Promising Practices

Filed under Evidence-Based Practice, Health / Physical Activity, Children

Goal: To improve children's nutritional status, increase their activity level, enhance their self-esteem, and create life-long health habits by using a multidisciplinary, community- and family-based system approach, and by engaging local health care professionals with community agencies.

Impact: The Fit Kids/Fit Families program shows that multidisciplinary, community- and family-based approaches to children's exercise, weight, & nutrition can have an effect on healthier nutritional choices, increased physical activity, decreased sedentary activity, healthier behaviors, and BMI reductions.

CDC

Filed under Evidence-Based Practice, Education / Childcare & Early Childhood Education

Impact: The Community Preventive Services Task Force (CPSTF) recommends center-based early childhood education programs (ECE) to improve educational outcomes that are associated with long-term health as well as social- and health-related outcomes. Economic evidence indicates there is a positive return on investment in early childhood education. The benefits from students' future earnings gains alone exceed program costs.

If targeted to low-income or racial and ethnic minority communities, ECE programs are likely to reduce educational achievement gaps, improve the health of these student populations, and promote health equity.

Filed under Evidence-Based Practice, Health / Maternal, Fetal & Infant Health, Children, Women, Families

Goal: To increase daily fruits and vegetables servings by half in women served by WIC participants with the long term goal of reducing risk of cancer.

Impact: The Maryland WIC 5-A-Day Program shows that while multi-faceted community based interventions can effectively promote and sustain dietary change among low-income populations in order to reduce the risk of cancer, many obstacles remain in implementing such programs.

Filed under Evidence-Based Practice, Economy / Government Assistance, Older Adults

Goal: The goal of this program is to reduce costs by using specially trained community health workers to help connect people with unmet long-term needs and/or those at risk of entering nursing homes to Medicaid home and community-based services.

Impact: Similar interventions may help other localities achieve cost-saving and equitable access to publicly funded long-term care options other than institutional care.

Filed under Evidence-Based Practice, Economy / Poverty, Families, Urban

Goal: The goal of this program was to help poor families build up their “human capital” and avoid long-term poverty.

Filed under Evidence-Based Practice, Health / Mental Health & Mental Disorders, Children, Teens

Goal: The Penn Resiliency Program is a depression prevention program that seeks to reduce the longevity of symptoms exhibited and the severity of symptoms at onset of depression, through cognitive-behavioral therapy and problem-solving techniques.

Impact: The Penn Resiliency program shows that a group-based program seeking to prevent the initial onset of and decrease the exacerbation of depression children and teens by incorporating specific coping and problem-solving skills can reduce depressive symptoms over time.

Filed under Evidence-Based Practice, Health / Adolescent Health, Teens

Goal: The long-term goals of the program are to arrest the development of teen antisocial behaviors and drug experimentation. Intermediate goals are to improve parents' family management and communication skills.

Impact: Parents had improved feelings toward their children and were less likely to react negatively to their children's behavior and less likely to take a "lax" approach to their children after participating in the program. They also showed improvements in the skill areas of tracking and reinforcing behavior, setting expectations and defining problems, and remaining calm in stressful situations. Antisocial behaviors in their children decreased significantly, measures of child adjustment showed improvement, and total problem behavior decreased. Furthermore, the PFS intervention resulted in significantly less use of tobacco, alcohol, and marijuana.

Filed under Evidence-Based Practice, Health / Adolescent Health, Teens, Racial/Ethnic Minorities, Urban

Goal: The goal of the Reach for health Community Youth Service program is to reduce risky sexual behaviors among urban Latino and African American youth.

Impact: Long-term impact has been recorded among participants after two years: this includes delayed initiation of intercourse and reduced frequency of intercourse among sexually active adolescents.

Filed under Evidence-Based Practice, Community / Social Environment, Children, Families

Goal: The Incredible Years® Parents, Teachers, and Children Training Series has two long-range goals. The first goal is to develop comprehensive treatment programs for young children with early onset conduct problems. The second goal is the development of cost-effective, community-based, universal prevention programs that all families and teachers of young children can use to promote social competence and to prevent children from developing conduct problems in the first place.

Impact: Studies have shown that children who participate in the programs demonstrate significant improvements in school readiness, emotional regulation, and social skills, as well as reductions in behavior problems in the classroom.

Filed under Evidence-Based Practice, Health / Children's Health, Adults, Women, Men, Families, Urban

Goal: The goal of With All Families: Parents is to support pediatric care visits and improve child welfare by using screening tools and individual parent coaching to identify and address social determinants of health. Specific program objectives are to improve family functioning generally while specifically focusing on improving protective factors and economic-self-sufficiency. As part of the program, staff also work with families to increase parent concrete support and connect parents to needed physical health, behavior health, and educational resources for their child.

Research supports the benefits of using the strategies employed by With All Families: Parents (i.e., screening, resource navigation, and parent coaching) to improve family welfare by addressing underlying risk factors related to poverty and access to resources. For example, programs designed to provide screening and resource navigation support are associated with reduced social needs, improved child health and decreased child hospitalization visits. In light of evidence suggesting that social factors may in fact play a larger role in determining one’s health than medical care, programs that target these social factors, such as With All Families: Parents, are becoming increasingly important.

References
Garg, A., Toy, S., Tripodis, Y., Silverstein, M., & Freeman, E. (2015). Addressing social determinants of health at well child care visits: a cluster RCT. Pediatrics, 135(2), e296-e304.

Gottlieb, L. M., Hessler, D., Long, D., Laves, E., Burns, A. R., Amaya, A., ... & Adler, N. E. (2016). Effects of social needs screening and in-person service navigation on child health: a randomized clinical trial. JAMA pediatrics, 170(11), e162521-e162521.

Pantell, M. S., Hessler, D., Long, D., Alqassari, M., Schudel, C., Laves, E., ... & Gottlieb, L. M. (2020). Effects of in-person navigation to address family social needs on child health care utilization: a randomized clinical trial. JAMA network open, 3(6), e206445-e206445.

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public health reports, 129(1_suppl2), 19-31.