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About Building Blocks | Search
Building Blocks for Primary Prevention
Building Awareness and Public Support
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Expand Lead Safety Education to New and Expectant Parents
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Click here for PDF version or MS Word version
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DESCRIPTION OF THE STRATEGY
Educational initiatives can be used to inform pregnant women of the danger of lead-based paint and lead dust hazards and are especially important in high-risk areas. Enhanced education and outreach programs to expectant and new parents can include information about lead poisoning, evaluation and control of lead hazards, home preparation, local lead safety resources and community groups, and screening recommendations. Indeed, educational programs can offer tangible support for primary prevention, such as vouchers for classes in lead-safe work practices or even cleaning equipment.
BENEFITS
Immediate/Direct
Results:
Each woman who learns about lead hazards may be motivated to take actions to reduce lead exposure to herself, her infant, and other family members. Reaching expectant and new parents is true primary prevention.
Public Health
Benefits:
Broad and sustained community-wide education targeted to expectant and new parents can yield changes in collective behavior and understanding. In particular, community norms about controlling lead hazards in the home or otherwise preparing the home for newborn children may be changed over time, creating more lead-safe homes and benefiting more families including children of all ages.
Other
Indirect/Collateral Benefits:
Increased community-wide awareness can generate broad commitment to improve community resources and political will for primary prevention.
Scope of Potential Impact
Statewide Regional (e.g. multi-county) City - or - County - Wide Neighborhood/Community
PRIMARY ACTOR(S)
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KEY PARTNER(S)
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Health Department
| Medicaid Agency
Physicians
Expectant Parents
Housing Agency
Head Start
WIC
Community-based Organizations
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CRITICAL ELEMENTS
Staff
requirements:
Varies, depending on the extent of the initiative and existing parent education activity (if any) by the sponsoring entity.
Other resource requirements:
Appropriate mechanisms for delivery and dissemination of desired educational messages are needed, but the mechanisms can vary dramatically depending on the design of the educational initiative. Typical educational methods include brochures, fact sheets, and web sites. The considerable range of materials already developed on lead safety obviates the need to develop materials, although modifications should be made to incorporate local referral resources. Programs can augment traditional materials with more attention-getting vehicles, such as diaper bags and other promotional items. Any materials used must be accessible and understandable to those who live in high-risk areas, where language barriers and reading levels can present a challenge. Programs will also need data and surveillance information.
Institutional
capacity required:
Health education initiatives rarely require special authorization.
Cost
considerations:
Adding a new subject to an existing education program is more cost-efficient than implementing free-standing education focused only on lead safety. Printing materials will cost nominal amounts per parent.
Timing issues:
Can be implemented anytime.
Feasibility of
Implementation:
Variable. Feasibility depends on the availability of people to manage the effort and resources to support it.
Potential Obstacles/Barriers
One potential obstacle is reaching agreement on a specific strategy deemed most effective for the circumstances, as there are so many possible combinations of messages, messengers, delivery mechanisms, and possible target audiences. In addition, it can be uncomfortable to make lead-safety recommendations to parents in communities where resources do not exist to assist families in repairing lead hazards.
A barrier to the effectiveness of education on lead safety is the fact that expectant and new parents may already be overwhelmed with other recent messages on multiple weighty issues and have many other concerns and priorities. Discussion of possible lead exposure in utero may help parents to focus attention on the immediacy of lead safety.
Programs may also encounter unexpected challenges in developing partnerships with seemingly natural partners. For example, one program reported difficulty in convincing obstetricians to participate in such an educational campaign.
Additional Resources
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ILLUSTRATION #1 OF STRATEGY IN PRACTICE MA CLPPP conducted a project to educate pregnant women about lead hazards and encourage them to adopt preventive behaviors, and to educate doctors and staff members for community health centers and agencies in the target communities. The project’s three core activities were:
1. Development and distribution of bilingual prenatal lead awareness kits packaged in large attractive diaper bags. The kit included educational fact sheets and brochures, promotional items, a community resource card, an evaluation card, and a voucher for free lead-safety training for a family member. The pre-existing educational materials were provided as bilingual documents, in English and one other language—Spanish, Khmer, or Vietnamese. On a limited basis, materials were also distributed in Russian, Chinese, and Portuguese.
2. Recruitment of community health centers and agencies that serve pregnant women in the target communities (e.g., WIC, Head Start, etc.) to educate their staffs and clients and distribute information kits; and,
3. Sponsorship of Grand Rounds training (offering CEUs) for physicians and other medical and program staff in the four communities.
