Introduction

Children’s awareness of their basic safety and health care needs is another important aspect of their overall physical health.  Although children’s awareness does not always translate into healthy and safe practices, children who are unaware of basic safety and health care needs are unlikely to consistently take good care of their physical health and engage in practices that increase their physical safety and reduce the risk of physical harm.

For very young children, much of the responsibility for protecting physical health lies with adults.  Young children first learn about safety and health care from their parents and other adults.  By observing adult actions and receiving verbal instruction, children learn that  basic health care and safety practices are important.  Knowledge about safety and personal health care needs increase with development and is particularly enhanced during elementary-school years.  Elementary-aged children learn about health and safety in classes at school and in community-based programs and activities.  One major goal of educators and parents is to help children develop and exercise critical-thinking abilities that allow them to begin taking responsibility for their own safety and health through the choices and decisions they make (Kann, Collins, Pateman, Small, Ross, & Koble, 1995). 

The Division of Injury Control (1990) lists nine leading causes of injuries or death for children under the age of fourteen.  Between the ages of 5 and 14, children are more likely to be injured because of their increased physical activities and the lessening of adult supervision (Schor, 1987).  The primary cause of death or injury to children in the United States include 1) traffic accidents, 2) drowning,  3) fire and burns, 4) suffocation, 5) homicide with firearms, 6) choking, 7) unintentional firearms discharge, 8) falls, and 9) suicide with firearm and poisoning. 

Increasing children’s awareness of safety is the primary method of preventing unintentional injuries and deaths (Schor, 1987).  Children who are naturally curious and active are often unaware of potential hazards.  Including information about basic health and safety during educational programs is a first step in teaching children to identify and avoid the hazards that may lead to unintentional injury.  Because studies have shown that formal programs of instruction on health and safety do not always lead children to adopt safer and healthier behaviors (see Carlin, Taylor, & Nolin, 1998), community projects may increase children’s healthy behavior by sharing information on safe and healthy practices during informal adult-child interactions at “teachable moments” as well as during more formally planned lessons.  For example, community program leaders might use a water spill on the floor as an opportunity to help children recognize the dangers of falling when a floor is slippery.  More formal instruction may be most effective if it takes place at times when children’s interest is engaged, such as fire drills, cooking lessons, or field trips to sites such as the fire or police station.  Formal instruction also tends to be more effective if it is 1) led by a combination of peers and health experts (Bruce & Emshoff, 1992); and 2) intentionally involves the child’s family in the educational efforts (St Pierre et. al, 1997).
 

Suggested Indicators

The following are some appropriate indicators of positive program outcomes for children in the area of awareness of health, safety, and fitness, based on the NCEO model (Ysseldyke & Thurlow, 1993), as adapted for community-based programs by the Children’s Outcome Work Group.  The appropriateness of any given indicator for your program evaluation depends on the age of the children you serve, the setting, and the goals and activities of your particular program.
 

• Percent of children who are aware of the potential dangers of drugs, alcohol, and tobacco
• Percent of children who are aware of the risks of unintentional injury and ways of reducing those risks
• Percent of children who are aware of the importance of nutrition, physical fitness, and basic health care to overall physical health

Summary

In order to help children better care for themselves, State Strengthening community-based programs should consider integrating basic health and safety instruction into their basic curriculum.  Educational programs can increase children’s knowledge of basic health and safety needs through both formal and informal instruction.  Many school-based and community-based programs and schools can also improve children’s physical health indirectly by providing their parents or guardians with information to help them modify unsafe behaviors and make environments and activities safer for the children.  Through this two-pronged approach of educating children and parents, children can begin to develop individual responsibility for their safety and health needs (Kann, et al, 1995).
 

References

Bruce, C., & Elmshoff, J.  (1992).  The SUPER II program: An early intervention program.  Journal of Community Psychology (Special Issue — Programs for Change: Office for Substance Abuse Prevention demonstration models), 10 - 21.

