HealthyCal.org

By Clare Noonan
California Health Report

Men in Merced County are making powerful changes in their lives and those of their children. It’s happening because of All Dads Matter, a Human Services Agency program that offers something for every male parent: a boot camp for expectant and new fathers; a resource center that helps with everything from job searches to finding child care; support groups at which men can open up about any issue; and events called Man Plays with Food, a cooking and learning time for dad and child.

The one-day, three-hour boot camp targets to-be dads or those with infants up to six months, explains program coordinator Lamar Henderson. It has served 2,000 men in six years.

What makes this class different is that it features the hard-earned knowledge of “veteran” dads. These men, acting as teachers, know what they’re talking about when discussing topics such as their role during birth, postpartum depression and how to bond with a newborn. They’re old hands at diapering, holding and soothing a crying baby and are eager to pass on useful tips.

In addition to learning how to handle their babies, dads learn that, just like moms, they can feel stressed by their new roles. By the time they leave boot camp, they understand the huge emotional upheaval a new baby can represent and have methods for coping with it.

Having these tools at their disposal allows the men to build happier and safer home environments, Henderson says. All Dads Matter fosters deep and profound connections between father and child, he continues. “If you can get the dad connected by the time the child is 2 years old, the dad will stay involved.”

Michael, 20, is a boot-camp graduate who stays focused on his 3-month-old daughter, London, while answering a reporter’s questions. He says the class taught him that a baby has different cries that require different responses. “I’m a better parent,” he says as he gazes at his baby. “There’s a lot of stuff to look for.”

Oscar, 38, and the father of 10-month-old Lucia Grace, says boot camp made him ask himself, “How do you want your kids to see you in the future?” He says he loved his dad but alcoholism kept the two at a distance from each other. Oscar smiles broadly as he shows off a picture of Lucia on his cell phone, noting that she will be parented differently than he was.

That’s the whole idea behind All Dads Matter, according to Ana Pagan, director of the Human Services Agency. The county focuses on making the child-welfare system “a child-friendly environment,” she says. “We want to keep families together.” The multi-faceted program specifically for dads is a key part of building good families, regardless of whether the parents live together. “It’s a good way of fighting child abuse,” Pagan says.

The philosophy of the Merced County program is that it’s just as important to nurture grown men as it is children. Henderson points out the importance of keeping things “strength-based” and positive in All Dads Matter.

“From the time the dad walks in the door, that’s already a plus. A workshop on Saturday? You didn’t have to come,” Henderson says of the dads. “The great thing is we acknowledge every success.” For boot camp, it’s important for a dad to receive not only a diaper bag crammed full of everything a baby needs but a certificate of completion. “It’s the only one they’ve had,” Henderson notes.

Oscar has attended the men’s support group in addition to boot camp. He ticks off what it has offered him, including “freedom of speech, respect, anonymity. You let go of things. You have the opportunity to make things different. It’s amazing.”

When the group began in 2006, there were two or three men meeting once a week, according to Henderson, Now, there are 12 to 14 attendees per session, which are held twice a week in English and Spanish. Half of the men are referred and half just “need a safe place to go,” Henderson says. He recalls a participant who told his group, “ ‘I feel worthless as a dad.’ ” Discussing issues from their childhoods leads to “tremendous healing.”

Kenny, 46, is dad to Shantell, 6, and three-year-old twins Ken Jr. and Precious. He heard about All Dads Matter at a community picnic and started participating. He says he had seen his father only three times by the time he was 13 and didn’t accept his stepfather as a parental figure.

The program has changed how he parents, Kenny says. During an interview, he makes time for Shantell, showing her how a toy works. “It’s good for all dads,” he says, adding, “No matter what, there’s no game plan for being a dad. There’s going to be questions.”

They might include “What’s to eat, Dad?” To provide an answer, All Dads Matter joined with Head Start to initiate Men Play with Food. The evening event teaches dads, or other role models in a child’s life, and their youngsters, how to make inexpensive, nutritious food. A peanut butter pinwheel is easy to make, fun to eat and gets lots of shouted answers when the leader asks, “What shape, kids?” The most recent Men Play with Food attracted more than 50 dads, according to Henderson.

While it’s a fun evening, a video of one event features a dad talking through tears. “The thing I hold dearest to me is my son’s smile that day when it was one hour of my time,” he says. “The hour, the smile, I can never replace that.”

By Clare Noonan
California Health Report

It wasn’t easy for David Arceo to let his firstborn, Lizandra, leave home to attend UC Santa Cruz. His wife, Blanca, graduated from Fresno State and teaches first grade, but David attended school only through eighth grade because of illness. “I worry about it,” he said as his 17-year-old prepared to move away from home in Merced to attend the fall quarter. Still, he added, “I think if other kids did it, she can do it.”

