Skip to Main Content Practice Center Header Images of Young Children
  Learning Center Navigation Link Teaching Center Navigation LInk Practice Center Navigation Link
Bullet Image Site Map Link

Health Promotion Curriculum
Tobacco Counseling
  Feeding Your Baby
  Oral Health Curriculum
Models of Practice

Pdf Library Icon
PDF Library
My Briefcase icon
My Briefcase
My Journal Icon
My Journal

Home""> Practice Center > Health Promotion Curriculum > Health Promotion > Session 1

Health Promotion Curriculum: Health Promotion

"" Promoting Health and Preventing Illness


Session 1: Identifying Relevant Health Promotion Topics


The objectives for this session are for the facilitator to:

  • Introduce the effective use of interview and follow-up questions in determining the health promotion topics important to each family.
  • Present useful approaches to providing personalized guidance, directing families to community resources, and achieving understanding with the family.


The materials and teaching aids needed for this session are:


Facilitator Form:

Teaching Aids:

  • Display board, flip chart, or chalkboard
  • Markers or chalk


Preparing for Session

Beginning the Session

Discussion and Exercises

Ending the session


Facilitator's Script:

facilitator's script  

Throughout the module is a script, designated by the star icon, which can be used to introduce issues, ask reflective questions, prompt discussion, elicit feedback, and summarize important take-home messages. The script can be read or preferably paraphrased by the educator(s) facilitating the teaching sessions.


The time allocated for this session is 30 minutes.

Beginning the Session: Introductions

At the beginning of the session, the facilitator and learners should introduce themselves briefly. Ideas for creative introductions can be found in the introduction to the Facilitator’s Guide.

Setting the Context: The Bright Futures Concept

The facilitator introduces the learners to the Bright Futures concept of health by reading or paraphrasing the following:

facilitator's script  

The World Health Organization has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Bright Futures embraces this broad definition of health — one that includes not only prevention of morbidity and mortality, but also the achievement of a child’s full potential. In the Bright Futures concept of health, providing the capacity for healthy child development is as important as ameliorating illness or injury. Recognizing and acknowledging the strengths and resources of the child, family, and community are essential to promoting healthy growth and development.

To build that capacity, the Pediatrics in Practice curriculum focuses on six core concepts: Partnership, Communication, Health Promotion, Time Management, Education, and Advocacy. The curriculum also includes a companion module (Health) and videotape that present an overview of Pediatrics in Practice and the Bright Futures approach.


Introducing the Session

Before introducing the session, the facilitator distributes the handout Health Promotion: Promoting Health and Preventing Illness to the learners.

The facilitator paraphrases the following:

facilitator's script  

Today’s session is the first of three that comprise the Pediatrics in Practice Health Promotion module.

As child health professionals, you are in a unique position to promote health and prevent illness. You have frequent interactions with children and families, particularly in the early years. These encounters give you ample opportunities to observe, listen to, and recognize issues in promoting health and preventing illness. Families may have questions about the seriousness of an illness; concerns about expenses; anxiety about child care issues; family issues such as divorce or separation; work-related issues; or even concerns about their own fitness as parents. Because families often hesitate to initiate discussions on these topics with child health professionals, it is essential that you identify and focus on the needs and concerns of each child and family.

In today’s session, our objectives will be to:

  • Focus on the importance of asking openended interview and directed follow-up questions in order to elicit a family’s concerns during a health visit.
  • Examine a specific case to demonstrate the use of interview and follow-up questions to promote health and prevent illness.

When we have completed the session, you should be able to answer the following questions:

  • How can I effectively identify relevant health promotion and illness prevention topics?
  • How can I ensure that I give personalized guidance?

The facilitator distributes copies of the case vignette handout Manuel’s Anemia Referral to learners and says the following:

facilitator's script  

This case about Manuel will demonstrate how asking open-ended questions, followed by asking focused questions, can help to identify problems specific to each child.

The facilitator now reads the case aloud or asks one of the learners to do so.

