Promoting Organizational and Staff Wellness

Marco Beltran: Greetings, Head Start community. We are so excited that you can be here with us today. My name is Marco Beltran, and I am the health lead for the Office of Head Start. I want to thank you for participating on this webinar titled Strategies to Promote Organizational and Staff Wellness, which is part of the Office of Head Start campaign to eliminate preventable risks to children's health, safety, and well-being. The Safe Foundations, Healthy Futures campaign supports safe children, thriving staff, and strong programs. When we think about why we work in Head Start many of us will come up with such things as a passion to serve children and families. We want to make a difference. It fulfills me, or even makes me happy. Along with that I can assure you that all of us have a deep-rooted belief to ensure that the children in our care are safe, healthy, and ready to learn.

So, why are we here? As Ann Linehan indicated during the first webinar that we had as part of the Safe Foundations, Healthy Futures campaign that the Office of Head Start feels that this is a very serious campaign. She shared a stat that last year we had about 131 documented incidents, and that might not seem like much, but when you think about it, the opportunities for something to happen to a Head Start—to an Early Head Start child is pretty huge. When you think about a program, all the days that those kids go to school, there are millions of opportunities for something to happen that is harmful or hurtful to a child. That said, the incidents are small, but one is too many, and 131 is far too many. Our goal as part of this campaign is to inform, to influence behavior, and also to offer support.

We're here to support you in the work that you do in creating these safe foundations, safe environments for our children We think that staff wellness is integral to this because staff wellness is not just important for an individual staff member, but also to an organization, and ultimately it is important to those relationships that we have with our Head Start children and families. Before I turn it over to our speakers, I want to let you know that the slides are available in a PDF form for you to download so that you can use them as you share this information with others.

We encourage you to ask questions, and make comments throughout today's presentation. In addition, we will also be recording the webinar, and it will available as soon as possible on the ECLKC. After the speaker's introduction we will show you where you can download the presentations, and ask the questions. I am delighted to be joined by Dr. Ariella Herman, Kim Stice from the National Center on Early

Childhood Health and Wellness, as well as by John Williams from the National Center on Program Management and Fiscal Operations. Now, I'm going to turn it over to our speakers so that they can introduce themselves and get started with the webinar.

Ariella Herman: Good afternoon. My name is Ariella Herman. I'm part of the National Center on Early Childhood Health and Wellness. I'm also the research director of the UCLA Healthcare Institute at the Anderson School of Management I'm delighted to be here.

Kimberly Stice: Hi, everyone. I'm Kim Stice, the director of professional development and collaboration for the National Center on Early Childhood Health and Wellness. It's nice to be with all you today.

John Williams: Hi, this is John Williams from the National Center on Program Management and Fiscal Operations. I'm the IST manager there, also the governance program management specialist. I'm happy to be here with you, as well.

Kim: Thanks, John. This is Kim again. My role in the webinar today is to guide us through the interactive pieces of the presentation. If you have questions for the presenters, type them into the Ask a Question box. You won't be able to see the questions that others ask, but the presenters will, and we'll try to get those questions answered by the end of the presentation. We'll also be asking you some questions to get your thoughts on some topics around adult wellness, and to share ideas you're already doing. When you see a question posed on the slide, I'll read it to you and you can type your response in the question box, and then I'll share the ideas that we are seeing from all of you.

As Marco mentioned, you can download a PDF of the PowerPoint slide in the Event Resources area. Just a side note, a recording of this presentation will be available on ECLKC and MyPeers soon after we're finished. So, our first question to get you all warmed up and thinking about staff wellness is what does wellness mean to you. I'd like you to give that a little thought, and share your ideas in the question box.

The reason we want you to think about this is because you and your team need to be on the same page about what you're wanting to achieve. For example, if you think wellness means physically fit, but someone else on your team thinks wellness means not stressed out it's probably important that you talk together about what your wellness initiatives and activities are going to include. Are they going to include both physical wellness and emotional wellness activities? There are other areas like what about intellectual wellness or social wellness? You might want to think about is wellness only an internal characteristic, or is it something about the way we interact with others, too? And I see we've got some answers popping up already.

Some of the answers we have are work-life balance, absolutely. Physical and mental well-being. Mind and body are healthy. Being at peace with your body and mental space. Balance. Spirituality and physically fit. Here's one, wellness is self-care. An overall healthy feeling. Sound mind, body, and soul. Let's see, some more of these. Feeling good physically and emotionally. I'm really glad to see people are understanding that there is both a physical component, and an emotional component. We have physically healthy, mentally healthy, and relationship wellness. That's an important one, too, relationship with those around us. Taking care of yourself and others. It means wholeness to feel complete. Mental and emotional health and physical fitness. Oh my gosh, we've got so many great answers coming in. Staff wellness means staff are taking care of themselves so they can best help others. Oh, give Christie a gold star. I love that answer. Wellness means that everyone is okay in all areas. Maybe not perfect, but good I like that one, too, that's good. We've got a lot of great answers here, and I can tell you all are on the right path thinking about all the different ways that wellness can be defined, and that it's not just one area, not just stress, not just physical fitness, but it really encompasses a lot of different areas. Thank you all so much for your answers for giving this some thought. I'm going to turn it back over to Ariella, so that she can get us talking about how programs can address staff wellness.

Ariella: Thank you, Kim. It's wonderful to see all this excitement. So, what are we trying to talk about today? First of all, to try and understand why are we talking about health and wellness as a workplace issue in general. Second, what do we know about health and wellness of Head Start staff? Then how can programs strategically approach the implementation of staff wellness initiatives?

So, as a starting point this is the definition that we're going to use for a culture of wellness. A culture of wellness is a working environment where an employee's health and safety is valued, supported, and promoted through worksite, health and wellness programs, policies, benefits, and environmental supports. As you can see this is a complex definition. There are many components to a culture of wellness. Many different goals. This is why it is really important to have a thoughtful and systematic approach to the implementation of staff wellness. A culture of wellness for staff is really going to be the foundation for creating a culture of health and safety for children.