A major reason he’s fine with the idea of college is the Parent Empowerment Program (PEP) run by the UC Merced Center for Educational Partnerships.

The 10-year-old center targets valley students, many of whom might not otherwise see college as a goal, and prepares them and their parents for higher education. “Our clear commitment is to fundamentally change the opportunity to learn,” said Jorge Aguilar, the UC Merced associate vice chancellor for educational and community partnerships.

Arceo and his wife attended PEP workshops that demystified all aspects of getting into and attending college: what courses and exams high-school students have to take in order to be admitted, how to fill out financial forms, what college courses to sign up for.

“It educates parents about college life for their children,” said Patrick Durr. “It takes away the fear of what college life will be like.” The social science teacher at Modesto High School coordinated the empowerment program that began there last year and will be held again in the spring. Presentations were given in English and Spanish, with the Spanish-speaking parents the most consistent participants, he said. An average of 40-45 parents attended each session and 36 earned a certificate of completion. Because the two-hour workshops were held in the evening, parents sacrificed to attend, Durr said. “It testifies to how important it is to them.”

English is not the first language for more than 67 percent of parents in the program, according to statistics on the center’s web site. The existence of such language and cultural barriers can make higher education seem an intimidating and unreachable goal. “Sometimes a kid is qualified but the parent says, ‘No, I’ve heard crazy things,’ “ Durr said.

PEP targets just that mom and dad, “unwilling parents of willing students,” vice chancellor Aguilar said with a laugh.

That could describe David Arceo, who said, “If it was me, I want her to stay here.”

Going to college “was a decision she made,” he said of Lizandra, who is interested in studying law. He said he told his daughter “it’s good you be a lawyer. You fight all the time.”

This is followed by his pointing out that Lizandra went to preschool at the tender age of 2 years, 7 months. She’s still his baby.

Spending time on a college campus made him more comfortable with the idea of her going away to college. A perk for parents who attend a majority of the eight PEP sessions is a bus trip to a guided tour of a college campus. It might include stops at a police station and a dorm cafeteria. The idea is to address parents’ concerns about safety as well as provide a feel for their student’s everyday life.

Over the years, Arceo has toured the campuses of CSUs Fresno, Sacramento and Monterey Bay, and UC Davis. “I liked them all,” he said, despite his opinion of UC Davis as being “too big, too many bikes. I’ve never seen so many bikes at a university.”

Lizandra has been involved since middle school in the Center for Educational Partnership’s initial program — UC Scholar EAOP (Early Academic Opportunity Program). It aims to get youngsters thinking about college early and, as they move to high school, get them into courses that will qualify them for higher education.

The group workshops in middle school turn into several annual one-on-one sessions with an advisor as the young scholars go through high school. That’s a good thing, Lizandra said, because “some kids didn’t feel good talking about their grades” in front of other students. The advisors “never say they’re too busy, no,” she said. “They always listen.” Center staff help high-school seniors apply for college and learn to write personal statements, according to Aguilar.

Lizandra attended a weekslong workshop that taught how to write effective college applications. She said her UC Scholars advisors provided “extra hope and a source I can go to.” Without the program, Lizandra said she would “kind of be lost in the application process. I probably wouldn’t be ready.”

“If parents go to the program it makes it easier for parents and the kids,” she added, explaining that in her mother’s college days, applications went snail mail while everything now is computerized. Lizandra said she takes comfort in the PEP sessions illustrating to her parents that even though computers will make some of her college chores faster and easier, “I’m still working hard.”

UC Scholars was the center’s first program. “It taught us that it was extremely difficult to work only with students and not other stakeholders,” said Aguilar. A cornerstone of the center now is its liaisons with families and school districts in a far-flung area that ranges from Bakersfield to Modesto, Avenal to Strathmore. Other programs at the center include one that compiles data on student enrollment and success, and another that looks for talented low-income students to help them become among the first generation in their family to attend college.

The center has brought in $15 million in grants over its 10-year history, Aguilar said, and served 10,000-plus people with that money. An additional 14,000 “benefit from our presence,” he said.

“College attendance is abysmally low in the valley,” Aguilar pointed out. So, while the center is part of UC Merced and started with a program called UC Scholars, the center wants to serve area students’ “overall college needs no matter where they go,” he stressed. “Many of our students enroll at CSU.”

By Clare Noonan
California Health Report

The San Joaquin Valley Program in Medical Education (PRIME) might not be that well known by residents yet, but it could improve health care for those who live in the eight-county area for years to come.

The program is training doctors, most of whom are from the San Joaquin Valley, who want to treat underserved populations in the area. Currently, the San Joaquin Valley has too few doctors, including both primary care physicians and specialists.

The SJ PRIME is a collaboration between the University of California at Merced, the UC Davis School of Medicine and UCSF Fresno’s Medical Education Program.

