Every Child Succeeds

Quality improvement (QI) has become an essential component of effective healthcare. In early childhood prevention programs, however, QI is in its earliest stages. Every Child Succeeds, a prevention program for first time, at risk mothers and their children, has taken a leadership role in developing and evaluating QI approaches for home visitation. Every Child Succeeds has constructed a state of the art data collection and management system which is the foundation of QI efforts. This web-based system, called eECS, is a data repository for 16 home visitation agencies across seven counties and two states. Over 100 home visitors record outcomes and related data on families participating in Every Child Succeeds. This information in turn is summarized in charts and tables that are used to direct services, focus supervision, and inform program administration about performance effectiveness. Home visitors, agency managers, and administration work together to identify areas in need of improvement, and use the strategies that have been developed at CCHMC to study the impact of new strategies designed to enhance efficiency and improve outcomes for children and families. Taken together, the QI program in Every Child Succeeds is an innovative approach to prevention that has emerged as a model for the field.

Even though brain research is replete with evidence demonstrating that brain stimulation in the earliest weeks and months of life is vital to lifetime success and even though we know that the first three years of life are more critical to the development of human capacity than any three that follow, there are few materials and/or tested strategies to address the emerging literacy needs of young children 0-3.  

Early literacy development is an important precursor to school readiness. In July 2007 Every Child Succeeds partnered with the National Center for Family Literacy (NCFL), the Toyota Motor Manufacturing North America Inc. and the Charles H. Dater Foundation to address this need by launching the three year Bringing Literacy Home program.

Elements of this program include: creating a literacy curriculum with weekly lesson plans and supporting materials that starts at birth and continues to age three; designing and implementing a two-day language and literacy training module for home visitors; initiating a demonstration pilot with two provider agencies to test and refine the program curriculum and strategies and initiating a rigorous evaluation to assess effectiveness and fidelity to the model.

At the conclusion of the pilot, half of the ECS home visitors will be trained; the other half will serve as a comparison group to allow us to measure the impact of the new curriculum. At the end of three years, our goal is to have a proven curriculum and teaching strategies that effectively build language and literacy skills in our infants and toddlers. Further, if we can demonstrate that our curriculum and strategy makes a difference, we believe that there is a market for the materials beyond Every Child Succeeds and the home visitation field. 

Maternal depression can be a devastating condition that adversely affects parents and children. For first-time, at risk mothers who participate in Every Child Succeeds, depression has been identified as a significant problem, affecting 44% of those receiving services. Although home visitation programs around the county recognize that maternal depression is a significant concern, no evidence-based strategy to help mothers and their families has been developed. In response, we created the Maternal Depression Treatment Program (MDTP). The MDTP was established with the support of a grant from the Health Foundation of Greater Cincinnati, and In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to address maternal depression. IH-CBT is an evidence-based treatment for depression that is adapted for use with new mothers in Every Child Succeeds. Delivered in the home in order to overcome one of the primary barriers to receiving effective treatment, IH-CBT is closely integrated with ongoing home visitation. In the MDTP, all mothers in Every Child Succeeds are screened for depressive symptoms. Those with clinically elevated symptom levels are given a more thorough assessment, followed by delivery of IH-CBT. Currently, through a grant from the National Institute of Mental Health, we are conducting a clinical trial to examine the efficacy of IH-CBT in comparison to treatments received in the community. Maternal depression has emerged as a primary focus of the clinical and scientific efforts of Every Child Succeeds, and we are in the forefront of informing the next generation of home visitation strategies.