Kendy Espinoza and her son Emmanuel look through the book "What to… (Mariah Tauger / Los Angeles…)
Spanish-speaking parents filled the cafeteria at Moffett Elementary School in Lennox earlier this month to watch Lorena Marin, a parent coordinator and literacy coach, demonstrate how to use a digital thermometer and liquid-medicine dispenser.
"What do you do when your child is choking?" Marin asked the crowd of about 50, some toting babies.
Get them to hold their arms up or look at a bird in the sky, parents said. Marin pointed to a section in a simply worded medical reference book that each had received that morning as part of the program. The book explained in Spanish about choking hazards and resuscitation.
"If you tell them to look at the bird," Marin said, "your baby could die looking at a bird."
During the last decade, UCLA health experts have helped Head Start coordinators train 45,000 low-income families in 39 states to use basic tools including reference books, digital thermometers and liquid medical dispensers to treat their children and avoid unnecessary visits to doctor's offices and emergency rooms. Now they are expanding to include training sessions at school districts.
Yet only 1,500 families in California have been trained, despite the fact that the state is home to the largest Head Start population in the country, about 108,000 children.
"The challenge for Head Starts is there's so much going on in early education that programs are slow in adopting even great new innovative programs," said Rick Mockler, executive director of the Sacramento-based California Head Start Assn.
So far, 13 of the state's roughly 180 Head Start programs have sponsored training sessions, including some in Pasadena, Santa Clara and San Francisco.
"A lot of them are already over-stretched and overburdened," said Ariella Herman, research director for the UCLA/Johnson & Johnson Health Care Institute, which coordinates the training. "Those who did it were really leaders who understood that bringing health literacy to their families would really be a benefit."
The Lennox School District, in an unincorporated neighborhood just east of LAX, was the first district in the country to host the training, Herman said. The training was funded by the nonprofit Los Angeles County Education Foundation.
The program costs about $100 per family, an expense covered by participating Head Starts or districts. Herman estimates that the program saves Medi-Cal and other public healthcare providers about $550 per family by reducing emergency room and clinic visits.
A UCLA study showed that from 2002 to 2006 the program reduced participants' emergency room visits by 58%, doctor's visits by 42% and missed school days by 29%.
New Mexico Head Start programs taught 5,000 families using a 2007 grant from pharmaceuticals giant Pfizer. Washington state funded training for 6,800 Head Start families during the last three years.
At Seattle's Denise Louie Education Center Head Start, which serves many immigrants and refugees, teachers found that the program had an added benefit for the 150 families they have trained.
"It increased the parents' comfort and knowledge of how to react to their own illnesses," said Susan Valdez, the center's director of family and community partnerships.
After state funding stopped this year, the center decided to pay for the program itself, Valdez said. Officials plan to train 125 families next month.
"If you can help your parent make better choices for the child, then you will see a better attendance for the child in the classroom. That means you will spend less time following up with the parent," Valdez said.
During the Oct. 9 training session at Moffett, parents asked lots of questions. Is it better to take a child's temperature by mouth or ear? If they have a temperature of 104 degrees, should you give them a cold bath? If a baby is twice as old, should you give them twice as much medicine?
"Can you see what might be going on if we don't do this?" asked JoAnn Isken, the district's assistant superintendent of instructional services, as she watched a UCLA resident explain to parents that dosages are based on a baby's weight, not age. "This is preventing emergencies."
Maria Esther Sixtos, 45, of Lennox, a mother of five, said she has taken her 4-year-old to the emergency room several times in the last year with fevers. At least once was told she could have avoided the trip by treating him at home with Motrin and a cold bath.
After the training, she said she felt reassured, and held up her new thermometer.
"I can look and see when he has a fever what the temperature is and what that means," she said.
Teresa Dejesus, 32, of Lennox, a mother of three, said she sees many neighbors who go straight to the emergency room when their children get fevers or other minor maladies.
"They get scared," she said, and held up her book. "Now if they have questions, I can help them and give them some of the information I have."