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STUDY GUIDE FOR MODULE NO. 11

PARENTS AND COMMUNITY PARTNERSHIP TO PROMOTE CHILDREN’S

WELLNESS
MODULE OVERVIEW

Schools play an important role in the promotion and maintenance of their students' health. Healthy
students are better learners. But schools can't do it alone. Parents are the other crucial half of the equation to
provide the healthy start that kids need to thrive in the classroom and in life. Research clearly shows that good
nutrition and plenty of physical activity are vital to children's academic success. That's why it's so important for
schools to engage parents in school health and wellness efforts and provide parents with the knowledge,
skills, and support they'll need to maintain their children on the path of health, wellness, and academic
success.

This lesson will highlight the ways in which you can play a significant role in supporting families of
preschool children with special needs. You will learn recommendations for effective collaboration with families
and other professionals and begin to understand the additional roles and responsibilities placed on  many
families of children with special needs. 

Culture is the patterns of ideas, customs and behaviors shared by a particular people or society. These
patterns identify members as part of a group and distinguish members from other groups. Culture may include
all or a subset of the following characteristics:

Given the number of possible factors influencing any culture, there is naturally great diversity within any
cultural group. Generalizing specific characteristics of one culture can be helpful, but be careful not to over-
generalize.
 ethnicity
 language
 religion and spiritual beliefs
 gender
 socio-economic class
 age
 sexual orientation
 geographic origin
 group history
 education
 upbringing
 life experience

Culture is:
 dynamic and evolving,
 learned and passed on through generations,
 shared among those who agree on the way they name and understand reality,
 often identified ‘symbolically’, through language, dress, music and behaviors, and
 integrated into all aspects of an individual’s life.

MODULE LEARNING OBJECTIVES

At the end of this module, you should have:

1. developed strategies that facilitate collaboration with families to meet children’s nutritional needs,
including the support of breast feeding;
2. planned educational opportunities for families in the areas of health, safety, and nutrition; and
3. described ways that early childhood educators can partner with families to provide for children’s
special health care needs.

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IMPORTANCE OF PARTNERSHIPS WITH FAMILIES TO MEET CHILDRENS NUTRITIONAL NEEDS

& EDUCATIONAL OPPORTUNITIES FOR FAMILIES IN THE AREAS OF HEALTH, SAFETY, AND
NUTRITION
The School-Parent Partnership in School Wellness Initiatives
Parents want what is best for their children. They want to see that their input makes a difference in their
children's outcomes. Similarly, educators work to impact children's lives in a holistic and positive way.
Therefore, a commonality exists for school administrators, teachers, staff, and parents to work together to
support the growth of healthy and productive children. Many school districts have found that professional
development programs are needed to teach administrators and teachers the skills and knowledge they need
to help make healthy habits a routine part of how kids learn, and the skills teachers need to engage parents in
this process.

The first step in creating a culture of wellness in which parents are engaged is making student and school
wellness a priority. This necessitates the establishment of a positive relationship between school staff and
parents. This can be accomplished by having a clear school vision for parent engagement in children's health
and communicating that vision to the entire school community.

Schools should strive to:

 Create a family-friendly welcoming place for parents to contribute to the school's wellness activities,
services, and programs. Display a welcome sign, in languages spoken by all families, to greet families
and visitors.
 Train staff, including main office staff, to greet and communicate with families in ways that show that
they are valued members of the school community.
 Offer professional development opportunities for staff members to learn to work with parents and
promote parent engagement.
 Develop multiple means of two-way communication between family and school personnel.
 Investigate, via surveys or focus groups, parents' needs, interests, and ways they would like to be
involved in their children's and school's health activities
 Include questions about parents' talents and availability that may contribute to the school health
environment, as well as what health topics spark their interest. Also ask about barriers to involvement
such as work schedules, child care, and transportation.
 Plan school activities that address parents' health interests and remove identified barriers to their
participation.
 Encourage staff to model healthy behaviors in order to demonstrate a commitment to student and
family wellness during the school day and at family events.
 Build parent confidence and empowerment by creating opportunities for shared decision-making
related to school health policies, services, and programs.

