Lara Mamikonian by keara

VIEWS: 22 PAGES: 26

									***86*** CHIC Block 2 30 September 2005

Childhood Lead Poisoning Prevention in Monroe County
Lead is an abundant, non-biodegradable substance that is toxic to humans when present in certain amounts. It can adversely affect the hematopoietic, renal, nervous, endocrine, and reproductive systems. Anyone can be afflicted by lead poisoning, but it is particularly harmful to young children who are still developing and absorb it more readily than adults (CDC 1997). Lead poisoning has been a known problem in the United States for over thirty years, and many different measures have been taken since then to decrease lead exposure. Removing lead from food and beverage cans, drinking water, gasoline, plumbing systems, and household paint has resulted in a significant decline in blood lead levels in the United States. Ongoing monitoring by the Center for Disease Control’s National Health and Nutrition Examination surveys showed that the average blood lead levels in children had dropped by approximately 80% between 1976 and 1994 (CDC 2000). Healthy People 2000: National Health Promotion and Disease Prevention Objectives was released in September 1990. This national initiative to improve the health and life of all Americans set forth 319 specific objectives stratified into 22 priority areas, with priority area 11 addressing environmental health (NCHS 2000, CRISNY). Objective 11.4 had the goal of reducing the number of children with elevated blood levels (set at >15mcg/dL) from three million to 300,000. Increased screening of at-risk individuals, improvements in substandard housing units, and wide-spread public education campaigns were highly successful, although the final number of affected children (393,000) fell short of the target (NCHS 2001). Data also showed that certain populations of children and 1

geographic areas remained at disproportionately high risk for lead exposure. Healthy People 2010 thus changed the focus of its lead poisoning prevention goal to elimination of elevated blood lead levels (currently set at >10mcg/dL) in children (CDC 2005). Why is lead poisoning prevention such a vital public health goal? First, prevention, rather than treatment, of elevated blood lead levels is an important distinction to make. Chelating agents are used to treat lead poisoning by increasing urinary excretion of lead in the blood. The blood lead concentration, however, is only a small proportion of the total body burden in a poisoned child. Also, chelation therapy is not without its own set of adverse effects, and it only treats acute elevations in lead. Blood lead levels can rebound within weeks or months, necessitating repeated treatments. More importantly, chelation therapy acts only to halt disease progression; it does not improve or reverse the long-term neurological sequelae of chronic lead poisoning. In other words, once a child is discovered to have an elevated blood lead level, the damage has already been done. Prevention is the only real treatment (Ettinger 1999). Lead poisoning is a national health concern for two main reasons: 1) it is entirely preventable, and 2) it has an impact on all of society. The devastating effects of lead poisoning on individual children are well-known and include lower IQ, reduced intellectual functioning, diminished capacity to learn, higher high school drop out rates, increased antisocial behaviour, and many others. But lead poisoning also affects schools, causing lower scores on standardized tests, inadequate yearly progress, and an increased need for special education. The economy, in turn, also suffers. The state of Michigan estimated the total annual economic cost of childhood lead poisoning to be one billion dollars, based on costs of direct health care, rehabilitation, lower wages, and diminished

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earnings. They did not take into account the costs of pain, emotional suffering, or deterioration of life (MLSP). Childhood lead poisoning is a nationwide problem, but in some respects it is an even larger problem in Monroe County. The New York State Department of Health reported that 5.8% of all children screened in 1999 had a blood lead level greater than 10mcg/dL. Of all the children screened in Monroe County in 2000, 9% had elevated blood levels. Why so high? Largely for the same reason why the United States has yet to eliminate childhood lead poisoning-- certain geographic areas of Rochester have the oldest housing with more than their fair share of peeling, lead-based paint. Many of these homes house some of the poorest families, and poverty has been shown to be an important risk factor in childhood lead poisoning (CDC 2000). Ralph Spezio quotes numbers as high as 40% of children attending School #17 have lead poisoning. These areas, often referred to as the crescent (please see appendix), are the main target of much of Monroe County’s efforts to eliminate lead poisoning.

