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Part 2: Home-Based Programs
Early Head Start Program Profile
Bear River Early Head Start
Logan, Utah
November 4-7, 1997
The Bear River Head Start agency operates an Early Head Start program for 75 families in three rural counties in northern Utah and southern Idaho. The program serves primarily white, two-parent, working-poor families. The program provides child and family development services primarily in weekly home visits and weekly Baby Buddy groups for parents and children. Staff members work to foster positive parent-child interactions and enhance parents' understanding of their children's development. They also work with parents to help them achieve their personal and family goals and link them with needed services in the community.
OVERVIEW
The Bear River Head Start (BRHS) agency operates an Early Head Start program serving families across 12,000 square miles of northern Utah and southern Idaho. Headquartered in Logan, Utah, BRHS has been operating a home-based Head Start program in this seven-county region since 1966. From 1972 through 1975, BRHS was a site in the highly successful national Home Start Demonstration Program, and subsequently served as a Home Start Training Center for other home-based programs in the region. Bear River Early Head Start (BREHS) builds on these 30 years of home-based program experience by extending services to families with infants and toddlers.
BREHS serves families living in Cache and Box Elder counties in Utah and Franklin County in Idaho. The main BREHS center is in Logan; the program also holds group socializations at Box Elder County Hospital and Franklin County Head Start in Preston, Idaho.
Community Context. Local residents describe the three counties as separate, close-knit communities that are set apart by their distinctive geographic features, histories, and economies. Low-income families in these communities need job training opportunities, jobs that pay a livable wage, affordable housing, child care, transportation, health care coverage, dental coverage and services, and substance abuse treatment and prevention. The communities have in common a strong work ethic, a focus on family life, low crime rates, improving economies, and a strong spirit of collaboration among community service providers.
Program Model. BREHS is a home-based program. Weekly home visits and weekly Baby Buddy group activities are the key contexts in which program services are delivered. Staff members conduct activities designed to foster parent-child attachment and to assist parents in supporting the intellectual, social, emotional, and physical development of their child. Additional services designed to promote these goals include child care referrals, parent discussion groups, counseling, child development associate (CDA) classes, parenting classes, breast-feeding consultation, and monitoring of children's health status and immunizations. The program's goal is to create an integrated (rather than component-focused) program so that all staff members share the same goals, especially for the child and family development cornerstones.
Families. BREHS serves mostly white families, but about one-fifth belong to other racial/ethnic groups. Two-thirds of the families include two parents. Approximately one-third of the mothers were pregnant when they enrolled in the program. Very few were receiving welfare cash assistance when they enrolled.
Staffing. The BREHS staffing structure is designed to support the work of the seven full-time and one half-time family educators (FEs) and two full-time and one half-time Baby Buddy group leaders who also work directly with families. By referring parents to cornerstone coordinators (the family development coordinator, the health/wellness coordinator, and the child care coordinator) and two mental health specialists for other health and social service needs, FEs are able to focus their efforts during home visits on facilitating positive parent-child interactions. With support from the project manager, the child development coordinator accompanies FEs on home visits to provide feedback and supervision. A male Baby Buddy group leader coordinates male involvement activities in the program. BREHS also employs a sanitation specialist and a half-time secretary. The project manager attends to matters of program administration, oversees staff training and supervision, and acts as a liaison to the BRHS program. The BRHS program director provides leadership to the staff and advocates on behalf of the Early Head Start program within the community.
RECRUITMENT AND ENROLLMENT
Program Eligibility. The BREHS target area includes Cache and Box Elder counties in Utah and Franklin County, Idaho. The target population consists of farm families, and families in agriculture-related businesses; mostly two-parent families; mostly white families (but two areas have increasing numbers of Hispanic families--largely migrant raspberry pickers and factory laborers); and many supportive extended families. The program serves families in the target area who meet the EHS eligibility requirements.
Recruiting Strategies. Recruiting strategies included personal visits to schools (a Young Mothers Program for teen parents), the Special Supplemental Program for Women, Infants, and Children (WIC) office, thrift shops, laundromats, and other places where low-income families might visit. The staff also relied on posters, flyers, word of mouth, and referrals.