It is the sixth and latest addition to PRIMEs in place at UC medical schools, according to Sneha Patel, program manager of UC Davis Rural PRIME and SJ Valley PRIME. Long-range plans call for a medical school to be built at UC Merced, according to university officials.

In addition to the rigorous training they receive at UC Davis medical school, students in SJ Valley PRIME learn about health‐care issues specific to the valley. The program’s goal is for these medical school graduates to return to the area after their training is completed.

“The history goes way back,” says Brandy Nikaido, UC Merced spokeswoman.

She explains that planning for medical education began even before undergraduates arrived on the newest UC campus in September 2005. The other two UCs were chosen as partners, Nikaido said, for purposes of “building on the accreditation of UC Davis and the infrastructure of UCSF Fresno.”

Students’ acceptance to SJ Valley PRIME hinges on a knowledge of the valley and a desire to practice as physicians in the area, Nikaido says. They receive a $10,000 scholarship that is funded by Children’s Hospital Central California, Community Medical Centers and Bryn Forhan, a Fresno businesswoman and co‐chair of the Valley Coalition for UC Merced Medical School, according to the UC Davis School of Medicine Alumni Association.

Medical students often don’t know which branch of medicine they will enter after completing training, but a range of physicians is needed in the San Joaquin Valley, says Dr. Joan Voris, associate dean of UCSF Fresno Medical Education Program.

According to a 2008 study by the California Healthcare Foundation, the San Joaquin Valley is lacking in primary care physicians as well as specialists. The valley had 45 primary care physicians per 100,000 population, while the recommended number was 60‐80. Specialists in the valley were at 74 per 100,000 population, with recommendations calling for 85‐105.

The hope is that San Joaquin Valley PRIME will change those figures, starting with UC Merced’s initial group of five students, which completed its first year of medical school this summer.

“It was really hard, really intense,” Sidra Ayub, 26, says of the year. Her family moved to Modesto from Pakistan when Ayub was 5 years old. She says she knew from a young age that she wanted to be a community leader and “saw medicine as a good opportunity to open myself to that. Doctors set the tone for good will.”

Ayub understands firsthand the health‐care deficits in the valley. “I have the worst dental episodes,” she says, adding that she didn’t take care of her teeth because her family couldn’t afford preventative care.

“You have to get people early,” Ayub says, before they show signs of dental decay or illness. For that to happen you need enough health‐care practitioners and access to the proper medications. Take statins, medications that lower cholesterol, for instance. “Why shouldn’t people be on that?” Ayub asks, regardless of whether they live in New York City or a small valley town.

Such empathy fosters her desire and that of other PRIME students to undertake the daunting work involved in medical school and at the same time attend weekly seminars, shadow valley physicians, volunteer to help underserved patients and even participate in book clubs whose selections concentrate on valley issues.

This June, SJ Valley PRIME students boarded a bus that carried them from Sacramento to Delano, near Bakersfield. They learned during the two‐day trip about the food, culture, traditions and health‐care needs of such groups as the Filipino community in Stockton and the Laotians in Modesto.

David Hosley, executive director of UC Merced’s Sierra Nevada Research Institute, acted as tour guide and spoke to the students about equity issues in the valley. Gerald Haslam, historian, author and professor emeritus at Sonoma State, and his wife, Janice, spoke to students about life in the San Joaquin Valley, pointing out that the area is one of entry for many immigrants.

Dr. Tonya Fancher, associate director for curriculum, UC Merced San Joaquin Valley PRIME, said that when students spoke to her after the tour they asked why they hadn’t known about many of the problems facing valley residents. She said her hope is that PRIME students will develop a passion in particular areas, including advocacy and outreach.

The medical students will move to UCSF Fresno during their third year of school, according to Fancher, where they will work directly with patients. Hands‐on contact with patients throughout the valley will continue in the fourth year.

“The students are itching to be in the valley,” Fancher says, but notes that it is difficult to get them there from Davis when medical school happens in “four‐hour blocks.”

The time crunch is a familiar one to medical student Ayub. “We had more preceptorships (supervised practical training) than our classmates,” she says.

“They’re hard to squeeze in in eight hours.” But she managed, working at Kaiser Permanente Medical Center in Roseville, where she shadowed an internal medicine physician and took a class for diabetics that included sticking herself with a needle so that she could relate to what a patient feels.

Ayub calls herself and the four other students in San Joaquin PRIME “pretty close knit” and says they work closely with members of UC Davis’ Rural PRIME, which has had four classes of 12 students each. “We ask them lots of questions.”

“UC Davis is a nurturing environment,” Ayub says. “There’s no ‘That’s a stupid question.’”

And because the San Joaquin Valley PRIME is in its infancy, it will continue to evolve, says Voris of UCSF Fresno Medical Education. “Our goal is to have a program that is really unique. Year Eight will look different.”

