Module 3: Personal Hygiene & Nutrition
Lead Awareness in Indian Country: Keeping our Children Healthy!Module 3:Personal Hygiene& Nutrition61
Lesson Plan ú Module 3Lead Awareness in Indian Country: Keeping our Children Healthy!PERSONAL HYGIENE AND NUTRITIONModule 3: Personal Hygiene and Nutrition focuses on the connections between personalhygiene, nutrition for children and potential exposure to lead. Good personal hygiene andhealthy nutritional practices can limit absorption of and reduce exposure to lead in children.By the end of Module 3 participants will: Learn specifc personal hygiene techniques that help reduce potential childhood leadexposure; Identify foods that contain calcium, iron, and vitamin C; and Understand nutritional practices and foods that may limit the absorption of lead.Instructor PreparationTo prepare for Module 3: Personal Hygiene and Nutrition, the instructor should take thefollowing steps: Preview the lesson plan to identify sections where examples, stories and localinformation may be inserted. Reach out to tribal personnel and other resources to find local information andpartners, if possible. Contact tribal leaders, elders, staff and other community members to compile a listof your tribal community’s local/traditional foods and snacks that are not listed in theModule 3 Worksheet.- Using Appendix A: Foods that Contain Calcium, Iron and Vitamin C and AppendixD: Supplemental Resources, determine which of your tribal community’s local/traditional foods contain calcium, iron and/or vitamin C.- On the blank Local/Traditional Foods slide in the presentation, add your tribalcommunity’s local/traditional foods to the appropriate row – Calcium, Iron orVitamin C (or create a table on flipchart paper if needed).- Compile a list of your tribal community’s common snacks that contain calcium,iron, and/or vitamin C.- Find images of your tribal community’s local/traditional foods and snacks (optional). Make copies of Module 3 worksheet, key messages and kids activity sheet (1 copy perparticipant). Gather materials for the Handwashing Demonstration. Gather foods and utensils needed for the Healthy Snack Activity. Gather any materials needed for the optional demonstration and activities included inModule 3:- Black Light Activity; and- Reading Food Nutrition Fact Labels. Edit the Module 3 Presentation Slides to incorporate relevant stories, images andvideos. Remove presentation slides you do not plan to use during the session. Use the “Notes” boxes provided in the lesson plan for personal notes.Instructor Notes written in italics can be found throughout the lesson plan. These notes areintended to help guide the instructor through the discussion and presentation and are notmeant to be read out loud during the session.63
Notes:Suggested Materials Laptop and projector to display presentation slidesand videosFlipchart and markersPens and pencilsModule 3 WorksheetModule 3 Key MessagesModule 3 Kids Activity SheetMasking tapeFaucet with running water or buckets of waterSoapPaper towelsUtensils and food to make a healthy snackOPTIONAL black light kit (black light powder, blacklight oil, ultraviolet lamp)OPTIONAL nutrition facts labelsIf access to technology is limited, you can use hardcopiesof presentation slides.OutcomesUpon the completion of Module 3, participants will be able to: List three personal hygiene habits that can reducepotential lead exposure in children; List three healthy snacks for children that may helpreduce the impact of potential lead exposure; Explain how meals and snacks can becomecontaminated with lead during preparation; and Discuss actions that can be taken in the home toreduce potential exposure to lead.64Lesson Plan - Module 3
OutlineNotes:I. Introduction (10 minutes).66II. Personal Hygiene (15 minutes).67a. Handwashing in 6 Stepsb. Handwashing Demonstrationc. Outdoor Best PracticesIII. Nutrition (25 minutes) .70a. Eating a Healthy Diet with Key Nutrients to ReduceLead Absorptioni. Optional Activity: Reading Nutrition FactsLabelsb. Meal Ideasc. Healthy Snacksd. Food Preparatione. Outdoor Best Practicesf. FishIV. Conclusion (10 minutes) .79V. References.80Lesson Plan - Module 365