Initial recruitment went fairly smoothly, although the program staff had to help some families overcome their sense of independence and reluctance to accept government help. BREHS targeted two groups who have particular needs--Hispanics (because of greater isolation) and teenage mothers (because they are at higher risk for attachment problems). Staff members had some difficulty recruiting Hispanics because of these families' distrust of those outside their culture. One potential recruitment issue, competition with the Community Family Partnership (CFP) Program in Logan, was resolved with an agreement that CFP and EHS will not recruit each other's control group families.
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BREHS serves a varied service area and population. The target area consists of three counties (Cache, Box Elder, and Franklin), which program staff members and parents describe as separate communities. Each community varies from the others, with the most marked contrast existing between Franklin County in Idaho and the two Utah counties. The counties are set apart by their distinctive geographic features, histories, and economies. Subcommunities--including the Mormon community, separate wards within the Mormon community, Utah State University, ethnic groups (Hispanic versus Anglo areas), residents of towns versus those in more isolated rural areas, professionals versus farmers, and enclaves where longtime residents do not mix with "newcomers"--exist within the larger communities. The communities in the BREHS service area have many strengths and resources. First, the communities tend to be close-knit. Even in outlying rural areas where families are more isolated, residents tend to know and look out for one another. Although not all families belong to the Mormon Church, it has a significant presence in these communities and provides an extensive array of support services for member families, including employment training and referral, financial assistance, child care, parenting classes, substance abuse treatment, and individual and family counseling. Utah State University also brings resources--such as employment and educational opportunities, community services, and economic vitality--to the area. Many families have two parents, at least one of whom is employed. Ninety-five percent of BRHS parents have completed high school. There is a strong work ethic and a focus on family life. Furthermore, the economy is improving and the crime rate is low. Most BREHS families are employed in factory or production labor jobs. Bear River Head Start conducted a comprehensive community needs assessment in spring 1997 (this assessment is conducted every three years). The needs assessment was compiled by members of the BRHS Policy Council, who surveyed Head Start staff members and parents as well as a number of community leaders. It identifies job training opportunities, jobs that pay a livable wage, affordable housing, child care, transportation, health care coverage, dental coverage and services, and substance abuse treatment and prevention as areas of need for BRHS children and families. These needs are most pronounced in Idaho, where few social service programs exist and many families are isolated and insist on being self-reliant. There is a strong spirit of collaboration among community service providers, and a number of interagency collaborative groups work together to address family needs. |
Enrollment. BREHS is funded to serve 75 families, all of which are participating in the local and national research and evaluation studies. The program was fully enrolled by the end of summer 1996 and, at the time of the site visit, had been providing services to families for more than a year.
All but two enrolled families speak English well enough to receive services in English. About 84 percent of families are Mormons. Twenty-five to thirty percent of the enrolled families were referred by other agencies. At the time of the site visit, the program had experienced relatively low turnover (about 19 percent since the program began). Word of mouth is sufficient to maintain a waiting list, which included 18 families at the time of the site visit.
Enrolled families bring several strengths and a variety of needs to the program. The majority are two-parent families with at least one wage earner. Most enrolled families do not have serious family problems, desire to be good parents, are committed to their children, and are connected to others in the program and community. Some enrolled families need jobs with higher wages, better housing, treatment for spousal and substance abuse, and help with problems related to immigration. Hispanic families and families living in more outlying areas also need opportunities for socialization to help fight increased levels of social isolation.
CHILD DEVELOPMENT CORNERSTONE
Weekly home visits by FEs and weekly group activities (Baby Buddy groups) to enhance child and parent socialization comprise the program's central child development activities. In addition, families are encouraged to take advantage of a number of other services designed to promote children's healthy development by providing parents with relevant information and experiences. These services include child care referrals, parent discussion groups, individual and family counseling, CDA classes, parenting classes, and breast-feeding consultation. The program also conducts child health screenings and tracks health status and immunizations.