Educating Families about School Wellness

Schools need to provide parents with the information and skills they need to support healthy attitudes,
behaviors, and environments for their children both at home and in school. There are many ways in which
schools can do this.
 Provide a variety of learning opportunities for families to learn about child and adolescent
development; how nutrition and physical activity impacts a student's ability to learn; how to set
expectations for appropriate healthy behavior and academic performance; and healthy cooking/fitness
tips. These topics can be addressed in a specific workshop or as a part of established activities, such
as report card pick-up day, and can be offered by school personnel or through collaborations with
community partners such as the local Cooperative Extension service.
 Hold a family health fair.
 Make information easily accessible through newsletters, handouts, phone calls, email, social media,
and school websites. Be sure to offer translated versions of this information for anyone who may need
it.
 Provide families with information about the school nutrition program.
 Provide meeting opportunities for parents at a variety of times to accommodate different work
schedules. Offer a meal and child care to eliminate these two major hurdles to family participation.

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 Offer "town hall" style meetings to solicit parent input and opinions on topics such as changes to the
school meal patterns, new curricula, or the addition of a school garden.
 Meet with the PTA/PTO to discuss school wellness.
 Place a suggestion box near the school office.
 Create a calendar that integrates wellness messages and reminders about regularly scheduled
wellness activities, such as workshops, wellness team meetings, and health screenings.
 Encourage healthy habits, such as gardening and healthy eating, which children can practice at home
with their families.
 Connect classroom learning to the home by assigning "healthy homework" such as asking students to
sample vegetables and fruits beginning with the letter of the week or color of the week; sending home
a physical activity calendar and asking students to report on what they and their family members
participated in over the weekend; recording alternate activities to screen time; offering extra credit for
participating in community health and wellness activities together, such as 5K walks/runs, visiting a
farmers market, or walking or biking to school.

Parents as Volunteers in School Wellness

Establishing a parent volunteer recruitment and training process focused on school wellness initiatives can
be very valuable. Volunteers are often skilled at organizing and networking and may have particular
connections to community resources that support wellness initiatives. Volunteers can help with classroom
activities, gardening projects, and lunch-time walks or after school exercise programs. They may serve as
mentors or tutors for school health activities or provide peer support for parents of students with special health
care needs (e.g., asthma, diabetes, or food allergies). Parent involvement is critical to a successful wellness
team. By working as part of a wellness team, parents can be the face of health and wellness initiatives in your
school, increasing peer-to-peer interaction with other parents and creating a comfortable environment in which
they can engage.

Extending School Wellness beyond the Classroom

In addition to creating a healthy in-school environment, it is important to promote healthy habits outside of
the classroom. Communicating with families and engaging community organizations to reinforce the
importance of healthy eating and physical activity when the school day ends and when school is not in
session extends the wellness environment. Organize a fun school wellness event for students, families, and
community members after school hours to further promote school wellness. Arrange for a farmer's market at
school to encourage fresh fruit and vegetable consumption and to engage local growers in school wellness.
Reach out to community organizations such as health care providers, mental health agencies, health
departments, public health organizations, university Cooperative Extension Services, YMCAs, farmers,
recreation program providers, clergy and law enforcement officers to involve them with school wellness efforts
after school hours and over the summer. Maintain newsletters, email, websites, social media, and engaging
activities to further your parent involvement efforts.

Celebrate School Wellness Successes

Successful school wellness programs, events, grants, and milestones should be celebrated with the entire
school and community at large. Local media often come out to cover exciting school events. Such recognition
will help sustain the momentum and motivation of parents, students and school personnel to work together for
school health.

Building Family and Community Involvement through School Gardens and Farm-to-School Efforts
School garden activities and Farm to School (FTS) programs can create a community environment where
students, teachers, and families learn healthy habits together. "FTS is the practice of sourcing local foods for
schools and providing agricultural health and nutrition education opportunities such as school gardens, farm
field trips and cooking lessons. FTS improves the health of children and communities while supporting local
and regional farmers."

School gardens are interactive classrooms for students to learn first-hand how to plant, tend and harvest
fruits, vegetables, and herbs. Research shows that children are much more likely to try a new fruit or
vegetable they have grown themselves. Gardening is also fun physical activity.

