WHAT WE ARE LEARNING
Catalytic Practices
During the first phase of PSP, our partners at the Center for the Study of Social Policy (CSSP) explored how pediatric professionals can promote healthy social and emotional development and nurturing parent-child relationships. The intention of this work was to review existing programs that support parents to foster the social and emotional development of their young children and which have been designed for use in pediatric primary care (and related) settings. These programs have research evidence or are building their evidence of effectiveness. Ultimately, we sought to identify and learn about what might be common practices across programs as a means to obtain a full picture of how pediatric primary care can best support all children and families and achieve key outcomes in their social and emotional development. Through a robust review and analysis of nearly 70 evidence-based and evidence-informed programs, followed by in-depth site visits with 13 selected programs, the team identified 14 common practices, each observed across several of the program sites.
Enabling Conditions
There are a number of structural barriers that make it challenging for pediatric practices to embrace a focus on children's social and emotional development and nurturing relationships, however, we see these barriers as opportunities. We are posing the question: what are the conditions that enable change to take hold?
To date, four conditions have been prioritized:
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Public Financing & Reimbursement
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Early Relational Health (Training & Professional Development)
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Integrated Technology & Screening
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Measurement
01.
Public Financing & Reimbursement
Capacity constraints and intricate regulations make it difficult for states and managed care organizations to navigate and understand how to secure financing to improve pediatric practices that promote healthy social and emotional development and nurturing parent-child relationships.
Through a partnership between the Center for the Study of Social Policy (CSSP), Manatt Health, DCR Initiatives, and Johnson Group Consulting, this Enabling Condition workstream focused on leveraging Medicaid, the Children's Health Insurance Program (CHIP), and the Title V Maternal and Child Health (MCH) Services Block Grant to help finance practice change.
Complementing this body of work was the development of a Multi-State Medicaid and CHIP Implementation Workgroup, comprising nine states, that worked to accelerate the financing strategies identified in the Medicaid/CHIP Blueprint and Title V and Medicaid Guide.
The following resources describe the specific strategies and tools that state Medicaid / CHIP / Title V agencies, managed care plans, pediatric care providers, and others can use to optimize the social and emotional development of young children through pediatric practice.
02.
Early Relational Health
Physicians and other pediatric professionals are not universally trained on the importance of social and emotional development and early relational health or how to promote these areas in the well-child visit.
One step Pediatrics Supporting Parents has taken is to support the establishment of the Early Relational Health Coordinating Hub to promote child health care transformation, system building, and emotional connection training modules and measures.
03.
Integrated Technology & Screening
Existing technological infrastructure falls short of allowing for a family-led agenda, enabling physicians to provide the best care, and effectively integrating care with other child-serving sectors.
To better understand this enabling condition, Help Me Grow National Center, Patient Tools, Inc., and a dedicated leadership team comprised of several early childhood leaders representing tools such as Cycle of Engagement, FINDconnect, the Welch Emotional Connection Screen (WECS), and the Survey of Well-Being of Young Children (SWYC), conducted an exploratory landscape scan regarding the feasibility and desirability of an integrated, modular technological platform in well-child care.
We also supported the design of a prototype and successful pilot of a technology platform in a community setting, among a select group of pediatric practices, guided by input from leading tool developers, practitioners, parents, and others with expertise in the policy and practice implications of transforming child health services.
04.
Measurement
Despite the documented importance of addressing the quality of the parent-child relationship, there are multiple barriers to advancing a focus on strengthening relationships, including use of a validated and acceptable measure of early relational health in well-child care.
Thus far, Pediatrics Supporting Parents supported the planning and design for the implementation of an Early Relational Health Measurement, Promotion, and Action Network for advancing the use and acceptability of observational measurement tools of early relational health in child health practices and communities.
Family Engagement
Undergirding all of this work is a desire to promote and support authentic parent and family engagement. Explore this case study which examines the partnership that the Center for the Study of Social Policy (CSSP) and Family Voices undertook to create and implement a process for engaging families in Pediatrics Supporting Parents to promote the social and emotional development of young children.