flu Fighter Coloring Book (National

Foundation for Infectious Diseases)


Ready Wrigley Prepares for Flu Season:

Activity Book (Centers for Disease Control

and Prevention)



www.ks.childcareaware.org Kansas Child 7



of those making

less than $15,000 a year

are uninsured

Adult tobacco

rate is




to Be



President & CEO,

Kansas Health Foundation

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, Kan., and graduated

from Emporia State University and

Washburn University School of Law.

For more than 30 years, the Kansas Health Foundation has invested

in ideas to promote healthier people and stronger communities. Through the

years, we have used data to identify top health threats across the state, and

worked with partners in Kansas communities to make positive and longlasting


Many of our efforts have focused on improving the health of Kansas children

and families and reducing health threats. From programs, to awareness

campaigns, to policy efforts, KHF’s work in collaboration with many groups

across the state is making a difference in the lives of Kansans of all ages.

At KHF, we have worked with partners on programs to increase the

number of primary care physicians in underserved areas, providing greater

access to care. We’ve funded efforts to reduce tobacco use and created the

“Take it Outside” awareness campaign to encourage parents not to expose

children to cigarette smoke. All Kansans, young and old, have benefitted

from partnerships to adopt clean indoor air policies and restrict tobacco use.

Kansas schools are promoting more physical activity through the funding of

a statewide physical education curriculum and training. Working with both

nonprofit organizations and government agencies, we have also advocated for

local and state policies to improve health and healthier behaviors for Kansans.

Despite these efforts, much work remains. Today, our work is focused

in four areas: increasing access to quality, affordable healthcare; improving

healthy behaviors; encouraging greater civic and community engagement;

and promoting educational success. Our vision is to create a culture in which

every Kansan can make healthy choices where they live, work and play.

Unfortunately, not all Kansans have the opportunity to lead a healthy life, and

significant differences in health outcomes exist for thousands.

We know from looking at Kansas data that health outcomes are greatly

affected by race, income, education level and geography. This affects both

individuals and families. Children from lower-income families, racial/ethnic

minority groups, and certain zip codes, experience lower health outcomes

and educational challenges. As child care and early childhood education

professionals, you see every day how children are affected by these social

factors and how other factors, including lack of nutritious food, serious dental

problems, and learning struggles can negatively impact the physical, social and

emotional development of Kansas children.

In order to make change happen, we first need to be sure others understand

the significance of these problems, and that means building greater awareness

of the gaps or disparities for these health-related issues.

For example, today more than 15 percent of all Kansans do not have access

to affordable health care. Some Kansans experience even greater challenges.

Forty-seven percent of working individuals are without a high school diploma,

and 39 percent of those making less than $15,000 a year, are uninsured.

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

The obesity

rate is



of Kansans with less

than a high school

diploma vote

Hispanics and African Americans in Kansas are less likely to have access to

health care, at 46 percent and 21 percent, respectively.

A similar story unfolds when we look at disparities in healthy behaviors,

as indicated by rates of obesity and tobacco use. While the statewide adult

tobacco rate is 17 percent and the obesity rate is 31.2 percent, the rates for

our priority populations are significantly higher. For example, tobacco use by

African Americans is at 24 percent, and obesity rates of those with less than

a high school diploma are nearly 40 percent. Unfortunately, the likelihood

is high for children growing up in these environments to experience similar

outcomes as they become adults.

There is a significant, but often overlooked, factor that can contribute to

improved health and stronger communities – and that is civic engagement.

However, Kansas data indicate that the same groups that traditionally

experience disparities in health outcomes (race, income, education level and

geography) also experience disparities in voter registration, voter turnout,

attending public meetings or contacting public officials. For example, while

more than 56 percent of Kansans vote in local elections, only 36 percent of

Kansans with less than a high school diploma vote, and only 27 percent of

Hispanics vote.

Active, engaged community members help to shape policies, express

needs and expectations, determine how resources are allocated, and elect

their representatives. Involvement in this process is essential for policies on

health issues such as access to affordable health care, eliminating food deserts,

promoting an environment for physical activity, and investing in quality child

care and schools. The result is both improved health outcomes for residents

and healthy, vibrant communities for all.

To make the greatest impact with our resources, the Kansas Health

Foundation has focused our efforts on addressing critical health and

civic engagement gaps. We reach out to low-income and racially diverse

communities, both rural and urban, and help individuals reach higher

education levels. This strategic approach helps engage and support these

priority populations, and work within communities and neighborhoods

for change.

Child care providers and early childhood educators are key stakeholders in

this process. You have an incredible voice to help inform policy and support

families as advocates for healthier children. Each day, you are the “boots on

the ground” to provide healthy environments and encourage lifelong healthy

behaviors. This provides children great support to thrive and succeed. We are

proud of your work with children, reaching out to families, and leading by

example as you have adopted healthy policies and habits.

We believe the next big step to make wider change possible is to encourage

greater civic engagement. Working together, we can create a culture where

every Kansan can make healthy choices where they live, work and play. n

www.ks.childcareaware.org Kansas Child 9


Healthy Food Access

Across Kansas


Center for Engagement and

Community Development,

Kansas State University

David Procter is the Director of K-State's

Center for Engagement and Community

Development. Since arriving at K-State in

1987, he has worked in partnership with

communities across the state. He has

worked on issues of school consolidation,

community strategic planning, heritage

museum education, facilitation of

community dialogue, and strategies for

re-populating rural communities. Procter

has authored two books on community

building - Enacting Political Culture (1991)

and The Rhetoric of Community Building

(2005) plus numerous essays and book

chapters on the subject. Before becoming

the Director of CECD, Procter served on the

Advisory Board for the Kansas Center for

Rural Initiatives.