Now why care about the culture of wellness? Definitely in early childhood education. Children are our most precious resource. The greatest impact on children's futures starts early, and for the age zero to 5 we have that opportunity. Head Start families are often in crisis. Working at Head Start is wonderful and exciting, but can be also challenging and stressful. Staff have health problems such as obesity, depression at rates above the national average. Early childhood education salaries are often low, creating personal financial stress. Staff turnover rates are high in Head Start and Early Head Start And as a summary, staff wellness and stability will affect really the quality of services delivered to families and children. When do we need to take a proactive approach? Children need the consistent, sensitive, caring, and stable relationship with adults. Adults who are well, physically and mentally, are more likely to engage in positive relationships. When we support staff well-being, we strengthen early care and education. So, why do we see so much stress in early childhood settings? There are many components.

The first one is that in early childhood education settings—and definitely in Head Start—staff carry heavy demands. They have high expectations for measurable outcomes. They have to meet many standards, requirements, and reviews. The second thing is that early childhood educational staff often feel undervalued. They're often underpaid in comparison to other pre-K settings, or kindergarten, or elementary school, and last but not least, early childhood education staff often work with at-risk children and families. Children living in difficult circumstances at home are more likely to exhibit challenging classroom behavior, and have greater needs. From the same perspective families also have greater needs; so these three are really three elements that really create the stress in early childhood education, Head Start being on our minds today. Without action in an unhealthy place, we're going to see work-related stress which will encourage unhealthy lifestyle practices, which will have different impacts, increased turnover, litigation, long and short-term disability, depression, accidents, and decreased employee satisfaction, commitment, and moral which will, again, affect the quality of services to children and families. So, a very big study was done by Dr. Whitaker with the Pennsylvania Head Start, and about 3,000 Head Start staff participated. And a lot of trends transpired from this study. First of all, the stress that Head Start staff feels can come either from a workplace stress, economic hardship, or adverse childhood experiences that the staff had. This will affect mental and physical health, which will actually affect the relationship quality, the children's learning and development, and the children's safety. So, to you Kim.

Kim: Thanks, Ariella. Hello everyone, it's Kim, again, with another question. So, now that we've been thinking about how stress can have an impact on us, let's talk about how healthy adults are better able to care for and support the development of young children.

So, what are some examples that you would give your staff if you were talking about how important it is for you to have a healthy and well workforce and work environment? Why is it important for them to be healthy and well while they're caring for young children? What are some ways that you would explain that other than saying, "You don't want to focus on how stressed you are. You want to talk about how much better things can be if you're healthy and well." So, some of the answers are starting to come in. You can be better role models.

That's a great one, especially, if you talk about how adults who are resilient can model coping behaviors like bouncing back if your block tower gets over, or if you didn't get the day off that you were really hoping you were going to get off, so that resilience can really help you role model for children. Let's see, some more responses we've got. A better attitude. Better model for self-regulation. I think everybody is hearing that one how we could model for the children. Better able to identify and respond to the needs of children.

Absolutely. Healthy adults are able to process and assess situations happening in the classroom easier. Great. If you are healthy yourself you can model better behaviors for the children, and can focus on the children, instead of on your own stressors That's true, your stress does pull your attention away even if it's just a physical pain that is pulling part of your attention away from children. Modeling good behavior, more caring. Taking care of yourself. Eating healthy, exercising. Consistency in care. If you are missing the children are missing you. That's a great response. Use the analogy of the full bucket. True, absolutely. Staff have a more positive outlook. They're able to focus on job responsibilities.

If you are physically healthy you can run around with students and enjoy outside time with them.

Absolutely, and getting up and down off of the floor, as well. More focused and positive to help children. Healthy adults are better able to be mindful of the moments of the day, and be grateful and a role model for children. These are great responses. You guys are right on track with what we're wanting to think about, what we're wanting to communicate to staff. Positive behaviors and attitudes A teacher can remain calm with patience. Absolutely. Decrease of absenteeism. That's always helpful for everybody.

You're not able to give care to others if you can't take care of yourself. That's true, it really does limit how much you can care for others if you haven't put your own oxygen mask on first, right? More role modeling, more positive tone, positive body language, patience. We have some great answers here. We'll be sure and share a lot of these answers after the webinar on MyPeers because it will give you some talking points to talk with your staff about why you're going to be doing more in the area of staff wellness. So, I'm going to turn it back over to Ariella to talk more about what we already know about staff wellness.

Ariella: Thank you, Kim, and what an inspiration I get from everything that you type in the chats. There's a reason why I love your community and that's really wonderful to read all your comments. So, to better understand what needs to be done it is really important for us to see what we know about the wellness and the health issues that staff have in Head Start because understanding the landscape will help us go forward in planning and being intentional in the implementation of staff wellness.

So, first of all, what are the sources of stress? There are three types of stress that we can see. The workplace stress, economic hardships that staff have or has had, and adverse childhood experiences that staff have had in their life. So, let's talk about each one in particular. Workplace stress can come from logical reasons.

One of them is the high demand. When you're saying that staff needs to keep children physically safe and emotionally secure, provide the instructions to meet child outcomes, communicate effectively with families and staff, being kept accountable, and address child behavior challenges— these are some examples of the high demand that creates the workplace stress. Another element could be staff feeling not enough autonomy in decision-making, and not enough flexibility in work schedules.

The third is the low support. Staff feeling lack of management support, lack of emotional support, and also inadequate resources for professional development. Now, second type of stress are the economic hardships. If you look at the five types of economic hardships here starting with not enough money for utilities, for health care, for housing. Now out of these five, Whitaker studies shows that one in three Head Start staff have at least one economic hardship. We really need to take that into consideration.

Now, when we look at the third type of stressor which are the adverse childhood experiences starting with emotional abuse, physical abuse that we usually look at families and children the study has found that one in four Head Start staff had three or more adverse childhood experiences. This definitely has a weight on their health and well-being.

Now, when we talk about the physical and mental health of Head Start staff the study found that one in three Head Start staff suffers from either lower back pain, obesity, or severe headaches. This relates to the physical health, and when we talk about mental health one in four suffer from depression. It is so hard to work with families and children in crisis when you have any one of these symptoms, and this is why it is so important to start really addressing intentionally improving staff wellness and building a culture of health for the staff, as well. So, wellness programs can create a culture of health, and deliver a

range of benefits to employees including a safer, more supportive work environment, improved health, well-being, self-image, and self-esteem. Improved coping skills with stress and other health factors, and improved job satisfaction and moral. A healthy workforce will help us keep children physically safe and emotionally secure. Provide instruction to meet child outcomes. Communicate effectively with families and staff. Shape the life trajectory of the future generation. So, back to you, Kim.

