Community
Service Council
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Suite 202
Tulsa, Oklahoma 74119-4402
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Copyright© 2009
Community Service Council
Community Service Council stopped publishing its newsletter when this website
became the Council's main way of sharing information. This page of the
website continues to feature a selection of key articles about PREVENTION and
DOING WHAT WORKS, from past issues.
Download the last issue of the newsletter - summer 2002
Please contact CSC's program directors to request latest publications and information about many aspects of the Council's current work.
The Community Service Council newsletter, "Community Works," helped further effective action by describing successes achieved by groups and individuals working together ... emerging trends ... research findings and their implications ... reflections and personal stories from leaders in the field, within and outside the Council ... advocacy updates and calls to action ... useful new publications ... opportunities to become involved ... and information about the Council, its work and its people. The theme "community works" suggests community involvement and support, community decision making, and building for the future based on a strong sense of community.
We hope you'll enjoy the following articles from past issues.
"Community Works" - guide to the newsletter "archive" articles featured below
The work of the Community Service Council is guided by our commitment to doing what works to improve the well-being of children & families, focusing on prevention. The following articles describe social policy, strategies for success, and examples of successful initiatives ... all supported by the Council because research shows they WORK!
PREVENTION
... the key guiding principle for all the Council's work
PREVENTION: Doing What
Works ... applying what we already know about successful social policy
Examples of "doing what works":
CHILDREN FIRST
COVERING KIDS
IMPROVING CHILD CARE
PREVENTION:
The key guiding principle underlying all of the Community Service
Council's work
It’s clear: Prevention works.
Recent research has confirmed what common sense suggests: Doing a few key things right, as early in people’s lives as possible, can significantly reduce their chances of ever having to face a whole range of problems. Early, high-quality prenatal care; education and support for families, especially those with new babies; high-quality care and learning experiences throughout early childhood ... these are among the things that work. Locally, as nationally, these and other specific prevention strategies are now widely recognized as keys to better outcomes for people, and therefore for society as a whole.
It has been a decade since the Council’s Long Range Planning Committee set prevention as the focus for the Council’s work:
"Health and human service needs are growing so dramatically, no amount of programs or services could ever hope to keep up. Prevention provides our best hope of ever reducing the gap between these growing needs and increasingly limited resources available to meet them. Prevention is the essential overall direction most desirable in human terms, and as sound, cost-effective social policy, given the difficult and growing social problems facing our society and our own community."
As Lisbeth Schorr wrote in Within Our Reach: Breaking the Cycle of Disadvantage, "Prevention is the reduction or elimination of rotten outcomes." (Read more excerpts from Schorr's writing about prevention in the next article, below.) The Council has defined prevention in practical terms: providing opportunities for parents, children and families to develop the educational, social and personal skills to enable them to take care of themselves.
The Council views prevention as a strategic approach which encompasses a lifespan perspective, considers the whole person, and impacts all the key conditions which foster positive development, health, and well-being for individuals, families, neighborhoods and communities.
Prevention means ...
Investing in people, our society’s human capital
Improving the conditions which affect people’s lives
Valuing families, education, and communities as keys to success
At Community Service Council, we are
committed to prevention as a philosophy and as a strategy. Only prevention
offers a realistic hope for a brighter future for our community and all of its
people.
PREVENTION: Doing What Works
Applying what we already
know about successful social policy
From an article by Lisbeth B. Schorr, author of "Within Our Reach;" adapted by Phil Dessauer, Community Service Council
Long-term economic prosperity requires an educated work
force,
which in turn requires investment in children, especially those on the margin.
EXAMPLES of ACTIONS/investments and positive results documented by research ...
- Comprehensive prenatal care & nutrition programs can result in 1/3 reduction in proportion of babies born at low birthweight -- 1/2 reduction for very low birthweight
- Intensive family support, nurse home visits, and child care can result in child abuse 1/5 to 3/4 lower, fewer children removed from home, fewer mothers on welfare
- Quality early childhood programs can result in increased school readiness and fewer dropouts, delinquents, teenage mothers, jobless youngsters
- School-based
clinics can result in 50% reduction in teen childbearing and
postponement of sexual activity
WHAT WORKS: economic & social remedies working together
Risk factors for "rotten outcomes" (school failure, teen pregnancy, intergenerational poverty) are multiple and interactive.
The single most powerful risk factor is child poverty, so higher family incomes are the single most critical need. Strategies include expanded earned income tax credits, guaranteed child support payments, strengthened income supports, and policies that lead to full employment, make work pay, and provide job training and supports for the transition from welfare to work.