Ten years ago, Kansas State University’s Center for Engagement and

Community Development, along with several K-State faculty, communitydevelopment

Extension specialists, healthy food stakeholders, and four grocery

owners, applied for and received a small USDA grant to assist rural Kansas grocery

stores. Through this collaboration, Kansas State University’s Rural Grocery

Initiative (RGI) was launched.

We had come to understand the incredible importance of grocery stores in

rural communities. These small businesses are one of the primary economic

drivers in rural towns, annually adding nearly a million dollars to local economies;

employing, on average, 17 full-and part-time workers; and providing these towns

significant tax revenue. Not only do these businesses strengthen local economies,

they also provide healthy foods to rural residents.

Nearly 800,000 Kansas residents live in what are known as food deserts – areas

where significant poverty and limited access to grocery stores exists.

Research from the Academy of Nutrition and Dietetics explains that rural

grocery stores offer healthier foods, at lower cost, than convenience stores, and

that these stores are often distribution points for locally grown foods. Finally,

these businesses are community hubs. They are places where people gather,

socialize, and catch up on local happenings.

Despite their critical importance, rural grocery stores struggle to survive.

Since 2007, 45 rural communities have seen their independently owned grocery

store close. To address this rural community challenge, Kansas State University

launched the Rural Grocery Initiative. The RGI is a multi-state, multi-university,

campus/community collaboration involving numerous food access and small

business stakeholders from across the food system. Working in towns of 2,500 or

fewer people, the RGI has worked to: identify the challenges facing rural grocery

stores, develop responses to those challenges, identify sustainable grocery business

models, build virtual and face-to-face information networks for rural grocers, and

strengthen rural access to healthy foods.

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

Growing Healthy

Kansas Kids

A Child Care

Provider’s Story

In our efforts to address these goals, the RGI created a database of nearly 200

Kansas rural grocery stores, surveyed owners to better understand the challenges

they face, built an informational website (www.ruralgrocery.org), and developed

a rural grocery business toolkit. We have facilitated numerous community

conversations called FEAST (Food.Education.Agriculture.Solution.Together),

where citizens have come together to chart their path to strengthen local food

systems and their grocery stores. We have also hosted five national rural grocery

summits where hundreds of owners and food access stakeholders have come

from states across the U.S. to discuss the latest research and best practices

regarding rural grocery operations.

Perhaps most inspirational has been the amazing communities and people we

have worked with around this initiative. For example, following a FEAST event,

Crawford County is working to increase production of food to be consumed

locally by establishing a land bank to provide land for students who want to start

their own “farming” business. In addition, K-State Research and Extension is

offering classes for building food business plans and writing grants for funding.

In Little River, Kan., the city commission, a community foundation, local bank,

and the local grocery owners collaborated to secure stable financing for the

grocery store ensuring it will survive and also will be available to transition to

other owners when the current owners decide to step away. In Plains, Kan., the

community is not only planning to open a grocery store, but is also developing

programming focused on healthy eating. The community recognizes that

simply having a grocery store doesn’t necessarily translate to healthy eating, so

they are developing healthy recipes, grab-and-go healthy food products, and

planning for a commercial kitchen that will offer healthy-cooking classes.

Residents all around Kansas are working hard and innovatively to bring

healthy foods to their communities. K-State’s Rural Grocery Initiative is proud

to work alongside Kansans in this important work to increase healthy food for

all Kansans. n

By Kimberly Smith,

Community Outreach Coordinator,

Child Care Aware ® of Kansas

After 24 years in the early childhood

education world, Tammie Petrik knows

a thing or two about healthy, happy

children. And she knows that providing

an environment rich with experiences

leads to a love of learning. Within Little

Angels Daycare, her home-based child

care program, Tammie has created a

unique opportunity for the children. For

several years, Tammie and the children

have planted a garden. From tomatoes and

carrots to pumpkins and fruit trees, their

land yields a generous bounty.

During the spring and summer, one can

often see Tammie and her children out

and about at her Highland, Kan., home.

Tammie talks to the children about seeds

and plants. The children discuss if larger

seeds will yield larger plants, or if the plant

will have bigger leaves, or longer vines.

They understand that some seeds seem

to sprout miraculously overnight, while

others take a little more time and patience.

She and the children keep track of the

weather, and if the rains fall short, the

children help water their plants. They wait

with excitement for the first tender, green

shoots to break through the rich soil.

Once the fruits and vegetables are ripe,

the children are eager to harvest. Tammie

explains that when the children have a

hand in growing the different fruits and

vegetables, they are very willing to try even

unfamiliar foods. “I just love to see the

amazement in their eyes,” Tammie shares.

“They love to watch over their garden, and

pick their own fruits and vegetables to eat.”

In a time when most families are

rushed and busy, and processed

“convenience” foods are often more

readily available, Tammie is teaching

children a multitude of lessons. Not

only the science and academics behind

plants, but something much more.

She is teaching them about patience,

achievement, curiosity, respect for the

health of their bodies, as well as a love of

the land and the abundance it provides. n

www.ks.childcareaware.org Kansas Child 11


Risks of


(tank) holds

the liquid


Parts of an Electronic Cigarette



Heating elelment/atomizer heats the

“juice” to make vapor.

Many devices have a

switch to activate the

heating element.

Some devices have a light-emitting

diode on the end to simulate the

glow of a burning cigarette.



Tallgrass Family Medicine

Dr. Michelle Louis serves

on Tobacco Free Wichita

Coalition’s Medical Advisory

Council and is a practicing

physician with Tallgrass

Family Medicine in

Wichita, Kansas. She

graduated from the

University of Health

Sciences College

of Osteopathic

Medicine in 1988.

Parenting is fun, yet very

challenging. Just when it has become

cool for teens to make the healthy

choice not to smoke, the market

introduces another novel, exciting

way to get addicted to nicotine that

is marketed as a “healthy” and hip

alternative to smoking.