Kim: Thanks, Ariella. It's probably not a surprise to most of you to hear that many staff who work in

Head Start have stress and health problems. You've probably seen that in your own programs. Many Head Start programs try to support their staff to reduce stress and get healthier with different kinds of activities for staff to participate in.

We'd like to hear from you. What are some of the ways that your programs have supported staff wellness? Over the past few years our center has been talking with a lot of programs around the country about staff wellness, and about how to help staff have lowered stress and healthier lives. We hear some great examples all the time. We see them posted online on MyPeers. We love sharing them, as well. Some of the recent ones I've heard a program recently shared with their local hospital sponsored gym memberships for their center staff for six months. I mean, that's just amazing that's wonderful.

Several programs have told us that they do lunch and learn sessions on various health and wellness topics. Sometimes it might just be like a 15-minute session so that it can fit into a break time where you have a floater go into the classrooms and give the teacher time to attend that. Some programs have monthly challenges about increasing their steps or drinking more water things like that.

So, let's see what some of your responses are. We offered a yoga program for one month—so that's neat. We just redid the staff lunchroom to be more welcoming. Oh, wow, that's great. I love when you do environmental changes that really makes a difference for people. They really appreciate that someone's caring enough to make their environment more welcoming and more relaxing. Some of the other answers. Stress reduction and mindfulness techniques That's great. Health challenges. Offering counseling through community partnerships. Walking and exercise challenges. We started Walking Wednesdays where we offer two times a day for the staff to meet in the fitness room, or outside to walk together. That's great. Offering classes. Staff training on work-life balance. Guided breathing exercises.

Here's one. We just partnered with our insurance agency on a Fitbit program they offer to members. That's great. I love hearing that some of you are actually reaching out to community partners and other agencies to help sponsor these kinds of things. We have many that are looking for new ideas. Well, that's why you're here today. Hopefully, you're going to pick up some more ideas both today and on MyPeers. Take what you need inspirational bulletin board at each center. I love that idea. We have monthly wellness calendars, or different activities, or ideas for every day. We have Walking Wednesdays where we walk together at the end of the day for 30 minutes. That's a nice way to debrief the day before you go home that's really nice. Walking Wednesdays seems to be a really positive one, a really popular idea. Let's see, a suggestion box. Open door policy. Appreciation gifts. Working to develop health and well-being programs. A laugh or two 10-minute breaks daily. Provide sources for counseling. Annual wellness day for staff. Center is closed to children and we get together at a central location where staff can get massages, health screenings, painting sessions, Zumba. Wow, that sounds fun. I love it. Monthly make it and take it. Oh, that's great. Crafts really help to distract from all of this stress. Lots of great ideas here. Self-care events for our home visitors. Exercise groups. We have a gym in our central office. That's a great idea. We have nutritionists that provide counseling for staff. That's awesome. Once-a-month self-care. Paint with a twist. We have a staff wellness committee focusing on ways to improve our agency. We try to do fun things like secret pal activities, and health surveys with prizes. Lots of great ideas here. We actually have a question that I'm going to go in and jump in and answer.

Can we have the program ideas presented back to us? Absolutely, we're going to share these with you so that you can have these ideas to take back and work with your team in your program. So, I'm going to go ahead and hand things back to Ariella to find out more about what you can be doing to support staff wellness in your programs.

Ariella: I love to hear this. This is so, so inspiring. Now, let me share with you my idea and what inspired me and this is the L.O.V.E. Well, we all know what love is, but in terms of building the culture of wellness for the staff, L.O.V.E. the "L" stands for listening, the "O" for observing, the "V" for valuing, and the "E" for encouraging. To really be successful the L.O.V.E. will be the cutting theme. It will really be the glue that keeps all the — all the pieces together. It is really important to listen what the staff wants, desires. Observe the environment. Show that you value them, and encourage to make change. This is continuous improvement using the L.O.V.E. that needs to trickle down and up in the agency all along the way. Obviously, together with this you need to really build different possible components.

And these are different components of a healthy workplace. It will not happen overnight. It is a process. And you're not going to be able to change everything at once, but our experience has shown that you really need to be able to have an impact that is lasting. You need to think strategically about how you are going to implement this healthy workplace. Is it the organizational culture? In other words, are you going to look at attitudes, values, and beliefs that are demonstrated in the workplace through respect, appreciation, commitment, decision latitude, employee involvement? Are you going to touch personal health by giving opportunities to support the employee's effort to improve and maintain their personal health such as time to exercise, immunization clinics, smoking cessation, stress management, healthy food choice in the cafeteria, or in the vending machine?

The third one is physical work environment. A physical healthy work environment is really going to be important to be recognized, assessed and monitored, and this is where the leadership is going to be really important in the decision-making. So, to build a successful workplace health program we really need the use of a coordinated, systematic, and comprehensive approach. This is an example of a model that was created by the CDC, the Center for Disease Control. It's not the only one, but it's a recognized research-based model. When you start your first step is assessment. By assessment, we mean at the individual level. Who is your staff? What is their health risk? What are their needs? What are their desires? What are their choices?

Then the assessment in terms of the organizational. What are the current practices and work environment that exist? The third one the community. What is the status of the transportation, food and retail, parks, and recreation? This is what I would call understanding the landscape. This is really the most crucial starting point to be successful. Obviously, in your assessment you might find many needs that you're going to need to prioritize because we cannot do everything in the first step.

The second step is your planning and management, crucial role to the leadership. Leadership support is essential to be able to implement the culture of wellness for the staff. Then creating the team, the wellness committee. A wellness coordinator that will help this implementation. Then, create a plan that I call here workplace health improvement plan where you define your goals, your objectives, and the strategies. What resources they'll need. In other words, what partners, who do you have in the community that you can partner with, vendors, and communication both internal and external. Once you have done the planning and the management, you can go to the next step which is implementation. Again, here you can implement programs, policies, increasing benefits, environmental support, and you're not going to do all at once. It's just a continuous process.

