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4/26/2016 Morehouse School of Medicine TCC for Health Disparities Research K N O W L E D G E ~ W I S D O M ~ E X C E L L E N C E ~ S E R V I C E TCC Research Summit (CACE/SSC sub-project 1) April 28, 2016 TITLE SLIDE K N O W L E D G E

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4/26/2016 1 Morehouse School of Medicine TCC for Health Disparities Research

K N O W L E D G E ~ W I S D O M ~ E X C E L L E N C E ~ S E R V I C E

TCC Research Summit (CACE/SSC sub-project 1) April 28, 2016

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K N O W L E D G E ~ W I S D O M ~ E X C E L L E N C E ~ S E R V I C E

Sub-Project 1 (OUTLINE slides): Progress and Outcomes in Promoting Quality Parenting Leadership and Early Childhood Policy and System Improvements in 13-states: A Closer Look

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Official Statement

 The project described was supported by

the National Institute on Minority Health and Health Disparities (NIMHD) Grant Number U54MD008173, a component of the National Institutes of Health (NIH) and Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIMHD or NIH.

MSM sub-pro roject ject 1 Team:

⁻ Dr. David Satcher ⁻ Dr. Glenda Wrenn ⁻ Dr. LeRoy Reese ⁻ Mrs. Aneeqah Ferguson, MS ⁻ Dr. Victor Ede ⁻ Ms. Tasha Alston ⁻ Mrs. Ayanna Jackson, MBA ⁻ Mrs. Glendale Manning

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2016 CA CACE CE/SS SSC C state part rtners rs: :

⁻ Alabama (Gail Piggot & Felicia Wilburn) ⁻ Florida (Elaine Cauthen & Shaleana Eubanks World) ⁻ Georgia (Tacia Estem, Staci Tucci) ⁻ Maryland (Dr. Bettye Muwwakkil, Dr. Stacey Little) ⁻ Mississippi (Director Brenda Bell Caffee, Angelic Mister) ⁻ Missouri (Commissioner Melba Moore, Chief Joe Palm) ⁻ Minnessota (Mitchell Davis) ⁻ North Carolina (Dr. Diane Rowley, Arnold Dennis) ⁻ Oregon (Richard Hines Norwood) ⁻ South Carolina (Jaunita Dean Bates, ) ⁻ Tennessee (Clintonia Simmons, Jessica Simmons) ⁻ Texas (Dr. Ashley Butler)

Background

The vision of CACE is to reduce disparities in health, wellbeing and school readiness for every child age 0-5 years, in order to advance health equity. GA TN TX FL OR KY MS MN SC MD MO NC AL Impact Areas Use quality parenting as an intervention for mitigating childhood obesity and mental health inequities. Assess the extent to which existing early childhood policies (at all levels) and their implementation programs ensure: (i) equitable child development and school readiness at 5 years. (ii) parents are actively engaged in informing early childhood policy formation and the program implementation. The Mission

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Specific ific Aims: s:

 SA1a: To use the SSC parenting intervention to increase the

physical activity levels and improve nutritional intake among children ages 0-5

 SA1b: To use the SSC parenting intervention to improve parental

mental well-being among parents of children ages 0-5

 SA1c: To use the SSC parenting intervention to increase social

competence skills for school readiness among children ages 0-5.

 SA1d:To assess changes in parents’ perceptions about child

abuse and neglect among parents of children ages 0-5

 SA2: To evaluate the impact of CACE participation on engagement

in strategies and activities that influence early childhood policy at the local and/or federal levels.

The Approach

 Build & maintain partnerships.  Form local TCC on early childhood policy

(a.k.a. CACE).

 Facilitate SSC implementation and

Policy improvements through local CACE.

 Utilize breakthrough series (BTS) & SSC

parent leadership approach.

 Translate findings into sustained

practice and improved policies.