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Family members, including grandparents, who have familiarity with, and a love of gardening, offer
invaluable multi-generational and cultural enhancements to the gardening experience. Interested family
members can become involved by:

 Helping in the garden during the school year and summer months.
 Washing and preparing produce for tasting, and if necessary buying locally grown vegetables to
supplement what is grown, so there is enough for all children to taste.
 Reading a book at story time that links the garden to healthy behaviors.
 Assisting with cooking and/or nutrition lessons in the classroom.
 Sharing recipes with the entire school community that feature garden-grown produce.
 Writing school newsletter or website articles highlighting the activities in the garden.
 Fundraising to support the school garden.

LEARNING ACTIVITY 1

Make a brochure of online resources about young children’s health, nutrition, and safety for parents

IMPORTANCE OF PARTNERSHIPS WITH FAMILIES TO MEET CHILDRENS SPECIAL HEALTH

CARE NEEDS

Families of Young Children with Special Needs

Preschoolers with special needs are members of our communities, programs, and families and it is our
responsibility to provide high-quality, inclusive support for these children and their families. While these
families often experience additional situations and stressors, they have hopes, dreams, and concerns for their
children just like other families. You can positively impact families with a preschooler with special needs by
empowering them with knowledge, empathizing with their feelings, and collaborating with other support
professionals in their lives.

Working with Families of Children with Special Needs

Establishing meaningful relationships with families is a critical part of your work, and your communication
is especially important when working with families with preschoolers with special needs. Some preschool
children will enter your program with known special needs, and other families will learn that their child has a
disability or is delayed while enrolled in your program. Families with eligible preschool-age children may
receive special education services and have an individualized education program (IEP). Others may only
receive support from a medical center, and some families will be involved with multiple systems of support.
Regardless, families can be overwhelmed by what feels like a constant flow of suggestions and appointments
to help their children learn and develop. These families may need more help supporting their children and may
turn to you, or others in your program, for assistance with connecting to services or agencies outside of your
program. It may be helpful to form relationships with outside agencies so you, or trainers and administrators in
your program, have up-to-date information on how to make a referral and the types of services offered.
Positive interactions with families and other professionals can decrease families’ stress and improve their
well-being. 
Families with preschoolers with special needs may go through various evaluation processes and may ask
you to complete questionnaires or provide input at the request of a doctor, specialist, or teacher. Other
professionals rely on this input, especially when they have limited amounts of time with children compared to
program staff who often spend many hours each week caring for, educating, and observing children. This
information can be used to determine if a child has a specific condition, support the child outcomes summary
(COS) process, determine eligibility for specific services, and develop goals for an individualized education
program (IEP). You, or a trainer or administrator from your program, may be asked to participate in an  IEP
review, a time when the team of professionals and families come together to assess progress, create new
outcomes, and determine needed services. Preschool children with IEPs may attend your program and their
local education agency (LEA). Services on an IEP may only be provided at the LEA, or interventionists and
related services personnel may “push in” and provide services within your program. Regardless of how
special education services are delivered, working with professionals from outside agencies helps things run
smoothly for families and ensures that all of the professionals and caregivers in a child’s life are
communicating. This lessens family stress by reducing the need for primary caregivers to act as the in-
between messenger of important information.