Once you have done one implementation you get to the evaluation that will allow you to see how well you've done, what worked, what didn't work, what are the lessons learned, and how can we improve the cycle for the next step, the next level of staff health improvements. So, what we're trying to do in this assessment is capture the big picture, identify current health issues, as well as employee interests and health promotions offered If your staff requests physical activity, but you don't ask them how they would like to do it, and you just decide that it's goingto be one hour at 6:00 a.m. every day you might have no one attend; so it's really important not only to ask the staff their interests, but how they would like it to happen. The more involvement you get from the beginning from the staff the stronger your impact. I take you back to the L.O.V.E. You have to listen, you have to observe what the staff wants, and what their needs are, and it's in general a combination of these elements that will help you decide what are your priorities.

One tool that allows you to assess the culture of wellness in your agency is the CDC work site health scorecard. It's a research-based assessment that was not created specifically for Head Start. It was created in general to assess workplace health. It is online. It is free. Once you have entered the answers to all the questions which will relate to what do you do relative to weight management? What do you do relative to nutrition? What do you do in your agency do you have a team to support it? Do you involve the Policy Council, the HSAC, and so on? You are going to get a report that will be specific relative to your result that shows you your strengths and your weaknesses, which is a wonderful starting point to let you know where is an area that you should start to address. Now, how you're going to address it then you're going to have multiple options, but this gives you a general vision of the culture that you have in your agency. Now, you might have a central office and multiple agencies in different places. You could fill a CDC scorecard for everyone of your agencies because they might not have the same priorities, and what works for the central office might not necessarily work for all the other agencies. These are the type of questions that the CDC worksite health scorecard answer.

Does your worksite have an active health promotion, staff wellness, or health education committee? Has your agency conducted a needs or interest survey for planning wellness activities? Does your agency have a dedicated space that is quiet where employees can engage in relaxation activities such as deep breathing exercises? So, if you look at these questions they have a different level of intensity and a different level of time needed to implement at different costs, but once you will get the summary of your answers you can make the decision of what to change. A year later once you have started implementing some activities you can take again the scorecard and you will see the improvement that you made from one year to the other.

Other type of questions. Does your worksite have posters or flyers in common areas that identify the signs and symptoms of a heart attack or a stroke? So, these are just examples. Does your agency have an emergency response plan that addresses acute heart attack or stroke events? Does your program have a written injury and/or illness prevention program? It doesn't mean that you have to answer that you have everything, but it really would give you an image of what you have and what your strengths are, and where your weaknesses are.

So, once you have done your assessment, and really listened to your staff you can start really your planning. To start the planning the first step is really to dedicate senior leadership to support and lead this initiative as a role model and champion. Then identify a workplace health coordinator or committee.

Third step, develop a plan, and we're going to call this plan S.H.I.P.—standing for Staff Health

Improvement Plan—that has sufficient resources to articulate and execute the goals. Very important to clearly communicate. The way you create engagement is by listening and by communicating with staff on what you're going to do once you have done it, on what you have done, and what works, and what didn't work, therefore, the last step, but is definitely one of the most important ones is keep collecting data that could really help you to continue your planning and evaluation. Now, since we talked about planning and management I'm going now to pass the mic to John Williams that will talk to you about the importance of systems-thinking and introducing and building a culture of wellness. John?

John: Thank you, Ariella. As we think further about planning and management this is a key opportunity for Head Start program leadership, and what we mean by that are the governing body, Policy Council, and senior leadership to work together to make sure they are implementing the Head Start management systems in a strategic way to address staff wellness concerns. We've heard this theme earlier in the webinar.

So, I'm going to take you through a tour of some slides to delve deeper into these considerations. First of all, what are the core concepts of systems-thinking? This is really a key element in thinking about effective planning and management approaches. The core concepts that drive those approaches are the following: The ability to see the larger picture. What we mean by that is seeing what is most visible from one's own vantage point. Next is reflection thinking about your way of thinking about things. Holding the mirror to see the taken for granted assumptions that we often carry. Three, more generative conversations. These discussions happen once we are able to be reflective. It opens the door to more productive and rich dialogue.

So, again, this is all reflecting some of the communication aspects that Ariella and Kim have talked about earlier. Then, finally, shift the focus from reactive problem solving to co-creating the future. What we mean by that is systems-thinking really causes you to shift to a more proactive way of operating. It is important to remember that Head Start operations by their very design are an example of complex systems, and staff may need technical support in understanding how these systems work across the organization especially in support of aspects like staff wellness.

So, what does systems-thinking look like? When we talk about what systems-thinking looks like we're looking at three main characteristics. First of all, this all comes from Leading from the Emerging Future by Otto Scharmer and Katrin Kaufer. They outline the following aspects: Opening the mind to challenge our assumptions. Example of guiding questions here include are our assumptions correct on how staff wellness might lay a role in preventing child incidents.

Can we be creative in finding a way to develop more of our staff using approaches such as trial runs that simulate child incident scenarios? Examples now of behaviors activities in this area include revealing our policies and procedures around child incidents along with the discussion of staff wellness considerations.

The next area is opening the heart to be vulnerable and truly hear one another. Examples of guiding questions here include are we truly listening for the other perspectives that need to be considered in revising our approach to protecting children. Do we understand how our program staff process information in different ways, and what we mean by that are visual, text, and auditory. Examples of behaviors and activities here include actively surveying staff to develop a sense of their own work styles and using this information to explore how training and development activities around preventing child incidents can be effective.

Also, thinking about conducting possible dialogues with governing body members with professional development expertise to see if they have the insight of how this process has worked in other environments. Finally, we also think about opening a will when we talk about systems-thinking. What we mean here is opening the will to let go and think broadly to see what is really needed and what is possible. Examples of guiding questions here include how does a greater focus on professional development resonate within our program and strategic plans. Most notably, are outcomes around lowering incidents, lowering—lowering the incidents rate? Examples of behaviors and activities here include building role—building out role playing scenarios based on this enhanced model so that key stakeholders can see how this greater attention to incidents and staff wellness radiates throughout the agency. So, now we're going to take a look at one very important management systems here, and that includes looking at the system of communication.

This is one of the 12 Head Start management systems. As you see here, we have two arrows. We call this the two arrow discussion where we look at on the left-hand side the traditional top-down communication. In other words, our Head Start management influenced by our policy council and our governing body, and coming from our director also flows down to the managers, and then our frontline staff. That's the traditional mode of communication. What we also counter that with, or compliment it with is the service aspect of communication, and that is starting with the frontline staff that are really getting that information, experiencing issues with children and families, and having that flow up. This is very instrumental because, again, we look at both of these as really important aspects of communication to honor not just the hierarchical on the left-hand side, but also thinking about what your folks are seeing out there and flowing back to you to inform you to make better strategic decisions. This is also a place where because of using these two arrows you get to really explore a number of issues that we've been talking about so far.