Home Visits. FEs conduct home visit activities designed to assist
parents in providing for the intellectual, social, emotional, and physical development of their
infant. FEs' primary responsibility is to promote positive infant/parent interactions to enhance
and promote secure attachment between parent and child. They begin by concentrating on the FE-parent
relationship as the basis for all other interventions. BREHS thinks of FEs as facilitators who
are trained to follow the parents' lead, gradually introducing attachment concepts and activities.
Rather than interacting directly with the child, FEs are trained to work "through the parent
to the child" by promoting parents' abilities to read cues from the child and respond appropriately.
FEs are expected to have a B.S. degree in early childhood, social work, psychology, or family
and human development or else an infant/toddler CDA certificate, and they must have a stated commitment
to forming partnerships with parents.
| Program staff members seek to foster positive parent-child interactions and attachment in order to promote children's developing abilities to trust others, regulate emotions, and sustain healthy relationships with peers and others. |
At the beginning of each visit, FEs write out the lesson plan for the visit with the parent. Each lesson plan includes a review of the previous visit, a hands-on infant-parent play activity, and planning for the following visit. Activities are drawn from a variety of sources, including published curricula such as Partners in Parenting Education (PIPE)--parent activities to facilitate attachment; Hawaii Early Learning Profile (HELP)--age-appropriate assessment activities that sensitize parents to children's evolving developmental capacities; With Love and Wisdom; WestEd's Program for Infant/Toddler Caregivers; Creative Curriculum; Small Wonder; Teaching Strategies; Baby Your Baby; and First Steps (a language-development program). The program also maintains files with other sources of parenting information that FEs can refer to when planning activities. FEs try to elicit parent-generated ideas for activities to do on future visits. Another segment of the visit involves informing the parent of program news and events, sharing flyers and the Baby Babbler newsletter, and filling out a parent volunteer form.
Because BREHS staff members believe that the success of the intervention depends on FEs' effectiveness at promoting positive parent-child interactions, they had recently undertaken measures designed to lend greater support to FEs in their mission and thus increase the intensity of the intervention. Whereas FEs originally spent much of their time during home visits focusing on parental social service needs and crises, the program's revised strategy calls for them to refer such matters to the cornerstone coordinators and specialists if it seems likely that a problem will require more than a few minutes' attention. This change allows FEs to focus more attention during visits on facilitating positive parent-child interaction and enhancing parents' knowledge of child development. Another strategy designed to enhance FEs' effectiveness includes having the child development coordinator and/or project manager accompany FEs on home visits to provide them with routine consultation and feedback.
At the time of the site visit, all enrolled families were actively participating in home visits. Each FE has a caseload of between 10 and 12 families. Most FEs reported that, in an average week, they are able to complete visits with about 80 percent of their families. Although staff members originally planned for visits to last an hour and a half, FEs found it difficult to try to engage parents for that long early in their relationships with families. Both parents and FEs were somewhat apprehensive in early visits as they got to know each other, and FEs needed time to become comfortable in their role. As their relationships with families and home visiting skills have developed, FEs have been able to complete longer visits and continue to work toward the hour-and-a-half goal for family home visits.
Group Child Development Activities. Staff members also attempt to foster positive parent-child interactions and greater parental understanding of children's development in Baby Buddy groups. The groups also provide opportunities for both child and parent socialization. The main focus of Baby Buddy group activities is promoting as much interaction between parents and children as possible. Activities include Play and Chat (parents and children playing and talking with each other and other families); Try It Out (practicing child development and parenting activities to see how babies react and to give parents confidence in how to interact with their babies); Take and Make (activities that parents and children can do together and take home with them--to provide reward and carryover); Eat and Learn (making nutritious snacks or meals); and Table Talk (mealtime group discussions about child development topics).