By Clare Noonan
California Health Report

Ildefonso Nava, left, and Silverio Damien, right, at Community Day in Planada on May 12, 2012.

There’s a movement afoot at Merced’s Cesar Chavez Middle School and it has nothing to do with improving test scores, increasing literacy or battling bullying.

While it’s true that those three things could result, this effort is all about students’ dads.

It’s called Tiger Dads, and it’s a group that aims to tighten the bond between a father and his children. It began a couple of years ago when Principal Ildefonso Nava noticed that not many dads were attending student‐teacher conferences and other school events.

“I wanted to have more dads participate in school,” he says. “It was always only mothers.”

So, two years ago, he held a dads‐only meeting. The men talked about ways in which they could help their community, including the middle school, which has 230 students of mostly Hispanic heritage. The one‐time meeting eventually morphed into the Tiger Dads club, which meets once a month and has 24 members. The group might hear from a motivational speaker or plan an activity.

Residents of Merced can spot the men, sporting their Tiger Dad T‐shirts, hauling away garbage from streets and alleys or scrubbing graffiti from buildings and fences.

Seeing the men hard at work has a positive impact on neighborhood residents, Nava says. The message is clear and simple: “This is our town. We’re not going to put up with it.”

Tiger Dads also make their presence known in fun ways. They served sno‐cones at a recent spring outreach festival to the tune of 1,200 drippy treats.

Nava says he had a hunch that once dads came to one event, they’d be “hooked.” And that can happen in more ways than one. When he announced an ice cream social this year, Nava says the dads expected a time to just relax, talk and enjoy themselves with their children.

While the good times and calories did roll, there also was a serious purpose to the gathering that the dads didn’t know about beforehand. A question was posed during the social for the dads to answer for their children and for the children to answer for their dads. The fathers were told to ask their children: If you could change anything about me, what would it be? And kids were told to query their dads: I know I’m important, but how important am I?

Pretty serious stuff, and Nava acknowledges that the questions and answers “changed the tone a bit.” But he says he wants Tiger Dads to accomplish something beyond better communities. “Our goal is to change the culture,” Nava says.

Long, hard hours in agricultural fields are the norm for many Cesar Chavez fathers, many of whom speak Spanish only. “Some of our parents just work, work, work,” Nava says, leaving them without much time or energy to interact with their kids.

Through membership in Tiger Dads, men “get that ‘Our role is important,’ ” he adds.

Education is an important aspect of the club. Nava says that the dads learned at one meeting what steps were involved in getting their children into college. And this spring a speaker talked about the role of a father and how traditions and customs in a family affect a child.

The change in the dad‐child relationship is playing out at Cesar Chavez, according to Nava. “We’ve already started to see the impact on the kids.”

“You can really tell in these students. Their self‐esteem has gotten better.”

He tells about girls in his school who were always tardy. That changed once their father became a Tiger Dad, Nava says. “Once their dad got involved, they have almost perfect attendance.” Of youngsters who were acting out and causing problems during school hours, he says, “their behavior changed.”

Nava says he believes the improvements he and his staff are seeing are a result of Tiger Dads getting the message about their kids that “if they’re in school, they do better.”

One dad says that he feels becoming a Tiger Dad has made him a better person and a better parent.

“It’s helped me unfold myself,” says Silverio Damien, father of Vanessa, an eighth-grader at Cesar Chavez Middle School, and Anahi, a sixth‐grader. He became a member of the club during this school year. He speaks about what the club has meant to him as Nava interprets for a reporter.

“It’s very important to support your children,” Damien says, “and be involved with the community and your children.”

He adds that he’s learned ways to help his daughters “and guide them to be better people.”

Before joining Tiger Dads, Damien says, his voice would be a “little louder” when speaking to the girls. Now he has more confidence as a parent, he continues, and says he feels “prouder.”

He laughs as he talks about his membership in the club being important to Vanessa and Anahi. “They’ll ask me, ‘Do you have a meeting today?’ ”

Nava, dad to Julian, 17, and Cristian, 15, has been principal at Cesar Chavez for eight years. Before that, he taught history, language arts, industrial arts and fine arts. He says that a club like the one he started brings “a change in a community,” whether people belong or not.

After serving as an announcer at the recent Community Day parade in Planada, Nava gestures toward a barbecue pit. It used to take hours to wrap the meat for the event.

This year, 500 pounds of meat were wrapped in 45 minutes because so many more people pitched in, according to Nava.

He says that groups like the Tiger Dads go far toward encouraging all kinds of activism. For instance, Silverio Damien started a Neighborhood Watch group after joining the club, according to Nava.

For him, the goal is to change a school, a neighborhood, a city one dad at a time. “We try to get everybody involved, to take ownership.”