This project was supported by a nine-month CDC supplemental grant of $100,000.
Jurisdiction or Target AreaLawrence, Fitchburg, Lynn, and Holyoke, MA Primary ActorCLPPP, Massachusetts Dept. of Public Health
Staffing utilizedStaffing was routinely about 1.25 FTE, but spiked during busy periods associated with trainings and implementation (e.g., about 5 FTEs for a few days). Other resources utilized Factors essential to implementation Staff felt that success was dependent on the availability of a full-time project coordinator and—for effective materials distribution and training recruitment channels—on the network of existing contacts in the community. MA CLPPP was able to use existing MOUs with some partners, which expedited administrative processes. Limitations/challenges/problems encountered Major challenges were in the areas of deadlines and evaluation. Various administrative factors meant that the program had about seven months to hire staff and complete the project, operating within the constraints of state governmental systems for purchasing. Due to time and realities, the program was limited to a self-reporting evaluation. Logistical constraints, including an interpretation of HIPAA requirements, prevented an evaluation approach involving tracking individual women’s names. Magnitude of Impact/Potential ImpactApproximately 3,500 diaper bags/information kits were distributed in 4 months, with many distributed in high-risk areas; 29 agencies signed Memoranda of Understanding (MOU) and partnered in the project; 138 self-reported evaluation cards were returned from kits; and Grand Rounds attendees gave high evaluation marks. Potential for ReplicationModerate Contact for Specific Information References for additional information | 1. | - “CDC Supplemental Prenatal Grant: Overview and Evaluation”--August 2003 | | | ILLUSTRATION #2 OF STRATEGY IN PRACTICE As part of a nine-month project focused on increasing testing rates for lead among pregnant women in Alameda and Fresno counties and prompting early intervention, CA CLPPP developed, disseminated, and field-tested educational materials for at-risk pregnant women. To this end, brochures were developed urging women to get tested, and explaining how lead gets into the body, how it can affect a baby, and how to create a lead-safe environment. County-specific phone numbers were provided so that women could easily seek medical care and information regarding lead and pregnancy. After completion, 25,000 packets of culturally-appropriate outreach
materials were distributed to high-risk pregnant women and their families through community programs that also provide services to these populations in the two counties, including WIC, Head Start, MediCal, Black Infant Health, and other agencies. 15,000 postcards with a brief “get tested now” message and county phone numbers were also mailed to specific high-risk areas and addresses based on analyses of county tax assessor and Census data. CA CLPPP also conducted direct outreach to medical providers, sponsoring training meetings, distributing educational information, and offering CME/CEU credits. CA CLPPP also sought to help develop and sustain an infrastructure of primary prevention resources for pregnant women and families, beginning with distribution of referral information.
The larger project was supported by a nine-month CDC supplemental grant of $100,000 focused on preventing lead poisoning in at-risk pregnant women and their offspring. The educational materials were tested with 35 participants in a WIC health information class, who provided feedback via a questionnaire and group discussion. Staff were surprised to learn that, despite having used professional translators to develop their materials, there were still some words that were not understood and some graphics that were not clear to the audience. Jurisdiction or Target AreaAlameda and Fresno counties, CA Primary ActorCLPP Branch of CA Dept. of Health Services
Staffing utilized2 FTE plus 0.5 in-kind. Other resources utilized Factors essential to implementation Project staff felt that the key ingredient for success was the genuine collaboration and support of the community partners. The WIC clinics were particularly effective partners as they already had ongoing and trusting relationships with the pregnant women, and because they incorporated the lead education into their WIC orientation sessions to reinforce the written information. Limitations/challenges/problems encountered None. Magnitude of Impact/Potential ImpactCA CLPPP has not yet been able to measure the larger outcomes of the project, as they are waiting for access to 2003 vital statistic files with data on how many neonates were tested for lead in the target counties. The program will also look at Occupational Lead Poisoning Prevention Branch records for data on how many women were tested in the target counties. Potential for ReplicationHigh Contact for Specific Information Laura Jelliffe Pawlowski, PhD
Research Scientist
Childhood Lead Poisoning Prevention Branch
CA Department of Health Services
510-622-4915
LJelliff@dhs.ca.gov
| | References for additional information | 1. | - CA DHS has available its June 2003 report provided to CDC at the end of the grant period. | | |
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