Circumstances beyond a child’s control can shape his or her destiny, for better or worse, far into the future. That’s why helping children avert a cascade of lifelong problems triggered by early adverse experiences is central to two area programs funded by Health Forward Foundation.
Known as Promise 1000 and Healthy Kids Bright Futures, the initiatives take different but complementary paths toward the common goal of strengthening early childhood health and development among at-risk populations. Promise 1000 focuses on families at the earliest stages of childhood and in a home setting; Healthy Kids Bright Futures targets families and toddlers already engaged in center-based care.
Both efforts are informed by a growing body of evidence that points to the profoundly destructive effects negative childhood health and environmental factors can have later in life. Research shows, for example, that excessive or prolonged activation of stress response systems in a child’s body and brain — known as toxic stress and sparked by experiences like psychological, physical, or sexual abuse — can lead to permanent changes in brain architecture that may compromise intellectual development, behavior, and health.
This neurological damage can lead to cognitive challenges, delayed social-emotional development, problem behavior, depression, alcoholism, drug abuse, or smoking, as well as substantially higher risk for serious health problems like heart attack, cancer, diabetes, and stroke.
Strength in numbers
In the Kansas City region, an array of independent home visiting agencies (HVAs) has long worked to mitigate childhood risks through home visits targeting vulnerable newborns and mothers. Promise 1000 reinforces these efforts by bringing additional resources and greater continuity to the area HVA community.
Now in its seventh year, the program takes its name from the critical first 1,000 days of life and is modeled on a similar initiative started in Cincinnati more than 20 years ago. The local organization — jointly founded by Children’s Mercy Hospital, the United Way of Greater Kansas City, and Health Forward — provides a collaborative network to help 10 regional HVAs maximize their home visit capabilities.
Toward that end, the collaborative has established:
- A centralized referral and intake system for area HVAs to ensure eligible families are connected with the most appropriate program.
- A standardized data collection system for measuring the ongoing efficacy of home visit services, including shared outcomes, standards, and quality measures.
- A formal quality improvement process to help agencies advance their outcomes.
- Consistent professional training for more than 50 area home visitors.
- Culturally responsive home visiting protocols that meet the needs of a diverse population.
- An umbrella funding structure that supports sustainable funding to continually improve quality and expand capacity.
In addition to supporting a range of childhood and maternal health and well-being services, Promise 1000 has developed a program to help home visit mothers overcome depression. Also underway are efforts to fully integrate health care services and home visiting through a collaborative, cohesive approach. This includes the participation of home visitors in well-child checks with the family.
Since Promise 1000 began offering funding to HVAs to participate in structured home visiting activities in 2016, more than 700 families have been served through approximately 13,000 home visits by 10 agencies in seven Missouri and four Kansas counties.
“What’s important about this approach is that the many benefits are not static, but dynamic, and play out over the lifetime of both the parent and the child,” said Mary Moffatt, MD, a pediatric subspecialist at Children’s Mercy Hospital and the medical director for Promise 1000. “From a development standpoint, this is especially true for the children as they move to adulthood, contribute to society through the workforce, and eventually become parents themselves.’’
The second childhood development initiative funded by Health Forward, Healthy Kids Bright Futures, pursues objectives not unlike those of Promise 1000 but does so through the prism of early care and learning centers.
The project was launched in late 2017 by KC Healthy Kids, a longtime leader in boosting healthy eating and active lifestyles to help reduce childhood obesity. Healthy Kids Bright Futures today works with eight early childhood centers on both sides of the state line to strengthen services provided to more than 200 children of up to two years in age and their families.
Director Rhonda Erpelding said the project emulates the federal Head Start program and was born from an acknowledgment by early education teachers that they were not fully equipped to support optimal child development. At the same time, families shared that they frequently didn’t know where to turn for assistance with everyday challenges that could impact a child’s health and welfare.
Because access to area Head Start programs is limited and the number of children in Missouri and Kansas qualifying for the program far exceeds available positions, Healthy Kids Bright Futures fills an essential need in the community, Erpelding said.
The project focuses on four broad areas:
- Helping provide technical assistance, including professional development for teaching staff, to enhance the quality of education provided at non-early Head Start (non-EHS) care and education centers.
- Assessing centers’ healthy eating and active living practices to optimize opportunities for improving diet and physical activity among young children.
- Supporting parents by helping them address a range of secondary family and home issues that can affect children, such as job loss or problems sustaining housing.
- Helping boost academic programming, including the implementation of appropriate child screening and assessments as well as the establishment of center-specific educational goals. Assessments include social and emotional development in addition to motor, problem-solving, and communications skills.
Erpelding said the latter efforts rely on coaching and technical assistance provided by The Family Conservancy, a Kansas City, Kansas-based nonprofit specializing in early childhood development.
Continuity for children and families involved in the project is provided on a case management basis by community navigators. Trained in community outreach, the navigators conduct an initial visit with families to help them assess needs ranging from dental care to help repairing a vehicle, then connect the families with available resources in the community.
The navigators also provide support and conduct child screenings through ongoing monthly visits.
“We’ve tried to build something that is comprehensive in nature,” Erpelding said. “It’s an approach that helps establish best practices within the centers while addressing the needs of both the child and the family on an individualized basis.
“All children deserve to be in a high-quality early learning program, regardless of where they live or their income level, so that they are truly prepared to go to kindergarten and be successful in life.”
In addition to Health Forward, project funding also has been provided by the W.K. Kellogg Foundation, Wyandotte Health Foundation, REACH Healthcare Foundation, and Jackson County Community Children’s Service Fund. The program incorporates a wide range of partners, including Connections – Project Eagle, Maternal and Child Health Coalition of Greater Kansas City, Inc., Children’s Mercy Hospital, Mid-America Regional Council, The Family Conservancy, Start at Zero, Guardian Group, and the University of Kansas Medical Center.
Editor’s note: to learn more about issues Health Forward supports, download our 2018 annual report.