Notes:I. Introduction (10 minutes)Good personal hygiene and healthy nutritional practicesmay assist in reducing the absorption of lead in a child’sbody. It is important that everyone, not just parents andcaregivers, understand the benefcial impacts that simpleactions, such as consistent hand washing and feedingchildren healthy foods, can have to help reduce the risk oflead exposure. Today, we will discuss simple actions we cantake to reduce potential exposure to lead by focusing onpersonal hygiene and nutrition.I am going to defne a few words that will be used throughoutour discussion.1. Hygiene – Actions taken to keep our bodies clean,such as washing our hands or hair and taking a bath.2. Nutrition – The process of consuming food orbeverages necessary for health and growth, whichour bodies need to stay alive and healthy.3. Nutrient – A substance in food or beverages thatprovides nourishment for growth and the maintenanceof life.To better understand what we already know and think aboutpersonal hygiene and nutrition, I have a few questions for thegroup. If you do not know the answers, that is fne. We willcover all the information shortly. Instructor Note: Dependingon time, ask one or all four questions. Record participants’responses on flipchart paper and post them in a place thatwill be visible throughout the session.1. What are examples of good personal hygienebehaviors for children? Instructor Note: Answersmay include: washing hands after playing outsideand going to the bathroom; covering your mouthwhen you cough or sneeze; brushing teeth twicea day; bathing regularly.2. What foods do you think should be part ofa healthy diet for children? Instructor Note:Answers may include: fruits and vegetables.3. What are some nutrients that are important for ourhealth? Instructor Note: Answers may include:vitamins, minerals, calcium, magnesium, protein,water and fiber.66Lesson Plan - Module 3
4. What nutrients may limit the absorption of lead inchildren’s bodies? Instructor Note: Answers include:calcium, vitamin C and iron.Notes:Some of the personal hygiene and nutritional tips that we willdiscuss today may be actions you already follow.II. Personal Hygiene (15 minutes)Taking care of our bodies and keeping ourselves andsurroundings clean and clutter-free are important to maintaingood health. To minimize the possibility of illness and reducechildren’s potential exposure to lead, teaching children goodpersonal hygiene habits is essential. Adults can teachchildren good personal hygiene by: Making sure they wash their hands several timesa day. Keeping their fngernails and toenails trimmed short. Bathing them daily. Pinning pacifers to their clothes. Washing bottles and pacifers daily. Washing toys often. Washing clothes and shoes soiled by lead dustor soil separately from other items.One way young children ingest lead is through dust orsoil contaminated by lead-based paint or other sources oflead that settles on their hands as they play. When childrenput their hands in their mouths, they may swallow leadcontaminated dust or soil, which can then get into theirbloodstream. Elements of good hygiene, such as consistenthandwashing, reduces the likelihood of this happening andis the best way to reduce the number of germs on children’shands in most situations. Children should wash their handswith soap: Before eating, drinking and sleeping; After using the bathroom; and After playing outdoors or with animals.When children wash their hands, they should wash withsoapy water for at least 20 seconds, and then dry their handsthoroughly with a clean towel or paper towel. While warmwater is preferred, cold water is better than not washing.Hands should not be wiped off or dried on their clothes,which could be contaminated. Six steps are recommendedfor effective handwashing.Lesson Plan - Module 3Using Hand SanitizerThere are differences betweenwashing hands with soap andwater and cleaning them withhand sanitizer. Alcohol-basedhand sanitizers do not kill alltypes of germs and may notremove harmful chemicals, suchas pesticides and heavy metals,such as lead. Handwashing withsoap and water reduces theamounts of all types of germs,pesticides and metals on hands.For more information, readHandwashing and Hand SanitizerUse at Home, at Play, and Outand About at factsheet.pdf.67
Notes:Optional Black Light ActivityBefore beginning thedemonstration, ask participants:why is warm, soapy waterimportant? Then:1. Show participants yourseemingly clean hands and askif they look dirty – you may evenwant to walk around the roomto allow participants to get acloser look.2. Put black light powder on yourhands and then show them tothe participants. Explain thatthe powder represents tinyparticles of lead. Now showparticipants your hands underthe black light. The powder willglow in areas where your handsare dirty.3. Run your hands quicklyunder running water and thenshow participants your handsunder the black light again.Participants will see that theblack light powder is stillpresent, demonstrating thatsimply running your handsunder water is not a goodmethod of hand washing as itrelates to lead.4. Wash hands thoroughlyfollowing the Handwashing in 6Steps procedure outlined. Endthe demonstration by showingyour clean hands under theblack light.a. Handwashing in 6 StepsStep 1: Wet hands with clean, running water.Step 2: Add soap, then rub hands together making a soapylather. Do this away from the running water; be careful not towash the lather away.Step 3: Scrub the front and back of hands, between fngersand under nails. Wash for at least 20 seconds, the amountof time it takes to sing the