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Effective Practices
The first step to establish strong relationships with families of children with special needs is to spend time
discovering their wishes and concerns for their children and to learn about the meaningful activities they
participate in at home. Maintaining this communication throughout a child’s time in your program is essential.
Ask questions to learn about strategies that work at home and consider using them in your classroom.
Through your interactions you can build trust so both you and families feel comfortable sharing children’s
strengths and if there are concerns (Sandall, Hemmeter, Smith, & MCLean, 2005). Before communicating
concerns with families, it may be helpful to discuss with a coach, trainer, or administrator your plan to share
this information using family-centered practice. Be prepared for families to react in a variety of ways, and
know how you can offer support if they choose to take specific steps or access other agencies and resources.
For families already receiving support from other professionals, ongoing communication with both families and
professionals is critical to maintain consistency between program and home environments. When all the
caregivers and professionals in a child’s life are consistently using effective strategies to promote
development and outcomes, children are more likely to benefit and learn new skills.
In your collaboration with families, acknowledge and respect their strengths and unique background, while
realizing their ability to make decisions that are right for them (Hanson & Lynch, 2004). This means that when
family wishes and decisions are different from what you would recommend, you will respond to the family’s
decisions with respect. Ultimately, meaningful communication and relationship-building will enrich the process
for both yourself and families.
Take a look at the following guidelines that reflect family-centered practice.. Then, think about which of
these you can use in your work with families of children with special needs (Turnbull, Turbiville, & Turnbull,
2000):
 Recognizing the family as a constant in the child’s life; caregivers and service systems may come
and go
 Facilitating collaboration between families and professionals
 Honoring and respecting family diversity in all dimensions (cultural, racial, ethnic, linguistic, spiritual,
and socioeconomic)
 Recognizing family strengths and the different approaches that families may use to cope
 Sharing unbiased and honest information with family members on an ongoing basis
 Encouraging family-to-family support and networking
 Acknowledging and incorporating the developmental needs of the child and other family members
into your practice
 Designing and implementing services that are accessible, culturally and linguistically respectful and
responsive, flexible, and based on family-identified needs
There are many ways you can demonstrate respect and consideration for families of children with special
needs in your classroom. Consider the following:
 Acknowledge that families know their child best and ask them questions about services or
resources that may be helpful to you.
 Establish ongoing communication between home and school. Communication journals are a great
way to maintain communication. These are usually sent home with the child and returned the next
day. Teachers can share noteworthy observations or events, and families can respond to those or
share their own news or reflections. While communication journals can be used with families of all
children in your classroom, they can be an especially valuable tool in establishing consistency
between home and school environments for children with special needs.
 Incorporate children’s books in your classroom library that reflect consideration of multiple abilities
and differences.
 Invite families to talk about their children with special needs. For example, a family member may
come in your classroom and talk about their child’s use of adaptive equipment (e.g., braces,
wheelchair, or a communication device). The family member may explain the use of equipment,
which can help children and other families understand aspects of their life. This also promotes
acceptance of differences.
 Be a team player! Work collaboratively with families and other professionals who may be involved in
the delivery of services to children with special needs.

If disagreements or miscommunication arise, consider the following:

 Remind yourself that your role is to support families’ hopes and dreams for their child.

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 Be patient. Dealing with a child with special needs may be challenging at times, and family
members need time to navigate this experience at their own pace.
 Avoid making judgments for families and their children.
 Consider difficult times as opportunities to build trust between yourself and families.
 Question your assumptions about working with families of children with special needs and urge
other professionals you know to do the same.
 Talk with your trainer, supervisor, or coach when in doubt about any aspect of your work with
families.

LEARNING ACTIVITY 2

Design a parent’s orientation program about children’s health, nutrition, and safety

WAYS THAT CULTURE CAN PLAY A ROLE IN CHILDREN’S WELLNESS

Culture: The Hidden and the Obvious

Culture has been described as an iceberg, with its most powerful features hidden under the ocean surface
as illustrated in Figure 1. Explicit cultural elements are often obvious but possibly less influential than the
unrecognized or subconscious elements.

Figure 1: Elements of culture

Source: Slide 6, Introduction to clinical cultural competence. Clinical Cultural

Competency Series. Courtesy of the Centre for Innovation & Excellence in Child
& Family Centred Care at SickKids Hospital.

The Cultural Continuum

Culture is commonly divided into two broad categories at opposite ends of a

continuum: collectivistic or individualistic. Most cultures fall somewhere between the two poles, with
characteristics of both. Also, within any given culture, individual variations range across the spectrum. Still,
being familiar with characteristics of collectivistic and individualistic cultures is useful because it helps
practitioners to ‘locate’ where a family falls within their cultural continuum and to personalize patient care.  

Collectivistic and individualistic cultures can give rise to different views on human health, as well as on
treatment, diagnoses and causes of illness. Depending on where a patient ‘fits’ along their cultural continuum,
including  extended family in discussions about disease origin, diagnosis and treatment may be helpful.
Consent for certain diagnostic and therapeutic interventions may be needed from extended family members.

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Collectivistic Individualistic

Focus on “we” Focus on “I”

Promote relatedness and interdependence Value autonomy

Connection to the family View ability to make personal

individual choices as a right

Value respect and obedience Emphasize individual initiative and

achievement

Emphasize group goals, cooperation and harmony Lesser influence of group views and
values, and in fewer aspects of life
Greater, broader influence of group views and
values

Source: Adapted from slide 11, Cross-cultural communication.Clinical Cultural Competency Series. Courtesy of the
Centre for Innovation & Excellence in Child & Family Centred Care at SickKids Hospital, Toronto.

