Caring for Our Children (CFOC)

Chapter 2: Program Activities for Healthy Development

2.4 Health Education

2.4.1 Health Education for Children Staff Modeling of Healthy and Safe Behavior and Health and Safety Education Activities

Content in the STANDARD was modified on 1/10/2017.


The program should strongly encourage all staff members to model healthy and safe behaviors and attitudes in their contact with children in the indoor and outdoor learning/play environment, including, eating nutritious foods, drinking water or nutritious beverages when with the children, sitting with children during mealtime, and eating some of the same foods as the children. Caregivers/teachers should engage in daily movement and physical activity; limit sedentary behaviors when in the outdoor learning/play environment (e.g., not sitting in structured chairs); not watch TV; and comply with handwashing protocols, and tobacco, electronic cigarettes (e-cigarettes), and drug use policies.

Caregivers/teachers should talk about and model healthy and safe behaviors while they carry out routine daily activities. Activities should be accompanied by words of encouragement and praise for achievement.

Facilities should encourage and support staff who wish to breastfeed their own infants and those who engage in gardening to enhance interest in healthy food, science, inquiries and learning. Staff are consistently a model for children and should be cognizant of the environmental information and print messages they bring into the indoor and outdoor learning/play environment. The labels and print messages that are present in the indoor and outdoor learning/play environment or family child care home should be in line with the healthy and safe behaviors and attitudes they wish to impart to the children.

Facilities should use developmentally appropriate health and safety education materials in the children’s activities and should also share these with the families whenever possible.

All health and safety education activities should be geared to the child’s developmental age and should take into account individual personalities and interests.

Modeling is an effective way of confirming that a behavior is one to be imitated. Young children are particularly dependent on adults for their nutritional needs in both the home (1) and child care environment (2). Thus, modeling healthy and safe behaviors is an important way to demonstrate and reinforce healthy and safe behaviors of caregivers/teachers and children. Young children learn better through experiencing an activity and observing behavior than through didactic training (3,4). Learning and play have a reciprocal relationship; play experiences are closely related to learning (4).

Caregivers/teachers impact the nutrition habits of the children under their care, not only by making choices regarding the types of foods that are available but by influencing children’s attitudes and beliefs about that food as well as social interactions at mealtime. This provides a unique opportunity for programs to guide children’s choices by assigning parents/guardians and caregivers/teachers to the role of nutritional gatekeepers for the young children in their care. Such intervention is consistent with the U.S. Department of Agriculture's (USDA's) and U.S. Department of Health and Human Services' (DHHS') 2015-2020 Dietary Guidelines for Americans, 8th Edition. The Dietary Guidelines focus on increased healthy eating and physical activity to reduce the current rate of overweight or obesity in American children (one in three in the nation) (5).

The effectiveness of health and safety education is enhanced when shared between the caregiver/teacher and the parents/guardians (6,7).

Caregivers/teachers are important in the lives of the young children in their care. They should be educated and supported to be able to interact optimally with the children in their care. Compliance should be documented by observation. Consultation can be sought from a child care health consultant or certified health education specialist. The American Association for Health Education (AAHE) and the National Commission for Health Education Credentialing (NCHEC) provide information on certified health education specialists.

An extensive education program to make such experiential learning possible indoors and outdoors should be supported by strong community resources in the form of both consultation and materials from sources such as the health department, nutrition councils, and so forth. Suggestions for topics and methods of presentation are widely available (7). Examples include, but are not limited to, routine preventive care by health professionals; nutrition education and physical activity to prevent obesity; crossing streets safely; how to develop and use outdoor learning/play environments; car seat safety; poison safety; latch key programs; health risks from secondhand smoke (exhaled smoke from smokers into the air), thirdhand smoke (residual smoke and chemicals on the smoker's clothes and hair or on surfaces where smoking occurs) (8,9), and secondhand emission from e-cigarettes (exhaled vapors into the air) (9); personal hygiene; and oral health; including limiting sweets; rinsing the mouth with water after sweets; and regular tooth brushing. It can be helpful to place visual cues in the indoor and outdoor learning/play environments to serve as reminders (e.g., posters). “Risk Watch” is a prepared curriculum from the National Fire Protection Association (NFPA) offering comprehensive injury prevention strategies for children in preschool through eighth grade (10).

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Screen Time/Digital Media Use Health and Safety Education Topics for Children Staff Modeling of Healthy and Safe Behavior and Health and Safety Education Activities Active Opportunities for Physical Activity Playing Outdoors Caregivers’/Teachers’ Encouragement of Physical Activity Situations that Require Hand Hygiene Handwashing Procedure Use of Tobacco, Electronic Cigarettes, Alcohol, and Drugs Written Nutrition Plan Availability of Drinking Water General Plan for Feeding Infants Preparing, Feeding, and Storing Human Milk Serving Size for Toddlers and Preschoolers Meal and Snack Patterns for School-Age Children Socialization During Meals Participation of Older Children and Staff in Mealtime Activities Nutritional Quality of Food Brought From Home Nutrition Learning Experiences for Children
  1. Lindsay, A. C., K. M. Sussner, J. Kim, S. Gortmaker. 2006. The role of parents in preventing childhood obesity. Future Child 16:169-86.
  2. Ward, S., et al. 2015. Systematic review of the relationship between childcare educators' practices and preschoolers' physical activity and eating behaviors. Obesity Reviews 16: 1055-1070.
  3. Hemmeter, M. L., L. Fox, S. Jack, L. Broyles. 2007. A program-wide model of positive behavior support in early childhood settings. J Early Intervention 29:337-55.
  4. White. R.E. The power of play. A research summary on play and learning. 2012.
  5. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015.
  6. Centers for Disease Control and Prevention. Education and community support for health literacy. 2016.
  7. Gupta, R. S., S. Shuman, E. M. Taveras, M. Kulldorff, J. A. Finkelstein. 2005. Opportunities for health promotion education in child care. Pediatrics 116: e499-505.
  8. Dale, L. 2014. What is thirdhand smoke, and why is it a concern?
  9. American Lung Association. E-cigarettes and Lung Health. 2016.
  10. Kendrick, D., L. Groom, J. Stewart, M. Watson, C. Mulvaney, R. Casterton. 2007. Risk Watch: Cluster randomized controlled trial evaluating an injury prevention program. Injury Prevention 13:93-99.

Content in the STANDARD was modified on 1/10/2017.