Three Baby Buddy group leaders are responsible for planning and conducting the groups. Their qualifications include a background in child development or infant/toddler care and the ability and desire to work closely with staff members and parents. Baby Buddy groups are held at the Logan, Preston, and Box Elder County Hospital centers, and parents are encouraged to attend weekly. Six groups are scheduled throughout the week during both daytime and evening hours. Sixty-five out of the 75 enrolled families have participated. Attendance varies across families; the average number of sessions attended is 11 per year. Staff members found that allowing parents to choose which group was most convenient for them resulted in higher levels of participation than assigning families to specific groups. Scheduling groups during the evening has also boosted participation among parents who work during the day.
Other Child Development Services. The program offers other activities designed to help parents learn about their children and their own influence on their children's well-being, including a parent discussion group, individual and family counseling, CDA classes, parenting classes, and the program's monthly newsletter. The mental health specialists lead parents in weekly group discussions of parent-generated topics in the areas of child behavior and socioemotional development. They also work with individual parents and families who are grappling with parenting and child development issues (behavior management and toilet training, for example). The child care coordinator conducts CDA classes, which are open to parents who want to earn CDA certification or state child care licensure or want to become family child care providers. The BREHS program refers families to parenting classes sponsored by the Head Start program and other community agencies. Finally, the Baby Babbler newsletter features information on a variety of child development topics.
Child Care Services. BREHS does not provide child care directly but refers parents to Child and Family Focus (CFF), Utah's state resource and referral agency, which screens and trains providers and provides referrals to families seeking child care. A recent BREHS survey indicated that program families that needed child care either had it or had been referred to another source. Seven program families (9 percent) were linked with family child care providers through referral to CFF, and 21 families (28 percent) selected child care providers independently. About five of these qualified for subsidies under the state's Workforce Services program. With few slots available in the target area for infants in center-based care, most families use family child care providers.
At the time of the site visit, BREHS was constructing a respite or "safety net" child care facility at the Logan center, which will have the capacity to serve eight children whose parents are temporarily unable to care for them due to a crisis situation (for example, illness, drug or alcohol rehabilitation, or incarceration). This center was scheduled to open in early 1998 and will be staffed by the child care coordinator, a child care training provider, a recently hired full-time child care provider, students in the program's CDA class (who will be able to complete practicum hours at the site), and BREHS parent volunteers.
Child Development Assessments. FEs conduct monthly developmental screenings during home visits with the HELP protocol.
The assessment is conducted through play activity with the child. In addition to providing information about each child's developmental status, the assessment serves the purpose of helping parents to learn about their child's developmental capabilities as well as developmentally appropriate ways to play with their child.
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BREHS refers families who need child care to the state resource and referral agency. At the time of the site visit, nearly two-fifths of program families were using child care, primarily relative care or other family child care arrangements. Insufficient child care is available in the BREHS service area, especially for infants, school-age children, and special needs children. Child care centers that take infants or older children are rare. Family child care is more prevalent; the Utah resource and referral agency lists 200 licensed family child care providers in its service area. In addition, there are many in-home providers who are unlicensed. The quality of the available child care varies. Licensed providers are monitored by the state and Child and Family Focus. The quality of unlicensed providers is largely unknown and is presumed to vary greatly. Some concern exists that the state's method of making fixed subsidy payments directly to parents provides an incentive for parents to choose the least expensive child care options. A representative from Child and Family Focus reported that child care quality and professionalism have improved substantially in the past three years due to improved training and the efforts of state resource and referral agencies to get communities to focus attention and devote resources to improving child care quality. To increase the quantity and quality of child care settings, BREHS works with Child and Family Focus to assist new providers in starting family child care businesses and becoming licensed. The program also provides CDA training to providers and EHS parents. Program staff members also attempt to raise community consciousness about the importance of quality child care for infants and toddlers in their meetings with other community agencies and by setting up booths at community fairs and shopping malls. |
Health Services. Most families have a medical home for their children. At the time of the site visit, staff members had worked with families to identify primary health care providers for 86 percent of the children. The BREHS program tracks immunizations, well-child checkups, and children's growth and follows up to ensure that children receive needed health care.