Discussion and Exercises

Use of Interview Questions: Ask Open-ended Interview Questions

The facilitator asks the learners one or more of the following questions:

facilitator's script  

What are your impressions and reactions to this case?

What might you want to address and explore further?

What questions would you ask and how would you ask them?

The facilitator records the learners’ answers on a display board. Some responses might include:

  • Adequacy of diet
  • Past medical history
  • Family and social history

After noting the suggestions, the facilitator continues

facilitator's script  

What are some nonjudgmental interview questions you would want to ask the mother?

The facilitator again records the learner's responses as they brainstorm about possible questions to ask Manuel's mother. If the learners are not responding, the following are examples of appropriate interview questions that might be used to stimulate discussion:About diet:

  • Please tell me what Manuel usually eats each day.
  • What kinds of food does he like?

About past medical history:

  • Please tell me about your pregnancy, labor, and delivery.
  • What concerns do you have about Manuel’s health now? Have you had any in the past?
  • What aspects of his behavior worry you?

About social and family history:

  • Who lives with you and Manuel in your home?
  • Tell me about where you are living now.

After the questions are listed on the display board, the facilitator asks the learners:

facilitator's script  

Which questions do you think were the most effective interview questions? Which were less effective?

The facilitator summarizes by noting:

facilitator's script  

Effective questions are open ended and nonjudgmental.

Good questions allow the child health professional to ask follow-up questions.

Ineffective questions are those that invite yes or no answers and may imply judgment of behaviors.

The facilitator continues the session, telling the learners that the open-ended questions revealed the following information:

facilitator's script  

Beatrice’s husband left her 6 months ago.

Beatrice and Manuel moved in with Beatrice’s sister and her children.

The living conditions in the apartment are not good. There is often no heat, and the paint is peeling.

Beatrice is quite concerned about the effects of this situation on Manuel.


Use of Interview Questions: Ask Directed Follow-up Questions

The facilitator now paraphrases the following:

facilitator's script  

Your initial questions have disclosed the family’s concerns. The next step is to ask directed follow-up questions that will elicit more information from the family.

Examples of directed follow-up questions follow:

About diet:

  • What does Manuel eat for breakfast? For lunch? And for dinner?
  • Children seem to put everything in their mouths. Have you ever seen Manuel or his cousins eat any of the peeling paint in the apartment?

About medical history:

  • You’ve already told me about your pregnancy with Manuel. Was he delivered on time or was he born early? How much did he weigh?
  • Do you think he’s growing like other children his age, or do you think there’s a difference?
  • Has Manuel ever been tested for anemia or lead poisoning? If so, do you remember the results?

About social and family history:

  • What changes have moving in with your sister brought for you and Manuel?
  • Is Manuel’s father involved in his care at all?
  • Have your sister’s children ever had problems with anemia or lead poisoning?

The facilitator tells the learners that the directed follow-up questions have provided the following additional information:

facilitator's script  

Beatrice has noticed that Manuel and her sister’s children have eaten some of the paint chips.

Beatrice has been concerned about Manuel’s development.

Manuel has never been anemic or had lead poisoning.

Beatrice must support herself since Manuel’s father is no longer in the picture.

The facilitator also reveals:

facilitator's script  

When Manuel’s lab results return the next day, they show that his hemoglobin is low at 10.8 gms%, and his venous lead level is quite elevated at 45 mcg/dl.

In this example, we see that the initial openended interview questions, combined with the more-specific, directed follow-up questions, uncovered the needed diagnosis of lead poisoning.

Using the display board, the facilitator creates the following chart to compare the two types of questions and to clarify the major differences.

Interview Questions
Follow-up Questions
  • Are open ended
  • Are nonjudgmental
  • Allow for follow-up questions
  • Focus the discussion
  • Seek specific information
  • Can be answered with yes or no


Working with the Family: Give Personalized Guidance

The facilitator continues:

facilitator's script  

When the family returns to get Manuel’s laboratory results, you will want to help them understand the information and to provide personalized guidance.

How would you share this information with the family?