Project Description and Process ***86.5*** and I worked together on this project, which had two main components: 1. WXXI lead intervention video 2. Lead poisoning education at Jordan Healthlink WIC

WXXI Video This was a continuation of ***71*** and ***60*** project from the first CHIC block. WXXI (the local public broadcasting station) is working in conjunction with the Coalition to Prevent Lead Poisoning (CPLP) and the University of Rochester Department

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of Community and Preventive Medicine to create a ten minute video explaining the consequences of childhood lead poisoning and its prevention. The content of the video will be directed at new mothers, and ***71*** and ***60*** were charged with the task of determining where and how the video should be distributed and/or shown. They spoke with many individuals and pinpointed six locations (ABC Head Start, Local WIC programs, and prenatal classes at the four area hospitals) that were willing to distribute or show the video (please see either ***71*** or ***60*** paper for complete details). ***86.5*** and I contacted the coordinators at each location to update them on the progress of the video and the target deadline for production (October 2005). Everyone was still willing to view the video when finished and to find a way to either show it (i.e. during prenatal classes, at parent conferences at ABC Head Start, etc.) or to distribute it to parents. We informed them that we would no longer be working on the project when the video is completed, but that their contact information would be made available for the following set of students who will hopefully pick up where we left off.

Needs Assessment In week one of CHIC ***86.5*** and I attended a meeting at WXXI to discuss the video, as well as other lead poisoning prevention projects that are either in the works or in progress in the community. At this meeting we learned that we could most significantly contribute to the video by creating a program evaluation to test parents’ knowledge about lead poisoning and lead poisoning prevention both before and after viewing the video. The ultimate goal of the video is to raise awareness about the dangers of lead poisoning and what parents can do to protect their children. The program evaluation will be one way to determine if this goal is achieved or if changes are needed.

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Program Evaluation A few days after our meeting at WXXI, we were fortunate enough to enlist the help of Dr. Ann Dozier in creating the program evaluation. Neither ***86.5*** nor I have any experience in this field, and her assistance was invaluable. Our first goal (after EPRP numbers were established), was to determine the type of evaluation that would be the most useful and feasible for the video (and at this stage of the project). Through our discussions with Dr. Dozier and the population health online tutorial, we decided that an impact evaluation would be the most appropriate. Impact evaluations look at short term effects and usually measure changes in such areas as behaviours, attitudes, knowledge, and skills. In an impact evaluation, information is collected before, during, and after the program is implemented (Andrus 2005). We designed our program evaluation to gauge parents’ knowledge of lead poisoning and lead poisoning prevention. We began the process by conducting key informant interviews in the waiting room at Jordan Healthlink WIC (see below for more information on WIC) to collect baseline, qualitative data. We asked each parent several, questions to gain a sense of their knowledge of and attitudes toward lead poisoning (see appendix for transcribed interviews). Examples of questions we asked include: 1. What do the words ―lead exposure‖ and ―lead poisoning‖ mean to you? 2. How does lead affect you and your children? 3. Where do you find lead? 4. How would you know if your kids are affected? 5. Where have you heard about lead? 6. If you were worried or had questions about lead, whom would you call? 7. Do you talk about lead with family and/or friends? 8. Has your child been tested for lead? We interviewed a total of nine parents (seven mothers and two fathers) during one afternoon and very quickly picked up on a few common themes. Everyone with whom

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we spoke was aware that lead exposure was harmful for children, but very few knew why. No one knew whom to contact if they were concerned specifically about lead in their home, and several believed one could tell if lead was a problem just by seeing chipped paint and/or dirt. Lead poisoning is not commonly discussed within the community, and only a few of the parents were aware of any relatives or friends who had children with elevated blood lead levels. We met again with Dr. Dozier in week three of CHIC to share the results of our interviews and to discuss the next step of the program evaluation—developing a survey. We all agreed that a telephone survey that could potentially be used also in an interviewtype setting (i.e. face-to-face) would be the best way to reach our target population. We could not reliably count on a mail survey to be returned, and any sort of written questionnaire would require the respondents to be literate. Constructing the questions themselves was a very difficult task, and we realized right away that the survey would require multiple revisions. The first version (please see appendix) had a section for key demographic information, followed by ten questions about lead poisoning. Each question was accompanied by a list of possible, correct answers including ―I don’t know,‖ as well a space to write in other options not listed (unless it was a Yes/No question). It was designed so that the researcher would read the question to the participant, but not offer any answer choices. The researcher would then circle all answers given by the respondent and appearing on the given list, and/or enter other answers in the blank. The last five questions were based on a scenario involving a concerned neighbour. We spent another afternoon in the WIC waiting room doing a pretest of the preliminary survey. We re-evaluated question content and wording, making changes

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along the way. We asked each participant for feedback at the end. All respondents felt that the questions were clear and not too demanding, although a few people felt that they were being tested. We prefaced the survey with a small explanation of the goal of our project, and we found that specifically stating that ―I don’t know‖ was an acceptable answer helped eliminate any sort of fear or ill-feelings. The second version of our survey asked for the same demographic information and had eight questions about lead poisoning (please see appendix).