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Implementing yr4: SSC/pilot = PAP= Capacity building yr4 = Awaiting RFA decision yr4 =

Multisite SSC Implementation (Year 4)

New pilots of SSC yr4: OR, MN, FL, MD, NC, (SC-pending RFA) At least 1 SSC prior to 2016: TN, MO, MS, AL, TX, GA

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Key Year Activities 4

 Multisite SSC Implementation: TN/MO, FL,  Policy Action Plan Implementation –TX  CACE Master SSC Training (multi-state): 9/2015  Capacity Building: Internal—new subaward

process; (CACE Partners): RedCap data entry, CITI training, COI Smart, DUNS/SAM, FWA,

 CACE BTS Supports (SSC technical support, monthly

collaborative calls & 1-1 TA calls with states)

 Fidelity assessment & Evaluation

 SSC in Atlanta Housing Authority Choice

Neighborhoods includes an SSC pilot project

McKinlay Model Framework for CACE Approach

Upstream impacts Midstream impacts Downstream impacts

Programs and service delivery systems are supported and ‘proportionately’ implemented to provide healthy early childhood development and quality parenting in the communities & neighborhoods

Policies are in place to eliminate disparities by supporting ‘every’ child to have healthy age appropriate development, and encourage quality parenting

SSC (Smart & Secure Children) training for developing quality parenting knowledge & skills of parents and families to reduce childhood obesity and child neglect; while improving mental health & school readiness of children 0-5 years

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Collaborative Action on Childhood Equity

Alabama

Policy Action Plan Smart and Secure Children (SSC) Parent Leadership Pilot Project

Alabama Blueprint for Zero to Five

Ready Families +Ready Communities +Ready Services (Health and Early Education) +Ready Schools and + Ready States =Ready Children Prepared for Success

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Alabama Partnership for Children Blueprint for Zero to Five

Ready Families

Parents and families play the most critical role in children’s healthy development.

Smart and Secure Children Model of Parent Leadership Policy and Practice Assessment and Recommendations

Strengthening Families

Building protective factors and parent leadership through community-based programs.

Collaborative Action for Child Equity

Satcher Health Leadership Institute

15

Policy Action Plan

2014 2016

  • I. Ready Families in Ready Communities +

Emotional Insecurity -- % of mothers experiencing depression; rates of substantiated child abuse and neglect; % of parents who have concerns about their child's development, including social and emotional development 2 Community Coordination – % of communities that have well-developed and active groups to coordinate, promote, fund, and evaluate family support and school readiness activities II. Ready Services: Health + Comprehensive Screenings and Referrals -- % of children who receive periodic developmental screenings (social/emotional) and appropriate referrals and follow-up; % of children served by Early Intervention 3/4 1 Blueprint for Zero to Five (School Readiness) Comparison of Indicator Priorities 2014 and 2016

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SSC Pilot in Alabama

  • Pilot began Sept. 2014
  • Montgomery County
  • Lowndes County (ACJF)
  • 17 participants, small

data set

  • General improvements

in mental health and parenting knowledge

  • Some statistically

significant increases

Results:

  • 1. Ages and Stages Questionnaire (ASQ-3)

Communication Skills: P value=0.0781 Gross Motor Skills: P-value=0.043

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ASQ Cont’d

Fine Motor Skills: P-value=0.129 Problem Solving Skills: P-value= 0.082

ASQ Cont’d

Personal-Social Skills: P-value=0.0078 ASQ Social Emotional: P-value=0.137

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  • 2. Knowledge Assessment:

Set weekly parenting goals for child’s healthy brain development

At Baseline Post SSC

___ /_ /‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ___ ‚**‚ ‚ ƒƒ/_ /‚ƒƒƒƒƒƒƒƒ‚**‚ ‚ƒƒƒƒƒƒƒ / ‚**‚ ‚ / ‚**‚ ‚ / / ‚**‚ ‚ / ‚**‚ ‚ / / ‚**‚ ‚ / ‚**‚ ‚ / / ‚**‚/ / ‚**‚/ / / / / / 5 / 12 / /ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ No Yes ___ /_ /‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ‚**‚ ‚ƒƒƒƒƒƒƒ / / ‚**‚ ‚ / / ___ / ‚**‚ ‚ / / /_ /‚ / ‚**‚ ‚ / / ‚**‚/ / ‚**‚/ / / / / / 1 / 15 / /ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ No Yes