The modern e-cigarette was

invented in 2003 by Hon Lik, a

Chinese pharmacist and inventor, as

an alternative to smoking. E-cigarettes

were dismissed as a fad at first but

have since gained mass appeal. In

the U.S., tobacco producers have a

significant share of the e-cigarette

market. As of 2015, 80% of all

e-cigarette sales in convenience stores

were produced by the big tobacco


According to the U.S. Surgeon

General and leading researchers,

e-cigarettes (electronic cigarettes,

vape pens, tanks, e-hookahs)

contain harmful and potentially

harmful ingredients that are inhaled

by the user and exhaled into the

environment. The majority contain

nicotine, propylene glycol, and

flavorings. In addition, marijuana

and other drugs may be vaped.

The popularity of these products

among young people has increased

significantly over the past five years,

and the use of these devices is now

more common than the use of regular

cigarettes among middle and high

school students. In fact, e-cigarettes

are now the most commonly used

tobacco product among U.S. youth 1 .

Nicotine Poisoning on the Rise

The Kansas Poison Control Center

received 110 calls involving electronic

devices and liquid nicotine from

2014 - 2015, a significant increase

from previous years 2 . The liquid

for e-cigarettes can be purchased

at smoke shops, gas stations and

convenience stores, and is often not

regulated by city inspectors. Most

contain high enough levels of nicotine

to cause nicotine poisoning if ingested

or absorbed through the skin. It’s

especially dangerous for young

children, who may be attracted to

the liquid because of the flavors and

bright colors. In Kansas, there are no

child-proof packaging restrictions,

making the e-juice containers easy to

access for children of all ages.

According to the CDC, nicotine

in any form -- including e-cigs -- is

unsafe for youth. It is highly addictive

and can harm the developing

adolescent’s brain. The brain continues

to develop through the early to midtwenties.

Because the adolescent

brain is still developing, nicotine

use during this critical period can

disrupt the formation of brain circuits

that control attention, learning, and

susceptibility to addiction.


Young people are uniquely

at risk for long-term effects

of exposing their developing

brains to nicotine, including

mood disorders and permanent

lowering of impulse control.


Nicotine activates the limbic

system more strongly in the

adolescent brain than in the adult

brain, making addiction a greater

risk for youth who use nicotine.


E-cigarette use is strongly

associated with other tobacco

product use, including regular


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

Secondhand Vapor



The secondhand vapor exhaled

into the air is not harmless water

vapor as advertised by many. Besides

nicotine, e-cigarettes and their vapor

can contain harmful and potentially

harmful ingredients, including:


ultrafine particles that can be

inhaled deep into the lungs


flavorants such as diacetyl, a

chemical linked to “popcorn

lung,” (so identified because

of the incidence of the disease

in workers at plants that used

flavorants containing diacetyl in

microwave popcorn)


volatile organic compounds


heavy metals, including nickel,

tin, chromium, and lead.

How can we keep our children

breathing clean air? Traditional

tobacco prevention strategies that

have reduced tobacco use over

the past two decades can easily

be adapted to include electronic

devices and other new products. By

supporting the adoption of tobaccofree

building and ground policies,

tobacco-free park ordinances, smokefree

multi-unit housing policies, and

creating smoke-free home and vehicle

rules, parents and caregivers can

protect the health of their children

and help prevent exposure for

children in their care. n


1. U.S. Department of Health and Human Services.

E-cigarette use among youth and young adults: a

report of the Surgeon General. Atlanta (GA): US

Department of Health and Human Services, Centers

for Disease Control and Prevention, National

Center for Chronic Disease Prevention and Health

Promotion, Office on Smoking and Health; 2016.

2. University of Kansas Hospital – Poison Control

Center – Kansas E-Cigarette Related Poisonings

2014 - 2015

SMOKE-FREE Public Housing

2006, the Surgeon General stated, “no amount of secondhand

smoke is safe.”

Secondhand smoke is not just annoying; it is deadly – containing hundreds

of toxic chemicals with approximately 70 of them known to cause cancer. Since

that warning was issued, cities and states across the country have adopted clean

indoor air laws to protect workers and the general public.

For many of us, including some of our most vulnerable populations in public

housing, the greatest amount of time spent indoors is in our homes. Science

has shown us that more than half of the air in multi-unit housing is “shared”

through ventilation, plumbing, electrical paths, etc. So, if you have a neighbor

who smokes, you and your family are exposed to secondhand smoke.

For many Americans who live in their own homes, they are able to make

their own “house rules,” and the majority of Americans have voluntarily made

their homes smoke-free. However, for

those who live in multi-unit buildings,

such as public housing, up until now

there has not been a choice to live in a

smoke-free home.

In order to protect the residents in

public housing from the real health

hazard of secondhand smoke exposure,

the U. S. Department of Housing

and Urban Development (HUD) has

announced that all public housing

nationwide is to implement a smokefree

policy by July 30, 2018. HUD has

provided an 18-month timeline for

public housing to work together with

residents to educate them, put a plan

together and to answer questions about

compliance and enforcement. HUD also

has provided an implementation guide.

Not only will the health of all

residents improve, but there is an

annual estimated cost savings of $326

million in property damage. Getting an

apartment ready for a new resident can

cost two to seven times more when the

previous resident was a smoker. The

smoke-free rule also will greatly reduce


Regional Senior

Director, Tobacco

Control Programs and

Policy, American Lung

Association of the

Upper Midwest

Pat McKone, Regional Senior Director

– Tobacco Control Programs and

Policy, American Lung Association

of the Upper Midwest, has worked

with lung health programming for

more than 35 years. Her work has

included tobacco cessation programs

for adults and youth, limiting youth

access to tobacco, public and

school-based education, raising

awareness of the impact of tobacco

in those with mental illness and/or

substance abuse disorders, advocacy

for limiting exposure to secondhand

smoke, smoke-free housing, point

of sale, and e-cigarettes. She has

presented at international, national

and state conferences and provides

technical assistance to coalitions

across the Midwest.

the risk of fire-related deaths. The leading cause of fire deaths is smoking.