Sustainability The survey ***86.5*** and I developed is just the tip of the iceberg. It will need to be revised several times, particularly once the WXXI video is complete and the video’s goals and objectives are clear. The video should also, hopefully, be produced in Spanish and possibly American Sign Language, and the program evaluation will need to encompass these other parent populations. Administration of the survey is also a key component. Telephones and telephone service, lists of telephone numbers in target, highrisk areas, people (likely volunteers) to conduct the surveys, and others to process the data collected will all have to be arranged. Longer term goals for this project might include an outcome evaluation. While the impact evaluation ***86.5*** and I worked on is designed to examine whether or not the video increases lead poisoning and lead poisoning prevention awareness in the community (which might be evident through an increase in the number of children presenting for blood level testing or an increase in the number of calls to the housing council), an outcome evaluation will look for a decrease in the percentage of children in Monroe county with elevated blood levels.

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Aside from the program evaluation component, there are other opportunities for future students to continue this project. The video will need to be distributed to the area partners identified by ***71*** and ***60***. Contact information is located in the appendix. One might also consider designing (with WXII and CPLP) other informational items to hand out with the videos or at video screenings (e.g. magnets or pens/pencils with the housing council telephone number on them, etc.).

WIC The Special Supplemental Nutrition Program for Women, Infants, and Children is known by most as the WIC Program (or just ―WIC‖). It is a Federal grant program maintained by the Food and Nutrition Service with a mission to ―to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care.‖ WIC was established in 1972 and serves 45% of all infants born in the U.S. Women and children on Medicaid are automatically eligible (from an income standpoint) to apply for WIC benefits (FNS). WIC participants are generally at higher risk for lead poisoning than non-WIC participants in a given area, including Monroe County.

Needs Assessment ***86.5*** and I met with Dr. Richard Kennedy, a family practice physician at Jordan Health Center, in week one of CHIC and brainstormed various ideas to promote lead poisoning prevention in the community. The three of us went to the Jordan Healthlink WIC on Upper Falls Road to meet with their coordinator, Sasha Paduano.

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Sasha had previously met with ***71*** and ***60***, and WIC had agreed to show and distribute the WXXI video when available. Sasha also had a Microsoft Power Point presentation on lead poisoning prevention created by ***71*** and ***60***, as well as Rochester-specific lead poisoning brochures originally designed by two students working with Dr. Kristina Korfmacher at the University of Rochester Environmental Health Sciences Center. ***71*** and ***60*** had edited, updated, and distributed this pamphlet not only to WIC, but to many of their other partnerships as well. Although ***71*** and ***60*** had simplified the brochure, Sasha felt that it was still too complicated and difficult to understand for the parents participating in WIC. She also mentioned that she wasn’t sure what she was supposed to do with the Power Point presentation, but that perhaps it could be used to run a lead in-service for her staff, which would be very helpful. We noticed that the waiting room at the Jordan Healthlink WIC had colourful posters on breastfeeding and nutrition, but only had one black and white notice about the New York State blood lead level testing requirements taped to the front desk window. Sasha suggested not only creating a display on lead poisoning for the waiting room, but organizing an interactive presentation to do with the parents once or twice during the month.

Lead Poisoning Education ***86.5*** and I had an ambitious list of ways to raise lead poisoning awareness in the WIC participant population during our CHIC block. Unfortunately, we ran into some problems along the way. Creating the program evaluation turned out to be much more time consuming than we expected, and more afternoons were spent at WIC to work on that aspect of the project than any other. We were also never able to arrange the staff

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in-service. Secondly, we planned to obtain ready-made, colour posters on lead poisoning prevention from the New York State Department of Health, but multiple attempts to get in touch with the Monroe County Department of Health Lead Program contact failed. ***86.5*** made numerous telephone calls and left messages that were never returned. We had also hoped to procure baby bibs that say ―At One and Two Testing for Lead is What to Do!‖ Dr. Kennedy had a few in his office, and he suggested displaying one on a stuffed animal in the WIC waiting room and handing them out to the mothers, which everyone thought was an excellent idea. We were successful in redesigning the Rochester-specific lead poisoning prevention brochure. The original brochure was a double folding document loaded with information and statistics. We changed it to a single fold and included only the basic, essential information on where lead is found, how children get lead poisoning, and how to keep your child safe, along with contact numbers (please see appendix). We printed and folded 100 copies on coloured paper and gave them to the Upper Falls WIC office to distribute.

