Head Start Health Managers Descriptive Study
Appendix E
Head Start Teacher, Family Service Worker, and Home Visitor Semi-Structured Interview Protocol
March 6, 2012
NOTE: This interview protocol is annotated to show (1) headers for each module and the objective for that section; and (2) question numbers and instructions to the interviewer (in red).
OMB No.: XXXX-XXXX
Expiration Date: MM/DD/YYYY
The Office of Head Start, Administration for Children and Families (ACF) within the Department of Health and Human Services (DHHS), is funding a Head Start Health Managers Descriptive Study. This study is being conducted by the RAND Corporation. The purpose of the study is to provide a current snapshot of health-related activities and programming within Early Head Start (EHS) and Head Start (HS) programs, to better understand the context in which the health service area operates, and to identify the current needs of health managers and health staff as they work towards improving the health of HS children, parents and staff. The objectives of the survey are to:
Describe the characteristics of health managers and related staff in HS and EHS programs;
Identify the current landscape of health services being offered to children and families;
Determine how health initiatives are prioritized, implemented, and sustained; and
Identify the programmatic features and policy levers that exist to support health services including staffing, environment, and community collaboration.
This study is descriptive; it is not designed to capture individual child or family data or performance standards compliance. Data from this study will not be used for monitoring purposes. Instead this study will provide the Office of Head Start with a picture of what Head Start programs are working on and the areas in which further assistance may be needed.
As part of this study, we asked all health managers within EHS/HS programs to complete an on-line survey. We are also conducting interviews with a small number of health managers, family service workers, teachers and home visitors to gain a better, more in-depth understanding of the health service area within HS. This phone interview will take about 45 minutes.
The risk to participation in this study is minimal. In any written reports of the data obtained from this survey, your responses will be combined with others and reported together. If quotations are used in any reports, they will not be connected to an individual or grantee. Identifiable information that you provide (e.g., name, program) will not be shared with anyone outside of the RAND project staff without your permission, except as required by law. At the end of the study, we will destroy any information that identifies you as a participant. There may be questions for which you do not have answers, but as stated earlier, we will not identify your name in any report.
Although there are no direct benefits to you for answering the following questions, your participation in this study will provide information that will help Head Start improve the health service area and the support that you receive to enhance your health programming.
Taking part in this survey is voluntary and you may choose to skip any questions that you do not want to answer. While your participation is voluntary, we do hope you will decide to contribute to this important study. Your participation is extremely important to ensure that we capture what is occurring in all Head Start programs.
If you have any questions or comments about the study please contact Lynn Karoly (Lynn_Karoly@rand.org, 703-413-1100 x 5359) or Laurie Martin (Laurie_Martin@rand.org, 703-413-1100 x 5083). If you have any questions about your rights as a research participant, you may contact Tora Bikson, Administrator, RAND Human Subjects Protection Committee by phone at (310)393-0411 or by email: tora_bikson@rand.org
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is XXXX-XXXX. The time required to complete this information collection is estimated to average 45 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.
Do you agree to participate in this study?
Yes → proceed to survey
No → Thank you for your consideration
OBJECTIVE OF MODULE A. To obtain contact information of teacher, home visitor, or family service worker.
Interviewer: Before we begin, it would be helpful to obtain some information on your background and role in the Head Start program.
CON1: Name
_______________________________________
CON2: Please
indicate your role in the Head Start program:
a. Classroom teacher b. Family Service Worker c.
Home Visitor
CON2a. Do you work in the home with families?
Yes
No
How often do you go to the home?
Several times a week
Once a week
A few times a month
Once a month
Every few months
Annually
CON3: Head Start
Program Name _______________________
CON4: How long have
you worked in this Head Start program in this role?
_____________ years
CON5: How long have you worked
in Head Start programs, whether in this role or in another program?
(cumulative)
_____________
years
CON6: What is the highest grade or year of school that you completed? [FACES, collapsed response categories]. Select one.
Less than a high school diploma/equivalent (GED)
High school diploma/equivalent (GED)
Vocational/tech program after high school but no vocational/tech diploma
Vocational/tech diploma after high school
Some college but no degree
Associate’s degree
Bachelor’s degree
Graduate or professional school but no degree
Master’s degree (MA, MS, MPH, MSN, MBA)
Doctorate degree (Ph.D., Ed.D.)
Other Postgraduate Degree (Medicine/Md; Dentistry/Dds; Law/Jd/Llb; Etc.)
CON7. Please describe any health training that you have received in the past 3 years? What were the topics, how often, etc? [Interviewer check from this list, or use as probe. This also could be sent in advance.]
