A growing number of child health experts, health policy leaders, early childhood system builders, national organizations, federal agencies, thought partners, innovators, and parent experts have collectively come to recognize the emergence of a breakthrough moment for advancing health equity, social justice, and improved child, family and community outcomes. These leaders are aligning around a vision for the transformation of child health services and early childhood systems that equitably support all families of young children with the services and supports they need to flourish.
Nurture Connection’s Guide for Transforming Care of Young Children in Community Health Centers by Kay Johnson and David W. Willis, MD serves as the authoritative, state-of-the-art resource for child health care transformation specifically targeted achievable advancements for community health centers. The opportunities are great for millions of families and young children.
The 1,400 federally funded community health centers across the nation are an important source of primary care for 2.8 million children under age 6, representing 1 in 10 young children and 1 in 4 young children living in poverty nationwide. Health centers are also disproportionately likely to serve young children living in poverty and those with Medicaid or no insurance — notably, Black, Indigenous, and Hispanic children overrepresented in those groups. In August 2023, the Health Resources and Services Administration (HRSA-HHS) made Early Childhood Development (ECD) grants to 151 community health centers across 40 states. This Guide is designed to anchor their work in research, best practices, and policy.
A strong body of research summarized in the Guide confirms that federally funded community health centers, other clinics (e.g., children’s hospital and academic medical center clinics), and private pediatric practices can dramatically improve their rates of recommended screening, referral, and family engagement. Studies point to the impact of quality improvement (QI) projects, clinician and staff training, use of electronic records, and enhanced care coordination and support for families. The use of evidence-based models designed to improve child development is a complementary strategy. The importance of partnering with parents, using strengths-based approaches, and promoting early relational health are also underscored by this research.
Lessons from Research in Exemplary Practices:
- Partner with families and design efforts that are family-centered, strengths-based.
- Maximize team-based care and specify roles for all team members.
- Apply QI methods to increase rates for screening and effective referrals.
- Use electronic health records and other technology as needed.
- Set up workflows for all five recommended types of screening in well-child visits.
- Don’t forget referral and care coordination processes.
- Identify and train staff who will engage and support families (e.g., community health workers, care coordinators, family peer navigators, parent coaches).
- Give attention to equity in access, workplace cultural congruency, and linguistic appropriateness.
- Use measurement to drive quality