Sustainability This part of our CHIC project (which was also, in essence, a continuation of ***71*** and ***60*** project) has multiple sustainable features. Sasha Paduano gave us a short list of relatively simple things that could be done at WIC to promote lead poisoning prevention and that could easily be the focus of a CHIC project. Getting the resources from the Department of Health to set up a display in the waiting room, getting handouts (like the bibs) and creating an interactive presentation for the parents, and holding an in-service training session on lead poisoning for the WIC staff are all things

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that still need to be done and that would be very beneficial to the community. Furthermore, ***86.5*** and I purposefully distributed only a small number of our revised brochures to WIC (and not to any other locations) to ―test‖ them out. Another part of the project could involve interviewing parents in the waiting room and asking their opinion of the pamphlet to see if the information is clear and if they consider it useful. Asking the staff the same questions would also be helpful. Further revising the brochure based on the feedback and then distributing it to more locations would be the ultimate goal.

Impact on the Community The WXXI video project is having, and will continue to have, a huge impact on the community. The interviews we conducted at WIC showed that there is an overwhelming need for the video and for other resources to increase lead poisoning and lead poisoning prevention awareness. It was really quite staggering to see just how little the mothers and fathers at WIC knew about the subject, or how misinformed some of them were. If more children in our high-risk areas have their blood lead levels tested and more problem homes are inspected and fixed, Monroe County could reach the Healthy People 2010 goal of eliminating childhood lead poisoning. This would benefit individual children, schools and the economy, and provide amazing, positive change for our community.

Personal Impact

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The meeting ***86.5*** and I attended at WXXI in week one had the most impact on me. I don’t know that I have ever before been in a room full of adults from several different organizations that exuded so much energy and excitement. Everyone was so eager to begin production on the video and get it out to as many people as possible. Everyone involved in the project has such unwavering faith that now, finally things are being done. Now, finally we have a chance to keep children in our area from being harmed by a completely preventable disease. This project also had an impact on me because my own lack of knowledge about lead poisoning prevention was shameful, and I never realized how permanent the effects are. My only regrets with this project are that we could not accomplish more (especially at WIC) and that we won’t be able to see the video project through to the end. I hope that this project will be continued in subsequent CHIC blocks as there is still much to do and this is one area where we can truly make a difference in the community.

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Works Cited
Andrus, Noelle. Population Health Online Tutorial. University of Rochester. 2005. Accessible via Blackboard at: http://bb.urmc.rochester.edu. Capital Region Information Service of New York (CRISNY). Healthy People 200 Fact Sheet. March 1994. Available at: http://www.crisny.org/health/us/health7.html. Centers for Disease Control and Prevention (CDC). Blood lead levels in young children-- United States and selected states, 1996-1999. MMWR. 22 Dec 2000; 49(50):1133-1137. Available online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4950a3.htm. Centers for Disease Control and Prevention (CDC). Preventing Lead Poisoning in Young Children. Atlanta: CDC; 2005. Available online at: http://www.cdc.gov/nceh/lead/Publications/PrevLeadPoisoning.pdf Centers for Disease Control and Prevention (CDC). Update: Blood lead levels-- United States, 1991-1994. MMWR. 21 Feb 1997; 46(07):141-146. Available online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00048339.htm. Center for Governmental Research Inc (CGR). Lead Poisoning Among Young Children in Monroe County A Needs Assessment, Projection Model, and Next Steps. May 2002. Available online at: http://www.monroecounty.gov/documentView.asp?docID=2052. Coalition to Prevent Lead Poisoning. Website: http://www.leadsafeby2010.org. Ettinger, AS. Chelation therapy for childhood lead poisoning: does excretion equal efficacy? Harvard Reviews in Pharmacoepidemiology. 1999. Available online at: http://www.hsph.harvard.edu/Organizations/DDIL/chelation.htm. Food and Nutrition Service (FNS)- WIC Program. Website: http://www.fns.usda.gov/wic/. Michigan Lead Safe Partnership (MLSP). Childhood lead poisoning in Michigan fact sheet. Available online at: http://www.bridges4kids.org/lead-facts.html. National Center for Health Statistics (NCHS). Healthy People 2000. Available at http://www.cdc.gov/nchc/about/otheract/hp2000/hp2000.htm. National Center for Health Statistics (NCHS). Healthy People 2000 Final Review. Hyattsville, Maryland: Public Health Service. 2001. Wilson DJ & Berg GG. Protecting children from lead poisoning. In: Learning from the Past: The Origins of RCSI. Rochester Committee for Scientific Information. December 2000. Available online at: http://www.rcsiweb.org/bulletins/RCSI-CHAP3.DOC. Woodward CA & Chambers LW. Guide to Questionnaire Construction and Question Writing. The Canadian Public Health Association. Ottawa:1983.

