Moving Beyond Program to Population Impact: Toward a Universal Early Childhood System of Care

Abstract

Families have clearly benefited from increased availability of evidence‐based intervention, including home‐visiting models and increased federal funding for programs benefiting parents and children. The goal of population‐level impact on the health and well‐being of infants and young children across entire communities, however, remains elusive. New approaches are needed to move beyond scaling of individual programs toward an integrated system of care in early childhood. To advance this goal, the current article provides a framework for developing an early childhood system of care that pairs a top‐down goal for the alignment of services with a bottom‐up goal of identifying and addressing needs of all families throughout early childhood. Further, we describe how universal newborn home visiting can be utilized to both support alignment of, and family entry into, an early childhood system of care with broad reach, high quality, and evidence of population impact for families and children.

Estimating the monetary cost of risk factors for crime in boys using the EARL-20B.

“…To deal with this, Dodge (2018) and colleagues (Goodman, O’Donnell, Murphy, Dodge, & Duke University, 2019) have argued for a dramatic shift in how we monitor, support and evaluate the psychosocial health of children. They propose establishing a universal early childhood system of care with “universal reach with services concentrated for highest risk families” and a “prescriptive assessment and prevention focus” (Goodman et al, 2019, pp. 115–116).…”

Universal child health and early education service use from birth through Kindergarten and developmental vulnerability in the Preparatory Year (age 5 years) in Tasmania, Australia

“…Children in the Regular service use group had regular contact with the Child Health and Parenting Service, LiL and Kindergarten. Frequent and regular contact with universal services is desirable for developmental monitoring, prevention and intervention, and timely referrals from universal services to specialist and targeted services (Australian Health Ministers' Advisory Council, 2011, 2017; Goodman et al, 2019; Richter et al, 2017). The children in this cohort, born 2011–2013, were the first children in Tasmania to have access to the universal LiL, which was implemented in government schools in 2012.…”

“…Our intention in modelling the associations between risk factors and service use patterns was to draw attention to service system changes that might improve access to and use of services for priority population groups (Goodman et al, 2019; Munari et al, 2021). Risk variables from the Tasmanian Perinatal Data Collection were collected at the child's birth, and risk variables from the AEDC Data Collection were obtained in the child's first year of full‐time school (Table 1).…”

The case for rigorous comparative research and population impacts in a new era of evidence‐based interventions for juvenile offenders

“…Loss of treatment fidelity, heterogeneity in target populations, heterogeneity of service providers, and changes in implementation context are among the main factors that contribute to attenuation of effects (Yohros & Welsh, 2019). In a series of works centered around a universal nurse home visitation program for newborns in North Carolina, Dodge (2018Dodge ( , 2020Goodman, O'Donnell, Murphy, & Dodge, 2019) calls for a move away from the traditional process of scaling and its focus on individual programs and practices. In blunt terms, Dodge (2018Dodge ( : 1118 refers to this as a "scale-up failure.…”