But economic remedies alone are not enough. They must be coupled with social supports -- good schooling, quality child care, comprehensive health services, safe and supportive communities, and services to strengthen families.
School success and job training won’t pay off if there are no jobs, and expanded job opportunities can’t be seized by young people who lack skills, motivation, networks, and confidence in themselves and their futures.
A good education and high skills can best break the
intergenerational cycle of chronic poverty, and an educated work-force is the key to
higher national productivity.
SEVEN STRATEGIES FOR SUCCESS
Accountability based on outcome and results
... judging programs and other efforts by what they accomplish rather than the details of what they do. Agreeing on desired community-wide outcomes encourages cross-system collaboration and a community-wide culture of responsibility for children and families. Useful baseline information is critical.
Less bureaucratic, more responsive bureaucracies
... difficult, but not impossible, and critically important.
Better integrated services
... by and large, funding sources are so categorical and
crisis-oriented that a child or family can get help only if the need can be classified
into a construct that the available services happen to fit. Service integration and
interagency collaborations will not improve outcomes if the services that are put together
are of mediocre quality and rendered disrespectfully and grudgingly.
Focus on early childhood programs
... helping children do better in school and be less likely to
drop out, become pregnant, or be arrested ... all documented outcomes from Head Start. But
even full funding of today’s Head Start will not be enough. To reflect new realities
and new research, Head Start must be expanded upward, downward and sideways: downward to
support beleaguered families for the whole five years of their children’s preschool
development; sideways to make high-quality services available full day and full year;
upward to assure that the children are ready for school and the schools are ready for the
children. The reinvented Head Start would include all the elements whose
cost-effectiveness and long-term benefits have now been established: prenatal care, home
visits, immunizations, parent support, and developmentally sound child care.
Targeted support to inner-city neighborhoods
... targeting the most devastated inner-city areas and
rebuilding key local institutions like schools, churches, neighborhood centers, and
recreational services that support families.
New definitions of professionalism, new forms of
professional training
... for front-line staff and program managers to gain the
necessary outlook and skills to build respectful, trusting relationships, and to have
current information on policies, programs, eligibility criteria.
Leadership that defines the societal stake and encourages
bolder thinking
... from every sector including not-for-profits, state
governments, universities, foundations, and businesses.
An example of "doing what works" -- from the Community Service Council "CommunityWorks" newsletter, 2002:
Getting new mothers
& babies off to a good start brings about dramatic & long-lasting results
Oklahoma's CHILDREN FIRST uses the
successful model developed by David Olds, Ph.D., and his colleagues. The Prenatal and
Early Childhood Nurse Home Visitation Program is a highly acclaimed, well-tested model
that improves the health and social functioning of low-income, first-time mothers
and their babies. In the program, nurse home visitors work intensively with
families to achieve three broad goals:
the improvement of pregnancy outcomes by helping women improve their health behavior related to substance use, nutrition, and prompt treatment of pregnancy complications
the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children the child's health and development by promoting parents' responsible and competent care of their children
parental economic self-sufficiency, including preventing subsequent unintended pregnancy, completing education and finding work, and strengthening the family's formal and informal support systems.parental economic self-sufficiency, including preventing subsequent unintended pregnancy, completing education and finding work, and strengthening the family's formal and informal support systems.
The program has demonstrated its significant potential as a means of improving child health, preventing child maltreatment, reducing the length of time women receive public assistance, and reducing violence and criminality in young adults.
Highlights of MAJOR FINDINGS on maternal and child outcomes (from two randomized trials in Elmira, New York and Memphis, Tennessee) are --
For mothers,
25% reduction in cigarette smoking during pregnancy
43% reduction in subsequent pregnancies
2 years' greater interval between birth of first and second child
44% reduction in behavioral problems due to alcohol and drug abuse
69% fewer arrests
83% increase in the rates of labor force participation
30 month reduction in welfare use
For children,
56% fewer hospital emergency room visits
79% reduction in rates of child maltreatment
For children at age 15,
54% fewer arrests
58% fewer sexual partners
28% fewer cigarettes smoked
51% fewer days consuming alcohol
The programmatic elements of the intervention have been refined over the past 20 years and detailed visit-by-visit protocols guide home visitors in their work with families. Strong supervision, training and careful record-keeping support implementation of the model's key components.
Key program components include:
Home visits begin during pregnancy and continue for two years after the child is born.