The change does not mean people who smoke cannot live in public housing,

rather, people who smoke cannot smoke in public housing units. The rule is

about the smoke, not the person. For those who smoke and want to take this

opportunity to quit, there are free resources online and by phone at 1-800-


Let us be clear -- there is no constitutional right to smoke. For me, the

HUD rule is a social justice issue. As a child, I was raised in public housing.

Like me, many children are living in public housing, through no fault of their

own. They deserve the right to breathe clean air at home. My only sister was

developmentally disabled and lived in public housing her whole adult life.

Her apartment was saturated with secondhand smoke. As public housing

authorities move forward to implement this new rule, it’s important to

remember that everyone deserves the right to breathe clean air. n

www.ks.childcareaware.org Kansas Child 13

Clean & Healthy Outdoor Spaces



Wichita State University

Picture this: You take your family to enjoy the park

in your community. As your children begin playing,

it’s not difficult to notice other park-goers smoking

on or around playground equipment, lounging areas,

and largely populated spaces. You notice a substantial

amount of litter from cigarette butts and other tobacco

products just waiting to be picked up by a curious child.

This is a problem that needs to be addressed in the

interests of safety and cleanliness in your community.

This situation is a reality at many parks across the

nation and state of Kansas, where comprehensive,

enforceable tobacco-free park policies are few and

far between. This lack of policy allows community

members to smoke cigarettes and other tobacco

products in public recreation areas without

consequence, subjecting others, especially children, to

secondhand smoke and littering the ground with many

dangerous toxins for any child or pet to pick up and

perhaps accidentally consume.

When exposed to the effects of secondhand tobacco

smoke, people are at a much higher risk of serious and

life-threatening health issues, including heart disease,

cancer, asthma, and other respiratory disorders. 1 It’s

important to remember that there is no safe level

of exposure to secondhand smoke. Recent studies

have even found that secondhand smoke is just as

dangerous in an outdoor area as it is indoors, and can

deter those with asthma and allergies from going to

places where they might encounter tobacco smoke. 2

In addition to the obvious health benefits of

tobacco-free park policies, cigarette butts are not

biodegradable. 3 Because of this, tobacco-free park

policies save city staff from picking up this toxic litter

and benefit the environment. Litter from tobacco

products is incredibly unattractive, expensive to

remove, and a blatant hazard to waterways and wildlife.

Additionally, parks and other outdoor public spaces,

such as ballparks, could be some community

members’ only access to a relaxing, natural

environment, which is why cities need to provide clean,

healthy outdoor spaces. Several cities in Kansas have

already passed legislation or policy to make their parks

tobacco-free, including Lawrence, Eudora, Hiawatha,

Highland, and South Hutchinson. Please advocate for

tobacco-free policies in your city’s parks and outdoor

settings and let’s provide clean and healthy outdoor

spaces for all Kansas families to enjoy. n

Chris Thiel is a Public Health Sciences

student at Wichita State University,

serving as a Health Professions Senator

for Student Government, member

of Sigma Phi Epsilon, and the Greek

Relations Chair for the Interfraternity

Council. He also works on campus as

a Supplemental Instruction leader for

Anatomy and Physiology and as a Student

Project Assistant at the Community

Engagement Institute in the Center for

Public Health Initiatives. After graduation,

Chris plans to become a Physician

Assistant and get a Master’s in Public

Health. He has also served as the Youth

Advisor for Resist for a little over a year,

and is passionate about tobacco control

and youth advocacy.

1. U.S. DEPT OF HEALTH & HUMAN SERVICES, CENTERS FOR DISEASE CONTROL AND PREVENTION, The Health Consequences of Involuntary Exposure to Tobacco Smoke: Report

of the Surgeon General (2006), http://www.surgeongeneral.gov/library/secondhandsmoke/report/index.html.

2. James Repace, Benefits of Smoke-free Regulations in Outdoor Settings: Beaches, Golf Courses, Parks, Patios and in Motor Vehicles, 34 WM MITCHELL LAW REVIEW 4 (2008)

3. CigaretteLitter.org, Cigarette Litter, http://www.cigarettelitter.org.

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

Quit smoking for

you and them.

Get FREE help:



www.ks.childcareaware.org Kansas Child 15


Safe Routes to School

You can do it, too!

Kansas Department of

Transportation, Bicycle &

Pedestrian Coordinator

Matt is the state of Kansas’ Bicycle and

Pedestrian Coordinator at KDOT. In this

position, he evaluates and reviews many

Safe Routes to School projects throughout

the state. As an avid walker and bicyclist,

Matt also knows what it takes to make

sure walking and biking remain routine,

even with a busy schedule.

It is difficult to deny that children need

safe routes that allow them to walk or

bike to school (and other places). For

this reason, Safe Routes to School (SRTS)

projects and programs are becoming

increasingly popular in Kansas and

around the country. The associated

benefits of promoting SRTS include an

increase of physical activity, improved

safety in communities, and reduced traffic

congestion. In fact, a 2009 assessment

showed that 10-14% of rush hour traffic

is related to parents driving kids to and

from school 1 .

While some parents can easily adjust

their daily routines and access the new

sidewalks in their neighborhoods, some

families are still beyond the limits of a

“safe route” and are not comfortable with

their children traveling the whole way to

school or walking alone. These concerns

are understandable; it’s instinctive to

be concerned for and protective of our

children. But, there are solutions worth

considering for you and your children.

Here are some tips that can help make

sure you’re able to benefit from your

community’s investments in Safe Routes to

School projects:

Split the trip – You may not want your

child to walk the whole way to school.

