Wisconsin Healthiest Families Initiative

Definitions

The Wisconsin Healthiest Families Initiative focuses on networks of services addressing four areas of focus: family supports, child development, mental health, and safety and injury prevention. Local public health departments will work with community partners to build an integrated system that promotes optimal physical, social-emotional, and developmental health of children and their families. Populations to be served are: all infants and children, including children with special health care needs, expectant mothers (with a special focus on those at risk for poor health outcomes), and parenting families with young children.

Definitions and sample outcomes for the four areas of focus are:

Family support

The collection and management of resources and services provided by individuals and organizations to enhance the capacity of the family unit to promote the health and optimal development of each of its members. These resources may be formal or informal. Formal supports are provided by paid professionals and include screening, information sharing, emotional support, help with setting goals, concrete assistance, and links to other community resources. Informal supports are provided by family, friends and the community and often enable a family to prevent or solve problems on their own while providing protective factors such as stress reduction and reduction of isolation. Family support programming is family driven. Professionals work in partnership within the family system to determine the family’s needs and directions for the future. Services are comprehensive, flexible and individualized based on the family’s own goals, culture and context.

Sample outcomes:

Increase awareness among community service providers about the continuum of resources available for expectant and parenting families with young children with special focus on those at risk for poor health outcomes and supporting collaborative entry into services. Examples of evidence-based or research-informed programs or training using this approach include; Home Visitation: Foundations, Parents as Teachers, Great Beginnings Start before Birth, and Head Start.
Establish a "no wrong door" policy for entry into community resources for expectant and parenting families with young children including children with special health care needs.
Improve utilization of the continuum of resources available for expectant and parenting families with young children (including children and youth with special health care needs) with special focus on those at risk of poor health outcomes.
Increase community capacity to engage women of childbearing age in a medical home and needed community resources to reduce the risks for poor birth outcomes.

Child development

The collective process of achieving optimal milestones in key areas of growth including prenatal, motor, intellectual, language and social development. Development is the result of “interactions” between the child and his/her environment including physical, social, and economic. Each interaction results in new learning which results in the development of skills. The frequency, quality and intensity of interactions between children and their environment will result in each child reaching his or her full potential. Each child develops at his/her own particular pace but in a predictable pattern. Developmental milestones give a general idea of the expected pattern of changes as a child gets older. Developmental screening provides parents and professionals a valid comparison between an individual child and typical development of other children of the same age. Screening always involves the use of a standardized tool. Screening tool questions are designed to answer the question, "Is this child's development like other children of the same age?" Follow up to developmental screening includes several options; reassurance the child is developing as expected, increased attention to a particular developmental domain as indicated, or a formal referral to early intervention services for further assessment.

Sample outcomes:

Increase use of a valid developmental screening tool such as the Ages and Stages Questionnaires across all service providers with results routinely communicated to the Medical Home provider.
Adoptions by community partners of the American Academy of Pediatrics recommendations for developmental screening at 9, 18 and 30 months.
Increase the number of completed referrals across service providers, for follow-up services as indicated, including referrals to Early Intervention providers.
Increase community support and resources for women and infants to exclusively breastfeed for 6 months.

Mental health

Emotional well-being are core tasks for the developing child and those who care for the child. Because cultures may differ in their conceptions of mental health, it is important to learn about the family members’ perceptions of a mentally healthy individual and their goals for raising children. In their shared work to raise a child, parents, family, community, and professionals commit to fostering the development of that child’s sense of connectedness, self-worth, intellectual growth, and the many brain functions that define mental health. There are critical periods in the life span when mental health is most vulnerable. Therefore, it is important to design support for mental health protective factors in relationship to these critical periods, early childhood being most critical. Prevention activities include risk assessment family support and referrals to appropriate interventions. Common risk factors for child behavioral and mental health problems include: genetic risk factors, environmental risk factors, and chronic medical illness in the family.

Sample outcomes:

Increase use of a valid social emotional screening tool, such as the Ages and Stages Social Emotional Questionnaires, across service providers with results routinely communicated to the Medical Home provider.
Increase knowledge among community providers of relationship-based family support. Examples of evidence-based or research informed programs using this approach include; Mental Health Endorsement, Home Visitation: Foundations, Parents as Teachers, Great Beginnings Start before Birth, and Head Start.
Increase community capacity to provide mental health consultation to providers serving expectant and parenting families with young children.
Increase screening for depression in all women of childbearing age across service providers.

Safety and injury prevention

Ensuring that mechanisms are in place to protect a child from harm during the long journey from infancy through adolescence. It requires the participation of parents, other care givers and the community. Safety and Injury Prevention encompasses a broad array of topics. Unintentional injuries are often referred to as accidents despite being highly preventable. Examples include falls, drowning, motor vehicle crashes, suffocation and poisoning. Intentional injuries include those that were purposely inflicted, with the intent to injure or kill someone (including self). Intentional injuries often involve a violent act. Examples include homicide, child maltreatment, sexual assault, bullying and suicide. Common prevention strategies exist across all causes and manners of injury that include but are not limited to environmental changes, education, and enforcement of policies, laws and standards.

Sample outcomes:

Increase awareness among community service providers about the continuum of resources and services available for expectant and parenting families with young children, supporting safety and injury prevention.
Increase access to child passenger safety seats and fitting stations to assure all children are properly positioned on every vehicle ride.
Adoption by community partners of consistent messaging and service provision that promotes infant safe sleep.
Increase screening for violence and follow-up services in primary care settings.