The health/wellness coordinator offers prenatal visits to all pregnant women in the program. About 8 to 12 expectant mothers have participated in prenatal visits; some of these women are now pregnant for the second time and are receiving prenatal visits again. The health/wellness coordinator also visits all newborns in the program within two weeks of birth, and all program children received health screenings within 90 days of birth or enrollment. In addition, the health/wellness coordinator offers breast-feeding consultation (about 10 families have participated so far).
The health/wellness coordinator also collaborates with other staff members to provide health information to families during home visits, guidance on nutritious snacks and children's developing readiness for different foods during Baby Buddy groups, health workshops for parents at the Head Start centers in the three largest communities, and assistance to qualified families in applying for Medicaid.
Services to Children with Disabilities. Although BREHS did not specifically recruit disabled children, 19 percent of the children enrolled at the time of the site visit had suspected or diagnosed disabilities. These problems surfaced during program assessments of children. The Family Intervention Program (FIP) at Utah State University (USU) provides services for children with disabilities. BREHS coordinates with FIP to provide Part C services. FIP conducts infant/toddler assessments and works with EHS staff to develop each family's Individualized Family Service Plan. The team updates the plan every six months, reviews how services are going, and prepares for children's transition out of BREHS at age 3 by coordinating with the school district's disabilities coordinator. The FIP staff train EHS staff members to maintain the documentation needed for Part C services.
Transitions. BREHS shares curriculum and training approaches with Head Start and recently met with Head Start staff to plan for children's transitions out of EHS, which were scheduled to begin two years from the time of the site visit. Six months before each child's third birthday, program staff will determine the child's eligibility for Head Start and develop a transition plan that takes into account the child's health, developmental status, and progress made while in EHS. Children who turn 3 years of age after the state's September 1 deadline will remain in EHS until the following September. Program activities will be adapted to provide small-group socializations for these older 3-year-olds to better prepare them for Head Start
| The program staff aims to promote children's development by enhancing parents' knowledge of child development and helping parents achieve individualized personal and family goals, including reducing parenting stress, maintaining mental and physical health, strengthening family relationships, connecting with sources of social support in the community, and achieving economic self-sufficiency. |
FAMILY DEVELOPMENT CORNERSTONE
Needs Assessment and Service Planning. During their early home visits with families, FEs work with families to develop an Individualized Family Partnership Agreement (IFPA). The IFPA consists of an assessment of family resources and interests, an Individualized Family Plan (IFP), a contract between the program and the family, and referral tracking forms. Currently, BREHS uses a self-generated survey of family interests and needs that builds on questions included in the Head Start Family Information System. It asks parents about their concerns as well as ways they might be able to assist other families. FEs use this information to help families define their goals and to identify steps and timelines for accomplishing them.
FEs assist families in developing both short- and long-term goals that are linked in some way to the child. They encourage parents to start with smaller, more achievable goals and to consider how they can reach these goals. Families have been working on such goals as improving budgeting skills, gaining parenting knowledge, getting more education, obtaining medical care, getting a job (or a better job), and obtaining items the family needs. The contract spells out what the program expects from parents and what parents can expect from the program. Referral tracking forms--which document family concerns, the actions taken to refer families to appropriate sources of assistance, and follow-up efforts--had recently been added to the IFPA.
The family development coordinator estimated that approximately 75 percent of enrolled families had IFPAs at the time of the site visit. Some families have resisted setting formal written goals with their FE. All families, however, are working on goals at least informally. IFPAs are reviewed and updated on a continuous basis. FEs review family goals and document progress during home visits at least monthly. The coordinators review family files with the FEs three times a year to monitor program practice and family progress and to brainstorm additional strategies for working with families.
Case Management. The coordinators and mental health specialists
have taken on more of the responsibility for dealing with family social service needs. The family
development coordinator assists families who need help with family violence, finances, housing,
transportation, employment, public assistance, illiteracy, educational opportunities, and food
and clothing by referring them to community agencies and following up to monitor outcomes. The
health/wellness coordinator and mental health specialists work directly with families on family
planning, family relationships, depression, eating disorders, grief, and substance abuse. When
necessary, they refer families to other agencies for more intensive services. The child development
coordinator helps families with special needs children get treatment services, and the child care
coordinator helps families with child care needs and offers child care training.