I want to highlight that in, first of all, saying with the two arrows you have a more inclusive communication approach which then can result in a healthier organizational culture that Ariella talked about earlier. I want to highlight the issue of—

[Inaudible]

Sorry about that. The Wellness Wednesdays from the National Center of Early Childhood Health and Wellness also outlined a number of key practices in their series. In this series can be referenced in the staff wellness community in MyPeers. One of the things here—

There a number of great—messages that came here that really reinforce the importance of good communication. So, one of the sessions focused on supportive supervision. This is the importance of actively listening to your staff and their needs so then it's definitely a best practice. A focus on leading by example that was another session that came out of these series how a supervisor can model wellness practices to their staff. It was very encouraging so far to hear people actually talking about some of those best practices, so we know that you're actually utilizing some of these yourself.

We also feel that these can help staff stay sharp and, therefore, more observant. And finally, a focus on nutrition and exercise, and we noted just from the question boxes that Kim was facilitating earlier that all of you have a focus on both the nutritional aspects and the physical aspects of helping staff increase their energy level and, therefore, again their response in this in a very strategic way.

So, with that, what I want to just summarize with is that this slide here really reminds you of the key things to think about when looking at your Head Start programs, and that is that your programs are professional organizations that are also complex systems. I don't need to tell anybody on this webinar that you know that your Head Start program is comprised by a number of moving parts that you have to manage and supervise each and every day. Not only your staff, your materials, your playgrounds, but also the processes that make all of those go. Again, that's really the power of the management systems, so as we think of PMFO complex systems involve working through constant change and adaptations to the environment regardless of the organizational structure, or the auspice in which they operate Program leadership understands change management, and leads the organization forward making and communicating adjustments and corrections as needed. This process can help improve the organizational culture of a Head Start program. Before I leave this, I just want to stop very briefly at our next slide which is the management systems wheel and make some final points. Again, this management systems wheel as you know is available on ECLKC in both English and Spanish.

Just as a quick reminder, everything starts with the leadership and governance on the outside level. Again, this really encompasses the senior management that Ariella talked about earlier. It really sets the tone for your organizational culture. So, when that is running well you have a better chance of having a culture that really supports staff wellness. Also, just highlighting a couple of others. Ariella already talked about data and evaluation. I want to highlight fiscal management. Again, these programs cost money so you do have to have those budgetary discussions on what they will look like, and I'm sure some of you have had those already. I also want to highlight one last one because we've already talked about communication and human resources, and that's community and self-assessment.

I really want to focus on the self-assessment aspect. This is a natural point of reflection for any Head Start program to improve their internal practices. So, just as Ariella and Kim have been talking about, this is a great place. I'm thinking of the S.H.I.P. that you just talked about, to really think about how your S.H.I.P. might look if that's an issue that comes up in your self-assessment. That's a natural organic place to address that. Finally, I want to just give a quick shout-out because we'll say more about this later on, but next month PMFO will be hosting the next webinar in this series, and it will focus on human resources. So, we'll have more details on that coming up near the end of the webinar, but at this point I want to just say thank you to Ariella, and pass it back to her.

Ariella: Thank you, John. So, we talked about the starting assessment, the planning, and now we are at implementation. There are different types of programs that you can implement Some can be done quicker than others. You will have to choose and improve as you go along. You can have health-related programs, health-related policies which would probably take longer, and will come based on lessons learned from the health-related program. Impact on health benefits can take a longer horizon to be achieved, and environmental support that you can increase as you go along. Let's just talk about one example, which is the health-related programs, policies, and benefits. We're always going to need to remember that change doesn't happen automatically. You begin; you change; and you try to maintain healthy behavior. This is why, again, the L.O.V.E. is so important. Listen at the beginning, observe what's happening, show the value of what you bring and keep encouraging. Now there are different levels that we can reach with health-related programs.

The lowest level that is the first that probably we should all start with is raising the awareness. You can do this through newsletters, posters, health fairs, one-time education classes because we all know that one-time education classes will raise knowledge, will raise awareness, but will not change behavior, and health screenings. So, this is the first level which is raising awareness. Then how to get really to lifestyle change? We can start providing health education classes. Provide supporting mentors or coaches whether it's for physical activity or nutrition. Encourage walking meetings or short fitness breaks. Encourage positive communication. Provide stress management trainings.

So, really according to what you find in your assessment you're going to take one of these directions. These are some examples, and from what I heard from your feedback you already are doing so many of these, but if you do them in a way that is strategic based on the needs of your staff, and the assessment of the culture of your agency you're going to get stronger results, and you're really going to get longterm impact. All this, obviously, with a supportive environment which would be adopting a wellness policy, adopting a tobacco-free policy, creating a break room for relaxation, or stocking a vending machine with healthy food. So, you see they're not at the same levels, and it would be for you to make the decision of where you start, and how you continue. If you get the buy-in and the ideas of your staff you can really go very far in this implementation.

Last but not least is the evaluation step. Why is evaluation important? To obtain feedback so that you can adjust and improve. You have lessons learned of what worked and what didn't work. To measure your change and demonstrate success. If, for example, you enter your information in the CDC scorecards that would be your baseline data, and you want to start implementing that CDC a year later you're going to enter the data again, you will be able to see change, and demonstrate success. When staff see success it's really pushing to continue. Evaluation is really important to keep engagements, to validate the need and the value of your program, and also to secure ongoing resources even when you get support from your community, and you can really showcase the impact that you're having through their support. It's a wonderful way of maintaining the engagement of your community, but the truth is that change is constant, and so are measurements and evaluations.

This is not a one-time, but it's really important to help you guide where you should continue, what you have learned, and where you want to go next, extremely important. Now if we think about the evaluation framework according to what you do, you're not going to get all the results at the same time. So, over a timeframe of a year you can do process evaluation. How many employees came to a health training? Was there an awareness increase? What was the participation? What was the satisfaction rate? Can we use pre- and post-service to see if knowledge or skills have changed?

