In June, I was invited to participate in a WK Kellogg Foundation (WKKF) Think Tank entitled, “Realizing Our Vision: Healthy Birth Outcomes.” Patrick Simpson, who was recently appointed as director of programming for WKKF’s Food, Health & Well-being portfolio, convened the meeting and expanded the focus to “Healthy Births, Healthy Lives.” The Think Tank covered a wide swath of topics presented by a roster of preeminent experts in the field of maternal and child health. (I attributed my interloper presence to our close colleague Amy Fine, of the Center for the Study of Social Policy, who helped to organize the content and invite speakers for the meeting.)

I spoke about scaling up effective models and strategies and offered a brief version of the Help Me Grow story as a case study. In my remarks, I called out five key strategies that have contributed to our collective success in spreading and scaling Help Me Grow and securing support for long-term sustainability.

The strategies, invoked by the National Center and its affiliates, serve as a set of guiding principles. The strategies are well known to our affiliates for our efforts at the national and state levels.

1. Delineating the core components and structural requirements of innovations such as Help Me Grow.
Clearly articulating the essential elements of an evidence-based innovation ensures fidelity to the model and the promise of efficacy, while affording local discretion in implementation strategies and acknowledging that “all politics is local.”
 

2. Embedding innovations within federal initiatives that support early childhood system building.
We frequently emphasize the synergy among Help Me Grow and an array of federal initiatives such as Maternal, Infant, and Early Childhood Home Visiting (MIECHV; MCHB), Early Childhood Comprehensive Systems (ECCS; MCHB), Project LAUNCH (SAMSHA), Race to the Top-Early Learning Challenge (RTT-ELC; US DOE), Birth to Five-Watch Me Thrive (ACF), and Learn The Signs. Act Early (CDC). In fact, our affiliate states often use federal grants (e.g., ECCS, MIECHV, RTT-ELC, Project LAUNCH) to fund their Help Me Grow replication efforts.
 

3. Implementing a business model to evolve from grant-support to revenue generation.
I applauded WKKF for being so forthright in declaring their unwillingness to continue to support Help Me Grow replication beyond the original 3-year grant that established the National Center. Rather than succumbing to a false sense of security based on unrealistic prospects of long-term foundation support, we devised the strategy of securing membership fees and providing fee-for-service technical assistance to ensure long-term sustainability.
 

4. Persevering in efforts to secure line-item state budget support for Help Me Grow implementation and sustainability.
Our initial experience in Connecticut suggested the feasibility of successfully advocating for state budget support. Certain affiliates are successful in securing support from unique and discretionary funding streams , e.g., tobacco tax dollars (First 5) in California and “independent” tax entities (Children’s Services Councils) in Florida. However, until recently, states have not included support for Help Me Grow in their budgets. Recent positive developments in such states as Florida and Minnesota emphasize the benefits of perseverance in advocacy efforts. 
 

5. Recognizing the value of the Help Me Grow National Affiliate Network to diffuse system-building innovations.
Our commitment to data collection as a core component of Help Me Grow has identified critical gaps and capacity issues in early childhood system building.

For example, the need for enhanced care coordination capacity to ensure the linkage of vulnerable children and their family to community-based programs and services informed the design of the Care Coordination Collaborative Model, a shared resource, central utility approach to “coordinating the care coordinators.” In addition, the success in promoting early detection of children at risk for adverse developmental outcomes and the need for such children to receive timely and efficient assessment to enable triage to community services informed the design of Mid-Level Developmental Assessment.

Both innovations are now being disseminated through the Help Me Grow National Affiliate Network with new grant support from WKKF. We anticipate ultimately transitioning support for the dissemination of these innovations, similar to that of Help Me Grow, to a fee-for-service model of technical assistance.

I was so privileged to have the opportunity to share Help Me Grow’s lessons learned and consider how they may be applied to the dissemination of other, evidence-based innovations in support of promoting children’s optimal healthy development. Such sharing acknowledges the critical need for our collaboration in the comprehensive task of early childhood system building.  

Further Think Tank highlights included Vijaya Hogan of the University of North Carolina Institute of Public Health, who discussed an equity frame to achieve healthy births and healthy lives. Deborah Allen of the Boston Public Health Commission and Mario Drummonds of the Northern Manhattan Perinatal Partnership, Inc., talked about integrating interventions at the local level to achieve greater impact.

On the policy level, Kay Johnson provided an update on recommendations of the Secretary’s Advisory Committee on Infant Mortality, and Binta Beard and Amy Pellegrino of The Podesta Group gave a brief overview of the current federal and state policy landscape.

I hope you are inspired and encouraged by the articulation of these ideas for spreading, scaling, and sustaining innovation for vulnerable children. Articulating and embracing effective strategies surely enhances our success. 

As always, we welcome your thoughts and suggestions.