Staff members also offer a variety of parent workshops on such topics as budgeting, communication,
self-esteem and assertiveness, social support, parenting, General Educational Development (GED)
test preparation, cardiopulmonary resuscitation (CPR) and first aid, diet and weight control,
and making scrapbooks and activity books to keep children occupied in quiet settings.
Father Involvement. The program hired a male involvement staff person (he also serves as an FE and a Baby Buddy group leader) to encourage father/male involvement. He encourages fathers to attend home visits, Baby Buddy groups, and other program activities. The program has also tried to increase male presence at the centers by recruiting more male volunteer interns from Utah State University.
Other strategies for increasing father involvement have included seating two fathers on the Parent Council, scheduling Baby Buddy groups in the evenings, organizing a father-child breakfast, organizing male?oriented activities such as a trap shoot, offering CPR and money management workshops, and making the center decor more gender-neutral to promote a more comfortable atmosphere for men. November was Male Involvement Month, and a contest was held to encourage men to attend Baby Buddy groups (the names of men who attended were entered into a drawing for a prize).
Parent Involvement in the Program. The program formed three parent committees (one in each county) to promote parent involvement in the program. The parent committees, which include all parents in the program, elect officers who serve on the BREHS Parent Council. In addition, each parent committee elects one representative to serve on the BRHS Policy Council. Program parents nominated and cast ballots for Parent Council officers at a family picnic held in the summer (staff members delivered ballots to families who were not able to attend). The parent committees work with the BREHS staff to organize monthly family outings and programwide events. Parents attend an average of four such events per year. In addition, parents also serve on the health services advisory group, employment screening committees, career development committee, and various subcommittees on Baby Buddy group planning, child care center startup, literacy, and male involvement. Some parents do volunteer work at the center and help with such tasks as home visit preparations, party preparations, and building maintenance tasks.
STAFF DEVELOPMENT CORNERSTONE
The project manager works with the cornerstone coordinators, the local research partner/continuous improvement partner, and the program's Technical Assistance Support Center (TASC) and Resource Access Project (RAP) consultants to plan and implement staff development activities. These activities are grounded in a shared vision, frequent staff performance evaluations, and joint reflection and discussion of staff needs.
Training. Last year, staff members completed a survey asking them to identify their strengths and training needs. Communication, home visits, and responding to families' mental health needs emerged as main areas in which staff members need training. The project manager consulted with the cornerstone coordinators, mental health specialists, and outside consultants to plan training to meet these needs. Other topics have been added to the training agenda as specific needs have emerged.
Cross-training occurs across cornerstones; all staff members receive training in the areas of child, family, and community development. The cornerstone coordinators conduct training for other staff members in their respective areas of expertise. BREHS has also engaged in some cross-training with FIP, the local Part C provider.
Supervision and Support. Staff meetings are held every Monday. The entire staff meets as a group for one hour before breaking into smaller group sessions. FEs work with the project manager and cornerstone coordinators on home visiting skills and engage in one-on-one reflection and problem solving with another FE partner. Another hour is spent in a small group discussion with a mental health coordinator, who facilitates discussion about the special "front line" stresses that FEs face and helps them avoid burnout. Baby Buddy group leaders also have opportunities to discuss the challenges they face and to receive feedback from other staff members, including supervisors and the project manager.
To offer further support and training to the FEs, the child development coordinator had recently begun accompanying FEs on home visits. She now spends two days a week observing home visits, working with FEs to solve problems, and providing constructive supervisory feedback. All staff members receive formal feedback on their performance every three months from either a cornerstone coordinator or the project manager. Performance reviews also include staff self-evaluations.
The BREHS program encourages staff members to take classes to broaden their skills and knowledge, to get professional certification in their respective areas of expertise, and to attend professional conferences. The program pays for these activities. The Baby Buddy leaders attended a Head Start conference in Montana, and at the time of the site visit, the coordinators, mental health specialists, and FEs were preparing to go to the Zero to Three Conference in Nashville.