Carlin, J. B., Taylor, P., & Nolan, T. (1998).  School based bicycle safety education and bicycle injuries in children: a case-control study.  Injury Prevention, 4, 22-27.

Cushman, R.,  Down, J., MacMillan, N., & Waclawik, H.  (1991).  Helmet promotion in the emergency room following bicycle injury:  A randomized Trial.  Pediatrics, 88, 43-47.

Division of Injury Control, National Center for Environmental Health and Injury Control, Centers for Disease Control and Prevention.  (1990).  Childhood injuries in the United States.  American Journal of the Diseases of Child, 114, 627-646.

Dykeman, C., & Nelson, J. R.  (1996).  Students’ evaluations of the effectiveness of substance abuse education: The impact of different delivery modes.  Journal of Child & Adolescent Substance Abuse, 5, 43 - 62.

Hall, N. W., & Zigler, E.  (1997).  Drug-abuse prevention efforts for young children:  A review and critique of existing programs.  American Journal of Orthopsychiatry, 67, 134 - 143.

Hendricks, C. M. & Reichert, A.  (1996).  Parents’ self-reported behaviors related to health and safety of very young children.  Journal of School Health, 66, 247-251.

Kann, L., Collins, J. L., Pateman, B. C., Small, M. L., Ross, J. G., & Koble, L. J.  (1995).  The school health policies and programs study (SHPPS): Rationale for a nationwide status report on school health programs.  Journal of School Health, 65, 291-294.

LoSciuto, L., Freeman, M. A., Harrington, E., Altman, B., & Lamphear, A.  (1997).  An outcome evaluation of the Woodrock Youth Development Project.  Journal of Early Adolescence, 17, 
51 - 66.

Schor, E. L. (1987).  Unintentional injuries:  Patterns within families.  American Journal of the Diseases of Children, 141, 1280.

Sheps, A.,  & Evans,  F. S. (1987).  Epidemiology of school injuries:  A 2-year experience in a municipal health department.  Pediatrics, 79(1), 69-75.

St. Pierre, T. L., Mark, M. M., Kaltreider, D. L., & Aikin, K. J.  (1997).  Involving parents of high-risk youth in drug prevention: A three-year longitudinal study in boys & girls clubs.  Journal of Early Adolescence, 17, 21 - 50.

Ysseldyke, J. E., & Thurlow, M. (1993, October). Developing a model of educational outcomes (NCEO Report No. 1). Minneapolis, MN: University of Minnesota, College of Education, National Center on Educational Outcomes.
 
 

MEASURES:  Is Aware of Basic Safety, Fitness, and Health Care Needs

Substantial research evidence indicates that comprehensive health education programs do increase children’s awareness of basic safety, fitness, and health care needs somewhat (e.g., LoSciuto et. al, 1997; Dykeman & Nelson, 1996; Bruce & Emshoff, 1992).  Because the content of health education curricula differ from program to program, however, standardized assessments of children’s knowledge about health, safety, and fitness are difficult to identify (Hall & Zigler, 1997).

This is not to suggest that awareness of basic safety, fitness, and health care needs is impossible to assess.  Children’s knowledge can be evaluated using locally developed measures, with questions about the specific content presented.  To be most effective, such measures should use pretest - post test comparisons to confirm that the health education efforts have actually increased children’s health and safety knowledge.

In many cases, school records may be an existing source of data about children’s health and safety knowledge.  Children who have received formal health education or substance abuse prevention courses during school may have taken classroom tests to assess their knowledge of the information covered.  Scores on such classroom tests may provide State Strengthening projects with some information about what children know.  Keep in mind, however, that a classroom test measures knowledge at a given point in time.  If the test was not given recently, it may not provide an accurate index of children’s current knowledge.

When assessing children’s knowledge of basic health, fitness, and safety, it is also important to recognize that knowledge does not always translate into behavior.  Children who know more about the risks of certain types of behavior are not necessarily less likely to engage in that behavior.  Thus, measures of a child’s knowledge should not be used as indicators of behavior change.
 

Physical Health Outcomes

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