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APPENDIX 1. The Crescent Example of infant bib from Dr. Kennedy 2. Transcribed Key Informant Interviews (5 pages) 3. Program Evaluation Survery- Version 1 (2 pages) Version 2 (2 pages) 4. Contact information for WXXI video distribution 5. Revised Rochester-specific lead poisoning prevention brochure (Separate file)

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Infant bibs that we had hoped to acquire for WIC

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WIC Interviews: September 14, 2005
Mom #1 Have you heard about lead poisoning? Yes, I know it can be in paint, crayons, those types of things. Do you know how it affects children? No, I don’t know much about it. I know it affects their growing and blood, but I don’t know much about it. Where have you heard about lead poisoning? WIC office, doctor’s office. Where can lead be found besides what you mentioned earlier? In old houses, they might have it. My kids get tested at their physical and the WIC office. Do you know who to contact if you had questions or concerns about lead? I know there’s a number but I don’t know it off the top of my head. I’ve never had to use it. Who provided lead testing for your children? Here at the WIC office and at my doctor’s office. Have you talked about lead poisoning with people in community? No. Do you know of anyone who has been affected by lead? No.

Mom #2 Have you heard about lead poisoning? What have you heard? Yes, it could be harmful, my daughter got tested yesterday though. Otherwise I don’t know much else about it. Where did your daughter get tested? Rochester Gen. Where can lead be found? Paint. Where have you heard about it? Her doctor’s office, pediatrician. What have you heard? Gave me pamphlets so that she might get tested and if she’s ever been exposed it that she should get tested. Problem in home, who do you call? Doctor’s office. I did, I called the doctor’s office and they told me to bring her in. Any other resources in the community? No, not really. Would you like to learn more about lead poisoning in general? Most definitely when her test results come back. Have you heard about talked about in community? My father’s idea to take her into the doctor’s office. He noticed there was chipped paint in our house.

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Mom #3 What have you heard about lead poisoning? It can cause some disorders in children, I think you can find it in paint…I work with children with lead poisoning and they have some real issues. Where have you heard about lead? I’ve always worked in childcare and I used to work in Mary Cariola. I heard it in the pediatrician’s office. I have four children and my oldest is 9 so… Have your children been tested? Yes, I’ve never had a problem with lead. I’ve never lived in a house with chipping paint or anything else like that. If you suspect there was a problem, who would you contact? We’ll go right to the pediatrician. Do you have any friends or family members who have been affected by lead? No. Do you talk about lead amongst friends in the community? No, not really since my children are the youngest of my friends’. If somebody asked then yes, but I will not volunteer information. At the daycare, all that stuff is pretty much discussed in the intake.

Mom #4 Have you heard about lead poisoning? Yes ma’am. I think lead poisoning is like paint chipping, and stuff babies shouldn’t run throughout. It’s like in old houses, remodeled old houses, with all that lead out in the houses, it’ll hurt babies. How does it affect children? No, I don’t know how, but I know it’s not good for them. How would you know? No. Where else can you find lead besides old houses, any other places? Warehouses, old buildings. How do you know if your house may have lead? Chipped paint, if I see paint chipped around. If you have concerns, who do you talk to? Doctor or landlord, somebody who works in the house or knows about lead. Where have you heard about lead? At doctor’s office. Your doctor or their doctor? My doctor and their doctor’s office. Have your children been tested? No, but since I’ve had them they haven’t had any lead poisoning. Any friends or family members have been affected by lead? No, not that I know of.

