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Pawnee Service Unit Reach Out and Read Program

Program Type: Promising Practice -Programs not formally evaluated (or formal evaluation is not yet complete) but identified by experts as programs with results suggesting efficacy and worthy of further study in broader pilot implementation efforts.

The purpose of the Pawnee Service Unit’s Reach Out and Read Program is not about teaching our young Indian children to read early, but is about helping them to grow really motivated, loving books, associating books strongly with the pleasure of spending time with their parents. At the Pawnee Service Unit, when a child comes in for a Well Child Exam- the Pediatrician encourages reading and each child goes home with a new book. There are certain aspects of reading development that can be thought of as the literacy equivalent of a vaccination towards Health. The goal here is to promote Wellness and Family Attachment. The Pawnee Service Unit’s Reach Out and Read Program are based at both the Pawnee Indian Health Center and at the Pawhuska Indian Health Center.

According to a leading expert on Mental Health, John Bowlby, believes that for Good Health that it is essential for the infant and young child to experience a warm, intimate and continuous relationship with their mother (or permanent mother substitute). According to John Bowlby, with the comfort and security of a stable and routine attachment to the mother-or other primary caregiver- a child is able to organize other elements of development in a coherent way. In contrast, instability in the care-giving relationship—whether physical distance, erratic patterns of parental behavior, or even physical or emotional abuse—may interfere with the sense of trust and security, potentially giving rise to anxiety and psychological problems later in childhood or even decades later in life. The Adverse Childhood Experiences (ACE) study1has revealed that the roots of Medical Problems are from Childhood Psychological Trauma. The Ace Study has shown us that Adult Risk Behaviors such as smoking, overeating, substance abuse or promiscuity are often Masks for other Problems. As children witness multiple adult dysfunctions, they will cope by overeating, smoking, becoming promiscuous or using drugs and alcohol. This all leads to poor physical and mental health later in life. One way to foster attachment for our families is simply by supporting our reading program. We can help our children to grow up loving books & stories in a strong association with the pleasure of spending time with their parents and families. So far, our reading program has brought in more than $25,000 in funding or book donations and has given out more than 2,000 books. Program sustaining grants include 2 large book distributions from the First Book National Book Bank over the last 3 months.

References 1. The Ace Study. Conducted by Kaiser Permanente Medical Care Program in San Diego, the Centers for Disease Control and Prevention, Emory University in Atlanta, & University of Arizona Health Sciences Center in Tucson.

Target Population: Children, 17 yrs and younger. The Pawnee Indian Health Service Unit serves American Indian children from a 7 county area of Northeast Rural Oklahoma including the counties of Garfield, Grant, Kay, Noble, Osage, Payne and Pawnee. There are an estimated 5,000 Native American children in this area from the following tribes: Kaw, Osage, Otoe Missouria, Pawnee, Ponca, Sac & Fox and Tonkawa. 90% of our children age 5 years and less are from low income families according to our Medicaid data. In 1992 25.4% of American Indian/Alaska Native (AI/AN) students who should have graduated dropped-out of school--the highest percentage of all racial/ethnic groups in the U.S. (National Center for Education Statistics, 1994, p. 34). 34). In 1999, the Kids Count fact book reported the worst rate of Oklahoma children leaving school was in Pawnee County at 9.0%. Current, specific examples of our continuing problems in 2005 includes that our Wynona School District with a 16% drop-out rate and a 25% rate of students in Special Education. Dr. Englestead is the only Pediatrician for our Indian children for this 7 county area. He has created and has run our reading program here at the Pawnee Service Unit for the last 2 years. In our clinics, Dr. Englestead encourages reading during Well Child Exams and distributes new books. He has collaborations with our Indian Language Departments and 4 of our major School Districts.

Project Evaluated: Yes, number of books obtained, given. Number of Well Child Exams and Well Child Referrals. Currently Well Child visits are exceeding 300-400 a month. Well child referrals are now the predominate referral. Sickness referrals used to be the number 1 referral at the Pawnee Service Unit. Now- Well Child Referrals to Dietary, Dental, Optometry and to Audiology are the Number One type of Referrals.

Age Group(s):
Children, Adolescents

Site Type(s):
Clinic/Health Center, Hospital

Health Indicator(s):
Maternal Child Health

Service Area:

Alcohol/substance abuse prevention


Name: Brady Englestead M.D., M.S.P.H., F.A.A.P
Site or Location Name: Pawnee Service Unit
1202 Heritage Circle
Pawnee, OK 74059
Phone: 918-762-6531