Exploring Early Childhood Care and Education Levers to Improve Population Health Proceedings of a Workshop (2019) / Chapter Skim
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2 Exploring the Evidence at the Intersection of Early Care and Education with Health
2 Exploring the Evidence at the Intersection of Early Care and Education with Health
Pages 5-24
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From page 5... ...
, discussed family-centered early childhood education as a lever to improve population health and promote health equity. Allison Gertel-Rosenberg, the director of National Prevention and Practice at Nemours, described a collaborative model to bring early care providers together to learn how to change their policies and practices related to healthy eating and physical activity.
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From page 6... ...
Following the presentations and discussion, participants moved to the adjacent gallery to reflect on the panel discussion with other attendees, and to consider specific questions that were posed on posters around the gallery. Upon reconvening in plenary session, Valora Washington, the chief executive officer of the Council for Professional Recognition, moderated a discussion of the responses to the questions.
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From page 7... ...
This discrepancy in language experience between higher- and lower-income children has been known for a long time, Carta said, and it is essentially a health disparity and a life outcome disparity. There are evidence-based interventions for promoting language in infants and toddlers, including simple behaviors that parents and caregivers can embed in their daily routines to provide a rich language experience to children.
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From page 8... ...
The initiative brings together a diverse array of programs from a number of sectors, such as libraries; pediatric settings; the United Way; early childhood education organizations; community-based, literacy-promoting organizations; and home-visiting organizations. Population-Based Interventions in Pediatric Settings Another strategy for population-based language interventions, Carta said, is to engage sectors that interact with high numbers of families of young children, such as the pediatric public health sector.
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From page 9... ...
, which promotes parent–child interaction p through one-on-one support; Thirty Million Words, which informs parents about the importance of language and literacy shortly after a child's birth while they are still in the hospital and then has a home visit to teach simple strategies when the child reaches 6 months; and Tools for Advancing Language in Kids, which is a professional development program for early childhood educators. Potential Challenges for Future Work In summary, Carta concluded, multi-sector collaboration to close the word gap is already taking place.
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From page 10... ...
During the preschool period, self-regulation skills begin to come together as children hone their ability to pay attention, control impulses, delay gratification, and regulate their emotions, Brotman explained, and these skills are malleable early on. With this evidence in mind, ParentCorps was developed by NYU Langone Health as an enhancement to pre-K programs that supports leaders, teachers, and parents in creating safe, nurturing, and predictable environments for children.4 ParentCorps The goal of ParentCorps, Brotman said, is to promote population health and reduce socioeconomic disparities through a family-centered intervention that is broadly available, engaging, and effective for low 3 This section is the rapporteur's synopsis of the presentation by Laurie Brotman, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 11... ...
ParentCorps is based on a theory of change that the school, home, and classroom program components come together to create safe, nurturing, and predictable environments; effective family engagement and strong parent–teacher relationships; and social and emotional skills. The result is positive child outcomes in terms of self-regulation, academic achievement, mental health, and physical health (see Figure 2-1)
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From page 12... ...
12 . FIGURE 2-1 ParentCorps theory of change.
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Potential Opportunities, Challenges, and Future Directions The opportunities to partner with education providers and leaders to implement health promotion programs are enormous, Brotman concluded. The greatest challenge, she said, will be moving from the efficacy data and the promise of these interventions to actually implementing, evaluating, and improving at scale.
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From page 14... ...
A practice component offers early care providers the tools and technical assistance to change the practices in their care centers or family child care homes. There are best practices for physical activity, screen time, breastfeeding, and other areas.
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From page 15... ...
They could consider, for instance, integrating into existing systems, especially other child-serving systems. Each state provides examples of how to integrate and embed the content and demonstrate 6 State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (DP13-1305)
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From page 16... ...
She discussed several examples of the work that Zero to Three is doing at the intersection of the health sector and the early care and education sector, spanning physical health, 7 This section is the rapporteur's synopsis of the presentation by Sarah LeMoine and Jody Whiteman, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. 8 See https://www.zerotothree.org (accessed October 30, 2017)
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From page 17... ...
This professional development resource covers eight competency areas: early childhood development; family-centered practice; relationshipbased practice; health and developmental protective and risk factors; cultural and linguistic responsiveness; leadership; professional and ethical practices; and service planning, coordination, and collaboration. These competencies build on and are aligned with related professional criteria, and they are intended to enhance cross-sector collaboration and foster shared language.
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From page 18... ...
The critical competencies also address working with vulnerable populations and multi-language learners. Sometimes children need more than what even the most skilled educator can provide, LeMoine said, and Zero to Three also emphasizes a multi-disciplinary approach to help educators connect with families in meaningful ways and understand where their role might end and where other partners and support services can step in (e.g., identification of children who may need additional specialized services, coordination with medical partners, referring for mental health evaluation)
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From page 19... ...
Measuring Mental and Physical Health Outcomes Aly Richards of the Permanent Fund for Vermont's Children noted the challenges of identifying the right metrics to use for child mental health and physical health outcomes, especially metrics that translate to health and mental health partners. She asked specifically about the teacher ratings used by ParentCorps and also about whether ParentCorps has been able to leverage those metrics and outcomes to secure funding.
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From page 20... ...
GALLERY WALK REFLECTIONS Following the panel discussion, participants moved to the gallery to consider the following questions: • How can the field better apply what is known at the interface of early care and education and health (e.g., screening for develop mental milestones)
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From page 21... ...
The Reach Out and Read program, which incorporates books into pediatric care (discussed by Carta) , is an example of working to prevent child development disparities before they occur, he said.
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Bonnie Kerker of the NYU Department of Population Health agreed with Mendelsohn and said that it will be critical to expand the focus of the pediatric visit to include, in addition to developmental programs, mental health and social aspects of the family environment. These areas also have tremendous impact on both immediate and longer-term outcomes for children and thus need greater attention.
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From page 23... ...
New York State recently released a value-based payment model for pediatrics that is focused on achieving population health–level impacts. The model addresses the need to transition to yet-to-be-developed common metrics between the early education sector and pediatrics.
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