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Have you talked about lead with friends or family? With my family and friends. What do you call it? I say lead poisoning.

Father #1 (with Mother #2) Have you heard about lead poisoning? Yes, risk of getting child sick. Do you know how lead does that? No. Where is lead found? Window sills, chipped paint. Where have you heard about it? School. Do you know who to call if you had concerns? No. Have your children been tested? Yes, she was tested yesterday.

Mom # 5 (accompanied by friend who acted as Spanish translator) Have you heard about lead poisoning? I’ve never understood it very well. Where have you heard of it? In Puerto Rico, before I came here. How long have you been here? 1 month. Do you know if lead affects children? Yes. What can it do? I don’t know exactly, but it affects their blood and bones. Is there a way to know if there is lead in your home? I don’t know, the only place I know is in paint. Do you know who to call with questions? No. Have your children been tested? No. Is it something you talk about with your family? Yes, to my babies’ dad because he had other children who were affected.

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Mom #6 (the Spanish translator mentioned above) Can we ask you the same questions? I have nothing to add. Have your children been tested? Yes, my son had lead poisoning, it was 17. What have you been told to do about it? They told me to give him enough liquid and to maintain the whole…. so I got to retest him again Who tested him? Strong. Who do you talk to if you have questions? Their doctor. What can lead do to your children? Affects blood and damages brain. Have you been able to keep them away? It’s kind of hard, he’s 3 years old he’s always in everything Has your house ever been tested? Yes, there is nothing in it.

Father #2 (with Mother #7) Have you heard about lead poisoning? Yes, I’ve heard of it, on the news. What did you hear about it? It’s mostly in old houses in neighborhood, they’re very old. Landlords aren’t maintaining what they’re supposed it and it’s very dangerous for these kids. Especially since I have a kid of my own, I wouldn’t want him to live at no place like that with lead poisoning. How does it affect children? By their blood, in their brains too. How would you know if your house had lead in it? Check any paints and by the window and all the dirt that’s around it, I would know by that, and if they house is always filthy. I can know by looking at it. How would lead in the paint look like? Dry, I guess and filthy. I really don’t pay that much attention to it. Have you heard about lead anywhere else? No. Have you talked about it with friends or family? I have, when I was a child, my brothers and my little sister. I heard my mom talk about it in those days. Back then it wasn’t even that serious like it is now. It’s all over the news now. Has your child been tested? Yes, at Jordan I think.

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Questions, who to contact? Look up in yellow pages, where the poison things are.

Mom #7 Have you heard about lead poisoning? Yes. How can it affect kids? It’s bad for kids, get in blood level and cause brain damage. Where can you find lead? In paint, in houses, around houses, paper, crayons, markers. How can you tell if there is lead in the house? Old paint peeling off. Where have you heard about lead? When I go to the doctor’s they give me papers and when I was pregnant, and see it on TV too. Questions/ Concerns about lead, who would you call? Doctors. What if you had concern about lead in the Home? I would call Housing Authority.

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Childhood Lead Poisoning Awareness Survey
Age__________ Are you: Male Female Zip Code: ______________ Do you have children under the age of 5 in your household?

Yes

No

1. Do you consider childhood lead poisoning to be a problem in your community? a. Yes b. No 2. What are the effects of lead on children? a. Learning Disability b. Behavior Problems/ Hyperactivity c. Kidney Disease d. Bone damage e. Anemia f. Dental Caries g. Hearing Loss h. High blood pressure i. Death j. Other_________________ k. I don’t know 3. Where is lead found? a. Old Paint b. House Dust c. Soil d. Window Sills e. Water f. Other_____________ g. I don’t know 4. How do children get lead poisoning? a. Eating Paint Chips b. Chewing on window sills c. Putting dusty toys/hands in mouth d. Drinking contaminated water e. Playing in the dirt / eating dirt f. Other_________________ g. I don’t know