Instead, find a place that is within a

reasonable distance from the school that

you are comfortable with (a nearby park

or a friend’s neighborhood), drive there

and let the child walk or bike the rest of

the way. This allows the child to get some

physical activity, keeps you out of the

school-related congestion, and addresses

the “distance” problem. This tactic can

also be applied to a group carpool, which

allows kids to walk in a group for the rest

of the way.

Take a turn – If you’re uncomfortable

with your child walking alone and

unchaperoned, chances are other parents

feel the same. Organize a group of parents

who have similar concerns and create

a schedule to take turns walking with

the group. The more parents you get to

sign up, the fewer days you’ll need to be

the chaperone. If you’re already part of

a carpool group, this should be an easy


Get in gear – There is a saying, “There

is no such thing as bad weather, just bad

gear.” You don’t need to cancel a walking

or cycling trip to school because of

some rain or snow. There are plenty of

successful SRTS programs around the

country that manage in less-desirable

weather conditions—think Alaska, or New

Hampshire. With the right gear, like an

umbrella, galoshes, and a raincoat, you’ll

realize that a little rain or snow is not the

end of the world.

Plan for what works – You don’t have

to commit to having your child walk or

bike every day. Start by picking a day

of the week (or even month) that you

know will work for you and your family’s

schedule. You can make adjustments later

as you become more familiar with the new

routine, adding a day or altering the route.

Being involved with your community’s

SRTS program is the best way to take

advantage of the benefits. By following

these tips and adjusting them to meet your

needs, you can start to develop a routine

that increases your child’s physical activity

levels, improves traffic safety in your

community, and helps you avoid the chaos

and congestion at the school’s student

drop-off zone. n

1 McDonald N, Brown A, Marchetti L, et al. “U.S. School

Travel, 2009: An Assessment of Trends.” American Journal

of Preventive Medicine, 41(2): 146-151, 2011.

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

Healthy Habits for a Healthy Future

Every child deserves the chance to grow

up healthy and strong. When children have

a lifestyle that includes nutritious food

and plenty of time for active play, they are

more likely to reach their full potential.

In the U.S., nearly one in four

preschoolers (ages 2 to 5) is overweight

or obese, an alarmingly high number.

Children who are overweight as

kindergarteners are four times more

likely to be obese as eighth-graders. With

obesity comes a high risk for other health

conditions, even in childhood, such as

asthma or Type 2 diabetes.

While childhood obesity rates (ages 2

to 19) have remained stable for the last

decade, they are still three times as high as

they were in 1980. During this same time

period, our food and fitness environment

has shifted, making it more difficult to eat

healthy and be active.

Some of our most vulnerable children

have limited access to healthy food, and

many are bombarded with unhealthy

food offerings. The food and beverage

industry spends $2 billion each year

marketing specifically to children. In

addition, for young children, screen time

may be replacing physical activity time.

The good news is that, together, there is

much we can do to help children grow up

healthy and active. One of the best ways

to prevent childhood obesity is to start


Healthy Habits in Early Childhood:

Why they’re so important!

When children are preschool age, they’re

still learning and forming their health

habits and tastes.

Studies suggest that children’s

experiences in early care and education

(ECE) programs have an important

influence on weight status in childhood.

Regular physical activity and good

nutrition help children grow up healthy

and strong. Children learn better in

healthy environments.

Early care and education programs in

Kansas and Missouri have been working

to create this healthy start for children by

changing policies. They are serving more

nutritious foods and drinks and ensuring

that kids are physically active every day.

At Children’s Mercy, we are excited

to partner with organizations such as

the American Heart Association, The

Family Conservancy, Child Care Aware®

of Kansas, local health departments and

many others to support these efforts.

One of the ways we work together is to

share a consistent message about health

-- 12345 Fit-Tastic! This message promotes

five specific habits for kids (ages 2 and up)

to engage in every day:






hour or more

of physical activity

hours maximum

of screen time

servings of low or

nonfat milk or yogurt

servings of water

-- not sugary drinks

servings or more

of fruits & vegetables

At Children’s Mercy, we’ve worked with

partners to create the Healthy Lifestyles

Initiative in Early Childhood toolkit.

The toolkit helps guide early care and

education programs on how to share

the 12345 Fit-Tastic! message, tips and



Project Coordinator,

Weighing In Program,

Children’s Mercy Hospital

Emily Meissen-Sebelius, M.S.W., is project

coordinator for the Weighing In program

with Children’s Mercy Hospital. Emily

works with community partners on

policy and environmental changes that

support healthy lifestyles. Before joining

Children’s Mercy, Emily was an analyst at

the Kansas Health Institute, where she

worked to conduct research, evaluate

programs and inform policy in the fields

of early childhood, mental health and

public health.

resources with families. It also connects

the 12345 Fit-Tastic! message with those

important wellness policy changes that

make it easier for children to practice

healthy habits.

What’s in this toolkit?


12345 Fit-Tastic! materials and parent

handouts available to ECE providers


Ideas for how to use 12345 Fit-Tastic!

messaging within ECE programs and

in communication with families


Examples of 12345 Fit-Tastic! wellness

policies and practices for ECE



Sample 12345 Fit-Tastic! family letters

that connect wellness policies with the

12345 Fit-Tastic! behaviors

We hope this toolkit can give you

ideas for how you might be a Fit-Tastic!

champion within your family, program or

community! Together we can help young

children thrive through the healthy habits

of 12345 Fit-Tastic! For more information,

contact us at weighingin@cmh.edu or visit

www.FitTastic.org . n

www.ks.childcareaware.org Kansas Child 17

Protecting and Securing Healthier


National Director,

Eco-Healthy Child Care ® ; Children’s

Environmental Health Network (CEHN)

Hester Paul, National Director of Children’s

Environmental Health Network’s (CEHN)

Eco-Healthy Child Care® (EHCC) program,

works to ensure that children throughout the

nation benefit from the reduction of harmful

environmental toxins within child care facilities.