Physical Health /Oral Health
Diabetes
Overweight (BMI over the 85th and below the 95th
percentile) and
Obesity (BMI above the 95th
percentile)
Underweight or stunting or failure to thrive
Asthma or other lung disease
Vision conditions
Hearing conditions
Ear infections
Lead poisoning
Tuberculosis
Anemia (e.g., sickle cell, low iron)
Infectious diseases
Proper use or administration of medication, medical equipment, or medical supports
Other physical health problem (specify) ___________
Tooth decay or cavities
Other dental health problem (specify)_____________
Behavioral Health and Developmental Delay
Child neglect or abuse
Family violence
Substance abuse (e.g., alcohol, illicit drugs)
ADHD or ADD
PTSD (post traumatic stress disorder)
Depression
Anxiety
Autism spectrum disorders
Developmental delays (including language delays)
Other behavioral health problem (specify)__________
Prevention and Wellness
General health promotion or wellness
General child development
Oral Hygiene (e.g., brushing teeth)
Immunizations
Nutrition or healthy eating practices
Physical activity or fitness
Food safety
Injury prevention and safety (e.g., dog bites, motor vehicle safety)
CPR and other first aid
Preventing spread of infectious disease (e.g., hand washing, covering mouth when
cough)
Head lice
Bed bugs
Environmental concerns (e.g., pesticide, lead poisoning ,second hand smoke)
Prenatal or postpartum issues
Emergency preparedness
Universal precautions
Health literacy or health communication
Other prevention or wellness topic (specify)__________________
CON8: Did you ever have a child in your household who attended EHS/HS? [FACES]
1. Yes
2. No
CON9: Interviewer Name
______________________________
CON10: Interview Date and
Time _________________________
OBJECTIVE
OF MODULE B. To describe how the health needs of students,
particularly medically fragile children and/or those with chronic
health conditions, are met.
Interviewer: To
start, we would like to learn more about your experience in
addressing the health needs of students in the Head Start program.
This may include your experience in helping to manage the health
conditions of medically fragile students or students with chronic
illnesses (this includes range of physical and behavioral health
issues, of ranging severity).
MHN1. What has been your experience in working with children with chronic health issues or children deemed as medically fragile?
[If family service worker/home visitor who conducts home based activity] :
When you go to the home to work with families on health issues, what does this entail? What types of activities are you doing for children with chronic health issues, if any?
Probe (for teachers/family service workers/home visitors):
• What are the health issues that you see (e.g., asthma, behavioral health problems)?
• What is your role in addressing the health needs of these children? Medication administration?
• How do you work with the Health Manager or health staff to support or address the health needs of these children? (e.g., discuss in staff meetings, share classroom or home visit notes for child’s health file, other)
• How do you communicate with parents/other family members about the health issues of these students? (also probe on culture, language issues where appropriate, developing relationship with family/having a foundation/history with the family
MHN2. What factors make the process of addressing the health needs of these children easier? What factors make the process more difficult?
[For teachers]
In particular, do you have any difficultly in balancing the needs of children with health issues in your classroom, relative to conducting your class? Are there any disruptions, and if so, how is this managed? Are there benefits?
[If family service worker/home visitor who conducts home based activities]
When you go to the home to work with families, what factors make the process easy and/or difficult (Probe: safety issues, family receptivity, other)?
MHN3. What training or other resources have you had to assist you in addressing or managing the health needs of these students? Please describe where you received this, topics, how often, etc. Is this training enough? What more would you want/need?
MHN4. All children in Head Start/Early Head Start go through screenings and assessments when they enter the program.
Do you help to ensure that these screenings and assessments are completed? How do you do this?
Some children end up needing referrals and further treatment.
How do you help with referrals? With treatment? Do you help to track whether the children have completed all necessary screenings, assessments, and received treatment? How do you do this tracking? With what mechanism (child’s files, computer tracking program, etc.)?
OBJECTIVE OF
MODULE C. To describe the roles and responsibilities of the Health
Services Advisory Committee in supporting and informing the EHS/HS
health component.
Interviewer: Next, we’d
like to delve a bit more into any role that you may have on the
Health Services Advisory Committee (HSAC).
HSC1. Are you
involved in the HSAC? If so, what is your role?
[If
answer is no, skip to section D]
HSC2. How well do
you think the HSAC has performed in the following areas? Describe
successes/accomplishments in these areas:
[Note
areas should be selected based on role of teacher vs. family service
worker/home visitor]
a. Develops comprehensive health promotion programs for HS children, families, and staff
b. Helps to develop health policies and procedures that support the health goals for HS children, families, and staff
c. Engages parents in identifying and accessing sources of continuous, accessible health care
d. Supports parents in becoming advocates for their children’s health
e. Supports parents as leaders in efforts to improve the health of their community
f. Informs your program about current and emergent health issues, trends, and best practices
g. Develops long- and short-term goals and objectives and strategies for implementing services that meet the needs of the community
h. Advocates for community systems changes that support the health of the children and families in your program
i. Helps to establish ongoing, collaborative partnerships with community organizations
j. Educates health care providers, other professionals, and community
leaders or policy makers on
the needs and issues
of HS/EHS/MS/AIAN children and families
k. Other (specify)___________________________
HSC3. Sometimes
there is a real or perceived power differential between parents and
professional service providers (e.g., physicians) on the Health
Services Advisory Committee. What steps do you take to ensure that
parents have a voice at the table? Feel comfortable participating?