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5. At what ages should children be tested for lead? a. One year b. Two years c. Whenever there is concern for lead poisoning d. Other___________________ e. I don’t know 6. Your neighbor who has 2 children, ages 3 and 1, lives in a house that was built before 1978. Her house has chipped paint, and the window sills are covered with dust. Are her children at risk for lead poisoning? a. Yes b. No 7. If your neighbor is concerned that her children are at risk for lead poisoning how can she find out for sure? a. Test blood lead levels b. House inspection for lead c. Other___________ d. I don’t know 8. Your neighbor goes to the pediatrician to have her children’s blood levels tested for lead. Both children have lead levels above 10mcg/dl, which means they have lead poisoning. How can she find out if her house is the source of lead? a. Have her house inspected b. Other____________ c. I don’t know 9. Who can she call for help? a. Housing Council (585)546-3700 b. Landlord c. Coalition to prevent lead poisoning (585)256-2260 d. Monroe County Health Department (585)274-6087 e. Other________________ f. I don’t know 10. a. b. c. d. e. f. g. h. i. What can she do in the meantime to minimize her children’s lead exposure? Wash children’s hands frequently Wash toys frequently Wet mop floors and window sills 3x/week Take off shoes on entering house Keep children from playing in dirt Feed children diet high in calcium and iron Have children retested for lead Other____________________ I don’t know

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Childhood Lead Poisoning Awareness Survey
Instructions for Interviewer: All questions should be read aloud. Responses should not be offered as choices, but should be circled if mentioned or written on ―Other‖ blank if not included on the list. Inform interviewee that ―I don’t know‖ is an acceptable answer before beginning.

Age__________ Zip Code: ______________

Are you:

Male

Female

Do you have children under the age of 5 in your household? If Yes, how many? ________________

Yes

No

1. Do you consider childhood lead poisoning to be a problem in your community? a. Yes b. No

2. What are the effects of lead on children? a. Learning Disability b. Behavior Problems/ Hyperactivity c. Kidney Disease d. Bone damage e. Anemia f. Dental Caries g. Hearing Loss h. High blood pressure i. Death j. Other_________________ k. I don’t know

3. Where is lead found? a. Old Paint b. House Dust c. Soil d. Window Sills e. Water f. Other_____________ g. I don’t know

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4. How do children get lead poisoning? a. Eating Paint Chips b. Chewing on window sills c. Putting dusty toys/hands in mouth d. Drinking contaminated water e. Playing in the dirt / eating dirt f. Other_________________ g. I don’t know

5. At what ages does NY state require that children be tested for lead? a. One year b. Two years c. Other___________________ d. I don’t know

6. Your neighbor who has 2 children, ages 3 and 1, lives in a house that was built before 1978. Her house has chipped paint, and the window sills are covered with dust. She is concerned that her children are at risk for lead poisoning. How can she find out for sure if her children are affected? a. Test blood lead levels b. House inspection for lead c. Other___________ d. I don’t know 7. Your neighbor goes to the pediatrician to have her children’s blood levels tested for lead. Both children have lead levels above 10mcg/dl, which means they have lead poisoning. Who can she call to find out if her house is the source of lead? a. Housing Council (585)546-3700 b. Landlord c. Coalition to prevent lead poisoning (585)256-2260 d. Monroe County Health Department (585)274-6087 e. Other________________ f. I don’t know 8. What can she do in the meantime to minimize her children’s exposure to lead? a. Wash children’s hands frequently b. Wash toys frequently c. Wet mop floors and window sills 3x/week d. Take off shoes on entering house e. Keep children from playing in dirt f. Feed children diet high in calcium and iron g. Have children retested for lead h. Other____________________ i. I don’t know 25

Contact Information for WXXI Video Distribution
1. WXXI PBS – Michael Collins 258-0345 mcollins@wxxi.org

2. ABC Head Start – Deborah Ajewole 325-5116 ext.3302 dajewole@abcinfo.org 3. WIC – Sasha Paduano (coordinator @Jordan Healthlink) spaduano@jordanhealth.org -Amylyn Blodgett (Monroe County Coordinator) ablodgett@monroecounty.gov 454-2630 530-4248

4. Prenatal Education Classes Highland Hospital – Kathleen Garvey 473-2229 kathleen_garvey@urmc.rochester.edu SMH Strong Beginnings RGH Women’s Center Lorrie Morgan 275-4058 lorrie_morgan@urmc.rochester.edu Marian Brohman 922-4687 marian.brohman@viahealth.org Kristin Opett 922-5452 kristin.opett@viahealth.org

Park Ridge Hospital - Rhonda Seeler 368-4006 rseeler@unityhealth.org 5. Dr. Richard Kennedy 520-9263 (cell) RKennedy@rochester.rr.com

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