EHCC offers comprehensive training, technical

assistance, resources and an endorsement to

child care professionals. CEHN is a national multidisciplinary

organization whose mission is to

protect the developing child from environmental

health hazards and promote a healthier

environment. Hester can be reached at 585-307-

7170, or hesterp@ecohealthychildcare.org

The chemicals a child encounters

daily—at home, in the early learning

setting, and even in the womb—can play

a greater role than previously imagined

in a child’s health and development. In

the United States, an estimated 13 million

children spend at least 35 hours a week

in some form of child care; therefore,

child care providers represent a cadre

of professionals uniquely positioned to

influence children’s cumulative exposures

to harmful substances.

Fortunately, parents and early learning

leaders can benefit from a variety of

resources that will assist them in making

healthier choices for their children,

including the free checklist and fact sheets

available from the Eco-Healthy Child

Care® (EHCC) program that offer simple

steps to reduce harmful exposures.

Advances in science have dramatically

changed our understanding of how our

bodies interact with our environment, and

how these interactions affect our health,

especially the health of young children.

Scientists are identifying more and more

substances in products that we use every

day that have the ability to suppress or

mimic hormones. These hormone mimics,

often called endocrine disruptors, can

impact not only sex-related hormones that

influence reproduction and fertility, but

also thyroid hormones that are related to

the ability to learn. 1

Baby bottles, sippy cups, teething

rings, dolls, rubber duckies, beach balls

and inflatable pools are often made

with phthalates and Bisphenol A (BPA).

These two toxic ingredients in plastics

are of particular concern, as research

increasingly shows that these chemicals

mimic or suppress hormones (e.g.,

1 De Coster S and van Larebeke N, “Endocrine-

Disrupting Chemicals: Associated Disorders and

Mechanisms of Action: Review article,” J Environ Public

Health. 2012; 2012: 713696.

Published online 2012 September 6. doi:

10.1155/2012/713696 PMCID: PMC3443608

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

Early Learning Environments

estrogen and testosterone) and disrupt

normal development and growth.

Unfortunately, this is just one example

of a growing body of evidence about

worrisome health effects resulting from

exposure to a number of chemical

categories, such as fragrances, flame

retardants, and compounds in building

materials. Despite this knowledge,

children are still being exposed, whether

it is through their drinking water, poorly

maintained lead-based paint in their

homes, schools or child care facilities,

consumer products, food, or air pollution.

Of the 85,000+ synthetic chemicals

in commercial use today, only a

small fraction has been tested for

their impact on children’s health.

For example, a wide variety of toxic or

hazardous chemicals are routinely used

as ingredients for cleaning products.

Household chemicals can make indoor

air unhealthy to breathe, irritate the

skin and eyes, harm the respiratory

tract and hormone system, and pollute

the natural environment. Children are

especially vulnerable to toxic chemicals,

because their bodies and organs are still


It is essential that parents and caretakers

understand the differences in products

when cleaning, versus sanitizing and/

or disinfecting. Routinely cleaning with

detergent and water is the most useful

method for removing germs from surfaces

in the child care setting or home. There

are times that a sanitizer or disinfectant

is needed however, such as after a diaper

change, but it is important not to overuse

sanitizers and disinfectants. EHCC

supports child care professionals in

understanding how to effectively follow

their state’s licensing regulations for

cleaning, sanitizing and disinfecting,

while still being careful to protect a child’s

environmental health. Key available

resources are highlighted by EHCC when

appropriate, such as Appendix J of Caring

For Our Children, 3rd Edition, which

provides helpful guidance in selecting an

appropriate sanitizer or disinfectant.

Safer cleaning products are not only less

toxic and environmentally safe, but they

also often cost the same or less compared

to conventional cleaners. Green Seal

and EcoLogo are nonprofit companies

that research and certify products that

are biodegradable and environmentally

friendly. Visit www.greenseal.org and/

or www.ecologo.org to verify whether

the products you and/or your child’s

provider use are safe, healthy and effective.

Additionally, the US Environmental

Protection Agency

(EPA) has created

Safer Choice. This label

verifies that the product

ingredients have been

thoroughly reviewed

by the EPA review.

EPA also has Safer

Choice Fragrance-Free,

a label for products

without fragrance. Visit



If we as a society

want to ensure that

children’s opportunities

to learn and to grow

are not stunted, our

goals should include

preventing children’s

exposures to chemicals

of concern that are

commonly found in the

early learning environments.

Get empowered! Access the low-cost

practical steps and healthier purchasing

policies that have already been adopted

in thousands of child care facilities

across the nation. Download the free

checklist offered by Eco-Healthy Child

Care® (EHCC) at www.cehn.org/ehcc to

About Eco-Healthy Child Care ®

Eco-Healthy Child Care ® is a sciencebased,

award-winning program managed

by the Children’s Environmental

Health Network, a national nonprofit

organization created to protect the

developing child from environmental

health hazards and to promote a

healthier environment. The best

practices promoted through EHCC are

guided not only by EHCC’s Science

Task Force, a committee made up of

nationally recognized researchers,

pediatricians and toxicologists, but

also by EHCC’s 30-member National

Advisory Committee, which includes

representatives of the National Resource

Center for Health and Safety in Child

Care and Early Education, Child Care

Aware® of America and other early

learning and environmental health

professional organizations.