The program serves first time mothers.
Nurse home visitors visit weekly during the first month and during the first six weeks after delivery, every other week through the child's 21st month, and monthly until the child reaches age two.
Nurse home visitors work with families following the comprehensive focus of the program on personal health, environmental health, quality of caregiving for the infant and toddler, maternal life course development, and family and friend support.
The clinical processes are family-centered, protocol-driven, and directed toward nurturing family strengths and competencies.
Nurse home visitors link families with the other health and human services they need.
The program is built upon a strong conceptual base that weaves together Bronfenbrenner's ecological theory of human development, Bowlby's attachment theory, and Bandura's self-efficacy theory. The program is built upon a strong conceptual base that weaves together Bronfenbrenner's ecological theory of human development, Bowlby's attachment theory, and Bandura's self-efficacy theory.
Human ecology theory focuses the nurses' attention simultaneously on developing parents' individual, social and material resources that influence the health and well-being of the famiy.
Attachment theory emphasizes the importance of conducting the program through a stable, trusted relationship with a nurse who is committed to each family, and using the relationship between the nurse and parent as a tool for promoting parents' empathic care of their children.
Self-efficacy theory provides the underpinning for many of the specific clinical strategies the nurses use to help young parents develop the skills and motivation to succeed as individuals and in their roles as new parents.
To learn more about Children First, please call Annette Jacobi at the Oklahoma State Department of Health, 405 / 271-4477.
An example of "doing what works" -- from the Community Service Council "CommunityWorks" newsletter, 2002:
COVERING KIDS
Bringing
health care to Tulsa children
Through Covering
Kids, more children will have access to the health services they need for prevention and
care.
According to the National Center for Education in Maternal and Child Health at Georgetown University, "To reduce the number of uninsured children in this country and improve children's health status by providing access to health care, Congress recently created, and states are now implementing, the State Children's Health Insurance Program (CHIP) ... but simply making coverage available does not guarantee that all, or even most, eligible children will receive health coverage ... we must use effective outreach strategies to reach low-income families, encouraging them both to apply and, once covered, to use appropriate preventive and primary care services to keep their children healthy."
Tulsa is one of three Oklahoma communities now piloting Covering Kids, providing family outreach services designed to enroll more eligible children in the state's Children's Health Insurance Program.
Covering Kids is a collaborative effort funded by the Robert Wood Johnson Foundation. It seeks to eliminate barriers known to prevent parents from getting their children covered by CHIPS. The Tulsa pilot project received $41,000, and plans to enroll 1800 currently-uninsured children. The Community Action Project of Tulsa County is the lead agency, and the Community Service Council's Tulsa Area Coalition on Perinatal Care (TACPC) serves as the local coalition for planning and implementation.
The effort is building on the social marketing and outreach efforts of Tulsa Healthy Start, Children First, Tulsa Alliance for Families, and the Earned Income Tax Credit/Individual Development Account Program of Community Action Project of Tulsa County.
The Tulsa Area Coalition on Perinatal Care has conducted several studies on patterns of women's use of prenatal care and family planning services, revealing at least three groups: the transitionally poor (college students, recent job loss, recent divorce), the working poor (underemployed or fully-employed without health benefits), and the chronically poor (complicated medical or social histories which maintain the poverty). Health coverage enrollment techniques need to be different for each group, according to Ann Turner with TACPC. The transitionally poor and working poor families are likely to respond to traditioal media approaches such as public service announcements, posters and pamphlets. However, chronically poor families require door-to-door canvassing and community support interventions. Through Covering Kids, outreach workers from several programs are now making the door-to-door initial contacts and follow-up visits necessary to enroll families and encourage them to access children's health services. To defer costs, agencies may receive incentive fees for completed enrollment.
Meanwhile, state agencies have worked together to significantly streamline the Medicaid enrollment process. Changes include a widely-available, shorter application form, which can be mailed-in, eliminating face to face interviews. A toll-free number is provided for information and assistance. Application time has been reduced from 45 to 20 days. Barriers to enrolling eligible Hispanic and Native American children are also being addressed.
Jan Figart, Community Service Council's senior planner for
maternal/child health, reports: "In Tulsa County there are 64,000 children who
are eligible for SoonerCare services -- but only 19,000 are enrolled. Through Covering Kids, more children will have access to the health
services they need for prevention and care."
