Providing quality health education for young children can be a major challenge facing caregivers. Teaching children to cover mouths and wash hands in days filled with runny noses and constant sneezes are not easy. Overworked and overwhelmed staff can too easily fail to reinforce healthy behaviors when the opportunities arise, or discontinue healthy routines over time. Also, caregivers need constant support because adhering to rapidly changing health guidelines and immunization requirements can be frustrating.

Although most states require basic health and safety training for all staff working in licensed or registered childcare, additional training is important to reinforce the concepts and update staff on new requirements.

Concerns about Television

For many parents and early childhood educators, "television" and "healthy children" do not go together. Healthy children, many parents would say, are children who spend as little time in front of the television set as possible. Likewise, much of the childcare community still adheres to a 'no TV in childcare' philosophy, whether that care occurs in family or group homes, preschool, childcare or Head Start centers. The fears of parents and caregivers are often well founded. Research (The National Television Violence study, 1997), reports (AAP Media Education Policy Statement, 1999), and guides (NAEYC Media Violence and Children: A Guide for Parents, 1994) all describe the negative impacts of television, including increased aggression, limited imagination, and reduced sensitivity to pain and suffering of others. Given this and other data, it is understandable that the idea of using the television to support the development of healthy practices in the childcare setting might seem difficult to grasp.

Television can be good!

In the early days of television, programs such as Romper Room and Captain Kangaroo provided safe, educational messages for children. Most viewers of public television would agree that the Public Broadcasting System (PBS) also has provided educational programming that is consistently appropriate for young children.

Studies of specific programs such as Mister Rogers' Neighborhood and Sesame Street have provided concrete evidence of the positive impact viewing such programs can have on young children's pro-social behavior. In 1992, at the completion of a pilot study, the Mister Rogers' Neighborhood Child Care Partnership was launched. Twenty-five childcare centers participated in the study which provided children in those centers with opportunities to view Mister Rogers' Neighborhood as part of their daily activities. Results showed that children were kinder and less hostile toward each other, and more imaginative in their play. Child caregivers and teachers also were influenced. They lowered their voices, slowed down their pace, and used a more developmentally appropriate approach to the children in their care. These results demonstrate that positive modeling by television personalities such as Fred Rogers can translate into positive behavior in the childcare setting-by both children and adults

Bringing it all together

Research has shown that television can be used effectively to shape audience response; and if properly used, to positively influence attitudes and behavior. Appropriate television programming can motivate viewers through: modeling of healthy behaviors; producing an emotional response to a health issue; applying social pressure or influence; serving as a subconscious memory prompt, and; actively encouraging healthy behavior.

For example, in one episode of Mister Rogers' Neighborhood, Fred Rogers receives an immunization. Another segment can encourage a child to eat healthy foods, or help a child be brave enough to get an immunization. Sesame Street's A is for Asthma and Lead Away! projects can enhance parent and caregiver awareness of these health issues. Barney's Safety Video can give children easy to follow safety rules.

Health-related episodes can serve as springboards for talking about illness and safety, and engaging in creative health-related play. All three of the following components should be part of media-related health education:

• Child-oriented programming. Television or video programs on health related topics presented at the child's level.
• Training materials for staff. Developmentally appropriate health information and resources.
• Health-related activities for children. Hands-on activities that encourage children to play about health issues.

The key to success in these kinds of endeavors is understanding that television and video are only the beginning. Fred Rogers, creator, writer, and host of Mister Rogers' Neighborhood has a quote which says "television is the only electronic appliance for which the most use comes after it's turned off." The quote offers a great way to look at media--as a starting point from which learning, sharing, and even fun can begin.

If your childcare program is interested in introducing television and video programming into its activities, the steps which follow should provide some guidance to getting started.

• Be aware. Review programs carefully to determine which products and programs are appropriate for use in your childcare program.
• Think education. Consider appropriate ways to incorporate television/video content into your daily schedule/lesson plan.
• Keep it simple. Take ideas from the television program and recreate the activity. For example, ordinary products such as a paper cup, yarn, and pipe cleaner, make a great stethoscope.
• Use creative control. Stop the video player when the segment you want to show is over, or fast forward through the parts that may not be relevant.
• Encourage staff involvement. Recommend programs on adult health for your staff to reinforce their own healthy behaviors.
• Collaborate with parents. Explain to them why and how your program is using television. Encourage them to practice similar viewing habits and to plan healthy, educational activities or discussions around the programs they watch.

Simply watching television will not in and of itself support healthy care. But viewing interesting programs that promote healthy behaviors (Elmo going to the doctor, Fred Rogers making healthy snacks) and using this as a springboard for health activities will make learning about health interesting, and memorable for children and adults alike.

by Aisha White
National Coordinator
The Mister Rogers' Neighborhood Child Care Partnership

Sesame Street A is for Asthma, Sesame Street Lead Away!
Sesame Workshop, One Lincoln Plaza, New York, NY 10023; 212-875-6807; www.ctw.org

Taking Good Care of You, Going to the Doctor, Family Communications, Inc.,
PO Box 2284, Burlington, VT 05407-2284; 877-677-6437; www.misterrogers.org