OBJECTIVE OF
MODULE D. To describe the planning and implementation process of
health activities within the program, including facilitators and
barriers.
Interviewer: Next, I’d like
to hear a bit more about your role in planning and/or implementing
health activities in your Head Start program (in the classroom or
home), with the Health Manager or other health staff. By health
activities, we’ll mainly focus on health promotion activities
(anything that focuses on promoting healthy behaviors, and reducing
the risk of disease or illness).
IMP1. Do you participate in implementing health promotion activities in the classroom/program? If so, what types of health promotion activities have you been a part of?
Probe:
• Health topics
• What the activity(ies) entailed (e.g., curriculum, family activity, other)• Who is part of the activity? Parents, children?
[If family service worker/home visitor who conducts home based activities]
Do you participate in implementing health promotion activities in the home? If so, what types of health promotion activities have you (do you) conducted?
Probe:
• Health topics (e.g., teeth brushing, healthy eating)
• What the activity (ies) entailed (e.g., curriculum, family activity, other)
• Who is part of the activity? Parents, children?
IMP2. Were you part of the selection of the topics and/or activities with the health staff? Describe that process. What training did you receive on the activities (probe for duration, intensity, frequency)? Was the training sufficient? What did you still need?
Probe:
• Introduction to health activity (by health manager or other health staff), training
• Prior experience with implementing health promotion activity
IMP3. When you implement health promotion activities, how do you roll-out the activity in your classroom/families home? From your perspective, what has worked well in this process? What impedes roll-out? (e.g., staff buy in, child receptivity, activity quality, parent buy in, culture/language, other?)
IMP4. What training or other supports would facilitate (or ease) future implementation of health promotion activities? (Prompt: In classroom, in home as relevant)
IMP5: Working with families:
What health needs do you see that families have?
What health topics do you work on? Are any of these parent specific? Are there health topics or needs that you feel are not being met that you would like to work on with families? What supports do you have/need for working with families?
What is challenging with working with families around health? How do you address those challenges?
What are the successes you have had in working with families? How did you get there? What supports did you use/have?
What training would be helpful for you in working with families around health?
OBJECTIVE OF
MODULE E. To describe the network of community partners and other
stakeholders that support health activities in EHS/HS and provide
other health and social services for children and
families.
Interviewer: Next, we’d like
to learn a bit more about how you engage with community health
providers and the extent to which you engage in the broader network
of community services to support your Head Start families.
[This may only be relevant for
family service workers, who may play a role in partnership
development. Please build on prior responses to determine which
questions may be appropriate.]
PRT1. Are you involved in engaging health providers to support health services in your program? To support health promotion activities in your program? If yes, what is your role? What has facilitated that process? What has made it difficult to engage health providers? What is the level of effort to engage and sustain these partnerships?
PRT2. Do you link with community health activities to support the health activities within Head Start (e.g., health fairs)? If so, how did that linkage come about (e.g., HSAC, you or staff participate in other community coalitions or boards)? If not, why not?
What about related
health supports, such as social services (employment support for
families, education, other)?
PRT3. How would you characterize your programs partnerships with community organizations to support Head Start health activities? Do you feel that your Head Start program is well-integrated into the community service network?
PRT4. Are there particular partnerships that you would like to have, and your program has not been able to forge? If so, what are they, and what has impeded that partnership to date?
OBJECTIVE OF MODULE
F. To learn more about potential needs for training and support for
the health component of the Head Start program.
Interviewer:
Finally, we would like to learn more about other training or
resources that would help you in your efforts to support health in
your Head Start program.
TSP1. What training
topics would benefit you as a [teacher/family service worker/home
visitor] in support health activities in your program? What level of
training would be helpful (duration/intensity/frequency)?
[Build
on answers from Sections B, D as relevant]
TSP2. What
other resources or support would help you in these areas:
• Addressing the needs of children living with a chronic illness, children with medical fragility
• Supporting health promotion activities in your program, in the home (if relevant)
• Addressing staff well-being or health needs of staff
• Linking with community partners to support HS health activities and education
• Other?
| File Type | application/msword |
| Author | RAND Authorized User |
| Last Modified By | DHHS |
| File Modified | 2012-11-07 |
| File Created | 2012-11-07 |