Impact of Culture on Health

Health is a cultural concept because culture frames and shapes how we perceive the world and our
experiences. Along with other determinants of health and disease, culture helps to define:
 How patients and health care providers view health and illness.
 What patients and health care providers believe about the causes of disease. They may not accept a
diagnosis and may even believe they cannot change the course of events. Instead, they can only
accept circumstances as they unfold.
 Which diseases or conditions are stigmatized and why. In many cultures, depression is a common
stigma and seeing a psychiatrist means a person is “crazy”.
 What types of health promotion activities are practiced, recommended or insured. In some cultures
being “strong” (or what Canadians would consider “overweight”) means having a store of energy
against famine, and “strong” women are desirable and healthy.
 How illness and pain are experienced and expressed. In some cultures, stoicism is the norm, even in
the face of severe pain. In other cultures, people openly express moderately painful feelings. The
degree to which pain should be investigated or treated may differ.
 Where patients seek help, how they ask for help and, perhaps, when they make their first approach.
Some cultures tend to consult allied health care providers first, saving a visit to the doctor for when a
problem becomes severe.
 Patient interaction with health care providers. For example, not making direct eye contact is a sign of
respect in many cultures, but a care provider may wonder if the same behavior means her patient is
depressed.
 The degree of understanding and compliance with treatment options recommended by health care
providers who do not share their cultural beliefs. Some patients believe that a physician who doesn’t
give an injection may not be taking their symptoms seriously.
 How patients and providers perceive chronic disease and various treatment options.
Culture also affects health in other ways, such as:
 Acceptance of a diagnosis, including who should be told, when and how.
 Acceptance of preventive or health promotion measures (e.g., vaccines, prenatal care, birth control,
screening tests, etc.).
 Perception of the amount of control individuals have in preventing and controlling disease.
 Perceptions of death, dying and who should be involved.

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 Use of direct versus indirect communication. Making or avoiding eye contact can be viewed as rude
or polite, depending on culture.
 Willingness to discuss symptoms with a health care provider, or with an interpreter being present.
 Influence of family dynamics, including traditional gender roles, filial responsibilities, and patterns of
support among family members.
 Perceptions of youth and aging.
 How accessible the health system is, as well as how well it functions.

What Health Professionals Can Do?

Health care providers are more likely to have positive interactions with patients and provide better care if
they understand what distinguishes their patients’ cultural values, beliefs and practices from their own.

The following suggestions may help you care for and communicate with patients:
 Consider how your own cultural beliefs, values and behaviors may affect interactions with patients. If
you suspect an interaction has been adversely affected by cultural bias – your own or your patient’s –
consider seeking help.
 Respect, understand and work with differing cultural perceptions of effective or appropriate treatment.
Ask about and record how your patients like to receive health care and treatment information.
 Where needed, arrange for an appropriate interpreter. 
 Listen carefully to your patients and confirm that you have understood their messages.
 Make sure you understand how the patient understands his or her own health or illness.
 Recognize that families may use complementary and alternative therapies. For appropriate, specific
conditions, remind them that complementary and alternative medicine use can delay biomedical testing
or treatment and potentially cause harm.
 What are their language skills? 
 Negotiate a treatment plan based on shared understanding and agreement.
 Find out whether a patient or family would benefit from spoken or visual messaging for reasons of
culture or limited literacy.

Providing health care to different cultural groups

Developing a guide to help health professionals understand cultural preferences and characteristics
around the world would be a mammoth undertaking. Also, any such document would be biased by the
authors’ own cultural perspectives.

However, health care providers should learn skills around cultural competence and patient-centered care.
Such skills can be a compass for exploring, respecting and using cultural similarities and differences to
improve quality of care and patient outcomes.
Above all, remember that:
 Cultures are dynamic.
 There is huge diversity within any culture.
 Even when you think you understand one culture, it will have evolved or you will have identified
exceptions. 