An example of "doing what works" -- from the Community Service Council "CommunityWorks" newsletter, 2002:
Improving CHILD CARE
The CHILD CARE RESOURCE CENTER
(CCRC),
sponsored by the Community Service
Council, helps build and maintain
the infrastructure necessary to support our community's child care system.
The CCRC is involved in these and other initiatives to improve the quality as well as the availability of child care in the Tulsa area.
SUCCESS BY 6
"Success By 6 is designed to mobilize the community to ensure that by age six, all children are ready to learn."
- Kathleen Coan, President, Tulsa Area United Way
This year the Tulsa Area United Way became the newest member of Success By 6, a nation-wide effort to improve the lives of children and their families and assure that all children enter school healthy and ready to succeed. United Way received a $134,000 Success By 6 grant from the Bank of America Foundation (formed through the merger of NationsBank Corporation and BankAmerica Corporation in October).
Research shows, and the experience of the Child Care Resource Center confirms, that when child care programs lack quality, children's development can be compromised. "An investment in early childhood education assures a bright and promising future for our entire community," said Roger Whaley, NationsBank Oklahoma president. Success By 6 will help address a critical need: a formal local process to move interested child care providers to higher levels of quality care.
The Child Care Resource Center is serving as administrator of the project, in partnership with five child care centers managed by YWCA of Tulsa, The Salvation Army and the Margaret Hudson Program. All serve children of low-income working families. Liz Reece, CCRC director, said the Success By 6 grant will establish a foundation for other child care centers to build upon: "The Success By 6 grant will allow these centers to demonstrate how high-quality care can help prepare children for success in school, and also support and encourage families in the face of the increasing stress in their lives."
With Success By 6 funds, centers will receive capital improvement funds to improve their facilities, and will establish child care staff salary scales based on education and experience. The participating centers will receive assistance and support as they prepare for their two star rating. Reaching for the Stars, a three-tiered rating system instituted by the State of Oklahoma in 1998, allows child care programs that meet quality enhancement requirements to receive higher reimbursement rates for caring for children. One star programs are those that meet minimum health and safety standards as required by licensing; programs that receive a national accreditation will be awarded three stars. Of the 221 licensed child care centers in Tulsa County, currently eight are nationally accredited and eight have achieved Oklahoma's two star status.
The improvement process for each of the five child care
centers includes orientation to the star rating system; teacher training toward the Child
Development Associate certification; substitute support; director support; initial
assessment and quality improvement reviews; on-site technical assistance from a child care
development specialist; and community development planning to improve parent participation
and community awareness of the quality rating system.
CARING HEARTS
Funded as a pilot program by a
United Way Venture Grant in 1997, Caring Hearts is a program to recruit new family child
care home providers and provide information and support which can help them successfully
operate family child care home businesses. Technical assistance is also provided to
churches interested in establishing child care programs.
"Finding licensed child care is at a critical level
for many of Tulsa's working families," according to Liz Reece. Caring Hearts has
received a three-year grant to recruit more providers for difficult-to-find types of child
care, especially care for infants and toddlers, children with special needs, and care
during non-standard hours. Collaborative partners in the Caring Heart network include
Community Action Project of Tulsa County and Tulsa Technology Center.
CHILD CARE ACCREDITATION PROJECT
This summer, a United Way
Venture Grant is funding a new child care accreditation project. CCRC will assist child
care centers with the process of self-study and validation necessary to become accredited
by the National Association for the Education of Young Children. A Quality Improvement
fund will be established to offer financial assistance in meeting accreditation
requirements and a Board will be established to benchmark child care issues for our
community.
SUPER STAR SATURDAYS
The State of Oklahoma has taken a very
positive step by establishing Reaching for the Stars, a three-tiered quality rating system
for child care facilities. Licensed programs that have a contract with the state to care
for children receiving state child care subsidies can receive a higher reimbursement rate
when they meet enhanced quality requirements. But family home providers have found it
difficult to complete requirements and make application for the two-star ranking. The
Child Care Resource Center is now addressing this need through Super Star Saturdays, where
providers receive personal assistance and guidance.
CLOSE TO HOME CARE
Close to Home is a new program supported
through an American Business Collaborative grant for employees of BP Amoco who use
relatives as caregivers. Through CCRC, relative caregivers receive training in health and
safety and child development issues. Information is shared on activities in which the
children in their care can participate. This is CCRC's first project designed to
impact informal caregivers (those not required to be licensed).
Find out more about the Child Care Resource Center and its other initiatives!
See also: What works to prevent crime, youth violence and substance abuse?
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