So, this is process evaluation. In a timeframe of a year to two years you can get impact evaluation. Did you see a change in self-esteem, in motivation, in moral? Did you see lifestyle changes, self-care practices, health risk change? You can see this over a range of two years. The long-term or really the outcome evaluation that you can really get usually in two to five years where you can start seeing a reduction in turnover, a reduction in absenteeism, reduction in disability, in accidents, and an increase of retention, increase of employee morale, and definitely an impact on the safety of the children that comes from the increased health and wellness of your staff. So, you cannot expect everything to happen at once neither will the results from what you are doing.

Okay. So, to summarize the whole strategic approach using this S.H.I.P. and S.H.I.P. stands for Staff Health Improvement Project, but we can also think about this, you know, a ship sailing to start improvement of staff wellness. So, the first step is really to understand the needs what I call the landscape. What are current health issues and career interests? Make sure you involve the employees from the beginning. Will you do wellness? How can you create a supportive environment? Once you understand the needs set your goals and objectives. What do you want to achieve? Then you really need to make sure that you communicate this information, so you need to create staff and community engagements. If you involve the staff from the beginning that's a wonderful way of creating engagement. Do the same in your community wherever you are.

There are always community partners that can help you in implementing staff wellness. Look at what your staff interest is, and what your community has to offer, and that will be a wonderful way of creating the engagement. Then think about what resources do you have internally? What community resources are available? What partnership do you need to create to increase the success rate? Once you have defined your goals, create the engagement and identify the resources, this is when you're going to write your action plan and the budget. Define what needs to be done, how it needs to be done, by whom, what are the different roles, and responsibilities. Involve your staff. The staff has a lot to offer, and can definitely participate in providing some of the stuff. There's a richness in your staff. Some could do a Zumba class, or a yoga class, or a cooking class, so involving them from the beginning can be really impactful. And at the end of the cycle evaluation It is important to establish the metrics to measure success, to look at problems that happened, how can we improve, and also to showcase. Go inside your agency and outside of your agency to keep the engagement going. And once you have done one cycle, again, start with the needs, and keep improving. So, the Staff Health Improvement Project should be ongoing. We start with small steps, and slowly build really a culture of wellness for your staff.

So, let me just finish with the L.O.V.E. that I started. "L" stands for listening. So, let's listen to the staff needs and wishes. Listen to the staff feelings about their own health, and listen to the staff ideas for improving worksite wellness. The letter "O" stands for observe. Observe and understand your staff challenges. Observe staff cultures and beliefs concerning health and wellness, and serve staff aspirations about their health. The "V" stands for value. Value staff for their unique strengths and experiences. Value staff expertise about their health and well-being Value staff as partners in supporting the wellness problem. And last but not least: the letter "E" that here stands for encouraging. It could be empowering, could be engaging.

Encourage every staff member's effort to support the implementation of the wellness problem. Encourage every staff member's ability to be a positive health role models for others. Encourage staff to attend training and workshops on wellness. The L.O.V.E. obviously is important and needed to build a culture of health for your family, but it's as crucial to build a culture of wellness for your staff. These are the references of the most recent articles that have been developed. Some come from the Center for Disease Control. One is the Whitaker study that we mentioned. So, you can access them and see if you can learn more. To access the CDC website, you just go to the CDC and type, "worksite wellness," and you will have the access to this survey that you can take as I said free of charge. Kim?

Kim: Thanks, Ariella. We have had a lot of great ideas and suggestions today. Our whole team over here has been so excited reading all of your suggestions and thinking about how we want to share them with you. And we would really like to keep the conversation going online. If you haven't joined MyPeers before, there's a link here to show you how to become a member. If you're already a member we want you to go ahead and head over if you have a few minutes today after our webinar, and we're going to continue the conversation over there. It's not just something that will be going today.

We'll continue it. We also are pretty active on MyPeers so if you have a question later, an idea to share, feel free to just pop in there and share it. We've got a lot of people that are participating online and like to share what they're doing, so these links will help you get there, and help you continue the conversation with us And after the close of the webcast when the file is ready the link to this recorded webinar will be put there as well as some of the resources we've talked about today. As John mentioned earlier, and I think Marco mentioned, as well, we actually have two more webinars coming in the next couple of months to continue on the Safe Foundations, Healthy Futures campaign. The first is in March. It will be on Human Resources: Systems to Recruit and Retain Responsive Staff, and the next one in April is about Planning for In-service Training. So, we want to keep on the theme of supporting our staff, working with our programs on how we can take care of each other to help promote safety for our children.

Kim: So, as we start thinking about reflecting back on everything you've heard today you've heard a lot. I want you to think for a minute about what stood out to you today. What is something that you'll remember? Whether it's something that you learned that was new that you didn't know before. Maybe it was something that you heard that you want to try. Maybe it was a resource that you saw that you want to try when you go back to your program. Is there something that you heard today that you want to share with some of the staff on your program? We'd like to hear about some of your reflections in the question box, so type your instant reactions, your reflections from today into the question box, and we'll share those. In that way for some people who are thinking, "Oh, my gosh, my head is swimming," it may help them to focus down on a few things, too. So, let's see, people are responding: the L.O.V.E.

acronym. S.H.I.P., Staff Health Improvement Plan, yeah, that's a great one. The workplace survey on wellness. Let's see. Change needs to be staff-led and based on assessment of their needs. Well, a team I

think if people heard that from us then I think our job here is done. That's absolutely right. The importance of assessment. The S.H.I.P. and ideas on wellness activities. This person says that the thing that they remember and will take with them is the staff of Head Start employees mental and physical health. You know, that's really some information that's very helpful to take to your staff, to your community partners and say there's been some research done. We all know that we are stressed out, and we work really hard, but now we've actually got some data on this on why we need to be devoting some time to this. Some other things people hearing about—people are remembering, and they're going to take out of this time they've spent with us today. The whole systems multi-step approach, and that making a positive change will take a team effort. That's true, absolutely. The L.O.V.E., listening, observing, valuing, encouraging. I'm so so glad that you caught onto those four key terms. Tailoring staff wellness supports to different types of stress. I want to look into the CDC worksite health scorecard. Great. This person says involving staff from the beginning. Absolutely, that makes a huge difference.