LEARNING ACTIVITY 3

Propose a project/program with the barangay

SUMMARY

Parent engagement in schools is defined as parents and school staff working together to support and
improve the learning, development, and health of children and adolescents. Parent engagement in schools is
a shared responsibility in which schools and other community agencies and organizations are committed to
reaching out to engage parents in meaningful ways, and parents are committed to actively supporting their
children’s and adolescents’ learning and development. This relationship between schools and parents cuts
across and reinforces children’s health and learning in multiple settings—at home, in school, in out-of-school
programs, and in the community.

Navigating the health care system can be challenging for anyone. For families of children with special

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health care needs (CSHCN), it can be even more challenging. By partnering with providers, families have
experienced fewer frustrations, increased satisfaction with providers, and comfort in knowing that their child’s
care is being coordinated by caring and compassionate providers. Families should be recognized as experts
and engaged as active participants in their child’s care. When this is done, providers and families gain mutual
respect and trust for one another. By increasing provider’s understanding of the child’s and family’s needs,
meaningful partnerships are developed.

When families are experiencing emergent health needs and are fearful for their child’s health and safety, it
is critical for providers to understand the extreme stress surrounding that and be compassionate to the
family’s needs and feelings. Families of CHSCN are familiar with what is typical for their child and when
something is not right, providers who acknowledge the family perspective and work in partnership with the
family can be a blessing.
 Culture is a pattern of ideas, customs and behaviors shared by a particular people or society. It is
constantly evolving.
 The speed of cultural evolution varies. It increases when a group migrates to and incorporates
components of a new culture into their culture of origin.
 Children often struggle with being ‘between cultures’– balancing the ‘old’ and the ‘new’. They
essentially belong to both, whereas their parents often belong predominantly to the ‘old’ culture.
 One way of thinking about cultures is whether they are primarily ‘collectivist’ or ‘individualist’. Knowing
the difference can help health professionals with diagnosis and with tailoring a treatment plan that
includes a larger or smaller group.
 The influence of culture on health is vast.  It affects perceptions of health, illness and death, beliefs
about causes of disease, approaches to health promotion, how illness and pain are experienced and
expressed, where patients seek help, and the types of treatment patients prefer. 
 Both health professionals and patients are influenced by their respective cultures.
 Cultural bias may result in very different health-related preferences and perceptions. Being aware of
and negotiating such differences are skills known as ‘cultural competence’. This perspective allows
care providers to ask about various beliefs or sources of care specifically, and to incorporate new
awareness into diagnosis and treatment planning. 
 Demonstrating awareness of a patient’s culture can promote trust, better health care, lead to higher
rates of acceptance of diagnoses and improve treatment adherence.

REFERENCES

Brandt, R. (1989). Strengthening partnerships with parents and community. Educational Leadership, 47(2).
Davies, D. (1991). Schools reaching out: Family, school, and community partnerships for student success. Phi
Delta Kappan, 72(5), 376-382.
Davies, D., Burch, P., & Johnson, V. R. (1992). A portrait of schools reaching out: Report of a survey of
practices and policies of family-community-school collaboration. Boston, MA: Center on Families,
Communities, Schools and Children’s Learning.
https://www.cdc.gov/healthyyouth/protective/parent_engagement.htm
Epstein, J. L., Coates, L., Salinas, D. C., Sanders, M. G., & Simon, B. S. (1997). School, family, and
community partnerships: Your handbook for action. Thousand Oaks, CA: Corwin Press.
Frede, E. (nd). Getting involved: Workshops for parents. Ypsilanti, MI: High/Scope Press.
Galen, H. (1991). Increasing parental involvement in elementary school: The nitty-gritty of one successful
program. Young Children, 46(2), pp. 18-22.
Powell, D. R. (1989). Families and early childhood programs. Washington DC: National Association for the
Education of Young Children.
https://www.virtuallabschool.org/preschool/family-engagement/lesson-4
https://www.kdheks.gov/shcn/download/Comm_Partner.pdf
University of Minnesota, Center for Advanced Research on Language Acquisition. What is culture?
Nova Scotia Department of Health, Primary Health Care Section, 2005. A cultural competence guide for
primary health care professionals in Nova Scotia.
Kodjo, C. Cultural competence in clinician communication. Paediatri Rev 2009;30(2):57-64.
University of Washington Medical Centre. Communication Guide: All Cultures. Culture Clue for Clinicians,
2011

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