Healthy Alternatives for Little Ones

Empowering young children to make healthy choices.

HALO Program Research

HALO Evaluation

Between 1997 and 1999 HALO was evaluated for its effectiveness. More than 300 children were interviewed over four time periods about their attitudes, knowledge and skills in six areas: efficacy, expressing feelings, human body knowledge, healthy/harmful choices, family and communication, and stress management. Pre-HALO data was compared to data from each of the follow-up interviews after the children participated in the program. The report, compiled by the Nebraska Council to Prevent Alcohol and Drug Abuse, stated that the population of preschoolers who participated in the HALO programs in Omaha underwent significant change in their attitudes, knowledge and skills over the course of two years.

In 2007, program evaluation was conducted by Lisa Riley, Ph.D. This research included 287 children in a quasi-experimental study using a Solomon Four Group design which included control groups.  A developmentally appropriate interactive storybook was designed and used as the test instrument for evaluating changes in four indices — know what “healthy” means, increase knowledge about how to make healthy choices, increase knowledge of key internal organs and functions, and increase knowledge of the harmful effects of alcohol, tobacco and drugs on internal organs.  The main effect for each of the indices, with the exception of “understanding what healthy means”, was statistically significant for the children who participated in HALO.  The evaluation results have been published and used to submit an application to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidenced-based Programs and Practices (NREPP).

Parents of children who are participating in HALO are asked to provide feedback regarding their child’s increase in knowledge and skills. The most recent outcome data collected in 2008 showed that 98% of parents surveyed said that their children now talk about how things are healthy or harmful, 81% report that their children can name the internal organs and their important functions, 99% report their children can define “healthy” as “growing bigger, stronger and better able to think,” and 93% report their children now talk about how they feel.

Activities in each unit of the HALO curriculum are supported by child development and prevention research.

Units 1-3

Unit #1 (“I Am Special”), Unit #2 (“I Can”), and Unit #3 (“Families”) reflect activities that strengthen a child’s sense of self or identity.

Self-concept, or “what an individual knows about him/herself,” (Houck and Spegman, 1999) and self esteem, referred to as self-image or self worth (Santrock, 1997) are both related to the incidence of drug experimentation.

Towberman and McDonald (1993) report that lower levels of self-confidence, bonding, as well as higher levels of negative image were strongly correlated with drug experimentation and frequency of drug use in adolescence.

Higher levels of depression, anxiety and lower self-esteem were related to positive attitudes concerning drugs and an increased willingness to take drugs.

Activities in all three units promote a positive self-concept and feelings of self-esteem, which are developed in early childhood and difficult to change later in life (Houck and Spegman, 1999).

Read our white paper – How Families Impact a Child’s Brain Development

Units 4-6

Unit #4 (“Communication”), Unit #5 (“I Feel Happy and Sad”), and Unit #6 (“I Feel Mad and Scared”) focus on recognizing and expressing feelings to promote social competence, healthy peer relationships, and school success.

Social competence, which in part is predicted by emotional competence, is not only relevant to developing peer relationships, but also predicting their success at school. Socially competent kindergarteners are more successful in developing positive attitudes about adjusting to school, get better grades, and achieve more. Kindergartners who are victimized by peers or are aggressive have more school-adjustment problems, and are at risk for future problems such as drug abuse (Denham et al., 2003).

Units 7-9

In Unit #7 (“Healthy Bodies/Healthy Choices”), Unit #8 (Healthy Choices/No Harmful Drugs”), and Unit #9 (“Healthy Choices/Drugs are Dangerous”) children learn about their internal organs, the harmful effects of alcohol, tobacco, or other drugs on their organs, and that drugs are dangerous.

“One’s ability to make choices is not only a desirable skill but also creates a pattern of social competence. When taught how to identify, select, and initiate choice making opportunities, young children can become adults who independently make choices” (Jolivette, Stichter, Sibilsky, Scott, Ridgley, 2002, pg. 396).

The American Council for Drug Education (1999) states that “children who resist drug experimentation are generally adept at problem solving and self-help, parents need to ensure that the foundations for these skills are laid down during the preschool years.”

Unit 10

Children are also taught in Unit #10 (“Stress”) that drugs are not an acceptable way to handle stress, and they learn alternative coping mechanisms for dealing with stress. Increasing the social supports and coping skills of youth influence their likelihood of using drugs as a coping device to alleviate stress.

A study by Block and Block indicated that “preschool children who were less resilient, less socially competent and more rebellious were more likely to be drug abusers at age 14 than the other children” (Spooner, 1999, pg. 461).

Units 11-12

In Unit #11 (Healthy Lifestyles/Healthy Eating) and Unit #12 (Healthy Lifestyles/Physical Activity) children learn what foods are healthy and the importance of being active. Children are taught that being the appropriate weight and being able to participate in physical activities with other children reduces stress, both physically and emotionally.

Data from the National Health and Nutrition Examination Survey (NHANES 2003-2004), indicate that 14 percent of two to five year olds and 17 percent of children and adolescents ages 12-19 years in the United States are overweight. The prevalence of overweight children and adolescents has quadrupled and tripled, respectively, in the last 30 years. Only a small percentage of overweight children may attribute their problem to endocrine disorder or other underlying physical problems.

When children are overweight, the 2005 Dietary Guidelines for Americans recommend reducing the rate of weight gain while allowing for growth and development. Overweight children and adolescents are more likely to be overweight or obese as adults.

Decreasing levels of self-esteem in obese children were associated with significantly increased rates of sadness, loneliness, and nervousness compared with obese children whose self-esteem increased or remained unchanged. In addition, obese children with decreasing levels of self-esteem over the 4-year period were more likely to smoke and drink alcohol compared with obese children whose self-esteem increased or remained unchanged. (Richard S. Strauss, MD , ‘Childhood Obesity and Self-Esteem’, PEDIATRICS Vol. 105 No. 1 January 2000, p.15)

The Substance Abuse and Mental Health Services Administration (SAMHSA) ‘Keeping Youth Mentally Healthy and Drug Free — Family Guide’ website advises: “Overweight children have a much greater risk of developing physical and mental health problems than their non-overweight peers. The effects are more than just physical. Overweight youth often face social discrimination, like teasing and exclusion, by their peers. Studies have found that overweight youth are more likely to be diagnosed with mental health disorders, such as depression, than their non-overweight peers.”