Staff wages exceed those of other programs in the area. Staff members are generally satisfied with the benefits they receive, but they desire better dental coverage.
Staff Turnover. At the time of the site visit, the program had experienced no staff turnover.
COMMUNITY BUILDING CORNERSTONE
BREHS staff members articulated a number of community-building goals for the program. First, they are attempting to increase the community's focus on supporting families with infants and toddlers and to continually increase community recognition of and respect for EHS. Additional goals include linking parents to other families and resources in the community, helping to increase child care availability and quality, and increasing access to needed services for families in Idaho.
Program Collaborations. The BREHS program collaborates with many community agencies and interagency groups. Although most arrangements with agencies are informal, based on 30 years of working in the region, BREHS has formal agreements with FIP (to coordinate services for children with disabilities) and Community Family Partnership (to refrain from recruiting each other's control group families). Other agencies with which BREHS collaborates are Child and Family Focus; Baby Your Baby (a Utah agency that works with expectant mothers); Bear River Mental Health (which provides substance abuse-related services); Bear River Valley Hospital; the Supplemental Nutrition Program for Women, Infants, and Children (WIC); La Leche League; IHS Lactation Clinic; Bear River Health Department; Utah Health Department; Division of Child and Family Services (DCFS); State of Utah Workforce Services (welfare office); American Red Cross; Deseret Industries (thrift store, employability training); Food Pantry (emergency food supplies); USU Psychology Community Clinic; and the Logan Transportation Department.
Some of the most intensive and fruitful of BREHS's collaborative efforts
have been with FIP, DCFS, Baby Your Baby, and WIC. In general, these community partners reported
profiting from BREHS's access to and degree of contact with vulnerable families in the community.
For example, FIP relies on EHS for day-to-day contact and followup with families, while BREHS
relies on FIP for its expertise in disabilities. Together, the two agencies promote greater access
to continuous services for special needs children. In its efforts to reach families, DCFS profits
from BREHS's access to families and the relatively nonthreatening nature of its relationships
with families. In turn, BREHS relies on DCFS to monitor children's safety and to intervene when
necessary. Finally, collaborations with Baby Your Baby and WIC have aided BREHS's recruitment
efforts and have also enabled low-income families with infants to receive a
broader array of services over a more sustained period of time.
Interagency Collaborations. BREHS staff members also participate in interagency collaborative groups. With 25 to 30 other service providers, BREHS participates in the Local Interagency Council, which meets monthly to address community issues, share information and referrals, and strategize about how to collectively create and maintain a seamless system of services for families in need. Additionally, BREHS participates in the Interagency Self-Sufficiency Council, another group of community agencies that meets to discuss the needs of and provision of services to individual families. BREHS staff members also attend meetings of groups of community service providers concerned with safety and quality in child care (the Coalition of Child Care Providers), children's health care (Health Services Advisory Group), and child safety (Safe Kids Coalition).
Community Building Among Parents. The BREHS program also fosters social support among program families. The Baby Buddy groups are designed to help parents form social networks that will outlast their program participation. A number of parents reported appreciating the opportunity to "get out of the house" and join other adults and children at the center.