L.O.V.E, CDC health scorecard, Walking Wednesdays. Boy, that was a big one. A lot of people are doing the Walking Wednesdays. I'm glad you're thinking about adopting that yourselves. The importance of having a wellness program and getting staff participation. I like the L.O.V.E approach. That's a great one. Let's see. I'm going to take home the challenging stats from the study. Yeah, absolutely. To remember to conduct an evaluation of your efforts, so you can adjust your wellness plan. I can just hear Ariella cheering over there that they understand, yay. The importance of intentionality, and systematic approach to shifting culture of wellness, and that it will take time. That's absolutely right. You don't change everybody's attitudes, and everybody's health and wellness overnight. This person backs it up. Change does not happen automatically. Boy, that's the truth. Active listening is key. Very good, that's right. Let's see, some of the others. We're getting so many responses here. You all have really been listening. A lot of people commenting on L.O.V.E. and S.H.I.P. Considering the role staff wellness takes on preventing child incidents. Absolutely, we're so glad that you're seeing that connection. Let's see: The CDC worksite card. I appreciate that the timeline is over several years because this can seem overwhelming if the expectation is a quick turnaround. Yes, absolutely, we're glad to provide that information for you so that when things don't happen right away you have a way to say this is going to take some time, and we have to invest in the long haul here. We have to understand. Ideas from each other like the inspirational bulletin board and Walking Wednesdays. Always evaluate with the different types of evaluation is what I'm thinking about. Amazed at the actual stats on staff wellness and indicators. I'm glad that that was helpful for you. Let's see. Definitely promoting wellness among staff, so they can be the best that they can be. Absolutely, we want to value our staff. They do great work. They're wonderful people, and we want them to know how much we appreciate them. Let's see. The importance of all to be involved, mindful, and aware that what we see in our children are also present in employees. Absolutely right. I want to work for you all. These sound great. These sound like wonderful people to work for. So, it looks like we're ready to start moving onto the next slide because I'm seeing a lot of questions posted. That is for you to let us know if there were questions that you have. Some of you have posted questions along the way, and we're going to try to take a few of those. We may not get to all of them, and some of them may take a little more time for us to respond to. So, I'm going to pull up some of the questions that you've asked. I can answer some. Our team, hopefully, will jump in and answer some, as well. So, one of the first questions that we saw is: how can an agency provide ongoing wellness programming when sites are in different cities and staff end their days at different times? And this question was actually asked at the beginning of the webinar; so I'm hoping now that we've talked quite a bit about how to do planning, and assessments, and surveys, that what you could do is look to the unique needs of the different centers. Are these activities that you're thinking about? Are they things that would apply across the board? Are there different interests of one group versus another group? You have to start looking at flexibility. I think if you pull in some of the staff from those centers you can start getting answers from them about some ways that you can meet different needs in different locations. Anyone else of our presenters want to chime in on that one?

Ariella: Yes, Kim, it's Ariella. That's a great question. What I noticed with the CDC scorecard is that you can do it for the whole agency, but if you have groups in different cities you should do an individual one.

You will get the consolidated result for the whole agency. Then you can make specific plans for the different locations because different locations have different needs, different times, and adapt it specifically. If you really create the variance in each one of the cities they will be in charge of their own class.

Kim: Great, thank you, Ariella. Some more questions that we have. We have tried to promote wellness activities, tried to motivate Walking Wednesdays, monthly calendars with daily ideas for staff self-care. The staff response is thank you but we don't have time. My question is how do we get staff to be more activated, or motivated to participate. Anybody want to take that one? I have a thought on it, but I will see if my co-presenters want to share.

Ariella: I have a thought, it's Ariella. Maybe ask your staff if five-minute activities twice a day would work for them. In other words, obviously, if you decide that you're going to offer one hour a week that people say that they don't have the time, but according to the answers that's why it's so important to listen to your staff. If they express that they would like multiple activities each one five to 10 minutes this is what you need to implement. That's the best way to get things happen by really showing them that you have listened, and that you're going to implement according to the demand as much as possible.

John: Can I add onto Ariella's response? I mean, to me most programs have an in-service approach to supporting their staff. This is another aspect of in-service approach, so maybe not think of it as something different, but something that's already part of your existing operation; so just as you would schedule an in-service how does this become that? So, is that seen as an add-on?

Marco: Dr. Herman, and John, and Kim. This is Marco, and I just had a quick question. Just thinking about the concept of time, and some of the comments where people are expressing that being a difficulty and/or a barrier for establishing a wellness program in their program, and then what's been asked early on with the question of how we think about wellness and what it means. There was a variety of pieces that came on related to physical wellness and mental health and different aspects of wellness in general. Is there anything in the research that can lead us? I'm thinking about going back to the initial process of doing the assessment and working with your staff, and asking questions of your staff that it might not be a huge program, but it could be something like staff recognition, and how that impacts staff morale, and then how that leads to wellness, as opposed to having it be the particular activity. My understanding is that there is some research that indicates that. Is that true?

Ariella: Yes, there is research that is done, but the conclusion of most of this research is that you have to listen, and it's not really the level of the activities that you are going to do. Definitely listening and showing that you value people is definitely one way of doing things. You know your staff, so it's important to give them a voice. And all the research shows that if you listen with your heart to what they have to say and try to implement small steps at a time, this is what will help you get the engagement, but you're right, Marco, creating the engagement is difficult for families. It's also difficult for staff, but when staff feels valued and listened to, they will be more appreciative. When I sent the first survey to a group of Head Start grantees, I got 100 percent response, and some of the comments were, "finally someone asks me what I would like." So, it's really an impression of how you listen to staff, and supportive, and what you do about it.

John: If I can add, Marco, I don't have the factoids that go right to the research, but in our session next month on human resources we will add some factoids around the importance of recruitment and retention, and those drivers that help staff stay engaged as Dr. Herman was alluding to. There are things in the retention realm that can be addressed there, as well.

Kim: Thank you, all. Those are great points. To sum up, a lot of people have responded in the question box their concerns about time, and about people saying they barely have time to do their daily work.