Knowledge assessment cont’d

Set weekly parenting goals for Your child's healthy emotional development

At Baseline Post SSC

___ /_ /‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ‚**‚ ‚ƒƒƒƒƒƒƒ / / ‚**‚ ‚ / / ___ / ‚**‚ ‚ / / /_ /‚ / ‚**‚ ‚ / / ‚**‚/ / ‚**‚/ / / / / / 1 / 15 / /ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ No Yes ___ /_ /‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ‚**‚ ‚ ƒƒƒ___ ƒƒƒƒƒƒƒƒ‚**‚ ‚ƒƒƒƒƒƒƒ / /_ /‚ / ‚**‚ ‚ / / ‚**‚ ‚ / ‚**‚ ‚ / / ‚**‚ ‚ / ‚**‚ ‚ / / ‚**‚/ / ‚**‚/ / / / / / 4 / 13 / /ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ƒƒƒƒƒƒƒƒƒƒƒƒƒ/ No Yes

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  • 3. Self reported Parental Mental Health

Assessment

Mental Health Continuum- Short Form (MHC-SF) Items (n=17) Baseline mean score Post SSC mean score Mean difference P value

During the past 30 days, how often did you feel that you had something important to contribute to society? 4.0 5.3 1.3 0.015 During the past 30 days, how often did you feel that you belonged to a community (like a social group, or your neighborhood)? 3.0 4.9 1.9 0.002 During the past 30 days how often did you feel that the way

  • ur society works makes sense to you?

3.3 4.8 1.6 0.006 Total Mental Health Score (all 13 items) 4.5 5.1 0.6 0.09

Alabama Parent Leadership Network (APLN)

  • Funding: Alabama Department of Child Abuse

and Neglect Prevention

  • Purpose: To develop the next steps in leadership

development at the community level and the formation of an Alabama Parent Leadership Network (APLN). The program incorporates the mentoring structure of the SSC model with the conversation-based learning of the SSC and Community Café models, and adds more intensive leadership skill-building.

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Parent Leadership

  • 1 Peer Learner

Parent Leader

  • 2 Parent Leaders Parent Mentors
  • 1 Parent Leader

Board Member Vadonna Williams

Leveraging SSC

  • Alabama Civil Justice Foundation
  • Project LAUNCH (Linking Actions for Unmet

Needs in Children’s Health) – includes SSC

  • Nemours: National Early Care & Education

Learning Collaboratives Project (ECELC)

  • Child Care Aware: Healthy Child Care, Healthy

Communities

  • Kellogg: Don’t Be In The Dark About Child Care
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Published:

Bolar, C.L., Hernandez, N., Akintobi, T.A., McAllister, C., Ferguson, A., Rollins, L., et al. (2015). Context matters: A community based study of urban minority parents’ views on child health. Journal of Community Health.

Okafor M, Sarpong DF, Ferguson A, Satcher D. “Improving health outcomes of children through effective parenting: model and methods.” Int J Environ Res Public Health. 2013 Dec 23; 11(1):296-311.

Manuscripts near completion:

Bolar, CL, Akintobi, TH, Sarpong, D, Ferguson, AS. Parental stress and children’s externalizing behaviors: The effects of a peer-led parenting

  • program. Family Relations (Projected, August 2015)

Ede, V, Ferguson, A, Bolar, C, Alston, T, Oliver, Latisha, Dugart, V, Wrenn, G, Assessing the impact of a parent leadership model of conversational learning in underserved communities: Smart and Secure Children. (Projected, May 2016)

Progress on Academic Publications