ABCs once or the Happy Birthdaysong twice.Step 4: Rinse hands from wrists to fngertips under clean,running water. Let the water run back into the sink, not downto your elbows.Step 5: Dry hands thoroughly with a clean towel or papertowel.Step 6: Turn off the faucet with the used towel. Remember,dirty hands turned on the faucet.Following these six steps will ensure that children are gettinglead dust off their hands. This information is found in the keymessages handout, a take-home resource that summarizesinformation covered today. Instructor Note: Give a copy ofthe Module 3 Key Messages to each participant.b. Handwashing DemonstrationInstructor Note: Use the six steps of handwashing outlinedabove to have participants wash their hands. You will needliquid hand soap, a faucet with running water, and papertowels. If you do not have access to a faucet with runningwater, you can use buckets for the demonstration: one bucketfor the faucet and one bucket for the sink. One participantcan pour water from a bucket into the other bucket simulatinga faucet while another participant washes their hands. Ifpossible, expand the demonstration to include the optionalBlack Light Activity. As an alternative you can show a video,such as this one from the Centers for Disease Control andPrevention: sh-your-hands.html.c. Outdoor Best PracticesThis session mainly focuses on indoor activities. However,we may be exposed to lead in our outdoor environmentsthrough contaminated soil or breathing in dust containing68Lesson Plan - Module 3
lead. Exterior lead-based paint from houses and buildingscan fake or peel, and then get into the soil. Past use ofleaded gasoline in cars, from industrial sources, or evenfrom contaminated sites, including former lead smelters,can contaminate soil.Notes:Some plants that grow in soils with a high lead concentrationcan absorb lead from the soil with most of the lead remainingin the roots and, in some rare cases, even making its way tothe aboveground parts of the plant. A certifed professionalcan remove (or partially remove) contaminated soil andreplace it with “clean” soil.How can we reduce potential exposure to lead while outdoorsin areas suspected or known to be contaminated with lead?How can we prevent lead from getting inside our homes?Instructor Note: Allow participants time to think and sharewith the group.To reduce potential exposure to lead while outdoors we can: Check the exterior of your home, including porchesand fences, for deteriorating paint. Cover bare soil with grass, plants, gravel, or woodchips, especially near the exterior walls of your home. Play in grass and dirt not contaminated with lead, ifpossible. Wash outdoor toys and playground equipmentregularly using an outside faucet or hose. Use designated picnic, camping, biking and hikingareas.To avoid tracking soil into your home: Put doormats outside and inside all entryways. Remove shoes before coming inside. Wipe pet’s paws prior to bringing them indoors. Remove soil from clothes, toys, pets and equipmentoutside, if possible.Instructor Note: Give a copy of the Module 3 Worksheet anda pencil to each participant. Go through the Personal Hygienequestions together.We will use the worksheet during this session as a discussiontool and to review what we learned together. Look at thePersonal Hygiene section at the top of your worksheet.1. List two personal hygiene habits that may assistin reducing children’s potential exposure to lead.Lesson Plan - Module 369
Instructor Note: Answers may include washingchildren’s hands several times a day; trimmingchildren’s fingernails and toenails short; daily baths;pinning pacifiers to their clothes; washing bottlesand pacifiers daily; washing toys often; and washingclothes and shoes soiled by lead dust or soilseparately.Notes:Use Caution When EatingImported FoodsUse caution when consuminginternational candies, spices andother foods. On occasion, foodsand food products imported to theUnited States have been foundto contain high levels of lead. Notall countries have set the samestandards to reduce the amountof lead in paint, foods and otherproducts (Ref. 2).2. You should wash your hands with soapy water for atleast seconds. Instructor Note: The answer is 20.III. Nutrition (25 minutes)Instructor Note: Familiarize yourself with the lists of foods,meals and snacks provided in the lesson plan and beprepared to share examples to start the conversation. If youneed additional ideas, use Appendix A: Foods that ContainCalcium, Iron and Vitamin C which is a list of over 150 generaland local/traditional foods that are known to contain calcium,iron and/or vitamin C. Record participants’ ideas on foods,meals, and snacks, preferably on flip chart paper.Specifc nutritional choices you and your children makeare crucial. Proper nutrition is important for a child’s overallgrowth, development, learning and more. Creating healthyeating