For many low-income children, a pediatrician is the only professional they interact with before they start kindergarten. This fact inspired Jecca Steinberg, a second-year Stanford medical student and Schweitzer Fellow, to think about how that interaction could improve these children's school readiness, which often lags behind that of their peers. If these kids could be equally well-prepared for kindergarten, their potential for economic mobility would skyrocket.
Now, in an innovative collaborative effort, the pediatrics waiting room of Fair Oaks Health Center in Redwood City, Calif. is being turned into a learning center. According to previous research conducted by the Stanford Pediatric Advocacy Program, the clinic's patient population includes more than 900 low-income children between the ages of 2 and 5; surveys indicate that only 31 percent participated in any kind of formal pre-school education and 82 percent were not school-ready by kindergarten.
In collaboration with Neel Patel, MD, the medical director at the clinic, Steinberg reached out to Stanford art practice lecturer Lauren Toomer, MFA, who volunteered her time and talent to produce a mural that will transform the drab waiting room into a space for learning opportunities. The mural incorporates letters, numbers, shapes, and images of the Redwood City community, as well as three interactive learning panels. Patel generously donated the funds for the supplies. See the prototype above; the actual mural will be finished by early October.
In a recent phone conversation, Steinberg explained to me that the mural project is one component of a larger project called Kinder Ready, which is part of Stanford's Pediatric Advocacy Program led by Lisa Chamberlain, MD, MPH, and Janine Bruce, DrPH. (The work at Fair Oaks Clinic has been led by Stanford pediatrics residents Jaime Peterson, MD, and Ashley Case McClary, MD.) I asked her more about their efforts:
How did you get involved in this work?
I’d say my entire motivation for entering the field of medicine is centered on providing opportunities for socioeconomic mobility, and although health is an incredibly important aspect of that, it can’t be viewed in a vacuum as a solution. So these interdisciplinary efforts touch on everything I’m passionate about. For my first-year Stanford Medical Scholars research project, called community based participatory research, I set up a series of focus groups with low-income parents to talk to them about their conceptions of school readiness: what they think a role of a parent is, and how they think a pediatrician could help them.
Currently I help screen children for their school-readiness level, and I work with the parents to teach them different activities that they can do at home to promote their children learning. I’ve been working with Dr. Patel to include activities and interventions in well-child visits that parents can take home with them. We set them up with library cards, let them know about parent-child reading hours and mommy-and-me classes in the community, and make it easier to get a hold of books and other learning materials.
Why are pediatric offices a good site for learning centers?
One key is access - for many of these low income families, they don’t see any other professional for their child before they enter kindergarten, so the pediatric office itself is a place where educational resources could be made available to families. It provides an incredible mechanism to reach large numbers of people. Over 90 percent of families in this area get vaccinated by a pediatrician at a pediatrics office.
A second aspect I find equally important is that it has been demonstrated that pediatricians are very trusted in the community. Families feel comfortable with their pediatrician and are likely to listen to what they have to say. Something I learned through my research this summer is that families would love to hear more about what resources are available to them from their pediatrician because they trust them and believe they’d point them in the right direction. I think one of the many things the pediatrics office could do is be a directory of resources for parents who maybe don’t know what’s out there.
What barriers to education readiness do these families face?
Time is definitely a huge barrier because a lot of our parents are working multiple jobs and working at night, but we’ve found that for a lot of these children, their primary caretaker is a family member, so we're really hoping that that person will be able to do these activities with the child at home, maybe replacing some TV-watching time with a book or a different educational activity. Another barrier is that a lot of these parents aren’t sure what a child is supposed to know by the time they enter kindergarten. Overall, families face a complex matrix of barriers that include finances, immigration status, crowding, insufficient community resources, limited educational opportunities, and food and housing insecurity.
Steinberg emphasized her gratitude for the "incredible mentorship" of Chamberlain, Bruce, Peterson, and McClary, and for the two programs that made it possible for her to designate protected time to work on school readiness: the Schweitzer Fellowship and LCHAMP. She told me, "Upon arriving at Stanford there have been more opportunities than I could possibly imagine to do the type of work that I’m passionate about, and the best part is that these mentors are unbelievably encouraging and have set up a space for students to pursue their dreams while balancing their student workload." She also noted that "it’s really inspiring that different graduate schools are getting together to work with the community to provide much needed service."
Previously: An ounce of action is worth a ton of theory: Med student encourages community engagement, Using texting to boost preschool reading skills and Med students awarded Schweitzer fellowships lead health-care programs for underserved youth
Photo courtesy of Jecca Steinberg