How am I going to add a yoga session in the middle of the day, or how am I going to add a staff wellness session in the middle of the day? I think thatit starts by saying: "Okay, let's get a group of people together," including representatives fromthe staff and say: "Look, we understand that you don't even have time to breathe. You don't have time to take a pause, which we know that kind of stress is going to be building up and building up, and it's going to jeopardize children's safety." So, maybe we start there and say, "Look, I know everybody is really stressed out. Everybody is really busy. There's not a minute to breathe. That is a challenge. What can we look at doing? We don't have new money. We don't have money to hire somebody, but let's think out of the box. Let's get creative and start thinking about what we can do and sometimes, just starting the conversation, and saying we recognize what you're dealing with. We want to try to make it better. Understand that we have limitations, too. Just starting that conversation sometimes can be enough to get people to feel like they can take a breath and say, "Okay, let's think about it. Let's talk about it." So, we understand, absolutely, that time and funding are huge challenges, and that's where you start having conversations with lots of people, and you start getting creative. Some of the other questions that we had. We had several questions for John about the resources, the authors of the Open Mind, Open Heart, Open Will model, and where to find more information about the pyramid image that you showed. Would you be able to do some follow-up on that, John, on MyPeers?

John: Yes, Kim. The two-arrow model is actually something that came directly out of PMFO based on our earlier forays on this so I'll go back to our staff that formulated that, and we can get that up on MyPeers. I did send out an answer to the question around Otto Scharmer and Katrin Kaufer. I sent both their names and their book, Leading from the Emerging Future, to everyone answering that question.

Kim: Great, thank you so much. Other resource questions we had a few people asking about. The CDC workplace health model chart, and about the scorecard, and we've put links to both of those in MyPeers so you can actually go into the Safe Foundations community now and see them there. We want to make sure that you're able to find those and use them. Another question that came up was how do we sell this wellness program to our ISB board. We tried. My personal response to that is you start with a little bit of statistics, and then you try to recruit somebody from that board onto your wellness committee. Anytime you're trying to convince someone of something if you can get them onto your side and helping you make the case you're going to get a lot farther, but I'm going to see if the others have some suggestions on going to governing bodies and others to try to convince them of the importance of this.

John: So, Kim, people did also ask me also because they did not define what CP meant, and I also sent out an answer on that. That's your community partners. I would say that one of the key parts to think about all of this is your community assessment as you think about not only what are the resources directly serving your children and families, but what are some of those resources that might also help with staff wellness? It might be a supplementary study, but are there gyms? What are the gyms? What are the other physical fitness resources, and could those maybe be part of your community partners that can serve in either your governing body, or your Policy Council. Again, it's the beauty of the Head Start model to think about these processes, and how they inform questions like this.

Kim: Great, thank you, John. Any other thoughts from Ariella or Marco on that one? Okay, I'm going to go ahead and move us into this one. This is an interesting unique one. How do you get your peers to come into your office to provide support to them? I am an RD, registered dietician, but I feel like my coworkers would not want to talk about their own nutrition concerns with me. I think it is awesome that you are feeling like here's what I can do to contribute to staff. I have this information I'd be happy to share it with people, but people might not be willing to talk to me one on one. So, maybe there are some other ways to start getting that information out. Ariella, and John, and Marco, do you all have suggestions there?

Ariella: I have one. If you can share what your struggles are that's a wonderful way to put the person in confidence, and start sharing theirs.

Marco: The only thing I would add is if you can identify groups of folks that have like-minded or similar type of things that they want to address, and start bringing them together that's a way to start. In some of the situations that I've seen is if people are trying to address weight, there's usually some other folks that are close by that they have relationships with that are also probably trying to do that, and we've seen them come together in small groups, and seen that group get larger, and they've figured out ways to bring in outside consultants, or outside individuals who can address specific topics that folks are interested in. We've seen that with weight programs, or fitness challenges as a way. So, sometimes, it's starting with the assessment, identifying what people want, and then figuring out how we can identify things for like-minded folks. I'm using the wrong phrase. For folks who have a similar interest in coming together on specific topics.

Ariella: Absolutely.

Kim: Great, thank you. So, I'm also noticing there are a lot of questions about what kinds of expenses are allowable, how would we budget this that kind of thing. Those are more complex questions. We're going to move those over to MyPeers, and try and give you some support there.

John: Kim?

Kim: Yes.

John: Could you say something now? Thank you, because we'll have to continue that there. I'm not one of our fiscal experts, but I do have a note to kind of consult with them. I mean, I think that one of the basic starting points, though, would be to think about as you are managing your human resource area, what are some of the basic staff benefits included in your health plans, for example. That's a starting point. I will research and get back to you on MyPeers on some of the issues around cost allocation, and the like, but that's a natural starting point to think about. What does your benefit package offer?

Kim: Great, thank you so much, John. One more comment I just have to share that I just saw from

Reyna. I just presented at an in-service for my agency on staff wellness, You Matter. That was her topic, Staff Wellness, You Matter. Staff was validated on their feelings that the job is demanding yet rewarding. So, we provided them with several resources and strategies to support them in managing and reducing stress like a stress blog, healthy eating habits, exercise, free yoga classes, and meditation classes throughout our county. I did a meditation activity that was loved, and encouraging videos of selfcare. Each participant was given a water bottle labeling, committed to your health today, tomorrow, and for life. It was a successful training to initiate wellness into our agency. I think that's a great idea, and we're going to continue to gather these great ideas and put them on MyPeers. We do have a question if we can put up the MyPeers link just one more time. Maybe we can try and do that really quickly?

John: For contact info, yes.

Kim: We'll try to do that.

Ariella: Wonderful questions, Kim. I mean, very good questions. Obviously, the world was not built in one day, and staff wellness will not be built in one day either, but you know, step-by-step, we have to start somewhere, but when we listen, and we start, and we go step-by-step we will get there. We're here to support you. As I'm sure you must have guessed, I really value staff, and I think it is really important that we listen and we show them that we value them. Marco?

Marco: So, at this point I just want to thank Dr. Herman, Kim Stice, and John Williams for presenting the information today. I know that it seems – On some respects it seems like a little overwhelming to start a whole staff wellness program within our agency, but one of the key things to remember is start small, go big, taking a systematic approach, and value, listen to our staff, and figure out how we can move forward. As Ariella indicated, you know, we are — as an Office of Head Start, and as national centers we are here to help as we move forward, and that's why we wanted to provide you with the presenters contact information. In addition, you can reach out to both the national centers afterwards if you have any information that you want related to anything that was presented and/or to ask questions, and we will respond to you appropriately.

Finally, we just want to once again thank you. We at the Office of Head Start feel that the time to act is now, and we look forward to starting this journey to create a culture of wellness for all our amazing staff within Head Start.

Thank you.