get started on making healthier choices

right away. Read the tips and resources

offered within EHCC’s 16 fact sheets, also

free to download at www.cehn.org/ehcc/


How does the Eco-Healthy Child Care®

program work? The 30-item Eco-Healthy

Child Care® checklist offers practical,

free or low-cost steps in 11 areas: Air

Quality, Household Chemicals, Lead,

Mercury, Radon, Art Supplies, Furniture

and Carpets, Plastics and Plastic Toys,

Pesticides, Arsenic: Treated Wood and

Water, Recycling and Garbage Storage

and Education and Awareness. Child care

facilities that participate in the EHCC

endorsement program receive a certificate

and poster announcing their two-year

endorsement. They are also recognized

on the EHCC website, where their efforts

are recognized and where parents can

go to search for providers who are going

above and beyond child care licensing

regulations to incorporate environmental

health best practices into their daily

routines. n

www.ks.childcareaware.org Kansas Child 19


Program Officer,

United Methodist

Health Ministry Fund

Katie Schoenhoff is a program officer

for the United Methodist Health Ministry

Fund focusing on strategic initiatives in

breastfeeding support and early childhood

social-emotional health. Additionally, she leads

Healthy Congregations, a Health Fund program

supporting targeted, outcomes-oriented

wholistic health ministries in United Methodist

churches throughout Kansas and Nebraska.

She is a graduate of Sterling College with a

double major in Health/Physical Education

and Athletic Training. Previously, she

worked as an athletic trainer and then in

health education at the Reno County Health

Department. She joined UMHMF in 2013.

Project NeuroNurture

Investment across 35 Kansas counties

leverages proven, short-term,

cortisol-regulating intervention for

families facing adversity

Providing a nurturing environment

does not come naturally to all parents.

When a family faces extreme financial and

emotional adversity, parents can struggle

to offer the comfort and care their babies

and toddlers require.

A growing body of research on brain

development is connecting these adverse

childhood experiences to toxic levels

of the “stress hormone” cortisol, which

can have devastating effects on a young

child’s growth and development. This

includes cycles of behavior challenges,

school struggles, and troubled adulthood.

Surprisingly, the answer to infant

and toddler cortisol regulation is not

medication, but nurturance. Now, a pilot

program called Project NeuroNurture

is implementing a proven

early intervention to help

regulate elevated levels

of cortisol in infants

and toddlers in just 10

weekly home visits.

Aimed at new

parents and caregivers of 6-to-24-

month-old children in adverse family

circumstances, the Attachment and Biobehavioral

Catch-up (ABC) intervention

method consists of home visits by a parent

coach. Throughout each of the ten sessions,

the parent coach observes interactions

between parent and child and provides

feedback on behaviors that relate to the

intervention targets. Sessions are captured

on video, so coaches can highlight parents’

strengths, weaknesses, and behavioral

changes. These sessions help parents learn

play-based strategies that build attachment

— and in turn, regulate cortisol levels in

infants and toddlers. Evidence shows that

caring and responsive relationships with

adults early in life can help develop positive

coping skills and reduce the likelihood

of chronic health concerns caused by

continuously elevated cortisol levels.

Developed by researchers at the

University of Delaware, the ABC

intervention is approved by

Health and Human

Services and received

a 1 rating on

the California



for Child

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

to serve 850 families

Welfare scientific rating scale, indicating

that ABC has one of the strongest bodies

of research evidence among those rated.

“We’ve known for years that very early

interventions pay dividends in the long

term,” said Kim Moore, President of

United Methodist Health Ministry Fund

(UMHMF), a funding partner for the

pilot. “Our challenge now is to find the

most effective way to achieve the greatest

outcome, and ABC is an excellent example

of a science-based, proven program that is

very short in duration, yet very powerful

in results.”

Project NeuroNurture aims to serve

850 families over a three-year period

across 35 Kansas counties. The $2.4

million investment is underwritten by

United Methodist Health Ministry Fund

(UMHMF), Kansas Health Foundation,

Wyandotte Health Foundation, REACH

Healthcare Foundation, and Hutchinson

Community Foundation. The University

of Delaware and Kansas University

Endowment Association are conducting

program training and evaluation with

grant support.

Grants are directed to five sites, which

are incorporating

the ABC method

into existing infant/

toddler home

visit programs as

a means to speed


and create synergy

with existing staff

and resources. Those sites are:

Horizons Mental Health Center: Reno


Northwest Kansas Council on

Substance Abuse: Cheyenne, Rawlins,

Decatur, Norton, Sherman, Thomas,

Sheridan, Graham, Wallace, Logan, Gove,

and Trego counties.

Project Eagle – University of Kansas

Medical Center: Wyandotte County

Rainbows United: Sedgwick and Butler


Russell Child Development Center

(Southwest Kansas): Greeley, Wichita,

Scott, Lane, Ness, Hamilton, Kearny,

Finney, Hodgeman, Stanton, Haskell, Gray,

Ford, Morton, Stevens, Seward, Meade,

and Clark counties

A unique component of this program

is the testing of cortisol levels via saliva

samples collected from the children at the

start and end of the program. Researchers

at the University of Kansas will evaluate

the samples, which are expected to

demonstrate the same cortisol regulating

effects seen in prior ABC implementations

across the country.

“We’re able to prove this program is

helping with cortisol regulation. Anytime

you can back up the work you’re doing

with scientific evidence, it’s very exciting,”

said Moore.

Return on Infants (ROI): A Smart

Investment for Kansas: Science-based,

short-term early interventions have the

potential for large, long-term savings

for Kansas taxpayers. Research by the

Heckman Institute reports that highquality,

birth-to-five programs for

disadvantaged children can deliver a 13%

per year return on investment. These gains

are realized through better outcomes in

education, health, social behaviors, and


“Most people understand and value

the investment in

early childhood

programs,” said

Moore. “But if we

can be even more

strategic with our

funds, the savings

for Kansans

longterm could

be incredible. We have an opportunity to

make a major shift in the lives of these

children and ultimately in our future

workforce and tax base.”