habits will maintain our health and reduce the risk ofdiseases. Everything we eat and drink matters, which is whyit is important to include a variety of vegetables, fruits, wholegrains, proteins and dairy products in our diets (Ref. 1).a. Eating a Healthy Diet with Key Nutrients toReduce Lead AbsorptionEating a variety of foods gives children the vitamins andminerals they need to grow up healthy. When children donot have enough calcium or iron in their bodies, their bodiesmay absorb lead instead of these nutrients. Calcium, ironand vitamin C are natural blockers that may help reduce theabsorption of lead in the bloodstream.A diet rich in important nutrients such as calcium, iron andvitamin C plays an essential role in reducing the absorptionof lead: 70Calcium helps bones stay strong and may keep leadout. Foods that contain calcium include: Milk and milk products, such as yogurt andcheese; Broccoli;Lesson Plan - Module 3
Canned salmon and sardines; andFoods with added calcium, such as orange juiceand soy milk.Notes:Iron may block lead from being absorbed. Foods thatcontain iron include: Lean red meats, fsh, chicken and eggs; Beans, peas, green leafy vegetables and lentils; Iron-fortifed cereal, bread and pasta; and Dried fruit, such as raisins and apricots. Vitamin C increases the absorption of iron, which maydecrease the absorption of lead. Foods that containvitamin C include: Citrus fruits, such as oranges and grapefruit; Kiwi, strawberries and melon; and Tomatoes, potatoes and peppers.A couple of other important facts to understand regardingchildren and preventing the absorption of lead are: An overall unhealthy diet high in fat and oil mayincrease the rate of lead absorption; and A child with an empty stomach will absorb more lead.What other foods, in addition to those already mentioned,do you think we can provide our children to ensure theyare getting calcium, iron and/or vitamin C in their diets?Instructor Note: Allow participants time to think and respondbefore showing them the Foods that May Help Reducethe Absorption of Lead table that is in the worksheet andpresentation. Foods are listed by the nutrient they containthe most of: calcium, iron or vitamin C.Look at the Foods that May Help Reduce the Absorptionof Lead table on your worksheet.1. Did we mention any of these foods earlier?2. Are any foods already in your family’s diet?Take a moment to carefully read through the General Foodscolumn and circle all the foods you and your family eat.Lesson Plan - Module 371
Notes:Foods that May Help Reduce the Absorption of LeadNutrientsGeneral Foodsalmonds, bone broth, broccoli, cannedCalciumsalmon, cheese, chia seeds, collardgreens, cottage cheese, crab, edamame,(mineral needed to fgs, okra, milk, non-dairy milk, nopalbuild and maintain cactus pads, prickly pear, sardines,strong bones)seaweed, sweet potatoes, tofu, whitebeans, whole wheat bread, yogurtIron(mineral critical toblood function)apricots, asparagus, beans, beef,bison, black walnuts, chicken, clams,eggs, fsh, fsh eggs, hazelnuts, lentils,liver, mushrooms, mussels, mustardgreens, oats, oysters, peanutbutter, peas, pine nuts, pumpkinseeds, prunes, raisins, salmon,scallops, shrimp, spinach, venison,water potato, wild riceapples, bananas, bell peppers, blackberries, blueberries, brussels sprouts,cabbage, cantaloupe, caulifower,(vitamin thatchestnuts, citrus fruits, corn, greenprotects the body beans, honeydew, huckleberries, kale,from disease and kiwi, leeks, parsnips, pears, plums,increases thepotatoes, raspberries, rhubarb,absorption of iron) squash, squid, strawberries, tomatoes,turnips, watercressVitamin CCount the number of foods you circled and then record thenumber in the box below the table. Instructor Note: Sharewith participants the number of foods in the General Foodscolumn eaten in your home. Ask a few of the participants toshare the number of foods eaten in their home.Do you think the table is missing any foods, specifcally anylocal/traditional foods eaten in our community? Take a fewminutes to compare your thoughts with others and write theseunder the Local/Traditional Foods column on your worksheet,listing them by the nutrient you think they contain the most of:calcium, iron or vitamin C. Instructor Note: Allow participantsa few minutes to discuss; share your findings based onAppendix A and your own research.72Lesson Plan - Module 3
Based on my own research, this table lists some of our local/traditional foods that contain these three nutrients. Each foodis listed by the nutrient it contains the most of: calcium, ironor vitamin C.Notes:Foods That May Help Reduce the Absorption of LeadNutrientsCalcium(mineral needed tobuild and maintainstrong bones)Iron(mineral critical toblood function)Local/Traditional FoodsInstructor Note: Please includeyour tribe’s local/traditional, foodsthat contain calci
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