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Utah's welfare reform program, the Family Employment Program (FEP), was implemented statewide in July 1996. The provisions of the plan were originally implemented in January 1993 under a welfare reform waiver (the Single Parent Employment Demonstration Program). Two major emphases of the plan are supporting employment through individualized self-sufficiency plans and child support enforcement. The plan requires immediate and universal participation in employment-related activities (employment, education, mental health treatment, or some combination thereof), and it has instituted a 36-month lifetime limit for cash assistance. Up to 20 percent of the state's caseload can be exempted from the time limit due to hardship, domestic violence, disability, or other special circumstances. Teenage parents are required to live in their parents' household and to attend school or work. Parents who accept employment can keep more of their earnings, receive transitional Medicaid for up to 24 months, and receive a state child care subsidy based on a sliding fee scale as long as they remain eligible. Idaho's welfare reform program, Temporary Assistance for Families in Idaho, is very similar to FEP. It places a 24-month lifetime limit on cash assistance and requires recipients to earn their benefits through work BREHS staff members and families had not yet been affected by the new limits on cash assistance, and, at the time of the site visit, they were not apprehensive about the welfare changes. Very few program families were receiving cash assistance when they enrolled in the program. Public reaction to the change has been mostly positive, reflecting citizens' strong work ethic and preference for self-reliance. The unemployment rate is low, and jobs (albeit low-paying ones) are widely available. A high proportion of program families are already wage-earning families, and families that currently receive assistance are still two years away from potentially losing their benefits. Families and staff members were more concerned about low wage levels for working parents and the comparatively high costs of housing and other necessities in the area. |
CONTINUOUS IMPROVEMENT AND LOCAL RESEARCH
Early Program Support. As noted earlier, the program has worked closely with its Technical Assistance Support Center(TASC) consultant to plan staff development activities. The program director has also discussed program issues and ideas with this consultant. The program's Resource Access Project (RAP) consultant provided materials and discussed procedures and ideas with the program staff. The program has also received key support from its federal project officer.
Continuous Program Improvement. The program is constantly being refined as staff members see things that are not working or could be working better. They monitor needs of families, the staff, and the community and seek feedback on program practices from parents, the staff, TASC and RAP consultants, and the program's continuous improvement partner (the local research team).
A team of researchers from Utah State University's Department of Family and Human Development, with expertise in infant/toddler development, attachment, play, parenting, and program evaluation, serves as the BREHS program's local research partner. The principal investigator for the local research team gives formal continuous improvement feedback to the program once a year but also speaks informally with the project manager on a frequent basis. This investigator has worked with the staff members to help them articulate their theories of change and has helped them identify strategies for bringing about desired outcomes.
Local Research. In collaboration with BREHS staff, the local research team is conducting an evaluation of the BREHS program. The main focus of the first phase of the evaluation was BREHS's startup and planning, hiring of staff, staff training, facility development, curriculum planning, community development, health services planning, parent involvement planning, social services planning, disabilities services planning, and overall continuous program improvement process. The evaluation examined staff ratings of program performance and parent ratings of their relationships with FEs and the quality of home visits. Although most staff members rated the program's performance on each program objective as "adequate" or "perfect," some of the staff noted a need for improvement in the areas of father involvement, child care services, transitioning, IFPs, and community collaboration. Staff members also noted the need to focus more intensely on parent-child interactions during home visits and Baby Buddy groups. On average, parents rated their relationships with FEs and the quality of home visits very highly. Year One results have been shared with the program in a Continuous Program Improvement Report.
The local research builds on the experimental design implemented by the national evaluation and emphasizes two main outcomes: security of attachment and development of play. It focuses on issues related to secure infant attachment and includes examining complexity and mastery motivation in object play, mutual responsiveness and positive affect in social play, and parents' positive parenting, mental health, adaptive decision making, and self-sufficiency. The main research objectives are to examine the impact of EHS on infant attachment and play in relation to parenting and, in turn, to examine the relation of attachment and play to later social and cognitive competence. The research team recently added videotaped observations of father-child interactions when the target children reach 14 months of age to its research plan.
PROGRAM SUMMARY
The BREHS program serves primarily white, two-parent, working-poor families living in rural areas in Utah and Idaho. In weekly home visits and weekly Baby Buddy group activities, program staff members focus on promoting positive parent-child interactions and strengthening parent-child relationships. They also work with parents to help them work toward personal and family goals. At the time of the site visit, the program was helping family educators focus more of their time during home visits on child development activities by arranging for other staff members to work with families on social service needs and crises. The program was also enhancing processes for providing consultation and feedback on home visits to family educators.
PROGRAM DIRECTOR
Sarah Thurgood
Bear River Head Start
670 West 400 South
Logan, UT 84321
LOCAL RESEARCHER
Lori Roggman
Utah State University
Department of Family and Human Development
UMC 2905
Family Life Building, FL 214
Logan, UT 84322-2905
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