Some examples might include:

  • Explain the results of the WIC evaluation and the laboratory results.
  • Explain that when a child has an elevated blood lead level, the Department of Health is contacted to assist in checking the home. Explain that the family should be helped in finding other housing while the lead is being removed.
  • Advise Beatrice that Manuel’s cousins should be tested for lead poisoning.
  • Discuss the need to temporarily remove Manuel and his family from the apartment if peeling paint or another source of lead is found.
facilitator's script  

While it’s important that you explain the medical aspects of the case (such as interventions), you also want to involve the family in the discussion about how to deal with the problem.


Working with the Family: Incorporate Family and Community Resources

The facilitator asks the learners to suggest various resources that could be used in this case. To help focus the discussion, the facilitator writes on the display board the following words: “Child/Family—Community.

Listed below are some possibilities that the learners might suggest for each category:

Child and family:

  • Arrange to have the amount of lead in the apartment analyzed.
  • If the apartment shows a large amount of lead, discuss options available to Beatrice and her sister (either remove the source of the lead or move out of the apartment).
  • Discuss the problem with the family’s landlord and with the local health department.


  • Work with the local health department to identify other children in the building who might have been exposed.
  • Work with the health department to identify areas of high lead and try to get the problem corrected.
  • Serve as a referral site for testing other children.

Working with the Family: Come to Closure with the Family

The facilitator continues:

facilitator's script  

At the end of the visit, you want to be sure that the family understands what is being done and what has been decided.

What would be a good way to end the health visit?

Possible examples might include the following:

  • What questions do you have about what we discussed today?
  • What other concerns do you have about your child’s health?
facilitator's script  

Answers to these questions might identify barriers to the guidance you have given and the care you have prescribed.

Examples of such barriers include:

  • Lack of transportation
  • Poor relationship with the landlord
  • Limited financial assistance to find alternative housing

Take-Home Message

The facilitator ends the session with the following:

facilitator's script  

The case vignette in this session demonstrates the importance of good interview questions, careful listening, and specific follow-up questions in identifying relevant health promotion topics.

Without the right interview questions, a child health professional might not have been aware that Beatrice had recently moved in with her sister and that Manuel was at risk for lead poisoning. This case also illustrates techniques that you, as a child health professional, can use to involve the family and community in handling a health promotion or illness prevention issue.

Before we conclude, what questions remain about what we addressed today?

The facilitator then distributes the Age-Specific Interview and Follow-up Questions handout and says:

facilitator's script  

This handout illustrates sample interview and follow-up questions (adaptable for use with parents). Please review the handout, and if you have any questions, we can answer them during clinic today or at another time.


Answers to Guiding Questions

The facilitator continues:

facilitator's script  

How can I effectively identify relevant health promotion and illness prevention topics?

  • Ask effective open-ended and nonjudgmental interview questions to obtain information.
  • Ask directed follow-up questions to focus the discussion and communicate understanding.
  • Listen to and recognize nonverbal cues during encounters with patients and families.

How can I ensure that I give personalized guidance?

  • Introduce new information and reinforce healthy practices based on responses to your questions and facts obtained in the medical, social, and family history.
  • Identify and address any barriers to care.

The facilitator explains:

facilitator's script  

The child health professional, the family, or the community might present a barrier to optimal health care. The following are some examples:

The child health professional may:

  • Encounter lack of trust by the family.
  • Lack confidence in the role of child health professional.
  • Experience scheduling difficulties.
  • Lack adequate time with patients.

The family may:

  • Be afraid or anxious.
  • Lack information or be in denial.
  • Have inadequate resources.
  • Experience spousal, grandparent, or sibling problems.

The community may:

  • Not have pediatric and family-centered hospitals.
  • Lack responsive social services.

Planning for the Next Session (if Session 2 is planned)

The facilitator continues:

facilitator's script  

In our next session, we will look at another case and review the importance of asking open-ended and follow-up questions. We will also discuss the use of family and community resources. As you prepare for the next session, please consider the following question:

How can I identify and use family and community resources to promote health and prevent illness?



The facilitator now distributes the Session Evaluation Form.

The facilitator also completes the Facilitator Self-Assessment Form.