Project NeuroNurture program leaders

will be contacting Kansas legislators,

business leaders, and leaders of the mental

health and early education communities

over the coming months to advocate

for investment in short-term, early

interventions programs as a means for

improving the Kansas economy and the

lives of our youngest citizens.

For more information on Project

NeuroNurture, the ABC program,

or how to get involved, visit www.

neuronurtureks.org. n






By Kami Cohorst, Director

Child Care Aware ® of Kansas

Research has demonstrated that

abuse, neglect and other household

stressors can increase the risk of health

problems throughout a child’s lifespan.



capacity to face

and overcome

adversity, to

bounce back

from difficulties

or challenges, to

cope and adapt

Did you know?

Only 25% of children

receive the mental

health care they need.

– childhoodresilience.org

to change—in children can contribute

to better health outcomes.

Resilience is not learned through a

one-and-done activity, but can be built

over time. Families and communities

can actively support and enhance

children’s resiliency by providing safe

and supportive environments, and by

ensuring access to community supports

and services.

Get to know supports in your

community. Who are the mental

health providers, pediatricians, school

counselors, faith-based personnel, etc.?

Get involved. Are there active civic

groups, community clubs, play groups,

or family activities you and your child can

participate in?

Be informed. Attend a training on

trauma-informed practices. Knowledge is


At the end of the day, understanding

what resources exist in your community

and leveraging community support are

key to strengthening resilience. For a

detailed list of resources available in

communities around Kansas, check

out the Parent & Community Resource

Sheets on the Child Care Aware® of

Kansas website, under the helpful

resources section. n

www.ks.childcareaware.org Kansas Child 21

Creating a Village

for Successful Living

By Alice Eberhart-Wright, Child and Family Specialist

I scratched my head as I thought about how to engage children in thinking about community

health, then headed to the shelves of new books in the library. There I found titles that dealt

with community health issues such as self-care, dealing with conflict, illness and possible


My Good Morning

For toddlers, community health starts with helping them learn and master all the self-help

rituals that begin with pulling their diapers off and moving up the developmental scale to

being able to get ready to go to school well-groomed. My Good Morning, by Kim Crockett

Corson and Jelena Brezovec, is delightful for children and also reminds

grownups how young children slowly master their world. Things get

messy, clothes are buttoned in ways that grownups probably want to fix,

toilet paper somehow drifts across the entire bathroom floor, and parents

sweat trying to get clothes on a jack-in-the-box child. For a while there

may be tears at child care, but then one day the tears are gone, and, in

an organized way, the child is well on her way to being ready for the

increasingly complex rituals involved with growing to adulthood. As

a bonus, this book helps our society see diversity as perfectly normal, with a light-skinned

mother and dark-skinned father. We are all beautiful.

Kid Amazing vs. the Blob

Next comes Kid Amazing vs. the Blob by Josh Schneider, a Theodor Seuss Geisel

Award Winner. This story deals with sibling issues where everyone tries to help brothers

and sisters love and care for one another. The Blob is the stinky, shrieking baby sister

who, for a time, creates havoc in a family that has been accustomed to just one child

who played center stage. The little boy handles his feelings by seeing the baby as an

uninvited intruder who must be reckoned with. He creatively makes a super hero

costume out of all kinds of ordinary things and heads out on an adventure to deal with

the stinking blob. The stinking blob of a baby is conquered by the super hero, who finds

her pacifier and plugs her up. For parents, the story introduces a strategy to engage

children in a different way to tame their annoyance. We want children to grow up to be

peace makers and problem solvers in their community.

Bear Feels Sick

Bear Feels Sick, by Karma Wilson and Jane Chapman, is an adorable book about a sick bear

and how all its friends rally around to care for him when he feels crummy. In the end they

get sick, too, and the bear gives back the love and caring he experienced. This is a great book

to read when some type of bug sweeps through a group of children. It has very few words but

wonderful illustrations to talk about. A follow-up activity might be to draw and tell a story

about when someone gets sick in your own family. What happens? What do people do about it?

How does a parent take care of you and how do you help take care of a sick parent who may not

be able to do all the things he or she usually does? The story helps us foster empathy for others.

Harry Goes to the Hospital

Harry Goes to the Hospital, by Howard J. Bennett, M.D. and illustrated by M.S. Weber, is a

book to use when a child has to go to the hospital and experience the scary IV, blood tests, and

x-rays. It includes tips about how to prepare a child, stay with him, help him relax, and use play

as therapy. The author practices pediatrics in Washington, D.C., and has written several books

that help parents deal with common issues. He also has a website that helps with bedwetting

(www.wakingupdry.com). n

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

Earn a teaching license

Change your life

and the lives of children

Our online and on-campus bachelor’s and master’s programs in Early

Childhood Education B-K Unified (early childhood education/early childhood

special education) uniquely prepares qualified teachers for the classroom.

• Utilize loan deferments and scholarship programs

• K-State students consistently earn a 99

percent pass rate on licensure exams

• No relocation required

• Enjoy summer breaks

Always on. Always there.

VISIT global.k-state.edu/early-childhood




SALINA, KS 67401


PO Box 2294, Salina, KS 67402-2294


Call Toll Free 1-855-750-3343

Picture this... a brighter future for all Kansas families!

Each gift will be matched

proportionally up to 50%!

Thursday, March 15, 2018


7:00 a.m. to 7:00 p.m.

Salina Fieldhouse 140 N. 5th St.



12 a.m. to 11:59 p.m.

During this event, 100% of in-person or online

donations made will support the Child Care Aware ®

of Kansas endowed fund and will be used for early

childhood scholarships for child care providers

across Kansas.

Visit us at our booth to learn more!

All gifts are tax deductible. Online gifts are subject to a credit

card fee of 2.25% plus 30¢ transaction fee.

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